Work to make simulation work: ‘Realism’, instructional correction and the body in training

This article explores the organization of instructional corrections in pre-clinical dental education. The students are practising manual skills using a simulator and tutors are inspecting and evaluating their progress. Simulators and simulation are critical to the organization of contemporary healthcare training, and the academic literature that explores forms of simulation in healthcare tends to consider the ‘fidelity’ (or ‘realism’) of systems and the extent to which they match the clinical situations that they are designed to mimic. In contrast, this article considers how tutors and students explicitly attend to matters of realism in the course of instructional sequences. We highlight the ways in which tutors routinely invoke ‘real life’ in instructional corrections and we discuss how these sequences reveal the work that tutors undertake to compensate for the ‘chronic insufficiency’ of the simulator. We show how tutors emphasize the reasoned character of manual bodily skills, reasons linked to the complexities and contingencies of clinical practice. To explore these issues and concerns, the article draws on the analysis of audio-visual data of everyday instruction.