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Feasibility and acceptability of virtually coaching residents on communication skills: a pilot study

BMC Medical Education volume 21, Article number: 513 (2021) Cite this article

Abstract

Background

Developing communication skills is a key competency for residents. Coaching, broadly accepted as a training modality in medical education, has been proven a successful tool for teaching communication skills. Little research is available thus far to investigate virtual coaching on communication skills for telemedicine encounters. The purpose of the study was to test the hypothesis that virtually coaching residents on communication skills is feasible and acceptable. We surveyed 21 resident-faculty pairs participating in a “fully virtual” coaching session (patient, coach, and resident were virtual).

Methods

We asked 50 neurology resident-faculty coach pairs to complete one “fully virtual” coaching session between May 20 and August 31, 2020. After each session, the resident and coach completed a 15-item survey, including Likert-style scale and open-ended questions, assessing feasibility and acceptability. Descriptive statistics and qualitative content and thematic analyses were performed.

Results

Forty-two percent (21/50) of all eligible residents completed “fully virtual” coaching sessions. The overall survey response rate was 91 % (38/42). The majority of respondents agreed that the direct observation and debriefing conversation were easy to schedule and occurred without technical difficulties and that debriefing elements (self-reflection, feedback, takeaways) were useful for residents. Ninety-five percent of respondents rated the coach’s virtual presence to be not at all disruptive to the resident-patient interaction. Virtual coaching alleviated resident stress associated with observation and was perceived as an opportunity for immediate feedback and a unique approach for resident education that will persist into the future.

Conclusions

In this pilot study, residents and faculty coaches found virtual coaching on communication skills feasible and acceptable for telemedicine encounters. Many elements of our intervention may be adoptable by other residency programs. For example, residents may share their communication goals with clinic faculty supervisors and then invite them to directly observe virtual encounters what could facilitate targeted feedback related to the resident’s goals. Moreover, virtual coaching on communication skills in both the in-person and telemedicine settings may particularly benefit residents in challenging encounters such as those with cognitively impaired patients or with surrogate decision-makers.

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Background

Residents frequently participate in difficult encounters, delivering serious news or discussing treatment options [1], and they express a pressing need for communication training [1,2,3,4]. Communication skills, recognized by The Accreditation Council for Graduate Medical Education (ACGME) as a core competency [5] can be successfully developed through coaching [6, 7], traditionally occurring with both the coach and coachee physically present in the same location [8]. However, COVID-related restrictions fortified the need for formal integration of virtual coaching into residency training – a format with utility anticipated to outlast the pandemic [9].

Although many health care systems utilized telemedicine before the COVID-19 pandemic [10], its use exploded after March 2020. In response to the pandemic, many medical institutions rapidly transitioned from in-person healthcare delivery and medical education to telehealth, including developing rapid telemedicine curricula [11] or creating new virtual opportunities for trainees to continue their professional growth despite adverse circumstances [12, 13]. Online teaching has enabled the continuation of medical education [14]. For instance, according to the survey conducted in Physical Medicine and Rehabilitation, 92.5 % of residents participated in virtual didactics due to pandemic [15].

Revisiting traditional routines in medical education and adaptation to new telemedicine practices expanded educational opportunities for trainees, increased access to tools and innovations, and enhanced collaboration between providers from different locations [15]. Telemedicine may increase access to care, limit the digital divide, and simplify longitudinal management of chronic conditions [16]. Telehealth is also a feasible and effective tool to screen patients before they reach a hospital and increase clinical volume during the COVID-19 pandemic [17, 18]. Studies conducted at our institution found that telemedicine encounters are largely considered acceptable by clinicians and are more convenient for patients than in-person visits [19, 20]. For these reasons, telemedicine is anticipated to remain a permanent supplement to in-person visits [19, 20]. Training residents to effectively care for patients through telemedicine is a critical need.

Virtual coaching in medicine has been utilized primarily for coaching patients on interventions such as diabetes management [21], weight management [22,23,24], and cardiac rehabilitation [25, 26]. In medical education, virtual coaching has been used to promote development of technical skills, such as surgical techniques [27,28,29,30]. To our knowledge, no existing studies have investigated virtual coaching on communication skills nor coaching in the setting of telemedicine encounters, which by their nature depend on effective verbal communication.

We conducted a pilot study to evaluate the feasibility and acceptability of virtually coaching neurology residents on communication skills for telemedicine patient encounters and to explore how those encounters occur [31]. We also described elements of the intervention that other residency programs may adapt.

Methods

Study design and setting

The Stanford Neurology Residency Communication Coaching Program was developed in response to a needs assessment to support communication goals identified by our residents [4]. This program was modeled on the Stanford Pediatrics Residency Coaching Program with an emphasis on communication skills [32]. Four faculty members received protected time to serve as communication coaches. The coaches participated in an intensive half-day orientation followed by monthly 90-minute faculty development sessions focusing on resident communication and coaching skills. The coaches and residents completed a foundational course in relationship-centered communication meant to create a shared communication framework. Course topics include establishing rapport, exploring patients’ understanding of their conditions, and responding to emotions (see Additional file 4 for faculty development curriculum). Resident input was incorporated throughout the development of the coaching program and the faculty coach selection process.

Each of the 50 neurology residents (36–39 in a given academic year; 50 total in this study due to academic year turnover) was paired with a coach and was expected to have 5–8 coaching sessions annually. In the pre-pandemic design, a coaching session was planned to involve in-person observation of the resident-patient interaction in an ambulatory or inpatient setting, followed by in-person debriefing during which the coach would facilitate the resident’s self-reflection on the communication performance, provide targeted feedback, and guide the resident to identify a communication-related takeaway to be practiced before the next coaching session. The faculty coaches were not part of the health care team and not responsible for evaluating resident performance.

The coaching program was set to launch in March 2020. This coincided with the pandemic’s onset, making in-person observations infeasible. At a series of morning report sessions and via email, residents shared their enthusiasm for continuing the coaching program despite the challenges of the pandemic. As resident ambulatory clinic encounters shifted rapidly to telemedicine, we pivoted the coaching program virtually to support resident communication skills within this new healthcare delivery method.

We asked all 50 resident-coach pairs to pilot one “fully virtual” coaching session between May 20 and August 31, 2020. Fully virtual coaching sessions met the following criteria: resident-patient clinical encounter by video; real-time observation by coach of resident-patient communication via video; debriefing conversation between coach and resident by video, phone, or email (Fig. 1). Residents conducted clinic visits using secure Zoom software. The coach joined the same Zoom session as the resident and patient, introduced themselves to the patient, and then muted audio and turned off video to unobtrusively observe the resident-patient interaction. After each coaching session, a 15-item survey was distributed via a secure personalized link to both the coach and the resident (see Additional files 1 and 2). Data were de-identified prior to analysis.

Fig. 1
figure 1

Conceptual Model of “Fully Virtual” Coaching Session. Legend: A “fully virtual” coaching session involved: a real-time observation of the resident-patient telehealth clinical encounter by the coach, followed by resident-coach debriefing via video, phone, or email, during which the coach facilitated the resident’s self-reflection on the communication performance, provided targeted feedback, and guided the resident to identify a communication-related takeaway to be practiced before the next coaching session. Residents conducted clinic visits using secure Zoom software. The coach joined the same Zoom session as the resident and patient, introduced themselves to the patient, and then turned off video and audio and observed the resident-patient interaction

Full size image

Measures

Survey included 5-point Likert-style scale questions to assess the feasibility of scheduling and executing direct observations and debriefing conversations, the acceptability of the coach’s presence as an observer, and the perceived usefulness of the three elements of the debriefing conversation: facilitated self-reflection, feedback, and takeaways. Three open-ended response questions explored attitudes, challenges, and benefits related to virtual coaching on telemedicine encounters.

Data analysis

We performed descriptive statistical analysis of Likert-style scale questions (Excel, Microsoft Corp., Redmond, Washington, USA). Distributions were stratified according to survey respondent type (coach/resident). Free-text responses were coded and analyzed in NVivo (Release 1.3, QSR International Pty Ltd.), resulting in code frequencies for content analysis and emergent themes for subsequent in depth thematic analysis [33].

Stanford University determined this study to be exempt from institutional review.

Results

Our pilot study included 21 fully virtual coaching sessions (completed by 42 % of resident-coach pairs). Barriers for residents who did not complete a virtual coaching session during the study were primarily logistical (e.g., senior residents with few remaining clinical encounters in the 6 weeks between study launch and graduation; residents assigned to clinics focused on in-person encounters; rotations occurring at night or off site, research rotations, or vacation). A lower-than-expected participation rate may be related to the departmental efforts concentrated on urgent patient care in the face of the global pandemic and coaching being a temporarily lower priority at this time. The overall response rate was 91 % (38/42), with 19/21 residents responding and the four coaches completing the survey for 19/21 encounters. All 21 coaching sessions were in the ambulatory neurology setting, with the majority in the resident continuity clinic.

Virtual coaching sessions were reported as feasible by residents and coaches participating in the intervention. The majority of respondents “fully” or “very much” agreed that the direct observation was easy to schedule and they did not experience any technical difficulties during the direct observation (respectively 82 %, n = 31 and 87 %, n = 33). Similarly, nearly all (97 %, n = 37) “fully” or “very much” agreed that the debriefing session was easy to schedule (Fig. 2; findings differentiated between residents and coaches are presented in Additional file 3). Debriefing sessions occurred by video (n = 23), phone (n = 8), or email (n = 4). Seven respondents (28 %) reported some technical issues: two (5 %) reported switching from video to phone due to technical difficulties and five (13 %) reported unreliable internet connection or equipment malfunction.

Fig. 2
figure 2

Feasibility, Acceptability and Perceived Effectiveness of Telecoaching on Virtual Encounters – Residents and Coaches’ Perspectives [n = 38]

Full size image

Nearly all respondents (95 %, n = 36) rated the coach’s presence as an observer “not at all” disruptive. Moreover, all or nearly all respondents “fully”, “very much,” or “moderately” agreed that debriefing elements were useful, including facilitated self-reflection (100 %, n = 38), feedback (98 %, n = 37) and takeaways for future telemedicine encounters (94 %, n = 36 moderately).

Qualitative content analysis initially identified five prominent categories related to feasibility and acceptability: logistics; technology; coach’s presence; feedback; and characteristics of virtual coaching. Deeper thematic analysis resulted in themes described in Table 1.

Table 1 Residents’ and coaches’ perceptions of virtual coaching on telemedicine encounters: qualitative themes and categorical frequencies
Full size table

The virtual coaching sessions were perceived as time-effective, easy to arrange, and offered more flexibility than in-person coaching. Occasional technical difficulties resulted from connection issues or poor technical skills of participants were the primary barrier to virtual coaching. The coach’s virtual presence was seen as less intrusive and disruptive than an in-person observation. A coach observing with video and audio off was barely noticed, which felt “more natural” and alleviated resident stress associated with observation. Participants appreciated immediate and useful feedback. Although virtual coaching on telemedicine encounters was a great opportunity to enhance verbal skills, participants found it challenging for coaches to observe body language in the way that they might during an in-person encounter. Additionally, virtual debriefing sessions did not facilitate the same degree of relationship-building between coaches and residents.

With its distinctive challenges and opportunities, coaching in the virtual setting was perceived as a unique approach for resident education that will persist into the future. Participants anticipated a hybrid model moving forward. Participants, even those who were initially skeptical about virtual coaching, found the program both feasible and acceptable: “I was initially skeptical of whether this would be a useful format to receive coaching, given there are limitations to interpersonal interaction with the patient through video. But the session turned out very helpful, it felt natural, was not disruptive at all, and I received good feedback from my coach” [Resident]. Benefits and challenges of virtual coaching model identified during thematic analysis are also summarized in Fig. 3.

Fig. 3
figure 3

Mechanisms of a Virtual Coaching Model - Benefits and Challenges in Practice. Legend: (+) indicates benefits of virtual coaching sessions; (-) indicates challenges of virtual coaching sessions

Full size image

Discussion

In this pilot study, neurology residents and their faculty coaches found virtual coaching sessions on telemedicine encounters feasible, acceptable, useful, and easy to schedule. Participants found the coach’s virtual presence as an observer not to be disruptive to the clinical encounter, even suggesting that the coach being “a fly on the wall” during telemedicine encounters is “less intrusive” than in-person clinical encounters. Although the logistics and less intrusive direct observation support sustaining virtual coaching sessions, residents and coaches also desire in-person coaching sessions to enhance the patient-coach relationship and encourage feedback on non-verbal communication.

Coaching of residents by specially-trained faculty has been associated with positive outcomes in other specialties. In pediatrics, residents felt faculty coaches provided higher-quality feedback and incorporated more self-reflection and goal setting than non-coaches and coaches demonstrated increased confidence in delivering feedback on communication skills and goal setting compared to non-coaches [32]. Positive psychology coaching has been associated with reduced emotional exhaustion, increased coping skills, and a positive residency experience in internal medicine residents [34, 35]. Post-operative coaching enhanced situational awareness, listening skills, and emergency decision-making in surgery residents [36]. This is the first study to our knowledge to examine the feasibility and acceptability of virtual coaching for residents on telemedicine encounters.

Regarding limitations and future directions, first, this pilot study analyzed a modest number of coaching sessions for residents from one specialty at a single institution. Second, only 42 % of the eligible residents completed fully virtual coaching sessions in the study period, which may be partially due to study onset and beginning of the COVID-19 pandemic corresponding to the launch of this coaching program, highlighting initial difficulties in scheduling observations within the limited study period and coaching to be lower priority at the time. Increasing resident buy-in by introducing potential benefits of the program early on, ensuring protected time for coaching, or mandating the communication coaching in the curriculum may be effective strategies to improve participation rate in the intervention. It is important to note that these early limitations have not persisted as the program has continued and grown.

Future directions include obtaining perspective of patients and clinic attendings, on the acceptability of the intervention, and demonstrating improved resident communication skills in this setting as rated by residents, faculty, or patients. However, with prior literature documenting the efficacy of coaching and the need for interventions toward resident communication in the new telemedicine sphere, demonstrating the feasibility and acceptability of this virtual coaching intervention is anticipated to be of interest to many residency programs.

Although self-assessments are broadly accepted tools in adult learning and medical education [37,38,39], they may be less accurate than expert evaluations, especially in those with less experience, lower training grade, and age [37,38,39]. Known as the Dunning-Kruger effect, individuals who lack knowledge and practice at a task tend to overestimate their performance and competencies and poorly identify areas for improvement [40, 41]. Trainees have been demonstrated to be better assessors in studies in which a grade was connected to the process [39], which was not a part of our intervention. Research also shows that nontechnical skills (such as communication skills) are more difficult to accurately self-assess than technical skills due to their complexity [37].

Given the modest number of coaching sessions, relatively small sample, and lower-than-expected participation rate, some potential biases may have occurred [42, 43]. Residents who completed a virtually coaching session might have been optimistic about coaching in general and thus more positively evaluated the intervention than those who did not participate. Subjects who were less likely to participate in the intervention for various reasons may be underrepresented in our study (selection bias). Since the intervention was conducted among the residents of one specialty only, the conclusions may not be relevant to all residents (interpretation bias). Therefore, we recognize that a communication coaching program may not be feasible for some residency programs. However, many elements of our intervention may be translatable. Residents, faculty, and program leadership may adapt coaching models in medical education [32, 34,35,36, 44], for example with residents consciously setting communication goals and actively reflecting on their performance after telemedicine encounters. Sharing these goals with clinic faculty supervisors and then inviting them to directly observe virtual encounters could facilitate targeted feedback related to the resident’s goals. Virtual coaching on communication skills in both the in-person and telemedicine settings may particularly benefit residents in challenging encounters such as those with cognitively impaired patients or with surrogate decision-makers.

Conclusions

In conclusion, neurology residents and their faculty coaches found virtual coaching on communication skills within telemedicine encounters feasible and acceptable. Virtual coaching allowed our program to continue our educational mission in the face of major obstacles related to the pandemic. Elements of virtual coaching may be adopted to meet the proposed development milestones [5] and the goals of residents. Future studies of our coaching program will incorporate data on patient outcomes and resident communication performance, as these data will be critical for other residency programs considering implementation of a coaching program.

Availability of data and materials

The anonymized datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Collins K, Hopkins A, Shilkofski NA, Levine RB, Hernandez RG. Difficult Patient Encounters: Assessing Pediatric Residents’ Communication Skills Training Needs. Cureus. 2018;10(9):e3340.

    Google Scholar 

  2. Ju M, Berman AT, Hwang W-T, LaMarra D, Baffic C, Suneja G, et al. Assessing Interpersonal and Communication Skills in Radiation Oncology Residents: A Pilot Standardized Patient Program. Int J Radiat Oncol. 2014;88(5):1129–35.

    Article  Google Scholar 

  3. Falcone JL, Claxton RN, Marshall GT. Communication skills training in surgical residency: a needs assessment and metacognition analysis of a difficult conversation objective structured clinical examination. J Surg Educ. 2014;71(3):309–15.

    Article  Google Scholar 

  4. Goyal T, Hasty BN, Merrell SB, Gold CA. Education Research: Understanding barriers to goals of care communication for neurology trainees. Neurology. 2019;93(8):362–6.

    Article  Google Scholar 

  5. ACGME Common Program Requirements. Accreditation Council for Graduate Medical Education; 2020. Available from: https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2020.pdf [cited 12 Aug 2021]

  6. Nassar A, Weimer-Elder B, Kline M, Minthorn C, Staudenmayer KL, Yang R, et al. Developing an Inpatient Relationship-Centered Communication Curriculum for Surgical Teams: Pilot Study. J Am Coll Surg. 2019;229(4):E48–E48.

    Article  Google Scholar 

  7. Joyce BL, Scher E, Steenbergh T, Voutt-Goos MJ. Development of an institutional resident curriculum in communication skills. J Grad Med Educ. 2011;3(4):524–8.

    Article  Google Scholar 

  8. Lovell B. What do we know about coaching in medical education? A literature review. Med Educ. 2018;52(4):376–90.

    Google Scholar 

  9. Zha AM, Chung LS, Song SS, Majersik JJ, Jagolino-Cole AL. Training in Neurology: Adoption of resident teleneurology training in the wake of COVID-19: Telemedicine crash course. Neurology. 2020;95(9):404–7.

    Article  Google Scholar 

  10. Office of Health Policy, Office of the Assistant Secretary for Planning and Evaluation. Report to Congress: E-health and telemedicine. Washington, DC: Department of Health and Human Services. Department of Health and Human Services; 2016.

    Google Scholar 

  11. Chick RC, Clifton GT, Peace KM, Propper BW, Hale DF, Alseidi AA, et al. Using technology to maintain the education of residents during the COVID-19 pandemic. J Surg Educ. 2020;77(4):729–32.

  12. Kohan L, Sobey C, Wahezi S, Brancolini S, Przkora R, Shaparin N, et al. Maintaining high quality multidisciplinary pain medicine fellowship programs: Part II: Innovations in clinical care workflow, clinical supervision, job satisfaction and postgraduation mentorship for pain fellows during the Covid-19 pandemic. Pain Med Malden Mass. 2020;21(8):1718–28.

  13. Loh TY, Hsiao JL, Shi VY. COVID-19 and its effect on medical student education in dermatology. J Am Acad Dermatol. 2020;83(2):e163–4.

    Article  Google Scholar 

  14. Dost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students. BMJ Open. 2020;10(11):e042378.

    Article  Google Scholar 

  15. Escalon MX, Raum G, Francio VT, Eubanks JE, Verduzco-Gutierrez M. The Immediate Impact of the Coronavirus Pandemic and Resulting Adaptations in Physical Medicine and Rehabilitation Medical Education and Practice. PM&R. 2020;12(10):1015–23.

    Article  Google Scholar 

  16. Perez DL, Biffi A, Camprodon JA, Caplan DN, Chemali Z, Kritzer MD, et al. Telemedicine in Behavioral Neurology-Neuropsychiatry: Opportunities and Challenges Catalyzed by COVID-19. Cogn Behav Neurol Off J Soc Behav Cogn Neurol. 2020;33(3):226–9.

    Article  Google Scholar 

  17. Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A, Farokhi E, Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol. 2020;126:104345.

    Article  Google Scholar 

  18. Loeb AE, Rao SS, Ficke JR, Morris CD, Riley LH, Levin AS. Departmental Experience and Lessons Learned With Accelerated Introduction of Telemedicine During the COVID-19 Crisis. J Am Acad Orthop Surg. 2020;28(11):e469–76.

  19. Saliba-Gustafsson EA, Miller-Kuhlmann R, Kling SMR, Garvert DW, Brown-Johnson CG, Lestoquoy AS, et al. Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation. J Med Internet Res. 2020;22(12):e24328.

    Article  Google Scholar 

  20. Kling SMR, Falco-Walter JJ, Saliba-Gustafsson EA, Garvert DW, Brown-Johnson CG, Miller-Kuhlmann R, et al. Patient and clinician perspectives of new and return ambulatory teleneurology visits. Neurol Clin Pract. 2021. https://doi.org/10.1212/CPJ.0000000000001065.

  21. de Vasconcelos HCA, Lira Neto JCG, de Araújo MFM, Carvalho GCN, de Souza Teixeira CR, de Freitas RWJF, et al. Telecoaching programme for type 2 diabetes control: a randomised clinical trial. Br J Nurs Mark Allen Publ. 2018;27(19):1115–20.

    Article  Google Scholar 

  22. Huber JM, Shapiro JS, Wieland ML, Croghan IT, Vickers Douglas KS, Schroeder DR, et al. Telecoaching plus a portion control plate for weight care management: a randomized trial. Trials. 2015;16:323.

    Article  Google Scholar 

  23. Mertens L, Braeken MAKA, Bogaerts A. Effect of lifestyle coaching including telemonitoring and telecoaching on gestational weight gain and postnatal weight loss: a systematic review. Telemed J E-Health Off J Am Telemed Assoc. 2019;25(10):889–901.

    Google Scholar 

  24. Muñoz Obino KF, Aguiar Pereira C, Caron-Lienert RS. Coaching and barriers to weight loss: an integrative review. Diabetes Metab Syndr Obes Targets Ther. 2017;10:1–11.

    Google Scholar 

  25. Frederix I, Hansen D, Coninx K, Vandervoort P, Vandijck D, Hens N, et al. Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial. J Med Internet Res. 2015;17(7):e185.

    Article  Google Scholar 

  26. Batalik L, Filakova K, Batalikova K, Dosbaba F. Remotely monitored telerehabilitation for cardiac patients: a review of the current situation. World J Clin Cases. 2020;8(10):1818–31.

    Article  Google Scholar 

  27. Wahr JA, Prager RL, Abernathy J.H., Martinez EA, Salas E, Seifert PC, et al. Patient safety in the cardiac operating room: human factors and teamwork. Circulation. 2013;128(10):1139–69.

    Article  Google Scholar 

  28. Augestad KM, Butt K, Ignjatovic D, Keller DS, Kiran R. Video-based coaching in surgical education: a systematic review and meta-analysis. Surg Endosc. 2020;34(2):521–35.

    Article  Google Scholar 

  29. Andreassen HK, Warth LL. The impact of telementoring. Stud Health Technol Inform. 2018;255:127–31.

  30. Kramer NM, Demaerschalk BM. A Novel application of teleneurology: robotic telepresence in supervision of neurology trainees. Telemed E-Health. 2014 Dec;20(12):1087–92.

  31. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76.

    Article  Google Scholar 

  32. Rassbach CE, Blankenburg R. A novel pediatric residency coaching program: outcomes after one year. Acad Med. 2018;93(3):430–4.

    Article  Google Scholar 

  33. Guba EG. Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ. 1981;29(2):75.

    Article  Google Scholar 

  34. Palamara K, Kauffman C, Stone VE, Bazari H, Donelan K. Promoting success: a professional development coaching program for interns in medicine. J Grad Med Educ. 2015;7(4):630–7.

    Article  Google Scholar 

  35. Palamara K, Kauffman C, Chang Y, Barreto EA, Yu L, Bazari H, et al. Professional Development Coaching for Residents: Results of a 3-Year Positive Psychology Coaching Intervention. J Gen Intern Med. 2018;33(11):1842–4.

    Article  Google Scholar 

  36. Yule S, Parker SH, Wilkinson J, McKinley A, MacDonald J, Neill A, et al. Coaching Non-technical Skills Improves Surgical Residents’ Performance in a Simulated Operating Room. J Surg Educ. 2015;72(6):1124–30.

    Article  Google Scholar 

  37. Nayar SK, Musto L, Baruah G, Fernandes R, Bharathan R. Self-Assessment of Surgical Skills: A Systematic Review. J Surg Educ. 2020;77(2):348–61.

    Article  Google Scholar 

  38. Falchikov N, Boud D. Student Self-Assessment in Higher Education: A Meta-Analysis. Rev Educ Res. 1989;59(4):395–430.

    Article  Google Scholar 

  39. Mays KA, Branch-Mays GL. A Systematic Review of the Use of Self-Assessment in Preclinical and Clinical Dental Education. J Dent Educ. 2016;80(8):902–13.

    Article  Google Scholar 

  40. Dunning D, Johnson K, Ehrlinger J, Kruger J. Why people fail to recognize their own incompetence. Curr Dir Psychol Sci. 2003;12(3):83–7.

    Article  Google Scholar 

  41. Kruger J, Dunning D. Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77(6):1121.

    Article  Google Scholar 

  42. Šimundić A-M. Bias in research. Biochem Medica. 2013;23(1):12–5.

    Article  Google Scholar 

  43. Smith J, Noble H. Bias in research. Evid Based Nurs. 2014;17(4):100–1.

    Article  Google Scholar 

  44. Rassbach CE, Bogetz AL, Orlov N, McQueen A, Bhavaraju V, Mahoney D, et al. The Effect of Faculty Coaching on Resident Attitudes, Confidence, and Patient-Rated Communication: A Multi-Institutional Randomized Controlled Trial. Acad Pediatr. 2019;19(2):186–94.

    Article  Google Scholar 

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Acknowledgements

We thank the Stanford Health Care Donors Fund. We thank David Entwistle, Alpa Vyas, and Mystique Smith-Bentley for their support and investment in this program. We thank Dr. Frank Longo, Dr. Yuen So, Dr. Laurice Yang, and the entire Neurology faculty for prioritizing resident education as the department rapidly shifted to teleneurology during the pandemic. We thank Dr. Arden Morris and S-SPIRE for their helpful input on earlier drafts of this manuscript. We thank Dr. Becky Blankenburg and Dr. Carrie Rassbach for their mentorship.

Funding

This educational innovation and its evaluation were funded by the Stanford Health Care Partners Donor Fund.

Author information

Authors and Affiliations

  1. Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, 1070 Arastradero Rd, Stanford, CA, 94305, USA

    Marzena Sasnal & Sylvia Bereknyei Merrell

  2. Department of Neurology & Neurological Sciences, Center for Academic Medicine, 453 Quarry Road, Stanford, CA, 94305, USA

    Rebecca Miller-Kuhlmann, Shannon Beres, Lucas Kipp, Sarah Lee, Zachary Threlkeld & Carl A. Gold

  3. Department of Surgery, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA, 94305, USA

    Aussama K. Nassar

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Contributions

MS, RKM, SBM, CG, and AN designed and conceptualized the study. MS acquired and analyzed the data, and was the major contributor in writing the manuscript. CG helped to focus and draft the manuscript. All authors revised and approved the final manuscript.

Authors' information

Marzena Sasnal, PhD, MA – Social Science Researcher.

Rebecca Miller-Kuhlmann, MD – Clinical Assistant Professor & Associate Director, Stanford Neurology Communication Coaching Program.

Sylvia Bereknyei Merrell, DrPH, MS – Research Scholar.

Shannon Beres, MD – Clinical Assistant Professor.

Lucas Kipp, MD – Clinical Assistant Professor.

Sarah Lee, MD – Clinical Assistant Professor.

Zachary Threlkeld, MD – Clinical Assistant Professor.

Aussama Nassar, MD, MSc – Clinical Assistant Professor & Director, Stanford Surgery Communication Coaching Program.

Carl A. Gold, MD, MS – Clinical Assistant Professor & Director, Stanford Neurology Communication Coaching Program.

Corresponding author

Correspondence to Carl A. Gold.

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Ethics approval and consent to participate

Stanford University Institutional Review Board (IRB) determined this study to be exempt from institutional review.

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Competing interests

The authors declare that they have no competing interests.

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Supplementary Information

Additional file 1.

Resident Survey, Description of data: Survey distributed to residents.

Additional file 2.

Coach Survey, Description of data: Survey distributed to coaches.

Additional file 3.

Feasibility acceptability, and perceived usefulness of virtually coaching residents on communication skills: findings differentiated between residents and coaches.

Additional file 4.

Faculty coaching training curriculum.

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Sasnal, M., Miller-Kuhlmann, R., Merrell, S.B. et al. Feasibility and acceptability of virtually coaching residents on communication skills: a pilot study. BMC Med Educ 21, 513 (2021). https://doi.org/10.1186/s12909-021-02936-w

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BMC Medical Education

ISSN: 1472-6920

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