Competencies for Those Who Coach Physicians: A Modified Delphi Study.

The rapidly evolving coaching profession has permeated the health care industry and is gaining ground as a viable solution for addressing physician burnout, turnover, and leadership crises that plague the industry. Although various coach credentialing bodies are established, the profession has no standardized competencies for physician coaching as a specialty practice area, creating a market of aspiring coaches with varying degrees of expertise. To address this gap, we employed a modified Delphi approach to arrive at expert consensus on competencies necessary for coaching physicians and physician leaders. Informed by the National Board of Medical Examiners' practice of rapid blueprinting, a group of 11 expert physician coaches generated an initial list of key thematic areas and specific competencies within them. The competency document was then distributed for agreement rating and comment to over 100 stakeholders involved in physician coaching. Our consensus threshold was defined at 70% agreement, and actual responses ranged from 80.5% to 95.6% agreement. Comments were discussed and addressed by 3 members of the original group, resulting in a final model of 129 specific competencies in the following areas: (1) physician-specific coaching, (2) understanding physician and health care context, culture, and career span, (3) coaching theory and science, (4) diversity, equity, inclusion, and other social dynamics, (5) well-being and burnout, and (6) physician leadership. This consensus on physician coaching competencies represents a critical step toward establishing standards that inform coach education, training, and certification programs, as well as guide the selection of coaches and evaluation of coaching in health care settings.

When fixing problems kills personal development: fMRI reveals conflict between Real and Ideal selves.

Many coaching approaches aim to change behavior by increasing self-knowledge. However, self-knowledge can be difficult to achieve. One hypothesis (e.g., Jung, Rogers) is that self-knowledge is challenging because there is inherent conflict between different aspects of the self. This hypothesis is foundational to Boyatzis' intentional change theory (ICT). ICT holds that effective coaching requires deliberate sequencing of the client's exploration of different aspects of their self. Coaches initially encourage clients to focus exclusively on their Ideal self. The ICT approach differs from that advocated by most coaching organizations that suggest collaborative goal setting at the start of the coaching engagement, encouraging clients to focus on fixing performance deficits and problematic behaviors-aspects of the Real self. If there is conflict between thinking about Ideal and Real selves, then this strategy will be suboptimal. The hypothesis of attentional conflict therefore has significant implications for coaching practice. Previous findings establish a link between attention to Ideal vs. Real selves and global vs. local visual processing, respectively. This association alone does not imply conflict because, in naturalistic settings, global and local perceptual processes usually work in concert. However, certain stimuli such as Navon figures (letters made from many smaller letters, e.g., a large E made of small R's) create conflict due to incongruence between the global and local features. Does thinking about the self inherently generate conflict, like a Navon figure, or is it more akin to everyday perception? To answer this question the current study uses functional magnetic resonance imaging to examine the overlap in brain activity in young adults between two pairs of otherwise very dissimilar tasks: coaching interactions focused on Ideal vs. Real self; and attention to global vs. local features of Navon figures. Despite the ostensible absence of overlap in the psychological processes involved in these pairs of tasks, we find a remarkable degree of overlap in brain activity. This overlap was pronounced in higher (parietal and temporal) areas known to be involved in resolving attentional conflict. These findings provide compelling biological evidence for inherent conflict between thinking about Ideal and Real selves.

Vision-based coaching: optimizing resources for leader development.

Leaders develop in the direction of their dreams, not in the direction of their deficits. Yet many coaching interactions intended to promote a leader's development fail to leverage the benefits of the individual's personal vision. Drawing on intentional change theory, this article postulates that coaching interactions that emphasize a leader's personal vision (future aspirations and core identity) evoke a psychophysiological state characterized by positive emotions, cognitive openness, and optimal neurobiological functioning for complex goal pursuit. Vision-based coaching, via this psychophysiological state, generates a host of relational and motivational resources critical to the developmental process. These resources include: formation of a positive coaching relationship, expansion of the leader's identity, increased vitality, activation of learning goals, and a promotion-orientation. Organizational outcomes as well as limitations to vision-based coaching are discussed.

Visioning in the brain: an fMRI study of inspirational coaching and mentoring.

Effective coaching and mentoring is crucial to the success of individuals and organizations, yet relatively little is known about its neural underpinnings. Coaching and mentoring to the Positive Emotional Attractor (PEA) emphasizes compassion for the individual's hopes and dreams and has been shown to enhance a behavioral change. In contrast, coaching to the Negative Emotional Attractor (NEA), by focusing on externally defined criteria for success and the individual's weaknesses in relation to them, does not show sustained change. We used fMRI to measure BOLD responses associated with these two coaching styles. We hypothesized that PEA coaching would be associated with increased global visual processing and with engagement of the parasympathetic nervous system (PNS), while the NEA coaching would involve greater engagement of the sympathetic nervous system (SNS). Regions showing more activity in PEA conditions included the lateral occipital cortex, superior temporal cortex, medial parietal, subgenual cingulate, nucleus accumbens, and left lateral prefrontal cortex. We relate these activations to visioning, PNS activity, and positive affect. Regions showing more activity in NEA conditions included medial prefrontal regions and right lateral prefrontal cortex. We relate these activations to SNS activity, self-trait attribution and negative affect.