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Nevin Manimala Statistics

SMARTer Goalsetting: A Pilot Innovation for Coaches During the Transition to Residency?

Acad Med. 2023 Jan 16. doi: 10.1097/ACM.0000000000005153. Online ahead of print.

ABSTRACT

PROBLEM: Ability to set goals and work with coaches can support individualized, self-directed learning. Understanding the focus and quality of graduating medical student and first-year resident goals and the influence of coaching on goal-setting can inform efforts to support learners through the transition from medical school to residency.

APPROACH: This observational study examined goal-setting among graduating medical students and first-year residents from April 2021-March 2022. The medical students set goals while participating in a Transition to Residency elective. The residents in internal medicine, obstetrics and gynecology, emergency medicine, orthopedics, and pathology set goals through meeting 1:1 with coaches. Raters assessed goals using a 3-point rubric on domains of specific, measurable, attainable, relevant, and timely (i.e., the SMART goal framework) and analyzed descriptive statistics, Mann-Whitney-U tests, and linear regressions.

OUTCOMES: Among 48 medical students, 30 (62.5%) set 108 goals for early residency. Among 134 residents, 62 (46.3%) entered goals. The residents met with coaches 2.8 times on average (range 0-8 meetings, median = 3). Goal quality was higher in residents than medical students (average score for S: 2.71 vs 2.06, P < .001; M: 2.38 vs 1.66, P < .001; A: 2.92 vs 2.64, P < .001; R: 2.94 vs 2.86, P = .002; T: 1.71 vs 1.31, P < .001). Linear regression showed the number of coaching meetings was associated with more specific and measurable goals (specific: F [1, 1.02] = 6.56, P = .01, R2 =.10; measurable: F [1, 1.49] = 4.74, P = .03, R2 =.07).

NEXT STEPS: Learners set realistic and attainable goals through the transition to residency, but the goals could be more specific, measurable, and timely. The residents set SMARTer goals, with coaching improving goal quality. Understanding how best to scaffold coaching and support goal-setting through this transition may improve trainees’ self-directed learning and well-being.

PMID:36652456 | DOI:10.1097/ACM.0000000000005153

By Nevin Manimala

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