ArticleLiterature Review

Peer-coaching with health care professionals: What is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review

October 2013
Medical Teacher 36(1)

DOI:10.3109/0142159X.2013.836269

Source
PubMed

Authors:

Heidi Schwellnus

Holland Bloorview Kids Rehabilitation Hospital

Heather Carnahan

Marine Institute of Memorial University

Background: Peer-coaching has been used within the education field to successfully transfer a high percentage of knowledge into practice. In recent years, within health care, it has been the subject of interest as a method of both student training and staff continuing education as well as a format for knowledge translation. Aims: To review the literature from health care training and education to determine the nature and use of peer-coaching. Method: Due to the status of the literature, a scoping review methodology was followed. From a total of 137 articles, 16 were found to fit the inclusion criteria and were further reviewed. Results: The review highlights the state of the literature concerning peer-coaching within health care and discusses key aspects of the peer-coaching relationship that are necessary for success. Conclusions: Most research is being conducted in the domains of nursing and medicine within North America. The number of studies has increased in frequency over the past 10 years. Interest in developing the potential of peer-coaching in both health care student education and continuing clinical education of health care professionals has grown. Future directions for research in this quickly developing area are included.

A Peer Coaching Curriculum’s Influence on Medical Educator Effectiveness

Thesis

Nov 2016

LaChelle Joy Wieme

Faculty development is imperative for the enrichment of medical education. Nurse anesthesia educators can benefit from faculty development initiatives and various means, such as peer coaching, should be explored. Not only should the design of the faculty development curriculum be scientifically supported, validating its effectiveness is as imperative to achieve academic excellence. The goal of faculty development should be to make deliberate use of learning theories and educational principles when designing and implementing faculty development programs. The purpose of this study is to improve the faculty developmental process of nurse anesthetist faculty educators through a structured peer coaching curriculum. Effectiveness will be measured by the utilization of coaching strategies, goal attainment as well as improvements in confidence, satisfaction, and collegiality. Nine certified registered nurse anesthetist (CRNA) core faculty educators participated in a formal peer coaching staff development curriculum. Participants were introduced to the coaching concepts and skillsets during a day-long Power of Coaching class. Personal and group goals were identified at this time and served as the means in which to apply deliberate coaching practice. CRNA faculty participated in monthly preparatory on-line modules related to the coaching skillsets and engaged in monthly, one-hour, face-to-face coaching sessions. The sessions comprised of a brief review and application a particular skillset. Group coaching using a whipped coaching technique to address the group goal was utilized and the participants engaged in coaching practice on their individual goal through assigned coaching triads. Reflective journals were encouraged to promote reflection and encourage goal progression. Participants completed pre and post implementation surveys to address impacts related to collegiality, job satisfaction, confidence, and coaching skills. Reflective journal entries were qualitatively analyzed for themes. A post-intervention interview was conducted to gather additional qualitative information. Certified Registered Nurse Anesthetist (CRNA) faculty educators valued their experience as participants of an organized peer coaching curriculum. Participants gained tools and skills associated with awareness of mindset and relationships, communication and feedback, active listening and powerful questions, accountability, and the coaching process. Both individual and group goals progressed for all individuals. The most impactful experiences included having new “tools” to use personally and professionally, group goal progression, and improved communication and collegiality amongst the group. By using the Job Satisfaction Survey, participants showed improvements in overall job satisfaction. Results indicated improvements in coaching skill after completion of the Coach’s Evaluation Checklist. Quantitative analysis also verified individual and group goal progression. No statistical significance was discovered from quantitative assessments. Analysis of the data confirms the participants’ utilization of coaching strategies, goal attainment as well as improvements in confidence, satisfaction, and collegiality. As previously stated, faculty development is imperative for the enrichment of medical education. Nurse anesthesia educators can benefit from faculty development initiatives, specifically an organized peer coaching curriculum.

Scoping reviews in medical education: A scoping review

Article

Full-text available

Dec 2020

Introduction Over the last two decades the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting, and utility of scoping reviews. Thus, this review characterizes the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities. Method The authors searched PubMed for scoping reviews published between 1/1999‐4/2020 in 14 medical education journals. The authors extracted and summarized key bibliometric data, the rationales given for conducting a scoping review, the research questions, and key reporting elements as described in the PRISMA‐ScR. Rationales and research questions were mapped to Arksey and O’Malley’s reasons for conducting a scoping review. Results One hundred and one scoping reviews were included. On average 10.1 scoping reviews (SD=13.1, Median=4) were published annually with the most reviews published in 2019 (n=42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarize and disseminate research findings (n=77). In 11 reviews the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA‐ScR, with few authors publishing a protocol (n=2) or including stakeholders (n=20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal. Conclusions Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy, and research of medical education. However, these results suggest improvements are needed for this role to be fully realized.

Implementation and Effectiveness of Coaching for Surgeons in Practice – A Mixed Studies Systematic Review

Article

Feb 2020

Introduction: Despite recent changes to medical education, surgical training remains largely based on the apprenticeship model. However, after completing training, there are few structured learning opportunities available for surgeons in practice to refine their skills or acquire new skills. Personalized observation with feedback is rarely a feature of traditional continuing medical education learning. Coaching has recently been proposed as a modality to meet these educational gaps; however, data are limited, and few coaching programs presently exist. The purpose of this study is to summarize the characteristics of coaching programs for surgeons in practice including participant satisfaction, program outcomes, and barriers to implementation, in the published literature. Methods: A mixed studies systematic review was conducted according to PRISMA guidelines to identify all original studies describing or investigating coaching for practicing surgeons up to 06/2019. Quantitative analysis was used to summarize numerical data, and qualitative analysis using grounded theory methodology for descriptive data was used to summarize the results into themes across studies. Results: After identification of articles, 27 were included in the final synthesis. Twenty-six articles described execution of a coaching program. Programs varied widely with 18/26 focusing on teaching new skills, and the remainder on refinement of skills. Thematic analysis identified 2 major data categories that guided deeper analysis: outcomes of and barriers to coaching. Of the 16 (62%) programs that reported outcomes of coaching, 42% to 100% of participants reported changes in clinical practice directly associated with coaching. Positive satisfaction after completion of a program was reported by 82% to 100% of participants. Reported barriers to participating in a coaching program emerged along 3 main themes: logistical constraints, surgical culture, and perceived lack of need. Conclusions: Coaching for surgeons in practice is highly rated by participants and often results in clinical practice changes, while cultural and logistical issues were identified as barriers to implementation. A better understanding of these factors is required to guide coaching program development and implementation.

How to Continue Learning After Gastroenterology Fellowship With a Peer-Coach

Article

Feb 2020
GASTROENTEROLOGY

Coaching by design: exploring a new approach to faculty development in a competency-based medical education curriculum

Article

Full-text available

May 2019

As curricula move from a time-based system to a competency-based medical education system, faculty development will be required. Faculty will be asked to engage in the observation, assessment and feedback of tasks in the form of educational coaching. Faculty development in coaching is necessary, as the processes and tools for coaching learners toward competence are evolving with a novel assessment system. Here, we provide a scoping review of coaching in medical education. Techniques and content that could be included in the curricular design of faculty development programming for coaching (faculty as coach) are discussed based on current educational theory. A novel model of coaching for faculty (faculty as coachee) has been developed and is described by the authors. Its use is proposed for continuing professional development.

Video-based coaching for surgical residents: a systematic review and meta-analysis

Article

Full-text available

Jun 2022
SURG ENDOSC

Background: Video-based coaching (VBC) is used to supplement current teaching methods in surgical education and may be useful in competency-based frameworks. Whether VBC can effectively improve surgical skill in surgical residents has yet to be fully elucidated. The objective of this study is to compare surgical residents receiving and not receiving VBC in terms of technical surgical skill. Methods: The following databases were searched from database inception to October 2021: Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed. Articles were included if they were randomized controlled trials (RCTs) comparing surgical residents receiving and not receiving VBC. The primary outcome, as defined prior to data collection, was change in objective measures of technical surgical skill following implementation of either VBC or control. A pairwise meta-analyses using inverse variance random effects was performed. Standardized mean differences (SMD) were used as the primary outcome measure to account for differences in objective surgical skill evaluation tools. Results: From 2734 citations, 11 RCTs with 157 residents receiving VBC and 141 residents receiving standard surgical teaching without VBC were included. There was no significant difference in post-coaching scores on objective surgical skill evaluation tools between groups (SMD 0.53, 95% CI 0.00 to 1.01, p = 0.05, I2 = 74%). The improvement in scores pre- and post-intervention was significantly greater in residents receiving VBC compared to those not receiving VBC (SMD 1.62, 95% CI 0.62 to 2.63, p = 0.002, I2 = 85%). These results were unchanged with leave-one-out sensitivity analysis and subgroup analysis according to operative setting. Conclusion: VBC can improve objective surgical skills in surgical residents of various levels. The benefit may be most substantial for trainees with lower baseline levels of objective skill. Further studies are required to determine the impact of VBC on competency-based frameworks.

Buddy Care, a Peer-to-Peer Intervention: A Pilot Quality Improvement Project to Decrease Occupational Stress Among an Overseas Military Population

Article

Jul 2020

Introduction Occupational stress can have a direct influence on worker safety and health. Navy medical professionals are known to neglect self-care, putting them at risk for deteriorations in psychological health that can lead to adverse patient outcomes. To support medical professionals, a peer-to-peer intervention called Buddy Care, embedded in Navy Medicine’s Caregiver Occupational Stress Control (CgOSC) program, was evaluated. Strategies to prevent and better manage occupational stress are vital to improve the health care providers’ abilities to cope with day-to-day stressors, which is crucial to maintaining mission readiness. The overarching aim of this quality improvement pilot project was to implement and evaluate Buddy Care and to provide context as an evidenced-based peer intervention and leadership tool at a military hospital in Guam. This project is the first to implement and evaluate Buddy Care intervention for an active duty U.S. Navy population stationed overseas. Materials and Methods A convenience sample of 40 Navy active duty assigned to three inpatient units were offered Buddy Care intervention, which was introduced by conducting a Unit Assessment. A pre-test and 3- and 6-month post-test intervention design used a self-administered, 79-item CgOSC Staff Wellness Questionnaire which included five validated measures to assess the independent variable: (1) Response to Stressful Experience Scale, (2) Perception of Safety, (3) Horizontal Cohesion, (4) Perceived Stress Scale, and (5) Burnout Measure, short version. This project was determined as exempt by the Department of Navy Human Research Protection Program and did not require further review by the Institutional Review Board. Results Of the 40 questionnaires collected, 39 were partially completed. Paired sample t-tests were conducted between designated time-points to maximize the sample size and retain the repeated measures nature of the outcome variables. The small sample size allowed for statistical comparisons; however no statistically significant differences were found across the time-points. There was a large effect size for Perceptions of Safety and a medium effect size for Burnout Measure from baseline to 3 months, with both lowered at the 6 months. Although the sample size was too small to achieve statistical significance, the effect size analysis suggested that significance might be obtained with a larger sample. Conclusion The small number of participants and missing data significantly limited the ability to identify reliable changes across time-points. Despite the lack of statistically significant findings, there was an unintended positive result. The Unit Assessment piqued the interest of other departments, and during the project period, 11 departments requested a Unit Assessment. Although there were no requests for Buddy Care intervention from the targeted sample, it was occurring an average of 40 times per month throughout the command. Replication of this project in a similar setting is encouraged so that Buddy Care can be further evaluated. Understanding the effectiveness of well-mental health programs that promote early intervention and prevention efforts may contribute to a psychologically tougher medically ready force. Shortly after project completion, a CgOSC Instruction was approved by the Navy Surgeon General, highlighting the importance of CgOSC and Buddy Care on the operational readiness of Navy Medicine.

Video-based coaching in surgical education: a systematic review and meta-analysis

Article

Full-text available

Feb 2020
SURG ENDOSC

Background In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education. Methods We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control). Results Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61–1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06–0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20). Conclusion Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.

Design, implementation and evaluation of a long-term educational faculty development program for clinical faculty

Article

Full-text available

Sep 2022

Mahla Salajegheh

Background & Objective: Faculty development programs by improving clinical faculty members' educational skills affect society's health. Despite all the efforts for the educational development of clinical faculty, these programs do not always have adequate efficiency because of some challenges. This study aimed to design, implement and evaluate a long-term educational faculty development program for clinical faculty members. Materials & Methods: This triangulation study was conducted from September 2021 to February 2022. The program designed by adopting Harden’s 10 Questions of educational program development framework approach. Based on Sociocultural theory, a longitudinal, informal program performed in a group setting for eighty clinical faculty members. For program evaluation, a questionnaire based on the CIPP evaluation model was developed and tested psychometrically. Results: The results indicated the overall satisfaction with faculty development program was high. Participants reported awareness of strengths and weaknesses in education, more self-confidence, higher motivation in teaching, acquiring teaching skills in clinical settings, and providing effective feedback as the program's achievements. Conclusion: The combination of informal, longitudinal, and group-based approach increased the program's efficiency. This approach had short-term results such as enhancement of participants’ educational skills, improvement in the process of clinical education, and training clinical educators for future faculty development programs. hopefully, it will increase organizational capacities in the long time.

Trusted Friendships, Improved Performance And Organizational Success: The Case For Implementing Peer Coaching In The Workplace

Article

Dec 2020

Victoria Kozhushchenko

Peer coaching is a type of coaching under-represented and infrequently utilized within organizations, yet offers opportunity for organizations to improve employee wellness, build deeper connections between employees and develop stronger competencies in areas such as communication, collaboration and inclusion. This capstone seeks to reveal the myriad benefits and opportunities inherent to implementing a peer coaching program in the workplace, through a secondary research of available literature and proposal of a peer coaching framework that can be implemented with ease, at low cost and to maximum organizational benefit. Through the course of analysis of the literature, both the existing research as well as the gaps in the literature with regard to peer coaching are made visible, thus creating space for a conceptual peer coaching framework that focuses on trust and transparency along with key intersections of authenticity and psychological safety, suited for organizations of any size or type to implement.

Practices and changes associated with patient-centered medical home transformation

Article

Sep 2021
AM J MANAG CARE

Objectives: Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. Study design: We used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recognition to construct a stratified national sample of 105 practices engaged in PCMH transformation. We examined their QI practices and PCMH changes associated with PCMH transformation. Methods: We derived QI practice and PCMH change variables from semistructured interviews. Practice leaders completed the PCMH Assessment (PCMH-A) measuring the practice's degree of PCMH implementation, which is a proxy for patient-centeredness. Controlling for practice characteristics, we regressed PCMH-A scores on QI practice and PCMH change variables. Results: Practices undergoing PCMH transformation nationwide most commonly made care delivery changes in access and continuity of care. To improve quality, practices most commonly engaged in discussing and targeting areas of patient experience improvement, trending performance, and conducting targeted QI. However, practices lower in patient-centeredness as measured by the PCMH-A were more likely to engage in efforts to improve patient experiences, such as reviewing patient experience data or engaging in 1-on-1 provider counseling related to patient interactions. Mature PCMH practices focused on changes in continuity of care. Conclusions: Practices undertake a wide variety of care delivery changes and QI practices simultaneously to meet PCMH requirements. The patient experience-specific QI practices and PCMH care delivery changes that practices make to improve patient-centeredness differ by years of PCMH recognition.

Coaching to enhance qualified surgeons' non-technical skills: a systematic review

Article

Sep 2021
BRIT J SURG

Introduction: The lack of an effective continuing professional development programme for qualified surgeons, specifically one that enhances non-technical skills (NTS), is an issue receiving increased attention. Peer-based coaching, used in multiple professions, is a proposed method to deliver this. The aim of this study was to undertake a systematic review of the literature to summarize the quantity and quality of studies involving surgical coaching of NTS in qualified surgeons. Methods: A systematic search of the literature was performed through MEDLINE, EMBASE, Cochrane Collaboration and PsychINFO. Studies were selected based on predefined inclusion and exclusion criteria. Data for the included studies was independently extracted by two reviewers and the quality of the studies evaluated using the Medical Education and Research Study Quality Instrument (MERSQI). Results: Some 4319 articles were screened from which 19 met the inclusion criteria. Ten studies involved coaching of individual surgeons and nine looked at group coaching of surgeons as part of a team. Group coaching studies used non-surgeons as coaches, included objective assessment of NTS, and were of a higher quality (average MERSQI 13.58). Individual coaching studies focused on learner perception, used experienced surgeons as coaches and were of a lower quality (average MERSQI 11.58). Individual coaching did not show an objective improvement in NTS for qualified surgeons in any study. Conclusion: Surgical coaching of qualified surgeons' NTS in a group setting was found to be effective. Coaching of individual surgeons revealed an overall positive learner perception but did not show an objective improvement in NTS for qualified surgeons.

Shadow Coaching Improves Patient Experience With Care, But Gains Erode Later

Article

Aug 2021
MED CARE

Background: Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. Objective: We examined whether shadow coaching improves patient experience across 44 primary care practices in a large urban Federally Qualified Health Center. Research design: Seventy-four providers with "medium" (ie, slightly below average) overall provider ratings received coaching and were compared with 246 uncoached providers. We fit mixed-effects regression models with random effects for provider (level of treatment assignment) and fixed effects for time (linear spline with a knot and "jump" at coaching date), patient characteristics and site indicators. By design, coached providers performed worse at selection; models account for the very small (0.2 point) regression-to-the-mean effects. We assessed differential effects by coach. Subjects: A total of 46,452 patients (from 320 providers) who completed the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) Visit Survey 2.0. Measures: CAHPS overall provider rating and provider communication composite (scaled 0-100). Results: Providers not chosen for coaching had a nonsignificant change in performance during the period when selected providers were coached. We observed a statistically significant 2-point (small-to-medium) jump among coached providers after coaching on the CAHPS overall provider rating and provider communication score. However, these gains disappeared after 2.5 years; effects differed by coach. Conclusions: Shadow coaching improved providers' overall performance and communication immediately after being coached. Regularly planned shadow coaching "booster" sessions might maintain or even increase the improvement gained in patient experience scores, but research examining additional coaching and optimal implementation is needed.

Provider and coach perspectives on implementing shadow coaching to improve provider–patient interactions

Article

May 2021

Background Healthcare organizations want to improve patient care experiences. Some use ‘shadow coaching’ to improve interactions between providers and patients. A Federally Qualified Health Center (FQHC) implemented a half-day observation of individual primary-care providers by a ‘shadow coach’ during real-time patient visits, including an in-person verbal debrief afterwards and a written report with specific recommendations. Shadow coaching identified areas for improvement. We aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture. Methods We examined provider and coach perceptions of shadow coaching through interviewing coached providers, stratified by provider type and Consumer Assessment of Healthcare Providers and Systems (CAHPS) performance, and the coaches who coached the most providers. We interviewed 19 coached providers and 2 coaches in a large, urban FQHC. Content analysis identified implementation barriers, facilitators and themes. Results Coaches reported needing ‘buy-in’ throughout the organization and the need to be credible and empathize with the providers being coached. Most providers reported behaviour changes based on recommendations. Almost all providers recalled at least one coaching recommendation that was actionable. Providers and coaches highlighted patient-level and practise-level barriers that impeded their ability to implement recommended improvements. CAHPS data was reported as an effective performance management metric for measuring change, counselling providers, and evaluating provider-level efforts but was not always specific enough to yield tangible recommendations. Conclusions Regular messaging by leadership about the priority and purpose of shadow coaching was essential for both physician engagement and its mature implementation across the organization. Coaching could be embedded into a long-term strategy of professional development with periodic re-coaching. Re-coaching sessions could target issues raised by providers, such as dealing with difficult patients or specific populations. Research on the timing and content of re-coaching is needed.

Implementing a coaching model for the development of online teachers

Article

Full-text available

May 2020
Int J Acad Dev

Dawn Marie Gilmore

This paper details a six-step model for coaching online teachers that has been successfully implemented at an Australian university. Drawing on three fields of literature – online teaching, community of practice theory and coaching programs – the model involves (1) on-boarding and goal-setting, (2) coaching conversations about online teaching strategies, (3) implementing those strategies in the classroom, (4) collecting and triangulating data about their implementation, (5) sharing feedback and data with teachers, and (6) reflection. The success of the model to date and lessons learned from its implementation, will be of interest to the emerging field of academic professional development.

Using Peer Feedback to Promote Clinical Excellence in Hospital Medicine

Article

Sep 2020
J GEN INTERN MED

Hospitalists provide a significant amount of direct clinical care in both academic and community hospitals. Peer feedback is a potentially underutilized and low resource method for improving clinical performance, which lends itself well to the frequent patient care handoffs that occur in the practice of hospital medicine. We review current literature on peer feedback to provide an overview of this performance improvement tool, briefly describe its incorporation into multi-source clinical performance appraisals across disciplines, highlight how peer feedback is currently used in hospital medicine, and present practical steps for hospital medicine programs to implement peer feedback to foster clinical excellence among their clinicians.

Identifying optimal program structure, motivations for and barriers to peer coaching participation for surgeons in practice: a qualitative synthesis

Article

Full-text available

Aug 2021
SURG ENDOSC

Background Continuous advancement of surgical skills is of utmost importance to surgeons in practice, but traditional learning activities without personalized feedback often do not translate into practice changes in the operating room. Peer coaching has been shown to lead to very high rates of practice changes and utilization of new skills. The purpose of this study was to explore the opinions of practicing surgeons regarding the characteristics of peer coaching programs, in order to better inform future peer coaching program design. Methods Using a convenience sample, practicing general surgeons were invited to participate in focus group interviews. Allocation into groups was according to years in practice. The interviews were conducted using open-ended questions by trained facilitators. Audio recordings were transcribed and coded into themes by two independent reviewers using a grounded theory approach. Results Of 52 invitations, 27 surgeons participated: 74% male; years in practice: < 5 years: 33%; 5–15 years: 26%; > 15 years: 41%. Three main themes emerged during coding: ideal program structure, motivations for participation, and barriers to implementation. For the ideal structure of a peer coaching program all groups agreed coaching programs should be voluntary, involve bidirectional learning, and provide CME credits. Live, in situ coaching was preferred. Motivations for coaching participation included: desire to learn new techniques (48%), remaining up to date with the evolution of surgical practice (30%) and improvement of patient outcomes (18%). Barriers to program implementation were categorized as: surgical culture (42%), perceived lack of need (26%), logistical constraints (23%) and issues of coach–coachee dynamics (9%). Conclusion Peer coaching to refine or acquire new skills addresses many shortcomings of traditional, didactic learning modalities. This study revealed key aspects of optimal program structure, motivations and barriers to coaching which can be used to inform the design of successful peer coaching programs in the future. Graphic abstract

Scoping reviews in medical education: A scoping review

Preprint

Full-text available

Jul 2020

Purpose The purpose of this study was to characterize the extent, range, and nature of scoping reviews published in core medical education journals. In so doing, the authors identify areas for improvement in the conduct and reporting of scoping reviews, and highlight opportunities for future research. Method The authors searched PubMed for scoping reviews published between 1999 through April 2020 in 14 medical education journals. From each review, the authors extracted and summarized key bibliometric data, the rationales given for conducting a scoping review, the research questions, and key reporting elements as described in the PRISMA-ScR reporting guidelines. Rationales and research questions were mapped to the reasons for conducting a scoping review, as described by Arksey and O’Malley. Results One hundred and one scoping reviews were included. On average 10.1 scoping reviews (MED=4, SD=13.08) were published annually with the most reviews published in 2019 (n=42) in 13 of the included 14 journals reviewed. Academic Medicine published the most scoping reviews (n=28) overall. Authors described multiple reasons for undertaking scoping reviews, including to: summarize and disseminate research findings (n=77); examine the extent, range, and nature of research activity in a given area (n=74); and to analyze an emerging topic or heterogenous literature base (n=46). In 11 reviews there was alignment between the rationales for the scoping review and the stated research questions. No review addressed all elements of the PRISMA-ScR, with only a minority of authors publishing a protocol (n=2) or including stakeholders (n=20). Authors identified several shortcomings of scoping review methodology, including being unable to critically assess the included studies. Conclusions Medical educators are increasingly conducting scoping reviews with a desire to characterize the literature on a topic. There is room for improvement in the reporting of scoping reviews, including the alignment of research questions, the creation and publishing of protocols, and the inclusion of external stakeholders in published works.

Perceiving the effectiveness of structured peer observation of teaching among postgraduate students -single institutional experience

Article

Full-text available

Mar 2020

Background: Peer observation is one method of honing teaching skills by evaluating the presentation skills of others with a two-way process of improvement based on critical reflection. Structuring the process of peer observation helps identify gaps where individual students may err while teaching. The main aim of this initiative is to evaluate the quality of teaching among postgraduate students in one department using the principles of peer, near-peer, and faculty observation. Methods: Structured peer observation of postgraduate seminars was conducted where students’ teaching skills were critically commented upon by peers, near-peers, and faculty. Measurements included perceived confidence of students in the feedback process, self-appraisal of competence in selected teaching behaviors and participants’ attitude towards the process of observation using quantitative methodologies. The results were analysed using descriptive statistical methods and expressed as measures of central tendency. Results: Overall outcomes were highly positive in terms of confidence and appraisal abilities of students in the feedback process. The attitudinal perceptions of students were also positive. Conclusion: Using feedback from peer and near-peer evaluation, students can develop the teaching skills which will later manifest as beneficial teaching practices in long run. By repeatedly observing and then enacting teaching practices, the gap existing between the current state and the desired state of performance can be reduced.

Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Utter Pradesh, India

Article

Full-text available

Mar 2020

Background: Coaching can improve the quality of care in primary-level birth facilities and promote birth attendant adherence to essential birth practices (EBPs) that reduce maternal and perinatal mortality. The intensity of coaching needed to promote and sustain behavior change is unknown. We investigated the relationship between coaching intensity, EBP adherence, and maternal and perinatal health outcomes using data from the BetterBirth Trial, which assessed the impact of a complex, coaching-based implementation of the World Health Organization's Safe Childbirth Checklist in Uttar Pradesh, India. Methods: For each birth, we defined multiple coaching intensity metrics, including coaching frequency (coaching visits per month), cumulative coaching (total coaching visits accrued during the intervention), and scheduling adherence (coaching delivered as scheduled). We considered coaching delivered at both facility and birth attendant levels. We assessed the association between coaching intensity and birth attendant adherence to 18 EBPs and with maternal and perinatal health outcomes using regression models. Results: Coaching frequency was associated with modestly increased EBP adherence. Delivering 6 coaching visits per month to facilities was associated with adherence to 1.3 additional EBPs (95% confidence interval [CI]=0.6, 1.9). High-frequency coaching delivered with high coverage among birth attendants was associated with greater improvements: providing 70% of birth attendants at a facility with at least 1 visit per month was associated with adherence to 2.0 additional EBPs (95% CI=1.0, 2.9). Neither cumulative coaching nor scheduling adherence was associated with EBP adherence. Coaching was generally not associated with health outcomes, possibly due to the small magnitude of association between coaching and EBP adherence. Conclusions: Frequent coaching may promote behavior change, especially if delivered with high coverage among birth attendants. However, the effects of coaching were modest and did not persist over time, suggesting that future coaching-based interventions should explore providing frequent coaching for longer periods.

The Power of Peers: Faculty Development for Medical Educators of the Future

Article

Full-text available

Oct 2019

Coaching Palliative Care Conversations: Evaluating the Impact on Resident Preparedness and Goals-of-Care Conversations

Article

Aug 2019

Background: There is increasing need for nonspecialty physicians to deliver palliative care (PC) services to meet patient needs, but many physicians feel inadequately prepared. Objective: We aimed to improve the PC skills of resident physicians through a learner-centered, just-in-time coaching intervention. Design: Our quality improvement initiative consisted of two didactics and brief thrice-weekly coaching sessions that focused on real-time PC questions. Upper level internal medicine residents participated during an inpatient hospitalist rotation. Measurements: Residents completed pre/postrotation surveys of their preparedness in discussing PC topics. Electronic medical record data of documentation of goals-of-care (GOC) discussions and Physician Orders for Life-Sustaining Treatment (POLST) completion in at-risk hospitalized patients (age >65 with two or more hospitalizations in the past six months, or age >90) were obtained and compared with before hospitalization. These data were also compared with data from patients on the same resident hospitalist service during the six-month period before the intervention began. Results: During the 14-month intervention period, 42 residents cared for 232 at-risk patients. Among at-risk patients, 12.9% had a documented GOC discussion before hospitalization, which rose to 57.3% before discharge. Among at-risk patients preintervention, these rates were 5.2% and 25.0%, respectively. Residents reported their preparedness increased across many elements of GOC discussions and rated coaching sessions as useful and relevant to their training. Rates of POLST completion did not differ between preintervention and intervention groups. Conclusions: Brief coaching sessions can integrate PC education into a busy clinical service, improve residents' primary PC skills, and improve GOC documentation.

Peer-teaching cardiac ultrasound among medical students: A real option

Article

Full-text available

Mar 2019
PLOS ONE

Introduction Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. Methods Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of ≤5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students’ proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0–100 scale according to a predetermined key. Results The 6-minute test final grade displayed superiority of group A over group B (54±17 vs. 39±21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69±18 vs. 54±23, respectively), PSAV (65±33 vs. 41±32, respectively), 4ch (57±19 vs. 43±26, respectively), 2ch (37±29 vs. 33±27, respectively), 3ch (48±23 vs. 35±25, respectively), and SC (36±27 vs. 24±28, respectively). Conclusions Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.

TACKLING CHALLENGES IN SLT-PRACTICE: PEER COACHING AS A PROBLEM-SOLVING TOOL IN THE CLINICAL REASONING PROCESS

Presentation

Full-text available

May 2018

Christina Haupt

The increasing complexity of caseloads in SLT practice, e.g. due to higher comorbidity, lacking information or experience in the treatment of complicated cases, calls for support from experienced as well as specialist practitioners from within the field - especially for novice therapists. One way to tackle these challenges may be peer coaching and how it can be employed within the educational and professional SLT setting.

Reframing peer mentoring as a route for developing an educational community of practice

Article

Full-text available

Oct 2018

The benefits of peer mentoring in school settings are well-documented, however, the focus has been on the perceptions of teachers, as opposed to teaching assistants, who report distinct beliefs about their professional development. A mixed methodology was used in which 304 primary school teaching assistants completed questionnaires regarding their views of their professional development while undertaking training on a mathematics intervention for underachieving pupils. Open-ended questions elicited the perceived benefits of the peer mentoring aspect of the training. We utilized Lave and Wenger’s (1991) community of practice framework to inform the qualitative analysis and the principles of grounded theory to arrive at three themes representing the perceived benefits: an opportunity to discuss and share experiences; increased confidence; and a safe space to test teaching plans and resources. Findings were used to reframe the benefits of peer mentoring for teaching assistants undertaking intervention training, which can inform further research and future training programs.

Fostering "Reflection-On-Practice" Through a Multisource Feedback and Peer Coaching Pilot Program

Article

Dec 2022
J CONTIN EDUC HEALTH

Introduction: Reflective practice involves thinking about one's practice and often involves using data to effect such reflection. Multisource feedback (MSF) involves evaluation by peers, patients, and coworkers. Coaching has been identified as a key aspect of MSF with peer coaching involving two or more colleagues working together to reflect on current practices and share ideas. We introduced a pilot MSF and peer coaching program with a goal to evaluate its effect on fostering reflective practice. Methods: Physician participants completed a 360-degree assessment of their practices, followed by peer coaching sessions. Peer coaches were oriented to an evidence-based theory-driven feedback model (R2C2) to support coaching skills development. A mixed-methods evaluation study was undertaken, including pre to post surveys of readiness for self-directed learning, a postevaluation survey of participant satisfaction, and semistructured participant interviews. Results: Thirty four (N = 34) participants completed the 360-degree assessment, and 22 participants took part in two coaching meetings. Respondents reported significant improvement to aspects of their readiness for self-directed learning (P <.05), including knowing about learning strategies to achieve key learning goals, knowing about resources to support one's own learning, and being able to evaluate one's learning outcomes. Overall, respondents felt empowered to "reflect" on their practices, affirm what they were doing well, and, for some, identify opportunities for further and ongoing professional development. Discussion: MSF and peer coaching emerged as key elements in enabling reflective practice by facilitating reflection on one's practice and conversations with one's peers to affirm strengths and opportunities for strengthening practice through self-directed professional development.

Building diverse leadership in an academic medical center: The ACCLAIM program

Article

Jan 2023
J NATL MED ASSOC

As healthcare systems become more complex, medical education needs to adapt in many ways. There is a growing need for more formal leadership learning for healthcare providers, including greater attention to health disparities. An important challenge in addressing health disparities is ensuring inclusive excellence in the leadership of healthcare systems and medical education. Women and those who are underrepresented in medicine (URMs) have historically had fewer opportunities for leadership development and are less likely to hold leadership roles and receive promotions. One successful initiative for improved learning of medical leadership-presented as a case example here-is the Academic Career Leadership Academy in Medicine (ACCLAIM) at the University of North Carolina at Chapel Hill School of Medicine. ACCLAIM is uniquely designed for faculty identified as having emerging leadership potential, with an emphasis on women and URMs. Using a leadership learning system approach, annual cohorts of participants (Scholars) interactively participate in a multi-faceted nine-month long learning experience, including group (e.g., guest-speaker weekly presentations and exercises) and individual learning components (e.g., an individual leadership project). Since its initiation in 2012 and through 2021, 111 Scholars have participated in ACCLAIM; included were 57% women and 27% URMs. Two important outcomes described are: short-term impact as illustrated by consistent improvements in quantitively measured leadership knowledge and capabilities; and long-term leadership growth, whereby half of the ACCLAIM graduates have received academic rank promotions and almost two-thirds have achieved new leadership opportunities, with even higher percentages observed for women and URMs; for example, 87% of URMs were either promoted or achieved new leadership positions. Also consistently noted, through qualitative assessments, are broader healthcare system knowledge and shared tactics for addressing common challenges among Scholars. This case example shows that the promotion of leadership equity may jointly enhance professional development while creating opportunities for systems change within academic medical centers. Such an approach can be a potential model for academic medical institutions and other healthcare schools seeking to promote leadership equity and inclusion.

Healthcare Predictions Using Machine Learning and Artificial Intelligence Algorithms

Article

Full-text available

Jan 2023

Machine Learning (ML) combined with Artificial Intelligence (AI) are essential implements for enhancing medical care. Medical problems such as pulse rate, respiratory rate, oxygen level, blood pressure, falls, diabetes level, human body temperature and diagnosis blunders are prominent adverse occurrences in healthcare. This proposal aimed to employed AI's ability besides machine learning improve patient care in this eight high-risk areas to predict, avoid, or diagnose undesirable outcomes. Healthcare-associated Infections to determine if AI can improve safety, the literature was analyzed regarding incidence, cost, prevention, and treatment. The paper included 100 different samples, provided numerous cases of how intelligence was used in all eight damage categories. In several fields, AI and new data sources can help reduce damage rates. The proposed achieved 81% accuracy in diagnosing the tested cases. The treatment plan's reliability rate increased to 91% compared to the traditional treatment by the doctor to 58%. So, it includes adverse medication effects, hypertension, and diagnostics errors to mention several.

Collaborative faculty development transforms evaluation at a school of osteopathic medicine: an exploratory grounded theory study

Article

Jun 2022

Background: Faculty development (FD) initiatives for medical educators must keep pace with educators’ expanding roles and responsibilities in the 21 st century to effectively support and guide professional growth. Successful initiatives will be comprehensive and systematic, rather than episodic. Our research explores the impact of a collaborative, individualized, and focused FD program. The purpose of this pilot study is: (1) to describe the innovative design and implementation of the incipient FD program at University of the Incarnate Word School of Osteopathic Medicine (UIWSOM), San Antonio, Texas; and (2) to present insights from a preliminary process evaluation of the program’s initial launch to inform and facilitate broadscale implementation. Methods: We used a longitudinal, holistic approach to redesign the UIWSOM FD program to provide evidence-informed and experiential learning for faculty. We performed a process evaluation of the initial iteration of the FD program using an inductive qualitative research approach. We applied principles of constructivist grounded theory to analyze faculty’s responses collected during semi-structured interviews. Results: Three themes emerged from our analysis: communication, advocacy, and reciprocal learning. We found that effective communication, advocacy for faculty success, and reciprocal value between faculty and program developers undergirded the core concept of authentic engagement. Faculty’s perceptions of the quality of engagement of those implementing the program overshadowed the quality of the logistics. Conclusions: Our pilot study identified authentic engagement as critical to faculty’s positive experience of this new FD initiative. Practical implications for other health professions schools with similar FD initiatives include consideration of the relational aspects. Future studies should expand the process evaluation to determine key factors driving perceived program success for other skill domains and amongst clinical faculty, and include a long-range outcome evaluation of the fully implemented program.

Coaching Strategies for the Flip the Pharmacy Practice Transformation Initiative in Pennsylvania Independent Community Pharmacies

Article

Aug 2022

Background Flip the Pharmacy (FtP) is a nationwide initiative to scale practice transformation in community pharmacies. Participating pharmacies are coached through monthly practice transformation initiatives and document their patient-care activities through Pharmacist electronic Care (eCare) Plans. Objectives The objective of this study was to identify peer coaching strategies to facilitate practice transformation in Pennsylvania community pharmacies. Methods This was a qualitative study using semi-structured interviews with practice transformation coaches and pharmacy champions participating in Pennsylvania’s FtP program. The interview guide was informed by the Consolidated Framework for Implementation Research and elicited information using the intervention characteristics, inner setting, characteristics of individuals, and process domains. Interviews were conducted in-person or via telephone over a three-month period. An inductive qualitative thematic analysis was performed to identify coaching strategies. Results A total of 18 key informants were interviewed: 6 pharmacy champions and 12 practice transformation coaches. The following five coaching strategies emerged: (1) Learn to use the pharmacy’s specific Pharmacist eCare Plan software, (2) Build a trusting relationship with the pharmacy, (3) Engage all pharmacy team members in practice transformation, (4) Adapt communication strategies to the pharmacy’s preference, and (5) Tailor goals to the pharmacy’s stage of practice transformation. Conclusion This study elicited five peer coaching strategies to support community pharmacy practice transformation initiatives. These findings can be used to further practice transformation efforts in community pharmacies through FtP and other initiatives aimed at expansion of community pharmacy patient care services.

Peer feedback in graduate training: A phenomenological investigation of possibilities

Article

Jul 2022
MED TEACH

Background: Whilst feedback is an essential component of clinical education, it is often lacking in clinical workplaces due to competing priorities. Peer feedback has been proposed as a potential solution but remains underexplored in terms of practicality and effects. We aimed to examine the experiences of peer feedback among paediatric trainees, and the associated feedback culture. Methods: Following an Interpretative Phenomenological Analysis approach, the personal experiences of 12 paediatric trainees were explored using semi-structured interviews. Interpretive themes were developed between the transcripts using processes of abstraction, subsumption, contextualisation, and cross-case analysis. Themes were subsequently subjected to member checking and peer debriefing processes. Results: We found that peer feedback was influenced by three contextual factors, namely, prevalent feedback culture, interpersonal consent, and the quality of relationships. Peer feedback culture was lacking in clinical workplaces. Feedback between peers was constrained by avoiding criticism and maintaining work relationships. Social and cultural norms inhibited constructive peer feedback without explicit consent. Conclusions: Enabling peer feedback in clinical settings requires attention to cultural, relational, and consent barriers. Potential approaches should include helping clinicians to develop greater cultural reflexivity, resident training in how to be peer educators, and enhancing institutional supports for peer feedback.

Étude de la portée (scoping review)

Chapter

Jun 2014

Content and Actionability of Recommendations to Providers After Shadow Coaching

Article

Feb 2022
Qual Manag Health Care

Background and objectives: Health care organizations track patient experience data, identify areas of improvement, monitor provider performance, and assist providers in improving their interactions with patients. Some practices use one-on-one provider counseling ("shadow coaching") to identify and modify provider behaviors. A recent evaluation of a large shadow coaching program found statistically significant improvements in coached providers' patient experience scores immediately after being coached. This study aimed to examine the content of the recommendations given to those providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability. Methods: Providers at a large, urban federally qualified health center were selected for coaching based on Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) patient experience scores (92 of 320 providers), shadowed by a trained peer coach for a half to full day and received recommendations on how to improve interactions with their patients. We coded 1082 recommendations found in the 92 coaching reports. Results: Reports contained an average of 12 recommendations. About half encouraged consistency of existing behaviors and half encouraged new behaviors. Most recommendations related to behaviors of the provider rather than support staff and targeted actions within the examination room rather than other spaces (eg, waiting room). The most common recommendations mapped to behavioral aspects of provider communication. Most recommendations targeted verbal rather than nonverbal communication behaviors. Most recommendations were actionable (ie, specific, descriptive), with recommendations that encouraged new behaviors being more actionable than those that encouraged existing actions. Conclusions: Patient experience surveys are effective at identifying where improvement is needed but are not always informative enough to instruct providers on how to modify and improve their interactions with patients. Analyzing the feedback given to coached providers as part of an effective shadow-coaching program provides details about implementation on shadow-coaching feedback. Recommendations to providers aimed at improving their interactions with patients need to not only suggest the exact behaviors defined within patient experience survey items but also include recommended behaviors indirectly associated with those measured behaviors. Attention needs to be paid to supplementing patient experience data with explicit, tangible, and descriptive (ie, actionable) recommendations associated with the targeted, measured behaviors. Research is needed to understand how recommendations are put into practice by providers and what motivates and supports them to sustain changed behaviors.

Surgical coaching in Obstetrics and Gynecology: an evidence-based strategy to elevate surgical education and promote lifelong learning

Article

Feb 2022
AM J OBSTET GYNECOL

The American Board of Medical Specialties (ABMS), of which the American Board of Obstetrics and Gynecology is a member, released recommendations in 2019 reimagining specialty certification and highlighting the importance of individualized feedback and data-driven advances in clinical practice throughout physicians’ careers. In this manuscript, we present surgical coaching as an evidence-based strategy for achieving lifelong learning and practice improvement that can help to fulfill the vision of the ABMS. Surgical coaching involves the development of a partnership between two surgeons in which one surgeon (the coach) guides the other (the participant) in identifying goals, providing feedback and facilitating action planning. Previous literature demonstrates that surgical coaching is viewed as valuable by both coaches and participants. Video-based coaching, in particular, involves reviewing recorded surgical cases and can be integrated into physicians’ busy schedules as a means of acquiring and advancing both technical and non-technical skills. Establishing surgical coaching as an option for continuous learning and improvement in practice has the potential to elevate surgical performance and patient care.

Peer Coaching Increases Emergency Medicine Faculty Ability to Perform and Teach Awake Fiberoptic Intubation

Article

Nov 2021

Objectives This study sought to evaluate the impact of peer coaching as a continuing medical education (CME) modality to improve faculty performance and teaching of a low-frequency, high-complexity procedure, awake fiber-optic intubation (AFOI). Methods Academic emergency medicine faculty at a single tertiary-care, level I trauma center participated in a prospective pre/post-interventional assessment of a peer coaching educational intervention. Participants completed a pre-intervention online survey to identify comfort and previous experience with performing and teaching AFOI. The participants reviewed pre-session materials and then completed a 25-minute didactic session with a peer coach. Participants were then broken into dyads where they initially each practiced the procedure and then attempted to teach the procedure to their colleague. An institutional standardized checklist for AFOI was utilized to assess participants procedural competency. Post-intervention online surveys were compared to the pre-intervention surveys. Results A total of 15 faculty members were recruited for the study and completed pre- and post- intervention surveys. All participants showed ability to perform AFOI as proven by successful completion of the procedural checklist. There was a statistically significant increase for self-perceived efficacy in performing (p<.001, CI 1.34-3.06) and teaching AFOI (p<.001, CI 1.56-3.05). All participants felt more likely to attempt AFOI after a single peer coaching session and most (14/15, 93.3%) were more likely to teach AFOI. Participants identified peer coaching as more effective at instilling confidence to perform and teach the skill than other CME activities that they have experienced. Conclusion This study demonstrates peer coaching increases practicing faculty’s ability to perform and teach a low-frequency, high-complexity procedure, AFOI. Peer coaching may offer an opportunity to improve the utility of learning compared to more traditional didactic-based CME initiatives.

Nursing education and training on electronic health record systems: An integrative review

Article

Aug 2021
Nurse Educ Pract

Aim This integrative review aimed to synthesize evidence pertaining to interventions that have been used to facilitate nurse education and training on electronic health records. Background Inadequate education and training can threaten the adoption of electronic health records and negatively impact the quality of nursing documentation. A review of the literature may help facilitate the development of evidence-based interventions for nursing education and training on electronic health records. Design An integrative review framework was used to address the research question: What is the available evidence to inform best practices for nursing education and training on electronic health records? Methods A systematic search was conducted in five databases: the Cumulative Index to Nursing and Allied Health Literature, Scopus, PubMed, CBCA Education, and ProQuest Education Database. Included articles were peer-reviewed studies, published in English, in which nurses participated in an electronic health record education or training intervention. Results Fifteen articles, from a search conducted between 2010 to 2020, were reviewed. Findings identified a shift from classroom learning towards blended approaches for nursing education and training on electronic health records, incorporating methods such as e-learning, peer coaching, and simulation. Ongoing staff engagement is needed to develop interventions that allow nurses to integrate electronic health records into their daily workflows. Higher quality studies and more meaningful assessment of learning outcomes are needed to identify the most effective interventions to incorporate in blended learning strategies. Conclusions Consensus in the reviewed literature indicated that electronic health record education and training for nurses should be multipronged and targeted to nurses' clinical workflows. Key findings of this review identified a shift from classroom-based learning towards blended approaches for electronic health record education and training. Blended approaches often incorporated non-traditional methods that could support interactive and workflow-based content. These included e-learning, nurse superusers or peer coaches, and simulation training. The findings of this review also highlighted the need for early and ongoing involvement of frontline nurses during electronic health record education and implementation. However, more rigorous studies that assess both patient and organizational outcomes are needed to identify the most effective "cocktail" of blended learning strategies.

Proctorship in Minimally Invasive Colorectal Surgery

Article

May 2021

Teaching an established surgeon in a novel technique by a colleague who has acquired a level of expertise is often referred to as “proctoring” or “precepting.” Surgical preceptorships can be defined as supervised teaching programs, whereby individual or groups of surgeons (proctors) experienced in a certain technique support a colleague who wants to adopt this technique (sometimes referred to as “delegates” or “preceptees”). Preceptorship programs really focus on a specific technique, technology, or skill which is required to broaden, complement, or transform an established surgeon's practice. Within colorectal surgery, in the past 30 years, there is been an evolution of interventional options including open, laparoscopic, robotic, and endoscopic procedures. With each new emerging technology and technique, safe and effective uptake by established surgeons is best been attained by a period of proctorship by an experienced colleague. Formalizing this has been facilitated largely through industry support. There, however, remains a considerable chasm when it comes to standardization, quality control, and jurisprudence. This article aims to describe the requirements for a contemporary proctorship program, to examine instruments of quality control, and how to improve effectiveness.

Pharmacist peer coaching in a traditional community chain pharmacy: Implementation and Perceptions

Article

Feb 2021

Objective To determine pharmacists’ perceptions of peer coaching techniques designed to enhance pharmacists’ provision of targeted medication reviews for adherence in traditional chain community pharmacies. Methods A peer coaching method was designed and implemented by a community-based pharmacy resident. Pharmacies within a traditional community chain were selected from one region that spans parts of western Pennsylvania and eastern Ohio. Individualized peer coaching was provided face-to-face with pharmacists within pharmacy workflow. After the full coaching intervention was complete, semi-structured interviews with coached pharmacists were conducted to qualitatively assess their perceived impact of the coaching. Interviews were conducted by a member of the investigative team to limit bias. Interviews were audio-recorded, transcribed, then underwent full thematic analysis. Results Five major themes were elicited from the coached pharmacists’ interviews: 1) Tailor coaching to pharmacist skill level, 2) Empower pharmacists with strategies to conduct clinical interventions and self-assess, 3) Teach patient engagement strategies, 4) Include all team members to promote engagement, and 5) Utilize peer coach’s experience with the intervention. Conclusion Themes from this project can help guide the implementation of peer coaching programs in community pharmacies. Effective peer coaching is an important approach to increase the uptake and effectiveness of a variety of community pharmacist-led enhanced patient care services.

Educational Coaches: Facilitating Academic Vitality and a Pathway to Promotion for Clinician-Educators

Article

Nov 2020
J Pediatr

Video-based self-assessment enhances laparoscopic skills on a virtual reality simulator: a randomized controlled trial

Article

Full-text available

Dec 2021
SURG ENDOSC

Background Hysterectomy rates are decreasing in many countries, and virtual reality (VR) simulators bring new training opportunities for residents. As coaching interventions while training on a simulated complex procedure represents a resource challenge, alternative strategies to improve surgical skills must be investigated. We sought to determine whether self-guided learning using a video-based self-assessment (SA) leads to improved surgical skills in laparoscopic hysterectomy (LH) on a VR simulator. Methods Twenty-four gynecology residents from two university hospitals were randomized into an SA group (n = 12) and a Control group (n = 12). Each participant’s baseline performance on a validated VR basic task was assessed. Both groups then performed three virtually simulated LHs during which the participants received no guidance nor feedback. Following each LH, the SA group participants rated the video of their own performance using a generic and a procedure-specific rating scale, while the Control group participants watched an LH video demonstration. The LH videos of both groups’ participants were blindly reviewed and rated by expert surgeons, using modified Objective Structured Assessment of Technical Skills scores (OSATS). Objective metrics recorded by the VR simulator were also compared. Results There was no difference between the groups’ baseline performances on the VR basic task. For the first LH, the OSATS-derived scores did not differ between SA and Control groups (9 [7–13] versus 9 [8–14]; p = 0.728). For the third LH, the OSATS-derived scores were higher for the SA group than for the Control group (17 [15–21] versus 15 [11–17], p = 0.039). Between the two groups, the objective metrics did not differ from the first to the third LH. Conclusions The use of a structured video-based SA leads to improved procedural skills in LH on a VR simulator compared to watching benchmark expert performance, in a population of residents with moderate experience in the operating room.

The Hospitalist Peer Coach – Improving Feedback Skills, Professional Goal Achievement, and Camaraderie With the MN-PEACH Project

Article

Sep 2020

Practices of Freedom? Seeking the Social Justice Aims of Peer Mentoring Within a Higher Education Professional Development Programme for Teaching Assistants

Chapter

Full-text available

Sep 2020

The social and economic opportunities offered by education and the role that mentoring can play in this have been documented for a range of professions, including teaching. What has been less well documented is the extent to which peer mentoring within higher education programmes of study can be utilised for other professionals working within schools who are often overlooked within the research in this field. In this chapter we study the reported experiences of over 300 teaching assistants who were studying at a university in North West England to construct a dialogue with the work of Lave and Wenger (Situated learning: Legitimate peripheral participation. New York: Cambridge University Press, 1991) and Freire’s philosophy to explore peer mentoring as a “practice of freedom” (Pedagogy of the oppressed (30th Anniversary Ed.). New York: Bloomsbury, 2000, p. 41). In doing so, we reflect upon the social justice aims of developing a supportive community of practice for a group of education professionals who are often undervalued.

Peer Coaching as a Form of Performance Improvement: What Surgeons Really Think

Article

Aug 2020

Objective Coaching has been proposed as a potential form of continuing professional development (CPD) for surgeons. Our study aimed to elicit qualified surgeons’ perceptions of peer coaching as a form of CPD and to determine the effect of demographic factors on surgeons’ views. Methods A cross-sectional paper survey was conducted across 2 South Australian metropolitan hospitals from November 2018 to January 2019. This comprised 5 demographic questions and 6 Likert items eliciting views on peer-based coaching and was distributed at departmental unit meetings to surgical consultants and fellows. Participation was voluntary and a definition of “peer-based coaching” was provided. Results Hundred and eighteen surgeons of a possible 125 (94.4% response rate) from 8 surgical specialties completed the survey with 45.4% (n = 54) having received coaching since obtaining their fellowship. The majority of participants (72.9%, n = 86) reported consultant surgeons would benefit from peer coaching and that one-on-one coaching in an individual setting would be a useful CPD activity (73.7%, n = 87). Just over half the participants (53.4%, n = 63) felt that coaching by a nonsurgeon such as a psychologist would benefit their nonoperative skills. Many participants (61.8%, n = 73) felt more inclined to participate if CPD points were awarded. Despite the support in favor of coaching, a significant percentage of participants (45.8%, n = 54) wanted further evidence of its efficacy. Conclusions There is support amongst surgeons for peer coaching and its inclusion as a form of CPD, however, many require more evidence of its benefits, thus highlighting the need for ongoing research studies, consultation and pilot coaching programs.

Building capacity from within: A pilot peer coaching project in an early childhood program

Article

Apr 2020
J Early Child Teach Educ

This study evaluated the impact of a pilot coaching project that included peer coaching in an early childhood program in the Northeast. A total of 18 coaches provided coaching with 15 teachers. Peer coaches included a participant-selected teacher or a director-selected teacher; program administrators also provided coaching. A one-page coaching form included columns to document the coaches’ observations and notes on teacher strengths and suggestions for improvement. Reflection forms, completed by teachers following coaching, captured perceptions about the coaching process. Results suggested that, compared to other coaches, administrators were most likely to provide specific feedback to teachers. Teachers were most comfortable being observed by a self-selected peer coach and most comfortable receiving feedback from a director-selected peer coach. Participants shared perceived benefits of and challenges to engaging in the peer coaching process. Findings and implications for program-level peer coaching initiatives are discussed.

Scaling Implementation of the Serious Illness Care Program Through Coaching

Article

Mar 2020
J PAIN SYMPTOM MANAG

Background We designed group coaching calls to reinforce communication skill acquisition and Serious Illness Care Program (SICP) uptake in adult primary care. Measures Percentage of primary care physicians who have documented a Serious Illness Conversation in the electronic health record (EHR) approximately 3 and 6 months after the coaching intervention. Participant feedback surveys to better understand provider attitudes toward the coaching intervention. Intervention We offered 60-minute group coaching calls to internal medicine primary care physicians, previously trained in serious illness conversation skills, as part of an institutional quality incentive program. The calls addressed communication challenges common to serious illness care and instructed participants about how to document and bill for conversations. Outcomes We completed 31 coaching calls over three months in which 170 of 228 primary care physicians attended in groups of 2-9 participants per call (74.6% penetration rate). The percentage of primary care physicians who documented at least one Serious Illness Conversation in the electronic health record increased from 18.4% to 41.2% six months after the intervention. Primary care internal medicine physicians found the one-hour coaching calls to be highly valuable, with 86.9% of respondents attesting they would recommend the calls to their colleagues. Content analysis of participant feedback identified the most useful coaching content elements to be self-reflection around the impact of prior conversation skills training, instruction around using the EHR to find and document ACP discussions, the opportunity to share individual challenges and successes with peers, and feedback/advice from communication experts in palliative care. Conclusions/Lessons Learned Group coaching of primary care physicians resulted in more than a two-fold increase in documented serious illness conversations.

Current Practices and Perspectives on Peer Observation and Feedback: A National Survey

Article

Aug 2019

Objective: Peer observation and feedback (POF) is the direct observation of an activity performed by a colleague followed by feedback with the goal of improved performance and professional development. Although well described in the education literature, the use of POF as a tool for development beyond teaching skills has not been explored. We aimed to characterize the practice of POF among pediatric hospitalists to explore the perceived benefits and barriers and to identify preferences regarding POF. Methods: We developed a 14-item cross-sectional survey regarding divisional expectations, personal practice, perceived benefits and barriers, and preferences related to POF. We refined the survey based on expert feedback, cognitive interviews, and pilot testing, distributing the final survey to pediatric hospitalists at 12 institutions across the United States. Results: Of 357 eligible participants, 198 (56%) responded, with 115 (58%) practicing in a freestanding children's hospital. Although 61% had participated in POF, less than one half (42%) reported divisional POF expectation. The most common perceived benefits of POF were identifying areas for improvement (94%) and learning about colleagues' teaching and clinical styles (94%). The greatest perceived barriers were time (51%) and discomfort with receiving feedback from peers (38%), although participation within a POF program reduced perceived barriers. Most (76%) desired formal POF programs focused on improving teaching skills (85%), clinical management (83%), and family-centered rounds (82%). Conclusions: Although the majority of faculty desired POF, developing a supportive environment and feasible program is challenging. This study provides considerations for improving and designing POF programs.

Faculty development: From rubies to oak

Article

Nov 2019

Yvonne Steinert

Introduction: Faculty development has played a significant role in health professions education over the last 40 years. The goal of this perspective is to present a portrait of faculty development in Medical Teacher since its inception and to highlight emerging trends moving forward. Method: All issues of Medical Teacher were reviewed, using the search terms faculty development, staff development, professional development, or in-service training for faculty. The search yielded 286 results of which 145 focused specifically on faculty development initiatives, reviews, or frameworks. Findings: This review demonstrated a significant growth in publications related to faculty development in Medical Teacher over the last 40 years, with a primary focus on teaching improvement and traditional approaches to faculty development, including workshops, short courses and other structured, group activities. The international nature of faculty development was also highlighted. Recommendations: Moving forward, it is suggested that we: broaden the scope of faculty development from teaching to academic development; expand our approaches to faculty development, to include peer coaching, workplace learning and communities of practice; utilize a competency-based framework to guide the development of faculty development curricula; support teachers’ professional identities through faculty development; focus on organizational development and change; and rigorously promote research and scholarship in faculty development.

Peer Coaching Across the Curriculum

Article

Aug 2018
NURS EDUC

Training for Minimally Invasive Cancer Surgery

Article

Oct 2018
SURG ONCOL CLIN N AM

The surgical oncologist of the future requires training in minimally invasive techniques. Increasing constraints on time and resources have led to a new emphasis on finding innovative ways to teach these surgical skills inside and outside the operating room. The goal of producing technically gifted minimally invasive surgical (MIS) oncologists requires robust, educationally sound training curricula. This article describes how MIS oncology training occurs at present with an outline of educational ideals training programs can strive for, provides two examples of successful MIS oncology programs to highlight effective strategies for moving forward, and introduces three new developments on the horizon.

Peer Coaching Across the Curriculum

Article

Aug 2018
NURS EDUC

The State of Play in Coaching Today: A Comprehensive Review of the Field

Chapter

Full-text available

Mar 2010

Understanding CoachingSkills, Performance and developmental CoachingExecutive and Workplace CoachingThe Professional Status of Coaching: Accreditations and Industry OrganizationsCoaching Professionalization Parallels development in Other FieldsCoaching Psychology as an Emerging Psychological SubdisciplineCoaching ResearchOutcome StudiesRandomized Controlled StudiesLongitudinal StudiesMeasuring Outcomes of CoachingCompetencies of Effective Coaches and CoacheesResearch DirectionsA Positive Future?A Well-Being and Engagement Framework for Organizational CoachingCoaching and Coaching Psychology: A Shared Path Forward?References

Individual and Organizational Trust in a Reciprocal Peer Coaching Context

Article

Full-text available

Aug 2012

Elaine Cox

This paper explores organizational and peer dynamics that impact the potential for productive, trusting peer relationships. An in-depth phenomenological study of five peer coaching dyads was undertaken to examine the establishment and maintenance of peer coaching. Joint interviews were used to promote co-construction of responses. Findings suggested that formation of trust is impacted by values-based attachment, confidentiality, and the capacity of peers to make themselves vulnerable. Individual bonds are important at the start of coaching, but trust is further strengthened through contracting and reciprocity within the relationship itself and by an open culture within the organization. Organizational culture was found to influence trust and the need for a combination of benign organizational support, transparency, and non-intervention was seen as vital.

Cooperative Learning Returns To College What Evidence Is There That It Works?

Article

Full-text available

Jul 1998

The State of Play in Coaching Today: A Comprehensive Review of the Field

Article

Full-text available

Mar 2010

In this review, we draw on our past scholarship in this area (Grant & Cavanagh, 2007; Grant & Cavanagh, in press; Passmore & Gibbes, 2007) to provide an extensive overview of the state of play in relation to coaching research and practice. We review the professional status of coaching and the various bodies that seek to accredit and organise coaches and the coaching industry. We highlight the development of coaching psychology as an up-and-coming psychological sub-discipline, including a review of the research into the efficacy of coaching, and presentation of ideas for a future research agenda. The links between I/O psychology, positive psychology and Positive Organizational Scholarship (POS) are discussed in relation to organizational coaching, and we present a model that can guide organizational coaching practice by integrating workplace engagement and well-being. In conclusion, we outline some potential lines of inquiry for future work in this emerging and exciting sub-field of psychological research and practice. Published (author's copy) Peer Reviewed

Scoping Studies: Advancing the Methodology

Article

Full-text available

Sep 2010
IMPLEMENT SCI

Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.

Personal coaching: A model for effective learning

Article

Full-text available

Feb 2012

Kerryn E. Griffiths

The escalating success of personal coaching and the significant potential it holds as a vehicle for effective learning, appear to have had little impact within educational contexts to date. In response, this paper therefore presents an introduction to personal coaching practice and its outcomes and examines its processes through a discussion of learning theory. In doing so, it demonstrates the learning value inherent within the coaching framework and challenges educators to consider its potential as a model for active, collaborative, authentic and engaging learning.

Peer coaching as a technique to foster professional development in clinical ambulatory settings

Article

Full-text available

Feb 2003

Few studies have examined how peer coaching is an effective educational and development technique in contexts outside the classroom. This research focused on peer coaching as a platform to study the process of professional development for physicians. The purpose was to identify perceived benefits coaches received from a coaching encounter and how this relates to their own process of professional development. Critical incident interviews with 13 physician coaches were conducted and tape recorded. Themes were identified using a thematic analysis technique. Themes emerged clustering around two distinct benefit orientations. Group 1, reflection and teaching coaches, tended to focus on others and discuss how positively they experienced the encounter. Group 2, personal learning and change coaches, expressed benefits along more personal lines. Peer coaching contributes to physicians' professional development by encouraging reflection time and learning. Peer coaching affords positive impact to those who coach in addition to those who receive the coaching. The two clusters of benefits support the performance, learning, and development theory in that there are multiple modes to describe adult growth and development. Programs of this type should be considered in medical faculty development activities associated with medical education.

Does 'peer coaching' increase GP capacity to promote informed decision making about PSA screening? A cluster randomised trial

Article

Full-text available

Jun 2005

Very little effort has been directed to enable GPs to better informed decisions about PSA screening among their male patients. To evaluate an innovative programme designed to enhance GPs' capacity to promote informed decision making by male patients about PSA screening. The study design was a cluster randomised controlled trial set in New South Wales, Australia's most populous state. 277 GPs were recruited through a major pathology laboratory. The interventions were three telephone-administered 'peer coaching' sessions integrated with educational resources for GPs and patients and the main outcome measures were: GP knowledge; perceptions of patient involvement in informed decision making; GPs' own decisional conflict; and perceptions of medicolegal risk. Compared with GPs allocated to the control group, GPs allocated to our intervention gained significantly greater knowledge about PSA screening and related information [Mean 6.1 out of 7; 95% confidence interval (CI) = 5.9-6.3 versus 4.8; 95% CI = 4.6-5.0; P < 0.001]. They were less likely to agree that patients should remain passive when making decisions about PSA screening [Odds ratio (OR) = 0.11; 95% CI = 0.04-0.31; P < 0.001]. They perceived less medicolegal risk when not acceding to an 'uninformed' patient request for a PSA test (OR = 0.31; 95% CI 0.19-0.51). They also demonstrated lower levels of personal decisional conflict about the PSA screening (Mean 25.4; 95% CI 24.5-26.3 versus 27.8; 95% CI 26.6-29.0; P = 0.0002). A 'peer coaching' programme, supplemented by education materials, holds promise as a strategy to equip GPs to facilitate informed decision making amongst their patients.

A systematic review of peer learning in clinical education

Article

Full-text available

Apr 2008

Jacinta Secomb

The purpose of this review is to provide a framework for peer teaching and learning in the clinical education of undergraduate health science students in clinical practice settings and make clear the positive and negative aspects of this teaching and learning strategy. The practice of using peers incidentally or purposefully in the clinical education of apprentice or undergraduate health science students is a well-established tradition and commonly practiced, but lacks definition in its implementation. The author conducted a search of health science and educational electronic databases using the terms peer, clinical education and undergraduate. The set limitations were publications after 1980 (2005 inclusive), English language and research papers. Selection of studies occurred: based on participant, intervention, research method and learning outcomes, following a rigorous critical and quality appraisal with a purposefully developed tool. The results have been both tabled and collated in a narrative summary. Twelve articles met the inclusion criteria, representing five countries and four health science disciplines. This review reported mostly positive outcomes on the effectiveness of peer teaching and learning; it can increase student's confidence in clinical practice and improve learning in the psychomotor and cognitive domains. Negative aspects were also identified; these include poor student learning if personalities or learning styles are not compatible and students spending less individualized time with the clinical instructor. Peer teaching and learning is an effective educational intervention for health science students on clinical placements. Preclinical education of students congruent with the academic timetable increases student educational outcomes from peer teaching and learning. Strategies are required prior to clinical placement to accommodate incompatible students or poor student learning. The findings from this systematic review, although not statistically significant, do have pragmatic implications for clinical practice. It can increase clinical placement opportunities for undergraduate health students, assist clinical staff with workload pressures and increase clinician time with clients, while further developing students' knowledge, skills and attitudes.

Peer-Assisted Learning in Clinical Education: A Review of Terms and Learning Principles

Article

Jan 2000

Richard K Ladyshewsky

Maximize performance through an ongoing dialogue with employees

Article

Jan 2000
Nurs Manag

Vicki D. Lachman

: Learn to read your employees' perspectives and recognize the personal traits that may impede professional performance. Then start a coaching dialogue to set goals together and reach them.

Coaching isn't Just for Athletes: The Role of Teacher Leaders

Article

Jun 2001
PHI DELTA KAPPAN

Ellen Guiney

The Evolution of Peer Coaching

Article

Mar 1996
EDUC LEADERSHIP

Educational Leadership, March 1996 v53 n6 p12(5) Today, peer coaching study teams enhance staff development efforts and offer support for teachers implementing new strategies. Fifteen years have passed since we first proposed peer coaching as an on-site dimension of staff development (Joyce and Showers 1980). In the 1970s, evaluations of staff development that focused on teaching strategies and curriculum revealed that as few as 10 percent of the participants implemented what they had learned. Rates of transfer were low even for those who had volunteered for the training. Well-researched curriculum and teaching models did not find their way into general practice and thus could not influence students' learning environments. In a series of studies beginning in 1980, we tested hypotheses related to the proposition that regular (weekly) seminars would enable teachers to practice and implement the content they were learning. The seminars, or coaching sessions, focused on classroom implementation and the analysis of teaching, especially students' responses. The results were consistent: Implementation rose dramatically, whether experts or participants conducted the sessions. Thus we recommended that teachers who were studying teaching and curriculum form small peer coaching groups that would share the learning process. In this way, staff development might directly affect student learning. Our central concern has been helping students benefit when their teachers learn, grow, and change. In studying how teachers can create better learning environments for themselves (Joyce and Showers 1995), we noted with interest a serendipitous by-product of the early peer coaching studies: Successful peer coaching teams developed skills in collaboration and enjoyed the experience so much that they wanted to continue their collegial partnerships after they accomplished their initial goals. Why not create permanent structures, we wondered, that would enable teachers to study teaching on a continuous basis? In working with this broadened view of peer coaching as a mechanism to increase classroom implementation of training, we evolved our present practice of organizing entire faculties into peer coaching teams. We have been convinced throughout that peer coaching is neither an end in itself nor by itself a school improvement initiative. Rather, it must operate in a context of training, implementation, and general school improvement. There is no evidence that simply organizing peer coaching or peer study teams will affect students' learning environments. The study of teaching and curriculum must be the focus. Here we examine the history of coaching, describe changes in the conduct of coaching, and make recommendations for its future, including its role as a component of staff development that drives organizational change.

Trends in Peer Learning

Article

Dec 2005

Keith Topping

Developments in forms of peer learning 1981–2006 are reviewed, focusing mainly on peer tutoring, cooperative learning, and peer assessment. Types and definitions of peer learning are explored, together with questions of implementation integrity and consequent effectiveness and cost‐effectiveness. Benefits to helpers are now emphasised at least as much as benefits to those helped. In this previously under‐theorised area, an integrated theoretical model of peer learning is now available. Peer learning has been extended in types and forms, in curriculum areas and in contexts of application beyond school. Engagement in helping now often encompasses all community members, including those with special needs. Social and emotional gains now attract as much interest as cognitive gains. Information technology is now often a major component in peer learning, operating in a variety of ways. Embedding and sustainability has improved, but further improvement is needed.

Peer Coachng in Clinical TeachingFormative Assessment of a Case

Article

Sep 1994

Increasingly, medical education, and family medicine in particular, is focusing on improving clinical teaching. Peer coaching represents one alternative for improving and enhancing instruction. It enhances clinicians' understanding and use of new skills by demonstration, practice, and nonevaluativefeedback from their colleagues. This article introduces the idea of peer coaching as an approach to faculty development. It uses a l'/2-yearformative assessment of one family physician's teaching practices and beliefs to describe the process.

Reciprocal peer coaching and its use as a formative assessment strategy for first‐year students

Article

Jul 2010

Mandy Asghar

Co‐operative learning is underused as a teaching and learning strategy in higher education and yet is ideal for courses that require students to learn skills that require manual dexterity, knowledge and clinical reasoning – key elements of professional and clinical competence. Reciprocal peer coaching (RPC) is a form of co‐operative or peer‐assisted learning that encourages individual students in small groups to coach each other in turn so that the outcome of the process is a more rounded understanding and a more skilful execution of the task in hand than if the student was learning in isolation. Used as a formative assessment strategy, RPC has the capacity to increase motivation in students due to the nature of the shared interdependent goal, and to provide immediate feedback to students on completion of the assessment. The purpose of this research was to interview a group of first‐year students to elicit their perceptions of the RPC process. The data were analysed from a phenomenological perspective and revealed three themes: motivating learning, learning in groups and the context of learning. The findings were subsequently explored in relation to the concept of self‐regulation of learning and the benefits which RPC as a formative assessment strategy has in promoting students’ self‐regulation.

Scoping Studies: Towards a Methodological Framework

Article

Feb 2005

This paper focuses on scoping studies, an approach to reviewing the literature which to date has received little attention in the research methods literature. We distinguish between different types of scoping studies and indicate where these stand in relation to full systematic reviews. We outline a framework for conducting a scoping study based on our recent experiences of reviewing the literature on services for carers for people with mental health problems. Where appropriate, our approach to scoping the field is contrasted with the procedures followed in systematic reviews. We emphasize how including a consultation exercise in this sort of study may enhance the results, making them more useful to policy makers, practitioners and service users. Finally, we consider the advantages and limitations of the approach and suggest that a wider debate is called for about the role of the scoping study in relation to other types of literature reviews.

Leadership coaching in health care

Article

Apr 2006
Leader Organ Dev J

Purpose – Medicine is undergoing dramatic changes that will alter its basic organizational structure. The integration of evidence‐based medicine, patient centered care, and the electronic medical record into medical practice will necessitate innovative approaches to management. Design/methodology/approach – A review of the literature was undertaken to assess the current state of leadership coaching for physicians and non‐medical health care leaders. Different models of leadership coaching are described and examined. Findings – Leadership coaching has been an underutilized resource in health care executive training. The use of coaching methods has been of great utility for physician and non‐medical managerial leadership. Health care leaders will need to develop interpersonal and emotional intelligence competencies in order to successfully run increasingly complex organizations. Originality/value – To encourage further quantitative studies of coaching in the health care field. Such studies would be significantly helpful in elucidating those approaches to coaching that yield the best results. Encouraging the greater use of leadership coaching by medical executives can be of potentially important benefit to the successful operation of their institutions.

Low-Cost Arrangements for Peer-Coaching

Article

Jan 1987

The concept of peer coaching of teaching is discussed and specific, low-cost strategies are recommended to support peer coaching. (Author)

Peer Coaching

Article

Jun 1991

James Batesky

Presents three types of peer coaching as a staff development approach for physical educators that is usable at all levels on an individual, school, or districtwide basis. Peer coaching helps teachers feel less isolated, use educational practices effectively, use educational reflection positively, and develop professional collegiality. (SM)

Executive Coaching: A Continuum of Roles

Article

Mar 1996

Some executives use coaching to learn specific skills, others to improve performance on the job or to prepare for advancement in business or professional life. Still others see coaching as a way to support broader purposes, such as an executive's agenda for major organizational change. To an outsider, these coaching situations may look similar. All are based on an ongoing, confidential, one-on-one relationship between coach and executive. Yet each coaching situation is different and some of these distinctions are important to recognize, if only to foster informed choice by everyone involved. This article defines and explores key distinguishing features among coaching situations encountered in daily practice. Taking account of these factors, the authors suggest 4 distinctly different coaching roles. Case examples explore how these roles apply to common coaching issues facing executives and their organizations today. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Using Clinical Peer Coaching for Patient Safety

Article

Aug 2012

Laura Maynard

Implementing the Leadership Development Plans of Faculty Education Fellows: A Structured Approach

Article

Jul 2012

The literature about medical education faculty fellowship programs, which have grown in popularity, quantifies program characteristics, provides exemplars, and reports on delivery strategies. Evaluation is generally limited to satisfaction measures, with a few longitudinal studies of postprogram achievements, but none on the process of making these changes.The authors describe the development of faculty members' postfellowship leadership plans and a structured process to support plan implementation. They also compare the implementation of initiatives specified in individual leadership development plans of two cohorts of faculty. The participants were graduates of a fellowship program at the George Washington University School of Medicine and Health Sciences. One cohort participated in a structured process of monthly reciprocal peer coaching, followed by journaling and quarterly interviews with the program director; a second cohort functioned as a comparison with no structured process supporting them. (Study years are not provided because they could inadvertently lead to the identification of the participants.) Despite similar implementation challenges expressed by both cohorts, the cohort participating in the structured process implemented 23% more of their planned initiatives, including 2 times as many educational leadership initiatives and 3.5 times as many initiatives related to developing new curriculum. The combination of plan development, reciprocal peer coaching, journaling, and interview discussions provided faculty with focus, structure, and personal support. This structured process supporting leadership plan development and implementation can be easily transferred to other fellowship programs in medical education, adapted for use with residents and fellows, and used in similar development programs.

Transformative Learning: Theory to Practice

Article

Jun 1997
New Dir Adult Cont Educ

Jack Mezirow

Critical and autonomous thinking must take precedence over the uncritical assimilation of knowledge. Transformative learning is a route to the development of critical thinking.

Building cooperation in peer coaching relationships: understanding the relationships between reward structure, learner preparedness, coaching skill and learner engagement

Article

Mar 2006
PHYSIOTHERAPY

Richard K. Ladyshewsky

This paper outlines several of the key drivers that influence whether learners engage in cooperative, competitive or individualistic behaviour when aligned together in a peer coaching relationship. Reward structures are integral to driving cooperative behaviour. These structures can be implemented by designing instructional activities more strategically, which encourages learners to pursue joint goals while still remaining individually accountable for their performance. Similarly, learner preparedness for peer coaching is critical and skills development is necessary for success. Strategies for reducing the impact of competitive or individualistic behaviour are presented. By examining the literature on cooperative learning, reward structures and peer coaching, this paper provides a practical and evidence-based perspective that will support instructors in developing high-quality cooperative learning systems.

Peer Coaching and Mentoring: A New Model of Educational Intervention for Safe Patient Handling in Health Care

Article

Aug 2011
AM J IND MED

To reduce the risk of patient handling-related musculoskeletal injury, overhead ceiling lifts have been installed in health care facilities. To increase ceiling lift usage for a variety of patient handling tasks, a peer coaching and mentoring program was implemented among the direct care staff in the long-term care subsector in British Columbia, Canada. They received a 4-day training program on body mechanics, ergonomics, patient-handling techniques, ceiling lift usage, in addition to coaching skills. A questionnaire was administered among staff before and after the intervention to evaluate the program's effectiveness. There were 403 and 200 respondents to the pre-intervention and post-intervention questionnaires. In general, staff perceived the peer-coaching program to be effective. The number of staff who reported to be using ceiling lifts "often and always" went higher from 64.5% to 80.5% (<0.001) after coaching program implementation. Furthermore, staff reported that they were using the ceiling lifts for more types of tasks post-intervention. Staff reported that the peer coaching program has increased their safety awareness at work and confidence in using the ceiling lifts. The findings suggest that this educational model can increase the uptake of mechanical interventions for occupational health and safety initiatives. It appears that the training led to a greater awareness of the availability of or increased perceptions of the number of ceiling lifts, presumably through coaches advocating their use.

Developing Unit-Focused Peer Coaches for the Clinical Setting

Article

Feb 2011

In teaching, nursing management, and professional development, the traditional one-to-one approach is used in the peer coach relationship. In clinical environments, the use of peer coaches is a creative way to implement practice change. Tailoring the concept of peer coaching to consider the dynamics and structure of the clinical environment is essential. This article describes the use of a change model in the preparation of peer coaches for safe patient handling in an acute care setting. Unit-focused peer coach preparation includes multiple teaching techniques, such as lecture, hands-on experience, and scripting. Unit-focused peer coaches are a helpful adjunct to nursing staff development.

Building competency in the novice allied health professional through peer coaching

Article

Jun 2010

Richard K. Ladyshewsky

The development of competence is an ongoing journey, and one that is particularly punctuated in the early part of a health professional's career. These novice practitioners need to recognize that the challenges inherent in building competency might be resolved more readily by engaging with peers. This paper outlines what it means to be a novice practitioner, and how peer coaching can be used to support professional development in the allied health sciences. An overview of the reasoning process and how peer coaching and experiential learning can be used to build competence is described. A structured and formal approach to peer coaching is outlined in this paper. Novices who embrace this professional development strategy will find the model of coaching practice and underlying strategies described in this paper beneficial to their experience. The importance of formalizing the process and the underlying communication skills needed for coaching are described in detail with accompanying examples to illustrate the model in practice.

Student Achievement Through Staff Development

Article

Jan 1988

Incl.bibl.p.175-187

Using scoping literature reviews as a means of understanding and interpreting existing literature

Article

Jan 2010

This article compares and contrasts scoping literature reviews with other established methods for understanding and interpreting extant research literature. Descriptions of the key principles and applications of scoping reviews are illustrated with examples from contemporary publications. Scoping reviews are presented as an efficient way of identifying themes and trends in high-volume areas of scientific inquiry.

A quasi-experimental study of the differences in performance and clinical reasoning using individual learning versus reciprocal peer coaching

Article

Jan 2002

Richard K. Ladyshewsky

Peer assisted learning such as Reciprocal Peer Coaching (RCP) is being used more frequently in the clinical education of physiotherapists. The efficacy of this learning approach on clinical performance and reasoning, however, has not been evaluated with much rigour. The purpose of this research is to measure the impact of this method on clinical performance and reasoning in two groups of students. One group examined a simulated patient (SP) individually. The other group examined the SP as a reciprocal peer coaching (RPC) dyad. Sixty-two third year physiotherapy students participated in this study. Twenty individual students and twenty-one dyads each evaluated a SP with shoulder pathology. Clinical performance and reasoning were measured. Students in the RPC group significantly outperformed their peers in the individual learning group in the categories of physical examination, communication, and clinical reasoning. The cognitive support that RPC provides novices during patient encounters is a valuable educational support tool. By incorporating more peer coaching in clinical education environments, it is possible to influence the clinical performance and reasoning of novices in a positive manner, thus enhancing the development of clinical competency.

Peer coaching as an approach to faculty development

Article

Dec 2009
MED TEACH

Effects of a Multifaceted Minimal-Lift Environment for Nursing Staff: Pilot Results

Article

Nov 2009
WESTERN J NURS RES

Nursing staff are at risk for musculoskeletal injuries because of the physical nature of patient handling. The purpose of this study is to examine the effectiveness of a multifaceted minimal-lift environment on reported equipment use, musculoskeletal injury rates, and workers' compensation costs for patient-handling injuries. The pilot study consists of a mixed measures design, with both descriptive and quasi-experimental design elements. The intervention consists of engineering (minimal-lift equipment), administrative (nursing policy), and behavioral (peer coach program) controls. The comparison nursing unit has received engineering controls only. The convenience sample includes nursing staff employed on two medical-surgical nursing units, who provide direct patient care at least 50% of the time. Nursing staff employed in a multifaceted lift environment report greater lift equipment use and experience less injury, with reduced worker's compensation costs.

Peer coaching in clinical teaching: a case report

Article

Nov 1994
FAM MED

Peer coaching is a method for improving teaching skills that was developed for use in general educational classroom settings. Key elements of peer coaching include the identification of specific goals for improving teaching skills, focused observation of teaching by colleagues, and the provision of feedback, analysis, and support. As part of a faculty development project, we adapted peer-coaching methodology to the clinical teaching setting. This report describes the experiences of two family physicians who have served as peer coaches for each other over the past 2 years. The participating physicians report enthusiastically about their experiences with peer coaching as a method for personalized faculty development. They report more self-awareness of their clinical teaching behaviors, the ability to improve specific teaching skills, and the rewards of a collaborative relationship between colleagues.

Peer Coaching: Building Collegial Support for Using Innovative Health Programs

Article

Mar 1993

Phyllis Levenson Gingiss

To ensure students achieve intended benefits from effective health programs, it is necessary to maximize program implementation and maintenance. Peer coaching provides a post-inservice staff development approach for health educators to strengthen teacher use of new health programs during implementation trials. While peer coaching positively influences teacher behavior and student outcomes, previous coaching programs have been limited in scope, have not been theoretically derived or adequately evaluated, and have not been systematically applied to health programs. This paper addresses teacher needs during trials, reviews peer coaching program features, and proposes a model to guide future planning, evaluation, and research. In this model, critical components of the coaching program include classroom assessments, coaching team cluster meetings, and administrative support. Strategies based on Social Learning Theory and Diffusion Theory are incorporated into the peer coaching program to influence teacher perceptions of their work roles, capability to implement a program, and commitment to the new instructional program. Interrelations among components are discussed and directions for future research and practice are suggested.

Enrich your performance coaching techniques

Article

Feb 2000
Nurs Manag

V D Lachman

Learn to read your employees' perspectives and recognize the personal traits that may impede professional performance. Then start a coaching dialogue to set goals together and reach them.

The Skills of Coach are an Essential Element in Clinical Learning

Article

Jun 2000

Laurie Grealish

Students learn about the nursing profession through experience and close association with expert practitioners. It has been found repeatedly that expert nurses as clinical teachers "coach" students to realize their full potential. The steps of coaching have been described here to provide guidelines for clinicians new to the teaching role. The activity of coaching in clinical education is worthy of further investigation. Not only do students develop confidence in psychomotor skills, coaching appears to facilitate scholarship in the clinical setting. Skilled coaches encourage students to form meaningful, coherent theoretical frameworks for the information gathered. Without the support of a coach, students would continue to adhere to familiar views of the world and accept the clinical world as it presents itself without healthy scepticism or the ability to be creative. Cognitive coaching is not a separate activity to psychomotor coaching. Together both strategies offer a unique, and to date a poorly described, method to communicate practice knowledge to the nursing student. The ultimate benefit of coaching is the ability to instill in the student the motivation to improve performance and strive for excellence.

Preceptorsʼ Use of Reflection to Teach in Ambulatory Settings

Article

Oct 2000
ACAD MED

Reflection on one's teaching behavior is a means to question teaching events to bring teaching actions to a conscious level, to interpret the consequences of those actions, and to conceptualize alternative teaching actions. Ambulatory teaching settings are variable, unpredictable, and discontinuous, often resulting in less focused teaching. The authors sought to measure the level of reflection on teaching used by preceptors to plan teaching in these settings. Three preceptors who had participated in the Case Western Reserve University's peer-coaching program each answered four questions about how they planned to respond to two teaching case studies. The questions were posed by a medical educator who, for three of the four questions, also prompted the preceptors to stimulate their reflection. The audiotaped responses were assessed using Sparks-Langer and Colton's framework for reflective thinking. The levels of reflective thinking increased after prompting, but they did not exceed the rather low technical and practical levels, particularly for the more complex of the two cases. This exploratory intervention suggests that faculty rely more on external and non-reflective levels of thought when planning to teach in the ambulatory setting. The authors recommend further research to foster discussions about the cognitive processes involved in planning for teaching in this setting.

Differences in ambulatory teaching and learning by gender match of preceptors and students

Article

Nov 2000
FAM MED

Important differences exist in traditional medical education by gender of the teachers and learners. Much less is known about how gender influences educational experiences in community-based ambulatory settings. In this study, we explored how community-based teaching and learning varies by gender of the students and preceptors. This prospective study used both paper- and computer-based documentation systems to collect information on student-patient-preceptor encounters. A consecutive sample of third-year medical students contributed data on one full clinical day each week as they rotated through a required 8-week family medicine clerkship. The main measures of interest included patient age and gender, health care visit type (acute, acute exacerbation of chronic, chronic, and health maintenance), method of learning in history taking and physical examinations (observing preceptor, being observed by preceptor, performing unobserved, or working jointly with preceptor), content of physical examinations, amount of preceptor feedback, preceptor teaching content, and gender of the students and their preceptors. Ninety-three students contributed data on 5,017 patient encounters. The distribution of encounters by student-preceptor dyad included: 1,926 (38%) female students with male preceptors. 1,716 (34%) male students with male preceptors, 841 (17%) female students with female preceptors, and 534 (11%) male students with female preceptors. We found that female preceptors conduct more complete physical exams with students than do male preceptors (28% versus 23%). Female students with male preceptors devoted more encounters to observation only than any other dyad (20% versus 12%), and female preceptors are more likely than male preceptors to allow students to perform unobserved (70% versus 59%). Patient gender played little if any role in how students and their preceptors worked together. Differences of potential importance were found in teaching and learning by gender of the student-preceptor dyad. This factor can and should be considered when determining how students can best meet educational objectives in community-based ambulatory settings.

Peer Coaching

Article

Sep 2001
NURS EDUC

Coaching your unit team for results

Article

Oct 2002

Sarah S Detmer

Communication and critical thinking skills are core to the coaching processes. Bringing the coaching role to the individual and team level at the bedside is the key to improved results in patient care, nurse retention, clinical performance including error reduction, negotiation, and staff empowerment. Application of coaching concepts where the nurse meets the patient insures the growth and effectiveness of a coaching culture. Clinical review, individual communication, and teamwork examples are explored as effective arenas for coaching at the unit level.

Peer Coaching: The Next Step in Staff Development

Article

Mar 2005

A common problem in continuing nursing education and staff development is the transfer of learning to clinical practice. Peer coaching offers a solution to this problem. Initiated by educators, peer coaching has been researched in educational settings and found to be effective in facilitating the transfer of newly acquired knowledge and skill into classroom teaching strategies. This article describes the background, components, process, characteristics, and benefits of peer coaching. A specific example of using peer coaching to teach clinical breast examination skills is used to illustrate the application of peer coaching to the staff development of healthcare professionals. Peer coaching is the next step in nursing staff development.

Coaching for clinicians

Article

May 2005
Nurs Manag UK

Peer coaching shows promise for residents as teachers

Article

May 2006
FAM MED

Using an Executive Coach to Increase Leadership Effectiveness

Article

Jul 2006
J NURS ADMIN

Senior executive nursing roles demand excellence and rigor in both the technical and interpersonal domains of leadership. Many nurse leaders have begun seeking innovative self-development programs and practices to assist them as they strive to improve their effectiveness as leaders in complex organizations. One practice that has gained in popularity is that of engaging a leadership "coach." To understand this relatively new trend in healthcare leadership, the authors interviewed 4 coaches and 4 nurse leaders who had been coached. In this article, they present their overall findings about the effectiveness of coaching as a leadership development tool and offer recommendations for leaders who are interested in engaging a coach.

Building Leadership Capacity through Peer Career Coaching: A Case Study

Article

Feb 2008

Today's demanding healthcare environment requires resiliency, creativity and innovation in delivery of patient care and service. Hospitals must create a workplace where staff are supported to develop professionally as knowledge workers. In 2003, University Health Network (UHN) partnered with donnerwheeler, career planning and development consultants, to provide a program for its 2,700 registered nurses. One component of this project, a peer coaching program called Coach Mastery, is profiled in this case study, which describes how it was implemented and the successes, challenges and outcomes in building internal leadership capacity and supporting staff development through career planning and development.

School-based coaching. A revolution in professional development - or just the latest fad?

A Russo

Russo A. 2004. School-based coaching. A revolution in professional development -or just the latest fad? Harv Educ Lett 20:1-4, July/August.

Peer coaching in clinical teaching

F P Hekelman
S P Flynn
P B Glover
S S Galazka
J A Phillips

Hekelman FP, Flynn SP, Glover PB, Galazka SS, Phillips Jr JA. 1994. Peer coaching in clinical teaching. Eval Health Prof 17:366-381.

Study: Missouri's ed-tech program is raising student achievement. eSchool News Online Peer coaching

Jan 2001
212-214

C Branigan
Dj Saunders

Branigan C. 2002. Study: Missouri's ed-tech program is raising student achievement. eSchool News Online. [Accessed 25 April 2006] Available from http://www.eschoolnews.com/news/showStory.cfm? ArticleID=3673 Broscious SK, Saunders DJ. 2001. Peer coaching. Nur Ed 26:212–214.

Peer-coaching with health care professionals: What is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review

Abstract

No full-text available