Article In Brief
A coaching program at Cleveland Clinic brings neurologists and neuroscientists together from different departments to help collaboratively set goals, set achievable action plans, and become accountable for achievable outcomes.
Like all practicing neurologists, Mary R. Rensel, MD, FAAN, director of the pediatrics and wellness programming at Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research, is busy. But she makes time to participate in the Clinic's Advanced Peer Coaching Program because she knows it can make a difference in a colleague's satisfaction with work and life.
Coaching, as practiced at the Clinic, helps members of the professional staff—both MDs and PhDs—identify and pursue goals of their choosing, whether that means improving communication with a supervisor, getting a leadership post in a professional organization or anything else. In doing so, it can mitigate elements of physician burnout such as emotional exhaustion, depersonalization (treating patients as objects), and career dissatisfaction.
“It very much addresses some of the issues of burnout,” Dr. Rensel said. “Coaching can reframe your reality and help you get a wider lens on possibilities.”
The benefits accrue to coaches as well as their coachees, said Andrea Sikon, MD, executive director of the Cleveland Clinic Center for Excellence in Coaching and Mentoring.
A 2016 survey of the Center's program found that participants in a matched coaching or mentoring relationship reported significant increases on measures of engagement and resilience, two attributes that mitigate clinician burnout.
“What I'm most proud of is that the coaches and mentors get just as much out of it as the coachees and mentees,” Dr. Sikon, chair of internal medicine and geriatrics at the Clinic, told Neurology Today.
The survey found that the Clinic's peer coaches use their skills not just in formal coaching situations but also in conversations with their patients, in interactions with their professional colleagues, and at home in their personal lives.
“It's a different approach to life, a new way of thinking,” she said. “It's very empowering.”
The ‘Coach Approach’
Dr. Sikon and her colleagues developed the Clinic's “coach approach” nearly a decade ago before the nationwide crisis of clinician burnout was recognized. The Center was started because, after a period of very rapid growth, the Clinic's professional staff were asking for support in navigating the challenges of working in a huge and fast-changing organization.
In the Center's parlance, the terms “coach” and “mentor” are distinct positions that work in tandem to help a coachee/mentee solve problems and attain goals.
“What I'm most proud of is that the coaches and mentors get just as much out of it as the coachees and mentees.”
—DR. ANDREA SIKON
A coach is a professional colleague from outside the coachee's department and day-to-day work life. By design, the coach does not offer advice; rather, he or she supports a coachee through a three-stage process: goal setting, which involves answering questions to understand specific goals, motivations, and values; action planning, which helps the coachee build confidence by reflecting on prior successes and exploring ways to overcome barriers; and accountability, which comes from committing to an achievable outcome and sticking to it until completion.
A mentor, by contrast, is someone who has expertise in a specific domain—for example, research, education, or handling career transitions—usually within a coachee's department or institute.
“People match with a coach and they get a network of mentors, depending on what kinds of expertise they need,” Dr. Sikon said. “The coach helps the person reflect and prepare so they show up well-prepared for the mentor conversations with the experts.”
Since the Center's inception, more than 1,000 physicians and scientists have completed a full-day orientation course that delineates those roles and trains participants how to listen actively and ask questions to help their peers gain insights into their situation. After the orientation, participants can choose to serve as peer coaches, mentors, or coachees—and most participate in all three roles.
“I have mentored and have been the mentee of many within the Cleveland Clinic, depending on what kind of project I'm working on or what area I would like new insights in,” Dr. Rensel said. “And I have been an advanced peer coach to many throughout our system, even some who work in [Cleveland Clinic sites in] Abu Dhabi and Florida.”
Coaching for Leadership
Amy Sullivan, PsyD, ABPP, clinical health psychologist and director of behavioral medicine at the Mellen Center, uses the Center's coach-approach in her work as engagement chair for the Neurological Institute (NI).
Dr. Sullivan was assigned to that position three years ago after her review of the Institute's engagement survey data revealed that female professional staff—both MDs and PhDs—had lower levels of engagement than female nurses, female employees, or males working in any capacity. Female staff gathered at a retreat to explore the reasons behind the disengagement.
“We were particularly concerned about the mid-career to younger-career population of females because they had the lowest scores,” Dr. Sullivan said. “One of the things that came out so powerfully was that, although 37 percent of the Cleveland Clinic staff, are females, they are not having leadership roles at the rate that we should.”
She worked with Andre Machado, MD, PhD, chairman of the NI, to establish the NI Female Leadership Cohort. The chairs of each of the nine centers within the Institute identified a female staff member who has leadership potential, and those professionals were recruited to participate in the cohort.
Dr. Sullivan had direct experience with the coach/mentor program because, when she joined the Clinic staff eight years ago, she went through the orientation program so she could serve as a coach and have a coach.
“I started working with Dr. Sikon at the inception of the [leadership cohort] program because I knew it was going to be important for us to connect with her program,” she said.
Dr. Sullivan worked with each of the women to identify specific skills they wish to master. Dr. Sikon used that information to match them with an appropriate coach from outside the NI. The coachees meet with their coaches every four to six weeks to keep moving toward their goals.
The goals vary, of course, but a common one is to learn how to be effectively heard.
“What I hear frequently is ‘How do I work to change the way that things are done or to offer new insight?’” Dr. Sullivan said. “That's a big one for our women.”
Digging Deeper into Coaching
Beyond the basic program, which currently has 350 participants, Dr. Sikon's Center has an invitation-only program for coaches and coachees who want to dive deeper into the work.
The Advanced Peer Coaching Program, in which Dr. Rensel participates, starts with a four-day training program, followed by ongoing training. That program currently has 96 coaches and 101 coachees, Dr. Sikon said.
“What I hear frequently is ‘How do I work to change the way that things are done or to offer new insight?’ That's a big one for our women.”
—DR. AMY SULLIVAN
“It very much addresses some of the issues of burnout. Coaching can reframe your reality and help you get a wider lens on possibilities.”
—DR. MARY R. RENSEL
“It takes a lot of practice because it's a whole new way of thinking,” said Dr. Rensel, president of the Women's Professional Staff Association at Cleveland Clinic.
Physicians are used to quickly gathering information, diagnosing a problem, and making a plan for solving it. By contrast, coaching requires having conversations that let the coachee think about a situation in a new way and come up with his or her own plan for addressing it.
“As an advanced peer coach, we tend to work with bigger issues, so it takes more time to develop a relationship, to get to know what's important to that person and to give them time and space to really delve into what they are struggling with or what they would like help with,” she said.
The opportunity to connect with individuals outside one's own work unit opens up new ideas of how to pursue a goal. In one example, a coachee wanted to create a camp for children with multiple sclerosis. Dr. Rensel helped that person connect with individuals who run the Clinic's pediatric pulmonology clinic to get their advice and lessons learned.
“We are there to stretch their thinking on how to move to a new level,” she said. “And then we keep checking to hold them accountable.”