Letter to the Editor
Mar 2022

Response to “Education Solutions to the Medical-Dental Divide.” A Novel Approach to Creating Unifying Organizational Cultures in Medicine and Dentistry

Carolyn A. Chan, MD and Nora Makansi, DDS, PhD
AMA J Ethics. 2022;24(3):E247-248. doi: 10.1001/amajethics.2022.247.


We appreciate the perspective presented in Rasmussen and colleagues’ “Education Solutions to the Medical-Dental Divide” and the call for “purposeful educational unity” between medicine and dentistry. In addition to educational reform, unifying the fields1 requires changes to organizational culture (OC), which includes shared assumptions, beliefs, and values. Overcoming organizational separation also requires investment in interprofessional education (IPE), such that IPE does not become “something I did once in graduate school.”

Implementing IPE requires diverse groups of professionals to collaborate, support, contradict, and adjust in the face of omnipresent complexity and uncertainty. Successful collaboration requires competence-trust and openness-trust within organizations.2 A novel solution we propose is the use of improvisational (improv) theater techniques, which have been conventionally used to create unscripted performances. Medical improv is the application of improv techniques to improve communication and collaboration in the health professions.3 Medical improv has been used to teach interprofessional students empathy and develop personal and social competencies in a dynamic and practical way, and students have reported its positive impact on their capacity to cultivate quality interprofessional relationships.4 Within the business literature, teaching agreement and collaboration through improv games has been used to foster an OC of effective communication and team building.5

Medical improv is a promising solution to the medical-dental educational divide, and training curricula could be developed for students, faculty, and staff as a way to start changing OC by focusing on fostering collaborations within a safe learning and working environment. If we fail to address OC, it might take another 182 years to achieve educational unity between medicine and dentistry.


  1. Watling CJ, Ajjawi R, Bearman M. Approaching culture in medical education: three perspectives. Med Educ. 2020;54(4):289-295.
  2. Ibrahim M, Ribbers PM. The impacts of competence-trust and openness-trust on interorganizational systems. Eur J Inf Syst. 2009;18(3):223-234.
  3. Watson K, Fu B. Medical improv: a novel approach to teaching communication and professionalism skills. Ann Intern Med. 2016;165(8):591-592.
  4. Zelenski AB, Saldivar N, Park LS, Schoenleber V, Osman F, Kraemer S. Interprofessional improv: using theater techniques to teach health professions students empathy in teams. Acad Med. 2020;95(8):1210-1214.
  5. Vera D, Crossan M. Theatrical improvisation: lessons for organizations. Organ Stud. 2004;25(5):727-749.


AMA J Ethics. 2022;24(3):E247-248.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.