Jinelle Ramlackhansingh¹
Fern Brunger¹
1 Memorial University

Standardised Patients (SPs) are part of the OSCE triad of students, examiners and patients. SPs tend to perform as “professional” patients. Previous research show that SPs are “dehumanized”. My research examines this process. 

This critical ethnography examines professional identity development in pre-clinical medical students. Monthly focus groups were conducted with students, supplemented by interviews with faculty and administrative staff. Participant observation of classes and governance meetings contextualized the data. The theoretical frameworks of Bourdieu and Foucault were used in data analysis. 

My research shows how SPs are dehumanized. Administrative staff confirmed that “[SPs are] here just as a warm body” for OSCEs. Students described the SP as a “body to do a physical”. 

The “body” is a “sophisticated prop” used in OSCE. This dehumanization of the SP as a body has been described as reducing patients to be of a “less[er] human herd”. Dehumanization involves the lack of recognition of the person’s experiences and agency. The language used about SPs has the effect of depersonalizing the patient. In this case, the mechanization of the patient to a “body” for examination results in objectification of the patient incapable of emotional responses. 

From a Bourdieusian perspective, the normative assumptions about dehumanized patients that shape and are perpetuated by, the depersonalization of the SP body, impacts the formation of medical professional identity. The conception of the patient as dehumanized is conveyed through the hidden curriculum via the OSCE. Language influences physician and trainee attitudes and biases. Care should be taken to avoid expressions like examining a “body” in clinical examination. 

Faculty and administrative staff involved in clinical skills should be conscious of the language used. 

The de-personification of the patient can be resisted simply by stating that a “person” is here for a complete body examination. 

References (maximum three) 

Dawson, J. (2021). Medically optimised: Healthcare language and dehumanisation. The British Journal of General Practice : The Journal of the Royal College of General Practitioners., 71(706), 224–224. https://doi.org/10.3399/bjgp21X715829 

Gormley, G. J., Johnston, J. L., Cullen, K. M., & Corrigan, M. (2020). Scenes, symbols and social roles: Raising the curtain on OSCE performances. Perspect Med Educ., 2212-277X (Electronic). https://doi.org/10.1007/s40037-020-00593-1 

Nestel, D., & Kneebone, R. (2010). Perspective: Authentic patient perspectives in simulations for procedural and surgical skills. Academic Medicine, 85(5), 889–893. https://doi.org/10.1097/ACM.0b013e3181d749ac