Impact of Coaching on Medical Students During Their Clinical Clerkship: A Mixed-Methods Study

In undergraduate medical education, clinical clerkships (CC) serve as a platform for acquiring the integrated competencies essential to physicians. Simultaneously, CC plays a crucial role in facilitating a smooth transition to postgraduate training and preventing burnout. This study aims to elucidate the effects of coaching on medical students during CC, with particular focus on self-efficacy and resilience.

This was a mixed-methods study based on an explanatory sequential design. The participants were fifth-year medical students who underwent CC at Chiba University Hospital in Japan between June and October 2021. They received four weeks of one-on-one coaching during one department's CC by other attending physicians trained as coaches. The participants answered self-assessment web questionnaires using the Japanese version of the Generalised Self-Efficacy Scale (GSE-J) and the Brief Resilience Scale Japanese version (BRS-J) before and after coaching. In addition, they participated in semi-structured focus group interviews related to the effects of coaching. Narrative data were analysed using qualitative content analysis.

Fifteen medical students participated in the study. The mean GSE-J and BRS-J scores (n = 13) significantly increased after coaching (from 71.0 (11.7) to 77.5 (16.2), p = 0.018, Cohen's d = 0.76, Hedges' g = 0.71 and from 18.5 (4.7) to 21.4 (4.1), p = 0.019, Cohen's d = 0.75, Hedges' g = 0.70, respectively). Four focus group interviews were conducted. The effects of coaching were classified into eight categories (goal setting and milestones, positiveness, verbalisation, self-confidence, proactivity, good communication, dealing with difficulties, and reflection and metacognition) related to self-efficacy and resilience.

Medical students who receive coaching during CC improved their self-efficacy and resilience. Combining coaching with regular training in CC might serve as a useful educational strategy in terms of a smooth transition to postgraduate training and preventing burnout.