Goal co-construction and dialogue in an internal medicine longitudinal coaching programme

Area of Science:

• Medical Education
• Professional Development
• Qualitative Research

Background:

• Longitudinal coaching is integral to residency programs, involving collaborative goal setting between coaches and residents.
• Understanding the dynamics of goal development within these coaching conversations over time is crucial.
• This study explores goal development dialogues in resident and faculty coaching relationships.

Purpose of the Study:

• To analyze how goal development occurs in longitudinal coaching relationships within residency programs.
• To understand the nature of co-construction in goal setting during coaching sessions.
• To identify areas for optimizing coaching conversations for resident development.

Main Methods:

• Qualitative study employing interpretive description methodology.
• Eight internal medicine coach-resident dyads participated over one year.
• Coaching meetings were audio-recorded, and transcripts, along with exit interviews, were thematically analyzed using goal co-construction as a sensitizing concept.

Main Results:

• Coaching conversations primarily focused on 'how to be a resident,' with limited discussion on direct patient care challenges.
• Goal co-construction predominantly occurred in the 'how to meet goals' aspect, rather than in prioritizing or generating new goals.
• Residents' professional identity development and managing residency demands were central themes.

Conclusions:

• Coaching dialogues emphasized resident management and professional identity over direct patient care improvement.
• Academic coaching provides a dedicated space for focusing on residents' stage-specific professional identity.
• Future coaching optimization should integrate reflection on clinical competencies and professional identity formation for co-regulation.