A Culture of Coaching: Achieving Peak Performance of Individuals and Teams in Academic Health Centers

Transcription

1 Response to the 2012 Question of the Year A Culture of Coaching: Achieving Peak Performance of Individuals and Teams in Academic Health Centers Patti M Thorn, PhD November 5, 2012

2 Response Background Something happens to physicians in the training process. Somehow we train the curiosity and drive to perform to their fullest potential right out of them you should try to figure out how to keep or restore that curiosity and drive. Now that would be worthwhile. Richard Blinkhorn, MD 2

3 Peak Performance: Thinking/Doing and Being Self Awareness Mastery Goal and Drive Diverse Perspectives and Reflection Confidence and Self-Trust Knowledge and Competence Peak Performance Curiosity and Mindset for Possibility 3

4 Peak Performance: an uncommon goal [ACP, 2012: 10 major challenges that confront medical education over the next decade] Educating and Practicing cost-conscious, quality- focused, team-focused, patient-centered care Developing core faculty committed and rewarded for teaching Balancing needs for continuity of care and duty hour restrictions Encouraging career choices aligned with societal needs Managing student debt and conflicts of interest in CME Diverse Perspectives and Reflection Knowledge and Competence Self Awareness Peak Performance Mastery Goal and Drive Confidence and Self-Trust Curiosity and Mindset for Possibility 4

5 Peak Performance: a concerning culture Cultural Markers Language Satire and How To Guides Reflections from Medical Anthropology Empirical Studies Examples Survival, Flying under the radar Hits, Duty Hours Incongruent verbal and nonverbal expression Dismissal of emotion or inappropriate emotion expression House of God; Return to the House of God Staying Human During Residency Training Survival Guides A Culture of No Culture (1) Physician burnout, depression, suicide Physician impairment and failure to report colleagues The negative relational attributes of culture described by faculty working in academic medicine (2) Faculty attrition from AHCs, Tendency for Negativity Bias 5

6 An Answer: Coaching for Cultural Evolution [Senge, 1999, A Fifth Discipline Resource, The Dance of Change] Articulate New Ideas Propose Values Articulate the value of Peak Performance for Individuals and Teams in the agenda for AHC s Articulate Professional Coaching as a strategy for development of all elements of Peak Performance New Ways of Doing Things Teach faculty physicians coach-like behaviors and appoint faculty coaches for trainees (Medical Knowledge Coaches) 6

7 What is Professional Coaching? Parameter Who When Where What How Description Business executives and leaders Discipline used to enhance management and resource utilization Profession (Accrediting Bodies) Research Base through Harvard Inst. of Coaching at McLean Hospital Personal Best Atul Gawande, NY Times/Annals of Medicine Strengths- based human change methodology (distinct from counseling, consulting, mentoring) Theoretical foundations positive psychology/cognitive behavioral sciences Evidence-based (longitudinal, random assignment, outcomes) Utilizes inquiry process to discover being (values, strengths, purpose, longheld and limiting beliefs, self-trust, relational awareness, challenges and shift beliefs about reality) 7

8 Professional Coaching in an AHC: Use and Impact 1:1 Coaching Awareness Building [Experience personal transformation] Training Coaching Behaviors in Faculty [Deepen competencies] To start being who I always thought I would be To make work and life more manageable Ask impactful questions, listen, build trust, replace disempowering beliefs about teaching, learning, motivation, & intelligence 8

9 Impact of Professional Coaching Residents Shift from survival language to goals, strengths, and possibilities planning Attitude/Performance change Professional Coaching schedule filled-referrals 100% Board Pass Rate Greater intern satisfaction with ward rotations High value/appreciation for Faculty Medical Knowledge Coaches Faculty and Resident Collaboration New Curricula-Wellbeing, Career Transitions, Inquiry, Leadership in community service program, Med student tutoring Accountability Collegial relationships Increase in scholarly activity and pride in program Faculty Coaches Teacher of the year awards Trust and support Commitment to departmental and career goals Requests from faculty for training 9

10 Internal Medicine Department Leadership Priya Radhakrishnan, MD (Chair), Jaya Raj, MD, Jo Barone,RN, Denise Millstine, MD, Yousef Usta, MD, Kevin Olden, MD Residents (2005+) and Medical Students Faculty Champions Gabriel Colceriu, MD, Monica Mircescu, MD, Wesley Shealey, MD, Abby Roberts, DO, Sri Boddupalli, MD Moustafa Hazin,DO, Qaqish Ibrahim, MD,Feras Alyafi, MD Acknowledgements Co-Author: Jaya M. Raj, MD 10

11 References 1. Taylor JS. Confronting culture in medicine s culture of no culture. Acad Med. 2003; Pololi L, Conrad P, Knight S, Carr P. A sudy of the relational aspects of the culture of academic medicine. Acad Med. 2009; 84: Gawande A. Personal best: Top athletes and singers have coaches. Should you? The New Yorker. Oct 3, _fact_gawande. Accessed August 1,