Health professionals and the contingent body: social determinants in the curriculum.
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Health professionals and the contingent body: social determinants in the curriculum Background Health professional education situates health workers within an objectivist biomedical model. Yet workers are also expected to provide patient centred care to a significant proportion of people who have worse health outcomes associated with the social determinants of health. This study asks how health professionals are educated and what are some of the consequences? Summary of work The qualitative study interviewed 17 health professionals in order to explore how they were educated and some of the consequences of that through a lens of critical pedagogy, reflexivity, poststructural feminist critiques of education and Foucault’s theories of power/knowledge. Ethics approval was gained through Murdoch University. Results Participants expressed a slippage of the objectivist self with both themselves and patients. Their language of choice, control, individuality and the struggle to link abstract theorizing of biomedicine especially in relation to the social determinants of health and their own lived experience was apparent. Strategies to implement and understand social determinants of health only seemed to reinforce the ontological divide and the need for translation. Discussions and Conclusion The split between subjectivity and objectivity amplifies the ‘Othering’ that occurs in the biomedical curriculum and practice. This leaves health professionals unprepared to work with poverty and deprivation, and apparently less able to self-regulate effectively. In spite of evidence to the contrary, and experiencing suffering themselves, health professionals were unable to re-imagine how this could be different. Take home message Health professionals’ selves and bodies are tied up with their patients in a messy temporal space that seems to co-produce the contingent body. Narratives of trauma seem to be a way of managing the ontological gap between health as a definitive state and healing as a durative process located in time and space.