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A multisite randomized trial of implicit versus explicit modeling in clinical teaching.

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  • 1Department of Medicine, University of Colorado School of Medicine and Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.

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|October 27, 2022
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Explicit faculty role-modeling significantly improved medical students' communication skills and knowledge compared to implicit modeling. This suggests explicit instruction is more effective in clinical teaching for skill acquisition.

Keywords:
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Area of Science:

  • Medical Education
  • Communication Skills Training
  • Faculty Development

Background:

  • Faculty modeling is a cornerstone of clinical teaching, yet optimal strategies remain unclear.
  • The apprenticeship model traditionally incorporates faculty role-modeling for skill development.
  • Best practices for faculty modeling in medical education require further investigation.

Purpose of the Study:

  • To compare the educational impact of implicit versus explicit faculty modeling of communication skills.
  • To assess the effectiveness of different faculty modeling approaches in medical student training.
  • To identify optimal strategies for teaching communication skills in clinical settings.

Main Methods:

  • A multi-center randomized trial involving fourth-year medical students across six U.S. academic medical centers.
  • Students participated in simulated clinical encounters with faculty providing either implicit or explicit communication skills modeling.
  • Outcomes were evaluated using pre- and post-simulation electronic surveys, with students blinded to the study's objective.

Main Results:

  • Explicit modeling significantly increased students' correct recall of specific communication elements, such as body position and summarizing patient understanding (p < 0.001 for both).
  • A higher percentage of students in the explicit group felt faculty demonstrated desired future behaviors (93.2% vs. 62.8%, p = 0.002).
  • Faculty participants indicated a willingness to adapt their teaching methods based on study experiences.

Conclusions:

  • Explicit faculty role-modeling enhances medical students' communication knowledge and skill recognition more effectively than implicit modeling.
  • Students perceive explicit modeling as a clearer demonstration of expected behaviors.
  • Findings highlight the value of explicit instruction in faculty role-modeling for medical education, though limitations include a simulated environment and short assessment timeframe.