F1000Research F1000Research 2046-1402 F1000 Research Limited London, UK 10.12688/f1000research.179726.1 Study Protocol Articles Coaching programmes in undergraduate medical education: An integrative review protocol

[version 1; peer review: 2 approved with reservations]

 Weber Lucia Conceptualization Methodology Writing – Original Draft Preparation Writing – Review & Editing https://orcid.org/0009-0005-8830-3018 a 1 2 Freeman Jodie Conceptualization Methodology Writing – Original Draft Preparation Writing – Review & Editing 1 Gysin Stefan Conceptualization Writing – Review & Editing 3 Florin Jonas Conceptualization Writing – Review & Editing 3 Sondén Anders Writing – Review & Editing https://orcid.org/0000-0002-5239-9506 4 Schaer Dominik Conceptualization Writing – Review & Editing 2 5 Guttormsen Sissel Conceptualization Methodology Supervision Writing – Original Draft Preparation Writing – Review & Editing https://orcid.org/0000-0001-9932-1872 1 Institute for Medical Education, University of Bern, Bern, Switzerland Faculty of Medicine, University of Zurich, Zurich, Switzerland Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland lucia.weber@unibe.ch

No competing interests were disclosed.

 4 5 2026 2026 15 663 3 4 2026 Copyright: © 2026 Weber L et al. 2026 This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract* Introduction

Coaching programmes in undergraduate medical education are increasingly implemented to support students’ professional and personal development. Yet, the design and purpose of these programmes vary significantly across different institutions. This integrative review will systematically synthesise the literature on coaching programmes, focusing on structural characteristics, goals and educational strategies.

 Methods and analysis

A comprehensive literature review will be conducted using Whittemore and Knafl’s integrative review methodology. The search strategy includes the following electronic databases: MEDLINE, Embase, PsycINFO, ERIC, Education Research Complete, supplemented by a hand search. Two reviewers will independently screen all retrieved records, and study selection will be documented in a PRISMA flowchart. Data will be extracted from eligible full texts on descriptive metadata, structural characteristics, goals and educational strategies of the described coaching programmes. The quality of the included studies will be appraised using the Mixed Methods Appraisal Tool for empirical studies and the JBI Checklist for Text and Opinion for non-empirical studies. Extracted data will be analysed descriptively and thematically and integrated into a framework that can serve future programme development.

 Ethics and dissemination

As this review is based exclusively on secondary data, no ethical approval is required. The results of the review will be submitted to a peer-reviewed journal and presented at an academic conference.

Open Science Framework registration DOI 10.17605/OSF.IO/UTHJC

Coaching undergraduate medical education curriculum development medical student review University of Zurich’s teaching and learning fund “Innovative Medical Teaching Materials” The author(s) declared that no grants were involved in supporting this work. Introduction

Undergraduate medical education places considerable cognitive, organisational and emotional demands on students. Medical students are required to manage large volumes of learning content, develop their professional identity and make early career decisions, often while navigating stress, uncertainty and continuous assessment.

Around one-third of medical students experience mental health problems such as burnout, anxiety and depression. 1 Poor mental health has been associated with impaired academic performance, thoughts of dropping out of medical school, reduced professionalism and empathy, medical errors, substance abuse, and suicidal ideation. 1, 2

In parallel, the shift towards competency-based medical education places increasing emphasis on learners’ ability to direct and regulate their own learning. 3 Self-regulated learning skills are essential not only for managing the immediate demands of undergraduate training, but also for developing the adaptive expertise required in the rapidly evolving healthcare environment. 3– 5

In the context of these challenges, coaching has emerged as an educational approach to support students’ learning, wellbeing and professional development. Coaching can be defined as a structured, learner-centred process that supports students’ individual development through reflection, goal setting and personalised guidance. 6 In contrast to related concepts such as advising and mentoring, coaching uniquely focuses on stimulating students’ introspection and self-learning. 7

Coaching is used in a variety of ways within medical education. Lovell 8 differentiates between three categories: coaching for wellbeing and resilience; coaching for improved non-technical skills; and coaching for technical skills. More recently, the term academic coaching has gained prominence. While skills-based coaching typically involves direct observation and feedback for improving specific clinical skills, 8 academic coaching usually refers to guiding students’ individual development by reviewing assessment data and personal experiences to foster reflective processes and self-regulated learning. 5, 6

Although coaching programmes are becoming more common in undergraduate medical education, their structural characteristics, goals and educational strategies vary significantly across institutions. 9, 10 Variation in structural characteristics refers to differences in how the programmes are organised, such as their format (individual versus group-based), duration, session frequency and the profile of coaches involved. Differences in goals relate to the intended developmental focus of the programmes, which may range from academic performance to wellbeing, professional identity formation or development of learning skills. 10 Variation in educational strategies reflects the diverse approaches used to support students’ development, including the coaching activities and any theoretical frameworks the coaching is based on.

This heterogeneity can make it difficult for educators to understand what constitutes a coaching programme, how such programmes are designed and which components are essential. However, there is limited synthesised evidence that maps this variation in a systematic way. Although prior studies provide a basic overview of coaching in medical education, 8– 10 there is neither a recent nor a comprehensive review on coaching programmes in undergraduate medical education.

Objective

This review aims to synthesise literature on coaching programmes in undergraduate medical education, analysing programme structures, goals, and educational strategies to provide a foundation for future programme development.

 Research questions

The following research questions (RQ) will guide this review:

RQ1: What are the structural characteristics of coaching programmes in undergraduate medical education?

RQ2: What goals do these coaching programmes aim to achieve?

RQ3: What educational strategies are used to operationalise these goals?

Methods and analysis

We will conduct an Integrative Review, following Whittemore and Knafl’s 11 five-step framework: 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation. An integrative approach was chosen as it is suitable for general reviews and initial synthesis of emerging topics, allowing inclusion of various research types and enabling integration of evidence into new conceptual frameworks. 12

For the purpose of this review, we define a coaching programme as a structured, goal-oriented process, in which a coach meets regularly with medical students to guide their individual development and promote the students’ self-reflection. Our definition is adapted from the description of academic coaching. 5, 6 However, our definition intends to apply a broad scope, including not only coaching programmes that focus on reviewing assessment data to foster self-regulated learning but also other types of coaching, such as coaching for wellbeing.

Eligibility criteria

Table 1 shows the inclusion and exclusion criteria for our review.

Inclusion and exclusion criteria.
Criterion Inclusion Exclusion
Population (Target Group of Coaching)

Undergraduate medical students

Postgraduate medical students; residents; physicians

Students from other disciplines such as nursing, veterinary medicine, biomedicine

Medical faculty

Patients

Setting

Medical schools or universities with a medical curriculum

worldwide

Commercial coaching
Intervention

Coaching programmes that meet our definition of coaching

The terms ‘coaching’ or ‘coach’ must be in the title and/or description of the program

Programmes that also include other types of support such as mentoring or advising will also be included, if the main focus of the programme is on coaching

Mentoring, advising, training, tutoring, supervision, or interventions not explicitly described as coaching

Coaching that solely focuses on improving specific clinical skills

Type of Literature Peer-reviewed academic articles

Grey literature

Books and book chapters

Study Design

Empirical (quantitative, qualitative, mixed methods)

Non-empirical (e.g., descriptive programme reports)

Reviews (relevant reviews will not be included for data extraction, but will be used for handsearching reference lists)
Focus/Content of the Article

Article should include a description of an existing, planned or theoretical coaching programme for medical students

should include structural characteristics, goals and/or educational strategies of the programme

No description of structural characteristics, goals or content of a coaching programme
Time Period No time restriction
Language English and German Other Languages
Availability Full text available Full text unavailable
Data sources

An electronic database search was conducted as part of this integrative review. The following databases were searched to ensure broad coverage of relevant literature: Medline, Embase, PsycINFO, and ERIC (all accessed via Ovid), as well as Education Research Complete (accessed via EBSCOhost). We will further perform a hand search of reference lists of eligible studies and relevant reviews to ensure completeness.

 Search strategy

A university librarian assisted in developing and refining the search strategy. The searches combined free-text keywords with controlled vocabulary terms specific to each database. An example of the complete search string used in Ovid MEDLINE is presented in Table 2. Full search strings for all databases are provided in the supplementary materials. The electronic database search was conducted on 25 August 2025. Table 3 shows the results of our literature search.

Search string used in Ovid MEDLINE.
Line Search terms
1 coach*.mp.
2 schools, medical/
3 education, medical, undergraduate/
4 ((student* or school* or undergraduat*) adj5 medic*).mp.
5 2 or 3 or 4
6 1 and 5
7 limit 6 to (english or german)
Search results.
Database Number of articles found
Medline (Ovid) 626
Embase (Ovid) 1031
PsycINFO (Ovid) 247
ERIC (Ovid) 90
Education Research Complete (EBSCOhost) 162
Selection process

All retrieved records were imported into the screening software Rayyan 13 and deduplicated, resulting in 1,400 unique records. The screening process consists of two stages: an initial title and abstract screening followed by full-text screening. Prior to formal screening, a pilot test with a random sample of 20 titles and abstracts was used to refine the eligibility criteria. Both reviewers will screen all records independently using these criteria. Any disagreements will be resolved through discussion, with a third reviewer available to assist in cases of uncertainty. A reflexive diary will be maintained to record key decisions, reflections, and potential biases. Given the conceptual overlap between coaching and other interventions such as mentoring, the reviewers will apply the working definition of a coaching programme consistently during screening. Ambiguous or borderline cases will be discussed between reviewers to reach a shared interpretation. Any necessary refinements in our working definition and eligibility criteria will be documented in the reflexive diary. The study selection process will be reported using a PRISMA flowchart. 14

Data extraction

Once the eligible full texts have been selected, relevant data will be extracted using a data extraction form. Data will be extracted on the following components:

Descriptive metadata: Author, year of publication, journal, publication type, study design, country, institution, coaching program title

Structural characteristics of the described coaching programme (referring to RQ1): Target group, coaching format, number of students per coach, group size, group composition, group continuity, coach profile, overall duration, voluntary/obligatory, mode of delivery, frequency of sessions, duration of sessions

Goals of the described coaching programme (referring to RQ2): intended developmental focus of the coaching programme

Educational strategies of the described coaching programme (referring to RQ3): Educational frameworks referenced, session activities and content, activities outside of coaching sessions

The data extraction form will be piloted by two reviewers on a sample of studies and refined as needed. One reviewer will extract data for all included studies, and a second reviewer will cross-check a subset (10–20%) in the first phase of the extraction to ensure accuracy and consistency.

 Quality appraisal

The methodological quality of all eligible empirical studies will be appraised using the Mixed Methods Appraisal Tool, 15 which allows for the assessment of qualitative, quantitative, and mixed-methods studies within a single framework. For non-empirical studies, quality appraisal will be based on the Joanna Briggs Institute Checklist for Text and Opinion. 16 Two reviewers will independently appraise the quality of all included studies. Discrepancies will be resolved through discussion, including a third reviewer available, if needed. Each study will receive a descriptive rating for each of the corresponding methodological criteria, indicating whether the criterion is met, not met or unclear. These quality ratings will be reported in a summary table to contextualise the strength and transparency of the included evidence. However, no studies will be excluded based on quality, consistent with integrative review methodology. 11 Studies with lower quality ratings will be marked in the extraction sheet and interpreted cautiously during synthesis.

 Data analysis and synthesis

Extracted data will be analysed using descriptive analysis to summarise and compare structural characteristics across studies. Qualitative data on programme goals and educational strategies will be analysed using thematic analysis. 17 Findings from both strands will be compared and synthesised into a framework, illustrating how coaching programmes can be designed to address various student needs and developmental goals.

 Dissemination*

The findings of this integrative review will be shared through publication in a peer-reviewed journal and/or presentations at a relevant academic conference.

 Study status*

The electronic database search has been completed and screening is ongoing at the time of submission. Any important protocol amendments will be documented reported in the final review manuscript.

 Ethical considerations*

As this review is based exclusively on secondary data, no ethical approval is required.

 Data availability* Underlying data*

No data is associated with this article.

 Extended data

Open Science Framework: Coaching programmes in undergraduate medical education: An integrative review, https://doi.org/10.17605/OSF.IO/AWDPY. C-By Attribution 4.0 International. 18

Reporting guidelines*

Open Science Framework: PRISMA-P checklist for ‘Coaching programmes in undergraduate medical education: An integrative review’, https://doi.org/10.17605/OSF.IO/AWDPY. CC-By Attribution 4.0 International. 18

References* Jahrami H Alkaabi J Trabelsi K : The worldwide prevalence of self-reported psychological and behavioral symptoms in medical students: An umbrella review and meta-analysis of meta-analyses. J. Psychosom. Res. 2023;173:111479. 10.1016/j.jpsychores.2023.111479 Breslin L Dyrbye L Chelf C : Effects of coaching on medical student well-being and distress: a systematic review protocol. BMJ Open. 2023;13(8):e073214. 10.1136/bmjopen-2023-073214 Lomis KD Mejicano GC Caverzagie KJ : The critical role of infrastructure and organizational culture in implementing competency-based education and individualized pathways in undergraduate medical education. Med. Teach. 2021;43(sup2):S7–S16. 34291715 10.1080/0142159X.2021.1924364 Cutrer WB Miller B Pusic MV : Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education. Acad. Med. 2017;92(1):70–75. 10.1097/ACM.0000000000001323 King SM Carnicer Hijazo R Anas S : Academic coaching as a pedagogy to facilitate the navigation of complexity across the health professions education continuum. Front. Med. 2025;12:1523741. 40547912 10.3389/fmed.2025.1523741 PMC12179619 Wolff M Morgan H Jackson J : Academic coaching: Insights from the medical student’s perspective. Med. Teach. 2020;42(2):172–177. 10.1080/0142159X.2019.1670341 Santiesteban L Young E Tiarks GC : Defining Advising, Coaching, and Mentoring for Student Development in Medical Education. Cureus. 2022;14(7):e27356. 36043012 10.7759/cureus.27356 Lovell B : What do we know about coaching in medical education? A literature review. Med. Educ. 2018;52(4):376–390. 10.1111/medu.13482 Taylor D Anderson K Dathatri S : Medical student coaching in the U.S.: a national survey of clinical skills educators. BMC Med. Educ. 2025;25. 10.1186/s12909-025-08115-5 Wolff M Hammoud M Santen S : Coaching in undergraduate medical education: a national survey. Med. Educ. Online. 2020;25(1):1699765. 31793843 10.1080/10872981.2019.1699765 PMC6896497 Whittemore R Knafl K : The integrative review: updated methodology. J. Adv. Nurs. 2005;52(5):546–553. 10.1111/j.1365-2648.2005.03621.x Elsbach KD Van Knippenberg D : Creating High-Impact Literature Reviews: An Argument for ‘Integrative Reviews’. J. Manag. Stud. 2020;57(6):1277–1289. 10.1111/joms.12581 Ouzzani M Hammady H Fedorowicz Z : Rayyan—a web and mobile app for systematic reviews. Syst. Rev. 2016;5:210. 27919275 10.1186/s13643-016-0384-4 PMC5139140 Page MJ McKenzie JE Bossuyt PM : The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;n71. Hong QN Fàbregues S Bartlett G : The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ. Inf. 2018;34(4):285–291. 10.3233/EFI-180221 McArthur A Klugarova J Yan H : Chapter 4: Systematic reviews of text and opinion. JBI manual for evidence synthesis JBI. 2020;10:134–74. Braun V Clarke V : Using thematic analysis in psychology. Qual. Res. Psychol. 2006;3(2):77–101. 10.1191/1478088706qp063oa Weber L Freeman J Gysin S : Coaching programmes in undergraduate medical education: An integrative review. Open Science Framework. 2026. 10.5256/f1000research.198269.r484767 Reviewer response for version 1 Hunter Krystal 1 Referee Cooper University Hospital, Camden, New Jersey, USA

Competing interests: No competing interests were disclosed.

 16 6 2026 Copyright: © 2026 Hunter K 2026 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

According to PRISMA, a systematic review protocol describes the rationale, hypothesis, and planned methods of the review. 

The protocol does all the following:

1. Describes the rationale:  The authors stated the following:

Given the rigors of being an undergraduate student, one third of them experience mental health problems (burnout, anxiety and depression).  This can lead to impaired academic performance, thoughts of dropping out of school, potential medial errors and other issues.

Coaching has emerged as an educational approach to support students’ learning, wellbeing and professional development. Coaching can be defined as a structured, learner-centred process that supports students’ individual development through reflection, goal setting and personalised guidance.

 2.  Hypothesis/ Study Objectives:

a. This review aims to synthesize literature on coaching programmes in undergraduate medical education, analysing programme structures, goals, and educational strategies to provide a foundation for future programme development.

b. Research questions

1. RQ1:What are the structural characteristics of coaching programmes in undergraduate medical education?

2. RQ2:What goals do these coaching programmes aim to achieve?

3. RQ3:What educational strategies are used to operationalise these goals

3.  Planned Methods

1. Integrative Review using he Whittmore and Knafl’s five-step framework

2. Electronic database search

3. Provided detail summary of the data extraction process where there will be two primary reviewers and one tie breaker review.

4. Quality appraisal

               a. Will use Mixed Models Appraisal Tool

               b. Will also use Joanna Briggs Institute Checklist for Text and  Opinion

5. Also provided a summary of the data analysis and synthesis and planned dissemination. 

In summary, the authors provided sufficient information for a PRISMA compliant protocol.  It should be noted that further details are expected to be provided in the final report. 

Strengths of work:

Great background information that provided details as to why this subject matter was and important topic. 

Detailed summary of the inclusion and exclusion that will be used to determine peer-reviewed papers  that would be eligible to be part of the review. 

 Proposed Edits:

While there were a lot of details that made it very straight forward for review; one thing that was missing was the background of those who will be reviewing the papers for quality and review inclusion.  I this should be added to the methods section

Is the study design appropriate for the research question?

Yes

Is the rationale for, and objectives of, the study clearly described?

Yes

Are sufficient details of the methods provided to allow replication by others?

Partly

Are the datasets clearly presented in a useable and accessible format?

Not applicable

Reviewer Expertise:

NA

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

 10.5256/f1000research.198269.r487628 Reviewer response for version 1 Garcia Dieguez Marcelo 1 Referee https://orcid.org/0000-0003-2117-0984 Universidad Nacional del Sur, Bahía Blanca, Argentina

Competing interests: No competing interests were disclosed.

 12 6 2026 Copyright: © 2026 Garcia Dieguez M 2026 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

Summary of the article : The article  present a protocol for an integrative review of coaching programmes in undergraduate medical education. The protocol follows Whittemore and Knafl's five-step framework and aims to synthesise literature on structural characteristics, goals, and educational strategies of such programmes. The review addresses three focused research questions . The search has already been conducted across five electronic databases (MEDLINE, Embase, PsycINFO, ERIC, Education Research Complete), yielding 2,156 total records and 1,400 unique records after deduplication Quality appraisal will use the Mixed Methods Appraisal Tool (MMAT) for empirical studies and the JBI Checklist for Text and Opinion for non-empirical work. Synthesis will combine descriptive and thematic analysis.

Cooments: Genewrally method are well-described, and  the search string for MEDLINE ias well); The two-stage screening process (title/abstract then full-text) is described. and a pilot test of 20 records is mentioned

The  data extraction domains are also enumerated in detail; quality appraisal tolls are mentiooed and are appropriately selected.

Some atention is needed to improve the paper.The protocol describes that two reviewers will screen independently and the process for disagreements resolution is also describer, but  no mention is made of calculating or reporting inter-rater reliability.  The protocol states that "10–20%" of studies will be cross-checked by a second reviewer. Maybe this range is broad and tshould be s specify the exact percentage. About the thematic analysis, the authors mention some autors to follow as guidance for the process, but do not specify whether they will use inductive or deductive coding, or how themes will be generated and agreed upon between reviewers. Even brief clarification would strengthen replicability. Finally the authors acknowledge that distinguishing coaching from mentoring is challenging and describe a reflexive diary to document decisions. It would strengthen the protocol to briefly describe any decision rules that will guide this distinction in ambiguous cases. Short definitions around similarities and differences in the context of the review could also facilitate recplicability.

Is the study design appropriate for the research question?

Yes

Is the rationale for, and objectives of, the study clearly described?

Yes

Are sufficient details of the methods provided to allow replication by others?

Partly

Are the datasets clearly presented in a useable and accessible format?

Not applicable

Reviewer Expertise:

competency-based curriculum design EPAs for undergraduate and residency, burnout/vitality in faculty, EPAs for undergraduate and residency, OSCE/ECOE assessment, Script Concordance Test, psychometrics (cut-off methods), postgradute medical education and residency trainin

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.