Have you heard of
an American golfer called Jack Grout? No, I thought not. He didn’t win any
majors, in fact he didn’t win any significant prizes but he is still one of the
most important men in golf. Why? Well he was Jack Nicklaus’s ‘first and only’
golf coach. Now, you’ve heard of Jack Nicklaus haven’t you? This arrangement
highlights 2 key facts; firstly, you can never be too good to benefit from
coaching and secondly, you don’t have to be an expert to be a good coach. Nicklaus
said of Grout “…he made you so confident of your skills that you could identify
and fix your own swing flaws even in the heat of battle, even without him there
by your side”. In coaching terms, this approach is referred to as “The Four
Stages of Competence” (attributed to Abraham Maslow). So, you have a flaw in
your golf swing that you cannot see yourself (unconscious incompetence), a
coach points this out to you (conscious incompetence), you work to eliminate this
fault (conscious competence) and eventually you can do this without thinking
The coaching paradigm is different to the teaching paradigm. In teaching, the aim is graduation. You learn a new skill (such as driving a car), you pass a test, you get your certificate and you are deemed competent. In coaching, you are never good enough, there is always room for improvement.
In the 1970’s, randomised trials done by Jim Knight (The Kansas coaching project - Ref 1) studied how teachers might better learn new teaching skills. Those randomised to study in workshops used 10% of skills they were taught. With coaching, 80% of the skills were acquired.
In coaching, there are no menus or recipes, no carrots or sticks. The aim is to be creative, to foster the ability of people to maximise their own capabilities. But does this have any relevance in medicine? Well, studies by K Anders Ericsson (ref 2) suggests that the answer is yes. Let’s face it, medicine is a lonely place. Very few of us have the opportunity to stand shoulder to shoulder in the operating room with a colleague who’s only role is to help you to improve. When the consulting room door closes, who is there to say “…what do you want to work on? Here is what I see”.
Inspired by Atul Gawande’s article in the New Yorker magazine (Ref 3), I decided to test this for myself. I chose Azfar Zaman to coach me in the catheter lab (PCI), Paul Hynam in the outpatient clinic (coaching on communication skills) and Peta Foxall for teaching.
This is what we
found…watch this space
1. K Anders Eriicsson http://www.uvm.edu/~pdodds/files/papers/others/everything/ericsson2007a.pdf