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Table 2 Exemplary quotes that contribute to participant experiences of better together

From: “We’re all going through it”: impact of an online group coaching program for medical trainees: a qualitative analysis

Theme

Quote

Usefulness of the Metacognitive Coaching Model

 

 Subtheme: Burnout

"Wow, I really do resonate with [this coaching] about not feeling good at work and feeling frustrated with my patients and feeling these feelings that I've never felt before. I was like, I really do feel burnt out." (Participant 3)

"Being able to separate my circumstance from my thoughts made me feel like there was hope, and my thoughts are just thoughts, and I can work on changing them and that would give me a different result and ultimately end in me trusting myself a little bit more." (Participant 4)

 Subtheme: Self-Compassion

“I got something out of the program, [and] it was to be a lot more gentle with myself” (Participant 3).

“I think having that grace towards yourself definitely can make you more confident as a physician … more happy as a physician. I definitely love what I do, but that doesn’t mean there’s not challenges … having these frameworks helps with being more equipped when there’s something tough that comes up” (Participant 4).

“[BT] has also just helped me tell myself it’s okay to have a personal life again. I think when you get into some of these cycles, you think like, “Oh, I’m not working hard enough,” or, “I’m not good enough, and so I need to be doing all these other things outside of work.” I just had a lot more confidence to say like, “Nope. Today’s my day off. I deserve this.’” (Participant 3)

“Every single day something brings me a feeling of joy, being like, I love being here. I get to like deliver babies, so I get to bring people’s greatest joy into the world. But second year with the pandemic and just ... there was like lots of like bad pregnancy outcomes and things like that. But [by the end of BT] I was like, wow, I do feel like I’m sort of moving towards not feeling so bad every day.

Not every day feels just like quite as heavy as it did before.” (Participant 15)

 Subtheme: Imposter Syndrome and Perfectionism

“[Prior to BT] I thought that constructive feedback meant that I was a bad doctor, and that I was bad at operating, whereas she was literally just helping me. And it was funny that I finally realized that my thoughts were, oh, I should be perfect at everything. I should know everything and no one should ever give me any feedback, like this unrealistic expectation that I didn’t even realize.” (Participant 6).

“[I used to think] ‘Oh, I made the wrong decision, therefore I am a bad doctor’ or, ‘I did the wrong diagnosis or triaged this person to the wrong place’ and just heavily internalized that and felt worse. I feel so much more strongly now that I allowed myself to not be perfect on those shifts, and like what I was just saying before, it just was a growing period and it helped me when I left the hospital leave that tough shift behind me.” (Participant 11)

I think I just allowed myself to be imperfect sometimes, and now I feel like I don’t even like saying “imperfect.” I don’t like focusing on the things I may have thought as bad before at all. I think I’ve really shifted my mindset to say anything that maybe had a poor outcome or wasn’t what I wanted is all just a growth period for me. (Participant 12)

I had stated my thoughts and feelings around doing procedures was like, “I’m not going to be good at it,” … And from the coaching session, their big thing was taking those thoughts and feelings that I have about myself and then separating them from actually the circumstance ...So, instead of thinking, “I am not good at this procedure because I don’t know how to do it,” changing it to, “I am learning to do this procedure.” (Participant 3)

 Subtheme: Improving

Relationships

“I’ve made some improvements with shifting slightly from my avoidance [in relationships] to being more proactive. I am not fully satisfied with where that’s at, but I definitely think it nudged me in some way. … [For example] there could be a million different reasons why he is acting this way. And maybe also he’s just a human being and wants to be quiet for a little bit. Rather than jumping to conclusions or some crazy story about it, if I’m not sure, then I can ask him what’s going on …. And then often I would get the answer and it was never about me.” (Participant 11)

“I had two male seniors who would make jokes or make comments or demand more of me. And I felt like I was working really hard but still like not being respected... so we worked through a different model, for a different result...and I wrote in my planner, like their thoughts about you are their models and what they have going on and their thoughts about you are actually no reflection of how you are as a doctor or a teammate, or any of that. So really being able to separate these other people from my life and not letting them have as much control over my thoughts or any control over my thoughts was so helpful.” (Participant 6)

Community

“I think connection to people, feeling … a sense of community, or that we all share something that we’re going through. Learning based on their experiences.” (Participant 8)

“I don’t know if the program would have been different if it wasn’t for COVID. Instead of Zoom, these groups would be in person … that would have been a good idea because it’s nice to [feel] human interaction and bonding … the nice thing about the Zoom was that when you went up there [for coaching], you didn’t see anyone else looking at you. You kind of felt you were privately talking to someone.” (Participant 9)

“I think a huge strength is just being able to see, ‘... although some things in my experience are unique, a lot of it isn’t’... [It’s] something that we all share being residents, working really hard, feeling inadequate at times, wanting to be perfect, feeling like we are going to get found out … it was helpful to look around and be like, ‘Oh, there’s all these amazing women who are awesome doctors who also feel all the same things …’” (Participant 8)

“A huge benefit of it was having so many residents in different specialties, because you get so caught up in your world of surgery, and you think that you’re the only residents that work hard and feel miserable sometimes. So just hearing people and lots of other programs talking about very, very similar issues just felt super validating and made me feel like I was connected to a bigger pool of trainees.” (Participant 13)

Customizable Experience

 

 Sub-theme: Multimodal

“...allowing multiple ways to interact with the program [was helpful]. So not only the live coaching, but the ask-for-coaching and then being able to watch the videos on your own time, and then some people participated by just watching others. I was someone who was pretty regularly being coached live, which I found nerve wracking at first, but then probably the most beneficial part” (Participant 10).

“… it’s nice being able to have a format that you can ask [for coaching] at any time and then also having a written response so that you can go back to it if you need to.” (Participant 8)

 Sub-theme: Self-paced

“Access and availability...if I was in an inpatient rotation where I just was not free by the time [the call] started, I could go back and listen to it later. I read through some of people’s coaching requests. I was like, ‘Oh, yeah. This is useful for me, too’ in addition to other curriculum that you can go at your own pace for” (Participant 4)

“I think that it was nice that you could pick and choose from the level of commitment that you wanted.” (Participant 5)

“It was nice that you could pick and choose from the level of commitment that you wanted.” (Participant 2)

 Sub-theme: Option for Anonymity

“...[live coaching] wasn’t a good fit because a lot of my co-residents were around. But I still feel like I benefited from watching other people get coached” (Participant 12).

“So I really liked that they had an anonymous ask for coaching thing. I thought that was great.” (Participant 8)