Seminar with Janelle S. Taylor: The Demise of the Bumbler and the Crock – From Experience to Accountability in Medical Education and Ethnography

Venue: Center for Sundhed og Samfund (CSS), Øster Farimagsgade 5A, room 5.0.22.

Time: September 12th 10.30 am -12.00

Host: Centre for Medical Science and Technology Studies and the research project LifeWorth

In this paper I consider the methods and findings of my own late-2000s U.S. based ethnographic research on Standardized Patients, or SPs (i.e., people hired to portray patients in staged clinical encounters with medical students), in relation to those of Howard Becker’s 1955 research among U.S. medical students.

Becker’s mid-20th-century subjects used the term crock for patients who presented obstacles to their acquisition of valued kinds of clinical “experience.” By contrast, SP simulations, as one among many forms of simulation used to teach clinical skills today, exclude the possibility of crocks. Such changes in medical education, meanwhile, have been paralleled by changes in ethnographic practice. Becker’s account of his fieldwork, like many at midcentury, portrayed the ethnographer as a clueless “bumbler” who, through experience, gains understanding and expertise and is transformed into a professional anthropologist. Today, by contrast, the necessity to account in advance for the risks, rewards, and outcomes of ethnographic research has rendered bumbling inadmissible.

In this paper I argue that the disappearance of the “bumbler” and the “crock” as regular figures in the discourses of anthropology and medicine points toward a revaluation of “experience” in both fields and a shift toward new regimes of accountability, grounded in the changing political economy of knowledge production. At risk of being lost in the process are faith, surprise, and humor.

Janelle S. Taylor is Professor and Chair of the Department of Anthropology at the University of Washington, Seattle.  Her research over the past decade has focused on a variety of topics relating to medical technology, medical education, and medical practice, including fetal ultrasound imaging, medical decision-making at the end of life, and how ‘culture’ is formulated within medical education. Most recently she has been examining how persons get represented within U.S. biomedicine, and considering the social, cultural, and political as well as clinical consequences of such processes of representation.