Article:

Carlson K, Ashford A, Hegagi M, Vokoun. “Peer Coaching as a Faculty Development Tool: A Mixed Methods Evaluation.” J Grad Med Educ 12.2 (2020): 168-175. doi: 10.4300/JGME-D-19-00250.1.

Summary:

Graduate medical education faculty are generally enthusiastic about teaching, but many lack formal educational training. The authors of this paper implemented a peer-coaching intervention involving peer observation and feedback in routine inpatient clinical teaching settings. Participants reacted positively to the program and felt it was beneficial for them when serving as coaches and when being observed. The authors concluded that this peer-coaching program was feasible, acceptable to faculty, may have improved individual teaching effectiveness. For this blog post, Stephen Doyle interviewed first and last authors Kristy Carlson and Chad Vokoun.

Interview:

SD: What peaked your interest in researching peer coaching? How did you come up with the idea for this study?

CV:  I feel clinical educators lack feedback to improve their teaching skills.  A few years back, one of my partners and I “split” a month of teaching service and watched each other teach.  It was amazing and extremely valuable.  This led to my idea of peer observation and formal feedback of clinical teaching skills.

SD: You discuss that many educators do not have pedagogical training in medical education and their own training was different than our current education model. Do you feel it is necessary to formally teach these educators about adult learning theory and optimal ways to teach during rounds is something that could be learned informally?

KC: Teaching during rounds is a complex task that requires educators to engage learners and empower them as valuable members of the team. Developing the skills to become a "master attending" is a longitudinal process. It may be helpful to deliver formal faculty development in the short-term; however, an organized and structured approach is more effective. Faculty development activities could be delivered in "bite-size" pieces via email, video, or at department meetings. For example, information regarding generational differences could be presented in a group meeting followed by one-on-one sharing of the strategies that could be used to improve teaching skills. It is also critical to provide training and learning tools such as chat rooms, just-in-time feedback, and activities (i.e., journal club) based on clinically relevant topics.

CV:  I think formal and informal education about adult learning theory is needed.  Most of our educators are great doctors first and we mimic effective skills that we have seen from our teachers.  I agree with Dr. Carlson that bite size pieces are best.  The nice thing about peer observation is it links learning with the day to day activities of clinical teachers.

SD: You mentioned time being a potential limiting factor for some participants. What are other barriers to peer coaching that you have see

KC: The hospitalist division at our institution is growing at a rapid pace and many of the attending physicians had limited experience in that type of leadership role. A few were reluctant to be observed by others. This was the reason we chose to separate the early career physicians from the experienced faculty.

CV:  Feeling comfortable giving feedback to peers can be challenging.  Recording actionable observations is a challenge as well.  Using the Stanford Faculty Development Program tool as a base helped a lot (https://pubmed.ncbi.nlm.nih.gov/9653408/).

SD: What suggestions do you have for an institution attempting to implement a peer coaching faculty development program? What barriers have you seen with this? Do you have any advice to overcome these barriers?

KC: Since time was a major barrier in implementing this type of program, reducing the number and intensity of activities would be helpful. Our participants attending an opening meeting, observed a peer three or four times, attended a one hour debrief, and some attended a focus group. A simple peer coaching program could involve observing a few peers in the attending role and holding a structured group debrief session to share ideas.

CV:  A needs assessment and rallying enthusiasm will help.  Having leadership set aside some protected time will show how committed you are to improvement of your faculty.

SD: Has this program at your institution continued since the study has been completed? Has it been implemented into a standard faculty development program?

KC: Unfortunately, this program has not continued at our institution due to shifting resources and the logistical requirements to coordinate it.

CV:  We are working on implementing coaching and peer observation across the campus through our career development resources. Unfortunately, COVID-19 has put this on hold.

 

Blog post author

Stephen Doyle, MD, MBA is an Assistant Professor of Medicine at Spectrum Health-Michigan State University College of Human Medicine. He graduated medical school from Kansas City University of Medicine and Biosciences and obtained his MBA in healthcare leadership from Rockhurst University. He completed residency in Internal Medicine at the University of Kansas and fellowship in Pulmonary and Critical Care Medicine at Ohio State University. His interests include end-stage lung disease, critical care medicine, and medical education. He currently serves on the American Thoracic Society Section of Medical Education Social Media Subcommittee and the Training and Transitions Committee for the American College of CHEST Physicians.

Twitter: @stevedoyle85

 

 

Article authors

Kristy Carlson, PhD is the Otolaryngology Director of Research and Scholarship Development at the University of Nebraska Medical Center College of Medicine. Dr. Carlson is responsible for mentoring clinicians, residents, and medical students by guiding them through department research projects from planning to publication. Her professional background includes over 20 years in teaching, education research, marketing, and information technology. She enjoys volunteering, family activities, is an avid fan of Sci-Fi, and a LEGO enthusiast. 

Twitter: @kristycarlsonnu1

 

 

Chad Vokoun, MD is the Section Chief for Hospital Medicine at the University of Nebraska Medical Center / Nebraska Medicine.  He completed medical school, residency training and a Chief Resident year at UNMC.  Dr. Vokoun has been awarded many campus wide teaching awards and is very interested in innovations in education.