title: Beyond Continuing Medical Education: Clinical Coaching as a Tool for Ongoing Professional Development.
abstract: For most physicians, the period of official apprenticeship ends with the completion of residency or fellowship, yet the acquisition of expertise requires ongoing opportunities to practice a given skill and obtain structured feedback on one's performance.
  
  
  
  In July 2013, the authors developed a clinical coaching pilot program to provide early-career hospitalists with feedback from a senior clinical advisor (SCA) at Massachusetts General Hospital. A Hospital Medicine Unit-wide retreat was held to help design the SCA role and obtain faculty buy-in. Twelve SCAs were recruited from hospitalists with more than five years of experience; each served as a clinical coach to 28 early-career hospitalists during the pilot. Clinical narratives and programmatic surveys were collected from SCAs and early-career hospitalists.
  
  
  
  Of 25 responding early-career hospitalists, 23 (92%) rated the SCA role as useful to very useful, 20 (80%) reported interactions with the SCA led to at least one change in their diagnostic approach, and 13 (52%) reported calling fewer subspecialty consults as a result of guidance from the SCA. In response to questions about professional development, 18 (72%) felt more comfortable as an independent physician following their interactions with the SCA, and 19 (76%) thought the interactions improved the quality of care they delivered.
  
  
  
  To better understand the impact and generalizability of clinical coaching, a larger, longitudinal study is required to look at patient and provider outcomes in detail. Further refinement of the SCA role to meet faculty needs is needed and could include faculty development.
authors.affiliation: C.A. Iyasere is instructor, Harvard Medical School, and member, Inpatient Clinician Educator Resident Teaching Service, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. M. Baggett is assistant professor, Harvard Medical School, and member, Inpatient Clinician Educator Resident Teaching Service, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. J. Romano is instructor, Harvard Medical School, and member, Hospital Medicine Group, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. A. Jena is associate professor, Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, member, Hospital Medicine Group, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, and faculty research fellow, National Bureau of Economic Research, Cambridge, Massachusetts. G. Mills is associate program administrator, Internal Residency Program, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. D.P. Hunt is acting professor, Emory University School of Medicine, and director, Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Christiana A
authors.initials: CA
authors.lastname: Iyasere
authors.forename: Meridale
authors.initials: M
authors.lastname: Baggett
authors.forename: Jordan
authors.initials: J
authors.lastname: Romano
authors.forename: Anupam
authors.initials: A
authors.lastname: Jena
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Mills
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Hunt
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing / Q000592:standards*; D064416:Hospital Medicine / Q000592:standards*; D006769:Hospitals, General; D006801:Humans; D008404:Massachusetts; D000071252:Mentoring; D011787:Quality of Health Care / Q000592:standards