Lifelong development in medicine: a thematic analysis of coaching goals throughout medical careers.

OBJECTIVES: Healthcare grapples with staff shortages and rising burnout rates for medical students, residents and specialists. To prioritise both their well-being and the delivery of high-quality patient care, it becomes imperative to deepen our understanding of physicians' developmental aims and needs. Our first aim is, therefore, to gain comprehensive insights into the specific developmental aims physicians prioritise by examining the coaching goals they set at the beginning of coaching. Since physicians face distinct roles as they advance in their careers, our second aim is to highlight similarities and differences in developmental aims and needs among individuals at various medical career stages. DESIGN: We conducted a qualitative analysis of 2571 coaching goals. We performed an inductive thematic analysis to code one-half of coaching goals and a codebook thematic analysis for the other half. Our interpretation of the findings was grounded in a critical realist approach. SETTING: Sixteen hospitals in the Netherlands. PARTICIPANTS: A total of 341 medical clerkship students, 336 medical residents, 122 early-career specialists, 82 mid-career specialists and 57 late-career specialists provided their coaching goals at the start of coaching. RESULTS: The findings revealed that coachees commonly set goals about their career and future, current job and tasks, interpersonal work relations, self-insight and development, health and well-being, nonwork aspects and the coaching process. Furthermore, the findings illustrate how the diversity of coaching goals increases as physicians advance in their careers. CONCLUSIONS: Our findings underscore the significance of recognising distinct challenges at various career stages and the necessity for tailoring holistic support for physicians. This insight holds great relevance for healthcare organisations, enabling them to better align system interventions with physicians' needs and enhance support. Moreover, our classification of coaching goals serves as a valuable foundation for future research, facilitating a deeper exploration of how these goals influence coaching outcomes.

Career coach preferences of medical students: coaching specialist or specialistic coach?

BACKGROUND: Medical students' demand for career coaching is growing. However, little is known about what type of career coach they prefer. Using the Warmth-Competence Framework, we investigated if and why medical students prefer physician coaches compared to career psychologist coaches. We also examined whether students' coach choice related to coaches' amount of experience with medical students. METHODS: In a two-by-two between participants vignette study (n = 147), we manipulated coach occupational background (physician vs. psychologist) and experience with coaching medical students (limited vs. considerable). Participants read one coach description, rated the likelihood that they would choose the coach, and rated the coach on dimensions of warmth and competence. RESULTS: Students who evaluated a physician career coach were more likely to choose the coach than students who evaluated a psychologist career coach. Students expected that a physician career coach would better understand their situation and be better able to provide career information, while they expected a psychologist career coach to have better conversation skills, all of which were relevant to choosing a coach. Coaches' experience with coaching medical students was unrelated to students' coach choice and their assessment of the coach's warmth and competence. CONCLUSIONS: Our findings highlight the relevance of coaches' occupational background and have implications for the implementation of career coach interventions. Medical schools could help students choose a career coach by providing information about the coach qualities that students value. Future studies could investigate whether career coaches with different occupational backgrounds differ in coach behaviors and coaching effectiveness.

Medical students' career decision-making stress during clinical clerkships.

OBJECTIVES: Many medical students experience career decision-making stress in the final phase of training. Yet, the factors that induce or reduce career decision-making stress and how progression in their clerkships relates to these factors are unknown. This knowledge gap limits the possibilities for medical schools to develop and implement interventions targeting students' career decision-making stress. This study explores content, process, and context factors that may affect career decision-making stress. METHODS: Using cross-sectional survey data from medical master students (n = 507), we assessed content (future work self), process (choice irreversibility, time pressure, career decision-making self-efficacy), and context (supervisory support, medical school support, study load, competition) factors and their relationships with career decision-making stress. The hypothesized relationships were tested with structural equation modelling. RESULTS: A clearer future work self and higher career decision self-efficacy were associated with lower career decision-making stress, while experienced time pressure, competition, and study load were associated with higher career decision-making stress. Choice-irreversibility beliefs, supervisory support, and medical school support were unrelated to career decision-making stress. As students' clerkships progressed, they gained a clearer future work self, but also experienced more time pressure. DISCUSSION: Clinical clerkships help students to form a clearer future work self, which can diminish career decision-making stress. Yet, students also experience more time pressure as the period of clerkships lengthens, which can increase career decision-making stress. A school climate of high competition and study load seems to foster career decision-making stress, while school support hardly seems effective in diminishing this stress.