Surgeon Education, Engaging with the Immanence of Events of Practice: an exploration of the ontological and ethical dimensions of surgical training and practice

Mahendran, Arunthathi Oormila. 2017. Surgeon Education, Engaging with the Immanence of Events of Practice: an exploration of the ontological and ethical dimensions of surgical training and practice. Doctoral thesis, Goldsmiths, University of London [Thesis]

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Abstract or Description

This thesis contrasts the construction of medical knowledge that surgeons must acquire to practice with the kind of knowing that arises unpredictably, through actual events of surgical practice. Such knowing is demonstrated through the research process in which surgeons discuss events of practice and their strategies for coping. As such, the thesis argues that this kind of knowing is central to the onto- epistemological task of becoming a surgeon and is therefore, a crucial pedagogic dimension of such becoming.

In actual situations of practice, surgeons may be forced to respond, act and think in ways that exceed the approved teachings of surgical knowledge and technical skills. This is not to diminish or disregard the structured programmes of education and training. Instead, I advocate reconfiguring the dominant models of surgical teaching and learning to include pedagogies that are sensitive to the immanent nature of clinical relations and practice. Whilst established clinical knowledge may be said to be abstracted from actual occasions of practice, knowing that emerges through the contingencies of such occasions is grounded in the ‘thisness’ of practice. In this practical immediacy, affective experiencing is a critical precursor to clinical strategies.

The thesis draws upon theories of affect and becoming from Alfred North Whitehead, Gilles Deleuze, Brian Massumi and Gilbert Simondon. In analysing the policy documentation and training materials, the thesis draws from the theories of Michel Foucault, Judith Butler and Pierre Bourdieu. This investigation identified affective relations that form and develop within the local flows of experiencing of an event of practice. These forms of ‘thinking-feeling’ contribute to the entangled subjectivities and heterogenous obligations that can expand surgeons’ capacities of becoming. A pedagogy of the surgical event attempts to engage with a learner’s ideas and intensities of experience, triggered by the affective connections that arise when coping with the thisness of contingent events of practice. These immanent relations express how an event of practice comes to matter to a surgeon, how it attains significance.

Item Type:

Thesis (Doctoral)

Identification Number (DOI):


pedagogy, surgical events, affect, immanence, transcendence, events of practice, surgeon education, surgical education, training, clinical practice, professional education, ethics, individuation, hylomorphism, Alfred North Whitehead, Gilles Deleuze, Brian Massumi, Gilbert Simondon

Departments, Centres and Research Units:

Educational Studies


31 March 2017

Item ID:


Date Deposited:

04 Apr 2017 13:55

Last Modified:

12 Sep 2022 11:12


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