University: Harold Washington College
Description of Work:
Recently, I completed a draft of a proposed chapter for an edited collection. It is based on my research experiences in neonatal intensive care units (NICUs) in hospitals in Copenhagen, Denmark and in Texas. In discussing the process and obstacles of accessing the research sites and collecting data, I argue for the importance of exceeding Institutional Review Board ethical behavior standards of conduct by being attentive to a participants’ microwithdrawals of consent.
By infusing rhetorical listening into a code of ethical research conduct, I suggest the rhetorical researcher can a) recognize how participants withdraw and engage at different parts of the research process, b) understand informed consent is a constantly negotiated and ongoing process, and c) listen for small withdrawals of consent during data collection. Ratcliffe’s rhetorical listening can be part of a rhetorical methodology for respecting persons, providing ongoing opportunities for participant consent, and accessing data ethically in sensitive research spaces.
Another article is based on my research in the Texas NICU, and it’s a feminist and medical rhetoric piece: “.” In the article, I highlight potential systemic and non-verbal factors inherent in the NICU’s environment: the aural rhetoric. The aural rhetoric is comprised of sound. Sound interrupts and impedes the communication and care of NICU infants. I critique paternalistic biomedicine’s aural rhetoric as a hindrance to these babies’ growing and healing. The nurses’ care of those babies and communication about that care is consistently and constantly interrupted by the sounds in the NICU—a perpetual reminder of the dominance of paternalistic biomedicine. The work of paternalism in biomedicine manifests as noises that produce a soundscape that reinforces biomedical dominance in a matriarchal space. http://medicalrhetoric.com/symposium2015/participant-profiles/kristin-bivens/
Ethical Expectations: Rhetorical Listening as a Code of Cross Cultural and Ethical Research Practice Conduct, (or Learning to Bridge with Enhanced Ethical Research Practices)
My Proposal specifically responds to two questions: How can we (re)cast our methods to increase acceptance form and enhance interest in partnering with individuals in the healthcare professions? And, how can and do cultural factors affect communication practices related to health and medicine?
Condit (2013) has called on healthcare and medical communication researchers to conduct more international research in order to reach multiple audiences for our scholarship. As yet, there has been little attention regarding the logistics of accessing and doing such research. In this proposal, I offer a methodological reflection of my experiences researching in a neonatal intensive care unit (NICU) in a hospital in Copenhagen, Denmark, including the process and obstacles of accessing the research site, as well as arguing for the importance of applied research in healthcare and medical communication studies.
Specifically, I argue rhetorical listening is a code of ethical research practice that can help contribute to the discourses of health and medicine methodologically and across disciplines: it is an applied practice, which may provide a disciplinary bridge to engage acceptance and enhance interest with others in health care practices.
I will provide a methodological reflection, rooted in Ratcliffe’s (2006) rhetorical listening—a code of cross-cultural conduct. I will discuss the process and obstacles of accessing the research site, as well as arguing for the importance of exceeding Institutional Review Board ethical behavior standards of conduct by being attentive to a participant’s microwithdrawal of consent—an insight and practice I realized upon reflecting upon a frustrating and discouraging day of data collection in the NICU in Copenhagen.
After initially establishing a contact and cultivating a relationship with a nurse at Copenhagen University’s Rigshospitalet, over the course of less than a year, I was able to acquire human research protection approvals from the unit, the hospital, and the Danish Data Protection Agency (DPA), as well as my institution’s IRB to conduct field research in the NICU in Copenhagen in February and March 2014. Interestingly, in Denmark, the human research protections are nationalized and centralized through the Danish federal government, not institution by institution like in the U.S.
During this process, healthcare and medical communication literature were little help, as the logistics of doing research like mine, including surmounting obstacles, was not adequately addressed. I encountered several obstacles, including geographical and cultural problems, like Denmark’s location in northern Europe, and acquiring access to a foreign hospital. Interestingly, obtaining access to a NICU research site, though, was easier in Denmark than in the U.S., which afforded me an opportunity to note the methodological advantages of listening rhetorically in another culture.
Expanding our research sites across national borders is necessary for healthcare and medical communication to continue to thrive as a burgeoning field and to understand the growth and directions within our field; it is essential in order to continue learn about health care and medical communication and position our research to be useful and relevant outside of our disciplinary boundaries. And with more attention to the logistics of conducting such research, it may be easier than we think to do so.
Another challenge healthcare and medical communication researchers face is making our research available for the multiple audiences that may benefit from it. There is an exigency for applied research (e.g., Brasseur 2012) in healthcare and medical communication studies. Scott, Segal, and Keränen (2013) reminded us of the modest ameliorative goals of our scholarship. In concerted effort with allied public healthcare fields, our scholarship’s applications may contribute to increasing the effectiveness in health care and medical communication ethical research practices. While not absent, applied research is underrepresented in the discourses of health and medicine studies, and it can be valuable and relevant outside our discipline, reaching multidisciplinary audiences with our enhanced ethical research practices—a strategy to further bridge across disciplinary boundaries.
By rhetorically listening, a code of ethical conduct in research practice, the rhetorical researcher: recognizes participants withdraw and engage at different parts of the research process; knows informed consent is a constantly negotiated and ongoing process; and listens for small withdrawals of consent during data collection. I argue Ratcliffe’s rhetorical listening is a rhetorical method medical rhetoricians can use as a framework to respect persons, provide ongoing opportunities to consent to the research they participate, and diligently maintaining the principles of the Belmont Report (1979), which may provide an attractive ethical framework from healthcare professionals here and abroad.