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] Learning Objectives: List one question from the lens of positive psychology or ideal state that can be used to frame development of a plan for optimum well-being and professional fulfillment in the coachee. Identify Coach Self-monitoring as a technique to spot areas for professional development, or ongoing coaching education. Describe a way to encourage the coachee to set the agenda for the meeting.
Competencies: cultivate self-development, support coachee in cultivating well-being and professional fulfillment.
Here we are going to see examples of coaching to support wellbeing and professional fulfillment. Ideally, a coach would use open inquiry to support a coachee in defining a vision of their ideal self or goals for optimal wellbeing and professional fulfillment.
In this scenario, the coach is working with an early-career physician who is overwhelmed and is seeking coaching, ostensibly around time management. The coach sees a lot of herself in her and needs to self-monitor to ensure she is adhering to boundaries, which brings up the need for the competency of cultivating self-development in the coach.
As you watch the first demonstration, take note of instances where the coach slips out of the coaching role. Who is setting the agenda for the meeting?
Coach: [01:28] Well, it's great to see you again. I remember last time we had talked about preparing for that Clinical Competency Committee that you had to run and not letting it get derailed by that dominant personality. Is there anything you want to report back on how it went?
Early Career Physician: [01:43] Yeah, so it actually went really well. I rehearsed our lines, just the way that you know, we had practiced together and I'm really pleased with how it went, we were able to get through the entire thing without any interruptions!
Coach: [01:55] That is wonderful! And I love how you were able to stay true to your goal of being a calm and outcomes-oriented leader, so well done. What do you want to talk about today?
Early Career Physician: [02:06] So I was wondering if today we can actually focus on time management, and just coaching around that.
Coach: [02:12] Okay. Well, what makes that a priority for you today?
Early Career Physician: [02:15] So just a few things, I feel like I'm not really in control of a lot of domains of my life right now. You know, I have notes from last week that I need to finish up, I'm running a journal club for the residents in two days, and I still haven't even started their worksheet. And I haven't gone for a run in two weeks, I have three weeks of unfolded laundry on my floor.
So it's just I'm not really feeling control of all the domains of my life. You know, I heard I was thinking about, you know, maybe I should switch to a Google Calendar or paper calendar. I also heard of this, like, organizational system where it color codes or emails. So I was wondering if I should maybe switch to that.
Coach: [03:00] All right. Well, it sounds then like the goal for our meeting today should be to solve your inefficiency and organization problems.
Early Career Physician: [03:06] Yes, that would be great. I'm just trying to figure out what organizational system to buy next.
Coach: [03:11] Yeah, I can understand that. Are you having the same problem as I did, where the university Outlook calendar doesn't sync with the home calendar? That's so frustrating.
Early Career Physician: [03:22] Yes, I am. Exactly the same problem.
Coach: [03:27] Yeah, well, I can definitely understand the frustrations you're having. Have you heard of the Getting Things Done System?
Early Career Physician: [03:33] Um, no, I haven't, but I will definitely take a look.
Coach: [03:36] Alright, well, have you given any thought as to why you're not good at organizing your time?
Early Career Physician: [03:42] Well, you know, I just feel like I'm constantly reacting to, you know, things as they're coming up. I'm accountable to so many different people, but I just wish they better understood all my different responsibilities.
Coach: [03:53] Yeah, I feel like that as a particular problem at our hospital. It's really nice to see someone feels the same way as I do.
Early Career Physician: [04:00] Yeah, no, definitely. So I wanted to ask you, are there any areas that you think I should focus on or work harder at to get to get better on top of things?
Coach: [04:10] Yeah, since you want to be a calm leader, I think I would recommend that you prioritize exercise first. I think that would help with your mindset the most and then maybe give you more energy to tackle some of those other items on your to-do list.
Early Career Physician: [04:23] Sounds like a plan. So I will definitely exercise more. And also get that book, get better on top of things like you recommended.
Coach: [04:32] That sounds great. It's just so rewarding to be able to help people like you whose shoes I was once in myself.
Early Career Physician: [04:38] Thank you.
Host: [04:41] Let's reflect. Think about some of the effective techniques the coach used here. Did you notice how they remember the coachee's goal of being a calm and outcomes-oriented leader? They also open the meeting by asking the coachee to set the agenda and try to discover what the deeper motivation under the agenda was by asking why this had urgency for her today.
However, did you notice the moments when the coach was slipping into other roles like commiserator and advisor? At one point, the meeting seemed to be more about the coach than the coachee.
The coachee tended to look at external factors contributing to her dilemma and the session could have been more powerful if the coach directed her back towards examining things she could work on within herself beyond the nebulous goal of simply "working harder."
Also, by setting the goals herself, and focusing on fixing the problems, the coach missed an opportunity to use effective positive psychology techniques. Let's see how this conversation could have gone better. Watch for some examples where the coach truly views the coachee as the expert in what is needed.
Also, make note of any particularly powerful questions the coach asks. How is the coach doing on the competencies of using open inquiry, leading the coachee to envision her ideal self, and ensuring her coaching is consistent with professional standards?
Coach: [06:05] So when thinking about our goal, then for the next 30 minutes, what do you want to accomplish in this meeting?
Early Career Physician: [06:12] So I was hoping that we could focus on time management. I feel like I'm just not getting things done in a very time-efficient way.
Coach: [06:21] Well, when we think back to your goal about being a calm and outcomes-oriented leader, I could see how that would really align with your goal and that you would want to prioritize being able to finish what you start.
Early Career Physician: [06:35] Yeah, you know, I've been thinking about whether I should buy like a new organizational system just to help make sure that I'm getting things done and, you know, getting things done... in a time efficient way.
Coach: [06:48] Alright, so what needs to be examined more deeply, then, in order to move forward?
Early Career Physician: [06:53] So I've been like going back and forth about maybe getting a ideal calendaring system, so I can just use my time better.
Coach: [07:01] Okay, well, how will you know what the right amount of time to spend in each area is?
Early Career Physician: [07:07] Well, I was just wondering... maybe I'll feel more sure about how I'm using my time... in the way that I'm getting paid for. So that I'm using my time to really... be true to my true self, my family, having time to exercise... I think, you know, maybe it'll be... being able to spend my time in a way that is... really true to my values and my commitments.
Coach: [07:36] Mm hmm. Okay. Well, in light of that insight, is there something you want to change about your goal for today's session, then?
Early Career Physician: [07:44] Yeah, maybe we can talk about how I can, you know, better clarify my priorities, so that I'm, you know, working smarter and not just harder.
Coach: [07:54] Alright. Sounds great. So, as we start to wrap up our meeting of what new insights have you had today?
Early Career Physician: [08:05] You know, I feel like a new book—like a time management book—will really help me until I figure out what my priorities are. And... I don't want to be just reacting to... all the new emergencies that come up, I want to make time for myself, for my family, for exercise.
Coach: [08:30] Well, that's great. That sounds like some really wonderful reflection. So is there any homework you would like to assign yourself based on these thoughts? Like, I think it would be so great if you told yourself that you're going to go on a run three days a week. I have a coupon actually, for a meal delivery service that I can give you if you're interested, just to save some time.
Early Career Physician: [08:51] That sounds wonderful.
Coach: [08:53] I'm sorry, I totally realized I just gave you advice. Sometimes I get a little bit fired up when I see people who have been in the same shoes as I did. And so much of what you're saying resonates with me from when I was a junior faculty member, so I apologize. Let me try again, as your coach: Are there any assignments you would like to make for yourself based on what we just talked about?
Early Career Physician: [09:15] Yeah. So I think I'm going to, you know, really focus on how I'm tracking and using my time and just kind of see how much time I'm allotting to different domains of my life, and we can talk about that at our next meeting.
Coach: [09:29] That sounds great. And it sounds like that really tracks back to your overall vision for yourself with being a calm and outcomes-oriented leader. So good work.
Early Career Physician: [09:39] Thank you. And yes, that is true.
Coach: [09:42] All right. Well, can you think of anything that might get in the way of that homework that you want to brainstorm around in advance?
Early Career Physician: [09:49] Yeah, you know, actually, on Tuesdays, I have a lot of back-to-back meetings so it might be hard for me to track how I'm using my time on Tuesdays, but... maybe on Wednesdays, I can retroactively fill in my log so that way I can still see and track how I'm spending my time.
Coach: [10:13] All right, well, that sounds perfect. And I look forward to hearing how that goes at our next meeting. And in the meantime, I'm going to give myself some homework and try and look for some resources for myself around how to coach people like you better who are interested in time management planning.
Early Career Physician: [10:31] Thank you so much. That sounds great.
Coach: [10:32] All right. Well, we'll see you next month.
Early Career Physician: [10:34] Sounds like a plan.
Host: [10:37] Did you notice how this meeting took an entirely different turn when the coach prompted the coachee to envision her ideal state, and they began to work toward that? The coach also used what she had heard in prior sessions and mirrored back the coachee's values. The conversation was ultimately productive when the coach helped the coachee realize the issue is around prioritizing areas of life and ensuring she is spending her time in concordance with those priorities.
This was a great example of supporting the coachee and cultivating well-being and professional fulfillment, which is one of the competencies. And the coach in this scenario used open inquiry nicely. It's natural to feel the temptation to slip into more comfortable or familiar roles. But with self-monitoring, the coach can identify this and course correct back into the coaching role. The coach might seek their own coaching around this tendency and talk to other coaches to gather strategies to improve that would be congruent with the goal of ensuring their work is consistent with national standards.
Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.
If applicable, all relevant financial relationships have been mitigated.
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