Medical Education Research and the Limits of Objectivity

• In Event: Rethinking Health Professions in the 21st Century: Innovations, Interruptions, and Regenerations

Abstract

Standardization of training and evaluation in medical education research emerged during the 1970s as a response to crises of public trust and incursions into the profession from ‘unqualified’ outsiders. In this paper, I consider the development of the communication and interpersonal skills checklist as a kind of technology for evaluating a medical trainee’s ability to foster a relationship with their patients in a more or less standardized way. I pay particular attention to the aspects of intersubjectivity (such as empathy) that have been cast as observable and knowable actions. I demonstrate that the development and continued adaptation of the checklist is guided by a distinct body of expertise, that of medical education research. It is a field oriented primarily to objective, scientific knowledge production. And yet, because the work of physicians deals intimately with human suffering and death, medical education as a discipline must also be adaptive to the social and, more specifically, emotion. In this way, I argue that the communication and interpersonal skills checklist is a technology of affect that attempts to capture the inherently relational and intersubjective phenomenon of the physician-patient relationship as an objectively observable and knowable object. This paper adds to our understandings in STS of the tensions between standards and subjectivity, and I demonstrate the importance of theories of affect for studies of scientific knowledge production.

Author

• Kelly Underman, Drexel University