‘It’s more like checking in with an old friend’: A qualitative study of medical students’ experiences with longitudinal coaches throughout medical school

Coaching in medical education facilitates learners’ growth and development through feedback, goal-setting and support. This study explored how coaching relationships evolve throughout medical school and the impact of longitudinal coaching relationships on medical students’ approach to feedback and goal setting in the clinical years. In this qualitative study using a constructivist paradigm, authors purposively sampled 15 senior medical students at University of California, San Francisco, to participate in individual semi-structured interviews (October–November 2021). The authors used an inductive approach to thematic analysis. The authors identified four themes: First, the student-coach relationship deepened over the course of medical school. Second, students identified factors that sustained and strengthened the student-coach relationship over time: a strong foundation to the relationship, the non-evaluative nature of the relationship, coach supportiveness and responsiveness, and coach knowledge of the institutional landscape. Third, coaches provided individualized advice, assessed trajectory, and guided feedback interpretation. Lastly, students applied skills of soliciting and responding to feedback and creating learning goals, originally learned through coaching experience. Coaching relationships, grounded in trust, evolve to meet students’ changing needs as they grow into physicians. Students apply feedback and goal-setting skills learned with the coach in clinical settings with other supervisors.

医学教育中的辅导（Coaching）通过反馈、目标设定与支持，助力学习者的成长与发展。本研究探讨了医学就读期间辅导关系的演变历程，以及长期辅导关系对医学生在临床阶段处理反馈与设定目标的方式产生的影响。本项采用建构主义范式的定性研究中，研究者于2021年10月至11月，对加州大学旧金山分校的15名高年级医学生开展目的性抽样，并实施个体半结构化访谈。研究者采用归纳式主题分析法开展研究，最终提炼出四大核心主题：其一，医学生与辅导者的关系随医学生涯推进不断深化；其二，学生总结出长期维持并强化该辅导关系的多项要素：牢固的关系基础、关系的非评价性特质、辅导者的支持性与响应能力，以及辅导者对所在机构运作环境的熟悉程度；其三，辅导者会提供个性化建议、评估学生成长轨迹，并指导其解读反馈信息；其四，学生将通过辅导经历习得的技能付诸实践，包括主动征求反馈、回应反馈以及制定学习目标。以信任为根基的辅导关系会随医学生成长为医师的过程不断演进，以适配其不断变化的需求。学生们会将在辅导关系中习得的反馈处理与目标设定技能，应用于临床场景中与其他临床督导的互动中。