curricula, the committee found it necessary in developing such strategies to rely in part on more-generic studies related to medical school curriculum change, and in part on the collective experience of committee members and those interviewed during the course of this study.

It should also be noted that, while the committee makes suggestions and recommendations regarding both content and other ways to improve behavioral and social science instruction in medical school, the committee believes each school should design its own educational program, and has therefore not attempted to specify details of a behavioral and social science curriculum per se.

BARRIERS TO INCORPORATING THE BEHAVIORAL AND SOCIAL SCIENCES INTO MEDICAL SCHOOL CURRICULA

The development and administration of the medical school curriculum are the centralized responsibility of each school of medicine, but the curriculum is difficult to change, in part because so many individuals, departments, and committees are involved. Curriculum reform occurs when there is consensus or the need for change among faculty leaders (AAMC, 2000). At present, however, no consensus exists regarding the importance of the behavioral and social sciences in medical education, making curriculum committees uncertain about how to proceed.

A general lack of leadership in medical schools is often cited as the most fundamental barrier to curriculum change (Bland et al., 2000b).

Faculty and administrative leaders often oppose such change because they do not understand or agree with the vision and rationale for the change, are uncertain that the change will improve learning, are unwilling to undertake the extra work required during the planning process, or do not want to relinquish instructional time for something new. Resistance to change can also arise from faculty members’ failure to understand the importance of content outside their own domains of knowledge, a lack of innovative teaching skills, and inadequate funding (Robins et al., 2000).

The behavioral and social sciences remain undiscovered by many medical school faculty members because they are not familiar with the literature and do not perceive these disciplines as relevant to the practice of medicine. Traditionally, “real medicine” has been defined exclusively as biological medicine—the domain of science—whereas the behavioral and social sciences are often referred to as “soft” sciences and are even considered by some to provide only marginal knowledge (Taylor, 2003a,b). Additional problems arise from a lack of available faculty with expertise in these areas. Not only do faculty members frequently lack the requisite knowledge, but they may also lack the pedagogical skills needed to capture student interest in these subjects (Beckman and Frankel, 1984; Benbassat et al., 2003; Freidin et al., 1990; Sachdeva, 2000). Moreover, it can be difficult for faculty to move from a traditional lecture format to small-group and problem-



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