"The Environment Fostered True Growth": Harnessing Coaching on an Innovative Medicine Sub-internship.

Abstract

Medicine sub-internships aim to prepare students for residency. However, the traditional sub-internship structure, with multiple learners at varied levels, poses obstacles to providing the clinical exposure, learning environment, and direct observation and feedback necessary to develop essential skills. Investigate the educational experience of learners on a coaching-centered sub-internship (CCSI) on a resident uncovered ward service. From 2017 to 2022, 73 sub-interns and 39 hospitalists participated in the rotation at a community-based university-affiliated urban hospital. Sub-interns rotated on a CCSI with teams comprised of one attending, one physician assistant, and one student. Students cared for patients across the continuum of hospitalization with frequent coaching by trained attendings. Students engaged in workshops targeting clinical skills essential for internship. Students (n = 67/73, 91.8% response rate) rated the quality of the course significantly higher on the CCSI than the traditional sub-internship rotation (mean [SD]) 4.87/5 [0.49] vs. 4.63/5 [0.61]; p < 0.001. Students and faculty found the CCSI fostered coaching, autonomy, accurate assessments, professional development, growth mindset, and readiness for internship. Our model demonstrates that a CCSI can cultivate the skills and mindset to prepare students for internship. This coaching model can benefit students in other settings.