180 - Teaching Pediatric Residents Coaching Skills: A Needs Assessment

Publication Number: 180.6585

Isaac Mayefsky, Washington University in St. Louis School of Medicine, University City, MO, United States; Rachel Moquin, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Oloruntosin Adeyanju, Nemours Children's Hospital, Wilmington, DE, United States

Background: The term “coaching” appears over 15 times in the current ACGME milestones for Pediatric Residency. This is consistent with literature suggesting that trainees may benefit from a mode of pedagogy loosely referred to as “coaching,” but there is a paucity of published curricula for teaching residents coaching skills. An additional complication is that applications of “coaching” vary according to the theoretical frameworks in which they are constructed.

Objective: In line with Kern's 6-steps, we performed a targeted needs assessment of our pediatric residents in preparation of designing a coaching curriculum to teach senior residents (SR) coaching skills to use with interns during their supervisorial rotations. With this curriculum, we hope to: 1) help SR achieve required milestones, 2) provide skills that will lead to more personalized intern improvement, 3) provide opportunities for interns to practice becoming Master Adaptive Learners.

Design/Methods: This was a sequential explanatory mixed-methods needs assessment, using a goal-oriented approach to coaching grounded in Control Theory and employing Self-Determination Theory. We distributed a survey about skills and attitudes in the realm of coaching interns amongst our pediatric residents. Additionally, convenience and purposive sampling of residents were used to recruit volunteers for semi-structured interviews to better understand motivations in engaging in intern improvement. Thematic analysis with inductive coding was used to analyze the transcripts and reach thematic saturation.

Results: 41 residents (36%) responded to our survey. Most residents felt that the goal-oriented coaching steps of goal setting, plan development, and plan follow-up were important. They were also confident in their ability to employ these steps. However, residents agreed that these steps were only sometimes or rarely employed. (Table 1)
15 semi-structured interviews of residents were performed. Initial themes focus on: 1) the impact that autonomy and relatedness have on SR motivation to deliver feedback to interns, 2) the barrier and boon of time, and 3) factors of external regulation, such as a sense of lacking of expectations. (Tables 2–3)

Conclusion(s): Residents recognize the importance of employing skills that fall within goal-oriented coaching, but lack the motivation to frequently use them due to issues of autonomy, relatedness, time, and an absence of expectations. We plan to develop a goal-oriented coaching curriculum with a focus on these concerns in the hope of helping SR achieve ACGME coaching milestones and encouraging their involvement in intern improvement.

Table 1: Survey of Pediatric Residents
Survey of pediatric residents regarding skills and attitudes in the context of goal-oriented coaching

Table 2: Semi-Structured Interview Excerpts, Part 1
Interview excerpts addressing themes of relatedness, intern-driven conversations, and senior resident autonomy in the context of improvement conversations between senior residents and interns

Table 3: Semi-Structured Interview Excerpts, Part 2
Interview excerpts addressing themes of time barriers, frequency of senior-intern interactions ("time as a boon"), and extrinsic regulation in the context of improvement conversations between senior residents and interns

Table 1: Survey of Pediatric Residents
Survey of pediatric residents regarding skills and attitudes in the context of goal-oriented coaching

Table 2: Semi-Structured Interview Excerpts, Part 1
Interview excerpts addressing themes of relatedness, intern-driven conversations, and senior resident autonomy in the context of improvement conversations between senior residents and interns

Table 3: Semi-Structured Interview Excerpts, Part 2
Interview excerpts addressing themes of time barriers, frequency of senior-intern interactions ("time as a boon"), and extrinsic regulation in the context of improvement conversations between senior residents and interns