Development, implementation, and evaluation of a novel fellowship coaching program

Coaching for professional development contributes to improved performance, personal satisfaction, and well-being. Although coaching programs have been widely introduced at the undergraduate medical education level and in certain residency programs, coaching programs targeting the unique experiences of fellows are less well described. Given high rates of burnout, pulmonary and critical care medicine (PCCM) fellows may benefit from professional development coaching.

To design, implement, and evaluate an individual coaching program for PCCM fellows.

Alumni surveys and trainee and faculty focus groups identified key needs of a coaching program. Coaches received salary support and were trained in competencies including positive psychology, learner engagement, and communication. Starting in 2019, 3 coaches were assigned 7 fellows each, spanning the 3 Accreditation Council of Graduate Medical Education (ACGME) years. The program was evaluated through ACGME surveys, Likert scale-based end-of-year surveys, and qualitative analysis of fellows' written feedback.

Coaching was associated with improved overall training program satisfaction (ACGME survey overall satisfaction [survey range 1-5, with 5 highest] was 4.2, 3.9, and 4.3 in the 3 years preintervention, and 4.6, 4.6, and 4.6 in the 3 years postintervention). Compliant responses in the ACGME survey domain of Evaluation increased above our program benchmark of 90% from a baseline of 75%. Fellow well-being demonstrated slight improvements through the evaluation period (2018-2022). Fellows rated the coaching program highly, especially in support and well-being, feedback, and goal-setting. Only 66% reported a direct impact on choosing a specific career path.

Implementation of this fellowship coaching program was associated with improvements in fellows' satisfaction with the training experience, evaluation and feedback, career development, and well-being, despite the added challenges of the COVID-19 pandemic. Future directions include standardizing coaching frameworks, exploring long-term impacts on career trajectories, and evaluating coaches' satisfaction with the program.