The AMA Accelerating Change in Medical Education Academic Coaching team has provided several workshops to develop faculty coaching skills and recently published new coaching competencies. As the team works to disseminate coaching and facilitate training of medical students and residents, there is a need for training about the coaching competencies. The AMA Accelerating Change in Medical Education coaching video series is a resource to help faculty coaches improve their coaching by incorporating the competencies into their coaching practice. The nine video modules demonstrate coaching competencies and include examples of inexperienced and experienced coaches. These modules may be used as a component of a comprehensive coaching curriculum to prompt reflection and discussion.
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The AMA ChangeMedEd initiative works with partners across the medical education continuum to help produce a physician workforce that meets the needs of patients today and in the future.
Host: [00:05] After viewing this module, you will be able to define Master Adaptive Learner, describe one technique you can employ to help your coachee move through the Master Adaptive Learning cycle of planning, learning, assessing and adjusting, and list at least two questions you can ask to elicit reflective behaviors from your coachee.
The coaching competencies demonstrated in this video are supporting a coachee in improving motivation and self-efficacy, and fostering the development of Master Adaptive Learners. In this set of videos, we will review portfolio coaching, a mechanism by which the coach can aid the coachee in discovering and assessing their feedback and performance data in order to create goals for future performance and progress.
Portfolio coaching differs from skills coaching in that the focus is on a compilation of data about past performance. This data may give the coach and coachee a global understanding of all facets of the coachee's progress towards meeting their goals.
Whereas skills coaching usually occurs by observing a coachee performance skill in order to provide real time coaching to change or improve performance. In portfolio coaching, the coach supports the coachee by demonstrating the competency of supporting the coachee in improving motivation and self-efficacy by asking guiding questions that prompt assessment and reflection on past performance, motivation and self-efficacy.
By asking questions in this way, the coach can help the coachee progress through the Master Adaptive Learning cycle of planning, learning, assessing and adjusting by tapping into their growth, mindset and resilience. Remember, coaching is the rheostat that accelerates the batteries of curiosity, mindset, motivation and resilience in the Master Adaptive Learning model.
This video will feature a resident meeting with their coach to review the clinical competency committee summary of their progress along the milestones. The coach and resident have an established relationship.
As you are watching, try to identify how asking closed ended questions might impact the coaches motivation and self-efficacy. Does the coach facilitate the coaches progression through the Master Adaptive Learning cycle? If not, what could the coach do to improve their coach use reflective or self regulating skills to help them develop as a Master Adaptive Learner?
Coach: [02:32] Hi, Sam, have a seat.
Sam: [02:34] Okay, thanks.
Coach: [02:35] So I've had a chance to review your portfolio And I noticed that you made an 80th percentile on your in-training exam. That's really great. I also noticed some concerning comments from your attendings regarding not pre-op-ing patients and calling them, and some other pretty concerning comments from your peds rotation.
Sam: [02:55] Okay...
Coach: [02:57] So let's talk about peds first. I think it's pretty clear you don't want to work with pediatric patients when you graduate from residency, right?
Sam: [03:05] Well, actually...
Coach: [03:07] So let's really just talk about what you do well, and I think I remember you thinking about wanting to apply for fellowships, and if so it's really about time to start that.
Sam: [03:19] That is my plan. But I actually think I might want to explore a career in pediatric anesthesia. I love the kids and the parents. I did have a chance to look at my rotation evaluations and I think I did okay, just not as good as I did in my other rotations. I actually wanted to ask you about that.
Coach: [03:38] Hmm. So that wasn't what I was expecting you to say. I really have some concerns about your ability to be successful in a pediatric fellowship, especially after some of the comments where you had difficulty speaking with the parents, especially when they were distraught or anxious.
Sam: [03:55] I saw those. I know I have some things to work on. But this is my first pediatric rotation. I initially felt uncomfortable being the expert because I'm not an expert yet. But I know I'll get more comfortable on my next rotation. I feel really motivated to get better, but I just need help figuring out where to go for help.
Coach: [04:14] So why don't we really talk about some of the things that you do well. I mean, you did so well in that regional anesthesia rotation. Don't you want to think about that again?
Sam: [04:24] No, I'm positive I want to go into peds.
Coach: [04:28] So I'm not a peds expert. So I think you're really going to need to find a peds anesthesiology faculty member to help you figure out these next steps.
Sam: [04:38] Okay...
Coach: [04:39] So let's take a look at your other goals. Oh, shoot. We're running late on time. I'm so sorry. I've got to run. So why don't you take a look at your other goals and email me any changes that you want to make? And we'll see if they make sense and then we'll catch up later and revisit them.
Sam: [04:58] Sure, we can do that.
Coach: [04:59] Okay, so I'll send you an appointment for about three months to see you.
Sam: [05:03] Okay, sounds good.
Host: [05:06] Let's reflect on what we just watched. As you saw in this encounter, the coach did very little to encourage the learner to be reflective about their performance.
To elicit reflection, focus on asking open ended questions that allow the coachee to understand their abilities and each component of the Master Adaptive Learning cycle. For example, if you're helping the coachee with self-assessment, instead of pointing out comments from attendings on evaluations, a coach could ask, "What sense did you make of the comments on your evaluations?"
If the coachee gets stuck at a particular point in the Master Adaptive Learner cycle, the coach can ask probing questions that support critical thinking, reflection, self regulation, and metacognition to help move them through the cycle. In the scenario we just watched the coach asked closed-ended questions and made assumptions about the coaches willingness and ability to further develop their skills. Also, the coach didn't support the coachee in improving their motivation and self-efficacy.
To do that, the coach should help focus their coachee on their personal values and how those are expressed in their goals. The coach can also help the coachee assess and understand their motivation for change, as well as exploring the coachee's strengths in order to help drive motivation and curiosity about learning. Throughout this next video, notice the strategies that the coach uses to ensure the learner is being reflective in their thinking and how the coach helps the learner understand their motivation for change.
Coach: [06:45] Hey, Sam, great to see you again. How's your new dog settling into the family?
Sam: [06:50 ] Oh, Bear is doing just fine. It took him a while for him to settle into his new home, but we've really enjoyed adding him into our family.
Coach: [06:56] Oh, that's fabulous. I'm so glad to hear it. So tell me about what data have you reviewed in your portfolio?
Sam: [07:03] Um, I think I've looked at everything.
Coach: [07:06] Okay. So tell me about what you thought when you went through that information? How did it make you feel? What did you think about it? What do you think are your strengths and weaknesses?
Sam: [07:15] Well, I clearly did well on my in-training exam, I scored in the 80th percentile, so I was pretty excited about that. But I've always been good at exams. I also noticed some comments my pediatric anesthesia rotation evaluation, and I really wanted to focus on that. I saw some comments about needing to work on my communication skills.
Coach: [07:33] I noticed that too. So let's talk about your peds rotation a little more. What exactly do you want to focus on and how do you want to improve?
Sam: [07:42] Well, I didn't do as well as I was hoping. I got really nervous talking to parents, and clearly the attendings and parents noticed. But I worked on it and I think I got better.
Coach: [07:52] So tell me more about how you worked on it and how you knew that that was an improvement or not? What exactly did you do?
Sam: [07:59] Well, I reached out to my fellow to talk me through some communication strategies. I also asked her to observe me a few times and give me feedback afterwards. But I didn't do that until the end of my rotation so I could use some more practice.
Coach: [08:11] Wow, that's a great strategy. So why do you think you're so motivated to improve your communication skills with pediatric patients and their parents?
Sam: [08:19] Hmm, good question. Well, this rotation made me realize that I'm interested in a career in peds anesthesia and if I want to go into pedes anesthesia, communicating with kids and parents is a skill that I'm going to need to work on.
Coach: [08:31] Well, that's great insight. So knowing that now, why don't we take a look at your revised goals, knowing that you want to go into a pediatric anesthesia fellowship.
Sam: [08:49] Thank you for pushing me to seek out additional resources to help me with my communication. I'll enter my revised goals into my online portfolio and then I'll circle back with you if I need help with anything. Is that okay?
Coach: [08:59] Of course! I'm really looking forward to seeing all the progress that you're going to make over these next several months, and I'm happy to help if you need anything, don't hesitate to reach out.
Host: [09:08] In this scenario, the experienced coach demonstrated the competencies of fostering the Master Adaptive Learner by asking open ended questions that supported critical thinking, reflection, self-monitoring, and metacognition.
Specifically, the coach asked the learner what they wanted to focus on after reading comments on their evaluations. The coach also asked the learner what they specifically worked on during the rotation, and ask the coachee to identify exactly how they knew that their skills were improving.
The coach also demonstrated the competency of helping their coachee develop motivation and self-efficacy. At times, a coachee may not connect the need to change with their future goals. Helping a coachee understand how changes in their performance are connected to their future goals will help support their continued motivation and self-efficacy.
Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.
If applicable, all relevant financial relationships have been mitigated.
Participation Statement: Upon completion of this activity, learners will receive a Participation Certificate.
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