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Study for Teaching Behavioral Sciences in Schools of Medicine, Volume III: Behavioral Science Perspectives in Medical Education

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Study for Teaching Behavioral Sciences in Schools of Medicine, Volume III: Behavioral Science Perspectives in Medical Education DOCUMENT RESUME ED 083 922 HE 004 790 TITLE Study for Teaching Behavioral Sciences in Schools of Medicine, Volume III: Behavioral Science Perspectives in Medical Education. INSTITUTION American Sociological Association, Washington, D.C. Medical Sociology Council. SPONS AGENCY National Center for Health Services Research and Development (DHEW/PHS), Rockville, Md. REPORT NO HSM-110-69-211 PUB DATE Jul 72 NOTE 467p. EDRS PRICE MF-$0.65 HC-$16.45 DESCRIPTORS Anthropology; *Behavioral Sciences; Biology; Economics; Health Needs; *Higher Education; *Medical Education; *Medical Schools; Political Science; Psychology; Sociology; *Teaching Methods ABSTRACT Volume III of a study of teaching behavioral sciences in medical school presents perspectives on medical behavioral science from the viewpoints of the several behavioral disciplines (anthropology, psychology, sociology, political science, economics, behavioral biology and medicAl education). In addition, there isa discussion of translating behavioral science knowledge in health skills and organizing behavioral sciences within the medical school faculties. Related documents are HE 004 788 and HE 004 789. (Author) VOLUME III BEHAVIORAL SCIENCE PERSPECTIVES IN MEDICAL EDUCATION I I US DEPARTMENT EDUCATION OF HEALTM. NATIONAL& WELFARE INSTITUTE OF EDUCATION THISDOCUMENT HAS BEEN DUCEO FYAC REPRO THE PERSON AS ',ECEIVE0 R I PO A TING O ORGArZATIONOPIGRI IT POINTS OP VIEW IN STATE° 04 OPINIONS SENT OrrICIAL00 Nor NECESSARIL EDUCATION NATIONAL rNSTITPEPRE POSITION OR TE Or POI_ ICU A Study for Teaching Behavioral Sciences N In Schools of Medicine National Center for Health Services Research and Development Contract No. HSM 110-69-211 FILMED FROM BEST AVAILABLE COPY. VOLUME III BEHAVIORAL SCIENCE PERSPECTIVES IN l',11..*.DICAE EDUCTION A Study for Teaching Behavioral Sciences in Schools of Medicine National Center for Health Services Research and Development Contract No. IISM 110-69-211 4VOLUME III TABLE OF CONTENTS tion Page Introduction A. The Context I. Curriculum Trends in Medical Education and Their Implications for Behavioral Science, by Evan G. Pattishall, Jr., Ph.D., M.D. 2 2. Psychiatry, The Behavioral Sciences and Medicine. by Edward J. Stainbrook, Ph.D., M.D. 41 B. Behavioral and Social Science Perspectives 3. Anthropology in Medical Education, by Charles C. Hughes, Ph.D. and Donald A. Kennedy, Ph.D. 59 4. A View from Psychology, by Murray Wexler, Ph.D. 108 5. Sociology and Medical Education, by Robin F. Badgley, Ph.D. and Samuel W. Bloom, Ph.D. 180 b. A Biobehavioral Curriculum for Medical Students, by Sol Kramer, Ph.D. 215 7. The Teaching of Economics in Schools of Medicine, by Ralph E. Berry, Jr., Ph.D. 310 8. The Teaching of Political Science in Schools of Medicille,b5"0/iniamJ.Gore, Ph.D.and Dorothy E. Gore 370 C. Implications for Action 9. Transformation of Behavioral Science Knowledge Into Health Practice, by Matisyohu Weisenberg,Ph.D. 409 10. Organizational Forms for Medical Behavioral Science Programs, by Evan G. Pattishall, Jr., Ph.D., M.D. 443 iii INTRODUCTION What are the "behavioral sciences" and what is their relationship to the training of medical practitioners? These are the central questions examined in this part of the report. We will not take time to offer history of the term or the events that led to use of the phrase "behavioral sciences"An preference to the older designation, "social sciences"; that has been detailed in Volume I. It should he clear from the outset, however, that the term should not be thought equivalent to the "behaviorism" of psychology, nor to the current "behavioral therapy" techniques. The term in its general usage refers to those academic disciplines that study the development and behavior of man as an individual organism and as a member of human society. In this connection it is therefore-preferable to the phrase "social sciences" as the more inclusive term, since it points more accurately and comprehensively to the basic empirical process being studied -- behavior, especially human behavior, its determinants, patterns, and functional implications p:of other observable features of interest- such as human biology and cellular disease. The common element among the various "behavioral sciences," is that at one point or another the scope of each scientific discipline touches behavior of the organism; empirically observable human behavior is the root datum for the various conceptualiza- tions. In this volume we do not include statements from all of the fields that have been included at one time or another among the "behavioral 74 sciences." Boundaries are a bit vague, and sometimes the work of scholars from non-behavioral science fields (such as history) is included under the rubric because of the nature of the problemsstudied and the approach taken to them. We do, however, cover the principal fields designated behavioral sciences. A first group of papers includes those that are at the core of the term: anthropology (by llughes and Kennedy), psychology (Wexler), and sociology (Bloom and Badgley). A second group of papers includes those from economics (Berry) and Political Science (Gore). Also included is a statement from behavioral biology (Kramer), a field which, in this context, provides a clear linkage between traditional medical concerns and the behavioral sciences. The overall format for this section of the report is as follows: In tied tun A are two papers dealing with the intellectual and institutional contextin which medical education occurs. Pattishall discusses the perceived current ferment and needs in medical educations, the shape of a changins; present that betokens an unclear future. Stainbrook then take:; np fiiscussionof the relationship of behavioral sciences LI) p::ychiatry-the medical specialty with strong historic involvement with the social sciences, and which has provided strong sponsorship for the introduction of behavioral science content in the medical curriculum. Section B presents papers from the individual behavioral sciences. Authors discuss the nature of their particular disciplines and the relevance to those disciplines for the training of medical doctors. obviously it is not easy in a few pages to characterize an entire discipline, much less its implications for the field of medical education. Beyond these common guideline:, it is clear that the vi authors in each case wished to stress particular aspects of the relationship between their discipline and the process of training .rodent physicians. gnilding upon the preceding section, in Section C, Weisenberg takes on the problem of how to translate or transform the data and skills ofthe behavioral sciences into instructional settings and modes that will be easily perceived as relevant by medical students at various stages in their educational careers. Finally, in the concluding chapter, Pattishall turns attention to one of the critical issues from an administrative as well as a teach- ing point of view: what is the best way to relate the behavioral scientists to the medical school setting? Is it through their being dispersed and administratively attached to several basic biological science or clinical departments, to serve in these contexts as con- tinual advocates for the injection of appropriate empirical findings? Or isit better to take on the "protective coloration" under which other scientists work in the medical school setting and be organized into formal departments? Or some organizational format in between complete diffusion and departmental organization? Here is a personal statement by the chairman organizing one of the few such departments in the country. vii Section A THE CONTEXT Curriculum Trends in Medical Education and Their Implications for Behavioral Science Evan G. Pattishall, Jr., Ph.D., M.D. Psychiatry; The Behavioral Sciences and Medicine Edward J. Stainbrook, Ph.D. , M.D. CURRICULUM TRENDS IN MEDICAL EDUCATION AND THEIR IMPLICATIONS FOR BEHAVIORALSCIENCE Evan G. Pattishall, Jr., Ph.D.,M.D. Professor and Chairman Department of Behavioral Science College of Medicine Pennsylvania State University CURRICULUM TRENDS IN MEDICAL EDUCATION AND THEIR IMPLICATIONS FOR BEHAVIORAL SCIENCE Evan G. Pattishall. Jr., Ph.D., M.D. Professor and Chnirman Department of Behnvioral Science College of Medicine The Pennsylvania State University, Hershey, Pa. It was sixty years ago when Abraham Flexner1studied the training of physicians in the United States. He made a series of recommendations which profoundly affected the evolution of medical education. These recommendations included the university affiliation, the academic model, the disciplinary laboratory, and the strong emphasis on the scientific base of medicine. The Flexner study and recommendations have been so frequently quoted and acclaimed that its significance has begun to reach the 2 stature of historical myth. As David Banta recounts, the first university-type medical school had already been established by 1893 and a number of significant changes were already in progress several years before the Flexner study. For example, during the years 1908-10, prior to the Flexner Report, 28 medical schools closed their doors because of the already existing trends affecting medical education. The Flexner Report, however, did serve as a powerful force to insure that the medical schools would eventually become university affiliated, laboratory oriented and scientifically based institutions. The science orientation continued to win favor during the 1920's and 301s, but the impact has been steadily growing during
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