Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers.

Abstract

Senior trainees (residents) are poised to be unique effectors of clinical feedback. While several curricula are available to teach residents to give or elicit feedback, our curriculum is unique in that it teaches both the giving and elicitation of feedback and focuses on the longitudinal coaching relationship as opposed to onetime feedback interactions. This curriculum provides a framework, called clinical coaching, for streamlining and enhancing feedback interactions between senior and junior trainees. This curriculum consists of: (1) a video module, (2) an interactive workshop, and (3) role-plays. Participants view the module, which simulates traditional feedback contrasted with the suggested approach. Next, an interactive workshop stimulates reflection on feedback, then defines and demonstrates clinical coaching. Finally, participants practice coaching with prewritten scenarios that illustrate critical steps in clinical coaching. This workshop was initially conducted in September 2014 with 50 participants. Thirty-nine house staff completed the postcurricular survey (13 had attended the workshop, 26 had not). Recognition of interns soliciting feedback one or more times per week was greater amongst workshop attendees (83% of residents, 78% of interns), as compared to nonattendees (53% of residents, 67% of interns). Preparation to give feedback differed amongst resident attendees versus nonattendees (0% vs. 19%, respectively, reported no preparation). These results highlight a need to increase awareness of and preparedness for the vital role that trainees can play in coaching. Training house staff in coaching has the potential to transform feedback for teachers and learners alike.