Impact of a coaching program on resident perceptions of communication confidence and feedback quality

Carl A Gold; Rachel Jensen; Marzena Sasnal; Heather S Day; Rebecca K Miller-Kuhlmann; Rebecca L Blankenburg; Caroline E Rassbach; Arden M Morris; James R Korndorffer Jr; Aussama K Nassar

doi:10.1186/s12909-024-05383-5

Impact of a coaching program on resident perceptions of communication confidence and feedback quality

BMC Med Educ. 2024 Apr 22;24(1):435. doi: 10.1186/s12909-024-05383-5.

Affiliations

¹ Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
² Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA.
³ Department of Surgery, Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Stanford University School of Medicine, Stanford, CA, USA.
⁴ Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
⁵ Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3639, Stanford, CA, 94305, USA. nassara@stanford.edu.

^# Contributed equally.

Abstract

Background: While communication is an essential skill for providing effective medical care, it is infrequently taught or directly assessed, limiting targeted feedback and behavior change. We sought to evaluate the impact of a multi-departmental longitudinal residency communication coaching program. We hypothesized that program implementation would result in improved confidence in residents' communication skills and higher-quality faculty feedback.

Methods: The program was implemented over a 3-year period (2019-2022) for surgery and neurology residents at a single institution. Trained faculty coaches met with assigned residents for coaching sessions. Each session included an observed clinical encounter, self-reflection, feedback, and goal setting. Eligible residents completed baseline and follow-up surveys regarding their perceptions of feedback and communication. Quantitative responses were analyzed using paired t-tests; qualitative responses were analyzed using content analysis.

Results: The baseline and follow-up survey response rates were 90.0% (126/140) and 50.5% (46/91), respectively. In a paired analysis of 40 respondents, residents reported greater confidence in their ability to communicate with patients (inpatient: 3.7 vs. 4.3, p < 0.001; outpatient: 3.5 vs. 4.2, p < 0.001), self-reflect (3.3 vs. 4.3, p < 0.001), and set goals (3.6 vs. 4.3, p < 0.001), as measured on a 5-point scale. Residents also reported greater usefulness of faculty feedback (3.3 vs. 4.2, p = 0.001). The content analysis revealed helpful elements of the program, challenges, and opportunities for improvement. Receiving mentorship, among others, was indicated as a core program strength, whereas solving session coordination and scheduling issues, as well as lowering the coach-resident ratio, were suggested as some of the improvement areas.

Conclusions: These findings suggest that direct observation of communication in clinical encounters by trained faculty coaches can facilitate long-term trainee growth across multiple core competencies. Future studies should evaluate the impact on patient outcomes and workplace-based assessments.

Keywords: Coaching; Communication skills; Non-technical skills training; Patient experience; Resident education.

MeSH terms

Clinical Competence
Communication*
Feedback
Female
Formative Feedback
Humans
Internship and Residency*
Male
Mentoring*
Program Evaluation
Surveys and Questionnaires