TeamSTEPPS 2.0: Module 9. Coaching Workshop
Instructor Outline: Coaching Workshop
Instructor Note: In this module, you will present information about coaching in general, as well as how to include coaching in the implementation of TeamSTEPPS.
The Coaching module includes the content provided in the outline below. More content is available than can be covered in the time provided; therefore, optional content and activities are noted. It is strongly recommended that instruction not focus solely on lecture, but also include exercises, videos, and other activities. As such, instructors should use the information below to plan how the module will be taught within the time available.
|#||Content||Page #||Approx. Time|
|1.||Introduction||5 - 6||3 mins|
|2.||What is Coaching and Why Is It Important?||7 - 9||4 mins|
|3.||The Role of a TeamSTEPPS Coach||10 - 15||10 mins|
|4.||Effective Coaches Exercise||16||5 mins*|
|5.||Competencies of Effective Coaches||17 - 20||10 mins|
|6.||Coaching Self-Assessment Exercise||21||15 mins*|
|7.||Implementing Coaching in TeamSTEPPS||22 - 27||10 mins|
|8.||Coaching Exercise||28 - 29||30 mins|
|9.||Coaching Tips||30||1 min|
|*Although all instructional content and activities are recommended to ensure that participants achieve the learning objectives, these activities may be considered "optional" if time is constrained.|
Additional Resources: There are many sources of additional information on coaching. The coaching self-assessment exercise included in this module is from the resource listed below, which provides additional information on coaching:
- Chen, C. (2003). Coaching training. Alexandria, VA: ASTD Press.
|Module Time: 75 minutes|
- Coaching Workshop
- What is Coaching?
- Why Is Coaching Important?
- Why Is Coaching Important (continued)?
- The Role of a TeamSTEPPS Coach
- The Coach as a Role Model
- Observing and Providing Feedback
- Motivating Team Members
- Providing Opportunities to Practice
- (Optional) Exercise: Effective Coaches
- Coaching Competencies
- (Optional) Exercise: Coaching Self-Assessment
- Implementing Coaching in TeamSTEPPS
- Consider Coaches in Implementation Planning
- Identifying and Preparing TeamSTEPPS Coaches
- Prepare Staff for TeamSTEPPS Coaching
- Organizational Support for Coaches
- Exercise: Coaching
- Exercise: Coaching, continued
- Coaching Tips
Following completion of this module, you will be able to:
- Define coaching and its outcomes.
- Describe the role of a TeamSTEPPS coach.
- List competencies of an effective coach.
- Describe how to implement coaching in TeamSTEPPS.
After TeamSTEPPS training is conducted, the changes your implementation plan targets will be driven primarily through on-the-job reinforcement and coaching. Coaches play a critical role in the success of your implementation and sustainment efforts by modeling the trained behaviors; observing and providing feedback to staff using the new behaviors; providing opportunities to practice what has been trained; and facilitating sustained motivation for the implemented changes. Because coaches work directly with staff in day-to-day situations, they can help identify and remove barriers to the adoption of new team behaviors.
As depicted in the slide, the role of coaches spans Phases II and III of the implementation process. During Phase II, coaches can provide implementation teams with essential information about staff readiness and current skill level. As implementation progresses into Phase III—sustainment—coaches help identify barriers to using the new skills.
"Coaching" is defined as instructing, directing, or prompting as a coach. The term "coaching" describes specific actions that include demonstrating, reinforcing, motivating, and providing feedback. These actions share the purpose of improving performance or achieving a specified goal for the individuals or team being coached.
Coaching is an active and typically ongoing process that can be used in structured and unstructured activities. It requires routine monitoring and ongoing assessment of performance.
Coaching is different from traditional instruction. With traditional instruction, teaching typically ends when the new content or skill is mastered. Coaching, however, continues even after content or skill mastery to ensure sustainment.
In this module, we will provide some general information about coaching, as well as provide specific information about the role and implementation of coaching in TeamSTEPPS.
Coaching is an effective way to influence and improve performance. The effective use of coaching can achieve several positive outcomes.
In general, the results of effective coaching include:
- Goals that are defined and understood.
- Alignment of expectations between the team leader and team members.
- Transfer of knowledge on a "just-in-time" basis.
- Increased individual motivation and morale.
- A more adaptive and reactive team.
- Early identification of unforeseen barriers to performance.
- Commitment to continual learning and improvement.
- Movement to superior team performance.
More specifically in the context of TeamSTEPPS, the key to integrating teamwork behaviors into daily practice is through frontline coaching. Coaches will help ensure that teamwork concepts are understood by team members and that the teamwork tools and strategies you implement are used accurately and appropriately. If you help staff become proficient and comfortable with the new behaviors, they will integrate them into daily practice.
Over the longer term of your implementation, coaches will continue to monitor teamwork behaviors to ensure continued use of implemented tools and strategies, as well as to identify new areas for improvement. As such, TeamSTEPPS coaches play a critical role in both TeamSTEPPS implementation and sustainment efforts.
In order to achieve the important outcomes of coaching, a TeamSTEPPS coach's role includes several activities. These include:
- Role modeling behavior.
- Observing performance and providing feedback.
- Motivating team members.
- Providing opportunities to practice and refine performance. Let's review each of these and discuss their application to the implementation of TeamSTEPPS.
Effective coaches must role model the behavior they intend to reinforce. Modeling the teamwork behaviors being trained and reinforced will not only provide a demonstration of performance of the behavior to the team members, but also highlight the acceptance of the behavior in the environment. This may include general teamwork skills or the use of a specific TeamSTEPPS tool or strategy, depending on your implementation plans.
Coaches should be individuals who are well respected and supported in their work area. As such, coaches will send an important message by demonstrating the behaviors they are working to improve and then reinforce in your organization. The most effective skills coaches are members of the team in which TeamSTEPPS is being implemented.
Effective coaches also observe and provide feedback about team members' performance. To do so, coaches must conduct ongoing observations of performance and identify what is being done well and what can be improved. TeamSTEPPS coaches will focus their observations and feedback on the use of TeamSTEPPS tools and strategies that align with the implementation plan.
Strengths and weaknesses in performance must be conveyed to team members through feedback. Effective feedback is:
- Timely. Coaches should provide feedback when the behavior is still fresh in the team member's mind.
- Respectful. Feedback from coaches should be about behavior, not about an individual. Coaches should not attribute a team member's performance to internal factors. If negative feedback is specific to an individual team member, the feedback should not be delivered in front of others.
- Specific. Coaches should describe behavior in a specific, objective way and not be judgmental. Feedback should clearly describe what was good about the performance or what was incorrect or demonstrated need for improvement.
- Directed toward improvement. Coaches should provide information aimed at improving skills. When a behavior is performed correctly, it is critical for coaches to identify what was good about the performance and reinforce it for continued use. When behavior is not performed correctly, or demonstrates room for improvement, coaches must not only point out what should be improved, but also how it should be improved. Feedback should include goals related to improvement.
- Two way. As part of providing feedback, coaches should allow team members the opportunity to ask questions. This requires active listening by the coach. Similarly, coaches should ask questions to try to understand team members' point of view and to ensure they understand the feedback provided.
- Considerate. Coaches should provide feedback with the goal of correcting or improving behavior while leaving self-esteem intact.
You may want to provide coaches with a specific structure or model for providing feedback. For example, the SMART model stands for "specific, measurable, attainable, realistic, and timely." If your organization already has a feedback model in place for use in performance management, teach coaches to use the same model.
In addition to role modeling behaviors and providing feedback, an effective TeamSTEPPS coach motivates team members. In this role, a coach:
- Helps team members see the bridge between new behaviors and patient safety and outcomes.
- Encourages belief in team members' ability to succeed. This includes asking powerful questions to identify the source of team members' perceived expertise, knowledge, or experience and aligning their level of confidence with their abilities.
- Expresses enthusiasm among and commitment in team members.
- Validates current levels of accomplishment while advocating greater achievement.
- Recognizes and reassures team members when they are successful, such as using a TeamSTEPPS tool or strategy effectively.
- Identifies potential challenges, pitfalls, barriers, and unforeseen consequences.
- Offers support and assistance, and displays empathy toward perceived challenges the team member is facing.
- Communicates positive results and outcomes with the team. For example, highlights for the team a potential error that was avoided with the effective use of teamwork behaviors.
TeamSTEPPS coaches must also provide opportunities for staff to practice the teamwork behaviors.
Opportunities for practice might be formal and structured in nature, such as a sports team's practice or a simulated exercise; or they may be informal in nature. In some environments, opportunities to practice TeamSTEPPS might be inherently frequent. In other environments, they may not occur frequently or may apply only to some team members. Ensuring that everyone has opportunities to perform the behaviors and to receive feedback will be critical in integrating—and sustaining—the behaviors into daily practice.
Coaches may provide opportunities to practice TeamSTEPPS in a number of ways, such as:
- Asking team members how they might have approached a situation differently by using a TeamSTEPPS tool or strategy.
- Using regularly scheduled meetings, such as staff meetings, to have a few staff role play or discuss a scenario in which the use of a TeamSTEPPS tool or strategy would be effective.
- Developing tools that facilitate use of a desired tool or strategy, such as preprinted notepads that outline the SBAR components for the easy organization of information that needs to be shared.
- Providing staff with a TeamSTEPPS "tip of the week" that facilitates use of a tool or strategy.
In conjunction with ensuring that skills are practiced, coaches may also wish to reward the effective use of TeamSTEPPS. For example, coaches may design contests that allow staff to submit descriptions of how a tool or strategy was used on the job.
Now that we have covered what coaches do, let's think about the characteristics of effective coaches. I'd like each of you to think about coaches you have known or observed in your life.
- What characteristics did those coaches have that made them effective?
- Are coaching characteristics innate or can they be learned?
Instructor Note: You may wish to document their answers on a whiteboard or flipchart. After you review the coaching competencies on the next few slides, you may want to compare what is discussed to what was originally brainstormed by the participants.
Because coaching skills can be learned, the use of coaching training is important in ensuring the effective use of coaches. Next we will discuss some coaching competencies.
Knowing the role of a coach is not sufficient to understanding what it takes to be an effective coach. Effective coaches exhibit specific competencies. The American Society for Training and Development, or ASTD, identified 13 competencies that coaches should exhibit. These can be organized into four clusters:
- Performance improvement.
- Relationship building.
We'll discuss each of these clusters. We'll also be distributing a handout that defines the competencies.
Skill in communicating is clearly critical for coaching effectively. There are three specific areas of coaching competency related to communication:
- Communicating Instructions―Demonstrating to the person you are coaching how to accomplish the task and clarifying when, where, how much, and to what standard it should be done.
- The role of coach often involves teaching a skill or procedure to another person. The ability to break down a task into easy-to-understand steps that you can articulate to another is vital to being an effective coach.
- Providing Feedback―As we have discussed, this involves carefully observing performance and sharing these observations in a nonthreatening manner.
- Listening for Understanding―Demonstrating attention to and conveying understanding of others.
- Listening is an indicator of respect. It requires being open minded to what others say, focusing on both the content of what is said and the feelings others may be expressing.
A coach cannot be successful without skill in improving the performance of others. There are four areas of coaching competency related to performance improvement:
- Setting Performance Goals―Collaborating with others to establish short- and long-term goals for performance on particular tasks.
- Effective coaching sometimes starts with pointing someone in the right direction. First, you work with the person to set broad goals; then you become very specific in agreeing on desired outcomes and how they will be measured.
- Rewarding Improvement―Using a variety of means to provide positive reinforcement to others for making progress on the accomplishment of important tasks.
- Timing of rewards is important. Don't wait until you see either perfection or failure on the task. Look for growth in task accomplishment, and reward that soon after you observe it. Although coaches don't always control formal rewards, such as pay, perks, or promotions, they can make frequent and effective use of informal rewards.
- Dealing With Failure―Working with others to encourage them when they do not meet expectations.
- When an individual demonstrates an inability or unwillingness to perform a task according to expectations and standards, you need to be able to deal with the result. This can mean encouraging, redirecting, retraining, or otherwise affecting his or her ability to willingly change. Patience can be a virtue or an enabler of more failure, so use it wisely.
- Assessing Strengths and Weaknesses―Identifying root causes of performance through keen observation and effective definition and articulation of performance issues.
- Properly identifying the skills, abilities, and interests of the person you are coaching directs your coaching efforts to the most critical areas. This involves distinguishing between symptoms and root causes of problems. Without accurate assessment, coaching efforts might be spent addressing the wrong problem or a nonexistent one.
Effective coaches must be able to build relationships with those they coach. There are four areas of coaching competencies related to relationship building:
- Building Rapport and Trust―Showing respect for others. Acting with integrity and honesty. Easily forming bonds with others.
- Rapport and trust are the cornerstones of an effective coaching relationship. The person you are coaching needs to trust that you have his or her best interests at heart, so he or she can be honest with you regarding shortcomings. There also needs to be a bond of mutual respect so the advice, teaching, and counseling of the coach will be more readily accepted.
- Motivating Others―As we have discussed, coaches must encourage others to achieve desired results.
- The right button to push to help motivate another person differs widely across people, so there are no hard and fast rules for motivating others. It is best to ask each person what is important to him or her and how the task at hand relates.
- Working With Personal Issues―Listening empathically and without judgment, and offering emotional support for personal difficulties.
- In general, coaches are not expected to function as counselors. Few are qualified to carry out such responsibilities, and the context of the organizational relationship might preclude this type of interaction. Faced with an individual whose personal situation is interfering with his or her performance, however, you need to be able to intervene. A good rule of thumb is that whenever you feel "in over your head," you are. Be prepared to refer the person to appropriate sources of professional assistance and adjust the coaching process to support getting through the personal situation.
- Confronting Difficult Situations―Raising uncomfortable topics that are affecting task accomplishment.
- Coaching often involves situations in which performance has not met expectations. Unmet expectations often lead to finger pointing, denial of personal responsibility, and other dysfunctional behaviors. Talking about these issues can make people uncomfortable. Good coaching requires the ability and willingness to confront difficult and uncomfortable situations head on, but with tact and diplomacy. When the best interests of all concerned are at heart, the honesty and courage to confront difficult situations are welcomed.
The final cluster relates to coaches' skill in executing their role as a coach. There are two areas of coaching competency related to execution.
- Responding to Requests―Consulting with others on an as-needed basis. Responding to requests in a timely manner.
- Timely response to requests is a tangible indicator of respect. To build and maintain a healthy coaching relationship, make sure your responsiveness reflects a high level of priority.
- Following Through―Keeping your commitments. Monitoring outcomes of the coaching process and providing additional assistance when necessary.
- Trust is a critical component of any coaching relationship. Keeping your commitments helps build and maintain trust. Showing an ongoing commitment to the long-term success of the person you are coaching also builds a strong relationship.
Instructor Note: This is an individual exercise. If the exercise falls before a break, introduce the exercise and hand out the self-assessment forms before the break. Ask the participants to fill out the self-assessment when they return from the break.
If the exercise does not fall around a break, introduce the exercise, hand out the self-assessment forms, and give the participants 15 minutes to complete the forms. No debrief is required.
So far in this module, we've defined coaching and the role of a TeamSTEPPS coach, and we've discussed coaching competencies.
We would now like to conduct an exercise to map your own coaching potential to the competencies we've discussed. You will each use the Coaching Self-Assessment Form to map the competencies to your individual coaching strengths and weaknesses. The self-assessment form is for you and will not be shared with anyone else unless you choose to share it. There is no "score" for this exercise, but please be honest in your evaluation. You will have 15 minutes to complete the self- assessment.
- Distribute the ASTD Coaching Self-Assessment Form to participants.
- Have participants fill out the form.
I hope that you found the self-assessment form helpful in identifying your areas of strength and areas for improvement among the coaching competencies. Please use this as a guide when you return to work.
|Time: 15 Minutes|
Now, we'd like to spend a few minutes discussing how to implement coaching in TeamSTEPPS.
In general, suggested actions for implementing coaching as part of your TeamSTEPPS initiative include:
- Developing a plan for whether and how coaches will be used
- Obtaining buy-in of the plan.
- Identifying coaches.
- Training coaches.
- Preparing staff to receive coaching.
- Ensuring that coaches are supported by the organization.
We'll discuss each of these in more detail.
Whether and how you include coaching in your TeamSTEPPS initiative is a decision you will address as you develop your TeamSTEPPS implementation plan. As with all aspects of your TeamSTEPPS implementation, you should present the coaching concept and plans to your organization's leadership. It is essential to gain the buy-in of your leaders to implement a coaching strategy in your facility. You may wish to create a coaching brief that discusses the following:
- The importance of coaching in TeamSTEPPS.
- Your plan or ideas for how coaching may be implemented, including number of people involved, the time it might take, and any associated costs.
- The anticipated results of coaching in terms of improving teamwork performance among staff.
After gaining buy-in of your coaching plan, you will need to identify your TeamSTEPPS coaches, prepare them for their role, and prepare staff to be coached.
As part of your TeamSTEPPS implementation plan, you will need to identify TeamSTEPPS coaches. Coaches may be those who have been trained as Master Trainers, other members of your change team, or additional individuals whom you identify, train, and otherwise prepare to serve as coaches.
Recommended considerations for identifying TeamSTEPPS coaches include:
- Where TeamSTEPPS is being implemented.
- What type of individual has access to observe, provide feedback, and direct staff in the targeted work area? Align the coaches to the professions represented in the work area. For example, if physicians and nurses staff the targeted area, your identified coaches should include a physician and a nurse.
- Individual characteristics.
- Identify coaches who are qualified to develop the skills of others in their practice of teamwork skills. Usually, the coach must have advanced knowledge and expertise in teamwork concepts and training. Effective coaches have integrated team behaviors into their own practice and coach by example. Some individuals may require training in the coaching competencies we reviewed earlier in the module.
- It is also important to ensure that identified coaches have the support of leadership and are highly respected among staff. These characteristics will facilitate the ability of coaches to effect changes in work patterns and behaviors.
- Interpersonal style can also have great bearing on the coaching outcome. Effective coaches typically demonstrate a supportive attitude and the ability to build confidence in others.
- The number of coaches needed for your implementation.
- In general, TeamSTEPPS recommends one coach for every 10 staff. However, you must also consider the availability of coaches across shifts and schedules.
After you have identified the coaches and they have agreed to participate, prepare them for their role by conducting a coaching session. This session can be conducted informally or formally, based on the resources and number of coaches that you select. The coaching material in this training can be used, along with adaptations that reflect relevant feedback tools and performance improvement processes already in place in your organization.
Finally, your implementation plan may involve matching coaches with team members. Your organization's culture may drive how this is done. You can match coaches with team members without feedback from the team member. You can have the coaches identify whom they would like to coach based on existing relationships. There are many options. Make matches based on what fits best in your organization's culture.
Another important aspect of ensuring the success of your TeamSTEPPS coaches is to ensure that staff are also prepared for being coached. Staff will require education about the role of coaches to allow them to engage the coaches in a meaningful way, have a shared understanding of the role and responsibilities of the coaches, and view the coaches as resources.
The change agents for your TeamSTEPPS implementation should:
- Identify who the coaches are to the staff.
- Describe the goals and positive outcomes of coaching.
- Explain the role and responsibilities of the coaches to staff.
- Describe expectations with regard to staff's interactions with coaches. For example, staff should expect to receive feedback from coaches about their teamwork performance. Staff should ask questions about teamwork to the coaches and view coaches as a source of guidance and support on the changes taking place. Finally, staff should be encouraged to provide the coaches with feedback about the TeamSTEPPS implementation based on their own observations and experiences.
We have established that frontline coaching is critical to the implementation and sustainment of teamwork behaviors in daily practice. However, the coaches' role in success of TeamSTEPPS also requires organizational support and reinforcement.
Organizational leadership can provide support for and reinforce TeamSTEPPS coaches by:
- Including coaches in efforts to integrate TeamSTEPPS performance into the organization, such as efforts to include TeamSTEPPS in processes to integrate staff into the unit or work area, or including TeamSTEPPS performance in staff performance evaluations. Coaches not only play a critical role in ensuring staff's use of teamwork skills, but also have knowledge of frontline staff and perceived and actual barriers to performance that should be leveraged by organizational leaders as they work to further integrate TeamSTEPPS performance into the organization's processes and procedures.
- Integrating TeamSTEPPS tools and strategies into policies and processes. In addition to including coaches in these organizational efforts, implementing such efforts serves as a way to support coaches and increase the likelihood of success. For example, an organization may implement use of the Two-Challenge Rule language as the first step in the organization's escalation policy.
- Formally recognizing and/or rewarding coaches for their contributions to the unit's or work area's success.
- Providing opportunities for coaches to work together. This could include planning, solving problems, and sharing feedback as a group. Having coaches work together will also promote accountability for their role.
As we mentioned earlier, as a Master Trainer, you may be identified to serve as a TeamSTEPPS coach. In this next exercise, you will each practice providing and receiving coaching. You'll also receive feedback on the coaching skills you practice.
- Divide the participants into groups of three.
- Hand out the Coaching Feedback Forms and Coaching Scenarios for each group to select from.
Instructor Note: If time permits, you may wish to demonstrate one of the coaching sessions to the group, using the same instructions described below.
You should each be in a group of three and have copies of the Coaching Feedback Forms and some Coaching Scenarios.
To practice your coaching skills, you will each take turns playing the role of the coach, the team member being coached, and the observer. The coach works through the designated issue with the team member; the team member acts out the particular scenario; and the observer watches the interaction and notes on the Coaching Feedback Form which competencies the coach exhibits and does not exhibit.
Within your group, read the first scenario and assume your designated roles of coach and team member. You'll have about 2 minutes to act out the scenario while the third person observes and completes the Coaching Feedback Form. At the end of the scenario, the observer provides feedback based on comments noted on the Coaching Feedback Form. You'll then rotate roles and use a new scenario.
You may wish to reference the coaching competencies and definitions on the ASTD Coaching Self-Assessment Form you completed earlier as you provide feedback to your team members.
- Are there any questions before we begin?
|Time: 30 Minutes|
- Help keep time to ensure that each participant has an opportunity to play multiple roles.
- Observe the coaching sessions. Identify a well-demonstrated coaching scenario and ask if the group would demonstrate their scenario in front of the class.
- After about 10-12 minutes, reconvene the group and have the identified group demonstrate their scenario.
- Which of the competencies of an effective coach were demonstrated in this exercise?
- How did you choose which team member(s) to coach? Is there an alternative approach?
- What did the team member do well in interacting with the coach?
- Were there opportunities for improvement?
This module has provided you with information to serve as a TeamSTEPPS coach, as well as prepare others for this role. Here are a few coaching tips:
- Actively monitor and assess team performance.
- Establish performance goals and expectations.
- Acknowledge desired teamwork behaviors and skills through feedback.
- Coach by example—be a good mentor.
- Coach from a distance.
- Coach only to problem solve.
- Lecture instead of coach.