Medical student coaching in the U.S.: a national survey of clinical skills educators

Coaching is increasingly recognized as a valuable tool to amplify learning in undergraduate medical education (UME), yet national data on its implementation, particularly in the context of clinical skills education, remain limited. Previous survey studies on coaching in medical education have focused on select institutions with established coaching programs, leaving a gap in understanding the broader landscape of coaching in UME. This study aims to address three critical gaps: current descriptions of coaching programs across U.S. medical schools, the nature of support provided to faculty coaches in these programs, and understanding how coaching is integrated into clinical skills development.

A national survey was distributed to members of the Directors of Clinical Skills (DOCS) organization, targeting clinical skills educators at U.S. allopathic medical schools. The 29-item survey included multiple-choice, ranked, and open-ended questions. Responses were analyzed using both qualitative and quantitative approaches, combining descriptive statistics with content and thematic analysis to explore coaching program structure, goals, clinical skills impact, evaluation practices, and faculty development.

Of the 44 respondents, 38 completed the majority of the survey. Nearly half (47%) reported having an active coaching program, with an additional 14% planning to implement a program. Coaching commonly begins in the pre-clerkship phase (93%) and emphasizes longitudinal relationships (87%). Key priorities included professional identity formation and clinical skills development, with history-taking, presentation skills, and clinical reasoning identified as skills most amenable to coaching. Respondents highlighted coaching's role in fostering constructive learning environments, promoting skill development, and increasing student confidence. However, variations persist in program structure, oversight, and evaluation practices between institutions. Faculty development is widely implemented, with 94% of programs offering ongoing training and 79% compensating their coaches. Communication skills were ranked as the most critical competency for coach development. Evaluation practices were varied, with most programs relying on student satisfaction surveys (69%) and formative feedback (73%).

This study provides a current national snapshot of coaching in UME through the lens of clinical skills educators. It underscores the growing recognition of coaching's value in clinical skills development and professional identity formation. While coaching programs are increasingly supported by faculty development and compensation, variability in structure, oversight, and evaluation remains.