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Doctor Coach: A Deliberate Practice Approach to Teaching and Learning Clinical Skills

Gifford, Kimberly A. MD; Fall, Leslie H. MD

doi: 10.1097/ACM.0000000000000097
Innovation Reports

Problem The rapidly evolving medical education landscape requires restructuring the approach to teaching and learning across the continuum of medical education. The deliberate practice strategies used to coach learners in disciplines beyond medicine can also be used to train medical learners. However, these deliberate practice strategies are not explicitly taught in most medical schools or residencies.

Approach The authors designed the Doctor Coach framework and competencies in 2007–2008 to serve as the foundation for new faculty development and resident-as-teacher programs. In addition to teaching deliberate practice strategies, the programs model a deliberate practice approach that promotes the continuous integration of newly developed coaching competencies by participants into their daily teaching practice.

Outcomes Early evaluation demonstrated the feasibility and efficacy of implementing the Doctor Coach framework across the continuum of medical education. Additionally, the Doctor Coach framework has been disseminated through national workshops, which have resulted in additional institutions applying the framework and competencies to develop their own coaching programs.

Next Steps Design of a multisource evaluation tool based on the coaching competencies will enable more rigorous study of the Doctor Coach framework and training programs and provide a richer feedback mechanism for participants. The framework will also facilitate the faculty development needed to implement the milestones and entrustable professional activities in medical education.

Dr. Gifford is assistant professor and residency program director, Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Dr. Fall is professor and vice chair of pediatric education, Department of Pediatrics, and associate dean for faculty development, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Funding/Support: The work presented in this manuscript was supported by a faculty scholar award from the Office of Research in Medical Education, Geisel School of Medicine at Dartmouth. Our initial resident-as-coach curricular development was funded through a local faculty scholar development award (KG devoted 0.1 FTE for one year).

Other disclosures: None reported.

Ethical approval: Ethical approval has been waived. This study received an exemption from the institutional review board (IRB) at the Geisel School of Medical at Dartmouth, Hanover, New Hampshire.

Previous presentations: Preliminary data were previously presented at the following conferences: Council on Medical Student Education in Pediatrics (COMSEP) annual meeting, San Diego, California, March 6, 2011 (poster); Association for Pediatric Program Directors (APPD) annual meeting, Miami, Florida, March 31, 2011 (poster); Pediatric Academic Society (PAS) Annual Meeting, Denver, Colorado, May 3, 2011 (poster); and Pediatric Educational Excellence Across the Continuum (PEEAC) Meeting, Arlington, Virginia, September 9, 2011 (poster).

Correspondence should be addressed to Dr. Gifford, Department of Pediatrics, One Medical Center Drive, Lebanon, NH 03756; telephone: (603) 653-9667; e-mail:

© 2014 by the Association of American Medical Colleges