Source: University of Waterloo http://newsrelease.uwaterloo.ca/news.php?id=4789 Prof studies language usage by health-care professionalsOctober 16, 2006 WATERLOO, Ont. (Monday, Oct. 16, 2006) -- A University of Waterloo expert in rhetoric heads a study into links between language and how health-care professionals conduct themselves in their dealings with patients and other professionals. Catherine Schryer, a professor of English language and literature, is researching the impacts of health-care communications, asking if something vital gets lost when a doctor explains an illness to a patient. Schryer said the research project, Crossing Borders: Sites of Discursive Negotiation in Healthcare Practice, consists of three case studies, each investigating the role that a genre or a distinctive pattern plays in facilitating or not communication between different health-care professionals. As a rhetorician (a specialist in the study into how we use language), Schryer does not confine her academic activities to the works of the great poets, dramatists and novelists. Rather, she has extended the field of English studies to include among other things, research into how language is applied. Schryer, who is also director of UW's teaching resources office, is the principal investigator of the project, sponsored by the Social Sciences and Humanities Research Council of Canada. Project co-investigators are Dr. Lorelei Lingard, of the University of Toronto's faculty of medicine, and Dr. Marlee Spafford, of UW's school of optometry. The project's first case study explores the production and reception of referral letters between optometrists and ophthalmologists. The second one investigates the production of reports by pediatricians in a child abuse prevention clinic and the reception of those reports by social workers, police, lawyers and judges. The third studies the role that electronic medical records play in team communication situations in a cancer care clinic. "Our program of study aims to connect research in health professions education to recent research in the role of language practices in the professional workplace," Schryer said. "What we are finding is that when the members of these professions transfer information from their patients or clients to other professionals, they rearrange it." She said that doctors, for instance, ask patients to describe their problems and then restate that information in professional terms as they pass it on to consulting specialists, such as internists, oncologists and cardiac specialists. Medical practitioners have special ways of relaying information about their observations, results of lab tests and diagnoses, to other practitioners, along with outlining the plans they have formulated for patients, including drug prescriptions, fitness programs, dietary changes and surgical procedures. For example, a patient tells the doctor about an illness. The doctor immediately translates what the patient says into language that would be more meaningful to a medical professional, including a specialist to whom the patient may subsequently be referred. Such case reports differ considerably from the way in which a patient first gives information to his or her doctor. "They almost never present cases in the order in which the patients have reported on their health or injury problems," Schryer said, adding that medical professionals only deal with details that have clear relevance to the case. "The entire process has become something of a genre -- a distinctive pattern," she said. "The advantage of the translation done by the doctor is that it enables him or her to transmit information rapidly and accurately to other doctors." But something always gets lost in the translation, including sometimes the ability to explain to the patient in their own terms the nature of their illness or injury. Schryer wonders about some of the consequences such as: Is something lost, at times, when the patient's story is reconstructed? Or, might there be problems later on because the patient fails to understand what the doctor is telling him or her to do? When her research team looked at the way language is used in doctors' case reports, they noticed language that seemed to turn the patient into a kind of object. "Doctors do need to keep some distance between themselves and their patients," Schryer said. "However, the case presentation system may tend to objectify patients. The medical professional may refer to patients not as the 'people in such-and-such ward' but as the 'cystic fibroses in such-and-such ward' or refer to child patients' mothers collectively as 'the moms'." Schryer sees her role as that of a rhetorician who can step back and ask questions, including What is language all about? How do we use it now? And how can we make better use of it in the future? She adds that this could lead to more effective ways of using language and to a better appreciation of the significance of language in all aspects of our lives.
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