ORIGINAL CONTRIBUTION Clinical Improvement Interventions for Residents and Practicing Physicians: A Scoping Review of Coaching and Mentoring for Practice Improvement Casey MacKenzie, MD Candidate, 1 Teresa M. Chan, MD, MHPE, FRCPC, DRCPSC, 2,3 and Shawn Mondoux, MD, MSc, FRCPC 4 ABSTRACT Background: Graduate medical education (GME) bodies are beginning to mandate coaching as an integral part of the learning process, in addition to current requirements for mentorship. Once an emergency medicine physician transitions beyond graduate training, there is no requirement and little focus on coaching as a method of improving or maintaining clinical practice. Our objective was to understand and describe the current state of the published literature with regard to the use of coaching and mentorship for both GME and practicing physicians. Methods: We conducted a structured review of the literature through PubMed and Google Scholar and included all articles applying coaching or mentorship modalities to GME trainees or practicing physicians. A Google Form was used for standardized data abstraction. Data were collected pertaining to the settings of intervention, the nature of the intervention, its effect, and its resource requirements. Results: A total of 3,546 papers were isolated during the literature review. After exclusion, 186 underwent full- text review by the authors of which 126 articles were included in the final data analysis. Eighty-two articles (65%) pertained to mentorship and 14 (11%) to coaching; the remainder of the articles discussed a combination or variation of these two concepts. Fifty-three (42%) articles were descriptive studies and 35 (28%) were narrative reviews or commentaries. Forty-seven (37%) articles originated from within surgical specialties and coaching was most commonly applied to procedural or manual skills with 22 (17%) instances among all studies. Conclusions: Most literature on coaching and mentorship is descriptive or narrative, and few papers are in the specialty of emergency medicine. Most interventions are limited to single instances of coaching or mentorship without longitudinal application of the intervention. There is an important need to study and publish further evidence on coaching interventions. C oaches have long been used to increase and aug- ment performance. We are familiar with their place in professional sports and business, but it is a burgeon- ing area in the field of medical education. 1–3 Coaching in medicine has even made it to the pages of The New Yorker, where attending surgeon Atul Gawande recently wrote about his experiment of employing a coach in the operating room. In his article, Gawande wondered, “Professional athletes use coaches to make sure they are as good as they can be ... so why did I find it inconceiv- able to pay someone to come into my operating room and coach me on my surgical technique?” 4 From the 1 Michael G. DeGroote School of Medicine and the 2 Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario; the 3 McMaster program for Education Research, Innovation, and Theory (MERIT), Hamilton, Ontario; and the 4 Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada. Received January 15, 2019; revision received March 12, 2019; accepted March 18, 2019. The authors have no relevant financial information or potential conflicts to disclose. Supervising Editor: Daniel J. Egan, MD, FACEP. Address for correspondence and reprints: Shawn Mondoux, MD, MSc, FRCPC; e-mail: shawn.mondoux@medportal.ca. AEM EDUCATION AND TRAINING 2019;3:353–364 © 2019 by the Society for Academic Emergency Medicine doi: 10.1002/aet2.10345 ISSN 2472-5390 353