Abstract:

Background & objectives:
The biomedical model is based on a biological conception of the patient, which is reduced to failures or imbalances in anatomical-biochemical functioning. This model predominates in medical education and practice and collides with the reality of the sick person and thus with the values that predominate in the Humanities and Social Sciences (H&CS). This makes the teaching and practice further away from clinical reality and promoting merely utilitarian attitudes in students. The design of a new Health Communication (HC) Curriculum (HCC) for medical studies should consider the effective integration of the H&CS from medical practice and education and make efforts to overcome the "entrenched epistemologies" that in medicine seems to anchor the different perspectives (Litva&Peters 2008). This means explaining and developing a "medical anthropology and epistemology" that integrates the different visions in an effective way in practice. In this way, our objective is to present:
1) the design of an HCC, introduced in these last ten years in an integrated way in medical studies, based on expanded anthropological and epistemological conceptions (which go beyond materialist visions), and taught with experiential and student-centered teaching methodologies that have as main key aspects: a) repeated exposures to habitual and significant practical situations, implemented in simulated and real scenarios;
b) patients feedback to the student
c) structured reflections on the students lived experiences
2) the main results students get in skills and attitudes about HC and other aspects of medical practice and teaching.

Methodology:
We describe the anthropo-epistemological foundations on which HC is based, the organizational design of the integrated HCC throughout the 6 years of medical career; the teaching methodologies used and the impact of the Program on students communication skills and their conceptions in relation to HC, ethics, practice and learning of medicine. These results are exposed through the publications made in recent years using different quantitative and qualitative research methodologies.

Results:
Throughout different educational interventions in the HCC, the students gave their opinion on the interventions carried out and improved their knowledge and communication skills as a whole to carry out general medical interviews with patients and in specific situations (bad news, behavioral changes). Students improved their abilities to empathize with patients and to capture and explore the experiences and contexts of patients illness. The students' opinions about the communicational strategies used were generally positive and their reflections revealed expanded anthropo-epistemological conceptions that go beyond scientific reductionist views of medicine.

Conclusions:
The HCC developed in the last ten years in our medical school is feasible and appropriate in our teaching context. This curriculum explains its anthropological-epistemological foundations by developing experiential teaching methodologies centered on students. The HCC is effective in improving students' knowledge, skills and attitudes in relation to HC, medicine and its teaching in general, and can contribute to advancing a change in the medical culture (practical and educational) that favors both the dialogue between the basic sciences and the humanities as well as the effective integration of the latter in medical curricula

Keywords:

Curriculum design, medical students, doctor-patient relationship, health communication, communication skills, epistemology, anthropology.