ABSTRACT
This chapter focuses on how patients are recruited for participation in clinical teaching. Stories by students and a clinical teacher reveal how common practices shape students’ identity construction in relation to patients and doctors. The obligation to obtain valid consent is emphasised in Daniel’s tutorial about intimate examinations, but in practice this is often disregarded. Thao’s story about an outpatient clinic experience tells of being asked to perform a breast examination without the patient’s consent. In Grace and Natalie’s stories about performing procedures and attending ward rounds, doctors often circumvent valid consent procedures to increase students’ access to patients. When students talk about these customary practices, patients can be identified as adversaries and doctors as their allies – and sometimes the reverse. This reveals that identity work is a struggle involving acts of negotiation, accommodation and resistance. A perceived conflict between the interests of students and patients is often used to defend practices that are less than transparent. This indicates that unspoken fears and desires are potential motivating forces for troubling consent procedures. Theories of group identification from the field of social psychology are discussed, which offer useful ways of understanding and addressing some of these concerns.
