The PREGNANT (Pregnant Resident Empowerment, GuidaNce, and Advocacy iN Training) Coaching Project

Overview

This is a mixed-methods study designed to develop and evaluate an innovative coaching program for physician trainee mothers. Approximately 48 participants will be recruited from informational flyers posted in resident work areas and distributed by program directors and GME. Interested participants will email study staff. Participants will be randomized to the control or intervention arm. Intervention participants will meet monthly with a novice physician coach of their choice (one-on-one) and a certified physician coach (with an assigned group of 6 peers through video-conferencing). Participants in both arms of the study will respond to surveys at three points: enrollment (baseline), 4 months, and 7 months. At each point, they will spend approximately 10 minutes filling the survey. The survey will query demographics, burnout, professional fulfillment, imposter phenomenon, self-valuation, self-efficacy, resilience, quality of life, and impact of work on professional relationships. The coaching intervention will last 4 months, and the 7 month survey will be used only to assess long-term effects of the intervention. At the conclusion of the study (7 months after enrollment), participants will be interviewed over video communication (secure Partners or Harvard Zoom) for approximately 30 minutes.

To bridge the gaps identified in traditional mentorship programs, the PREGNANT study aims to develop and evaluate a novel, 4-month coaching program tailored to the childbearing trainees. Professional coaching is one of the few interventions shown to be effective in reducing burnout by providing structured and unstructured discussions through active listening and goal setting. It is uniquely positioned to address gaps identified in the previous mentorship program, as it does not rely on shared experiences, offers a focused solution with clear objectives, and provides trainees the tools to sustainably reduce burnout by fostering resilience, self-efficacy, and self-compassion. Despite its efficacy, many coaching programs rely on resource-intensive, in-person interventions, which reduce accessibility for trainees and pose scalability challenges.To overcome these barriers, our pilot study draws on the success of two types of innovative programs: 1) those that increase number of available one-on-one coaches by training practicing physicians in coaching techniques so they can function as "novice coaches" and 2) web-based group coaching programs with asynchronous learning opportunities, led by certified physician coaches, ensuring accessibility for trainees regardless of geographical or scheduling constraints. Unlike traditional life-coaching interventions that use external non-physician consultants, this program will be delivered by physician coaches who understand the challenges, social hierarchy, and culture of medical training. This distinction ensures that coaching is relevant and contextualized to the realities faced by childbearing trainees, thereby enhancing its effectiveness and impact. This initiative will purposively include lesbian, gay, bisexual, transgender, queer, and other sexual identities (LGBTQ+) and underrepresented in medicine (URiM) trainee parents, who have been underrepresented in previous research on trainee parents and face barriers that make it harder to balance family life and training. LGBTQ+ parents often have fewer benefits and unique challenges, such as limited access to parental leave and more frequent use of assisted reproductive technology, while URiM parents face compounded challenges from the intersectionality of their identities. The expected outcome of this project is the development of a structured, scalable coaching program that reduces burnout in childbearing trainees by integrating one-on-one coaching with community-building and group support. This program will have a significant positive impact on the clinical learning environment by enhancing its diversity, equity, and belonging while improving the well-being of a vulnerable population.