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competencies. Gofton and Regehr [ 3 ] summarize characteristics of this taxing
learning environment:
The context of surgical practice is not generally an easy environment in which to function. It
is marked by stress, responsibility, and pressure. It requires the management of multiple inputs
and demands during critically emergent situations. It is often performed under suboptimal
psychomotor conditions of sleep deprivation or after previous tiring surgeries. [ 3 ] (p. 4)Not only is surgical practice a taxing learning environment, but also learners
come into the environment performing at markedly different levels across the differ-
ent targeted competencies. And certainly no one arrives to the surgical setting oper-
ating at peak performance in all areas. If our goal within surgical education is to
ensure learners grow and develop the knowledge, skills, and attitudes needed to be
effective surgeons, then education must be seen as a continuous process with learn-
ing as a social endeavor within the practice environment. Taking a process, continu-
ous learning approach recognizes learners’ differing performance levels, provides
flexibility for the complexity of the surgical learning environment, and promotes the
importance of ongoing, tailored, specific feedback across the competencies.
Although this seems to be an insurmountable task within the busy surgical setting,
creating a learning culture of mentoring and coaching within a workplace learning
environment may help demonstrate that meaningful professional relationships are
central for long-term growth and development in both life and work [ 3 ].
This chapter provides a brief overview of workplace learning, explores the roles of
coaches and mentors within these environments, provides a brief overview of research
around coaching and mentoring within surgical work environments, and offers path-
ways for building stronger cultures for coaching and mentoring. The chapter inte-
grates a modern tale of a surgical resident to provide an example of how coaching and
mentoring provide help within a very hectic workplace learning environment.
A Modern Tale of Surgical Mentoring and Coaching
Recently, a surgical resident experiencing a performance issue came into our
medical education office. He explained, “I need help with my communication
skills. I don’t know what that means.” Interestingly, this resident knew basic
aspects of communication: speaking clearly, body language, and active listen-
ing. He also fully accepted communication was an area for improvement.
However, prior feedback had been relatively vague, his awareness of his com-
munication style within the fast-paced surgical environment was limited, and he
was uncertain how to improve his performance. As the saying goes, we can’t fix
what we don’t know is broken. Given his limited awareness of the specific perfor-
mance gap, he was seeking an outside perspective to help. This resident’s story
is not unique, as many students and residents find themselves grappling with
varying performance issues within the clinical learning environment. While not
unique, this story does provide a practical example of how the role of mentors
and coaches may enhance performance in the busy world of surgical education.J.L. Koehler and E. Sturm