By: Pedro Tanaka and Aileen Adriano
When a program says it has “implemented CBE, an important question remains. How fully have its principles been put into practice?” Van Melle and the International CBHPE Collaborators offer a useful framework for answering this question. Their Core Components Framework names five interdependent components: outcome competencies, sequenced progression, tailored learning experiences, competency-focused instruction, and programmatic assessment. Fidelity depends on all five working together. When only one or two are adopted in isolation, we risk creating an educational system that looks different on paper but remains largely unchanged in in practice.
This raises yet another important question: What helps bring these five components together in everyday educational practice? While coaching is usually filed under a single component, competency-focused instruction, our experience developing Stanford’s Faculty Coaching Program, has led us to see its potential more broadly. We began to recognize that a thoughtfully designed coaching curriculum can connect and support all five components, helping translate the principles of CBE into meaningful educational experiences.
Coaching competencies made explicit.
A coaching curriculum should practice what it preaches, starting with explicit outcomes for the coaches themselves. Ours opens with four core competencies (coaching presence, relating, listening, and questioning), each defined by observable behavioral markers and an intended end result. Faculty can’t coach toward clear outcomes if their own outcomes as coaches are vague.
Sequenced progression that makes sense.
The curriculum builds deliberately: essential core competencies first, followed by the coaching process (Adapted from Columbia’s 3Cs: Context, Content, Conduct), then strategic reflection using the ORID framework, and ending with the ethics of internal coaching. A guiding principle that informs every part of the coaching conversation is “earning the right to advance at each stage,” Translated simply: perspective before action and understanding before solutions.
Tailored plans that are learner driven.
An individualized learning plan is only as good as the conversation that produces it. Coaching skills like entry and contracting, exploring developmental frames, and keeping the focus on the learner’s agenda rather than the coach’s, transforms a template into a plan a learner actually owns. In the Conduct phase, plans become small, time-bound experiments: act, observe, reflect, adjust.
Competency acquisition that is observed in real time.
This is the obvious fit and the hardest shift. Moving faculty from grader to coach takes practice, not a lecture. Each module is built as a “practice room.” Trios rotate through the coach, coachee, and observer roles, using structured observer worksheets and debriefing right away. Faculty experience direct observation and feedback before we ask them to provide it.
Programmatic assessment that is meaningful.
CBE generates a lot of data: workplace-based assessments, milestones, 360s, CCC reports. Data alone doesn’t change behavior; making meaning of it does. Our Situation Analysis and ORID sessions teach coaches to help learners sort objective, subjective, emotional, and contextual data, then move from “What happened?” to “What does it mean?” to “How will I respond?” Coaching is the bridge between the assessment system and the learner’s next step.
Where coaching and assessment can collide.
If the same faculty member coaches a resident and sits on that resident’s CCC, psychological safety may erode. Our ethics module takes this on directly, covering confidentiality, dual roles, power gradients, and clear agreements about what stays in the room. Any program that embeds coaching in CBE needs explicit rules that keep coaching roles separate from high-stakes decisions.
The takeaway.
Coaching isn’t an add-on to CBE, and it isn’t confined to one component. It’s the connective tissue that helps the five components work as a system. If your faculty development treats coaching as a one-hour workshop on feedback, consider what a longitudinal, practice-based curriculum could do for implementation fidelity. Such a curriculum would give faculty repeated opportunities to practice coaching, receive feedback, and refine their approach in authentic educational settings. Sustained investment in these skills can help turn CBE’s design principles into consistent day-to-day practice.
How is your program preparing faculty to coach? What has helped, or hindered, the move from evaluator to coach? Share your experience in the comments.
Refrences:
- Van Melle E, Frank JR, Holmboe ES, Dagnone D, Stockley D, Sherbino J; International Competency-Based Medical Education Collaborators. A core components framework for evaluating implementation of competency-based medical education programs. Acad Med. 2019;94(7):1002–1009.
- https://www.tc.columbia.edu/coachingcertification/about-us/coaching-foundations/coaching-process/
- https://www.tc.columbia.edu/coachingcertification/about-us/coaching-foundations/guiding-principles/
- https://www.tc.columbia.edu/coachingcertification/about-us/coaching-foundations/core-competencies/
About the Authors:
Pedro Tanaka, Clinical Professor, is from the Standford University School of Medicine. He is an Executive Coach, Columbia Teachers College.
Aileen Adriano, Clinical Associate Professor, is from the Standford University School of Medicine. She is an Executive Coach, Columbia Teachers College.
The views and opinions expressed in this post are those of the author(s) and do not necessarily reflect the official policy or position of The University of Ottawa. For more details on our site disclaimers, please see our ‘About’ page