A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program
Background: Resident physicians’ achievement of professional competencies requires reflective practice skills and faculty coaching. Graduate medical education programs, however, struggle to operationalize these activities. Objective: To (1) describe the process and strategies for implementing an Int...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-01-01
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| Series: | Medical Education Online |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10872981.2019.1591256 |
| _version_ | 1818025422174027776 |
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| author | Jed D. Gonzalo Daniel R. Wolpaw Karen L. Krok Michael P. Pfeiffer Jennifer S. McCall-Hosenfeld |
| author_facet | Jed D. Gonzalo Daniel R. Wolpaw Karen L. Krok Michael P. Pfeiffer Jennifer S. McCall-Hosenfeld |
| author_sort | Jed D. Gonzalo |
| collection | DOAJ |
| description | Background: Resident physicians’ achievement of professional competencies requires reflective practice skills and faculty coaching. Graduate medical education programs, however, struggle to operationalize these activities. Objective: To (1) describe the process and strategies for implementing an Internal Medicine (IM) resident coaching program that evolved in response to challenges, (2) characterize residents’ professional learning plans (PLPs) and their alignment with EPAs, and, (3) examine key lessons learned. Design: The program began in 2013 and involved all postgraduate years (PGY) residents (n = 60, 100%), and 20 faculty coaches who were all IM trained and practicing in an IM-related specialty. One coach was linked with 3–4 residents for three years. Through 1:1 meetings, resident-coach pairs identified professional challenges (‘disorienting dilemmas’ or ‘worst days’), reviewed successes (‘best days’), and co-created professional learning plans. Typed summaries were requested following meetings. Coaches met monthly for professional development and to discuss program challenges/successes, which informed programmatic improvements; additionally, a survey was distributed after three program years. Data were analyzed using quantitative and qualitative methodologies. Results: Disorienting dilemmas and professional learning plans mapped to all 16 EPAs and four additional themes: work–life balance, career planning, teaching skills, and research/scholarship. The most-frequently mapped topics included: PGY1 – leading and working within interprofessional care teams (EPA 10), research and scholarship, and work–life balance; PGY2 – improving quality of care (EPA 13), demonstrating personal habits of lifelong learning (EPA15), and research and scholarship; PGY3 – lifelong learning (EPA15); career planning was common across all years. Conclusions: Lessons learned included challenges in coordination of observations, identifying disorienting dilemmas, and creating a shared mental model between residents, faculty, and program leadership. The coaching program resulted in professional learning plans aligned with IM EPAs, in addition to other professional development topics. Operationalization of aspects of these results can inform the development of similar programs in residency education. |
| first_indexed | 2024-12-10T04:15:51Z |
| format | Article |
| id | doaj.art-fadba54801ea4c24b99de9c519484295 |
| institution | Directory Open Access Journal |
| issn | 1087-2981 |
| language | English |
| last_indexed | 2024-12-10T04:15:51Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Medical Education Online |
| spelling | doaj.art-fadba54801ea4c24b99de9c5194842952022-12-22T02:02:35ZengTaylor & Francis GroupMedical Education Online1087-29812019-01-0124110.1080/10872981.2019.15912561591256A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching ProgramJed D. Gonzalo0Daniel R. Wolpaw1Karen L. Krok2Michael P. Pfeiffer3Jennifer S. McCall-Hosenfeld4Penn State College of MedicinePenn State College of MedicinePenn State College of MedicinePenn State College of MedicinePenn State College of MedicineBackground: Resident physicians’ achievement of professional competencies requires reflective practice skills and faculty coaching. Graduate medical education programs, however, struggle to operationalize these activities. Objective: To (1) describe the process and strategies for implementing an Internal Medicine (IM) resident coaching program that evolved in response to challenges, (2) characterize residents’ professional learning plans (PLPs) and their alignment with EPAs, and, (3) examine key lessons learned. Design: The program began in 2013 and involved all postgraduate years (PGY) residents (n = 60, 100%), and 20 faculty coaches who were all IM trained and practicing in an IM-related specialty. One coach was linked with 3–4 residents for three years. Through 1:1 meetings, resident-coach pairs identified professional challenges (‘disorienting dilemmas’ or ‘worst days’), reviewed successes (‘best days’), and co-created professional learning plans. Typed summaries were requested following meetings. Coaches met monthly for professional development and to discuss program challenges/successes, which informed programmatic improvements; additionally, a survey was distributed after three program years. Data were analyzed using quantitative and qualitative methodologies. Results: Disorienting dilemmas and professional learning plans mapped to all 16 EPAs and four additional themes: work–life balance, career planning, teaching skills, and research/scholarship. The most-frequently mapped topics included: PGY1 – leading and working within interprofessional care teams (EPA 10), research and scholarship, and work–life balance; PGY2 – improving quality of care (EPA 13), demonstrating personal habits of lifelong learning (EPA15), and research and scholarship; PGY3 – lifelong learning (EPA15); career planning was common across all years. Conclusions: Lessons learned included challenges in coordination of observations, identifying disorienting dilemmas, and creating a shared mental model between residents, faculty, and program leadership. The coaching program resulted in professional learning plans aligned with IM EPAs, in addition to other professional development topics. Operationalization of aspects of these results can inform the development of similar programs in residency education.http://dx.doi.org/10.1080/10872981.2019.1591256competency-based educationcoachingentrustmentgraduate medical educationprofessional development |
| spellingShingle | Jed D. Gonzalo Daniel R. Wolpaw Karen L. Krok Michael P. Pfeiffer Jennifer S. McCall-Hosenfeld A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program Medical Education Online competency-based education coaching entrustment graduate medical education professional development |
| title | A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program |
| title_full | A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program |
| title_fullStr | A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program |
| title_full_unstemmed | A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program |
| title_short | A Developmental Approach to Internal Medicine Residency Education: Lessons Learned from the Design and Implementation of a Novel Longitudinal Coaching Program |
| title_sort | developmental approach to internal medicine residency education lessons learned from the design and implementation of a novel longitudinal coaching program |
| topic | competency-based education coaching entrustment graduate medical education professional development |
| url | http://dx.doi.org/10.1080/10872981.2019.1591256 |
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