Coaching in General Surgical Training: A Novel Approach Emphasizing Resident Wellness, Professionalism, and Patient and Family-Centered Care

Abstract

Key improvements to optimize current surgical training include solid foundations in professionalism, communication, and physician self-care. These are rarely assimilated in any existing training curriculum. To address this deficit, we implemented a coaching program aimed at improving resident communication skills. Early coaching goals were to further understand residents’ unique experiences, while rotating on different services with significantly varying demands. We built a rapport with trainees, and increased their comfort with undergoing direct observation of their peer and patient interactions. Subsequently one-to-one coaching was expanded to additionally focus on patient- family-centered-care, resident professionalism and wellness. An initial voluntary phase was followed by concentrating on trainees struggling professionally. A clinical psychologist directly observed residents across multiple rotations utilizing a structured observational tool. A formative summary was generated and reviewed with each resident. During feedback, residents’ strengths were emphasized. They were encouraged to develop specific, practical verbal and non-verbal tools identified as meaningful in patient and team interactions. Many trainees acknowledged the direct link between their professionalism and personal well-being. The program now aims to improve resident morale, to develop effective team leaders, and optimize communication skills in a variety of settings. Correlational data pertaining to coaching observations, professionalism ratings, and wellness is shared with trainees biannually. Coaching should become an integral part of modern surgical training. It needs to incorporate individualized and team training that focuses on resident development, to make trainees optimally equipped to lead their teams, engage in supportive patient-centered interactions, and recognize the need for self-care.