Lecture Notes: Feedback and Coaching in CBM II

Introduction

• Presenter is thrilled to discuss feedback and coaching within CBM II (Competency-Based Medical Education).
• Objectives: review role of feedback and coaching, research findings, describe the R2C2 coaching model, and discuss future challenges.

Goals of CBM II

• Improve healthcare outcomes, reduce errors, and increase safety.
• Learner development for safe and efficient care.
• Emphasis on helping learners develop and grow (beyond mere assessment).

Feedback vs. Coaching

• Feedback: Tells you where you stand, can feel intimidating and emotional.
• Coaching: Longitudinal, helps you learn, improve, and play at a higher level.
• Coaching uses specific, descriptive, and timely feedback/data.

Critiquing Feedback

• Example: End-of-Rotation Evaluation Form (Eider).
• Specificity and consistency between scores & narrative are crucial for coaching.
• Inadequate narrative description hinders effective coaching.

Requirements for Effective Coaching

• Good feedback requiring specific, objective, relevant, timely narrative description of observed behavior (performance data).
• Words in feedback have power and should be used to describe observed behaviors clearly.

Role of Feedback and Coaching in CBM II

• Use of rigorous, structured feedback to move learners efficiently from novice to expert.
• Focus should shift from mere assessments to helping learners learn and develop.

Influence of Culture on Feedback and Coaching

• Cultural barriers in medical education (autonomy, independent practice) prevent open feedback.
• Importance of creating a supportive and open feedback culture.

Coaching in CBM II

• Promote growth and continuous improvement.
• Growth mindset vs fixed mindset: encouraging a growth-centric approach.
• Study on residents' reluctance to ask for feedback due to cultural barriers.

Definition of Coaching in Education

• One-to-one conversation focused on enhancing learning and development through self-awareness and personal responsibility.
• Techniques: questioning, active listening, providing appropriate challenges.

Components of Effective Coaching

• Individualized, real-time feedback.
• Goal setting and co-development of goals between coach and learner.
• Facilitates new behaviors, insights, and approaches.
• Analytical understanding and motivation towards excellence.

R2C2 Coaching Model

• Four-phase model: Rapport building, exploring reactions, content, and coaching for change.
• Phase 1: Building a relationship, understand past feedback experiences.
• Phase 2: Exploring learner's reactions to feedback.
• Phase 3: Delving into content and knowledge elements.
• Phase 4: Coaching for actionable changes.

Research on R2C2 Model

• Theory: Informed self-assessment, learner-centered approaches, cognitive domains influencing behavior change.
• Positive reception in studies: valued engagement, focus on improvement, collaborative relationships.
• Learning change plan for structured, detailed feedback and goal setting.

Summary

• CBM II is dynamic and evolving: focus on sound educational principles and disruptive improvement.
• Effective role modeling by faculty to foster a feedback-accepting culture.

Questions & Answers

• Time allocated for Q&A at the end of the session.