Health professions educators often have limited opportunities to advance their teaching skills beyond CME events that happen external to the instructional environment. If they do not have a background in education, they may also have had little opportunity to observe instructional practices apart from what they experienced as students themselves. Instructional coaching can be highly effective in advancing instructional skills, but often requires dedicated staff and resources beyond what is available to the average medical educator.   Peer observation and coaching is a practical, high-leverage, professional growth strategy that focuses on teaching skill development in context. The coaching process involves focused observation of instruction (following a prescriptive protocol aligned to best practices) paired with pre and post-observation conversations that engage both the observer and observed in reflection about their teaching practice. As a result, each person develops deeper understanding of both educational best practices and the cause and effect relationships between those practices and learner experiences. Based on the instructional coaching frameworks of Knight (2007), Joyce and Showers (1996), and Rudd, et al. (2014), the process includes protocols and formats that allow peers to coach and learn from one another, regardless of their level of education expertise.