title: Clinical coaching: Evolving the apprenticeship model for modern housestaff.
abstract: Feedback is one of the core components of teaching in the clinical setting. Traditionally, this activity has emphasized observations made by senior physicians and delivered to medical trainees. However, the optimal approach to feedback remains uncertain, and the literature abounds with trainee-perceived inadequacies in feedback content, quality, and impact. Moreover, given the multiplicity of demands on trainees and their physician mentors, we propose that medical trainees themselves-specifically, medical residents-are poised to serve as unique adjunct effectors of feedback. We propose a model of "clinical coaching" for residents as teachers, with emphasis on the active roles of both the feedback "giver" and "recipient". We define "clinical coaching" as "a helping longitudinal relationship between coach and apprentice that provides continuing feedback on and assistance with improving performance." Here, "coach" is the more experienced trainee (e.g. supervising resident), and "apprentice" is the less experienced trainee (e.g. intern or medical student). By working to better recognize and prepare residents for this vital role, we propose to encourage efforts to optimize the structure, execution, and impact of feedback in the contemporary climate of medical education.
authors.affiliation: a Division of Hematology/Oncology , Beth Israel Deaconess Medical Center and Harvard Medical School , Boston , MA , USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Rangachari
authors.affiliation: b Division of Cardiology , University of Louisville School of Medicine , Louisville , KY , USA.
authors.forename: Lorrel E
authors.identifier: http://orcid.org/0000-0002-7789-1732
authors.initials: LE
authors.lastname: Brown
authors.affiliation: c Division of General Internal Medicine , Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Kern
authors.affiliation: d Division of Infectious Diseases , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Melia
mesh_terms: D004501:Education, Medical; D005246:Feedback; D006801:Humans; D007396:Internship and Residency; D000071252:Mentoring; D013337:Students, Medical / Q000523:psychology*