Teaching Writing in the Health Professions: Perspectives, Problems, and Practices. Michael J. Madson, Eds. New York, NY: Routledge, 2022. 222 pages, $44.95 paperback, $40.45 electronic.
Review by Yeqing Kong (she/her/hers)
Georgia Institute of Technology
Date posted: June 2023
Kong, Yeqing. (2023) “Book review: Teaching Writing in the Health Professions: Perspectives, Problems, and Practices,” Rhetoric of Health & Medicine: Vol. 6 : Iss. 3.
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Teaching Writing in the Health Professions: Perspectives, Problems, and Practices advances instructional scholarship on writing in health and medical professions. In his introductory chapter, Michael J. Madson introduces the global shortage of health professionals and the growing demand for training health professionals. However, various barriers exist in the process of teaching and learning writing in health professions such as the lack of accessible resources for health professions educators. Madson then positions writing in the health professions as an “emergent interdiscipline,” thus, it is “a growing body of knowledge and professional connections that cut across disciplines,” such as humanities, applied linguistics, technical communication, health communication, rhetoric and composition, and education (p. 4). Madson argues for a two-dimensional approach to writing instruction: an intraprofessional approach focusing on disciplinary approaches and an interprofessional approach encouraging interdisciplinary collaboration and cross-field synergies (p. 5).
The book is organized into four main parts, consisting of 14 chapters, each highlighting a health profession. The first part centers on writing in medicine and public health. In chapter one, Sarah Yonder explores the ways to teach medical students to write proper clinical notes using expectancy-value theory, which holds that two key factors influence one’s performance on a task, namely, “a person’s feeling of (1) the value they place on the task and (2) how well they can perform it” (p. 14). In her two-year clinical skills course, the curricula are designed to achieve two objectives: (1) helping students understand the value of note-writing skills in patient care and (2) boosting learners’ confidence that they have the required skills to deliver high-quality clinical notes. An external review of students’ notes written in different stages suggests the effectiveness of this instructional approach. In chapter two, Elizabeth Narváez-Cardona and Pilar Chois-Lenis apply a sociocultural approach to writing that views writing as a “literate activity.” The authors conduct content analyses of policy documents, time analyses of curricula, and participant observations of teaching and learning in two graduate programs in Latin America. Their study provides insights into curriculum development in literacy through “both enculturation and deliberate instruction” (p. 34). In chapter three, Rebecca Babcock and colleagues examine the challenges that medical writers face and strategies for supporting both native and non-native English speakers with writing in medicine. Their analysis of survey data suggests that offering classes, retreats, workshops, or boot camps, as well as editing and statistic services, would benefit medical writers’ writing process.
The second part focuses on writing in nursing. Opening this part is chapter four, where Barbara J. D’Angelo and Barry M. Maid describe the dynamics and challenges of redesigning an online writing course for the RN (i.e., Registered Nurse) to BSN (i.e., Bachelor of Science in Nursing) program. Guided by the frameworks of institutional ethnography, process pedagogy, and teaching for transfer, their revised course integrates a comprehensive peer-review process, which can not only cultivate students’ critical thinking, metacognitive, and collaborative skills but also develop students’ professional identity. Continuing the discussion of transfer of learning, Lillian Campbell, in chapter five, examines how junior-year nursing students make connections between their writing experiences across three distinct contexts: classroom, clinical simulation, and hospital placements. She argues that simulation texts—functioning as what Tachino (2012) calls an “intermediary genre” in experiential learning contexts—can help bridge students’ classroom-based and workplace writing, helping them recognize the value of classroom learning. To facilitate the “connection-making across contexts,” the author offers three practical takeaways for writing instructors, including encouraging concurrent transfer in experiential contexts, designing simulated writing assignments, and articulating shared heuristics in writing tasks (pp. 77-78).
In chapter six, Sarah Kosel Agnihotri and her colleagues consider ways to refine the partnerships between the writing center and a nursing program in a small liberal arts institution without a formal Writing Across the Curriculum (WAC) or Writing in the Discipline (WID) program. Their pilot collaboration suggests that semi-embedding writing center specialists in a graduate nursing course could improve students’ perception of the writing center as a valuable resource for writing in the health professions. Deborah E. Tyndall, in chapter seven, discusses strategies for developing doctoral nursing students’ writing competencies. She unpacks the liminal spaces entry-level Ph.D. students experienced within a “threshold concept” that students found most challenging (i.e., constructing researcher and writer identities). To help students navigate the states of liminality during a writing course, she suggests offering scaffolded assignments, metacognitive activities (e.g., reflective journals), and peer review opportunities.
The third part transitions to writing in allied health and pharmacy. In chapter eight, Elizabeth L. Angeli presents her ongoing effort in developing effective, community-engaged writing curricula for emergency medical services (EMS) providers. Adapting Johnson et al.’s (2017) “lean technical communication” framework to a “hybrid workplace-classroom space” (p. 108), she partnered with a local fire department’s training academy. Her 6-year longitudinal project suggests that writing specialists are well suited to enter such hybrid spaces in the health professions and “develop responsive and sustainable writing initiatives along the university-workplace-community continuum” (p. 117). The guiding principles and structures of curriculum development can inspire readers who are interested in building training courses in a context that combines workplace and classroom. In chapter nine, Isabell C. May and Emilie M. Ludeman develop a framework for online course development in a physician assistant program, which centers on the academic literacies model while integrating the existing literature on information literacy curricula, graduate writing instruction, and online learning. Like the writing center partnerships in chapter six, Janine Morris, Cynthia Moreau, and Kevin Dvorak in chapter ten detail a partnership between a writing center and a College of Pharmacy to improve students’ writing and communication competencies. The authors end their chapter with recommendations for enhancing partnerships between writing centers and health professions programs, such as relying on institutional expertise, establishing partnerships over time, and incorporating communication skills into the programs at multiple levels (p. 140).
The fourth part involves writing in interprofessional contexts. To include topics of diversity, culture, and inclusion in writing in the health professions, Cristina Reyes-Smith, in chapter eleven, illustrates the ways to prepare students for “culturally sensitive care” in an interprofessional elective course. She emphasizes the critical role of reflective writing in helping students progress to more complex levels of learning and preparing students for careers across diverse communities. In chapter twelve, Susan E. Thomas argues that “in-depth studies of how writing in various genres is operationalized in real-world settings have much to offer students” (p. 157). Recognizing the primary care clinic as a writing space, she conducts 31 interviews with staff from Lifehouse, a cancer treatment center in Australia, aiming to “capture staff insights into how communication is articulated and understood in actively developing an innovative comprehensive cancer care environment” (p. 158). She then implements a case study in a graduate-level Professional Writing class, inviting students to carefully consider the “importance of inclusive, purposeful, ethical writing and communication within a health-care setting,” focusing particularly on how the term “patient-centered care” is used in organizational documents (p. 162). This chapter highlights the usefulness of including case studies in writing classrooms.
Moving from traditional genres to a novel form of writing in the health professions, Kathryn West, and Brian Callender in chapter thirteen elaborate on the expansive field of graphic medicine, i.e., “a way to tell stories to ourselves and others through the medium of comics” (p. 168). With its theoretical underpinnings in narrative medicine, narrative therapy, and cognitive behavioral therapy, graphic medicine can help create space for self-reflection, recognize patients’ thoughts and feelings, and ultimately mitigate the tensions within patient-provider relationships. The authors share several workshop examples on enacting graphic medicine in the training of health professionals, such as body-mapping, life-mapping, and community-mapping. These sample activities can be modified by instructors for different scenarios. In chapter fourteen, Lucy M. Candib and her collaborators review the history of writing groups and share their experience running a Teacherless Writing Group to optimize participants’ writing experience. Informed by Peter Elbow’s (1998) Writing Without Teachers, a teacherless writing group allows each participant to take charge of their learning while sharing an ongoing commitment as healthcare professionals.
This book concludes with Michael J. Madson’s chapter, which summarizes the wide array of genres, places, theories (e.g., expectancy-value theory, threshold concept), and methods (e.g., surveys, interviews, participant observations, content analysis) covered by contributors and points out several promising future research directions in the context of the third and fourth industrial revolutions. For instance, future studies might examine the topics of visual literacy, professional identity formation in digital spaces, non-English writing practices, systemic injustices, and health disparity through diverse theoretical frameworks and expanded methodological repertoires, such as big data and user experience. Finally, Madson revisits the dual nature of writing in the health professions as an emergent interdiscipline: “It is emergent because of its rapid expansion yet peripheral status. It is an interdiscipline because of its many connections to existing bodies of literature” (p. 196). Madson thus calls for “a synergy of intraprofessional and interprofessional approaches,” as this collection has modeled, which not only attends to the “instructional needs in our own disciplines” but also collaborates “across institutional silos” and disciplinary traditions to foster “a culture of solidarity” in writing in the health professions (p. 196).
Overall, this collection brings together a diverse set of evidence-based empirical studies in medicine and public health, nursing, allied health and pharmacy, and other interprofessional contexts. These studies address multiple topics in academic, clinical, and community settings, ranging from curriculum (re)design to online instruction, writing center partnerships, knowledge transfer, literacy studies, and workplace writing. The pedagogical practices and practical takeaways can serve as an essential guide for writing instructors, researchers, and program administrators in health-related disciplines, technical and professional communication, and writing studies. The book, however, primarily focuses on the instructional needs and strategies in the U.S. context with only one of the chapters (i.e., chapter eleven) touching on the topics of global connectivity and cultural diversity. Future research could benefit from covering more non-Western perspectives, problems, and practices in writing in the health professions.
Elbow, Peter. (1998). Writing without teachers. New York: Oxford University Press.
Johnson, Meredith A., Simmons, W. Michelle, & Sullivan, Patricia. (2017). Lean technical communication: Toward sustainable program innovation. Routledge.
Tachino, Tosh. (2012). Theorizing uptake and knowledge mobilization: A case for intermediary genre. Written Communication, 29(4), 455-476.
Notes on Contributor:
Yeqing Kong (she/her/hers) is an Assistant Professor of Technical Communication in the School of Literature, Media, and Communication at Georgia Institute of Technology. Her research and teaching interests include transnational risk and crisis communication, science and health communication, cross-cultural communication, digital and visual rhetorics, and social justice.