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Behavioral Science

Integrated Sciences Model

Behavioral Science in Family Medicine Education

The Behavioral Science curriculum is based on the biopsychosocial, integrated sciences model (Carr, 1999). Residency education in the Behavioral Sciences approaches each patient as a complex but integrated system of many variables that can be organized under five domains: biological, behavioral, cognitive, sociocultural, and environmental. The curriculum is evidenced-based and designed so that every resident achieves competencies in the following areas including recommendations on Curriculum Guidelines for Family Medicine Residents by the American Academy of Family Physicians.

Incorporation of a knowledge of human behavior, mental health, and mental disorders into the every day practice of medicine.
Development of an understanding of the influential relationship between the patient and his or her family as fundamental to the practice of family medicine.
Improving the recognition and treatment of the emotional aspects of organic illness.
Training in the enhancement of the doctor-patient relationship as the foundation upon which medical care is delivered.
Development of therapeutic communication skills as essential elements in the delivery of effective and efficient health care.
Improving self-awareness and self-care as ethical responsibilities of a practicing physician.

Orientation

During orientation 1st year residents are videotaped and communication skills reviewed to prepare them for out-patient clinical care. 2nd year residents are also videotaped during their orientation and on-call communication skills are reviewed.

1^stYear Behavioral Science Rotation (two week block)

Didactics

Integrated Sciences Model
Mindfullness & Medicine
Communication Skills (Common Ground, Lang, 2005)
Delivering Difficult News
Primary Care Psychopharmacology
Psychopharmacology of Depression
Positive Psychology

Direct Observation of Clinical Activity

Videotaping
Shadowing

Noon Conference Lecture

Preparation and presentation of a one-hour lecture on a specialty topic to faculty, residents and medical students

Mini-Rotations

Center Point Human Services
Attendance at community self-help group
Exploration of community resources

2^nd Year Behavioral Science Rotation (two week block)

Didactics

Family Systems-Genogram
Depression
Anxiety
Suicide
Introduction to Cognitive Behavioral Therapy (CBT)
Challenging Conversations & Complicated Clinical Collaborations
Somatization
Integrated Psychopharmacology

Direct Observation of Clinical Activity

Videotaping
Shadowing

Mini-Rotations

Child & Adolescent Psychiatry Service
Kate B. Reynolds Hospice Home

Longitudinal Curriculum

Once a month at noon conferences and morning reports throughout the three years of the residency one of the core topics in Behavioral Science is presented including family systems, adherence to medical advice, sleep disorders, psychophysiological disorders, personality disorders, and persistent pain among many others.

Videotaping & Shadowing

Videotaping & Shadowing (direct observation of the clinical encounter) begins during the Human Behavior Rotation the 1^st year and continues throughout residency training.

Support Groups

1^st Year

HO-Is attend a support group one to two times a week throughout the year to provide the skills and group support that are necessary to learn and to grow during the challenging internship year.

2^nd Year

The HO-IIs meet two times monthly in the “Interpersonal Dilemmas in the Practice of Medicine” group. Primarily this is a Balint group which focuses on the complexities of the Doctor-Patient relationship but also explores all relationships as they contribute to or complicate the practice of medicine.

3^rd Year

The HO-IIIs support group meets once a month and continues the format from the 2nd year but also includes a focus on the complex transition from residency to their early career.