Nora Grand

Yale University

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Research Fellow

Programming the Patient: The Standardization of the Clinician-Patient Relationship in US Medical and Nursing Education, 1950-2000

From the 1950s-1990s, US medical and nursing educators developed new pedagogical technologies to simulate the clinical environment and teach clinical skills, including bedside manner, history-taking, physical examination, and diagnostic reasoning. Such technologies included standardized patients, paper games, gynecological teaching associates, and computer simulations. Using methods from science and technology studies and critical disability theory, this dissertation brings together two remarkably separate fields, the histories of medicine and nursing, to argue that both professions shaped new meanings of the therapeutic relationship in the late 20th century through the transformation of clinical skills education, from apprenticeship-like experiences in hospitals to standardized encounters with simulated representations of patients. By analyzing the values, attitudes towards patients, and power hierarchies embedded in the simulations’ designs, I argue that by developing, demonstrating, and teaching a standardized clinician-patient relationship, clinical educators defined not only what made a good doctor or nurse but also a good patient.

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Babak Ashrafi, Jan Golinski, Keith Wailoo, and Tom Misa at the Presidents of AAHM, HSS, and SHOT event. Held online on September 14, 2020

Babak Ashrafi, Jan Golinski, Keith Wailoo, and Tom Misa at the Presidents of AAHM, HSS, and SHOT event. Held online on September 14, 2020.