Modeling integration: co-teaching basic and clinical sciences medicine in the classroom

Figures & data

Table 1 Solo- and co-teaching faculty

Basic scientists	No. of solo- taught sessions	Clinicians	No. of solo-taught sessions	Co-teaching faculty pairs	No. of co-taught sessions
Prof A	7	Prof W	0	Profs A and W	6
Prof B	2	Prof X	2
		Prof Y	1	Profs A and Y	1
		Prof Z	1

Notes: Prof A is a PhD microbiologist. Prof B is a PhD immunologist. Prof W is an emergency medicine physician. Profs X, Y, and Z are infectious disease physicians.

Figure 1 Comparison of attitudes toward solo- and co-teaching (response rate=62%, n=122).

Table 2 Mean rank comparison of co-teaching and solo-teaching

Question	Mean rank			χ^2	MW
	Co-teaching	Solo-teaching
		Scientist	Clinician
Overall learning experiencea,b,c	248.28	166.33	125.18	92.11*	583.00*
Understanding basic scienceb,c	109.70	118.23	56.08	49.90*	1081.50*
Understanding clinical sciencea,b,c	128.45	62.78	97.73	46.95*	680.00*
Understanding the connectiona,c	257.95	150.18	131.42	109.31*	407.00*
Remaining engageda,c	213.74	147.01	133.36	47.52*	643.50*
Retaining contenta,c	217.75	152.08	137.80	45.84*	645.00*
Applying contenta,b,c	223.61	125.58	152.16	65.45*	509.50*

Notes:χ², Kruskal–Wallis test for three-group comparison. MW, Mann–Whitney U-test for co-teaching vs. solo-teaching comparison.

* p<0.01.

a Post hoc: scientist vs. co-teaching comparison, p<0.01 in pair-wise Mann–Whitney U-test.

b Post hoc: scientist vs. clinician comparison, p<0.01 in pair-wise Mann–Whitney U-test.

c Post hoc: clinician vs. co-teaching comparison, p<0.01 in pair-wise Mann–Whitney U-test.

Table 3 Themes from survey of students

What do you like most about sessions led by a scientist–clinician vbpair?
Context and holistic picture makes connections between basic sciences and clinical application more obvious
I liked how the clinical and the basic science aligned right there and then, and the connections were quite obvious.  These sessions really helped me to see the bigger picture of microbiology; it’s more than just memorizing what bug and what drug, and these paired sessions gave a holistic picture! The thing I liked the most was how everything that was presented during these sessions was additive; Dr. X would say one thing, and Dr. A would add something else that built upon the last thing to give us multiple perspectives.1
Instructor team dynamics
I liked how each wasn’t afraid to correct the other mid-lecture […] I felt like I was always getting the right and relevant information.  I liked their camaraderie and ability to give details on each other’s sessions.
More engaging and thought provoking
My favorite sessions in Interacting with the Environment (IE) Part 2 were the Approach To sessions that were led by a scientist–clinician pair because they were engaging, thought-provoking, and well-organized. I liked how the sessions were organized according to the patient’s chief symptom and how the powerpoint slides were organized based on going through a differential diagnosis with clinical cases. I loved how slides about the basic science of microorganisms were included right after their related clinical slides because this really helped me to retain information about certain bugs and why it all mattered.  It is much more engaging to hear two expert voices that trade off rather than one voice that can get repetitive and cause students to lose interest. The constant dual interaction and switching off not only kept me more engaged, but I truly appreciated the assisting/playing off of one another’s expertise to help explain disease processes from both lens[sic]. I think this combination was 1. much more engaging; 2. much more thorough; 3. helped me retain more information.
Improves learning in terms of retention and/or provides a better understanding
The connections that exist between clinical and basic science help cement knowledge in my memory, and often these were pointed out because of the pairing.  Presence of both clinician and basic scientist is more efficient, can ask wider variety of questions.  The interaction between the presenters increased the levity of the session and it was nice to have experts in their fields be able to answer all questions.
What do you like least about sessions led by a scientist–clinician pair?
Presentation is disjointed or distracting
Bouncing back and forth between the scientist and clinician can be somewhat distracting to the flow of the lecture.  I guess it can be a bit of whiplash between the two lecturers, but it honestly did not matter that much in my learning.  It is sometimes difficult to focus on both clinical and basic science learning within one lecture. Sometimes it is nice to compartmentalize.
Lack of clarity of roles of each instructor
There sometimes seemed to be a lack of communication between the two – like one person wasn’t always completely clear as to what the other would cover.  I think sometimes they were a little unorganized and seemed to veer off topic.
Amount of information makes prioritizing content difficult despite stated goals of session
There was an almost overwhelming amount of information when both the basic science and the clinical are taught together.  Sometimes it is overwhelming to learn about both the basic science of the microorganism and the clinical.

¹Note: Names of faculty changed for publication purposes.

Figure 2 Comparison of equated and scaled exam score by teaching type.

Notes: ^*statistical significance, p-value <0.05.

Figure S1 Faculty evaluation.

Figure S2 Shared teaching survey.

Table S1 Evaluation of teaching performance

Group	Instructor	Mean rank of evaluation item
		1	2	3	4	5	6	7
Solo	Clinician X	83.09	98.20	99.73	87.23	88.48	97.64	84.59
	Clinician Y	91.21	79.39	83.04	92.79	95.07	92.29	98.05
	Clinician Z	91.21	79.39	83.04	92.79	95.07	92.29	98.05
	Scientist A	114.34	118.54	121.50	115.39	120.73	120.55	111.54
	Scientist B	120.66	117.84	110.08	123.21	121.13	106.52	117.84
Co	Co-teacher A	104.69	105.61	104.19	101.34	96.26	106.15	105.23
	Co-teacher W	112.68	118.50	117.03	105.95	103.03	104.68	103.79
MW	Co vs. Solo	4080.50	3871.50	3961.00	4393.00	4225.00	4283.50	4339.5
	Three groups	11.50*b	14.63*b,c	10.08*b	10.53*b	9.96*b	4.61	5.70
	Overall	12.50	17.69**	13.31**	11.20	10.49	5.83	7.13

Notes: MW, Mann–Whitney U-test for co-teaching vs. solo-teaching comparison. χ² =Kruskal–Wallis test for overall comparisons. Post hoc Mann–Whitney U-test with Bonferroni correction was conducted revealing that no instructor-by-instructor comparisons were significantly different.

* p<0.05.

** p<0.05.

a Post hoc: scientist vs. co-teaching comparison, adjusted p<0.05 in pair-wise MW.

b Post hoc: scientist vs. clinician comparison, adjusted p<0.05 in pair-wise MW.

c Post hoc: clinician vs. co-teaching comparison, adjusted p<0.05 in pair-wise MW.

IrbyDMCookMO’BrienBCCalls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010Acad Med201085222022720107346

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