A Coaching-Centered Inpatient Rotation Fosters Growth Mindset and Deliberate Practice in Resident Physicians

Complex clinical environments create unique challenges for deliberate practice and growth mindset.

To evaluate a coaching-centered rotation called Mastering the Art and Nuance of Team Leadership and Education (MANTLE) designed to foster growth mindset and deliberate practice in residents.

From 2019 to 2024, 50 internal medicine residents and 25 attending coaches participated in MANTLE, a 2-week acting-attending inpatient medicine rotation with structured coaching. Using a pragmatic paradigm with an explanatory sequential mixed methods design, we administered 2 surveys consisting of Likert-style questions comparing residents': (1) frequency of deliberate practice compared to other rotations (4 questions), and (2) pre-/post-rotation confidence in coached leadership and teaching skills (7 questions). To contextualize survey findings and explore how coaching fostered deliberate practice and growth mindset, we interviewed 16 residents and 10 attendings and conducted thematic analysis on transcripts.

Survey response rates were 52% (26 of 50) and 56% (28 of 50). Median (IQR) scores (5-point Likert) for deliberate practice were higher on MANTLE versus other rotations: goal setting 4 (4-5) vs 2 (2-3); feedback 5 (4-5) vs 3 (2-3); repetition/refinement 5 (5-5) vs 3 (3-4); motivation 5 (4-5) vs 3 (3-4); (all P<.001). Interviews yielded 6 themes: (1) Destigmatizing feedback by setting expectations; (2) Coaching guided by residents' goals; (3) Naming resident as team leader; (4) Attendings pivoting to role modeling; (5) Tensions while changing resident mindset; (6) Coaches carrying coaching philosophies forward.

A coaching-centered rotation can promote growth mindset, deliberate practice, and confidence in coached skills.