What is Physician Coaching? The Evidence

We are continuing our blog series, What is physician coaching?  So far, we have covered the definition, discussed what the coach and the coachee bring to sessions, and the commonly used tools and approaches. This week we review some articles and evidence for physician coaching.

Dr. Atul Gawande, Harvard surgeon, author, and healthcare leader, was one of the earliest to experiment with coaching in healthcare. He published Personal Best in the New York Times in 2011. Initially, his interest focused on coaching to elevate surgical techniques. Dr. Gawande now accesses coaching for himself professionally beyond surgical techniques and recommends coaching for everyone.

In 2015, Dr. Gail Gazelle, one of the earliest physician coaches from Harvard, began to see the burned-out physicians recover with coaching. She published in the Journal of General Internal Medicine. 

In 2015 and 2016, Dr. Nicole M Deiorio, Emergency Medicine Physician and Leader in Academics at OHSU and now Virginia Commonwealth, began mapping out methods and research in coaching, especially in Undergraduate Medical Education.  In 2017, Dr. Deiorio helped the AMA release their handbook on coaching in medical education with a faculty guide and student guide. 

In 2016 Penn State conducted a QI study with medical trainees, but it mixed terms and skills, calling the coaches “mentors.” They also found that trainees weren’t very comfortable with apparent conflicts of interest with their coach mentors being part of the evaluative process. A pertinent finding was a strong preference that the trainees had to coach around topics that did not map directly to EPAs. 

The first review article I found on coaching in medicine in 2018, What do we know about coaching in medical education? A literature review. Based on very few early studies, it revealed weak to medium evidence of improved non-technical skills and physician well-being and strong evidence for improving technical skills.

The most recent review article, after most of the RCTs in physician coaching, was a systematic review of 14 studies representing 1099 participants, 64% of those being trainees, and about half being in primary care. There were an average of 5.5 coaching sessions. 10 of the studies used an individual coach approach and 4 used a group approach. One study showed a dose-response. One of the studies suggested that men benefited more than women. It demonstrated improved well-being and reduced distress/burnout. 

Then in Oct 2023, Drs. Adrienne Mann and Ami Shah published the results of the CU Better Together Coaching intervention of the largest mutii-center RCT to date of 1019 female-identifying trainees. Using meta-cognition as a basis for coaching, it demonstrated decreased burnout (NNT = 11), decreased moral injury, decreased imposter syndrome, and increased self-compassion, and increased flourishing with a 4-month, virtual, group-based model. 

I’ve created a page of continuing these links and will continue to update it as new studies arrive – feel free to bookmark it: https://www.joyinfamilymedicine.com/evidence-based

Next week, I’ll review answers to questions I receive about coach training then we will wrap up the series with the various ways it's being incorporated into graduate medical education. 

Until then, have a joy-filled week! Tonya

In 2020, I did my own QI look at coaching residents and recent graduates showing that all improved in at least one component of burnout (emotional exhaustion, depersonalization, sense of personal accomplishment) and 80% had improvement in linear quality of life. One of the residents and I presented at STFM 2021. Learn more about the development from my experience - my hybrid coaching program for family medicine residencies.

UPDATED evidence links 10/11/23.