The New Reality

Collaboration as Co-Thinking and Co-Working

AI is no longer just a tool you use. It's becoming a strategic thought partner that can engage with you through every phase of your work.

Old Paradigm

AI as a tool: You give it a task, it produces output. One direction. Limited context. Transactional relationship.

New Paradigm

AI as collaborator: Planning together, researching together, discussing ideas, creating products, getting feedback. A continuous dialogue.

The Strategic Thought Partner Concept

Jeremy Utley describes AI as a "Strategic Thought Partner" - not replacing your expertise, but amplifying it. This means using AI in every phase of a project: planning, research, discussion, product creation, and feedback loops. The key insight is that the relationship should be iterative, not one-shot.

Traditional AI usage follows a pattern: you have a task, you prompt AI, you get output, you're done. The strategic thought partner model flips this entirely.

Instead of treating AI as a vending machine for content, you treat it as a colleague who can help you think through problems, challenge your assumptions, surface non-obvious connections, and iterate on ideas with you.

This shift matters for program directors because the decisions you make - about curriculum, resident development, program policies - benefit enormously from having a thinking partner who can process vast context and offer diverse perspectives.

Beyond Emails and Meeting Notes

The 6 Levels of Co-Thinking

Co-thinking with AI exists on a spectrum. Start where you're comfortable and gradually expand your collaboration.

Take the Lead

AI as your research assistant and validator

You drive the conversation. Use AI to plan notes, validate ideas, find non-obvious solutions, and make connections you might miss. This is the entry point for most people.

Voice Dictation: Talk to AI naturally. Modern interfaces let you speak your thoughts and get responses verbally. Great for brainstorming while walking or between meetings.

Thinking Mode: Enable extended thinking or reasoning modes for complex decisions. The AI will show its reasoning process, helping you understand how it reached conclusions.

Deep Research: Ask AI to conduct comprehensive research on a topic, synthesizing multiple sources and perspectives before you make decisions.

Planning Mode: Use AI to help structure projects, create timelines, and anticipate obstacles before they occur.

Custom Skills: Create or use specialized prompts (skills) for recurring tasks like drafting feedback, creating schedules, or analyzing evaluations.

AI as Sparring Partner

Challenge your ideas and assumptions

Ask AI to push back on your ideas. Play devil's advocate. Surface potential problems with your plans. This creates a dialogue where both you and AI contribute to refining concepts.

Before implementing a new policy or program change, share your draft with AI and explicitly ask: "What are the strongest arguments against this approach? What am I missing?"

You can also ask AI to adopt specific perspectives: "Respond as a skeptical resident would" or "What would faculty who resist change say about this?"

This isn't about AI being right - it's about ensuring you've considered multiple angles before committing to a direction.

Let AI Take the Lead

AI as coach - structured questioning

Flip the dynamic. Let AI ask you questions to help clarify your thinking. Time clarity prompts help you articulate what you really want when you're not sure yourself.

From Dylan Davis: Time clarity prompts are structured questions that help you articulate fuzzy goals. Instead of you trying to explain what you want, AI guides you through questions.

Example prompt: "I'm going to share a challenge I'm facing. Ask me up to 6 clarifying questions before suggesting any solutions. Help me think through what I really need."

This works particularly well when you know something needs to change but haven't crystallized what success looks like.

Add Others

Team collaboration through shared AI workflows

Extend co-thinking beyond yourself. Share prompts with your team. Create scripts that multiple people can use. Build institutional knowledge into reusable AI workflows.

Create shared prompt libraries for common tasks: resident feedback templates, evaluation summaries, scheduling optimization.

Build "scripts" - sequences of prompts that walk through complex processes. New coordinators can use these to maintain quality while learning.

Use AI to facilitate team discussions: share meeting notes and ask AI to identify themes, disagreements, or action items that the group might have missed.

Change the Output

Transform ideas into different formats

Same thinking, different deliverables. Turn your ideas into infographics, podcast scripts, presentation slides, handouts, or interactive content. The medium shapes the message.

Policy document → Infographic: Dense text becomes visual, scannable content
Meeting notes → Podcast script: Create audio summaries residents can listen to during commutes
Curriculum outline → Interactive slides: Transform static plans into engaging presentations
Feedback → Coaching guide: Turn evaluation data into actionable development plans

The key insight: your ideas don't have to stay in the format you first conceived them. AI makes format transformation nearly effortless.

Create a Second Brain

Repository and connector for institutional knowledge

Build a persistent knowledge base. AI can serve as a repository for your program's accumulated wisdom - policies, decisions, context - and help connect ideas across time and documents.

Upload key documents to AI conversations: program policies, past evaluations, accreditation standards, strategic plans.

Ask AI to find connections: "Given our program's history with [X], what should we consider when implementing [Y]?"

Create ongoing project contexts where AI remembers previous discussions and can reference past decisions.

This is especially powerful for programs with high coordinator turnover - institutional knowledge persists in the AI-accessible repository.

The Next Evolution

From Co-Thinking to Co-Working

Co-working moves beyond conversation. AI doesn't just think with you - it works alongside you, executing tasks autonomously.

Live Demo: Claude Cowork

During the live presentation, this section includes an interactive demonstration of AI co-working capabilities.

Fill-in-the-Blank Prompts

Create one slide, generate 5 ideas on any topic, plan an application - using simple, templated prompts that anyone can use.

Vibe Coding

Describe what you want, not how to build it. AI handles the technical implementation while you focus on the outcome.

Output-Focused Work

Tell AI the result you need. Let it determine the process. This applies to all tasks, not just coding.

The Future: An Inbox, Not a Chat Box

The future of AI work isn't a conversation you watch unfold. It's an inbox you check. Multiple agents working on parallel tasks. You review outputs, not processes.

Imagine: A few cases opened, each being worked on in parallel. You're not waiting and watching Netflix. You're managing a portfolio of AI-assisted work, checking in when outputs are ready.

Today

Interactive chat sessions

→

Emerging

Autonomous task execution

→

Future

Multi-agent orchestration

The Hard Question

What About Training?

If AI handles low-level work, how do residents develop foundational skills?

The Core Tension

Residency has historically relied on repetition of fundamental tasks to build expertise. If AI can automate report generation, routine communications, and data synthesis - activities that currently train residents - we face a genuine pedagogical challenge.

Questions to Consider

What foundational skills are truly irreplaceable? Which "low-level" tasks actually build essential pattern recognition? How do we distinguish busywork from developmental work?

Potential Approaches

Deliberate practice periods without AI assistance. AI as teaching tool that explains its reasoning. Graduated autonomy where AI involvement increases with demonstrated competency.

The Opportunity

If AI handles routine work, residents can focus on higher-order skills earlier: complex decision-making, patient communication, ethical reasoning, leadership development.

This isn't a new problem - it's an accelerated version of questions we've always faced. When dictation software emerged, we worried residents wouldn't learn to write reports. When PACS replaced film, we worried about spatial reasoning.

The key is intentionality. We need to deliberately design training experiences that develop skills AI can't replace, while leveraging AI to compress time-to-competency in areas where it can assist.

Program directors who engage with this question now will be better positioned to design curricula that prepare residents for an AI-augmented practice environment.

Your Next Steps

Try Co-Thinking. Anticipate Co-Working.

Start Small with Co-Thinking

Pick one recurring task this week. Use AI as a thought partner, not just a task executor. Notice the difference.

Experiment with Levels

Try at least one technique from Levels 2-4. Let AI push back. Let AI ask questions. Share a workflow with a colleague.

Watch for Co-Working Tools

Pay attention to emerging autonomous AI capabilities. The transition from chat to inbox is happening now.

"A portion of your attention, for the rest of your life, needs to be devoted to becoming a better collaborator with AI."

— Jeremy Utley

The Long Game

This isn't about mastering today's tools. It's about developing a practice of continuous adaptation. The specific AI capabilities will change. The skill of effective human-AI collaboration will compound over your entire career.