Can Coaching Advance Medical Leadership Development? The positive evidence for workplace coaching – and especially for Coaching Psychology – for doctors, medical leaders and public health leaders

Click here for the full article in BMJ Leader and here for the pre-publication soft copy.

Day FJ, Hothi D. Can coaching advance medical leadership development? BMJ Leader Published Online First: 01 March 2024. doi: 10.1136/leader-2023-000853

Below is a summary of some of the key findings based on systematic reviews and meta-analyses.

Coaching works!

The scientific evaluation of coaching has been studied, and there is now a significant body of quantitative and qualitative studies, systematic reviews and meta-analyses. Different phases of coaching research have emerged, and initial questions such as ‘does coaching work at all?’ have moved onto ‘which factors work in coaching?’, ‘which processes occur and add to the effectiveness of coaching?’, and since 2013, into systematic literature reviews and meta-analyses(1).

The evidence base for coaching is growing rapidly. A brief summary of research into leadership, wellbeing, and career outcomes from trained professional coaches is provided below.

The effects are amplified when the coach is a Coaching Psychologist like myself!

The average effectiveness of workplace coaching (specifically, coaching in organisational context, business/ leadership/ workplace/ organisational coaching) is now well established, nine international systematic reviews and/ or meta-analyses have been published since 2010 (2–10). An analysis of 39 coaching randomised controlled coaching studies reported a strong effect size (0.59), a statistically significant effect of workplace coaching across all leadership and personal outcomes(10).

Other meta-summaries of effectiveness include: Graf & Dionne on the impact of general coaching (46,47); de Hann on the value of executive coaching (11), and Lai and Palmer at el (12) summarise the impact of coaching psychology research (psychologically-informed coaching by a coach with an academic background in psychology ‘Coaching Psychologists’) in the context of executive coaching.

Leadership Outcomes Include…

At an organisational level, coaching of leaders and/ or managers is found to result in greater: satisfaction in their direct reports’; and others’ work engagement, organisational commitment, psychological empowerment, reduced strain, and reduced turnover intentions. Improved self-efficacy in leaders has also been shown to directly improve the attitudes and motivation of followers (13). Psychologically-informed coaching specifically has been found to have a positive impact on the leader or manager’s objectively measured work performance by others (4).

Most research has focused on individual outcomes, and whilst this could be dismissed as internal bias from motivated participants, improved self-perception has been found to be an antecedent of substantial changes in the longer term which are then also noticed by others (14). At an individual level, coaching is now scientifically established to result in strong positive effects for the leader or manager being coached:

• Improved cognitive outcomes including: goal setting (ability and quality of); self-awareness; sense of responsibility to one’s own learning; goal achievement; goal-directed self-regulation; self-control; adaptability and flexibility.
• Improved meta-cognitive outcomes including: the processing and organisation of information; the planning, monitoring and revising of goal-orientated behaviours; internal self-regulation and cognition stimulating purposeful mental (internal) and behavioural (external) changes such as goal-attainment through a continuous cognitive process.
• Improved affective (emotional) outcomes including: satisfaction with coaching achievements; satisfaction with work, career and private life; wellbeing; coping; personal as well as work attitudes; motivation to apply new knowledge in the work environment; reduced stress; higher commitment to the organisation; self-worth; motivation; initiative; social integration; core self-evaluations (self-efficacy, self-confidence, and self-esteem; internal locus of control; reduced neuroticism).
• Improved skills outcomes including: improved performance and skills at work including strategic thinking, decision making, communication, interpersonal skills; improved transformational leadership; improved 360’ leadership ratings (self/others); improved resource management eg time.

Wellbeing outcomes

The 2022 NICE Guideline ‘Mental wellbeing at work’ (15) evidence review (16) found that ‘preventative coaching’ in the workplace for individuals resulted in improved quality of life, reduced job stress, and reduced mental illness symptoms. The subsequent Guideline recommended that individual approaches for employees with or at risk of poor mental health be offered cognitive behaviour therapy sessions, mindfulness training, or stress management training. My own research with senior doctors, medical and public health leaders found a +17.4% improvement in wellbeing. (https://fionadayconsulting.co.uk/public-health-medical-coaching-impact/).

Career outcomes

Whiston et al’s 2017 meta-analysis found that career interventions result in increased career decidedness, better vocational identity, increased confidence in decision making, and another meta-analysis found that career interventions increased chances of securing a job(17,18). Career coaching increases optimism, career security through clearer career goals, positive effects of women’s confidence and work-life balance, and on job-search behaviours in older workers (19). Certain models used in coaching psychology enhance career security, self-efficacy, career motivation, and/or reduce career indecision(19).

Leadership coaching lasts – and there is a ‘latency effect’ (delayed impact)

McInerney et al (2021)(20) undertook a systematic review of the enduring effects from executive coaching, and found limited but positive evidence of enduring effects. Some of these were not seen in the shorter-term, consistent with a ‘latency effect’ of internal sense making and cognitive processing.

They found evidence for longer term effects from executive coaching in two main dimensions:

• ‘leader identity development’ (the process of resolving ambiguities relating to performing leadership roles, through forming and refining one’s sense of identity as a leader involving increased intrinsic motivation, identity creation and the reframing of one’s relationships with subordinates), and
• ‘psychological resourcing’ (the process of motivating oneself through psychological self-regulation, which requires both goal setting and alignment with values, coupled with learning feedback cycles, in order to build confidence and internalise the learning).

Coaching is most effective when delivered by coaches who are Independently Accredited by a professional body, and especially by Chartered Coaching Psychologists.

I am Independently Accredited as a Master Practitioner Coach & Mentor, and as a Chartered Coaching Psychologist. I offer leadership coaching for doctors, medical leadership coaching, medical leadership development, coaching for public health leaders and coaching for global health leaders.

If you’re a senior doctor, medical or public health leader, contact me today to find out how I can help you!

1:1 Executive & Leadership Coaching for doctors and public health leaders

1:1 Career Coaching for doctors and public health leaders

CPD and Training for medical and public health leaders

Learn coaching skills for doctors and public health leaders

References

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2. Jones RJ, Woods SA, Guillaume YRF. The effectiveness of workplace coaching: A meta-analysis of learning and performance outcomes from coaching. J Occup Organ Psychol. 2016;89(2):249–77.
3. Athanasopoulou A, Dopson S. A systematic review of executive coaching outcomes: Is it the journey or the destination that matters the most? Leadersh Q. 2018 Feb;29(1):70–88.
4. Wang Q, Lai YL, Xu X, McDowall A. The effectiveness of workplace coaching: a meta-analysis of contemporary psychologically informed coaching approaches. J Work-Appl Manag. 2021 Jan 1;14(1):77–101.
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15. NICE. NG212: Mental wellbeing at work [Internet]. NICE; 2022 [cited 2022 Jun 16]. Available from: https://www.nice.org.uk/guidance/ng212
16. NICE. Mental wellbeing at work. Evidence review E: Targeted individual-level approaches [Internet]. NICE; 2022. Available from: https://www.nice.org.uk/guidance/ng212/evidence/e-targeted-individuallevel-approaches-pdf-10959822258
17. Whiston SC, Li Y, Goodrich Mitts N, Wright L. Effectiveness of career choice interventions: A meta-analytic replication and extension. J Vocat Behav. 2017 Jun 1;100:175–84.
18. Liu S, Huang J, Wang M. Effectiveness of job search interventions: a meta-analytic review. Psychol Bull. 140:1009–41.
19. Yates J. The Career Coaching Handbook. 2nd ed. Abington: Routledge; 2022.
20. McInerney E, Giga S, Morris A. Does it last? A systematic review of the enduring effects on managers from executive coaching. Int Coach Psychol Rev. 2021;16(2):22–50.