James Dalton – Conversing through the mechanism – improvisation and play between medical students and patients


James Dalton

University of Sydney, Australia 

Conversing through the mechanism – improvisation and play between medical students and patients 

Medical schools train their students in three areas: medical knowledge, clinical skills, and a third craft called ‘professionalism’. Of the three, ‘professionalism’ has been the most open to flux; once considered a normative set of practices for all doctors, more contemporary medical educators call for students to develop their own individualised ‘doctor identity’. This flux is linked to the medical profession’s relationship with society — the former has the privilege of self-regulating because medicine agrees to a social contract, one that can change as society’s priorities for ‘health’ changes over the decades. With these shifts comes pressure for culture change in medicine and healthcare, along with economic and political imperatives that can be more harmful than curative. My interest as a theatre maker and researcher is to grasp how professionalism is constitutive of a particular kind of cultural performance, and of what role such performances play in calls for culture change in healthcare.

This paper presents a vignette of medical student and patient working together in conversation to develop a ‘case history’, which is a fundamental part of medical training. My observation is that when talking with patients away from supervisors, they sometimes co-create a more playful relationship. I am interested in how this playful relationship is an example of Tim Fitzpatrick’s ‘flexible performance’ for the purposes of students developing their own ‘doctor identity’, as well as how this may relate to Sherry Ortner’s concept of ‘serious games’ in terms of potential culture change through performance.

James Dalton is a theatre-maker and PhD candidate in the Department of Theatre and Performance Studies at the University of Sydney, Australia. His research focus is on medical students and the multiple performance modes that afford their developing medical subjectivity. James’s artistic focus is on developing new writing, staging immersive participatory projects, and multidisciplinary collaborative CACD projects. His collaborations have included works at the Prague Quadrennial, in Novi Sad, and in theatres and found spaces around Australia. These projects reflect his interests in anxiety, community-building, historiography and apocalypse. James is a graduate of the National Institute of Dramatic Art, Australia.