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kent1334240629.pdf (2.04 MB)
ETD Abstract Container
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An Examination of the Literate Practices of Resident Physicians and Attending Physician Preceptors in a Resident-Run Internal Medicine Clinic
Author Info
Awad Scrocco, Diana Lin
Permalink:
http://rave.ohiolink.edu/etdc/view?acc_num=kent1334240629
Abstract Details
Year and Degree
2012, PHD, Kent State University, College of Arts and Sciences / Department of English.
Abstract
This dissertation considers resident physicians’ conversations with faculty physician preceptors and residents’ think-aloud reflections while composing chart notes to examine novice physicians’ literate practices. Using a composite of quantitative and qualitative methodologies, three studies contribute to a sociocognitive theory of resident physicians’ literate practices in a resident-run internal medicine clinic by exploring novices’ collaborative and independent literate activities. Assuming that writing and reading always involve social interaction, the analysis examines the “literate orientations” (Brandt, 1989) associated with these novices’ professional enculturation. More specifically, the first study uses institutional conversation analysis (Heritage, 2004) to examine the patterns in resident-preceptor interaction at different levels of residency training and to identify the institutional objectives in conversations about residents’ chart notes. This dissertation’s second study employs Aristotelian rhetoric to explore the argumentative structure, or topoi, used in resident-preceptor conversations to rehearse and model clinical logos and ethos. To explore the cognitive dimension of residents’ literate practices, the third study considers the rhetorical strategies residents use in their think-aloud protocol reflections while they compose chart notes in patients’ medical records. These three studies of residents’ conversations and independent reflections suggest that, from the first to the final year of residency novice physicians shift from relying on forensic rhetoric to using deliberative rhetoric; during this shift, they move from presenting concrete clinical knowledge and modeling preceptors’ suggestions to assuming clinical endoxa, or commonly accepted wisdom, while they independently contemplate nuanced concepts as more-seasoned professionals. Broadly, this dissertation’s explicit use of a rhetorical lens responds to calls by Atkinson (1995), Segal (2005), and others to employ rhetorical frameworks in studies physician-physician communication, a rarely studied area of clinical discourse. Because of the focus on literate practices, these studies also contribute to discussions of professional writing and reading and demonstrate the role of rhetoric in workplace reading, writing, and learning. Along with contributing to discussions of medical communication and professional literate practice, this dissertation offers a sociocognitive model that may facilitate teaching writing in the disciplines and medical education.
Committee
Sara Newman, Ph.D. (Committee Chair)
Raymond Craig, Ph.D. (Committee Member)
Pamela Takayoshi, Ph.D. (Committee Member)
Timothy Gallagher, Ph.D. (Committee Member)
Mary Anthony, Ph.D. (Committee Member)
Pages
293 p.
Subject Headings
Language
;
Linguistics
;
Literacy
Keywords
medical rhetoric
;
medical education
;
institutional conversation analysis
;
literate practice
;
professional communication
;
classical rhetoric
Recommended Citations
Refworks
EndNote
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Citations
Awad Scrocco, D. L. (2012).
An Examination of the Literate Practices of Resident Physicians and Attending Physician Preceptors in a Resident-Run Internal Medicine Clinic
[Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1334240629
APA Style (7th edition)
Awad Scrocco, Diana.
An Examination of the Literate Practices of Resident Physicians and Attending Physician Preceptors in a Resident-Run Internal Medicine Clinic.
2012. Kent State University, Doctoral dissertation.
OhioLINK Electronic Theses and Dissertations Center
, http://rave.ohiolink.edu/etdc/view?acc_num=kent1334240629.
MLA Style (8th edition)
Awad Scrocco, Diana. "An Examination of the Literate Practices of Resident Physicians and Attending Physician Preceptors in a Resident-Run Internal Medicine Clinic." Doctoral dissertation, Kent State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=kent1334240629
Chicago Manual of Style (17th edition)
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Document number:
kent1334240629
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Copyright Info
© 2012, all rights reserved.
This open access ETD is published by Kent State University and OhioLINK.