Behavioral Science Education Research Articles

Students’ technology acceptance of computer-based applications for analyzing animal behavior in an out-of-school lab

Behavioral biology is a field that students find fascinating. To get the most out of the various benefits of teaching it, a practical approach should be followed. One way to do this is to use video recordings of animals which are analyzed using various software. However, learners will only benefit from this approach if they choose to actually use the provided technology. Therefore, it is critical to survey learners’ acceptance towards the use of software in the field of behavioral biology. For this purpose, 171 students were questioned at an out-of-school student lab called “KILab.” By applying the Technology Acceptance Model (TAM), we investigated students’ acceptance of authentic behavior evaluation software and possible factors influencing it. In addition, potential effects of the student lab on attitudes toward artificial intelligence and technology affinity were examined. The results show a high technology acceptance toward the used software and a dependence of this on the factors technology affinity and acceptance toward artificial intelligence. Furthermore, the use of the software has a positive impact on the self-assessed technology affinity and attitude toward artificial intelligence.The study thus shows that the use of video recordings and software for behavior analysis is generally suitable for educational use and can be a possible extension of the practical implementation of behavioral science education.

A jury of scientists: Formal education in biobehavioral sciences reduces the odds of punitive criminal sentencing.

This study examines how formal education in biological and behavioral sciences may impact punishment intuitions (views on criminal sentencing, free will, responsibility, and dangerousness) in cases involving neurobiological evidence. In a survey experiment, we compared intuitions between biobehavioral science and non-science university graduates by presenting them with a baseline case without a neurobiological explanation for offending followed by one of two cases with a neurobiological explanation (described as either innate or acquired biological influences to offending). An ordinal logistic regression indicated that both science and non-science graduates selected significantly more severe punishments for the baseline case as compared to when an innate neurobiological explanation for offending was provided. However, across all cases, science graduates selected significantly less severe sentences than non-science graduates, and only science graduates' decisions were mediated by free will and responsibility attributions. Findings are discussed in relation to scientific understandings of behavior, the impact of science education on attitudes towards punishment, and potential criminal-legal implications.

No struggle, no progress: Taking the anti-racism conversation to a deeper level.

In order to promote ongoing dialogues about how to address racism in health care, the 2021 Forum on Behavioral Science included a workshop on how to take antiracism activities and conversations to a deeper level than what is typically offered. The workshop followed up on a previous antiracism plenary presentation at the 2020 Forum and was intentionally created to keep the importance of antiracism efforts on the forefront of behavioral science and medical education. The currently described presentation provided some background on how health inequity evolved in the United States. It also included information on the role that racism has played in the development of inequities in health care, the profession of medicine and medical education. Presenters included several activities specifically chosen to promote honest, open conversations about power imbalances that promote discrimination on the micro and macrosystem level. Participants were encouraged to start working on specific goals and ideas on how to conduct these activities and challenging conversations in their home institutions.

Problems in Physician-Patient Communication: What do our Students See and Hear? A Qualitative Study with a Pragmatic Approach

Background: Efficient communication with patients is an indispensable necessity for physicians of the 21 century. Over the past decades, much work has been done nationally and internationally to instill this essential skill in undergraduate students and medical graduates are now formally trained to become better communicators. However, deficiencies persist and medical students of today still observe various issues when they observe physician- patient communication interactions in their training. Objective: To understand perceptions of undergraduate medical students about the difficulties in Physician-Patient communication (PPC) & take suggestions on how to overcome them. Methods: A qualitative study design was employed, with data collection through three focus group discussions with medical students studying in Wah medical college, Pakistan in October 2019. Thematic data analysis was done using Atlas-ti 8
 software. A pragmatic approach was used to understand student perceptions about difficulties in PPC. Conclusion: The various issues regarding the problems in physician patient communication portray a realistic picture of our current communication practices. Various factors have been identified in this study and, the most practical solution to these problems lies in the effective teaching of behavioral sciences.

Medical Students Attitude & Knowledge of Psychiatry an Impact of Psychiatry Posting

India being a signatory to Alma-Ata declaration, envisaged ‘Health for all by the year 2000” and hence should look into training undergraduates in psychiatry. Medical students’ attitude towards psychiatry are determined by complex inter lacing variables. Low recruitment is a serious challenge for psychiatry worldwide. Moreover, psychiatry is poorly represented in medical education and undergraduate training in psychiatry and behavioral sciences in most medical colleges in India is unsatisfactory. Keeping these facts in mind, this study was carried out to assess the influence of psychiatry training, including direct patient contact on attitude of medical students towards mental illness. This study was conducted at Department of Psychiatry, Mahatma Gandhi Institute of Medical Science, Sevagram, Wardha, Maharashtra. Second year MBBS students were evaluated with a pre and posttest during their 2 weeks posting in the Psychiatry department. There was some improvement in attitude & knowledge of undergraduate medical students about mental health after two weeks of psychiatry posting. The improvement in male medical students is more than three times of that seen in female medical students, after two weeks of training. The existing M.C.I. recommendations need serious considerations for implementation in each & every Medical College of India. As per the current curriculum, the introduction to psychiatry is in the 1st term during lectures on behavioral sciences following which they not exposed again until the 5th semester when the undergraduate students are required to attend 40 hours lectures parallel to 4 weeks clinical posting culminating with compulsory short note questions worth 20 marks included in paper II of the General Medicine exam. Finally, another two weeks of psychiatry posting is mandatory during internship. Female medical students have shown deterioration in their attitudes & knowledge over more questions than male counterparts. Hence it can be deduced that, males tend to learn better by experience.

Comparison of Self-Reported Empathy Levels among Dental Undergraduate Students in Northern India: A Questionnaire-Based Cross-Sectional Study.

Context:Empathy is one of the fundamentals of communication relevant within the practice of dentistry, and the research is limited in this field.Aims:The present study was conducted to assess the self-reported empathy levels among dental undergraduate students in Lucknow city of Northern India.Settings and Design:A descriptive cross-sectional study was conducted among three dental colleges of Lucknow city during July 2019–September 2019.Subjects and Methods:E-survey link was circulated among 790 students through e-mails. It has two parts. The first part included sociodemographic information, wherein the second part, the empathy level of students was assessed using the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire. The possible score range is 20–140: the higher the mean score, the higher the self-reported empathy level.Statistical Analysis Used:The data collected were analyzed using SPSS software version 24. Chi-square test was used to test gender distribution differences among different years. One-way analysis of variance including post hoc tests was used to compare the differences between study variables.Results:The mean ± standard deviation empathy score was 92.55 ± 11.85, 91.85 ± 12.23, 93.25 ± 11.24, 93.37 ± 12.31, and 88.34 ± 12.01 among the first-year, second-year, third-year, final-year, and interns' students, respectively, with a statistically significant difference.Conclusion:It can be concluded from the results of the present study that the mean empathy score was highest among final-year students which is suggestive of the impact of education in behavioral sciences.

Behavioral Science Rounds: Identifying and Addressing the Challenging Issues That Residents Face on a Family Medicine Inpatient Service.

Training residents in the care of hospitalized patients offers an opportunity to integrate behavioral science education with medical care and to foster professional growth, given the severity of coexisting medical and psychosocial problems and the formation of intense transient relationships. Rarely do residents have the time or guidance to reflect on how these experiences and relationships affect them. Weekly behavioral science rounds (BSR) provide dedicated time to reflect on and discuss challenging clinical and professional developmental issues arising during inpatient training. To understand the range of issues that learners experience, we analyzed facilitator notes of 45 consecutive BSR discussions. Through open coding analysis we identified the common topics and recurring themes raised by residents. The most common topics related to residents' emotional responses, clinical challenges, and interpersonal conflicts. We identified frequently recurring themes, including understanding the power and limitations of the physician, defining roles and responsibilities, and articulating personal beliefs and values. Early first-year residents had difficulty acclimating to increased responsibility and worried about competence; later, they experienced strong emotional reactions, feared becoming cynical, and were apprehensive about future leadership roles. Inpatient BSR can serve as an important educational intervention and professional development tool at a critical time in training. BSR requires a commitment of teaching resources, an assurance that they will occur regularly, and a culture of safety in which residents trust their discussions will be confidential and that they will be treated with respect and caring.

Empathy among dental students: A systematic review of literature.

Empathy is just as relevant within dentistry, although research is limited in this field and very less is available in the current literature. The demonstration of empathy by dentists has been correlated with decreased dental fear. The authors systematically reviewed the literature to investigate empathy levels among dental students. A systematic review of the literature was undertaken concerning dental students' empathy, published from November 2016 to June 2018, using manual methods and the PubMed, PMC, PsycINFO, and other databases. Articles not in English and not concerned with dentistry were excluded, and intervention studies intended to enhance empathy, opinion articles, and reviews or reports of nonoriginal research were excluded. Eligible studies were those published from January 1, 2005, to May 31, 2017, in English language. A total of 34 full-text articles were obtained and assessed. Of these 34 papers, only seven publications were considered to have met the inclusion criteria and were directly related to the aim of literature search. Only seven articles that provided data and evidence describing empathy among dental students were included. Four studies reported that the difference in mean empathy level across the year of study was statistically significant (P < 0.05), and one reported that there was no significant difference in empathy scores between the year levels of study. Three articles reported that males had higher mean empathy score than females, whereas vice versa was found in the remaining four articles. This article demonstrates that there is only a limited evidence to provide the understanding of empathy among dental students. The results indicated that as patient exposure increases, the empathy level decreases among dental students. Furthermore, it is observed that education in behavioral sciences may be effective in increasing self-reported empathy, and further training may be necessary to maintain high levels.

Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association.

A healthy lifestyle is fundamental for the prevention and treatment of cardiovascular disease and other noncommunicable diseases (NCDs). Investment in primary prevention, including modification of health risk behaviors, could result in a 4-fold improvement in health outcomes compared with secondary prevention based on pharmacological treatment. The American Heart Association (AHA) emphasized the importance of lifestyle in its 2020 goals for cardiovascular health promotion and disease reduction. In addition to defining “cardiovascular health” based on criteria for blood pressure and biochemical markers (lipids and glycemia), the AHA Strategic Planning Committee further identified lifestyle characteristics of central importance: nutrition, physical activity, smoking, and maintenance of a healthy body weight.1 The World Health Organization estimated that ≈80% of NCDs could be prevented if 4 key lifestyle practices were followed: a healthy diet, being physically active, avoidance of tobacco, and alcohol intake in moderation.2 To support healthy lifestyle initiatives, major changes are necessary at the societal level to improve population health. Numerous strategies might help to create a culture that promotes and facilitates healthy behaviors, including creating laws and regulations, mounting large-scale public awareness and education campaigns, implementing local community programs, and providing individual counseling.3 Physicians are uniquely positioned to encourage individuals to adopt healthy lifestyle behaviors: Approximately 80% of Americans visit their primary care physician at least once a year. Physicians directly communicate with their patients during clinical encounters across numerous settings, and research indicates that patients highly value recommendations provided by their physicians.4,5 However, data further indicate that lifestyle counseling does not routinely occur in physicians’ offices, thereby representing a lost opportunity. Physicians report that they perform lifestyle counseling during ≈34% of clinic visits.4 Patients, in turn, report an even lower frequency of physician lifestyle counseling. For example, obese patients reported receiving physical activity and …

Practical teaching of behavioral sciences to medical students

IntroductionThe teaching of behavioral sciences was in form of lectures to the medical students in the 2nd year of the college, because the lecture is the least beneficial method of teaching. As I have noticed also that students were more interested to practice behavioral skills. So I suggested to the authority of the faculty to teach part of the behavioral sciences in a practical way and proposal of that was introduced and accepted to teach in that way and to give 20% of marks to this practical part, this in addition to the same theoretical lectures.MethodThe students were divided into groups of 30, every group present one day only through their 2nd year. This day divided into two parts each is 2 hours and in between have an hour break. The 1st part includes group discussion about communication, group dynamics, group leading and scientific way of problem solving. The 2nd part is dividing students into small groups of 10 students, to practice the previous skills in group interaction to solve one problem in a scientific way. All groups collected again to see what they have done.ResultsThe results revealed more interest and more enthusiasm to learn in that way and make it easy to practice in their daily life.ConclusionWe have to change into more practice in our teaching of medical students especially skills of human communication, group leading group dynamics as well as problem solving.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Behavioral science priorities in residency education: The perspective of practicing family physicians.

The family medicine residency behavioral science curriculum is more effective if prioritized to match what is needed in practice after graduation. Two prior studies (Kendall, Marvel, & Cruickshank, 2003; Marvel & Major, 1999) identified physician priorities for behavioral science education. The present study extends this research to include topics from more recent curriculum guidelines and examines the extent to which size of community and perceived competence correlate with prioritization of Washington state family physicians. Practicing family physicians in Washington state (N = 2,270) were invited to complete the survey. Respondents provided demographic and practice information. Respondents then rated, on a scale from 1 to 4, 35 behavioral science topics on 2 different scales including (a) priority to be given in residency education and (b) perceived level of competence. A total of 486 responded and 430 completed both priority and competence scales for a response rate of 19%. The top half of 35 topics of the present study included the top 13 topics found in the 2 prior studies. Priority and competence scales were moderately correlated (r = .48, n = 430, p = .001). There was a small significant correlation with size of community and priority ratings (r = .13, n = 435, p = .006). Family physicians in Washington state prioritize behavioral science topics in residency education similar to Colorado and Mississippi. The results of this study support recent ACGME guidelines, in that training should focus on common psychiatric illnesses, including depression and anxiety, and interpersonal processes. (PsycINFO Database Record

6. Necessity of Behavioral Science education in Clinical training for Medical Practitioners

6. Necessity of Behavioral Science education in Clinical training for Medical Practitioners

"Where Does the Circle End?": Representation as a Critical Aspect of Reflection in Teaching Social and Behavioral Sciences in Medicine.

This paper describes a reflective learning program within a larger curriculum on behavioral and social science that makes use of close reading, written representation of experience, discussion, and textual response. This response may in turn lead to further reflection, representation, and response in a circular pattern. A unique feature of this program is that it pays attention to the representation itself as the pivotal activity within reflective learning. Using the narrative methods that are the hallmark of this program, faculty writings were analyzed to characterize the essential benefits that derive from these practices. In the context of a faculty development seminar on the teaching of behavioral and social sciences in medical curricula, a group of 15 faculty members wrote brief narratives of reflective learning experiences in which they had made use of the methods described above. Their responses were submitted to iterative close reading and discussion, and potential themes were identified. Four themes emerged: writing as attention to self, writing as attention to other, writing as reader/writer contract, and writing as discovery. In each instance, writing provides a new or deepened perspective, and in each case, the dividends for the writer are amplified by the narrative skills of those who read, listen, and respond. The narrative pedagogy described and modeled herein provides a potentially promising approach to teaching the social, cultural, behavioral, and interpersonal aspects of medical education and practice. Future research will deepen our understanding of the benefits and limitations of this pedagogy and expand our appreciation of its applications.

Motivational Interviewing as a Pedagogical Approach in Behavioral Science Education: “Walking the Talk”

Motivational Interviewing (MI) is an evidence-based approach to facilitating behavior change. This approach has been applied in multiple settings (e.g., healthcare, drug and alcohol treatment, psychotherapy, health and wellness coaching, etc.). This article applies MI in a pedagogical context with medical residents as a semi-directive, learner-centered teaching style for eliciting clinical behavior change. Herein we present the foundational theories that inform this approach, describe the process of teaching, address barriers and challenges, and conclude with a review of performance to date including residents' narrative accounts of their experience with the curriculum.

Prerequisites in Behavioral Science and Business: Opportunities for Dental Education

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 percent of schools encouraged or recommended prerequisite course work in behavioral science and business, respectively. We suggest that the dental education community involve key stakeholders to discuss the incorporation of prerequisite course work in behavioral science and business. Additional courses in these disciplines would provide dental students better backgrounds from which the dental curriculum could build a more advanced and applied perspective to better prepare students for practice.

Columbia University College of Physicians and Surgeons

Columbia University College of Physicians and Surgeons

Godfrey H. Hochbaum (1916–1999): From Social Psychology to Health Behavior and Health Education

GODFREY HOCHBAUM WAS, for many years, a leading figure in health behavior and health education and the application of behavioral science in public health. He is most noted for the development of and research surrounding the Health Belief Model (HBM), one of the most widely used models for understanding health behaviors. The HBM arose from his landmark study with the US Public Health Service in the early 1950s in which he examined factors associated with participation in tuberculosis screening programs.1,2 Hochbaum was one of the first social scientists hired by the US Public Health Service as part of the new Behavioral Science Section.3 Hochbaum was born November 19, 1916, in Austria. His family immigrated to the United States in 1938. During World War II he served as an intelligence officer in the US Army. He completed his PhD degree at the University of Minnesota in 1952. From 1957 to 1967 he was Assistant Chief and then Chief of the Behavioral Science Section of the US Public Health Service. From 1972 to 1988 he was a professor in the Department of Behavioral Science and Health Education, School of Public Health, University of North Carolina, Chapel Hill. Throughout his career, Hochbaum received a number of distinguished awards and recognitions in the health sciences (e.g., the Mayhew Derryberry Award for “Outstanding Contributions to Health Education by an Eminent Behavioral Scientist” in 1981). Hochbaum is credited with creating 2 enduring contributions to public health science. The first was the HBM, which itself was one of the first social–psychological theories that directly addressed health behavior and most importantly laid the ground work for many of the social–psychological theories that now underlie health behavior and health education research and practice. The HBM, including the hundreds of studies that have employed it since it was established, is still taught in graduate public health programs today. His second contribution was showing how theoretically based modern scientific research could be applied to important questions about health behavior, that is, understanding why people behave the way they do with regard to their health. The 1961 Journal article abstracted here argues that principles of research design can guide the planning of public health investigations. From the early 1960s until his death in 1999, Hochbaum was a strong advocate for applied social science research in public health. Just prior to his death, Godfrey wrote to a colleague: The primary functions of behavioral scientists in applied fields like health education are to find ways of adapting and modifying theories and to turn them into “tools for planning and constructing programs. It is somewhat like the relation between physical scientists and engineers.3(p677) Hochbaum's contributions to public health are undoubtedly best summarized by a colleague, J. A. Earp, who wrote: Godfrey was our first social psychologist, one who made great strides in translating abstract theory to real life (and specifically to health) in an easy-to-operationalize theory. Although he did not actually do extensive research to test the applicability of the theory he helped originate, and although others would go on to develop the subtleties and complexities of both the theory and its application, he bridged these two worlds (J. A. Earp, ScD, Department of Health Education and Health Behavior, University of North Carolina, Chapel Hill, unpublished eulogy, 2000). Indeed he did.

A History of Multiple Sclerosis

This volume is part of the Healing Science: Disease, Medicine, and History series edited by John Parascandola. The goal of this series is to present history of medicine to a broad-based general audience, rather than limiting its readership to medical historians and physicians. With the exception of the final chapter, this book fulfills this mission. The author, Colin Talley, is an assistant professor of Behavioral Science and Health Education at Emory University who took his history of medicine training at the prestigious University of California at San Francisco program. The author begins his short text by defining multiple sclerosis as a disease of the spinal cord and brain that strikes adults between 20 and 50 years of age. In 2007 there were between 266,000 and 400,000 cases reported in the United States and over 2.5 million worldwide. He then outlines this book's content by asking a series of questions he intends to answer in his book. Why did multiple sclerosis emerge as a distinct neurological disease at the end of the nineteenth century in France? Talley credits this medical breakthrough to the clinical work conducted by Jean-Martin Charcot at the La Salpetriere hospital in Paris, beginning in the late 1860s. Until then multiple sclerosis had been misdiagnosed as a wide variety of neurological disorders. The author then asks, why did multiple sclerosis go from being a little diagnosed disease in the first half of the twentieth century in the United States to becoming a major neurological disorder by the late 1940s? He credits this major change to the rise of the neurology specialty and the impact of lay activities lead by the National Multiple Sclerosis Society, which started its work in 1946.

Culture of Death Denial: Relevant or Rhetoric in Medical Education?

Journal of Palliative MedicineVol. 12, No. 12 Guest EditorialCulture of Death Denial: Relevant or Rhetoric in Medical Education?Tara TuckerTara TuckerSearch for more papers by this authorPublished Online:8 Dec 2009https://doi.org/10.1089/jpm.2009.0234AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byCOVID-19 older hospitalized patients: three clinical-psychological patterns1 October 2020 | Journal of Gerontology and Geriatrics, Vol. 69, No. 1Community perspectives of end-of-life preparedness9 May 2018 | Death Studies, Vol. 43, No. 4Doctors’ learning experiences in end-of-life care – a focus group study from nursing homes31 January 2017 | BMC Medical Education, Vol. 17, No. 1When Terminal Illness Is Worse Than Death: A Multicenter Study of Health-Care Providers’ Resuscitation Desires3 August 2016 | American Journal of Hospice and Palliative Medicine®, Vol. 34, No. 9Living into death: a case for an iterative, fortified and cross-sector approach to advance care planning16 May 2017 | Anthropology & Medicine, Vol. 24, No. 3Nursing Home Physicians’ Assessments of Barriers and Strategies for End-of-Life Care in Norway and The NetherlandsJournal of the American Medical Directors Association, Vol. 18, No. 8Grupo de Educação para a Morte: uma Estratégia Complementar à Formação Acadêmica do Profissional de SaúdePsicologia: Ciência e Profissão, Vol. 37, No. 2Cracking open death: death conversations in primary careJournal of Primary Health Care, Vol. 8, No. 4Shared decision making and the use of a patient decision aid in advanced serious illness: provider and patient perspectives1 December 2014 | Health Expectations, Vol. 18, No. 6Lessons about Dying and Death from the Classroom of the Bedside16 October 2015 | Annals of Behavioral Science and Medical Education, Vol. 21, No. 1Cost–utility analysis of treating out of hospital cardiac arrests in JerusalemResuscitation, Vol. 86Tapu and the invention of the “death taboo”: An analysis of the transformation of a Polynesian cultural concept9 October 2013 | Journal of Social Archaeology, Vol. 13, No. 3Beyond Good Intentions and Patient Perceptions: Competing Definitions of Effective Communication in Head and Neck Cancer Care at the End of LifeHealth Communication, Vol. 28, No. 2Gardens of Stone: Searching for Evidence of Secularization and Acceptance of Death in Grave Inscriptions from 1900–20091 December 2011 | OMEGA - Journal of Death and Dying, Vol. 63, No. 4Palliative Care Communication Curriculum: What Can Students Learn From an Unfolding Case?10 November 2010 | American Journal of Hospice and Palliative Medicine®, Vol. 28, No. 4‘Doc, Is Palliative Care an Option for Me?’Onkologie, Vol. 34, No. 6Beginning of the end? Ending the therapeutic relationship in palliative care1 July 2010 | International Journal of Speech-Language Pathology, Vol. 12, No. 4 Volume 12Issue 12Dec 2009 InformationCopyright 2009, Mary Ann Liebert, Inc.To cite this article:Tara Tucker.Culture of Death Denial: Relevant or Rhetoric in Medical Education?.Journal of Palliative Medicine.Dec 2009.1105-1108.http://doi.org/10.1089/jpm.2009.0234Published in Volume: 12 Issue 12: December 8, 2009PDF download

An International Perspective on Behavioral Science Education in Medical Schools

The behavioral sciences are taught in medical curricula around the world. In the current paper psychologists teaching in medical schools in Australia, Mexico, Saudi Arabia, Thailand, the United Kingdom and the United States share their experience and reflections. Whilst direct comparisons between countries are not made, the themes that are evident within and between accounts are instructive. As behavioral scientists around the globe are struggling to maintain a presence in medical education many of the reasons behind this are shared, regardless of the country. Challenges discussed include those related to the impact of unrealized potential contributions of psychologists as health care professionals, teaching of behavioral sciences by other professions, domination of the biomedical model without a corresponding recognition of psychology as science, and modern medical pedagogies such as problem-based learning, which favor biomedicine. Systemic and political barriers over which we as a discipline may have little control are also highlighted.