Co-teaching in an Undergraduate Clinical Skills Course: Physicians and Social Behavioural Scientists Use a Shared Mental Model to Highlight Complementary Aspects of Medical Interviewing and Physical Exam Skills

Introduction: Interdisciplinary co-teaching by physicians (MD) and social behavioural scientists (SBS) has emerged as an innovative teaching practice in clinical skills courses, but little is known about how co-teachers operationalize instruction. The purpose of this study was to explore the shared mental model of co-teachers concerning medical interviewing and physical examination instruction. Methods: Twelve individual semi-structured interviews were conducted at Brown University. Participants were asked, “What and how do MD and SBS faculty contribute to teaching medical interviewing and physical examination skills?” Transcripts were subjected to thematic analysis. Discourse analysis was also used to determine if what faculty individually described as contributing to instruction was observed by the co-teacher. Results: Physician and SBS faculty emphasized different but complementary aspects of medical interviewing and physical examination skills. Physicians focused on content, targeting clinical reasoning, differential diagnosis, economy of movement, efficiency, synthesis, and technical skills. SBS faculty focused on process,emphasizing active listening, presence, non-verbal communication, rapport building, empathy, and patient comfort. Discussion: Co-teachers consistently articulated their relative contributions to teaching medical interviewing and physical examinations. Their shared mental model emphasized the importance of both content and process, creating a learning environment supporting the development of both biomedical and patient-centred perspectives. Graduating medical students must demonstrate proficiency in clinical skills as well as medical knowledge. In 2002, the Association of American Medical Colleges (AAMC) published a survey showing that only 24% of United States and 52% of Canadian medical schools had formal clinical skills curricula (Corbett and Whitcomb, 2004). These statistics have since rapidly changed, driven in part by national assessments such as the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills Exam and National Board of Osteopathic Medical Examiners (COMLEX) Level 2 Performance Evaluation (Gilliland et al., 2008). Today, nearly all US, Canadian, and international medical schools have formal clinical skills courses. Clinical skills courses typically include instruction on medical interviewing, physical examination skills, oral presentations, written documentation, clinical reasoning, and sociobehavioural topics. In 2008, the AAMC published competencies for pre-clerkship clinical skills