CONCLUSION
New technologies can change the nature of practice, perception, and experi-
ence, but their e√ects depend on how they become incorporated into a
social milieu. Since the turn of the twentieth century, physicians have re-
ceived training by doing clinical work in teaching hospitals, acquiring skills
and values from those with more training and experience, gradually em-
bodying the perception, a√ect, ethics, and judgments of physicians. Admin-
istrators, insurers, and practitioners have argued for decades that this sys-
tem of situated medical learning is ine≈cient, requiring time, labor, and
resources that harried hospital sta√ increasingly lack. Further, they argue,
trainee development can be highly contingent upon the skill and interest of
individual physicians or clinical groups.
In response, curriculum reformers and technology developers want to
retool clinical apprenticeships by making training more systematic and
more standard in the hope that all practitioners will receive the education
they need to provide adequate care. They are working to build new training
systems around simulators that can act as ‘‘patients on demand,’’ artificial
bodies that trainees can practice upon whenever they want and as often as
they need to hone their skills. Simulators thus promise to become essential
components in teaching programs that require trainees to develop compe-
tence with specific tasks, filling in gaps left in clinical education. Yet the
concept of the patient-on-demand and the new training regimes proposed
for it often neglect ways in which medical embodiment forms part of a
larger acculturation that takes place within a highly structured milieu and
entails lessons that go far beyond the technical skills a simulator can teach.
Surgical trainees have long honed basic skills, such as knot-tying, by
practicing on objects such as bedposts and drawer handles. But the embod-
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