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Preparing clinical teachers to observe, coach and document

Coaching is beneficial for anyone who is pursuing optimal performance. Simply defined, a coach is a person guiding another through a process, leading to performance enhancement. Applications can vary; helping an individual to do some task better, developing a skill they don't yet possess, or providing guidance to achieve a specific project.

In residency education, regular, direct observation of trainees is already an effective tool used by some to provide feedback meant to help learners improve. In Competence by Design (CBD), there will be an increased emphasis on direct and indirect work-based observation to facilitate resident learning.

The role of faculty must evolve from one of supervision, to one that also includes more observation (direct and indirect) of the work residents are doing on a day-to-day basis. Faculty need to be equipped to coach residents toward optimal performance, EPA after EPA, and milestone after milestone.

Coaching for excellence

These high-level coaching steps are outlined in detail in the CBD Meantime Guide

  1. Build a coaching mindset

    Review the major concepts associated with coaching, thinking specifically about the skills needed to assist residents for ongoing improvement. Consider how coaching is different from supervising a resident’s work.

  2. Make a specific plan for observation in your practice setting(s)

    Identify opportunities in your clinical environment(s) that are conducive to resident observation. Remember resident observation can be direct or indirect. If your program doesn’t have EPAs yet, identify a couple of competencies within one or two CanMEDS Roles that you can readily observe in your daily practice setting(s).

  3. Set the stage for coaching

    Think of yourself as a “Learning for Practice” coach: Initiate a learning partnership with the residents. Be explicit with the learners that you are approaching your interaction with a coaching mindset, with the goal of helping them progress. Be intentional in creating a positive learning culture in clinical setting(s).

  4. Observe, coach and document

    Plan when and where you can observe the resident by matching the resident’s learning objectives to the clinical opportunities for observation. Follow each observation with a timely, specific, constructive discussion — a coaching conversation to facilitate the resident’s development. Just like in sports, residents should start seeing you as a coach whose job is to help them improve their game.

  5. Be realistic about change — it won’t happen overnight

    Set realistic expectations for the frequency of observations – depending on your program, observations may or may not be done on a daily basis. Keep in mind that your observations are part of the whole.


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