Comparison of theoretically oriented and patient-oriented behavioral science courses

Effective teaching of medical behavioral science is an important challenge for psychiatrists. Two behavioral science courses taught at different times at the Yale University School of Medicine are described: a theoretically oriented course emphasizing symbolic function, primary source reading, and conceptual thinking and a patient-oriented course emphasizing the relevance of behavioral science to the practice of medicine, taught primarily by consultation-liaison psychiatrists. Students' evaluations of the two courses during the fifth year each course was taught were compared. The students' acceptance of the patient-oriented course was dramatically greater than that of the theoretically oriented course. The class mean scores on the behavioral science subtest of the Part I examination of the National Board of Medical Examiners during the last four years that the courses were taught were compared. The mean scores of the classes that had taken the patient-oriented course were significantly higher than those of the classes that had taken the theoretically oriented course. The mean score for the class that took the fifth year of the patient-oriented course was 52 points higher than the mean score for the class that took the fifth year of the theoretically oriented course. The authors concluded that the skills that consultation-liaison psychiatrists use every day in their work may be exactly those that are useful in teaching a successful behavioral science course for medical students.