Teaching behavioral sciences to medical students. Education or training?

Accepted paradigms in medical behavioral science education are development, conflict and defense, and disease. Teaching under these paradigms blurs distinctions between preclinical and clinical education, and between education and training--most commonly by including an introduction to clinical psychiatry in preclinical courses. Such approaches may provide students with technical skills at the expense of their developing conceptual bases for continuing self-education. We developed a first-year behavioral sciences course using the paradigm of symbolic function and language. This paradigm can organize knowledge that underlies clinical skills involved in talking with patients and establishing an effective physician-patient relationship. Believing that fostering knowledge should be the primary goal of preclinical education, we emphasized primary sources and classics. Our goal was to encourage analysis and synthesis rather than memorization; evaluating such higher taxonomic levels of education is extraordinarily difficult.