Early medical student experiences in a longitudinal coaching program grounded in the Master Adaptive Learner...

Coaching promotes self-directed learning, reflective practice, and professional development. Previous research has focused on senior medical students or established programs, leaving a limited understanding of how students experience coaching during the initiation of a new program. We sought to explore first- and second-year medical students' experiences in a newly established longitudinal coaching program oriented around the Master Adaptive Learner model, and to identify factors that support or hinder program effectiveness.

We conducted qualitative semi-structured focus group interviews with first- and second-year medical students within the coaching program. Audio recordings were de-identified, transcribed, and analyzed using thematic analysis informed by descriptive phenomenology. Three investigators independently coded transcripts, iteratively refining a codebook and achieving thematic saturation.

We held 7 focus groups with 20 participants. Three themes were identified: (1) Relational dynamics, emphasizing trust, personal connection, and the value of longitudinal interaction; (2) Role of coach in supporting education, highlighting coaches' neutrality, facilitation of self-reflection, and perceived educational benefits; and (3) Early program challenges, including prescriptive elements, communication barriers, and variability between coaches. Participants valued the relational aspects more than the structured Master Adaptive Learner-aligned reflective exercises, particularly during the pre-clerkship phase.

Early-stage coaching programs are most effective when they prioritize relationship-building and psychological safety: without consistently strong relational foundations, structured MAL-oriented reflection may not be feasible or salient for students. For institutions implementing new coaching programs, our findings suggest four actionable priorities: (1) invest early in relational groundwork; (2) clearly differentiate coaching from directive developmental relationships like advising or mentoring; (3) minimize overly prescriptive structures during launch phases, and (4) encourage MAL-oriented reflective work only after trust and psychological safety have been firmly established.