Graduate and post-graduate medical education with the synchronous systems model

Behavioral sciences have an important new role, particularly in medicine and prevention (Revans, 1990; Starr, 1982). A decade ago when the ideology of medical care shifted from a biomedical to a biopsychosocial model, behavioral and social factors ascended in importance in modern health concerns (see Engel, 1977). Now, a living systems model called Synchronous Systems (Jasnoski & Schwartz, 1985) incorporates environmental (including the social and physical) along with physiological and psychological factors into its structure. The environment has been gaining recognition as an important determinant in health, disease, and wellness (Daniel, 1990; Demick & Wapner, 1990; Lawton, 1990; Stokols, 1990). The phrase "Synchronous Systems" departs from the traditional linear thought patterns to depict contemporaneous occurrences. Synchrony refers to simultaneous experiences or events, with an emphasis on healthy, congruent process and function. Positive, beneficial process in human functioning emphasizes prevention as found in public health efforts but refers also to dysfunctional and recuperative foundation of medicine as a departure from the healthy norm. These process and functional dynamics in the Synchronous Systems Model derive conceptually from systems theory, specifically from control and cybernetic theories (Cannon, 1932; Weiner, 1948). The dynamic complexity of health in the whole human system, which also incorporates the environment, requires synthesis of knowledge from the biological, social, behavioral, and ecological sciences. This article provides the fundamentals of the structural and functional synthesis possible in the Synchronous Systems Model. Its direct application to multidisciplinary research is also presented along with its specific application to medical education, policy, research, and service delivery.