#251: Advancing Epistemic Justice, Equitable Medical Realism, and Inclusive Standard-setting in Medical Simulation Training

This paper examines standardized patient (SP) simulation in medical education as a cultural pedagogical practice shaped by institutional priorities, epistemic assumptions, and educators’ interventions. Based on 28 interviews with SP educators in the United States and one co-author’s three decades of experience in SP simulation practice, this study critically analyzes how the prevailing model of “medical realism,” framed through standardization, psychometric measurement, and objectivity, constrains the development of inclusive standard-setting practices and equity-oriented approaches to SP simulation pedagogy. Grounded in cultural-historical theories of learning and science and technology studies (STS) literature, the analysis identifies and critically examines epistemic contradictions in SP educators’ work towards advancing diversity, equity, and inclusivity (DEI) in SP simulations. We show how by transforming contradictions into opportunities for inclusive standard setting practices, SP educators reimagine simulation as a site of epistemic plurality and transformative learning.