Fellows can be excellent coaches, not only to each other, but also to those around them, including faculty members. A key competency that coaches and outstanding fellows share is curiosity. If you sincerely ask your colleagues how they are feeling, you are on the right path to becoming a great coach. If you raise your hand during a conference and provide insights into solving a longstanding clinical dilemma, that’s significant coach-like behavior. Moreover, one model of patient-physician relationships is as the coach (physician) who empowers the patient with their knowledge and skills.5 Fellowship is a great time to learn the competencies enabling this relationship dynamic.
It must be stated that there is a fine line between being a coach who helps solve problems, and being a rescuer who reinforces a relationship to another person based on a problem. My advice to you is to be your own best coach first; think about how to solve your own problems before reaching out to help solve others’ problems. Remain a coach, rather than becoming a rescuer, and maintain your well-being enough to continue being a coach.
Enter the Challenger
The last, and perhaps most misunderstood, member of the triangle is the challenger. The challenger is assertive and may drive the situations in ways that creators and coaches may not immediately appreciate. In the drama triangle, they are considered persecutors, whose actions are controlling and blaming. Challengers may criticize others in the triangle, but do so out of a desire to clarify the needs of a situation or a person. Much like coaches, challengers must be aware of their own limits and not overstep the bounds, disrupting the delicate lines of the winner’s triangle. They must challenge themselves first so a balance can be maintained in prompting a challenge while respecting others’ limits.
Fellows encounter a number of challengers throughout their training, including faculty members, co-fellows and others. Having challengers who are empowered to question assumptions is very important for fostering growth. In fact, it’s hard to imagine that without a healthy relationship to a challenger in fellowship, a creator can enter a growth mindset. Just as importantly, fellows must become challengers themselves. As part of their jobs, they must challenge healthcare systems to be more human centered and empathic. It’s not easy when you feel like you are at the bottom of the hierarchy, but that is why we have roles as coaches and creators.
