Technology advancements are transforming the practice of medicine and consumer expectations, requiring innovative approaches to provide best quality and affordability. This includes reskilling and upskilling workforce capabilities to meet future needs.In the 2021 Deloitte Global Human Capital Trends report, executives identified “the ability of their people to adapt, reskill, and assume new roles” as most important to navigate future disruptions.1 As a result, organizations are cultivating a learning culture at all organizational levels, and leadership styles are shifting from top-down “command and control” approaches to a style that engages, collaborates with and empowers others.2
The term “leader” can apply to anyone who demonstrates these characteristics, not just those in titled roles. Coaching and mentoring are two developmental methods — often used interchangeably while having similarities and differences — that leaders use to help people build more confidence, think more creatively, take risks, reflect and learn.
Mentoring is a reciprocal, collaborative relationship between a subject-matter expert (SME) or experienced person (mentor) and an individual (mentee). The mentor and mentee have a shared mutual responsibility and accountability with the primary purpose of growth, learning and career development of the mentee.3 The mentor may connect the mentee with resources, teach new knowledge or skills, model positive work culture, and serve as an advocate, advisor or sponsor. In turn, the mentor may benefit from the mentees’ perspectives.4
Mentoring powerfully benefits healthcare organizations by preparing newer or aspiring leaders to lead in the future5 — 60% of healthcare organizations have formal onboarding/mentoring programs for their new providers.6 Ultimately mentees are responsible for their personal growth and development. Mentees establish goals and set the mentoring meeting agendas. Mentees may have more than one mentor and perhaps a board of trusted advisors. Mentoring relationships can be informal or part of a formal, time-bound program.
Sample mentoring dialogue
In the following dialogue, the mentor acknowledges what the mentee is experiencing, explores what the mentee is already doing to address the situation, recommends additional resources, and shares insights from his or her own experience.
- Mentor: How is it going?
- Mentee: It has been hectic, with a lot of change. The staff have been working extra hours to cover the staffing shortage that has resulted from COVID.
- Mentor: Yes, I can relate. These are different times. Our team is going through the same and I know other areas are as well. What have you been doing to help the situation?
- Mentee: I have met with the team a few times to talk about the challenges. We took one meeting to talk about health and well-being and the importance of taking care of ourselves.
- Mentor: Did you see the great article in the staff newsletter about spring well-being and the resources available?
- Mentee: No, I will have to check it out. It sounds like a good resource.
- Mentor: What challenges did the group bring up when you asked them?
- Mentee: One of the big ones is staying connected in the work environment. We used to see each other daily in the hallway and now we tend to have those interactions periodically during virtual meetings. It’s not quite the same.
- Mentor: There is a new guide that was just developed that provides tips, ideas and resources for remote teams. One of the tips that has worked well for my team is …
“As a new administrator in a healthcare organization, I wanted to quickly understand the culture, best practices and build networks. During my first year, I connected with several senior leaders to get their perspectives, expectations and gain familiarity with their leadership style. There were a few I really connected with and met with periodically to discuss situations. Though not in my specific role, they understood the nuances of our organizational culture and helped me get some early wins. Their insights, experiences, connections and support have been invaluable in my leadership onboarding and performance success. I still continue to meet with them.”
Coaching is a newer developmental method compared to mentoring. The International Coaching Federation (ICF), founded in 1995, established standards and guidelines of practice, code of ethics and competencies.7 The ICF defines coaching as a thought-provoking and creative process that inspires an individual (coachee) to maximize their personal and professional potential. Coaching has traditionally been utilized for senior leaders and people with high leadership potential. The value of coaching is increasingly recognized and now being applied broadly across organizations.
A coach asks powerful questions, rather than giving advice as a mentor might, to stimulate critical thinking, prompt self-reflection, and generate action steps toward a defined outcome. A coach does not need to be a SME in the topic of the conversation, but rather skilled in the process of evoking insight and generating committed actions by the coachee.
Sample coaching dialogue
In the following conversation, the coach asks powerful questions to promote self-discovery. The coach listens and mirrors what he or she is hearing, observing and sensing to bring awareness to the coachee. In concluding, the coach builds in commitment and accountability to ensure forward movement.
- Coach: How are you today?
- Coachee: Okay. A lot of changes going on. Most of my team and I are now working from home. The staff have been working long hours to cover the staffing shortage that has resulted due to COVID.
- Coach: Based upon the tone of your voice, it sounds like it has been challenging.
- Coachee: Yes, this is a dedicated team who continuously goes above and beyond to support patients and their team. I want to support them but not sure of the best way.
- Coach: What about this situation is weighing most on you?
- Coachee: I think it is part of my leadership responsibility to be there for them and help them where needed. I have seen staff more frustrated than before. One person raised their voice to another during a meeting yesterday and that has not happened before. I am concerned about the well-being of staff.
- Coach: I can tell you care about your team. It sounds like you have also been impacted.
- Coachee: This is something I have also had to work on given my husband and kids are also home. It’s hard staying connected with staff. I have had to consciously … [talks about actions she has taken to work through this transition … and is still working on it]. This is reminding me that we are all in this together. I am wondering if I should have an open conversation with my team about well-being, even sharing some of my own challenges, and talking about how we can support each other.
- Coach: That sounds like a healthy approach for you and your team. What is a step that will help you move in that direction?
- Coachee: We have a team meeting tomorrow. There is time on the agenda so I think I will raise the issue and see what kind of response I get.
- Coach: So, you are going to talk with your team tomorrow. Would you let me know how it goes after the meeting?
“I used to have a manager who wanted me to bring problems to him and he would go on to solve them. He wasn’t really interested in my ideas or opinions. I was unhappy in that role as I felt I was just doing what I was told. Now I have a manager who really encourages me to think for myself. She is there to support me and hold me accountable and focuses on helping ME solve the problem rather than solving it herself. She listens and has an amazing ability to ask open-ended questions that encourage me to think of things I hadn’t considered or been aware of, or to challenge my thought process. It is without judgment, and I know she has my best interest in mind. By encouraging me to dig deeper within myself, I can come up with answers and solutions that I am excited about and committed to implement. With her encouragement I find I can apply what I’m learning to new situations. It makes me want to work harder and to believe in myself.”
Critical elements of coaching and mentoring
Although coaching and mentoring are often done formally, a leader has many opportunities in everyday interactions to be an informal coach or mentor. Coaching and mentoring have differences and similarities (Figure 1). At the core of both should be a sincere desire to foster growth and development in others. Building trusting relationships is important for more open sharing, leading to deeper dialogues and learning.
Key skills to encourage self-reflection and learning of the coachee or mentee include asking powerful questions, deep listening and giving feedback. Asking powerful questions can evoke self-awareness and foster self-discovery. Deep listening goes beyond what is being said to pick up on unstated emotions and beliefs. In turn, listening helps to formulate powerful questions or affirmations, or to provide an opportunity to give feedback.
Effective and transformational coaching or mentoring that challenges and motivates for change can only happen within a trusting relationship. When a leader embraces a mindset of developing people, they become open-minded, curious, flexible and demonstrate their commitment to and belief in the capabilities of the coachee or mentee. In turn, trust develops. When trust is present, difficult topics are broached, mistakes are admitted and feedback is exchanged. This allows real learning to happen.
Suggestions to create a trusting relationship include:
- Maintain confidentiality: Verbally agree to this commitment and the parameters of confidentiality.
- Be available and present: Don’t multitask during the conversation. Let the individual know he or she is the priority at that moment.
- Keep commitments: Lack of follow-through and broken promises erode trust.
- Be honest: Truthfulness and demonstrating respect go hand in hand. Provide challenge for thought while remaining supportive.
- Be vulnerable: Admit mistakes and show authenticity.
- Be curious, not judgmental: Curiosity leads to inquiry; judgment leads to defensiveness.
- Let go of the need to be right: Acknowledge there may be other perspectives.
Leaders, through their knowledge and expertise, can default to a position of directing and telling. This can unintentionally stifle critical and innovative thinking from others, which may impact engagement and job satisfaction. Coaches utilize powerful questions to evoke awareness and new insights. Mentors at times should refrain from advising and use more of a questioning approach.
Powerful questions prompt reflection, challenge assumptions, shift perspectives and create accountability. A powerful question is typically open-ended, and the leader is curious and completely open to the response, free from judgment or looking for a “right” answer. It should be non-leading and prompt the individual to reflect and think more broadly. Most importantly, powerful questions should benefit the coachee or mentee, not the coach or mentor asking the question. Examples of powerful questions include:
- If you were certain of success, what would you try?
- What is the cost of doing nothing?
- What evidence do you have to support that conclusion?
- What does that tell you about yourself?
- How would you handle this if you were fully confident?
Deep listening is essential to focus on the conversation and what is being said, and to pick up on unstated themes, assumptions and fears. Leader observations can evoke new insights and creative thinking to address the issue. As described in Coaching for Engagement,8 one should listen for four types of “energy”:
- Physical energy (body language, tone of voice, etc.)
- Emotional energy (emotions and reactions based on those emotions)
- Mental energy (assumptions and understanding their thought process)
- Spiritual energy (deeply held values and beliefs that motivate and influence the individual)
To enable deep listening, consider the following:
- Timing (If it’s not a good time, arrange another time or share how many minutes you have.)
- Manage distractions (email, noise, etc.).
- Focus and turn off the internal chatter in your mind.
- Don’t be afraid of emotions; acknowledge them and be curious about them.
- Allow for silence to give the individual time to reflect and think.
When done well, giving feedback creates dialogue and motivation for higher levels of performance. Stone and Heen9 describe three types of feedback: appreciative, evaluative and coaching, all of which have their place in developmental conversations.
Appreciative feedback recognizes attitudes, behaviors or characteristics of the individual and expresses them in a manner that enables them to see themselves in a new way. Rather than feedback on a task, appreciative feedback focuses on the person themselves and the impact of their behaviors — why what you are noticing matters. Separate from recognition or giving a compliment, appreciative feedback expands awareness, builds confidence, and promotes engagement. Be generous with this type of feedback and deliver with sincerity and authenticity.
- Example: “You have accomplished so much since the last time we talked. It really shows that you hold yourself accountable for the goals that you have set for yourself. I can tell you are really committed.”
Evaluative feedback provides a ranking or assessment of performance and has a lesser place in coaching or mentoring as it puts the leader in a place of judgment and can prompt defensiveness.
- Example: “If I were to grade this, I’d give it a B. There are too many grammatical errors and the flow of information just doesn’t read very well.”
Coaching feedback accelerates learning and invites the person into dialogue as it is based on observation of facts, not judgments, and invites the receiver’s perspective.
A simple framework for coaching feedback is to:
- Ask for permission to share.
- Describe the facts (what was seen and heard).
- State the impact of what was seen or heard, or your tentative conclusion.
- Ask for the other person’s perspective.
- Example: “May I offer an observation? I noticed in recent team meetings that sometimes you are looking at your phone when others are talking. I’m concerned this gives the impression to others that you aren’t interested in what they have to say and creates unnecessary tension. How do you see it?”
People will be more open to and accepting of feedback if they believe:
- It is being shared with positive intentions.
- Collected information is based on facts, not conclusions, and the individual is given an opportunity to respond.
- Ideas are respected and support is provided, despite differences in viewpoints.
Coaching and mentoring are two powerful yet distinct methods leaders can use to develop and grow the workforce. A skillful leader may fluctuate between the two approaches, recognizing when to apply coaching and when to apply mentoring.
Develop a practice of pausing before responding to someone who comes to you for help and consider whether they need guidance (mentoring) or coaching (figuring it out for themselves through a process of self-discovery). Ask yourself in that moment:
- Do they need new knowledge?
- Are they capable of handling this or learning from finding the answers for themselves?
- Is there more than one right answer?
- Is this a decision only they can make?
- How might this be a growth opportunity for this person?
- Are they suffering from lack of confidence or need a change of attitude that just telling won’t fix?
The answers to these and other questions will position you as a leader who brings out the best in individuals and increases team and organizational performance.
Acknowledgments: The authors acknowledge the assistance of Sonia Watson, PhD, in preparation of this article.
- Violini E, Schwartz J, Eaton K, Mallon D, Van Durme Y, Hauptmann M, et al. “The social enterprise in a world disrupted: Leading the shift from survive to thrive.” 2021 Deloitte Global Human Capital Trends. Available from: bit.ly/2N2VPpt.
- Ibarra H, Scoular A. “The leader as coach: How to unleash innovation, energy, and commitment.” Harvard Business Review. November-December 2019. Available from: bit.ly/3nFrfPj.
- Zachary LJ. Creating a Mentoring Culture: The Organization’s Guide. San Francisco: Jossey-Bass; 2005.
- Choi AMK, Moon JE, Steinecke A, Prescott JE. “Developing a Culture of Mentorship to Strengthen Academic Medical Centers.” Acad Med. 2019;94(5):630-3. Epub 2019/04/27. doi: 10.1097/ACM.0000000000002498.
- Newman KM. “Mentoring millennials for future leadership in healthcare.” ACMPE Fellowship paper. MGMA. Feb. 27, 2017. Available from: mgma.com/newman-facmpe.
- Moheiser S. “Steps to building a formal mentorship program.” MGMA. Oct. 23, 2019. Available from: mgma.com/stat-mentoring.
- International Coaching Federation. Available from: coachfederation.org.
- Hancox B, Hunter R, Boudreau K. Coaching for Engagement: Achieving Results Through Powerful Conversations. Vancouver: Takara; 2010.
- Stone D, Heen S. Thanks for the Feedback: The Science and Art of Receiving Feedback Well. New York: Penguin Books; 2015.