Standardized Patients (SPs) are lay persons who are employed extensively within health professional education to help teach and assess a range of clinical skills. Individuals trained to take on the physical, historical and emotional aspects of patient stories are integral to the dissemination of collective attitudes, values, and beliefs about what it means to be a competent health professional. As an embodied affective presence literally in front of and often in physical contact with health professionals SPs are a fertile site of knowledge production as well as transformative learning. Their unique contribution is a corollary of both their location as non-clinicians and their pedagogical facility with embodied emotions and affect. SPs in medical education teach about emotion and affect, engage affectively in the presentation of clinical material and as a professionalizing group have developed an educational methodology for facilitating understanding and experience of emotion and affect. In this thesis I examine the field of human simulation and the work of standardized patients (SPs) through critical theoretical perspectives seeking to broaden our understanding of their contributions as a present and future force in health professional education, specifically medical education. Central to my examination is the constitutive role of emotion and affect as they are conceived both within medical education and engaged by standardized patients as media through which different knowledges are produced. My analysis is shaped by poststructuralist feminist writers on emotion, Michel Foucault’s genealogical historical approach, and principally Gilles Deleuze and Felix Guattari’s alternative nomadology as theorized in a thousand plateaus (1987). I intend an alternative reading of the advent of SPs in medical education through a process of mapping rhizomatic networks that include acting, emotion, affect, medicine, and the place of women patients and standardized patients in medical arenas. I have located the current study within an ongoing project of embodied ethical practice and nomadic subjectivity within education specific to human simulation and standardized patients.

Standardized Patients (SPs) are lay persons who are employed extensively within health professional education to help teach and assess a range of clinical skills. Individuals trained to take on the physical, historical and emotional aspects of patient stories are integral to the dissemination of collective attitudes, values, and beliefs about what it means to be a competent health professional. As an embodied affective presence literally in front of and often in physical contact with health professionals SPs are a fertile site of knowledge production as well as transformative learning. Their unique contribution is a corollary of both their location as non-clinicians and their pedagogical facility with embodied emotions and affect. SPs in medical education teach about emotion and affect, engage affectively in the presentation of clinical material and as a professionalizing group have developed an educational methodology for facilitating understanding and experience of emotion and affect. In this thesis I examine the field of human simulation and the work of standardized patients (SPs) through critical theoretical perspectives seeking to broaden our understanding of their contributions as a present and future force in health professional education, specifically medical education. Central to my examination is the constitutive role of emotion and affect as they are conceived both within medical education and engaged by standardized patients as media through which different knowledges are produced. My analysis is shaped by poststructuralist feminist writers on emotion, Michel Foucault’s genealogical historical approach, and principally Gilles Deleuze and Felix Guattari’s alternative nomadology as theorized in a thousand plateaus (1987). I intend an alternative reading of the advent of SPs in medical education through a process of mapping rhizomatic networks that include acting, emotion, affect, medicine, and the place of women patients and standardized patients in medical arenas. I have located the current study within an ongoing project of embodied ethical practice and nomadic subjectivity within education specific to human simulation and standardized patients.

Hidden curriculum scholars have long since recognized the function of the visual in shaping the educational experiences of youth. Scholars have noted that the hidden curriculum of schooling has functioned as a primary socialization mechanism to reproduce capitalism, the state, gender, racial, and class-based inequalities. Today, urban high school spaces present both invisible and visible curricula that are shaped not only by the many images that comprise a school's visual culture, but also by the wider visual landscape. This is of particular import for working-class young Black women who are often framed and seen as social and economic problems within the discourse on urban schools/urban school failure. This discourse teaches. It is taught in and through the everyday visual texts, spaces, and places young Black women navigate to the point that the discourse linking Black femaleness, poverty, and failure becomes natural/normal. It is normalized to the point that it becomes "hidden in plain sight." The simultaneous transparency and invisibility of knowledge presents urban educators concerned about the Black girl and other youth of color with three intersecting problems. First, the educative role of the visual has been underexplored in the research literature on urban schools/urban schooling. Second, within the context of urban schools, we do not know enough about if and or how the educative role of the visual shapes young Black women's relationship with teaching and learning. Third, we do not know if or how the contentious relationship between visual learning inside and visual learning outside of school shapes young Black women's relationship with education as a formal institution and or a process. Given these three intersecting problems, this dissertation project centers on examining the educative impacts of place, visual culture, and design in an effort to fill the gap in the scholarship regarding this portion of the educational experiences of young Black women. Using visual ethnography and discourse analysis as primary methods, I engage a group of five primary student participants who attend a non-traditional, design-focused science and technology magnet school where they are one of the largest student cohorts. Einstein 2.0 is an instance of a progressive, non-normative, small learning community that is attentive to the power of the visual in shaping the teaching and learning experiences, especially for youth of color. In this way, it is a case that can help us better understand the challenges, opportunities, and complexities of harnessing the visual in the urban school context. In this study I argue that by creating a safe and emotionally engaging environment that rejects using punitive disciplinary frameworks and pseudo-factory/pseudo-prison design, Einstein's visual and school culture gave rise to an increased sense of emotional readiness for both producing and receiving knowledge that stands in sharp contrast to the more traditional ways urban schools often approach managing and controlling its student(s') body(ies). Given the increased role of the visual in shaping teaching and learning for youth in the 21st century urban context and the persistent link between young Black women and urban educational/societal failure, having the emotional readiness to deal with these challenges is crucial to their self-definitions (Collins, 2000) and internal motivation to reject and or exceed societal expectations. Using Einstein's approach to visual and organizational culture as a model, I make specific recommendations for educators tasked with or concerned about creating engaging school spaces for young Black women and other youth of color. These recommendations demand further attention to the ways that the visual, spatial, and emotional interact to contour the educational experiences and consumption practices of youth in urban America today. / Urban Education