Corporeal Nonmedical Excess in Patient Simulation

• In Event: Emotions and Affect in STS Work - II: Science, Technology, Medicine, and Affect

Abstract

Healthcare educators use the term “standardized patient” (SP) to refer to a performer in a clinical training simulation who portrays a patient with a disease. Educators standardize the “lived bodies” of SP performers to render them as objective and stable categories of human patient simulation. In doing so, they face the problem of how to develop a believable simulation of the patient’s body as both the object of biomedical gaze and patient’s personhood in order for scientifically oriented physicians to confront the subject of their work which is a person and not a thing. This paper engages with the qualities of human patient simulation that are perceived as necessary to negotiate lifelike medical simulation but at the same time it needs to be done in a way acceptable as a rigorous medical training. I draw on ethnographic methods to examine practices in medical simulation laboratories in the U.S.

By foregrounding the role of affect in SPs' trained subjectivity my argument clarifies the role of corporeal nonmedical excess in achieving legitimacy of patient simulation. Drawing on feminist epistemologies in STS and medical humanities I propose to de-trivialize forms of behavior educators see as nonmedical excess in patient simulation training, a field today largely driven by quantification, quality measurement, and tenets of objectivity. I show how patient simulation as an instrument of medical training puts the authority and credibility of the physician’s profession at stake.

Author

• Ivana Guarrasi Guarrasi, University of California, San Diego