Unexpected findings from an interdisciplinary case conference

Dear Sir

Multidisciplinary experiences enhance understanding of team-based approaches to health care (Joyner et al. 2003), building collegiality, and promoting an integrated treatment focus. Student comments from a Midwest medical school minimized Psychiatry's role in patient care. However, students dispatched to the psychiatric consult service reported greater satisfaction in the Psychiatry clerkship due to collaborative teaching with other disciplines.

In an effort to strengthen students’ understanding of the role of psychiatry in comprehensive care, Psychiatry and Pediatric joint clinical case conferences were initiated, which emphasized the impact of mental illness on the medical treatment.

For two academic years, students participated in case conferences while on Pediatrics and/or Psychiatry. Cases were chosen based on pediatric patients with common psychiatric problems. Facilitators role-played the patient and parent, answering students’ questions related to historical information, and periodically stepping out of role to provide instruction. Anonymous evaluations rated conferences on a Likert scale (1 = Strongly Disagree to 5 = Strongly Agree) and subjective comments were collected.

The medical students who took Psychiatry prior to Pediatrics rated conferences higher throughout both academic years. Overall ratings by students on Psychiatry were higher than Pediatric students the first semester of each year (AY 2009: 4.47 vs. 3.85; AY 2010: 4.39 vs. 4.16). When the Psychiatry students were on Pediatrics second semester, these students continued rating the conferences higher (AY 2009: 4.13 vs. 4.11; AY 2010: 4.23 vs. 3.81).

This innovation is unique because students who began the year learning about biopsychosocial models of patient care continued to have a greater appreciation for the role of Psychiatry while on the Pediatrics clerkship. The postulated explanation for this was that initially learning a biopsychosocial treatment model results in a more comprehensive approach to medical care. Further investigation needs to be done to understand this phenomenon.

Although some medical schools have undertaken pilot projects to provide longitudinal interdisciplinary clinical experiences (Ogur and Hirsh 2009), many medical schools do not have the infrastructure to provide such sweeping curricular reform. Therefore, this innovation demonstrates that interdisciplinary case discussions provide viable alternatives for students to better understand interdisciplinary collaboration.