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Affective Neutrality

Bernard L. Frankel, MD
JAMA. 1986;256(4):515. doi:10.1001/jama.1986.03380040089036.
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It seemed like a good idea. In our department's behavioral science course, our faculty decided to try something new to teach first-year medical students about the relationship between illness and psychological development. In four of the weekly, psychiatrist-led, small-group sections of about 15 students each, an internist would bring in one of his patients (a different one on each occasion). Together, the internist and the psychiatrist would help the patients talk about the impact of their illnesses on their lives. After the patient left, the two physicians would discuss with the students their observations and understanding of this patient and the patient-doctor relationship from a biopsychosocial point of view.

From the high level of their interest and participation in the three previous sessions, it was clear that the students in my group were very enthusiastic about this approach and eagerly awaited meeting the fourth patient. In our final joint teaching


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