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Short abstract:

In this short paper, I examine the stakes of deemphasizing biomedical expertise in two contexts of clinical training: in French mental health clinics for refugees and asylum seekers, and in simulation training for medical students in the United States.

Long abstract:

“It’s not with psychology that they’ll be able to do this kind of work. It’s with their own experience.” This statement made by a clinical psychologist reflected how she instructed budding psychiatrists and psychologists to support patients whose distress was shaped by displacement and migration. I heard similar refrains in mental health clinics for immigrants and refugees in France. In this short paper, I examine the stakes of deemphasizing biomedical expertise in two contexts of clinical training: in these French clinics, and in simulation training for medical students in the United States. In the mental health clinics, psychiatrists and psychologists instructed their students to avoid being “too psychological” in their ways of interacting with patients. Instead, they told their students to be attuned to their own lived experience of belonging to better relate to their patients. In the simulation training, medical students learned to perform technical procedures in a safe environment where they could make mistakes without harming patients. Medical students also learned how to have difficult conversations, develop empathetic dispositions, and learn other kinds of “soft skills” often seen as outside of medical expertise. Drawing on research with psychologists, psychiatrists, medical students, simulation professionals, and simulation instructors, I examine how clinical expertise can be reimagined by centering lived experience and material often considered to be extra-clinical. Putting science and technology studies perspectives into conversation with performance studies, I examine how enactments of clinical expertise that deemphasize biomedicine create new possibilities and foreclose others.