Daniel J Rosenkrans, MD; Debra L Klamen, MD, MHPE; Nicole K Roberts, PhD
Medicine is in a time of rapid change. New models of clinical clerkships have been proposed, including that of coaching. The authors studied a unique group of individuals able to comment on both worlds: upper level medical students who had been coached to high levels of performance in sports, music, and debate. The study was undertaken to understand the learning culture in the clerkships and whether it was similar to the coaching experiences our students had previously.
Using a constructivist grounded theory approach, the authors at Southern Illinois University School of Medicine conducted two separate focus groups in 2013 with 23 medical students who had extensive experiences in music (n=11), athletics (n=11) or competitive debate (n=1). Data were analyzed iteratively using constant comparison. Key themes were identified to obtain a conceptual understanding of coaching and clinical clerkships.
Five types of learning events regularly occurred between coaches and students, and a sixth was unique to medical students in the clinical clerkships. The six types were: relationship with the teacher, expectations, observation, practice, feedback, and measures of success (in the clinical clerkships). Notably, the five events associated with coaching were noted as strengths by students, while the same five were noted as weaknesses in the clerkships.
Medicine’s current learning culture makes it difficult for teachers to impact learners’ development, making thoughts about incorporating coaching into clinical settings problematic. The culture must be addressed, so that coached deliberate practice may be used to ensure our medical students achieve success.