For the latest Yale Child Study Center (YCSC) “On Leadership” blog post and newsletter column, Daryn David, PhD, posed several questions about coaching to David Della-Giustina, MD, FACEP, FAWM. Within the Yale Department of Emergency Medicine, Della-Giustina serves as the residency program director, vice chair for education, and program director for the Educational Leadership Fellowship as well as the Wilderness Medicine Fellowship. A devoted physician and educator, he has successfully integrated the coach approach into many of his professional commitments and roles.
How did you first get interested in coaching?
My interest in coaching was sparked through interactions with colleagues who were engaged in executive coaching. I found the process compelling and viewed it as a natural extension of my leadership roles in the Army and my current academic positions. This leadership development started in my initial days at West Point and continued until my retirement as a colonel. I have been a leader at many levels including as chief resident, residency program director in two different programs, department chair, consultant in Emergency Medicine to the Army Surgeon General, and as a teammate and situational leader in both Iraq and Afghanistan during combat deployments. I believe that excellent leadership inherently involves developing subordinates for success. I view my current role in leadership and executive coaching as a continuation of this practice.
What do you see as the core way(s) in which coaching benefits people?
Coaching is profoundly impactful as it allows individuals to explore their unique situations and issues in a focused and personalized manner. It encourages them to view their challenges from different perspectives and fosters self-derived solutions, rather than imposing external solutions from the coach. This process aids in problem resolution and helps to promote personal and professional growth within a safe, supportive, and non-judgmental environment. I believe that coaching results in greater job satisfaction and less burnout, which is a problem facing our various leaders and faculty in medical education.
Please describe the YSM role(s) in which you utilize a coach approach.
In my capacity as vice chair for education in the Department of Emergency Medicine, I employ coaching techniques to support and develop our faculty by helping them develop solutions to challenges and plan their career trajectories in an empowering way.
As the Emergency Medicine Residency Program Director, I oversee 76 residents in our 4-year program. In this role, I use coaching for my residents and fellows, but my approach also includes more directed advice, though it still employs fundamental coaching principles to foster self-directed learning and problem-solving when possible.
Finally, I developed a coaching program specifically designed for Graduate Medical Education (GME) program directors (PDs) and assistant/associate program directors (APDs) across YSM. It is named the “WISER Approach to GME Leadership: A Values Based Approach” and integrates the values of Well-being, Integrity, Service, Empathy, and Respect into leadership education with the GME focus.
The course utilizes group coaching that involves all the program director participants; here we focus on the WISER values and how they specifically apply to being a GME program leader. There’s a lot of peer coaching and positive discussion amongst the PDs/APDs, which makes it very appealing because they're getting input and reflection from their peers and realizing that there are many solutions to the problems that we've discussed. PD/APD leaders can also recognize that they're not alone and that many others face similar issues to their own.
In addition to the group sessions, I provide four individual coaching sessions to each course participant. These are designed as executive coaching sessions where we do things such as a behavioral self-assessment to enhance self-understanding, a dynamic review of their own GME program through a tool that I developed, and activities in line with how each person may like to develop further as a leader.
I have a big picture question for you. What are the biggest concerns you have at present about the culture of academic medicine?
My disclaimer up front is that my comments on this subject do not focus on the research side of medicine, as that is not my area of expertise. My primary concern centers around the imbalance between clinical care and the educational mission within academic medicine. There is a significant emphasis on the financial aspects of clinical care, often at the expense of robust educational support and recognition. This concern is echoed by educators nationwide who feel that their roles and the educational missions are often undervalued and under-supported, which impacts the quality of medical education and training, leads to burnout, and causes many great educators to move on from their educational efforts.
What could be the role of coaching in helping to address this concern?
I see the role of coaching as being supportive for educators in a couple of major ways. By coaching our educators and program leaders, we are enabling them to develop solutions to the problems that they have. Through the use of group coaching, they also come to see that there are multiple solutions that they may not have previously thought about, and that they are not alone in their work and stress and efforts to succeed. Hopefully through coaching there will be an increased opportunity for educators and program leaders to embrace their roles, rather than going off to other activities due to frustration and burnout.
Thirty years from now, how do you hope that the tools of coaching will be embraced by those working within academic medicine?
Some of the tools of coaching that could be embraced in academic medicine include active listening and allowing the individual to determine the solution to their own issues and problems, rather than giving them advice and expecting them to follow what you say. Also, some of the coaching assessments could be more broadly used to help struggling students, residents and fellows to gain insight into themselves and derive targeted solutions to the issues they may be facing.
The “On Leadership” blog was launched in 2022 to address the importance of connection, collaboration, and embodying a service leadership mindset in professional and personal contexts. YCSC Assistant Professor Daryn H. David, PhD directs the column and serves as director for leadership development and coaching initiatives in the Yale School of Medicine (YSM) Offices of Academic and Professional Development and Diversity, Equity, & Inclusion.