Incorporating coaching in the moment and coaching over time to support entrustable professional activity-based assessment in pathology residency training.

Entrustable professional activities have been implemented in pathology residency to support competency-based medical education. Coaching is an effective approach to support learner development that is gaining traction in medical education. Three residency programs implemented a two-part coaching program to support entrustable professional activities in pathology residency: coaching in the moment during formative entrustable professional activity assessments and coaching over time at end of rotation and semi-annual reviews. Program directors, faculty, and residents were asked to complete surveys six months into the study. Four major themes related to coaching and entrustable professional activity-based assessment were derived from narrative comments: (1) implementation methods of coaching in the moment and coaching over time to support entrustable professional activities; (2) evidence of success and value; (3) time investment as a limiting commodity; and (4) future intentions to expand adoption. While benefits around setting expectations, engaging learners in their development, building trust, and providing constructive feedback were evident, the time burden of completing these tasks is a constant trade-off for educators. Ongoing culture change and exposure to these modalities will be necessary to support both coaching programs and continued use of entrustable professional activities.