Cultural Shift

cultural-shift-2-880x300.jpgThe idea of coaching in medicine is gaining traction, but a knowledge gap remains. A unique coaching course developed by the Centre for Education Research & Innovation is training clinical faculty how to apply the principles of coaching in their work

By Emily Leighton, MA'13

Denzel Washington’s inspiring leader in Remember the Titans. John Candy’s loveable underdog in Cool Runnings. J.K. Simmons’ abusive conductor in Whiplash.

There are plenty of memorable portrayals of coaches on the big screen to inspire or avoid.

When we think of coaching, we often picture a football field, basketball court or orchestra pit. But the idea of coaching in medicine is also gaining traction and popularity – although applying the principles of coaching in a profession where the stakes are a lot higher is challenging.

“This is one of the biggest gaps in medical education,” said Dr. Chris Watling, Director of the Centre for Education Research & Innovation (CERI). “We’re telling physicians that now they are coaches and expecting that they somehow know what they need to do differently. We don’t think about the skills they need to be a coach.”

To address this knowledge gap, Dr. Watling worked with a team of researchers at CERI to develop a unique coaching course for clinical faculty. Coaching Clinical Learners in Medicine is a longitudinal course, consisting of six three-hour workshops during the academic year. It is aimed at faculty looking to develop a broad set of transferable coaching skills for a variety of clinical scenarios and contexts.

The series launched in September 2019, with a workshop featuring a live cello lesson courtesy of Dr. Michael Sanatani, MD’00, a faculty member in Oncology, and his cello instructor. The demonstration provided insights into the role of a coach, the philosophy of coaching and how it could apply to medicine. Other workshops explored the ways in which coaches ask questions, help learners to set and work toward goals, and provide feedback.

Dr. Watling says the idea of coaching is appealing for many medical educators because of frustrations with the issues plaguing medical training, particularly the pressure to perform. “There’s not a lot of room for vulnerability,” he said. “A lot of us are familiar with what coaching looks like from sports, music and other activities, and there’s a desire to shift to that model, to focus on growth and development.”

To learn more about how coaches think about their roles, Dr. Watling collaborated with Kori LaDonna, PhD’14, a medical education researcher at the University of Ottawa. Their 2019 study, “Where philosophy meets culture: exploring how coaches conceptualise their roles,” interviewed 24 individuals across three groups: physicians who consider themselves coaches in clinical learning settings, physicians with experiences as sports, arts or business coaches, and sports coaches without medical backgrounds.

Failure emerged as a dominant theme, and many of the study’s participants considered failure to be a significant trigger for learning. But in medicine, there are limits to failure.

”We’re telling physicians that now they are coaches and expecting that they somehow know what they need to do differently.” — Dr. Chris Watling

“We can’t just bring ideas from other coaching cultures and stick them in medicine and expect them to work the same way,” explained Dr. Watling. “Failure is a good example. When we translate it to medicine, how do you maintain and preserve patient safety while also creating a safe environment for learners to grow?”

And unlike sports, sometimes the coach has to step in and start playing. “We need to be more explicit in when and how to step in and be aware of what this does to the teaching dynamic,” explained Dr. Watling.

Disrupted by the COVID-19 pandemic, the coaching course’s final three sessions have been postponed. But the organizing team successfully pivoted to a podcast, called The Huddle, to continue the momentum and keep clinical faculty engaged in the learning.

In the first episode, Dr. Watling, Dr. Kylea Potvin, Assistant Professor, Dr. Marta Wilejto, Assistant Professor, and Sarah Burm, PhD, share their most meaningful coaching experiences, looking at why they worked well and how those lessons can be applied to medicine.

”We’re hoping to continue adding to the scholarship and understanding of coaching in medicine,” said Dr. Watling. “Athletes don’t stop at wanting to be competent, they’re always pushing to realize their full potential. We’re trying to make this gradual shift in medicine as well – to focus on growth, development and continuous improvement.”