The Rhetoric of Health and Medicine as a “Teaching Subject”: Lessons from the Medical Humanities and Simulation Pedagogy

The rhetoric of health and medicine has only begun to intervene in health pedagogy. In contrast, the medical humanities has spearheaded curriculum to address dehumanizing trends in medicine. This article argues that rhetorical scholars can align with medical humanities’ initiatives and uniquely contribute to health curriculum. Drawing on the author’s research on clinical simulation, the article discusses rhetorical methodologies, genre theory, and critical lenses as areas for pedagogical collaboration between rhetoricians and health practitioners

“MacGyver-Meets-Dr. Ruth”: Science Journalism and the Material Positioning of Dr. Carla Pugh

This article examines the rhetorical consequences of foregrounding female scientists\u27 materials through an analysis of seven news articles on Dr. Carla Pugh, a surgeon who designs medical patient simulators. Journalists foreground Pugh\u27s materials by positioning her as both “MacGyver,” creatively assembling simulators from everyday objects, and “Dr. Ruth,” willingly discussing intimate parts. These positions avoid focusing on Pugh\u27s personal life or body but still ultimately gender her and her work. The MacGyver position associates Pugh with gendered activities, objects, and spaces while undermining her affiliation with the technical aspects of design. Meanwhile, the Dr. Ruth position implies Pugh\u27s knowledge comes from inherent bodily expertise, making certain scientific fields appear more natural for women

Textual Mediation in Simulated Nursing Handoffs: Examining How Student Writing Coordinates Action

In clinical nursing simulations, a group of students provide care for a robotic patient during a structured scenario. As care is transferred from one group to another, they participate in a patient handoff, with outgoing students passing key information onto incoming students. In healthcare, the nursing handoff is a critical and perilous communication moment that is mediated by a range of participants and texts. Drawing on observations and video recordings of 52 simulation handoffs in the United States, this article examines how two student-designed texts – a collaborative patient chart and individual notes – are leveraged during the handoff. I also consider how handoff talk and writing changes as student nursing knowledge increases over the course of a year. By focusing on textual mediation of the simulated nursing handoff, this article contributes to existing research on professional writing pedagogy and to nursing scholarship on the handoff. Ultimately, it argues that a textual mediation framework can help bridge class room and professional contexts by evaluating student writing not for how successfully it meets a set of imposed criteria but for how effectively it supports classroom activities

Simulation Genres and Student Uptake: The Patient Health Record in Clinical Nursing Simulations

Drawing on fieldwork, this article examines nursing students’ design and use of a patient health record during clinical simulations, where small teams of students provide nursing care for a robotic patient. The student-designed patient health record provides a compelling example of how simulation genres can both authentically coordinate action within a classroom simulation and support professional genre uptake. First, the range of rhetorical choices available to students in designing their simulation health records are discussed. Then, the article draws on an extended example of how student uptake of the patient health record within a clinical simulation emphasized its intertextual relationship to other genres, its role mediating social interactions with the patient and other providers, and its coordination of embodied actions. Connections to students’ experiences with professional genres are addressed throughout. The article concludes by considering initial implications of this research for disciplinary and professional writing courses

Intuition in Healthcare Communication Practices: Initial Findings from a Qualitative Inquiry

This brief paper reports on how healthcare providers negotiate stages of care and communication by using intuition. This focus shifts attention away from the product-patient records-and towards the process of medical communication. To support this claim, the paper presents preliminary findings from qualitative analysis of two individual ethnographic research projects with live-action clinical nursing simulations and emergency medical services. Using a grounded theory analysis that identified intuitive moments in the writing practices of healthcare providers, this brief paper demonstrates how intuition manifests in all five stages of care-anticipate, assess, plan, act and reassess, and document-and grounds medical assessment and decision making. Analysis suggests three takeaways for healthcare communicators and educators: 1. intuitive work supports patient specific and responsive care; 2. coding and highlighting mediate patient sense; and 3. recognizing and valuing patient sense is a learned skill. The paper concludes with suggestions for reflective activities that could support incorporating intuition into healthcare communication pedagogy

Student-designed Texts and Classroom Mediation: A UX Analysis of Clinical Nursing Simulations

This experience report draws on a unique pedagogical contextclinical nursing simulations-to examine how student texts can mediate a classroom exchange. Focusing on 52 student handoffs, I analyze frequency of text use, correlation between text use and student talk, and the impact of a text’s content on its mediating role. This methodology centers student texts and in the process, reimagines possibilities for UX pedagogy and assessment

Co-Constructing Writing Knowledge: Students’ Collaborative Talk Across Contexts

Although compositionists recognize that student talk plays an important role in learning to write, there is limited understanding of how students use conversational moves to collaboratively build knowledge about writing across contexts. This article reports on a study of focus group conversations involving first-year students in a cohort program. Our analysis identified two patterns of group conversation among students: “co-telling” and “co-constructing,” with the latter leading to more complex writing knowledge. We also used Beaufort’s domains of writing knowledge to examine how co-constructing conversations supported students in abstracting knowledge beyond a single classroom context and in negotiating local constraints. Our findings suggest that co-constructing is a valuable process that invites students to do the necessary work of remaking their knowledge for local use. Ultimately, our analysis of the role of student conversation in the construction of writing knowledge contributes to our understanding of the myriad activities that surround transfer of learning

Autobiographically Significant Concepts: More Episodic than Semantic in Nature? An Electrophysiological Investigation of Overlapping Types of Memory

A common assertion is that semantic memory emerges from episodic memory, shedding the distinctive contexts associated with episodes over time and/or repeated instances. Some semantic concepts, however, may retain their episodic origins or acquire episodic information during life experiences. The current study examined this hypothesis by investigating the ERP correlates of autobiographically significant (AS) concepts, that is, semantic concepts that are associated with vivid episodic memories. We inferred the contribution of semantic and episodic memory to AS concepts using the amplitudes of the N400 and late positive component, respectively. We compared famous names that easily brought to mind episodic memories (high AS names) against equally famous names that did not bring such recollections to mind (low AS names) on a semantic task (fame judgment) and an episodic task (recognition memory). Compared with low AS names, high AS names were associated with increased amplitude of the late positive component in both tasks. Moreover, in the recognition task, this effect of AS was highly correlated with recognition confidence. In contrast, the N400 component did not differentiate the high versus low AS names but, instead, was related to the amount of general knowledge participants had regarding each name. These results suggest that semantic concepts high in AS, such as famous names, have an episodic component and are associated with similar brain processes to those that are engaged by episodic memory. Studying AS concepts may provide unique insights into how episodic and semantic memory interact

Correlation of mRNA and protein levels: Cell type-specific gene expression of cluster designation antigens in the prostate

Background: Expression levels of mRNA and protein by cell types exhibit a range of correlations for different genes. In this study, we compared levels of mRNA abundance for several cluster designation (CD) genes determined by gene arrays using magnetic sorted and laser-capture microdissected human prostate cells with levels of expression of the respective CD proteins determined by immunohistochemical staining in the major cell types of the prostate - basal epithelial, luminal epithelial, stromal fibromuscular, and endothelial - and for prostate precursor/stem cells and prostate carcinoma cells. Immunohistochemical stains of prostate tissues from more than 50 patients were scored for informative CD antigen expression and compared with cell-type specific transcriptomes. Results: Concordance between gene and protein expression findings based on 'present' vs. 'absent' calls ranged from 46 to 68%. Correlation of expression levels was poor to moderate (Pearson correlations ranged from 0 to 0.63). Divergence between the two data types was most frequently seen for genes whose array signals exceeded background (> 50) but lacked immunoreactivity by immunostaining. This could be due to multiple factors, e.g. low levels of protein expression, technological sensitivities, sample processing, probe set definition or anatomical origin of tissue and actual biological differences between transcript and protein abundance. Conclusion: Agreement between these two very different methodologies has great implications for their respective use in both molecular studies and clinical trials employing molecular biomarkers.This work was supported by grant DK63630 and DK069690 from NIDDK. Additional funding came from grants CA85859, CA98699 and CA111244 from NCI, and PM50 GMO76547/Center for Systems Biology