Accelerating Change in Medical Education

Amid diverse learning communities, coaches have a sensitive task

As the pool of physicians in training expands, the experiences and backgrounds that shape a learner’s vantage points will vary widely. Acknowledging and planning for that is essential to educating those medical students. These vantage points also factor in the relationship an academic coach has with a trainee.

The methods that may help an academic coach effectively work with diverse medical student populations are chronicled in a chapter of “Coaching in Medical Education: A Faculty Handbook.” The digital publication aims to provide a practical framework for medical educators who are forming coaching programs.

Jennifer Meka, PhD, is the director of cognitive skills programs at Penn State College of Medicine. She co-wrote the handbook’s chapter on coaching diverse student populations.

“[As a coach], it’s really important to be thinking holistically when you are working with all learners,” she said. “There are a variety of different domains and experiences that come into play that can enhance a student’s ability to be successful. What we can best do as coaches is work with our learners [to] identify some of those strengths and help them move forward in achieving success.”

Defining diversity

Meka believes that a prospective coach needs to understand that diversity in education has a broad definition.

“When I think about diversity in education, there are so many different way that learners are diverse and we need to take into consideration all the aspects that make a learner an individual—including how they operate in an academic setting and how they approach learning,” Meka said. “It’s really about developing a relationship with your learner that is built on trust, acceptance and respect. I think it’s a lot about asking questions. Finding out what people’s past and lived experiences have been and how you can create a plan that helps people get where they want to be.”

The text calls on coaches to be aware of existence of micro-inequities, conscious and subconscious patters of behaviors that devalue performance, at the individual and institutional levels. For many diverse learners, these can prove to be a consistent challenge, and it is incumbent upon a coach to help address them during coaching sessions.

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Facilitating change and success

The handbook states that “coaching is an evolving relationship of discovery for both the learner and the coach. It is this process of discovery that enhances the potential to deepen and enrich the coaching relationship and facilitates the self-actualization of the learner.”

An effective coaching relationship is going to a discovery process during which the coach works with the with the learner to identify how their background impacts their information processing and tools that can help them use their life experiences and background to their benefit. The text lists two coaching techniques that can help facilitate change and success:

  • Appreciative inquiry is a problem-solving technique that promotes diversity as a strength and accounts for a learners identity in plans, strategies and solutions for success. 
  • Motivational interviewing is a multi-faceted approach to helping the learner in the decision-making process by engaging them in safe space and focusing on the learner’s goals and how their behaviors impact them.

Those coach-coachee interactions are best approached with an open mind by both parties. Assumptions, even those about the role an educator plays and the role a student plays, can often be counterproductive to a coaching relationship.

“Instead of assuming a student does or doesn’t know something, ask them ‘what do you already know about this topic,’” Meka said. “If it is in the case of debriefing a patient encounter ask them, ‘what did you notice,’ instead of assuming that they did or did not notice certain things.”

Factors to consider

Coaches should be aware of both organizational policies and legal protections afforded to diverse learners. If learners feels any form of discrimination, the coach must report any incidents the appropriate office or department.

The handbook recommends faculty development that focuses on diverse learners’ needs and protections. Meka is encouraged by what she has seen in this arena during her work at Penn State.

“It’s a culture change,” she said. “We are helping people understand diversity and the role that plays within the learning environment. You start seeing and hearing things from interactions with faculty members and interactions with learners that tell us we are making progress.”