themes into the clerkships and advanced-study years. Sociocultural themes include (1) patterns of health and disease across populations; (2) ethnicity, gender, age, socioeconomic status, and health; (3) the cultures of medicine and health care institutions; (4) physician–patient relationships; and (5) the experience of illness and/or health. The three behavioral themes are (1) stress, distress, and coping; (2) understanding and facilitating behavior change; and (3) personality and social context. Each theme starts with basic attitudes and knowledge as informed by block objectives and active clinical cases, but quickly moves to complex, clinical applications. Demonstration of clinical significance and relevance to medical practice are provided by sharing epidemiologic data, case studies, and master clinician testimonials.

Primary teaching methods used for behavioral and social science content include didactic lectures, typically tied to active learning cases; “teachable moments” integrated into basic or clinical science lectures; multidisciplinary discussion panels; master clinician wrap-ups; guided small-group exercises; and special student projects. Full block calendars, session outlines, learning objectives, and samples of teaching materials can be found at http://medschool.ucsf.edu/ilios/.

The quality of the behavioral and social sciences curriculum was evaluated by examining student performance and conducting student “town hall” meetings, focus groups, and electronic student evaluations. A behavioral and social sciences student advisory board gathered feedback 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 questions; short-answer questions; essay exams; and special applied projects, such as dietary self-monitoring, preparation of a biopsychosocial discharge plan; role-plays for smoking cessation; and dietary counseling for a diabetic patient. In the near future, a competency-based, comprehensive assessment for behavioral and social science and other objectives will be implemented at the end of year 2 using adapted Observed Structured Clinical Exams (OSCEs) and standardized patients. Assessment data will be used to revise and improve the existing behavioral and social science curriculum and to extend all behavioral and social science themes into the Clinical Core and beyond.



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