Practicing Professionalism, Performing Authenticity: Simulating the Pelvic Exam in Medical Education

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 14. Medical Education II

Abstract

Studies of culture in medical schools have demonstrated the ways in which medical students are socialized to embody the professional behavior of physicians (Becker, 1977; Hafferty and Castellani, 2009; Lempp, 2009). One such milestone in medical school is the first time that a medical student performs a female pelvic exam. This sensitive exam requires a medical student to maintain a professional demeanor while examining a part of the body that carries a sexual association. Medical students at most schools in the United States first experience this milestone through the use of gynecological teaching associates (GTA), female-bodied laypeople who teach medical students how to perform sensitive and competent gynecological examinations using the instructor’s own body. This paper explores a tension in these types of teaching encounters between artificiality and authenticity. In order to learn professional behavior, medical students must examine a real person, but they cannot examine a real patient for ethical reasons. I argue that GTAs endeavor to maintain a sort of bounded authenticity (Bernstein, 2007): an encounter that has a genuine emotional resonance for the medical student but that is limited in its intensity, duration, and scope. The work that GTAs put into maintaining this authenticity in an artificial context requires careful management of their own emotions and bodies to manage the medical students' emotional experience (Hochschild, 2012).

Author

• Kelly Underman, University of Illinois-Chicago