The Success Coach’s New Role in PA Education

If you’ve read any of my past work or worked with me, you know I focus on the Student Success Coaching Model as a way to improve PA student outcomes, beginning almost the moment applicants are accepted to your program.

In doing so, we delineated the three major roles of the participants in such a program, namely:

• The faculty, who can greatly benefit from the approach’s timeliness and efficiency in helping their students flourish.
• The students themselves, who learn “how to learn” and become their own best resource
• The Success Coach, the guide who combines the previous two participants with the proven processes of the Student Success Coaching Model.

Of these three participating groups, it is the Success Coach that is the newest key to the approach, a specially appointed and specifically trained member of your PA program staff.

For students and faculty, a shift in thinking and/or behavior is a requirement. A Success Coach’s role, however, is not the same as an advisor, a remediator, or instructor. Rather, Success Coaches create a custom program of accountability and provide a safe environment for students to address challenges.

In this article I will examine the purpose of the success coach in detail, beginning with training, moving through duties and student interactions, and the methodologies for student success, and finally, looking at results, such as how to measure outcomes.

Let’s start with the problem.

Over the past several years, PA educators have noticed the following trends:

• Lower performance standards are becoming endemic.
• PANCE scores are decreasing, and pass rates are dropping to below 80%.
• Students are struggling more with the transition to graduate level.
• The current approach to student remediation follows a problematic pattern without positive results.

What’s more, attrition rates are rising, taking a heavy toll on the bottom line of PA programs. High attrition rates can devastate a program. The effort and investment alone to bring a student into a program is costly. Each student represents approximately $100K of annual revenue. I recently worked with a PA program that lost 8 students in one year; therefore, student attrition resulted in nearly a $1M loss for this program. PA programs run a risk of losing resources if they are unprofitable going forward.

A major focus of the Student Success Coaching Model is starting at the beginning, that is, improvements in student preparedness during the admissions process itself, where your program can select better applicants and help ensure that they are ready for the rigors of graduate medical education.

Once students are part of a cohort at your program, there still may be difficulties. Even the brightest and most motivated students can find themselves struggling for many reasons. The Student Success Coaching Model homes in on problems sooner rather than later, quickly empowering students to become their own coaches and learning mentors, and hopefully stopping educational difficulties before they become overwhelming.

Coaching doesn’t have to be a long process either. Actually, coaching works best when it is high-impact and action oriented. Students do not have weeks upon weeks to catch up with their peers. They need practical problem-solving sooner rather than later; Success Coaching provides this.

Who is a Success Coach?

There may be a member of your faculty who is perfect for this position: excited about the prospect and motivated to make it work. We highly recommend choosing such individuals for the role. Nevertheless, a Success Coach does not have to be an instructor from your PA program. Success Coaches need only to have some sort of background in academic counseling.

When working with students, Success Coaches focus on the following:

Improving metacognitive skills (Ability, awareness, and control of the process by which they learn). Students are encouraged to “think about their thinking.”

• Taking learning to different process levels (such as adaptation, synthesis). Students that are stuck on the “knowledge level” of Bloom’s Taxonomy will surface learn and no real intellectual growth will occur.
• Adopting a study skill program that the Success Coach can follow up on throughout the semester.
• Providing faculty with resources and recommendations and ensuring reports of student progress are delivered to advisors, coordinators, and the program director, as appropriate.

The number of medical and PA schools implementing a success coach model is growing because this process has been demonstrated to get better results than previous remediation measures.?

Success Coach versus Academic Advisor

The role of a coach must be clearly defined to extend the benefits of a coaching relationship beyond traditional mentoring and advising.?An advisor, for example, has responsibilities such as assisting in course scheduling or managing curricular obligations, writing letters of recommendation, assisting in performance review, and other academic requirements. Advisors may have only limited knowledge of a learner’s strengths and weaknesses.?

A Success Coach, on the other hand, may or may not have expertise in the realm of the self-identified need(s) in their learner, but is skilled at helping the learner accurately reflect on their performance, assess their needs for growth, and gain insight into desired outcomes. Coaches also help learners create specific action-oriented plans to achieve their goals while providing a space for accountability and re-assessment of their needs.

When a learner approaches a Success Coach, they have specific issues pertaining to their learning, retention, and use of the information they are required to gain from their PA education. Their problems don’t usually pertain to specifics in their classes, which an instructor might be able to assist with, but to overall difficulties they experience in graduate education. Some examples of these difficulties include:

• There is too much information for me to learn.
• I am too tired to study.
• I don’t remember what I study.
• I am easily distracted.
• I am too busy to spend hours studying.
• I have trouble making a study schedule
• I have trouble following a study schedule
• I can’t decide where to study
• I have always been a bad test taker
• I can narrow the answer to two choices, then I pick the wrong answer.

Building a coaching relationship with learners

The Coach-learner relationship should be based on rapport and trust, and this rapport and trust should be continuously enhanced. The Success Coach provides students with a safe space for informed reflection on academic, personal, and professional performance, while ensuring student well-being.

Expectations should be clearly defined for both participants, with the learner setting the agenda and the goals and the coach focusing on maximizing strengths that are identified by the learner to help achieve goals, that will lead to high levels of academic and professional achievement and personal satisfaction. The coaching relationship requires unique communication skills on the part of the coach and attention to privacy and confidentiality.

The Contract

Orientation to the coaching process is a critical first step, and a coaching program will only work if there are explicit shared expectations of engagement by both the learner and the coach.

A contract may be most appropriate for an optional program since these programs often require additional time from the learner. I offer the following suggestions for inclusion in such a contract between the Success Coach and Learner.

From the Coach:

I will…

• Ask provocative questions and encourage my learner to arrive at his/her own answers whenever possible.
• Encourage realistic expectations and goals.
• Assist my learner to identify and fully engage in his/her strengths.
• Acknowledge when an issue is outside my skill set and recommend other resources.

From the Learner:

I am ready to…

• Take responsibility to make and sustain changes.
• Become more self-aware.
• Listen to suggestions and try new and different approaches.
• Share personal information that is relevant to my performance.

Shared Goals for the Coach and Learner

I will…

• Be punctual.
• Maintain confidentiality.
• Be open and honest.
• Be responsive to phone and electronic communication within an agreed upon timeframe.
• Be aware that setbacks are normal on the path to change and necessary in order to establish new mindsets and behaviors.
• Commit to upholding the terms of this agreement.

Such a contract provides not only accountability, but a clearer understanding as to what precisely the coaching sessions are meant to produce.

Conducting a coaching session

The contract between the Success Coach and Learner has already established what is expected of both parties to make the most of sessions together. Time is of the essence in this situation, obviously to help the struggling learner as quickly as possible, but also because Success Coaching has techniques that, when properly utilized by the learner, are almost immediately beneficial. The ability to identify a learning problem is the first step in the metacognitive process that the Student Success Model utilizes.

The initial meeting

The Success Coach has the responsibility to set the agenda for the initial meeting, as most incoming learners have no previous experience with academic coaching. Therefore, meeting preparation ensures that time together is considered value added for both the student and the Success Coach. Meeting preparation can be conducted through contact, such as email, to identify the subjects of importance. The first meeting will set the tone for future meetings and provides an opportunity for the coach and learner to begin a conversation about goal setting. This time should be used to open the door to communication, getting to know each other, and begin building essential trust.

After the initial meeting, the close of each session is also bookended with goals for the next session, if applicable.

Students must have an active role in the agenda setting.?While we emphasize the importance of the Success Coach, nothing of value can be accomplished without the agency of the learners themselves.?The Success Coach understands that all learners have individual goals, styles, and comfort levels. The idea is not to conform all learners to one structure, but to teach individual learners how to best teach themselves.

Coaches provide guidance toward goal-setting by exploring student interests and needs, as well as a regular check-in toward achieving these goals. They form a relationship with their students through building trust, open communication, and respect.

Sample Session

In this paraphrased interview, at once you will note that the Success Coach asks the learner to identify the problem and her deficits, so she can actively participate in solutions that work for her.

Coach: What do you think is at the root of your struggle?

Learner: Procrastination

Coach: What study method(s) are you using?

Learner: PAEA Boot Camp. I divide topics by how many days until the EOR. I tried to take off the day before the exam. I do the practice questions and try to review the next day.

Coach: Is there anything else you feel I should know?

Learner: I want to do well but struggle with procrastination. I’ve been successful in the past despite procrastination. I procrastinated, but still did well, so I knew I could “get away with it.”?Now I get overwhelmed when the exam approaches. I get confused between topics. I cram, then skip over a topic I don’t expect to be on the exam, but then it is. Being on academic probation was a motivator to get help. I study eight hours a day (not all at once), using Pomodoro method, Exam Master, Rosh Review, SmartyPANCE (questions are lower level, better for topical study), flash cards based on info from SmartyPANCE, textbook, Current, Pearls.

Deficits Identified:

? Medical Science Knowledge

? Study Skills

? Organization of Study Materials

? Clinical Medicine Knowledge

? Test-Taking Skills

? Time Management

? Clinical Skills

? Stress Management

? Other

Learner Comments: I can make a study plan, but struggle to stick to schedule. I plan to study 10 things a day but then must reschedule when I skip a day.

Now that the learner has identified her problems and deficits, she and the Success Coach can move forward with an action plan.

Developing the Action Plan

As we have established, a Success Coach does not apply a “one size fits all” approach to problem solving for students. In the last issue, our sample learner identified herself as a procrastinator (her main source of trouble) who has been able to coast by on last-minute studying and exam “cramming” until the graduate level. While she can develop a study plan, she has trouble sticking to it.

The Success Coach moves onto discovery and goal-setting that will work for this individual learner, by asking:

• How did the learner tackle such a challenge in the past?
• What worked and what was problematic?
• How does the learner feel about the academic challenges?
• Is the learner ready to make a change?
• What is the learner’s comfort zone – and how can she move beyond it?
• How can she develop her own persistence and strategies for success?

The most important role for a coach is to help the student develop a systematic approach to responding to this information. The coach can start by supporting the student in the creation of an action plan in the form of learning goals. In addition, the coach should help the student limit learning goals to an achievable number. For example, a coach can help the learner identify high quality learning resources to fill learning gaps.

Certain documents can be used to help in the identification of learner-specific skills and gaps. These include a variety of handouts asking the learner to identify their habits and practices (such as a metacognition survey, a test-taking inventory, a survey of study methods).

Creating the action plan contract

A formal action plan provides structure for the learner to develop steps toward completing a goal, and accountability of that learner to be responsible for her own diligence and improvement. It is a tool for the Success Coach and learner to use continuously, revisit, and check ongoing alignment as sessions proceed.

The action plan should contain:

• A timeline (plot a course between now and the “goal”)
• Success measures
• Required resources
• Possible barriers to success
• A place to record results

Accountability

Holding the learner accountable is important. For some learners, accountability may be as simple as following up with them at the next scheduled session or touching base via email. For other learners, it can be helpful for them to email an action plan after a meeting and regularly email at predetermined points. Always go over the action plan in detail and ask the learner to reiterate their understanding.

A sample action plan

I offer this as a sample action plan put forth when a learner consulted a Success Coach regarding EOR preparation.

1.?The learner will take the practice EOR through ROSH/TEST BANK during the first week of the clerkship.

2.?The learner will map the incorrect items by diagnosis title to the check off list for the EOR provided.

3.?During the rotation, the learner will focus on these incorrect items with more depth by triangulating with the HIN Notes along with no more than two resources to double check the accuracy.

4.?The correct items on the practice exam as well as the subsequent question bank questions will guide the student in terms of the depth and breadth of individual topics.

As you can see, the action plan includes all the needed components: a specific timeline, measures for success, required resources, barriers to success (in the form of incorrect items) and a way to track results.

Ongoing meetings

Keep in mind that while metacognitive techniques can be employed at once in helping a learner, overnight success is seldom an outcome.?Determination of the root cause for a learner’s academic struggles may take several sessions. As such, finding the root cause can become part of the action plan, and the action plan itself remains flexible as new information is uncovered.

After the initial session(s) in which the action plan is constructed, future meetings follow this structure:

1.?A review of the last session, including goals.

2.?An update on what has occurred since the last session.

3.?Action plans toward short and long-term goals.

Providing feedback to the learner

Feedback is an essential component to maintaining (and adjusting, if necessary) an Action Plan. The Success Coach provides feedback to the learner with the following in mind.

Be empathetic. Realize that this may be painful for the learner or cause significant anxiety or stress. Try to demystify the myths, such as “a poor test score is because of lack of intelligence or ability.” There will likely be tensions created from this information that the student may need help processing. A Success Coach does not act as a therapist but can provide an empathetic interaction to help learners move beyond emotions and into an action plan stage.

Be considerate. Tone of voice should be positive and encouraging, and statements should avoid personal references and inferences. Coaches should be judgment-free and keep personal biases out of their assessments.

Be consistent. Keep the message clear and on the “same page” between Success Coach, Learner, Advisors, and any other parties involved.

Be timely. Provide feedback sooner rather than later.

Be goal referenced. Target outcomes the learner knows are necessary (such as a passing score on an exam). Objectives should be clear and attainable.

Be tangible and transparent. Provide authentic feedback, with evidence that supports that feedback.

Be user-friendly. Stick to one or two points that are not overly technical, and appropriate based on circumstances.

Offer solutions. Practical solutions that jibe with the learner’s style are invaluable. Success Coaches are trained to know several tips to help the struggling learner. Present these as a series of choices for solutions to problems.

Encourage action. Allow the learner to formulate ideas on how to do things differently.

Encourage reflection. Follow up on how the learner is progressing toward goal development, and how the feedback is being utilized. The coach’s role is to point learners to objective data and prompt them to reflect on the information.

At the conclusion of a session, document/supplement action plans and recommendations for improvement as well as follow-up times.?All assignments given should be clearly articulated.

Notes on Notetaking

A Success Coach is rather like a physician conducting an examination to discover the root of an illness – the more detail and thoroughness in the history, the more likely that there will be a successful “diagnosis” in the root cause for subpar performance and develop a plan of action.

In that vein:

Gather all information applicable to the learner’s circumstances. This includes the level of preparation strategies used to study in the learner’s understanding of expectations.

Delving into the undergraduate experience is essential because all students have established successful habits that can be emulated and replicated.

Use behavioral questions such as:

• Tell me about a time in your undergraduate experience that you struggled academically and found ways to change course and ultimately succeed.
• Review the performance data and provide objective feedback about its meaning and applications.
• Take copious notes, if necessary, then synthesize these into a narrative that the advisor and other faculty can use to conceptualize the learner’s status and recommendations.
• Document student comments and perspectives relevant to student success and well-being.
• Do not document personal information.
• Refer, if appropriate. We’ll delve further into important step in future issues.

As you can see, the Success Coach has an incredible opportunity to make a difference for a learner. I hope this brief overview of the Success Coach’s new role in PA education has been helpful!?If you’d like to implement the Student Success Coach and the Student Success Model at your school, feel free to reach out to me with any questions.?