ABSTRACT

This final chapter revisits the aims of the book and brings together insights from the analysis of the stories in the previous chapters. Medical students, patients and clinical teachers all construct identities through storytelling in relation to each other, both during their encounters and when they talk about them. The study of relational identity construction in patients’ stories highlights their diverse experiences of participation in students’ learning. Some patients describe being treated like a non-human object during teaching or being actively engaged in the process, while others show empathy for students, or judge their moral character. Related ethical issues are discussed, including the neglect of valid consent processes in some contexts and the types of encounter which place patients at particular risk of dehumanisation are considered. The author makes the case for a dialogic medical education, discusses what it might look like and considers opportunities for transformation, focusing on three domains: the clinical encounter itself, for example at the bedside or in the clinic; the design and delivery of medical curricula; and the broader institutional and professional contexts in which clinical education takes place.