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Appendix A: Methods
Pages 119-134

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From page 119...
... describe or review medical school curriculum content identified as relevant to the behavioral and social sciences; (2) describe or review medical school curricula or curriculum change; or (3)
From page 120...
... The majority of the articles describing or reviewing curriculum change were not specific to the behavioral and social sciences, but were deemed to address overarching principles and strategies applicable to these disciplines. INVITED PRESENTATIONS The committee held multiple open sessions at which invited speakers representing interested organizations, associations, and medical schools provided information.
From page 121...
... Four schools were selected and surveyed based on initial information that indicated their behavioral and social science program could serve as an example of current approaches being used. The survey consisted of two parts: a brief questionnaire completed by an official of the medical school, followed by a telephone interview with that individual.
From page 122...
... The committee's collective and individual experience in curriculum development and reform in the behavioral and social sciences largely directed the prioritization of the topics on the original list. The rating scale used to prioritize the topics ranged from 0 to 3, with 0 being the lowest score, and included "U" (for unknown)
From page 123...
... The committee reviewed a third ranked list and performed a final rating, this time using a 0 to 5 scale similar to the one discussed previously. This list was refined and finalized using the collective and individual expertise of the committee members in medical school curriculum development and reform in the behavioral and social sciences.
From page 124...
... 124 IMPROVING MEDICAL EDUCATION BOX A-2 Suggested Curriculum Content Organized by Five Domains Biological Domain Psychological Domain Social Domain Behavioral Domain Economic Domain 1.0 Biological Domain 1.1 Genetic contributions to behavior 1.1.1 Concepts in behavioral genetics 1.1.2 Assessment of genetic contributions to personality and behavior 1.1.3 Principles and strategies of genetic counseling 1.2 Mind­body interactions in health and disease 1.2.1 Brain/behavior/central nervous system/autonomic nervous system 1.2.2 Psychoendocrinology 1.2.3 Psychoneuroimmunology 1.2.4 Pathobiology 1.2.5 Biological basis of illness behavior 1.3 Mind­body interactions in specific disease states 1.3.1 Cardiovascular diseases 1.3.2 Gastrointestinal diseases 1.3.3 HIV/AIDS 1.3.4 Neurological disorders, e.g. Parkinson's disease, frontal tumors, chronic pain 1.3.5 Mood disorders 1.3.6 Substance abuse 1.3.7 Sleep disorders 1.3.8 Eating disorders 1.3.9 Psychosis 2.0 Psychological Domain 2.1 Psychological models of human behavior 2.1.1 Cognitive psychology: thinking habits, core schemas (Beck)
From page 125...
... -IV) 2.1.8 Normal development: birth through old age 2.2 The psychology of patients 2.2.1 Expectations, biases, and assumptions about the nature of illness and the roles of doctor and patient: mind­body dualism 2.2.2 The psychology of health risk behaviors: food, tobacco, alcohol and substance abuse, risky sex, risky driving, risky sports behaviors 2.2.3 Normal illness psychology: fear and anxiety, vulnerability, appropriate dependency, humiliation, anger, sadness, and loss 2.2.4 Abnormal illness psychology: denial, pathological dependency, depression, somatization, hypochondriasis 2.2.5 The psychology of somatoform disorders (e.g., lower back pain, irritable bowel syndrome, chronic fatigue syndrome)
From page 126...
... 2.4.2 Patient-centered: activated patient, patient as expert 2.4.3 Relationship-centered 3.0 Social Domain 3.1 Basic concepts 3.1.1 Social stresses and supports as determinants of health 3.1.2 The sick role as a social construct 3.1.3 The professional role and ethics as social constructs 3.1.4 Health care policies 3.1.5 Clinical medicine and public health 3.1.6 High-risk versus population-based approaches 3.1.7 Community health 3.1.8 Levels of organization in health care 3.1.9 Occupational health 3.1.10 Evaluating individual context (e.g., available tangible support) ; capacity for self-care, making medical decisions, and independent living 3.2 Multicultural medicine 3.2.1 Cultural competence in diagnosis 3.2.2 Cultural competence in patient management 3.2.3 Cultural issues in patient­physician interactions 3.2.4 Folk medicine, alternative medicine, and biomedical treatment 3.3 Social inequalities in health 3.3.1 Social inequalities in health care 3.3.2 Poverty/homelessness 3.3.3 Rural/urban issues and culture
From page 127...
... 3.9.3 Social marketing 3.9.4 Social change theories 3.9.5 Economic incentive theories 3.9.6 Public policy and advocacy 3.10 Medical practice organization to ensure optimal care delivery 3.11 Effective use of community resources to enhance care 4.0 Behavioral Domain 4.1 Principles of behavior management: accurate assessment and goal setting, contingent reinforcement and stimulus conditioning 4.2 Maladaptive behavior patterns of patients 4.2.1 Health risk behaviors: abuse of alcohol, nicotine, illegal drugs, legal drugs, unhealthy foods: over- and undereating; risk taking in sexual activities, sports, and driving: deliberate self-harm and self-mutilation; fictitious illness (Munchausen syndrome and malingering) Continued
From page 128...
... health care system 5.1.1 Public insurance 5.1.2 Employer provision of health insurance 5.1.3 Insurance models 5.1.4 Hospital markets
From page 129...
... 5.7 Health policy 5.7.1 The problem of the uninsured and public insurance crowd-out effects 5.7.2 Mandated health insurance benefits and employment effects 5.7.3 Hospital competition and medical arms race 5.7.4 Racial and educational disparities in health care 5.7.5 Are medical care prices really rising? 5.7.6 Quality report cards and consumer choice 5.7.7 Prescription drug benefits and costs 5.7.8 Direct-to-consumer advertising of pharmaceuticals 5.7.9 Community rating and adverse selection 5.7.10 Price controls in insurance markets
From page 130...
... for teaching Teaching is taught that behavioral Circle method* by checking includes and social Year (circle all yes or no YES NO information science content Taught that apply)
From page 131...
... by checking includes and social Year (circle all yes or no YES NO information science content Taught that apply) Health Care 1 PBL Quality 2 SG Improvement 3 L 4 U O Health Care 1 PBL Systems 2 SG 3 L 4 U O Health Literacy 1 PBL 2 SG 3 L 4 U O Human Development/ Life Cycle 1 PBL 2 SG 3 L 4 U O Medical Social 1 PBL Economics 2 SG 3 L 4 U O Pain 1 PBL Management 2 SG 3 L 4 U O Palliative Care 1 PBL 2 SG 3 L 4 U O Continued
From page 132...
... by checking includes and social Year (circle all yes or no YES NO information science content Taught that apply) Patient Health 1 PBL Education 2 SG 3 L 4 U O Population based 1 PBL Medicine 2 SG 3 L 4 U O Prevention and 1 PBL Health Maintenance 2 SG 3 L 4 U O Substance Abuse 1 PBL 2 SG 3 L 4 U O *
From page 133...
... Formal didactic sessions teaching faculty behavioral and social science material f. Other _____________________________________________ g.


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