Identifying coaching skills to improve feedback use in postgraduate medical education
Open accessAbstract
Objectives: Coaching in medical education has recently gained prominence, but minimal attention has been given to key skills and determining how they work to effectively ensure residents are progressing and developing self‐assessment skills. This study examined process‐oriented and content‐oriented coaching skills used in coaching sessions, with particular attention to how supervisors use them to enhance resident acceptance of feedback to enhance learning. Methods: This qualitative study analysed secondary audiotaped data from 15 supervisors: resident dyads during two feedback sessions, 4 months apart. The R2C2 model was used to engage the resident, build a r elationship, explore r eactions to feedback, explore resident perceptions of c ontent, and c oach for change. Framework analysis was used, including familiarisation with the data, identifying the thematic framework, indexing and charting the data and mapping and interpretation. Results: Process skills included preparation, relationship development, using micro communication skills and techniques to promote reflection and self‐assessment by the resident and supervisor flexibility. Content skills related to the specific feedback content included engaging the resident in discussion, ensuring the discussion was collaborative and focused on goal setting, co‐developing a Learning Change Plan, ensuring resident commitment and following up on the plan. Together, these skills foster agency in the resident learner. Three overarching themes emerged from the analysis: the interconnectedness of process and content; tensions between encouraging self‐direction and ensuring progress and competence; and balancing a coaching dialogue and a teaching monologue. Conclusions: Effective coaching by supervisors requires a combination of specific process and content skills that are chosen depending on the needs of the individual resident. Mastering these skills helps residents engage and develop agency in their own professional development. These outcomes depend on faculty maintaining a balance between coaching and teaching, encouraging resident self‐direction and ensuring progression to competence.
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Broadly reported themes of coaching focused on coachee development and/or performance, with medicine-specific models R2C2 and PRACTICE and general models SMART goals and GROW being cited.
“The broadly reported themes of coaching focused on coachee development and/or performance, with medicine-specific models such as R2C2 [152], and PRACTICE [138], and general coaching models such as SMART goals [161], and GROW [162] being cited.”
From Coaching in undergraduate and graduate medical education: a scoping review of success factors, barriers, and outcomes (2026) · cites this paper as [152]
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Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013) · BMC Medical Research Methodology · doi:10.1186/1471-2288-13-117 · Cited by 10,865 · see citing works
Qualitative data analysis for applied policy research
Ritchie, J., & Spencer, L. (2010) · Analyzing qualitative data · doi:10.4324/9780203413081_chapter_9 · Cited by 4,800 · see citing works
(2021) · Edward Elgar Publishing eBooks · doi:10.4337/9781788976954.00014 · Cited by 4,030 · see citing works
Rethinking models of feedback for learning: the challenge of design
Boud, D., & Molloy, E. (2013) · Assessment & Evaluation in Higher Education · doi:10.1080/02602938.2012.691462 · Cited by 1,636 · see citing works
Workplace-based assessment as an educational tool: AMEE Guide No. 31
Norcini, J., & Burch, V. (2007) · Medical Teacher · doi:10.1080/01421590701775453 · Cited by 984 · see citing works
Critically appraising qualitative research
Kuper, A., Lingard, L., & Levinson, W. (2008) · BMJ · doi:10.1136/bmj.a1035 · Cited by 784 · see citing works
State of the science in health professional education: effective feedback
Archer, J. C. (2010) · Medical Education · doi:10.1111/j.1365-2923.2009.03546.x · Cited by 783 · see citing works
What is feedback in clinical education?
Van De Ridder, J. M. M., Stokking, K. M., McGaghie, W. C., & Ten Cate, O. T. J. (2008) · Medical Education · doi:10.1111/j.1365-2923.2007.02973.x · Cited by 686 · see citing works
The “educational alliance” as a framework for reconceptualizing feedback in medical education.
Telio, S., Ajjawi, R., & Regehr, G. (2015) · Academic Medicine · doi:10.1097/acm.0000000000000560 · Cited by 572 · see citing works
Murray, J. (2010) · Wiley eBooks · doi:10.1002/9780470684214.ch7 · Cited by 531 · see citing works
Impact of workplace based assessment on doctors' education and performance: a systematic review
Miller, A. P., & Archer, J. C. (2010) · BMJ · doi:10.1136/bmj.c5064 · Cited by 462 · see citing works
Using F ramework A nalysis in nursing research: a worked example
Ward, D. J., Furber, C., Tierney, S., & Swallow, V. M. (2013) · Journal of Advanced Nursing · doi:10.1111/jan.12127 · Cited by 433 · see citing works
Haidet, P., & Stein, H. F. (2006) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2006.00304.x · Cited by 355 · see citing works
Sargeant, J., Lockyer, J., Mann, K., Holmboe, E., Silver, I., Armson, H., Driessen, E., MacLeod, T., Yen, W., Ross, K., et al. (2015) · Academic Medicine · doi:10.1097/acm.0000000000000809 · Cited by 306 · see citing works
Self-citationWhat do we know about coaching in medical education? A literature review
Lovell, B. (2018) · Medical Education · doi:10.1111/medu.13482 · Cited by 277 · see citing works
Workplace-based assessment as an educational tool
Norcini, J. J., Burch, V. C., & Gibbs, T. J. (2007) · Medical Entomology and Zoology · Cited by 266 · see citing works
Feedback for learners in medical education: What is known? A scoping review.
Bing-You, R., Hayes, V., Varaklis, K., Trowbridge, R., Kemp, H., & McKelvy, D. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001578 · Cited by 256 · see citing works
Feedback and the educational alliance: Examining credibility judgements and their consequences.
Telio, S., Regehr, G., & Ajjawi, R. (2016) · Medical Education · doi:10.1111/medu.13063 · Cited by 231 · see citing works
What is ‘Coaching'? An Exploration of Conflicting Paradigms
Ives, Y. (2008) · International journal of evidence based coaching and mentoring · doi:10.1177/174183050800600209 · Cited by 202 · see citing works
Ramani, S., Könings, K. D., Ginsburg, S., & van der Vleuten, C. P. M. (2018) · Medical Teacher · doi:10.1080/0142159x.2018.1432850 · Cited by 201 · see citing works
Self-citationMann, K. V., van der Vleuten, C. P. M., Eva, K. W., Armson, H., Chesluk, B., Dornan, T., Holmboe, E. S., Lockyer, J., Loney, E., & Sargeant, J. M. (2011) · Academic Medicine · doi:10.1097/acm.0b013e318226abdd · Cited by 198 · see citing works
Self-citationLearning culture and feedback: an international study of medical athletes and musicians
Watling, C., Driessen, E., van der Vleuten, C. P. M., & Lingard, L. (2014) · Medical Education · doi:10.1111/medu.12407 · Cited by 162 · see citing works
Features of assessment learners use to make informed self-assessments of clinical performance.
Sargeant, J., Eva, K. W., Armson, H., Chesluk, B., Dornan, T., Holmboe, E., Lockyer, J. M., Loney, E., Mann, K. V., & van der Vleuten, C. P. M. (2011) · Medical Education · doi:10.1111/j.1365-2923.2010.03888.x · Cited by 154 · see citing works
Self-citationThe power of coaching: a meta-analytic investigation
Sonesh, S. C., Coultas, C. W., Lacerenza, C. N., Marlow, S. L., Benishek, L. E., & Salas, E. (2015) · Coaching An International Journal of Theory Research and Practice · doi:10.1080/17521882.2015.1071418 · Cited by 152 · see citing works
Teunissen, P. W., Stapel, D. A., van der Vleuten, C., Scherpbier, A., Boor, K., & Scheele, F. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181a858ad · Cited by 151 · see citing works
Hedging to save face: a linguistic analysis of written comments on in-training evaluation reports
Ginsburg, S., van der Vleuten, C. P. M., Eva, K. W., & Lingard, L. (2015) · Advances in Health Sciences Education · doi:10.1007/s10459-015-9622-0 · Cited by 149 · see citing works
The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use?
Sargeant, J., Lockyer, J. M., Mann, K., Armson, H., Warren, A., Zetkulic, M., Soklaridis, S., Könings, K. D., Ross, K., Silver, I., et al. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002131 · Cited by 148 · see citing works
Self-citationStaging a performance: learners’ perceptions about direct observation during residency
LaDonna, K. A., Hatala, R. A., Lingard, L., Voyer, S., & Watling, C. (2017) · Medical Education · doi:10.1111/medu.13232 · Cited by 146 · see citing works
Kennedy, T. J. T., Regehr, G., Baker, G. R., & Lingard, L. A. (2009) · Medical Education · doi:10.1111/j.1365-2923.2009.03382.x · Cited by 141 · see citing works
Ramani, S., Post, S. E., Könings, K., Mann, K., Katz, J. T., & van der Vleuten, C. (2017) · Teaching and Learning in Medicine · doi:10.1080/10401334.2016.1244014 · Cited by 138 · see citing works
Self-citationRamani, S., Könings, K. D., Mann, K. V., Pisarski, E. E., & van der Vleuten, C. P. M. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002193 · Cited by 128 · see citing works
Self-citationBing‐You, R. G., Varaklis, K., Hayes, V., Trowbridge, R. L., Kemp, H., & McKelvy, D. J. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001927 · Cited by 122 · see citing works
Encouraging residents to seek feedback.
Delva, D., Sargeant, J., Miller, S., Holland, J., Alexiadis Brown, P., Leblanc, C., Lightfoot, K., & Mann, K. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.806791 · Cited by 118 · see citing works
Self-citationDriessen, E., & Scheele, F. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.798403 · Cited by 110 · see citing works
Watling, C., LaDonna, K. A., Lingard, L., Voyer, S., & Hatala, R. A. (2016) · Medical Education · doi:10.1111/medu.13062 · Cited by 107 · see citing works
Coaching in Education: Getting Better Results for Students, Educators, and Parents
Kops, W. (2014) · Canadian Journal of University Continuing Education · doi:10.21225/d5h89x · Cited by 93 · see citing works
Grant, A. M. (2013) · Coaching An International Journal of Theory Research and Practice · doi:10.1080/17521882.2013.850106 · Cited by 90 · see citing works
Unfulfilled promise, untapped potential: Feedback at the crossroads
Watling, C. (2014) · Medical Teacher · doi:10.3109/0142159x.2014.889812 · Cited by 90 · see citing works
Demonstrating the value of longitudinal integrated placements to general practice preceptors
Walters, L., Prideaux, D. J., Worley, P., & Greenhill, J. (2011) · Medical Education · doi:10.1111/j.1365-2923.2010.03901.x · Cited by 88 · see citing works
Music lessons: revealing medicine's learning culture through a comparison with that of music
Watling, C., Driessen, E., van der Vleuten, C. P. M., Vanstone, M., & Lingard, L. (2013) · Medical Education · doi:10.1111/medu.12235 · Cited by 72 · see citing works
Feedback in Clinical Education
Weinstein, D. F. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000559 · Cited by 60 · see citing works
Using a Smartphone App and Coaching Group Sessions to Promote Residents’ Reflection in the Workplace
Könings, K. D., van Berlo, J., Koopmans, R., Hoogland, H., Spanjers, I. A. E., ten Haaf, J. A., van der Vleuten, C. P. M., & van Merriënboer, J. J. G. (2016) · Academic Medicine · doi:10.1097/acm.0000000000000989 · Cited by 39 · see citing works
Self-citationCoaching with self-determination in mind: Using theory to advance evidence-based coaching practice
Spence, G. B., & Oades, L. G. (2011) · International journal of evidence based coaching and mentoring · doi:10.1177/174183051100900204 · Cited by 38 · see citing works
Exploring the influence of context on feedback at medical school: a video-ethnography study
Urquhart, L., Ker, J., & Rees, C. E. (2017) · Advances in Health Sciences Education · doi:10.1007/s10459-017-9781-2 · Cited by 37 · see citing works
Gagnon, L.-H., & Abbasi, N. (2017) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2017.05.003 · Cited by 32 · see citing works
Reed, S. M., Lockspeiser, T. M., Burke, A. E., Gifford, K. A., Hanson, J. L., Mahan, J. D., McKenna, M. P., Rosenberg, A. A., & Li, S. T. (2015) · Academic Pediatrics · doi:10.1016/j.acap.2015.10.005 · Cited by 26 · see citing works
What do coaches need to know? Using the Mastery Window to assess and develop expertise
Drake, D. B. (2011) · Coaching An International Journal of Theory Research and Practice · doi:10.1080/17521882.2011.596486 · Cited by 21 · see citing works
An Introduction to Coaching Skills: A Practical Guide
Oti, J. A. (2017) · International Journal of Mentoring and Coaching in Education · doi:10.1108/ijmce-06-2017-0046 · Cited by 20 · see citing works
Coaching during a trauma surgery team training: perceptions versus structured observations
Alken, A. P. B., Tan, E. C. T. H., Luursema, J., Fluit, C. R. M. G., & van Goor, H. (2014) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2014.02.009 · Cited by 14 · see citing works
What do you Really Want: An Examination of the Pursuit of Goal Setting in Coaching
Jinks, D., & Dexter, J. (2012) · International journal of evidence based coaching and mentoring · doi:10.1177/174183051201000209 · Cited by 13 · see citing works
On the Value of Coaching in Medicine
Graddy, R., & Wright, S. M. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001270 · Cited by 6 · see citing works
Suggestive techniques in coaching
Armatas, A. (2011) · Coaching An International Journal of Theory Research and Practice · doi:10.1080/17521882.2010.551009 · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [30]30. Ward D, Furber C, Tierney S, Swallow V. Using framework analysis in nursing research: a worked example. J Adv Nurs 2013;69 (11):2423-31.
- [35]35. Haidet P, Stein HF. The role of the student-teacher relationship in the formation of physicians. J Gen Intern Med 2006;21 (1):16-20.
- [46]46. Stanier M. The Coaching Habit: Say Less, Ask More and Change the Way You Lead Forever. Toronto, ON: Box of Crayons Press 2016.
Cited by
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Hauer, K. E., Chang, A., van Schaik, S. M., Lucey, C., Cowell, T., & Teherani, A. (2023) · Teaching and Learning in Medicine · doi:10.1080/10401334.2022.2111570 · Cited by 33 · see citing works
Goal co‐construction and dialogue in an internal medicine longitudinal coaching programme
Farrell, L., Cuncic, C., Hartford, W., Hatala, R., & Ajjawi, R. (2023) · Medical Education · doi:10.1111/medu.14942 · Cited by 21 · see citing works
Selling, S. K., Rooholamini, S. N., Grow, H. M., McPhillips, H., Hoang, K., Blankenburg, R., & Rassbach, C. (2023) · Academic Medicine · doi:10.1097/acm.0000000000005011 · Cited by 15 · see citing works
Bringing meaning to coaching in medical education
Lovell, B. (2019) · Medical Education · doi:10.1111/medu.13833 · Cited by 12 · see citing works
Tait, G. R., & Kulasegaram, K. M. (2022) · Education Sciences · doi:10.3390/educsci12040249 · Cited by 9 · see citing works
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King, S. M., Anas, S., Carnicer Hijazo, R., Jordaan, J., Potter, J. D. F., & Low-Beer, N. (2024) · Medical Teacher · doi:10.1080/0142159x.2024.2308058 · Cited by 8 · see citing works
Jain, P. G., McBride, M. E., Caliendo, A., & Eppich, W. (2022) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-21-00936.1 · Cited by 8 · see citing works
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Black, K., Feda, J., Reynolds, B., Cutrone, G., & Gagnon, K. (2025) · Journal of Physical Therapy Education · doi:10.1097/jte.0000000000000378 · Cited by 5 · see citing works
Mukherjee, B., Pfleeger, J., Custodio, H., Roca, M. R., Khalsa, G., & Clanton, C. (2026) · Medical Education Online · doi:10.1080/10872981.2026.2687304 · Cited by 1 · see citing works
- Authors
- Armson, H., Lockyer, J. M., Zetkulic, M., Könings, K. D., & Sargeant, J.
- Affiliations
- University of Calgary (CA)
- Hackensack University Medical Center (US)
- Maastricht University (NL)
- Dalhousie University (CA)
- Corresponding author
- Armson, Heather
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2019-02-18
- Volume
- 53
- Issue
- 5
- Pages
- 477-493
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2915951473
- Cited by
- 115
- References
- 52
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 21 · 2023: 15 · 2022: 16 · 2021: 22 · 2020: 10 · 2019: 6
- FWCI
- 12.43
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (acceptedVersion, other-oa)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- National Board of Medical Examiners (2014‐16)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Psychology › Applied Psychology › Coaching Methods and Impact
- Social Sciences › Psychology › Social Psychology › Mentoring and Academic Development
- Keywords
- coaching skills, feedback use, graduate medical education, resident supervision, self-assessment, goal setting, reflection
- MeSH terms
- Mentoring, Clinical Competence, Education, Medical, Graduate, Faculty, Medical, Feedback, Female, Humans, Internship and Residency, Male, Self-Assessment, Qualitative Research
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