Learning Processes in Physician Education: Integrating Psyche and Soma

Abstract

There was a wide range of difference in the way fifty-five third-year medical students wrote about a hypothetical medical patient with abdominal complaints and mild schizophrenic traits. The written exercise served as a projective test. Twenty-five wrote from a singularly psychological orientation; eighteen mentioned possible somatic disease in terms of dichotomy, psychic vs. somatic; twelve wrote in terms that allowed for the possible coexistence of psychic and somatic diseases. In each of these groups there were a few who demonstrated a relatively extreme attitude. The latter tend to represent a type of learning problem involving compartmentalized thinking. The three such students who dichotomized also demonstrated a tendency for strong ambivalence, vigorous likes and dislikes.

One of the students who made a strong dichotomy between psyche and soma is the subject of a more intensive study of his learning processes. Hypotheses are suggested to explain how the physician learns to regard the “whole man” in his practice of medicine. An integration of psyche and soma must pervade the medical curriculum to enhance professional development. The development of a well-integrated image of the whole man is an emotional as well as an intellectual learning task, especially if “the whole man” orientation is to take deep root in the physician and in his everyday practice of medicine.