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2 Current Approaches to Incorporating the Behaviorial and Social Sciences into Medical School Curricula
Pages 20-51

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From page 20... ... that, to be accredited, schools must include behavioral and socioeconomic subjects in their curricula. Because LCME does not specify how schools should incorporate any subjects, each school covers behavioral and social science content in a distinct manner appropriate to that institution. Read the entire page →
From page 21... ... medical students would also find this database useful. Based on the finding that existing national databases provide inadequate information on behavioral and social science content, teaching techniques, and as sessment methodologies, the committee recommends the development of a comprehensive database that is updated on a regular basis. Read the entire page →
From page 22... ... This common disconnect between content and title can make the identification and assessment of the behavioral and social science content of medical coursework especially challenging, particularly when course titles are the only available source of data. This chapter first outlines issues related to behavioral and social science content in medical school curricula, how these disciplines are integrated into the curriculum,1 and the teaching methods that are generally used. Read the entire page →
From page 23... ... . Some behavioral and social science content has already been considered part of classical medical education, serving to enlarge the content of courses in such areas as medical interviewing and the introduction to clinical medicine. Read the entire page →
From page 24... ... In reviewing curricular content across medical schools, it becomes evident that there are great differences in the amount of time spent covering the behavioral and social sciences, that a variety of courses are available, that behavioral and social science content is offered at various times during a student's medical education, and that a wide range of topics is included under the rubric of behavioral and social science (AAMC, 2003a; Milan et al., 1998; Muller, 1984; Waldstein et al., 2001) Read the entire page →
From page 25... ... 10 * Of the 110 North American medical schools that reported teaching basic communication skills at some point within their curricula, 89 completed the second-stage survey section on teaching methods. Read the entire page →
From page 26... ... The lack of a standard program design, however, hampers the systematic analysis of curricular content across medical schools, and makes it impossible to ensure that the most essential and empirically supported behavioral and social science content is included in medical school curricula. Use of the national database for medical school curricula of the Association of American Medical Colleges (AAMC) Read the entire page →
From page 27... ... . INVENTORY OF CURRENT BEHAVIORAL AND SOCIAL SCIENCE CONTENT IN MEDICAL SCHOOL CURRICULA Within the limitations of the available data, as described above, the committee pursued its charge of taking an inventory of current behavioral and social science content in medical school curricula by compiling the available data and using indicators to signify the presence, intensity, location, and adequacy of such content. Read the entire page →
From page 28... ... . The committee identified the topics that have a prima facie relationship to behavioral and social science content; these appear in bold in the tables. Read the entire page →
From page 29... ... aLCME Hot Topics are shown in bold. Subheadings under those topics represent the closest match to the Hot Topic and Medical School Graduation Questionnaire variables (see Table that can be found in the AAMC CurrMit database) Read the entire page →
From page 30... ... SOURCE: 2002�2003 AAMC Graduation Questionnaire (AAMC, 2003c) Read the entire page →
From page 31... ... After reviewing the data in these tables, the committee made the following observations. First, the data in Table 2-2a reveal substantial variations in the behavioral and social science topics taught in medical school curricula. Read the entire page →
From page 32... ... (For a more-detailed discussion of the methods used to obtain data on behavioral and social science content in medical school curricula, see Appendix A.) The four schools were the University of California, San Francisco, School of Medicine; University of Rochester School of Medicine; Ohio State University College of Medicine and Public Health; and University of North Carolina School of Medicine. Read the entire page →
From page 33... ... It is sometimes conveyed in lecture form, but often is discussed in facilitated small groups that evaluate cases prepared for problem-based learning exercises. For advocates of the inclusion of social and behavioral science content in medical school curricula, an encouraging fact is that it does not appear difficult to find course vehicles for lectures or problem-based learning exercises on such topics. Read the entire page →
From page 34... ... Taught Method* Communication � Doctor�Patient � Course Director: 1, 2 SG skills Relationship Family Medicine � Advanced Clinical � Taught by Interviewing multiple clinical departments Community � Patient-Centered � Family Medicine 1, 2, 3, 4 L, O -- community health Medicine � Geriatrics project and senior � Working with � Allied Medicine partners senior partners � Integrated pathway Cultural diversity � Patient-Centered � Family Medicine 1 SG, L Medicine Read the entire page →
From page 35... ... End-of-life care � Patient-Centered � Anesthesiology 1, 2, 3, 4 SG, L, O -- senior Medicine � Family Medicine partners � Working with � Geriatrics senior partners Epidemiology � Integrated pathway � Allied Medicine 1 SG, L Family/domestic � Patient-Centered � Pediatrics 1, 3 SG, L violence Medicine � Family Medicine � Clerkships � Obstetrics/ Gynecology Health care quality � Integrated pathway � General Internal 2 L improvement Medicine Health care systems � Integrated pathway � Allied Medicine 2 L Health literacy � Patient-Centered � Family Medicine 1 L Medicine Human � Patient-Centered � Pediatrics SG, L development/ Medicine � Family Medicine life cycle � Pediatric clerkship Medical social � Integrated � General Internal 2 L economics pathway Medicine Pain management � Patient-Centered � Anesthesiology 1, 2 SG, L Medicine � Neurology � Integrated pathway � Family Medicine Palliative care � Patient-Centered � Anesthesiology 1, 2, 3, 4 SG, L, O -- senior Medicine � Family Medicine partners � Working with � Geriatrics senior partners Patient health � Multiple � Anesthesiology 3, 4 O -- clerkships education clerkships � Family Medicine � Geriatrics Population-based � Integrated � Allied Medicine 1 L medicine pathway Prevention and � Integrated � Multiple 1, 3, 4, L, O -- clerkships health maintenance pathway Clerkships Substance abuse � Patient-Centered � Family Medicine 1, 2, 3, 4 SG, L, O -- elective Medicine � Neurology � Integrative � Internal Medicine pathway � Ambulatory clerkship � 4th year elective * L = lecture, PBL = problem-based learning, SG = small group, U = unknown, O = other (describe) Read the entire page →
From page 36... ... "The interaction of biology and the environment in determining health" was established as the foundational theme for the new curriculum, open ing the way for the meaningful inclusion of behavioral and social science content. A special behavioral and social sciences working group identi fied five broad sociocultural themes and three behavioral themes to span all nine Essential Core blocks, with the intent to eventually extend these Read the entire page →
From page 37... ... A behavioral and social sciences student advisory board gathered feed back on behavioral and social science classes and provided suggestions for future improvements. Student performance on behavioral and social science content was evaluated through standard multiple-choice ques tions; short-answer questions; essay exams; and special applied projects, such as dietary self-monitoring, preparation of a biopsychosocial dis charge plan; role-plays for smoking cessation; and dietary counseling for a diabetic patient. Read the entire page →
From page 38... ... Communication � Foundations of � Family and 1, 2, 3, 4 SG, L skills Patient Care Community � Multiple Medicine clerkships � Psychiatry � Medicine � Anthropology, History, and Social Medicine Community � Foundations of � Family and 1, 2, 3 SG, L health Patient Care Community � Family and Medicine community � Psychiatry medicine � Anthropology, clerkship History, and Social Medicine Cultural � Foundations of � Family and 1, 2 PBL, SG, L diversity Patient Care Community � Block courses: Medicine Prologue, Organs, � Psychiatry Cancer, Metabolism and � Medicine Nutrition, Life � Anthropology, Cycle History, and Social Medicine End-of-life care � Foundations of � Family and 1, 2, 3, 4 PBL, SG, L Patient Care Community � Block courses: Medicine Cancer, Life Cycle � Psychiatry � Multiple clerkships � Medicine � Anthropology, History, and Social Medicine Epidemiology � Block courses: � Epidemiology 1, 2 SG, L Organs, Cancer, Life Cycle, Integration and Consolidation Family/domestic � Foundations of � Family and 1, 2 SG, L violence Patient Care Community � Block courses: Medicine Brain, Mind, and � Psychiatry Behavior; Life � Medicine Cycle � Anthropology, History, and Social Medicine Read the entire page →
From page 39... ... Health care � Foundations of � Family and 1, 2 SG, L quality Patient Care Community improvement � Block courses: Medicine Brain, Mind, and � Psychiatry Behavior; Life � Pediatrics Cycle � Anthropology, History, and Social Medicine Health care � Foundations of � Family and 1, 2, 3 PBL, SG, L systems Patient Care Community � Block courses: Medicine Infection, Immunity � Medicine, and Inflammation; � Anthropology, Metabolism and History, and Nutrition Social Medicine � Clinical core intersessions Health literacy � Block course: � Anthropology, 1 SG, L Prologue History, and Social Medicine Human � Foundations of � Family and 1, 2, 3, 4 PBL, SG, L development/ Patient Care Community life cycle � Block courses: Medicine Organs; Life Cycle � Psychiatry � Multiple clerkships � Pediatrics � Medicine � Anthropology, History, and Social Medicine Medical social � Foundations of � Family and 1, 2 SG, L economics Patient Care Community � Block course: Medicine Prologue � Anthropology, History, and Social Medicine Pain management � Block courses: � Family and 1, 2, 3, 4 SG, L Organs; Life Cycle Community � Multiple clerkships Medicine � Pediatrics � Medicine Continued Read the entire page →
From page 40... ... Palliative care � Block courses: � Family and 1, 2, 3, 4 SG, L Cancer, Life Cycle Community � Multiple clerkships Medicine � Psychiatry � Pediatrics � Medicine Patient health � Foundations of � Family and 1, 2, 3, 4 SG, L education Patient care Community � Multiple clerkships Medicine � Psychiatry � Pediatrics � Medicine � Anthropology, History, and Social Medicine Population-based � Block courses: � Family and medicine Prologue; Organs; Community Cancer; Brain, Mind Medicine and Behavior; � Epidemiology Infection, Immunity, � Medicine and Inflammation � Anthropology, History, and Social Medicine Prevention � Foundations of � Family and 1, 2, 3, 4 SG, L and health Patient Care Community maintenance � Block courses: Medicine Prologue; Organs; � Psychiatry Cancer; Infection, � Pediatrics Immunity, and � Medicine Inflammation; � Anthropology, Metabolism and History, and Nutrition; Life Social Medicine Cycle; Integration and Consolidation � Multiple clerkships Substance abuse � Block courses: � Family and 1, 2 SG, L Brain, Mind, and Community Behavior; Infection, Medicine Immunity, and � Psychiatry Inflammation; � Pediatrics Life Cycle � Medicine � Anthropology, History, and Social Medicine * L = lecture, PBL = problem-based learning, SG = small group, U = unknown, O = other (describe) Read the entire page →
From page 41... ... In addition to building on their interviewing and physical examina tion skills, students learn and practice behavioral medicine skills, such as smoking cessation counseling, alcohol and drug screening and counsel ing, diet and exercise counseling, and adolescent health maintenance topics, in primary care offices. Behavioral and social science topics in year 2 are emphasized in the context of the integrated neuroscience course, entitled Mind, Brain and Behavior, and in the integrated pathophysiology course, entitled Disease Processes and Therapeutics. Read the entire page →
From page 42... ... This clerkship provides students with an opportunity not only to engage in structured service learning, but also to learn more about related health economics, health disparities, and diversity, essential top ics in today's health care environment. Rochester's long-standing tradition in biopsychosocial medicine and patient-centered care has a renewed emphasis in the DHC. Read the entire page →
From page 43... ... Cultural diversity � Diversity theme � Multiple 1, 2, 3, 4 PBL, SG, L � Addressed in departments problem-based learning cases within courses in years 1 and 2 End-of-life care � Ambulatory � Internal Medicine 2, 3 SG, L clerkship � Family Medicine � Ethics and law theme � Pediatrics � Aging theme � Medical Humanities Epidemiology � Mastering Medical � Community and 1 PBL, L Information Preventive Medicine Family/domestic � Ambulatory � Internal Medicine 2, 4 L, O violence clerkship � Family Medicine � Emergency medicine � Emergency clerkship Medicine � Pediatrics Health � Health economics � Neurology 2 PBL, L care quality theme � Community and improvement � Year 2 case Preventive seminars � Internal Medicine � Successful Interning Health care � Health economics � Neurology 2 PBL, L systems theme � Community and � Year 2 case Preventive seminars Medicine � Internal Medicine Health literacy -- -- -- - Human � Introduction to � Internal Medicine 1, 2, 3 PBL, L development/ Clinical Medicine � Family Medicine life cycle � Mind, Brain and � Pediatrics Behavior � Psychiatry � Ambulatory clerkship Medical social -- -- -- -economics Continued Read the entire page →
From page 44... ... Pain management � Ambulatory � Internal Medicine 2, 3 PBL, SG, L clerkship � Family Medicine � Inpatient clerkships � Pediatrics � Pharmacology/ Physiology Palliative care � Ambulatory � Internal Medicine 2, 3 SG, L clerkship � Family Medicine � Ethics and law theme � Pediatrics � Inpatient clerkships � Medical � Electives Humanities � Nursing Patient health -- -- -- -education Population-based � Mastering Medical � Community and 1, 4 PBL, L, O medicine Information Preventive � Community health Medicine improvement clerkship Prevention � Ambulatory � Internal Medicine 1 SG, L and health clerkship � Family Medicine maintenance � Mastering Medical � Pediatrics Information � Community and � Nutrition theme Preventive Medicine Substance abuse � Ambulatory � Internal Medicine 1, 2, 3 PBL, SG, L clerkship � Family Medicine � Mind, Brain and � Pediatrics Behavior � Neurology � Psychiatry � Psychiatry clerkship * L = lecture, PBL = problem-based learning, SG = small group, U = unknown, O = other (describe) Read the entire page →
From page 45... ... . In the Medicine and Society course, offered through the Department of Social Medicine in year 1, there are no examinations, but students are required to participate in creative writing assignments and engage in group discussions that teach a habit of critical reflection using the tools of the social sciences and humanities. Read the entire page →
From page 46... ... Seminar � Obstetrics/ selective Gynecology � Medicine, Family Medicine, and Obstetrics/ Gynecology clerkships Epidemiology � Clinical � Social Medicine 2, 3 PBL, SG Epidemiology � Internal Medicine � Medicine clerkship Read the entire page →
From page 47... ... � Social Medicine 1 PBL, SG care quality � HSS selective improvement Health care � M&S (1st year) � Social Medicine 1 PBL, SG systems � HSS selective Health literacy � ICM-1 and ICM-2 � Dean's Office 1, 2, 3 SG � Clinical � Social Medicine Epidemiology � Internal Medicine � Medicine Clerkship Human � Family Medicine, � Family Medicine 3 development/ Pediatrics, and � Pediatrics life cycle Obstetrics/ � Obstetrics/ Gynecology, and Gynecology Internal Medicine � Internal Medicine clerkships Medical social � M&S (1st year) Read the entire page →
From page 48... ... Many also do community service projects. Prevention and � ICM-1 and ICM-2 � Dean's Office 1, 2, 3 PBL, SG, L health maintenance � Clinical � Social Medicine Epidemiology � Family Medicine � Family Medicine, � Pediatrics Pediatrics, � Internal Medicine Medicine, and � Obstetrics/ Obstetrics/ Gynecology Gynecology Substance abuse � Special Topics � Dean's Office 1, 3 PBL, SG, L day (1st year) Read the entire page →
From page 49... ... There are some examples of new courses that have become extraordinarily popular with students, partly because of the introduction of new behavioral and social science content and partly because of the use of innovative teaching methods. Overall, the results of these surveys and interviews reveal both similarities and some distinctive differences in the behavioral and social science content in the four institutions' curricula. Read the entire page →
From page 50... ... The lack of national standardization among medical school curricula, of standardization in the terminology used to describe curricular content, and of a comprehensive strategy for creating a national database of medical school curricula makes it difficult to describe systematically the subject matter medical schools have incorporated into their curricula. The committee believes the creation of an improved, periodically updated database for information on the state of behavioral and social science instruction in U.S. Read the entire page →
From page 51... ... Conclusion 1. Existing national databases provide inadequate information on behavioral and social science content, teaching techniques, and assess ment methodologies. Read the entire page →

From page 20...

... that, to be accredited, schools must include behavioral and socioeconomic subjects in their curricula. Because LCME does not specify how schools should incorporate any subjects, each school covers behavioral and social science content in a distinct manner appropriate to that institution.

2 Current Approaches to Incorporating the Behaviorial and Social Sciences into Medical School Curricula Pages 20-51

2 Current Approaches to Incorporating the Behaviorial and Social Sciences into Medical School Curricula
Pages 20-51