Simulating Nursing: Rhetoric, Materiality, and Disciplinary Learning

Thesis (Ph.D.)--University of Washington, 2016-06

This dissertation explores live-action clinical nursing simulations as dynamic sites of discursive, embodied, and ethical rhetorical learning. Clinical simulations offer students hands-on practice with robotic patients in structured scenarios. Thus, in line with recent research on material rhetorics, simulations demonstrate how learning to communicate within new disciplines and professions is a material and embodied process, supported by interactions with people, objects, and environments. In order to effectively act within the medical community, students must make physical transformations (gesture, stance, gaze); discursive transformations (tone, voice, vocabulary); and interactive transformations (attitudes towards and capacities for engaging with other people and things). To demonstrate the rhetorical complexity of learning to be a nurse, then, this dissertation draws on a year of qualitative research on junior year nursing students in clinical simulations – including fieldwork observations, student interviews, and video recordings of their three simulations. I consider how students interact with the physician and the patient, negotiate their priorities for care in response to the robotic simulator and classroom space, and repurpose classroom and professional genres to meet their needs. Overall, I argue that clinical simulations create a unique context in which students practice professional care in rhetorically situated and responsive ways while also critically reflecting on these performances and possibilities for revision and change. I also discuss this research’s implications for creating writing classrooms that operate as unique rhetorical contexts and teach disciplinary and professional writing with greater attention to materiality and embodiment.