Amanda Cappon & Lynne N. Kennette
(Durham College, Oshawa, Ontario)

Every student is unique. They enter our classrooms at varying ages and stages in their life. Students present with differing learning preferences and motivations, and as educators in post-secondary institutions, we are a font-line point of contact, privy to this diversity in our students. Valuing this diversity and further striving to provide inclusive learning spaces in the classroom, we believe that educators of any discipline can benefit from using the biopsychosocial model.

The following article will first describe the model and its origins, link it to a “whole student” perspective, and then apply it to students’ current learning space and eventual workplace. Finally, it will connect the biopsychosocial model to principles of equity, diversity and inclusion (EDI).

The Biopsychosocial Model

Each of us is a product of both nature (our innate genetic make-up and personality) and nurture (our experiences and social-cultural exposures), which interact to create the unique combination that makes us, us. The biopsychosocial model originated in the 1970s through George Engel (see Fava & Sonino, 2017). Engel worked in psychiatry at the time and the biomedical model was considered the gold standard, but Engel saw the medical model as reductionistic, so he sought to expand it to integrate knowledge from the behavioural and social sciences which led to the inception of the biopsychosocial approach (Fava & Sonino, 2017).

Below is an adapted chart which readers may find useful in understanding the biopsychosocial model as it might relate to the students in their classrooms. We have based our version, which we have adapted for the focus of this paper, on a previous synthesis from the PsychDB psychiatry reference database (PsychDB, n.d.). Please note that this is not intended for educators to pry into the personal lives of their students. Rather, this chart and the model itself, can be used to shift perspective in acknowledging the diversity of our students and the internal and external challenges they may be dealing with while in our classrooms.

Biopsychosocial Model for Students
	Biological	Psychological	Social and Cultural
Predisposing Factors (What are the longstanding factors in the student’s life that may be affecting their functioning?)	Genetics Medical conditions Learning or developmental disorders	Interactions with peers Cognitive style Self-esteem	Poverty Access to mental health care Exposure to conflicts
Precipitating Factors (Was there an acute event in this student’s past?)	Medical illness or injury Use of alcohol or drugs	Conflicts around identity (common during transitions such as to post-secondary) Psychological distress/ disorder	Changes to relationships Recent immigration Loss of home
Perpetuating Factors (What chronic things are going on which might affect learning?)	Chronic illness  Cognitive deficits, or learning disorder Adjustment of medication Ongoing substance use	Beliefs about self/others/the world Self-destructive behaviours Poor coping  Personality traits	Loss of social support Ongoing transitions Food insecurity Working too many hours at part-time job Isolation Unsafe environment
Protective Factors (What is protecting them and allowing them to learn well?)	Overall health Intelligence Abilities Resiliency Popularity	Positive sense of self Good coping skills  Self-awareness	Positive familial relationships Availability of supportive social network Financial support

Seeing the Whole Student

As educators, we can apply the biopsychosocial model in our learning environments through how we engage with and respond to our students. If we engage with our students from a “whole human” perspective, we can not only better manage our personal biases (in an ongoing way), but we can also model this approach for our students to apply in their respective lives.

As an example of how faculty might apply the biopsychosocial model, consider a fictional student who repeatedly requests evaluation extensions. Understandably, this can be frustrating for the professor. It is likely that the student would have provided us with their “precipitating factors” resulting in their need for an extension, but we may not be privy to the longstanding, predisposing, or perpetuating factors that are impacting the student. While the student is not required to disclose this information, and we, as educators, are not required to grant an extension, we can better support students in their learning if we take a step back to consider these additional factors which could be contributing to our student’s struggles. In this way, we may be better able to support the diverse needs of this and other students while also mitigating our own frustration. Planning our courses a priori with the many factors outlined in the biopsychosocial model can help.

Similarly, by designing a course which provides all students choices for assessments, which is in line with the recommendations of universal design for learning (CAST, 2018), students may be able to demonstrate the same learning outcomes in a format which takes into account their whole life context. For example, students who don’t have their own computer at home, or who live in a low-income neighbourhood, might prefer to demonstrate their knowledge by writing a test rather than completing a digital project or group assignment. In both of these examples, the idea promoted by the biopsychosocial model is that it may facilitate open dialogue with the student, referral to on campus supports, and a supportive response that promotes genuine student-teacher engagement. In this way, seeing the whole student begins when designing the course and continues throughout the semester.

Fostering Student Application of the Biopsychosocial Model

In forty years since its inception, the biopsychosocial model has been thoroughly researched in the healthcare field (see Fava & Sonino, 2017) and has made its way into the classroom. In social science and humanities classrooms, the pedagogical application of this model is a little more obvious because it more easily connects to the content of the course. For example, educating future clinicians to look at the “whole human” (including biological, psychological, social, and cultural aspects) can be taught through various methods of self-reflection, having the student engage with their own biopsychosocial development, or by applying (individually or in groups) this model to an imagined client scenario.

In other disciplines, the application of the biopsychosocial model may be less obvious but valuable nonetheless, especially since many fields are experiencing a shift toward giving more space and importance to equity, diversity and inclusion practices. For example, Flynn et al. (2022) recently identified a paradigm shift in the field of occupational health and safety toward the biopsychosocial model. This paradigm shift is intended to advance “health equity” because the social determinants of health intersect with other social structures which have ultimately led to exclusionary practices in work environments, research findings, and more (Flynn et al., 2022). Flynn et al. (2022) also highlight the importance of using this model to better understand one’s position within the “complex social web” in which we exist. And, perhaps more prudently, this model can help with our awareness of our own perspective of the world which, if left unattended, can lead to reflexive thoughts and behaviours as well as innate assumptions or judgements of others.

An example of how this model can be included in the classroom of any discipline would be to create a “case scenario” specific to your course content and have students select one case to analyze (independently, in pairs, or in small groups) from a biopsychosocial perspective. That is, ask students to consider various aspects of the person in the scenario and how those aspects might affect behaviour. For example, would Einstein have come up with the theory of relativity had he not encountered some of the hardships in his life (such as World War II)? Alternatively, students can themselves create the descriptions of people related to their field of study (including all aspects of the model) and exchange with another student to examine. Depending on the specific outcomes for your course, you might consider using a celebrity, criminal, researcher/historical figure in your field, a family member, a client encountered during a co-op placement, or even themselves. Regardless of the figure chosen (or if you provide them with a fictitious description of a person), students should consider the influence or role of various aspects of the biopsychosocial model in determining behaviour. Some aspects that the student might consider could be biological (genetic predisposition, underlying medical issue, certain hereditary mental health disorders), psychological (developmental stage, certain mental health disorders, intelligence, attachment style), social (attitudes, social expectations, education, family values), and/or cultural (religion, economic status, sexual identity, ethnicity/race, trauma/crisis, language). Discussions can be quite engaging, especially as students bring in their own unique and diverse lived experiences. Various disciplines can adapt this activity to meet the needs of their curriculum. For example, in a law course, perhaps describe an accused/known criminal; in a social work course, it could be a client; in a nursing course, a patient; in a business course, an applicant for a job; in a literature course, present a character from a novel; in a math course, it could be a key historical figure. The purpose of the activity is to engage students in considering the “whole human” as it draws on their awareness of barriers, strengths, and struggles from a holistic perspective, and how that can impact various outcomes and behaviours. This type of discussion serves to deepen our awareness of diversity as well as social justice/injustice and can also promote a sense of cohesion in the classroom.

One of the primary benefits of exposing students to the biopsychosocial model in their courses is that they gain some additional skills (e.g., critical thinking skills) and become more familiar with the struggles of others, developing empathy. Thinking about all the variables that make people behave a certain way makes students less likely to defer to stereotypes for any particular group or to commit the fundamental attribution error (whereby erroneously attributing others’ behaviours to internal attributes). Ultimately, students will be equipped with enhanced interpersonal skills from their exposure to this model during the course of their studies.

Linking the Model to Students’ Eventual Workplace

Students attend post-secondary institutions with the goal of earning a credential and gaining employment in their field of study. Their learning journey is the foundation which will allow them to apply the learning outcomes and so-called “soft skills” which they developed during the course of their studies. The biopsychosocial model is about developing a general ability of looking at the “whole human” and the diversity among us which is beneficial regardless of one’s field of study. In business management, for example, an important biopsychosocial application might be equitable hiring practices. In health sciences (e.g., nursing), it may be particularly important to be able to assess and advocate for medical intervention on behalf of a patient, a skill which requires a holistic approach. An employee in the field of data analytics might be working on social science or humanities research projects where it would be advantageous to apply a biopsychosocial perspective in their representation of the research data. In any field, developing the skills and ways of thinking related to principles of diversity, equity and inclusion will place students in a better position to be competitive in the job market and better employees once hired.

A Connection with Equity, Diversity, and Inclusion (EDI)

Perez et al’s (2019) research revealed an overall lack of engagement and understanding of equity, diversity and inclusion (EDI) among post-secondary departments, and as a result, among students as well. And yet, these constructs are overwhelmingly relevant for a students’ own identity and ultimate success in their personal and professional lives. Barnett (2020) wrote about “leading with meaning” where he qualitatively reviewed 12 empirical articles on equity, diversity and inclusion among higher education institutions in the U.S. He concluded that, while educating students on constructs of equity, diversity and inclusion is a complicated process which is dependent on the context, it is imperative that post-secondary institutions focus not only on the specific content which is taught, but also on how that content is taught. Overall, engagement at all levels, including administrators, educators, and individual student relationships, is critical to truly infuse the practices of inclusion, promote equity, and maintain awareness of diversity. The biopsychosocial model is not the sole solution, but it can definitely aid in a more inclusive pedagogical practice.

Conclusions

As educators, we can lay a foundation for EDI by including the biopsychosocial model when designing and delivering courses. As we engage with each diverse learner, we should practice our own awareness of biological, psychological, and social/cultural influences for that learner, continuing to model inclusion by welcoming all student contributions in the classroom. We can help foster EDI in our students by helping them to engage with the biopsychosocial model in our courses to enhance our students’ learning and develop their thinking in a way that will promote EDI both in the classroom and in the workplace.

The classroom is a powerful space to model skills and foster the application of key concepts, and as educators, we can have a lasting impact on our learners. The biopsychosocial model can be used to help us focus on the diversity of our students, both in our pedagogical practices and in the content and skills we help to develop in them.

 

References

Barnett, R. M. (2020). Leading with meaning: Why diversity, equity and inclusion matters in US higher education. Perspectives in Education, 38(2), 20–35. https://doi.org/10.18820/2519593X/pie.v38.i2.02

CAST (2018). Universal Design for Learning Guidelines. Center for Applied Special Technology. http://udlguidelines.cast.org

Fava, G. A., & Sonino, N. (2017). From the Lesson of George Engel to Current Knowledge: The Biopsychosocial Model 40 Years Later. Psychotherapy and Psychosomatics, 86(5), 257–259. https://doi.org/10.1159/000478808

Flynn, M. A., Check, P., Steege, A. L., Sivén, J. M., & Syron, L. N. (2022). Health Equity and a Paradigm Shift in Occupational Safety and Health. International Journal of Environmental Research and Public Health, 19(1), 349–352. https://doi.org/10.3390/ijerph19010349

Perez, R,. J., Robbins, C. K., Harris, L. W., & Montgomery, C. (2020). Exploring Graduate Students’ Socialization to Equity, Diversity, and Inclusion. Journal of Diversity in Higher Education, 13(2), 133–145. https://doi.org/10.1037/dhe0000115

PsychDB, Psychiatry DataBase (n.d.). Biopsychosocial model and case formulation. https://www.psychdb.com/teaching/biopsychosocial-case-formulation

Quiros, L., Kay, L., & Montijo. A. (2012). Creating Emotional Safety in the Classroom and in the Field. Reflections: Narratives of Professional Helping, 18(2), 42–47.