Coaching Workshop: Instructor Slides

TeamSTEPPS® Long-Term Care Version, Module 9

The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.

Contents


Slide 1: Coaching Workshop


Text: 'A good coach will make the players see what they can be rather than what they are.' - Ara Parseghian. Image: Two penguins are hiding behind a snowdrift; one penguin is holding the other up on his shoulders so the second penguin can look over the snowdrift's top.

Icon of a Subsections.Subsections
  • Team Member Roles.
  • Coaching Roles.
  • Effective Coaching Characteristics.
  • Coaching Competencies.
  • Feedback Techniques.
  • Coaching Self-Assessment.
  • Teamwork Actions.
Icon of a clock.Module Time: 65 minutes

Say:

After TeamSTEPPS training is conducted, the changes will be implemented primarily through on-the-job reinforcement and coaching. Your coaches become important change agents by assisting with the implementation of teamwork initiatives. The coaches will model the new behaviors and discuss the change with staff members.

We'll now move into the Coaching module since it is such a key component in your change strategy and plan.

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Slide 2: Objectives


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Say:

In this module, we'll:

  • State how team members' knowledge, skills, and attitudes (KSAs) are accomplished.
  • Describe the characteristics of an effective coach.
  • Assess coaching strengths and areas for improvement.
  • Identify the results of good coaching.
  • Demonstrate and evaluate coaching competencies.
  • Describe how to implement a coaching strategy.

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Slide 3: Knowledge, Skills, and Attitudes


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Say:

Team member KSAs are developed through having:

  • A clear understanding of his or her role.
  • Clearly defined tasks and responsibilities.
  • A high level of commitment and firm belief in accomplishment of the task/responsibility.
  • A good understanding of the culture and norms.

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Slide 4: The Role of Each Team Member Is To...


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Say:

  • Apply specific teamwork skills to accomplish and fulfill the responsibilities and tasks.
  • Communicate pertinent information to teammates and the resident/family efficiently and effectively.
  • Demonstrate desired behaviors and skills.
  • Possess the desired attitudes necessary to develop mutual trust and team orientation.
  • Request clarification or additional information, as needed.
  • Make adjustments to behaviors, based upon feedback.

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Slide 5: Coaching

Coaching: Providing guidance, feedback, and direction to ensure successful performance.

Say:

The term "coaching" is used to describe a specific action, such as encouraging, reinforcing, giving feedback, and demonstrating. Coaching is used in structured and unstructured activities. Coaching provides an opportunity to discuss goals, priorities, and standards of performance.

Effective use of coaching can achieve the following outcomes:

  • Increased understanding of team concepts.
  • Increased teamwork competence among staff.
  • Commitment to continual learning and improvement.
  • Movement to superior team performance.

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Slide 6: The Role of a Coach Is...

The Role of a Coach Is... Establish and clarify goals of the session; Develop a plan to accomplish the tasks and responsibilities; Ensure team members have a clear definition and understanding of their roles and responsibilities; Align expectations with members of the team; Advise, instruct, and demonstrate desired teamwork behaviors and skills; Encourage and provide feedback for improvement; Acknowledge and reinforce desired behaviors when observed.

Say:

Coaching is an active process. It requires the routine monitoring and assessment of team performance. The coaching process is outlined on this slide in the context of a defined performance improvement need or sustainment goal.

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Slide 7: Characteristics of an Effective Coach

Characteristics of an Effective Coach: Competence; Influence; Interpersonal Style; and Effective Feedback.

Say:

The first general goal of successful coaching is to commit team members to higher levels of performance. Commitment can be influenced by four primary characteristics of the coach:

  • Competence.
  • Influence.
  • Interpersonal Style.
  • Effective Feedback.

Competence refers to the degree to which the coach is 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.

Influence refers to the ability to effect change. The effective coach is highly respected among colleagues and has the power (formal or informal) to effect changes in work patterns and behaviors. The effective coach is also able to influence changes in the environment that will support teamwork.

Interpersonal style can have great bearing on the coaching outcome. Successful coaching can depend as much on how the information is communicated as what information is communicated. Effective coaches typically demonstrate a supportive attitude and the ability to build confidence in others.

Successful coaches know how to provide effective feedback. They understand that the goal of feedback is to improve performance, and they give feedback that is:

  • Descriptive—Describe behavior in an objective way; do not be judgmental.
  • Problem Oriented—Provide information aimed at correcting or avoiding problems that place residents at risk.
  • Empowering—Encourage ownership of solutions to identified problems.
  • Exploring—Try to understand the other person's point of view.
  • Considerate—Try to correct behavior while leaving self-esteem intact.

Icon of a talk balloon. Discussion:

Think about people in your live who have been a coach to you. What characteristics did they have that made them an effective coach?

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Slide 8: Coaching Competencies

Four blocks are captioned Communication, Performance Improvement, Relationships, and Execution. A more detailed text description of the text in each block is provided below the image.

Say:

In addition to the characteristics of an effective coach, there are 13 competencies that coaches should exhibit.

Icon of an eye. Instructor Note: Let participants know that you'll be providing a handout that defines the competencies.

Communication

  • Communicating Instructions—Showing 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—Carefully observing performance on individual tasks and sharing these observations in a nonthreatening manner.
    • Giving others feedback on their task performance is critical to improving their performance. To do this effectively, you have to observe the person performing the task, noting what the person is doing well and what can be improved. Then you work with the individual to ensure he or she understands your feedback and uses it developmentally.
  • Listening for Understanding—Demonstrating attention to and conveying understanding of others.
    • Listening is another indicator of respect. It requires keeping your mind open to what others say, focusing on both the content of what they say and the feelings they may be expressing. Listening almost invariably involves checking your understanding of others' messages by reflecting what you hear.

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 (e.g., pay, perks, or promotions), they can make frequent and effective use of informal ones.
  • 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, reprimanding, redirecting, retraining, or otherwise affecting his or her ability to willingly change. Patience can be a virtue or an enabler of more failure. Use it wisely.
  • Assessing Strengths and Weaknesses—Identifying root causes of individual performance. Keenly observing people and events. Defining and articulating issues effectively.
    • Properly identifying the abilities and interests of the person you are coaching directs your coaching efforts to the most critical areas. This involves keen observation and attention to detail. It also means distinguishing between symptoms and root causes of problems. Without accurate assessment, your coaching efforts might be spent on addressing the wrong problem or a nonexistent one.

Relationships

  • Building Rapport and Trust—Showing respect for others. Acting with integrity and honesty. Easily forming bonds with others.
    • Making others feel their concerns and contributions are important. 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—Encouraging others to achieve desired results. Creating enthusiasm and commitment in others.
    • The right button to push to help motivate another person differs widely. There are no hard and fast rules for what motivates anyone. You can be effective by knowing what motivates the person you are coaching and aligning his or her desires and goals to the task at hand. This requires continual assessment and reassessment of the person and situation. It is best to ask the person what is important to him or her and how the task at hand relates.
  • Working With Personal Issues— Listening emphatically and without judgment and offering emotional support for personal difficulties.
    • In general, coaches are not expected to function as counselors or psychotherapists. 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 fingerpointing, 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.

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.

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Slide 9: The Coach As Motivator

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Say:

Help the team member see the bridge between:

  • What they value and desire and...
  • The task or role for which they are responsible.

Provide specific, timely observations on performance and effectiveness.

Encourage belief in their ability to be successful.

  • Inquire about the source of their perceived expertise, knowledge, or experience.
  • Align their level of confidence with their abilities.

Validate current levels of accomplishment while advocating greater achievement.

Identify potential challenges, pitfalls, and unforeseen consequences.

  • Offer support and assistance, and be sympathetic to perceived challenges the team member is facing.

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Slide 10: Coaches Provide Feedback That Is...

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Say:

  • Descriptive and nonevaluative.
  • Meant to improve skills by making team members aware of what was right or wrong about their task performance.
  • Considered a development tool for enhancing task performance.
  • Two way; allows team members the opportunity to interact and ask questions.

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Slide 11: Feedback Should Be...

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Say:

Well Intentioned:

  • Feedback involves giving information, not advice.
  • Effective feedback is meant to help the recipient—it's a gift.
  • Feedback is not used to "get something off of your chest."
  • Feedback will not fix what you believe is wrong with another person.

Nonjudgmental:

  • Don't use terms such as "good" or "bad."
  • The goal of feedback is to help someone understand and accept the impact of their behavior on others.
    • The team member's decision to change behavior is not part of the feedback process.

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Slide 12: Exercise: Coaching Self-Assessment Form

Text: Complete a coaching self-assessment form to identify coaching strengths and areas for improvement. Image: A penguin rides a stationary exercise bicycle.

Icon of a clock.Time: 15 Minutes

Icon of a pencil tip.Materials:
  • ASTD Coaching Self-Assessment Form.

Icon of an eye. Instructor Note: This is an individual exercise. This exercise typically occurs around lunchtime. If so, introduce the exercise and hand out the self-assessment forms before the lunch break. Ask the participants to fill out the self-assessment when they return from lunch.

If the exercise does not fall around the lunch break, introduce the exercise, hand out the self-assessment forms, and give the participants 15 minutes to complete the forms. No debrief is required.

Say:

In this module, we have discussed coaching competencies. I have a Coaching Self-Assessment Form that maps to those competencies. In this short exercise, I would like you to complete the self-assessment form individually. The self-assessment form is for you and will not be shared with this class or anyone else unless you choose to share it. There is no "test score," but please be honest in your evaluation. You will have 15 minutes to complete the self-assessment.

Do:

  • Hand out the ASTD Coaching Self-Assessment Form to participants.
  • Have participants fill out the form.

Say:

I hope that you found the self-assessment form helpful in identifying your areas of strength and areas for improvement in the coaching competencies. Please use this as a guide when you return to work.

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Slide 13: Coaching Tips

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Say:

Do...

  • 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.

Do not...

  • Coach from a distance.
  • Coach only to problem solve.
  • Lecture instead of coach.

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Slide 14: The Results of Good Coaching Are...

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Say:

  • 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.
  • Improved team performance and safer resident care.

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Slide 15: Exercise: Coaching

Text: Split into groups of three; Review the scenarios and Coaching Feedback Form (CFF); Each participant takes a turn playing the coach, team member, and observer; The coach provides feedback to the team member in the scenario; The team member role plays the scenario; The observer completes the CFF and then shares with the groups. Image: A penguin rides a stationary exercise bicycle.

Icon of a clock.Time: 20 Minutes

Icon of a pencil tip.Materials:
  • Coaching Feedback Form
  • Coaching Scenarios

Icon of an eye. Instructor Note: Optional: Before the exercise, consider demonstrating one of the coaching sessions.

  • Split the participants into groups of three.
  • Instructor hands out Coaching Feedback Forms and Coaching Scenarios for each group to select from.
  • Participants each take a turn as the coach, 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.

Do:

  • Within groups, participants read the first scenario and assume the designated role of coach and team member for about 2 minutes. The third person observes and completes the Coaching Feedback Form. Upon completion of the role play, the observer provides feedback based on comments noted on the coaching feedback form.
  • Have participants switch roles and conduct the next two scenarios in the same sequence and timing as the first one.
  • Instructors should observe the coaching sessions. Identify a well-demonstrated coaching scenario, and ask if they would role play in front of the class.
  • Highlight what they did well to the class and have other participants provide feedback.
  • Close the exercise by reiterating the competencies of a good coach and key points that were observed during the role-play. Ask participants if they have any questions.

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Slide 16: How to Implement a Coaching Strategy

Text: Present coaching concept to leadership; Select coaches based on the characteristics and competencies of an effective coach; Conduct a session on coaching for the appointed coaches; Match coaches with team members; Leverage current performance tools or create new tools to help coaches sustain a coaching environment.

Say:

The key to integrating teamwork behaviors into daily practice is through frontline coaching. Present the coaching concept to leadership?it is essential to get the buy-in from your leaders to implement a coaching strategy in your facility. We recommend that you create a coaching brief that discusses the importance of coaching, why your facility personnel need it, how you think it can be implemented within your facility (number of people involved, time it might take, any costs), and most important, what the results of the program could be.

Once you have gotten leadership approval and backing, you should work with the change team to identify coaches within the facilities' units where teamwork principles have been trained. It is important to use the characteristics and competencies of effective coaches presented in this course as well as coaching literature to select the coaches within your facility.

Depending on your facility, some instructors may also be coaches. After you have selected the coaches and they have agreed to participate, you should conduct 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, or you can create additional content based on your own research in the coaching concept.

The next step is important. You will match the newly trained coaches with team members. Your nursing home'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. You need to match based on what fits best in your nursing home's culture.

To sustain this effort, the team must leverage current performance tools, if they exist, to support the coaches and team members. If performance tools do not exist, the team should develop appropriate tools that make sense to support the coaching strategy and help sustain the goals for this effort in the long term.

Recommendation: The recommended coach to staff ratio is 1:10.

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Slide 17: Teamwork Actions

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Say:

  • Perform as a leader and coach of other team members.
  • Provide well-intentioned, nonjudgmental feedback.
  • Analyze results of your coaching to look for ways to continually improve team performance.
  • Ensure team members are performing their roles as appropriate.
  • Implement a coaching strategy.

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Slide 18: Reference

Chen, Chris. Coaching Training. ASTD Press, Alexandria, VA, 2003.

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Current as of November 2012
Internet Citation: Coaching Workshop: Instructor Slides: TeamSTEPPS® Long-Term Care Version, Module 9. November 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/module9/igltccoaching.html