Leadership Coaching in Surgical Residency: Reasons for Referral and Topics Addressed to Improve Nontechnical Skill

Professional coaching has been utilized in the military and private sector with a long track record of optimizing efficiency, improving high-functioning team performance, and creating greater satisfaction among the workforce. Recent studies in physician populations have suggested that coaching may protect healthcare providers from burnout and improve quality of life and resilience. The aims of the current study were to describe our single-institution experience with the introduction of a leadership coaching program among surgical residents and to characterize the nature of the common reasons for referral for coaching.

Upon identification by program faculty that a resident would benefit from coaching, an email was sent from the program director to the coach to establish contact between the coach and resident, with a brief synopsis of the factors that lead to the resident being referred for coaching. The study team obtained deidentified, simplified synopses of the initial email correspondences from program leadership reaching out to residents to refer them to coaching. Common recurring themes were quantified. Later, coaches reviewed their notes kept during coaching sessions and, in a similar fashion, identified topics discussed and skills developed in coaching sessions for each resident. Topics were summarized for each resident, and a deidentified list of residents and the themes reviewed in coaching were provided to the study team, who quantified these topics. Baseline demographic information on the resident cohort, including training level, gender, and number of repeat referrals were summarized to delineate differences in patterns of repeat referral and attrition.

This study was conducted within the general surgery residency program at a single academic medical center, composed of 43 categorical and 8 preliminary residents. Over a 2.5-year period, 21 residents were referred: 5 chief, 8 senior, 5 midlevel, and 3 junior (1 preliminary) residents. Male residents represented 2/3 and female residents 1/3 of the total number of referrals. There were 3 repeat referrals, 2 male and 1 female. We identified 2 overarching reasons for which residents were referred for coaching: request for structured leadership training and request for communication training. Six themes were identified upon review of referrals for coaching. Among these were the need for improved communication, methods to improve team integration, tools to balance professional and personal responsibilities, and practices to improve confidence and assertiveness. Through the coaching relationship, residents reviewed deficits and received an individualized plan to address newly identified problem areas. Upon initiation of coaching, new themes like anxiety management, emotional intelligence, and cultural acclimatization were identified. During each coaching session, residents participate in exercises designed to build habits of effective listening, communication, and conflict resolution.

Coaching in surgical residency provides a structured program for residents to develop skills in planning and orchestrating team operations, listening and communicating effectively, mitigating conflict, and managing professional and personal responsibilities. Follow-up studies will focus on the long-term effects of professional coaching, evaluating survey data from self-assessments and professional evaluations.