Training in health coaching skills for health professionals who work with people with progressive neurological conditions: A realist evaluation

Abstract

Background Supporting people to self‐manage their long‐term conditions is a UK policy priority. Health coaching is one approach health professionals can use to provide such support. There has been little research done on how to train clinicians in health coaching or how to target training to settings where it may be most effective. Objective To develop theories to describe how training health professionals in health coaching works, for whom and in what circumstances, with a focus on those working with people with progressive neurological conditions. Design Realist evaluation using mixed methods (participant observation, pre‐ and post‐training questionnaires, and telephone interviews with participants and trainers). Realist data analysis used to develop and refine theories. Intervention Two 1‐day face‐to‐face training sessions in health coaching with 11 weeks between first and second days. Setting and participants Twenty health‐care professionals who work with people with neurological conditions in the UK, two training facilitators. Results Four theories were developed using context‐mechanism‐outcome configurations to describe how training triggers critical reflection; builds knowledge, skills and confidence; how participants evaluate the relevance of the training; and their experiences of implementing the training. Some participants reported a major shift in practice, and others implemented the training in more limited ways. Discussion Fully embracing the role of coach is difficult for health professionals working in positions and settings where their clinical expertise appears most highly valued. Conclusions Training should address the practicality of using coaching approaches within existing roles, while organizations should consider their role in facilitating implementation.

Health Care Professionals’ Experiences of Facilitating Patient Activation and Empowerment in Chronic Illness using a Person-Centered and Strengths-Based Self-Management Program

“…10 HCP's treating people with progressive neurological conditions in England conveyed that training in health coaching methods was useful; however, it was difficult to fully embrace the coaching role in settings where their clinical experience was more highly valued. 11 This aligns with other studies reporting difficulties for HCP in moving out of their professional disease-focused treatment perspective towards emphasising the person's lived experiences of illness and utilising personal resources for health. 12 Alvarez et al 13 found that levels of patient activation were positively correlated with clinicians' assessment regarding the patients' role in self-management.…”

What Really Matters for Supervision Training Workshops? A Realist Evaluation

“…However, we found a wider variety of mechanisms in our evaluation than previously identified, 9 including those relating to pedagogy (i.e., peer learning, didactic teaching), workshop (i.e., duration, content relevance), and individuals (i.e., facilitator competence). Although some of these have been found in previous realist evaluations of faculty development (e.g., interventions employing participatory approaches including reflective practice, having content relevant to faculty needs), 11,15–17 these were previously identified as contexts, not mechanisms. Furthermore, we also identified novel negative mechanisms (e.g., suboptimal peer learning, content irrelevance, suboptimal facilitator competence), extending previous faculty development realist evaluations focusing exclusively on positive mechanisms.…”

“… 13 That 2 mechanisms, peer learning and didactic teaching, were most likely triggered in the health care sector, and 2, suboptimal workshop duration and content irrelevance to workplace, in human services, probably reflects differences in supervision cultures, training, and practices across different sectors. 11 , 48 For example, in health care contexts, individuals may prefer peer learning and didactic teaching. In human services contexts, individuals may prefer longer training targeted to their sector (the workshops were mostly underpinned by health literature).…”

“…Some studies have conducted realist syntheses or evaluations of workplace supervision, 2,7,8 but only one study has conducted a realist synthesis of clinical supervision training. 9,10 Although numerous realist evaluations have been published exploring health education interventions, including coaching skills training, 11 mentoring, 12 leadership development, 13 faculty development, [14][15][16][17] interprofessional learning, 18 knowledge exchange, 19 and preceptorship, 20 none have conducted realist evaluations of supervision training. Therefore, building on a previous realist synthesis of clinical supervision training, 9,10 we report on a realist evaluation of supervision training workshops to explore whether they work, for whom and under what circumstances, and why.…”

23.4 Briefing

“…Davies and colleagues used a realist approach to better understand how training health coaches to support those living with long‐term conditions works best, for whom and under what circumstances. After interviewing twenty health‐care professionals and two coaches, the authors concluded that growth in coaches’ confidence required ‘outside the box’ discussion regarding barriers to implementation in practice, and how existing teamwork structures and processes may influence the relevance with which coaching trainees view their training, including use of peer support and ongoing reflection about the training process 15 …”