Academic Coaching to Promote Self-Directed Learning in Graduate Medical Education

Graduate medical education is a critical period for fostering self-directed learning (SDL). This study introduced an academic coaching program to support SDL among internal medicine (IM) residents, leveraging Gallimore and Tharp's four-stage model as a scaffolding framework.

To assess the impact of academic coaching on residents' performance, including Internal Medicine In-Training Examination (IM-ITE) scores, individualized learning plans (ILPs), and attitudinal changes. The study also explored how coaching influenced SDL within the residency program.

A mixed-methods case study was conducted in a mid-sized university's IM residency program. Quantitative measures included pre- and post-coaching surveys, ILP analysis, and IM-ITE score evaluation. Semi-structured interviews provided qualitative insights into participant experiences. Of 77 eligible residents, 40 enrolled in the coaching program, and 27 (18 post-graduate year (PGY) 1 and PGY2) completed at least one session. Baseline IM-ITE scores guided enrollment for mandatory participants.

Of the 77 residents, 51 had complete IM-ITE data and individualized learning plans (ILPs) from 2022 and 2023. Residents attending one coaching session demonstrated significant improvement in IM-ITE percentile scores (p = .022), while those with two or more sessions showed significant gains in both percent correct (p = .015) and percentile scores (p = .003). No significant differences were observed in ILPs or attitudinal surveys. Qualitative analyses of resident participant interviews highlight coaching's positive influence on SDL, organized into input, process, and output domains.

Sustained coaching, defined as two or more coaching meetings, is associated with improved IM-ITE performance. Qualitative findings underscore the program's role in enhancing residents' SDL.