Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Med Educ. 2019 May;53(5):467-476. doi: 10.1111/medu.13799. Epub 2019 Jan 23.
Although conceptually attractive, coaching in medicine remains ill-defined, with little examination of the transferability of coaching principles from other fields. Here we explore how coaching is enacted both within and outside of medicine; we aim to understand both the elements required for coaching to be useful and the factors that may influence its translation to the medical education context.
In this constructivist grounded theory study, we interviewed 24 individuals across three groups: physicians who consider themselves coaches in clinical learning settings (n = 8), physicians with experience as sports, arts or business coaches (n = 10), and sports coaches without medical backgrounds (n = 6). Data collection and analysis were conducted iteratively using constant comparison to identify themes and explore their relationships.
We identified a shared philosophy of coaching, comprising three core elements that our participants endorsed regardless of the coaching context: (i) mutual engagement, with a shared orientation towards growth and development; (ii) ongoing reflection involving both learners and coaches, and (iii) an embrace of failure as a catalyst for learning. Enacting these features appeared to be influenced by culture, which affected how coaching was defined and developed, how the coaching role was positioned within the learning context, and how comfortably vulnerability could be expressed. Participants struggled to clearly define the coaching role in medicine, instead acknowledging that the lines between educational roles were often blurred. Further, the embrace of failure appeared challenging in medicine, where showing vulnerability was perceived as difficult for both learners and teachers.
Medical education's embrace of coaching should be informed by an understanding of both coach and learner behaviours that need to be encouraged and trained, and the cultural and organisational supports that are required to foster success.
尽管从概念上讲很有吸引力，但医学领域的辅导仍未得到明确界定，几乎没有考察从其他领域转移辅导原则的可能性。在这里，我们探讨了辅导在医学内外的实施方式；我们旨在了解辅导发挥作用所需的要素以及可能影响其向医学教育背景转化的因素。
在这项建构主义扎根理论研究中，我们采访了三个群体中的 24 个人：在临床学习环境中自认为是教练的医生（n=8）、有体育、艺术或商业教练经验的医生（n=10）和没有医学背景的体育教练（n=6）。使用不断比较来识别主题并探索其关系，对数据收集和分析进行迭代。
我们确定了一个共同的辅导理念，包括我们的参与者无论在何种辅导背景下都认可的三个核心要素：（i）相互参与，共同面向成长和发展；（ii）持续反思，包括学习者和教练；（iii）接受失败作为学习的催化剂。这些特征的实施似乎受到文化的影响，文化影响了辅导的定义和发展方式、辅导角色在学习环境中的定位方式，以及表达脆弱性的舒适度。参与者难以在医学领域明确界定辅导角色，而是承认教育角色之间的界限往往是模糊的。此外，在医学中，接受失败似乎具有挑战性，因为学习者和教师都认为表现出脆弱性很困难。
医学教育对辅导的接受应该基于对教练和学习者的行为的理解，这些行为需要得到鼓励和培训，以及需要文化和组织支持来促进成功。
