This submission is a description of an evaluation of a communication coaching program at the University of Rochester. This is a program that began at University of Rochester in 2011 and has now expanded to include trained communication coaches (often psychologists, though not exclusively) embedded in 11 residency programs at the institution. This project evaluated impact of communication coaching from the perspective of the residency program directors. The communication coaching program overall represents a unique way that psychologists with training in integrated clinical settings and with systems-training can impact patient care by enhancing physician communication.

Background: As of 2023-2024, the University of Rochester Medical Center (URMC) Physician Communication Coaching and Leadership Development program had 11 embedded communication coaches in residency programs educating 371 residents. In 2024, the URMC Physician Communication and Coaching program conducted a needs assessment survey in collaboration with the Graduate Medical Education (GME) office with two aims: 1) Evaluate impact of existing communication coaching interventions in GME programs with embedded coaches, and 2) Identify gaps and opportunities for expanding communication coaching to additional areas within GME.

Method: A needs assessment survey was developed by three senior communication coaches and two senior leaders within the GME office at URMC. The survey included questions regarding competence in communication and professionalism domains and confidence that training programs assess competence in these domains accurately. Participants could also include feedback about how they handle challenges with trainee communication and professionalism practices. The survey rationale was presented to potential participants at GME Committee on 10/21/24, with data collection occurring from 10/21/24 - 12/30/24 and several reminders for survey participation.

Results: 15 residency program directors (PDs) responded (60% response rate from the 25 residency programs overall). PDs who had embedded communication coaches (n = 8) reported significantly greater confidence that their training program assesses communication competence (4.38; 1 = not at all confident, 5 = extremely confident ), compared to PDs (n=7) without an embedded coach (3.14, p = .043). While PDs with embedded coaches were also more confident that trainees achieved competence in patient communication (4.75) compared to PDs without embedded coaches (3.86), this finding did not meet our threshold for statistical significance (p =.051). There were no other significant differences between PDs with or without embedded coaches in their assessment whether trainees develop skills communicating with families/caregivers, communicating on a team, or skills related to professionalism. When PDs were asked about how they approach situations with concerns about trainees’ communication and professionalism, PDs with embedded coaches reported using them as a central part of the process providing continual intervention and feedback. PDs without embedded coaches reported more ad-hoc strategies and increased faculty involvement as communication or professional concerns continue. 

Conclusions: In this sample, residency PDs who have embedded communication coaches reported more confidence that their trainees have achieved competence in communication domains than those without embedded coaches. URMC PDs also work closely with the expert coaches for assistance with challenging situations regarding trainee communication and professionalism concerns. Next steps include continuing to expand and study the communication coaching team and its ability to support trainee and PD needs.