Evaluating the Impact of Coaching Through the Transition to Residency

Background

Coaching has been proposed to support the transition to residency. Clarifying its impact will help define its value and best use.

Objective

To explore the experiences of residents working with coaches through the residency transition.

Design

A cohort comparison survey compared experiences of a coached resident cohort with coaches to the prior, uncoached cohort.

Participants

Post-graduate year (PGY)-2 residents in internal medicine, obstetrics and gynecology, emergency medicine, and pathology at a single academic center.

Interventions

Faculty trained as coaches had semi-structured meetings with graduating medical students and residents throughout the PGY-1 year.

Main Measures

An online anonymous survey assessed effects of coaching on measures of self-directed learning, professional development, program support and impact of coaching using existing scales (2-item Maslach Burnout Inventory, Brief Resilient Coping Scale, 2-item Connor-Davidson Resilience Scale, Stanford Professional Fulfillment Inventory), and novel measures adapted for this survey. Bivariate analyses (t-tests and chi-square tests) compared cohort responses. MANOVA assessed the effects of coaching, burnout and their interactions on the survey domains.

Key Results

Of 156 PGY2 residents, 86 (55%) completed the survey. More residents in the “un-coached” cohort reported burnout (69%) than the “coached” cohort (51%). Burnout was significantly and negatively associated (F = 3.97 (df 7, 75); p < .001) with the learning and professional development outcomes, while being coached was significantly and positively associated with those outcomes (F = 5.54 (df 9, 75); p < .001). Significant interaction effects were found for goal-setting attitudes, professional fulfillment, and perceived program career support such that the positive differences in these outcomes between coached and un-coached residents were greater among burned out residents. Coached residents reported a positive impact of coaching across many domains.

Conclusions

Residents experiencing coaching reported better professional fulfillment and development outcomes, with more pronounced differences in trainees experiencing burnout. Coaching is a promising tool to support a fraught professional transition.