taught through the dissection of a cadaver, may have given way to prosected demonstrations, “dissections” of a virtual human body in software programs, and a course on biological structure. Likewise, a course such as systemic function can include content ranging from cell biology to doctor–patient relationships (NCME, 2003).

Exploring the content of medical school curricula on the basis of course titles today is thus truly seeing through a glass darkly. 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. It then identifies the barriers that hinder efforts to inventory behavioral and social science content in current medical school curricula. The third section presents the results of the committee’s inventory efforts. The final section offers the committee’s argument for the need to develop an improved database on the status of behavioral and social science instruction in U.S. medical schools and a recommendation to that end.

THE BEHAVIORAL AND SOCIAL SCIENCES IN CURRENT MEDICAL SCHOOL CURRICULA

The multidisciplinary perspective that emerges from studying the behavioral and social sciences provides students with an understanding of the patient as part of a broader social and environmental context that influences—and is influenced by—biological processes to produce health and illness behaviors, resilience, and functional capacity. Because the expression of human behavior occurs at the interface between the internal (physiological) and external (sociocultural) environments, and because some change in behavior is usually involved in biological and social dysfunction, the teaching of behavioral and social science is an effective way to integrate the various disciplinary perspectives in medicine (IOM, 1983). Given the breadth and diversity of the content of the behavioral and social sciences, however, it has been difficult for medical schools and medical school educators to agree on what constitutes the crucial core of behavioral and social science knowledge to which medical students should be exposed during their undergraduate education. Additionally, as the content encompassed by the behavioral and social sciences has grown, so, too, has the range of subject matter that could be taught to medical students.

1  

An integrated curriculum for the purposes of this report means that behavioral and social science subject matter is taught as part of other courses in the basic and clinical sciences, not as a separate course.



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