Search Results

This chapter examines how teaching and learning the pelvic in United States medical education have been transformed by feminist practices of care, even as these same practices have been coopted in order to serve the interests of physicians and medical educators. It focuses especially on the disruptive potential of affect and how they are managed by new strategies of governance in medical education. The chapter is also informed by by ways in which, in the 1960s and 1970s, the Women’s Health Movement, medical education research, and transformations in biomedicine altered one another’s trajectories and changed how the pelvic exam is taught to medical students and, thus, the pelvic exam itself.

This chapter examines how patient empowerment seeks to train medical students to cultivate behaviors, attitudes, and values through disciplinary work done on physicians’ and patients’ affects. Because of the pelvic exam’s fraught history of rendering patients as passive objects prior to the intervention of the Women’s Health Movement, this exam serves as an interesting example to tease out threads of patient empowerment and professional authority. Patient empowerment is conceptualized as a technology comprised of discourses, knowledges, and practices that constitute patients as “partners”: fully informed subjects who are responsible for and obligated to participate in the maintenance of their own health.

The pelvic exam is a fascinating case for understanding medical socialization today, as it involves a two-pronged navigation of feelings. It is about the emotions of physician and patient, but it is also about the embodied experience of sensation for both. The GTA program today has been shaped as well by the legacy of feminist health activism and the science-driven reform efforts of medical educators. While it is surely an exceptional experience—one or several one-to-three-hour workshops during all of medical school—it is embedded in and demonstrative of larger trends in medical education and, indeed, the medical profession.

The conclusion looks at debates about the role of consent in teaching and learning the pelvic exam and what these indicate about affective governance in medical education and the making of physicians. The presence of the GTA program in most medical schools in the United States has meant an enthusiastic embracing of the “patient experience.” And yet, there is still a prioritization of the learning experience of the trainee at the expense of the patient when pelvic exams are performed on patients who are under anaesthesia. The chapter suggests that affective governance in medical education is about producing more efficient workers, and more compliant consumers. In short, it is no longer possible to set aside the important role that emotion and bodily capacities to move and be moved by play in the governance of conduct via expert knowledge.