The Precision Educator
The Precision Educator Podcast examines how coaching, assessment, learning analytics, and AI are shaping precision education in medicine. Hosted by leaders from Stanford Medicine, Yale Medicine, and the Society for Education in Anesthesia, the podcast is designed for program directors, clinician-educators, and education researchers seeking practical, evidence-informed approaches to improve learning and patient care.
The Precision Educator
Talk Less, Listen More: Coaching as Precision Education
Coaching is often discussed as a faculty skill or a professional development add-on. Far less often is it examined as a foundational mechanism for personalization, resilience, and growth within structured medical training programs.
In this episode of The Precision Educator Podcast, Dr. Aileen Adriano joins the conversation to explore coaching as a core pillar of precision education. Together, the discussion focuses on how coaching enables individualized learning pathways while maintaining standards, accountability, and programmatic coherence.
The episode examines what effective coaching looks like in real clinical environments, how faculty roles shift in a precision education model, and why coaching culture matters as much as coaching technique.
Key takeaways from this episode:
- How coaching functions as a personalization engine in medical education
- The relationship between coaching, learner agency, and resilience
- Practical considerations for building coaching capacity among faculty
- Implications for assessment, feedback, and educational culture
Especially useful for:
Clinician-educators, faculty development leaders, program directors, and educators responsible for coaching programs or learner support.
Related episode:
For a foundational overview of precision education and why coaching plays such a central role, start with Episode 1: What Is Precision Education? Rethinking How Physicians Learn.
Welcome back to the Precision Educator. I'm Larry Chu, and I'm here again with my colleague and co-chair of the Society for Education and Anesthesiology's Precision Education Task Force, Dr. VG Kurook. Today we're diving into a topic that sits right at heart of personalized learning and faculty development, and that is coaching.
Viji Kurup, MD:That's right, Larry. It's so great to be back, and I'm glad to know that there's a lot of people who are interested in this topic. So coaching really is one of those concepts that people think they understand until they actually experience it. And then once they experience it, it's transformative. It changes the way they teach, how they lead, and how they support their learners. So today we wanted to explore what coaching really looks like in medicine and why it matters so deeply in precession education.
Larry Chu, MD:And we do have the perfect guest to help us do just that. Joining us today is someone who has shaped coaching culture at Stanford and nationally. She is a clinical associate professor in anesthesiology at Stanford, Associate Division Chief, former Associate Residency Program Director, and our faculty schedule for our Stanford Anesthesiology Program. She also co-chairs the SEA coaching task force. She is passionate about helping faculty grow with purpose, identity, and resilience. We are excited to have Dr. Aileen Adriano with us.
Viji Kurup, MD:Aileen, we're so glad you're here.
Aileen Adriano, MD:Well, Viji and Larry, thank you so much for having me. I'm excited and honored to be here.
Larry Chu, MD:Well, Aileen, I would love to begin with your story. So you have had a remarkable path through anesthesiology. You've assumed many leadership roles across our own department at Stanford. Take us back a bit. How did you find your way into anesthesiology and academic medicine?
Aileen Adriano, MD:Yeah, I love the uh the phrase take us back a bit. And it reminded me of a moment I had in one of my coaching sessions recently. One of the participants said, to find myself, I had to go back to the beginning. So to understand how I got to this coaching portion of my career, well, you know, I trained at Stanford and I stayed on to be an attending there. And I really had two pivotal attendings take me under their wing. I'm going to uh give a shout out to Alex Macario, who served as the program director for a very long time and has done so much to advance anesthesiology education. And of course, now he's finishing up or had just finished up his term as ABA president. And the other uh person that had a pivotal impact on my career is Dr. Harry Lemmons, who at the time was head of liver transplant. And so when I was new at Stanford, I stayed on to focus on residency education, eventually became APD, and really enjoyed building the program during my time there. Of course, I focused on clinical operations, and I was the first female scheduler in the operating room. I was one of four schedulers, and to be the first female scheduler was quite a daunting task at the time, and now I've been doing it for 15 years. And then my clinical specialty is liver transplant, and actually, I did a liver transplant last night. So that's a little bit about my background.
Viji Kurup, MD:So you stepped into like leadership roles that cover a lot of ground, right? Like so you've been residency program director, scheduler division chiefs, and you talked a little bit about external factors that helped you in this growth. Talk a little bit about what internal factors guided your growth during these transitions.
Aileen Adriano, MD:Yeah, I think, you know, when you are kind of navigating academic medicine in addition to wanting to be clinically excellent, you're always looking for opportunities to grow professionally. You're looking for opportunities to get involved with endeavors that are meaningful to you, and you also want to make impact. And so I think naturally residency education allowed that. And also, kind of in this stage of my career, finding coaching allows for that ability to make meaningful contributions and have impact.
Larry Chu, MD:It's interesting that you talk about coaching, um, entering your career. What pulled you towards coaching specifically as part of your professional identity?
Aileen Adriano, MD:Yeah, I think, you know, when I reflect on that, people ask me that question quite a lot. And I don't think people start out thinking they're going to be a coach. I'll be quite honest with you. And when I was going through my training, the one common ground that all of us had during the training was that we were going through some form of transition. And when you're in transition, you're really figuring out what is most meaningful to you. And so when I've had coaching conversations with these mentors and attendings that had influenced my career at Stanford, those really had a huge impact on me. And so um coaching really, really showcases all of that.
Viji Kurup, MD:Yeah, so you know, it's really wonderful that um you're able to reflect on your journey and share some pearls with us. Is there a moment when coaching shifted your perspective? Maybe a conversation that stayed with you?
Aileen Adriano, MD:Yeah. Linda Boxer became dean in the School of Medicine. She started a leadership program for physicians. And at that time, now I guess that was back in 2014, so it's been over 10 years. You know, coaches had been reserved for C-suite physicians, C-suite executives, yeah, really just more administrative tasks. But in that program, I had a coach, and kind of my perception about having a coach was this person happened to be a woman. She was gonna tell me how I could be better, how I could achieve the goals I wanted, and she was gonna give me the next steps for me to be successful at Stanford. And when I kind of came out of that program, the experience was not what I anticipated at all. And she was such a great coach. The way she asked her questions, the way she listened, really helped me gain insights into my own strengths, into where I can grow professionally and personally. And it was empowering to come up with my own action steps, to come up with those items myself. And so that's really the transformative power of coaching, that you know, someone can guide you through that process, but you are the one that's driving that momentum, if you will.
Larry Chu, MD:Well, I think this is a good time, maybe to take a moment to dig a little deeper into the idea of what is coaching in medicine? You know, coaching is a term, I think, that is starting to get used a little bit more, but many faculty still aren't sure what it actually means. So when you talk about coaching in medicine, Aileen, how do you define it?
Aileen Adriano, MD:Yeah, I think coaching to help academic physicians understand it is really to compare it to other roles that we are very used to doing. So in our mentoring roles, in our advising roles, we're very comfortable in those roles. And so when I'm asked to compare how is coaching different or the same from mentoring or advising, I always say advising is telling someone what to do. Mentoring is showing them what to do, and coaching is really asking questions.
Viji Kurup, MD:And having people figure them that out themselves.
Aileen Adriano, MD:Yeah, is is really giving the power of the relationship and the conversation to the person you're coaching. And so coaching is really in the context of residency education, is learner-driven. In the context of professional development, it's really um it's the faculty member you're coaching that drives the conversation.
Viji Kurup, MD:And you also teach uh group coaching, don't you? So how do you describe the difference between group and one-on-one coaching?
Aileen Adriano, MD:Yeah, so one-on-one coaching, they're both forms of coaching that can be intense, but in terms of what the difference is between group coaching and one-on-one coaching, the idea came from the fact that we can have individual coaching, but not everybody has access to that. And so one of the thoughts I had was can we make group coaching scalable? Can we come up with a program that asks questions of uh faculty, leaves them to have insights about their own professional development, and then as a group, collaborate together, share insights, and grow together in a group. And it's that shared group experience that I think that makes group coaching special because you are able to connect to other faculty members. I think that's the main difference is that you're growing together as a cohort in a group, sharing stories, sharing experiences, connecting as people, really.
Viji Kurup, MD:Right. And also that, you know, as physicians, we really don't have a lot of structured spaces to pause and reflect, right? Like we are always doing things, and I think this kind of gives us that permission and a space to reflect.
Aileen Adriano, MD:Vijay, you're exactly right. As physicians, we don't take time for ourselves to pause and reflect. And um we don't think about ways that we can thrive at work always, right? We're always about meeting a metric. We're always putting others in front of us, whether it's our patients, our trainees, our junior colleagues that we mentor. But if you think about it, it's empowering to take that time to pause and reflect because that also helps you do those other things on a grander scale.
Larry Chu, MD:Let's talk um a little bit about some of the misconceptions or myths about coaching. Let me throw out a few at you and have you respond. Okay, myth number one: coaching. I think we talked about this a little bit, but coaching is the same as mentoring.
Aileen Adriano, MD:I I would say, you know, it's absolutely not the same as mentoring. You know, I would say one of the other things that's different about coaching is the mindset of the coach. The coaching mindset, at least in the way that I learned it, was that before you even start a conversation with someone that you're coaching, you believe that they have the skills, the abilities, and the resources to be successful. You're you already assume that before you start the conversation with them. Um and really uh to have the mindset of a coach is really to um ask questions and listen in a way that helps the person you're coaching see potential and possibilities.
Larry Chu, MD:Myth number two coaching is only for people who are struggling.
Aileen Adriano, MD:Yeah, that's a common misperception. And, you know, that comes from I think when coaching was utilized early on, it was for either residents or even faculty that were having professionalism issues or clinical issues. But coaching really is a way to help faculty gain insight into their own professional paths and again help think about um what is possible, what's the potential in their own careers.
Larry Chu, MD:Myth three, coaching is soft or lacks rigor in some way.
Aileen Adriano, MD:I think there are not necessarily proven frameworks that get a certain result, but the coach approach has been shown to help with wellness, to help with surgical trainees perform better. So there are measurable outcomes then. There are, but there's not a standard way to coach. I think that's why it's difficult to pinpoint what is it about coaching that's effective, because there's no, there's just not one way to do it. And I think that's why people think it's a soft skill. Because there's there's more than one way to do it correctly. You know, like if you think about anesthesia, there's just a certain way that we perform procedures and anaesthetics and you know, induce anesthesia and wake up patients. But coaching is you can get a great result approaching it in in a lot of different ways.
Larry Chu, MD:Myth four, group coaching is something that cannot work in medicine.
Aileen Adriano, MD:Yeah, group coaching, um, you know, that I think is an up-and-coming field. And that's what I'm trying to do at Stanford is to make coaching accessible and scalable for our faculty at Stanford and also through the SEA. We're starting that program uh this January, and Karen Souter is my co-chair of that program, and I'm really excited to start that in January. And I'm looking forward to seeing what insights and you know professional growth that we see in our faculty when they go through that program.
Larry Chu, MD:And the final myth: coaching takes too much time.
Aileen Adriano, MD:Yeah. You know, I think here I want to just make sure that want to point out there's the coach approach and then there's like coaching conversation. You can have a coach approach with a learner and take three minutes to review an interaction with the patient or a technical skill or a management decision, and that can be done in three minutes. But if you're talking about a coaching conversation that addresses your professional life and integrating your values and strengths, that definitely will take, you know, 30 minutes to an hour over several weeks. So I think when you think about coaching, you want to think of it as there's the coach approach, which probably is what we do most of the time in our interoperative teaching. And then there is that's what we call little C, and then there's big C, which is coaching for professional growth, professional development.
Viji Kurup, MD:So I think also in the long run, when you're thinking about return of investment on that time, it probably also saves time for a person in terms of giving them some clarity about where they're going, what is the direction that they need to take, and also maybe preventing burnout, right? Like being able to prioritize what they're doing and to um uh straighten out some of their alignments of their values to what they're doing.
Aileen Adriano, MD:Yeah, you're totally right, VG. And before this meeting that we're having, I thought about well, what is the purpose of coaching? And I wanted to ask you both what you thought the purpose of coaching was, just to see what your thoughts were on that.
Viji Kurup, MD:So I can go first, yeah. So for me, I think uh coaching is for clarity. I think that especially early on in your careers and maybe even during your late career, right? Because what got you from here to there will not get you to the next point, right? And sometimes people think the same thing needs to be done to get from one point to the other. And I think that having somebody who's been through that, you know, through that road, being able to tell you where are the valleys, where are the hills, where are the troughs, and it's almost like a GPS, right? And asking you questions about what is it that you want to do? Do you want to climb that mountain or do you want to swim that ocean, right? And then guiding you towards those areas. So, in a way, it's not probably what the person who's coaching had been through, but because they've been through that, they know what are the right questions to ask so that you have your goals a little clearer.
Larry Chu, MD:Yeah, I would say for me, you say clarity, I say almost for me, focusing on slow thinking. You know, I I think about the Conman the Yeah, the Conman slow and fast thinking. And I got to a stage in my career where I did all of that deep thinking, the the slow thinking, right? Where most of the stuff I do day to day now, it all has been formed. Those circuits were formed long ago. So I just do a lot of fast thinking. And to be asked questions that make me go back to that work again, that I have to slow down and really oh wait, nobody asked me that question. And I have to like think about it. It's a little humbling, it's a little uncomfortable, but then it's a little bit, hey, what I never thought about it that way. And also I don't have the fast answer. And what comes from that is the clarity that I probably wouldn't have had, but you need to do that work, and I and I I don't think I really um had that guidance. So in episode one, we talked about precision education as delivering the right support to the right learner at the right time. How do you, Aileen, see coaching? Fitting into that.
Aileen Adriano, MD:Yeah. You know, it was interesting uh that you you uh just when you say that, and when I heard that on your podcast, I actually I listened to your podcast, and when you said that, kind of a light bulb went on in my head because honestly, that was one of the first tenets I learned in coaching was that kind of the other thing that you said in that podcast was meeting the learner where they are. And you know, in that segment, you talked about giving the right support at the right time in the right way, and that's really meeting where your learner is. And in coaching, that's what you do, that person where they are. You meet them whether they see something as a problem, whether they see it as a challenge, or whether they see it as an opportunity. And the coaching process hopefully takes you from seeing something as a problem to seeing that same thing as an opportunity. So when you have a learner that sees a lack of knowledge as a deficit, you want to take them to seeing it as an opportunity to grow intellectually. And so that's what coaching can do. It can change and flip that switch, it can change that mindset where you see something as an opportunity and see something as a possibility.
Viji Kurup, MD:That's great. You know, I also know that you've coached faculty, residents, and trainees across different programs. Uh, what are some examples of how coaching can support learners in real time?
Aileen Adriano, MD:Yeah, so I would say an anecdote that I wanted to share with you both was when I um was working with a resident and she was perceived as not being strong in the operating room, as not being assertive enough, as you know, a little bit timid, and faculty had perceived her as not being essentially effective in the operating room. And there was an opportunity for us uh to chat during a long case, and we had an opportunity to explore that feedback that came on her evaluation. And so one of the first things I did when I I knew this about this resident because I was APD at the time. One of the first things I did was to gauge how she was doing in the program, asked her what she thought of her rotations and how she was doing with patient care and how her interactions were in the operating room. And I needed to get a perspective of where she was coming from. And I asked permission from her if we could talk about some of the things that I knew about in her evaluations. And the permission piece in coaching is very important because uh that syncs with the idea of delivering something at the right time. You want to gauge somebody's mindset and make sure they're open to that conversation. And um, anyhow, so when we explored her interactions to the operating room, um, we got into what her cultural beliefs were, how she was raised, how she was raised to be helpful, subservient in some way, because that was a cultural value. And after kind of a few conversations, after this initial conversation, she came up with the insight that, you know, it was okay to have different identities, and it was okay to activate different identities at different times. And so she had incorporated some practices that helped her be more assertive, more vocal, more of a leadership role in the operating room. So I think that illustrates an example of just using the coach approach to just gently open up and explore something that could be quite challenging to talk about.
Larry Chu, MD:I think that's also a great example for how coaching maps onto precision education because in a real way, that example you gave shows how coaching operationalizes the personalization, right? So you had some data about the resident, the learner, but you need to move beyond the data to really create some meaning out of that data, to personalize it for that learner. And that comes from that coaching relationship to understand the person and what they need, and then and then how to make some meaning out of it that can create that change for the person.
Aileen Adriano, MD:Yeah, Larry, and the whole point of coaching is for that person you're coaching to gain insight. Because once you gain that insight, you can make informed decisions about your next step. And so earlier we were talking about well, what does coaching mean to you? Vijay, you said clarity. Larry, you said uh focusing on slow thinking. And I think, you know, for me, one word would be insight. The coaching process, the coaching conversation. Really, for me, the purpose is to help that person gain insight. And with true insights, you can make good decisions and good action plans. And that that's what I think our job is as faculty members for our learners.
Viji Kurup, MD:So also, Aileen, you've been uh leading some major national initiatives in coaching. Can you tell us a little bit about the SEA Group coaching program, Thrive and Elevate?
Aileen Adriano, MD:Yeah, it's a four-part series. I'm really, really excited and just really honored to be working with Karen Suter, who's been a coach for a really long time. She was former SEA president and uh she's been coaching for eight years, and she leads the uh coaching for healthcare leaders as well through the SEA. And she and I partnered up because the idea of making coaching approachable, coaching accessible is really exciting to us, especially in some of these smaller institutions. I think at Stanford, we're lucky we have a coaching office, we have a coaching program, you can get certified, but some of these smaller programs don't necessarily have those resources. So the idea to offer a group coaching program for members of the SEA is really exciting. And it focuses on professional growth. We start with professional identity formation at our first session. We explore our own strengths and our own values. And hopefully at the end of the four-part series, people walk away with an action plan for professional growth, whatever that means to them.
Larry Chu, MD:Tell us a little bit more about the group coaching programs and what kind of benefits they can have beyond the individual for and since a department.
Aileen Adriano, MD:Yeah, I think I know earlier we talked about the ability to uh stop and reflect on your own professional journey. And I think the coach approach has been shown to improve culture in a department, to help have your relationships be more collaborative. And I think it it just you know sets the tone of keeping conversations and lanes of communication open and you know, really normalizing even difficult conversations. I think that's a real benefit of having a group coaching program in a department. It really hopefully has uh an imprint on the culture where you're really promoting collaboration through connecting with other faculty members.
Viji Kurup, MD:Yeah, and I'm so glad that the precision education task force is literally weaving coaching literacy into the faculty development strategy.
Larry Chu, MD:Well, let's talk a little bit about coaching across different career stages. You know, coaching meets people differently, I think, depending on where they are in their career, whether they're early in their career, meaning a resident, a fellow, or even junior faculty, or if they're mid-career, such as assistant or associate professor, and they're you know, getting grants, or they're starting to climb the leadership ladder, or they can be senior faculty, they're a full professor, or they're you know, 10 years to retirement. You know, can you can you, Aileen, walk us through how coaching might land on different faculty at these different stages and how they could envision it helping them?
Aileen Adriano, MD:Yeah, thank you so much for that question, Larry. So I think early on in your career, when you're first starting out, or even when you're a resident, the coach approach can help you figure out ways that work best for you to assimilate the professional identity and the professional norms for anesthesiology. And then as you go through your academic career, a coach can help you with a different strategy that it takes to navigate the complexity of an academic environment, of uh the politics of academics sometimes, and definitely having a thought partner to help you with that, uh, such as a coach, uh, would be really instrumental. And then in your later stages of your career, when you think about what you've accomplished, what you've contributed, really focusing on the latter part of your career, what would be most meaningful to you, and a coach can help you determine kind of, you know, to put into frame again your strengths and your values and to engage in academic endeavors that help you kind of live those strengths and values.
Viji Kurup, MD:Yeah, so that that makes a lot of sense, um, Aileen. And I'm pretty sure that the same type of these themes show up in our learners too, right? Like the early CA1, going from CA1 to CA2, and then the CA3s, and then fellows as they're preparing for their independence.
Aileen Adriano, MD:Yeah, you know, the coach approach really just tries to help you figure out what you're gonna focus on next.
Viji Kurup, MD:Right. And um so we go now to challenges that could come up in this, right? So what do you think are the barriers that get in the way of bringing coaching to academic medicine?
Aileen Adriano, MD:Yeah, I think when I think about the barriers, I think we touched upon it earlier. There's a misunderstanding of what coaching is. I think access to coaching is another barrier. And then in terms of getting buy-in about the people who are coaching you, traditionally the coaches that are offered to physicians are non-physicians. And right now there's so much energy of getting this coach training as a physician, as a medical educator. So I think we're addressing one of those barriers of lack of training in the medical education domain by this kind of really strong interest in coaching right now. And um I think just having access to physician coaches, I think, is a huge barrier.
Larry Chu, MD:Well, let me turn the coaching hat on you and ask you how we might turn that challenge into an opportunity, or maybe what are the opportunities from that?
Aileen Adriano, MD:Yeah, like how do you are you wanting to ask, like, how do you even start being a coach? Is that what you're trying to ask? Yeah, sure. Yeah, sure. Okay. I'm gonna share a story with you. And when I was going through my training, I asked my uh my mentor, and of course, I uh I did a year-long coaching course at Columbia University through their coaching center of excellence, and um they said four words because I, you know, I didn't know necessarily what I was doing as a coach when I first started, and so my mentor said talk less, listen more. That's the first step in becoming a coach. You talk less and listen more, and then the next thing is to ask a powerful question. You don't need training to ask a powerful question. You know, a lot of people feel like I don't know if I can be a good coach, or I don't know if the coach approach is gonna work for me, I don't have any certification, I haven't attended a workshop. But you don't need that to have a coaching mindset. If you talk less, you listen more, you ask a powerful question, that's 99% of the the work right there. So that's how you get started. You don't even have to go to start training for that.
Larry Chu, MD:And I think we've already mentioned some of the other ways we have the programs through the SEA. You've talked about some of the coaches that are available. Um Right.
Viji Kurup, MD:And also remember, Larry, we have a webinar coming up on a webinar coming up. So if any of the listeners are interested in learning more about coaching or even practicing coaching in a psychologically safe place, I think the webinar on December 8th is a place to be. The information will be on the SEA website. And if you're uh part of the task force, you should have already received an email for it. So I'm so excited for that webinar.
Larry Chu, MD:And that's a it's a great the upcoming webinars are a great way to explore some new approaches or tools to learn and practice coaching with newer AI tools that uh you can use to engage and practice your different coaching skills. So today's conversation highlighted how coaching anchors precision education by personalizing growth, supporting reflection, helping clinicians move with intention. Coaching gives faculty and learners a space to think clearly and align their values and make meaningful decisions.
Viji Kurup, MD:Yeah, and to learn more, you can visit the Society for Education and Anesthesiology website, or you can connect with the Precision Education Task Force. We're always waiting to hear from you. So you'll find coaching resources, program descriptions, and opportunities to get involved.
Larry Chu, MD:Aileen, thank you so much for sharing your insights and for everything you're building to support faculty and learners, both at your institution and nationwide.
Aileen Adriano, MD:Yeah, Larry Viji, thank you so much for having me. And um, you know, true to my coaching uh philosophy, you know, everyone can be a coach and you don't have to wait, you can just start today. So, you know, talk less, listen more, and you're already on your way.
Larry Chu, MD:I love that. I maybe that should be the title of our podcast uh today.
Viji Kurup, MD:And it's a good theme for life.
Larry Chu, MD:Exactly. I love it. Exactly. And thank you to our listeners for joining us. Stay with us for our next episode where we will explore how data and analytics integrate with coaching to shape the next generation of precision education. You've been listening to The Precision Educator, where we explore how data, coaching, and innovation can transform the way we teach and learn in medicine. Our goal is to help you move beyond one size fits all education and toward approaches that are proactive, personalized, participatory, and predictive. If you've enjoyed today's conversation, please subscribe and share the podcast with colleagues. And if you'd like to join the movement, connect with us and the Society for Education in Anesthesiology's Precision Education Task Force. Until next time, I'm Larry Chu with my co-host, N. And this has been the Precision Educator, personalizing learning, transforming medical education together.
Viji Kurup, MD:Thank you. Bye. See you next time.
Aileen Adriano, MD:Thank you so much for having me.
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