Behavioral Sciences Overview& Way Forward Dr Nargis Asad Dr Ayesha Mian Dr. Murad M. Khan Department of Psychiatry, Aga Khan University. March 7 th, 2015

YEAR I & II MODULES

What is the concept of medical/dental ethics? Common ethical dilemmas in doctor-patient relations, interaction with families, teachers, colleagues, pharmaceutical industry Attitude, value, belief, myths, social class, stigma, sick role and illness, health belief models Grief and bereavement, Family and illness, Dealing with difficult patients

Symptoms presentation and culture. Illness and Behaviour (sick-roles, stigma, Somatisation) Treatment Adherence (Compliance) What are the psychosocial aspects of illness, hospitalization, rape, torture, terminal illness, death

Breaking bad news: Introduction, Models, Methods, Death of the patient, abnormal baby, intractable illness Psychosocial correlates of hospitalization, illness behaviour, sick- roles Psychosocial issues in Emergency Departments, Intensive Care and Coronary Care Units, Operating Theatres, Cancer wards, Transplant Units, Anaesthesia

Psychological influences on sleep and consciousness, Non-pharmacological methods of inducing sleep, changes in consciousness Principles of effective communication, active listening, the art of questioning, the art of listening.

Good and bad listener. Counselling: Scope, Indications and Contraindications, Steps, Do’s and Don’ts, How to deal with real life crisis and conflict situations in health settings Informational Care: A practical method of communication between the doctor and patient.

Behavioral Sciences Respiration & Circulation Module (R&C): Year 1 Multisystem Module (MS): Year 1 Infectious & Immune Diseases (ID): Year II Neuro-science Module (NS): Year II

Behavioral Sciences Course Content 1.Introduction to Behavioral Sciences (R &C) 2.Life Span Development (LCF+ Tutorial) (ID) −Early Childhood −Middle Childhood −Adolescence and Adulthood −Aging 3.Family Functioning and Dynamics (LCF + Tutorial) (MS) 4.Psychological Reactions to Stress (LCF + Tutorial) (R&C) 5.Motivation & emotion (LCF + Tutorial) (R&C)

Neurosciences module: Introduction to Behavioral Neurology (LCF) States of Consciousness (LCF) Intelligence (LCF) Aggression & Violence (LCF + Tutorial) Behavioral Effects of Alcoholism (LCF) Human Sexuality: (Tutorial)

Module Objectives

Respiration & Circulation: Introduction to behavioral Sciences Introduce students to the limitations of narrow biological approach to health and disease To understand the bio psychosocial model of health and illness Become aware of areas of psychology that are relevant to medicine. Motivation To understand basic biological and survival motives To identify various biological and environmental determinants of basic drives To understand how various motives interact with health and disease

Emotion: To identify various emotional states and how they are influenced by cognition How various emotional states influence illness behaviors Psychological Reactions to stress: To understand the concept of stress To identify physiological and psychological reactions to stress To understand how stress influence various physical and psychological illness

Multi-systems: Family functioning styles and it's dynamics on health and illness

Neurosciences Module Objectives Longitudinal Themes Behavioral Sciences: By the end of the module, the students will be able to understand: The concept of intelligence Various measurements of intelligence The nature and psychological consequences of intimate violence

Identify: Psychological factors influencing arousal and sleep Psychosocial factors that contribute to gender differences in the expression and acceptance of violent behavior

Relate : Functional neuro-anatomy with normal psychological processes Various factors influencing intelligence with their clinical implications Factors affecting memory with different stages of memory Various disorders of memory with clinical implications principles of associative and complex learning to human behavior Factors influencing decision making in vegetative, terminally ill and brain dead patients with bioethical, economic and social considerations Importance of early detection to prognosis and describe the characteristics of good screening tests Integrate multiple perspectives on the etiology and perpetuation of aggressive behavior

Proposed Curriculum: Based on Institute of Medicine recommendations six domains to in corporate behavioral and social sciences are proposed

Mind–body interactions in health and disease Patient behavior Physician role and behavior Physician–patient interactions Social and cultural issues in health care Health policy and economics

Recommendations: Incorporate proposed six domains in the five year medical curriculum Weave Behavioral & Social Sciences (BSS) in Problem Based Learning (PBL) sessions Team teaching/ multi disciplinary teaching approaches BSS should be part of continues assessments

Teaching –learning strategies Interactive sessions Small project based assignments Audio –visual Presentations Theatre Case-studies − All assignments should be graded