Biomedical

Localizing Medical Information for U.S. Spanish-Speakers

Examines focus group data about Spanish speakers' preferences for health communication. Contrasts known preferences of Mexican Spanish speakers with Spanish speakers in the U.S. Makes recommendations from the data for communicating health information to Spanish speakers within the U.S.

Centralized Translation Processes: Overcoming Global Regulatory and Multilingual Content Challenges

Accurate translations of clinical trial documents play an important role in meeting global product demands. Mistakes from poorly done translations can result in product delays, cost overruns, malpractice or product liability lawsuits, and confused subjects / patients.

Health at High Speed: Broadband Internet Access, Health Communication, and the Digital Divide

The study reported here explored the broadband digital divide in the context of Internet- based health communication. Inequities in the adoption of broadband technology were examined and the comprehensive model of health information seeking (CMIS) was used to make predictions about the implications of broadband Internet for personal health. Data from a population-based survey conducted by the National Cancer Institute in 2005 (N = 5,586) were analyzed. Results showed that those who were younger, more educated, and lived in an urban area were more likely to have a broad- band Internet connection in their home. Furthermore, consistent with the CMIS, those with a broadband connection were more likely to use the Internet for health-related information seeking and communication than those with a dial-up connection.

My Journey from Technical Writing to Pharma Quality Management

Like most people who entered the technical communication profession in India in the mid to late 1990s, I too became a technical writer more by accident than by design. I enjoyed my technical writing career thoroughly, but slowly moved away, and a decade later, I now find myself heading the Quality Management function at a multi-national clinical research and technology company in India. The career paths of no two individuals are similar. And yet, there are always some common themes in successful transitions from one career path to another.

Playing Doctor? Trends in Health Information Seeking on the Web

Evolving and improving technology can improve health and healthcare in a myriad of ways. Equipment that is designed with the user, task, and environment in mind will reduce errors and improve outcomes. New designs make it possible for patients to do things for themselves that previously only doctors could.

Can Two Established Information Models Explain the Information Behaviour of Visually Impaired People Seeking Health and Social Care Information?

This study provides a new and valuable insight into the information behaviour of visually impaired people, as well as testing the applicability of a specific and generic information model to the information behaviour of visually impaired people seeking health and social care information.

A Grounded Theory Model of On-Duty Critical Care Nurses' Information Behavior: The Patient-Chart Cycle of Informative Interactions

Critical care nurses' work is rich in informative interactions. Although there have been post-hoc self report studies of nurses' information seeking, there have been no observational studies of the patterns of their on-duty information behavior. This paper seeks to address this issue.

Use and Outcome of Online Health Information Services: A Study Among Scottish Population

The purpose of this paper is to report on a research designed to find out how people in Scotland access and use online health information.

What You Need to Know to Create High Quality Electronic Documents

Submitting regulatory documents electronically to the FDA is beneficial for sponsors and regulatory reviewers, but the use of electronic submissions brings with it a set of problems associated with how these documents are read by reviewers.

Seeing and Listening: A Visual and Social Analysis of Optometric Record-Keeping Practices

This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to safely traverse the complex requirements of this apprenticeship genre. The article demonstrates that visual rhetoric research can meaningfully contribute to the understanding of genres by presenting an enriched contextual analysis achieved by consulting with context insiders.

Merck's Open Letters and the Teaching of Ethos

In fall 2004, Merck faced a significant threat to the company's public image because of the withdrawal of VIOXX, and Merck executives were forced to defend the company's actions, its motivation for those actions, and its reputation. Confronted with enormous rhetorical challenges, Merck tried to generate public goodwill toward the company by creating a personalized image of a corporate giant worthy of understanding, sympathy, and trust. Open letters released during the initial response to the VIOXX crisis rely on the intimacy of interpersonal communication and demonstrate to students of business communication arguments based on ethos.

The Rhetorical Helix of the Biotechnology and Pharmaceutical Industries: Strategies of Transformation Through Definition, Description and Ingratiation

Transformation wields great power. As individuals, we can define who we are and describe those essential characteristics that make us unique. Our view of ourselves, however, may not necessarily align with the opinions of those around us. Thus, the ability to reinvent oneself, to change how others see us and react to us, is critical for the process of ingratiation.

A Grounded Investigation of Genred Guidelines in Cancer Care Deliberations

Genred documents facilitate collaboration and workplace practices in many ways—particularly in the medical workplace. This article represents a portion of a larger grounded investigation of how medical professionals invoke a wide range of rhetorical strategies when deliberating about complex patient cases during weekly, multidisciplinary deliberations called Tumor Board meetings. Specifically, the author explores the role of one key document in oncological practice, the Standard of Care document. Each Standard of Care document (one for every known cancer) presents a set of national guidelines intended to standardize the treatment of cancer. Tumor Board participants invoke these guidelines as evidence for or against particular future action. In order to better understand how genred, generalizable guidelines like Standard of Care documents afford decision making amid uncertainty, the author conducts a temporal and contextual analysis of the document's use during deliberations as well as a modified Toulminian analysis of a representative sample. Results suggest that, while on its own the document achieves an authoritative, charter-like purpose, it fails to make explicit a link between individual patients' experiences and the profession's expectations for how to act. Implications for how genred, generalizable guidelines—given the way they encourage certain ways of seeing over others—organize and authorize work are discussed, and a modified Toulminian approach to understanding the relationship between claim and evidence in multimodal texts is modeled.

Ethical or Unethical Persuasion? The Rhetoric of Offers to Participate in Clinical Trials

Based on a sample of 22 oncology encounters, this article presents a discourse analysis of positive, neutral, or negative valence in the presentation of three elements of informed consent—purpose, benefits, and risks—in offers to participate in clinical trials. It is found that physicians regularly present these key elements of consent with a positive valence, perhaps blurring the distinction between clinical care and clinical research in trial offers. The authors argue that the rhetoric of trial offers constructs and reflects the complex relationships of two competing ethical frameworks—contemporary bioethics and professional medical ethics—both aimed at governing the discourse of trial offers. The authors consider the status of ethical or unethical persuasion within each framework, proposing what is called the best-option principle as the ethical principle governing trial offers within professional medical ethics.

Gestural Enthymemes: Delivering Movement in 18th- and 19th-Century Medical Images

This article contributes to recent efforts to add life and movement to rhetorical studies by focusing on the representation of movement in medical texts. More specifically, this study examines medical texts, illustrations, and photographs involving movement by Johann Casper Lavater, G. B. Duchenne de Bologne, Charles Darwin, and Étienne-Jules Marey. By identifying how figures of speech epitomize arguments, this examination follows a shift in the way arguments about movement are represented, a shift from static, visual arguments to gestural enthymemes, as they are named, arguments that are made in movements; these shifts are linked to developments in medical technologies involving photography. These arguments about and using movement attempt to “capture” or express the moments within which life, through the embodied gesture, resides. This extended understanding of the enthymeme broadens current understanding of argument to include delivery, links medical and rhetorical discursive practices, and informs how we make sense of and study the relationships between technology and rhetoric both in the past and present.

Exploring the Concept of “Profession” for Organizational Communication Research: Institutional Influences in a Veterinary Organization

Recent scholarship has argued that the concept of profession is undertheorized and accepted uncritically. The authors address this issue by summarizing the characteristics of professions and articulating professions as institutionalized occupations. Their study of a veterinary call center suggests that profession influences the workplace through (a) knowledge providing, seeking, and sharing; (b) self-management of behavior, emotions, and productivity; (c) internal sources of motivation; (d) a service orientation; (e) the invocation of field standards; and (f) participation in a knowledge community beyond the workplace. Although these features may be distinguishable analytically, they are unified in the experience of work. Moreover, the close match in this case between the service orientations of the profession and of the organization strengthened the workers' commitment and thus the legitimacy of the organization.

How Do People at FDA Read Documents On-Screen?

With the substantial move to submitting electronic documents versus paper documents to FDA, it is useful to pause and consider how a regulatory reviewer actually reads a large complex technical document on screen.

Why the Focus on Review Practices?

improving document review practices is of great concern to many in the biopharmaceutical industry. The reason for this interest can be explained by the following observations which provide some insight as to why review is, or needs to be, a central focus for improving knowledge propagation and dissemination.

Scope of Medical Writing

Medical writing requires a combination of technical skills in medical sciences and rhetorical skills in language arts.

What Employers Look For in Medical Writers

What Qualities Do We Look For? Enthusiasm for writing -willingness to go the extra mile. Ability to gather, synthesize and critically analyze large amounts of data. Express ideas succinctly –not “academic” documents.

New Medical Writers Survey

The most important skills or previous experience in securing present job: medical/scientific knowledge/understanding; writing skills/experience; ability to meet deadlines.

Toolkit for New Medical Writers

Working as a Medical Writer

The term "medical writing" encompasses different kinds of work for clients in media, government, and industry. Pharmaceutical companies, medical-device manufacturers, and clinical-research organizations (CROs) all employ writers to prepare regulatory documents used to seek U.S. Food and Drug Administration (FDA) approval for drugs and devices. Medical writers help doctors write research articles, monographs, and reviews on medical topics. Continuing medical education (CME) companies employ medical writers to produce educational materials and slide kits that doctors and nurses use to prepare for license renewals. Medical writers produce sales training materials, press releases for industry, and fact sheets or Web site materials for government organizations. Medical writers also write about research discoveries for medical journals, Web sites, newsletters, magazines, newspapers, and any other medium that includes coverage of health and medical issues.

Medical Writing

This resource contains information on medical journalism. The material explains the objectives of medical journalism and its applications in the media. Moreover, this resource demonstrates ways writers can accurately translate complex, scientific literature into layperson's terms.

Issues in Medical Writing

There is no doubt that medical communications is a very young field. The clearest picture of the issues, problems, and needs of a discourse community with as complex a membership as that of medical communicators comes from the AMWA materials. Drawing boundaries between academic vs. medical professional vs. medical communicator seems pointless because of the nature of the medical communication. It also seems to be an area ripe for study by those interested in power issues in rhetoric and certainly in research in communication systems. Medical communication really is both the most and least specialized area of technical communication.

Getting There: Medical Writing

Medical writing is a career that is often not predetermined but decided upon en route. Medical writers are well-rounded in terms of having both communicative and scientific knowledge, and this also means that a wide range of academic backgrounds and job experiences are welcome in the field. Medical writing allows for acquisition of various necessary skills through whichever means most suits the individual.

XML Initiatives in Pharma

The pharmaceutical industry has been slow to adopt XML until recently. Initiatives in the US and EU, as well as other jurisdictions, have begun that use XML to define important documentation formats as part of the drug product life cycle. In the US the FDA is mandating that drug product descriptions called "labels" be submitted in an XML format called the Standard Product Label (SPL) language by the end of 2005 and similar mandates are being made in the EU and other regions. Since most pharmaceutical companies are international, companies are scrambling to figure out the best method for managing their data in order to meet all of meeting these specific requirements. Also, drug label information will become an important component in the broader set of medical records and prescription standards that are being developed concurrently. This session will describe the roles and status of these standards, initiatives for adoption in the US and the EU, and provide some ideas on strategies for managing data within this complex set of requirements.

XML In The Pharmaceutical Industry: Structured Product Labeling

Pharmaceutical and biotechnology companies are required by law to compile and maintain over a multi-year life-cycle, large and complex collections of documents for submission to national regulatory agencies in order to obtain and sustain marketing approval for drugs and biologically active substances. The content includes both data and textual narrative, and is of great value in terms of intellectual property and legal liability. Over the past few years a cooperative effort between the regulators and industry has developed XML-based standards for electronic submission.

Technical Communicators Put the "Public" in Public Health

How does Web 2.0 fit into the world of public health? STC Fellow, Dr. Thomas Barker discusses the values of social networking in regards to largescale public disasters, such as Hurricane Katrina and the SARS outbreak.

Health Informatics: Current Issues and Challenges

Health informatics concerns the use of information and information and communication technologies within healthcare. Health informatics and information science need to take account of the unique aspects of health and medicine. The development of information systems and electronic records within health needs to consider the information needs and behaviour of all users. The sensitivity of personal health data raises ethical concerns for developing electronic records. E-health initiatives must actively involve users in the design, development, implementation and evaluation, and information science can contribute to understanding the needs and behaviour of user groups. Health informatics could make an important contribution to the ageing society and to reducing the digital divide and health divides within society. There is a need for an appropriate evidence base within health informatics to support future developments, and to ensure health informatics reaches its potential to improve the health and well-being of patients and the public.

Better Reporting of Randomized Trials in Biomedical Journal and Conference Abstracts

Well reported research published in conference and journal abstracts is important as individuals reading these reports often base their initial assessment of a study based on information reported in the abstract. However, there is growing concern about the reliability and quality of information published in these reports. This article provides an overview of research evidence underpinning the need for better reporting of abstracts reported in conference proceedings and abstracts of journal articles; with a particular focus in the area of health care. Where available we highlight evidence which refers specifically to abstracts reporting randomized trials. We seek to identify current initiatives aimed at improving the reporting of these reports and recommend that an extension of the CONSORT Statement (Consolidated Standards of Reporting Trials), CONSORT for Abstracts, be developed. This checklist would include a list of essential items to be reported in any conference or journal abstract reporting the results of a randomized trial.

The New Copyright Law: Its Impact on Bio-Medical Communication

Under previous copyright legislation and jurisprudence, medical, and to a lesser extent, educational professionals, were afforded broad discretion under the judicially created fair use doctrine. The Copyright Act of 1976 creates a statutory definition of fair use and prescribes a test to be used in determining when a use is "fair" and when it is infringement. Central to this test is "impact of potential market value" of the material. Biomedical communication involves material with a very high unit cost which is not offset by anything approaching mass distribution. There is no special exemption for, or understanding of, biomedical communication in the new law, with the result that the potential for a restrictive impact is great.

The Use of Electronic Mail in Biomedical Communication

Publication in general medical journals stimulates more conventional than electronic mail. However, the content of e-mail may be of greater scientific relevance. Electronic mail can be encouraged without fear of diminishing the quality of the communications received.

Introduction to Technical Communication: Perspectives on Medicine and Public Health

Over the course of the semester we will explore the full range of writings by physicians and other health practitioners. Some of the writer/physicians that we encounter will be Atul Gawande, Danielle Ofri, Richard Selzer, and William Carlos Williams. Students need have no special training, only a general interest in medicine or in public health issues such as AIDS, asthma, malaria control, and obesity. The writing assignments, like the readings, will invite students to consider the distinctive needs of different audiences.

Graphics and Ethos in Biomedical Journals

This article describes a study that examined the tables and figures in articles from a basic research journal, The Journal of Cell Biology, and compared them to tables and figures from an applied medical journal, The New England Journal of Medicine. Comparison of graphics between the two journals shows sharp differences in terms of range of graphics types, visual consistency within and between articles, or use of color. As the articles take into account what is needed by different audiences, the graphics help to build the credibility of the journal. The study also addresses the question of how scientific visuals contribute to the persuasiveness of a writer, looking at how the graphics within an article affect the credibility or ethos of the writer.

Distortion and the Politics of Pain Relief: A Habermasian Analysis of Medicine in the Media

This article invokes Habermas's ideal speech situation to analyze the controversy surrounding a recent study of pain relief for women in labor. Using Habermas's concepts, the authors argue that distortion of scientific and medical information originated in the New England Journal of Medicine article that first reported the study's results. Thus, their analysis aims to complicate the assumption that such distortion starts only with public reporting and to expose the ways that scientific or medical research from the beginning can be reported to either facilitate or preclude public debate and understanding of complex issues.

MD:Notes: Designing an Information System for Public Hospitals

By its very nature, an EMR (electronic medical record) is not subject to the physical limitations of a paper chart. Many clinics can access a patient’s EMR at once. EMRs are never in transit or waiting to be filed. For these reasons, using all-electronic records would greatly alleviate the problem of missing charts, and result in more efficient patient care.

Lessons from the Medical Community: Physicians Access Patient Information via PDAs

Genesys, a system of medical care facilities in central Michigan, has introduced an innovative way to couple emerging mobile communication technology with sophisticated medical care. Recently, the hospital system introduced the use of hand-held wireless personal digital assistants (PDAs) by physicians in its 440-bed system, which is made up of three local hospitals merged into one.

Bird Flu: Communicating the Risk

Most people have already heard a little about bird flu. But people face a host of other problems, and except for public health officials and poultry farmers, few are gearing up for action about H5N1 [the virus that causes the flu]. Yet.

Preparing Your Organization for Pandemic Flu

In the past few weeks, articles appeared on the inside pages of The New York Times and other news sources, with reports from Indonesia of human-to-human infection by avian flu, such as Elisabeth Rosenthal's article "Human-to-Human Infection by Bird Flu Virus Is Confirmed." Another article by Donald McNeil in the Times reported that mortality rates for avian flu are higher in young people, which was also the case in the devastating Spanish flu pandemic of 1918.

Bringing Usability to the Front Lines of Medicine

Will Emergency Medical Records (EMRs) make our delivery of medical care more usable?

The New World of Product Labeling: Alternative Architectures and Approaches

A discussion of the shift to structured content in pharmaceutical product labeling, which builds upon SPL and PIM regulations and the fundamental concepts of enterprise content management.

Health Care Institutions, Communication, and Physicians' Experience of Managed Care

This study uses the institutional theory of organizational communication (ITOC) to explain physicians' reactions to managed care. ITOC posits that enduring beliefs and practices both transcend and shape particular organizations and organizing. The authors find that physicians' institutional beliefs moderated the negative relationship between managed care medical practice and satisfaction. ITOC also posits that the negotiation of institutional, environmental, organizational, and individual factors occurs through communication. Controlling for these factors, communication with managed care representatives remains significantly and positively related to satisfaction. The results provide support for ITOC and macro approaches to organizational communication research and offer insights for the management of professionals in general and physicians in particular.

Are There ELF's in Your Monitor?

Technical writers are justifiably concerned with the health risks that their work entails. Although the dangers of poor ergonomics, stress and repetitive motion are well known, the effects of Extremely Low Frequency radiation may also present a hazard. This presentation looks at what research is telling us about this risk.

Health Care Prescriptions for a Terminal Job

What do you do about medical insurance coverage if you are laid off?

Carpal Tunnel Syndrome

Have you ever been working at the computer so long that your eyes 'went buggy?' Or so intensely that you could barely move when you got up? Working long hours at a computer may be more hazardous than you know. One real possibility is that you will develop Carpal Tunnel Syndrome (CTS).

Teaching Students to Design Information About Difficult Subjects: Public Information About Pediatric AIDS

Advanced technical communication students analyzed information about pediatric AIDS that was designed for dtrerent segments of the public. They then produced individual projects for local segments of the university and surrounding community. Through this assignment, students learned the importance of community standards in designing accurate and locally 'acceptable' communication about a difficult subject.

Writing Across the Chemistry Curriculum

While chemistry faculty agree that writing is an important professional skill, few know how to teach it. They lack a strategy for incorporating writing into their courses, skill in designing eflective writing assignments, and knowledge of evaluation methods. Our practical manual, funded by the Camille and Henry Dreyfus Foundation and the College of Arts and Sciences of the University of Tennessee Knoxville, will provide chemistry and other science faculty with these skills along with a set of ready-to-use assignments for their courses. The manual will allow chemistry faculty to teach writing purposefully and effectively, focusing on the scientific content while systematically developing this all-important skill.

Workplace Genres as Outcomes of Affiliated Professions' Interests and Practices

Often the first of many documents written about patients, the Emergency Medical Service's run report genre is a preprinted form on which prehospital care providers record the events of an emergency. These forms are important analytically since they represent the evolutionary outcome of the practices and interests of the multiple professions engaged in caring for critically ill or injured patients. Relative positions of power, authority, status, and autonomy among a set of affiliated professions can be examined by studying the historical evolution of a shared workplace genre such as the run report.

Graphic Barriers: Enhanced Comprehension of Patient Education Material

In this paper, I will demonstrate that when choosing graphics for patient education material, document designers should consider empirical research on memory of pictures and mental processing of graphs. It has been shown that comprehension of patient education materials is often impeded by text written at reading levels too high for the patient population. Graphics have been used to aid in overcoming the deficits of complex text. However, graphics too can be too advanced for the client to understand if designers do not consider audience and cognitive processing of images.

Adapting Technical Communication Core Skills to Navigate the Health Care System

Technical communicators gather data from subject-matter experts and then transform it into information that helps users accomplish tasks. In this workshop, we demonstrate how to adapt our expertise to effectively interact with health care professionals--to improve our understanding of the health care industry. By relying on our professional skills, we can successfully navigate the health care maze and effectively operate in the "foreign" environment of the doctor's office, hospital, and care facilities. And, in doing so, we will improve the quality of care we receive.

Assessing Information Needs of Diverse Users to Guide Web Design and Content Development

This paper presents a qualitative study of Centers for Disease Control and Prevention's diverse users and their mental models regarding injury-related content. The study employed an innovative modified contextual inquiry method utilizing tailored, in-depth interviews with five distinct user groups. Included in this paper is a detailed description of the background, framework, and method used for this study. Analysis of the full results was still in process at the due date of this paper. The results will be in the presentation's slide set and available from the STC website www.stc.org.

Congratulations, You Have ADD!

The author describes his history after being diagnosed with Attention Deficit Disorder (ADD), including a brief discussion of what the disorder is, how he came to be diagnosed as having it, and how he has come to live in harmony with, and even embrace, ADD. Murray concludes by offering helpful hints for accommodating the disorder that have helped him lead a fulfilling and successful career in technical communications.

Health and the Rhetoric of Medicine

Health and the Rhetoric of Medicine is a fine introduction to the burgeoning field of medical rhetoric and an excellent addition to the annals of rhetorical criticism in general. Written by Judy Z. Segal from the University of British Columbia, the work is solidly grounded in the mainstay rhetorical traditions of Burke, Perelman and Olbrects-Tyteca, Booth, and Aristotle. But Health and the Rhetoric of Medicine is hardly conservative in its mission or methodology, and the result is a work that captures the essence of discursive encounters in medicine, especially those between doctors and patients and their families, and yet unabashedly attempts to reform these encounters for the betterment of all parties involved.

A Visual and Social Analysis of Optometric Record-Keeping Practices

Implementation of Medical Research Findings Through Insulin Protocols: Initial Findings from an Ongoing Study of Document Design and Visual Display

Medical personnel in hospital intensive care units routinely rely on protocols to deliver some types of patient care. These protocol documents are developed by hospital physicians and staff to ensure that standards of care are followed. Thus, the protocol document becomes a _de facto_ standing order, standing in for the physician's judgment in routine situations. This article reports findings from Phase I of an ongoing study exploring how insulin protocols are designed and used in intensive care units to transfer medical research findings into patient care 'best practices.' We developed a taxonomy of document design elements and analyzed 29 insulin protocols to determine their use of these elements. We found that 93% of the protocols used tables to communicate procedures for measuring glucose levels and administering insulin. We further found that the protocols did not adhere well to principles for designing instructions and hypothesized that this finding reflected different purposes for instructions (training) and protocols (standardizing practice).

Medical Tables, Graphics and Photographs: How They Work

An examination of a random sample of four medical journals--The Lancet, The New England Journal of Medicine, The Journal of the American Medical Association, and The Journal of Laboratory and Clinical Medicine--reveals that one-fifth of the space of articles in medical science is devoted to an average of three tables and three flow charts, graphs, or photographs. Given these figures, the absence of discussion of visuals in the literature on medical communication may seem puzzling. But the puzzle is easily solved: our basic education gives us a coherent vocabulary for talking about prose, but no coherent vocabulary for talking about tables and visuals. Once we have this vocabulary in hand, we make another step in the direction of an explanation of the nature of communication in the medical sciences. We may note that understanding the meaning of a medical article is not just a consequence of understanding its texts; it is a consequence of understanding all its meaningful components working together--verbal, tabular, visual.

Multimodal Analysis: An Integrative Approach for Scientific Visualizing on the Web

The Multimodal approach offers technical communicators and science writers an analytical tool to synthesize the meaning made in the connections across communicative modes. This multimodal synthesis can help technical communicators better exploit the meaning-making potential of multimodal combinations and understand the needs of future generations shaped by their increasingly developed multimodal literacy.

Seeing Cells: Teaching the Visual/Verbal Rhetoric of Biology

This pilot study obtained baseline information on verbal and visual rhetorics to teach microscopy techniques to college biology majors. We presented cell images to students in cell biology and biology writing classes and then asked them to identify textual, verbal, and visual cues that support microscopy learning. Survey responses suggest that these students recognized some of the rhetorical strategies used and conflated others, revealing intriguing questions for further research in undergraduate microscopy education.

The Median Isn't the Message

Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action -- if it feels good, do it -- while intellect gets short shrift as a hang-up of outmoded elitism.

Florence Nightingale's Visual Rhetoric in the Rose Diagrams

Florence Nightingale is usually pictured as an angelic nurse tending to British soldiers in military hospitals during the Crimean War. Although Nightingale was indeed a tender of soldiers, she was also an administrator, advocate for the common soldier, and proponent of the use of statistics and information design. This article examines Nightingale's rose diagrams, which she designed following her service as the director of nurses at a field hospital in the Crimean War. When the war ended, Nightingale was asked by the queen to write a report on the poor sanitary conditions and make recommendations for reform. When, after six months, the government did not act on the reforms, Nightingale decided to write an annex to the report, in which she would include her invention, the rose diagrams. Nightingale's ultimate success in persuading the government to institute reforms is an illustration of the power of visual rhetoric, as well as an example of Nightingale's own passionate resolve to right what she saw as a grievous wrong.

Technical Communication and the Role of the Public Intellectual: A Community HIV-Prevention Case Study

This article argues that technical communicators are uniquely poised to function as public intellectuals. To demonstrate this point, the author offers the example of her work on a major AIDS prevention program report. Situating this work within the history of technical communication, the current discussion of rhetorics of risk, and the writing classroom, the author argues that technical writers don't have simply the opportunity to engage in textual activism; in many cases they have no alternative.

Context-Driven: How is Traditional Chinese Medicine Labeling Developed?

To promote intercultural understanding in medical communication, this article studies a regulation issued by the Chinese government to standardize traditional Chinese medicine labeling. Then the author claims that the traditional Chinese medicine labeling is medicine-focused. This feature has its roots in traditional Chinese philosophy of stressing the context while de-emphasizing individuals. The author examines a particular medicine label to support his claim that the medicine-focused feature draws patients' attention to the situations that cause disorders.

Imprecise Frequency Descriptors and the Miscomprehension of Prescription Drug Advertising: Public Policy and Regulatory Implications

Two separate studies, conducted among a total sample of 147 adults, explored the communicative effectiveness of imprecise frequency descriptors within the context of direct to consumer prescription drug advertising. Study One used imprecise frequency descriptors to describe level of side effect occurrence and then asked consumers to numerically estimate the frequency of side effect occurrence. A comparison of consumers estimated to actual level of incidence indicated that they are unable to accurately estimate level of side effect occurrence when those levels are described by an imprecise frequency descriptor. Study Two presented consumers with a list of side effects preceded by an imprecise frequency descriptor. Consumers were then asked to estimate the relative likelihood of side effect occurrence. The results indicated that consumers are unable to accurately estimate the relative likelihood of side effect occurrence when a list of side effects are preceded by an imprecise frequency descriptor. The pattern of consumer response across both studies indicates that when imprecise frequency descriptors are used to describe the incidence of side effects within the context of direct to consumer prescription drug advertising, consumers estimate likelihood of side effect occurrence on the basis of an intuitive judgment of the side effect s commonness/severity within the general population.

Learning-to-Communicate and Communicating-to-Learn in Veterinary Medicine: A Survey of Writing, Speaking, and Reading in Veterinary Medical Curricula

This article reports the results of a survey of thirty-one colleges of veterinary medicine in the United States and Canada to identify common writing, speaking, and reading tasks performed by veterinary medical students and practicing veterinarians. From the twenty-seven colleges that responded (87% response rate), we learned that writing, speaking, and reading tasks are assigned in almost every veterinary medical course and that the communication tasks assigned in veterinary medical courses accord well with the communication tasks expected to be performed by practicing veterinarians. Along with these learning-to-communicate tasks, veterinary medical students are also assigned communicating-to-learn tasks. Unlike many of the writing-to-learn tasks associated with writing-across-the-curriculum programs, communicating-to- learn tasks in veterinary medical courses seem concerned with teaching students to think like veterinary medical practitioners. The emphasis on communication in veterinary medical curricula is probably due to some extent to the emphasis on problem-based learning, a curricular innovation popular in veterinary medical education. Problem-based learning requires that instruction be designed around cases or problems to be solved rather than topics or information to be covered. This merging of research and practice in the education of veterinary medical students may offer lessons for the education of professional practitioners in technical communication.

The Missing Metaphor

To determine the metaphor that represents cloning, a contemporary scientific revolution, this study examines articles published in Nature, Nature Biotechnology, Science, and Time that describe the cloning of the sheep Dolly. A plethora of figurative language may be garnered from these articles, and this study describes a number of them: metaphor (dead, natural, and technical), simile, hyperbole, personification, irony, cliché, paronomasia, antithesis, metonymy, anthimera, oxymoron, the rhetorical question, and analogy. The significance and relationship to cloning are explicated. The article concludes that the figures do not support a central metaphor. Further research is suggested to determine if the lack of a metaphor is a fluke or a trend in the development of scientific research and what the difference may be between scientific and technical metaphor.

The Non-Fiction Novel as Psychiatric Casebook: Truman Capote's In Cold Blood

As proposed in the classic work by Hervey Cleckley, M.D.--The Mask of Sanity--a psychopath typically meets sixteen diagnostic criteria. Every one of them applies to Richard Hickock as he is revealed by Truman Capote's <em>In Cold Blood</em>, a nonfiction novel about the murder of Kansas farmer Herbert W. Clutter and his family forty years ago. It transcends the boundaries of traditional journalism by closely examining the entire constellation of antisocial personality traits that Hickock exhibits. Drawn in large part from jailhouse interviews, Capote's portrait of Hickock breathes life into the psychiatric literature, thus rendering intelligible the mental evaluation provided by the physician who examined the accused in preparation for his upcoming trial. In so doing, Capote s best-selling masterpiece serves as a case study of a psychopath, one that conforms to established medical authority while maintaining its popular appeal.

The Rhetoric Of Promoting Health

This article uses Chaim Perelman's theories of argumentation to examine a recent Institute of Medicine (IOM) report, Promoting Health: Intervention Strategies from Social and Behavioral Research (2000). The IOM's text explores social and behavioral research to devise multipronged intervention strategies; it focuses on social, economic, behavioral, and political health as a means of assuring population health--and thereby expands the conventional boundaries of public health. Since Chaim Perelman's rhetoric is seldom applied in the field of health communication, employing his ideas to consider the role of style, arrangement, and argument in such a cutting-edge document can illuminate public health writing, as well as shed new light on Perelmanian rhetoric.

Technical Communication and Clinical Health Care: Improving Rural Emergency Trauma Care Through Synchronous Videoconferencing

While debates continue over the effectiveness of innovative communication technologies to bring information and services to populations that have been underserved by such new technologies, a federally-funded program at the University of Vermont and Fletcher Allen Health Care (FAHC), Burlington, Vermont, has enabled trauma specialists to link with rural emergency room health care providers through a synchronous videoconferencing (telemedicine) network. Analysis of patient histories and surveys completed by the participating physicians after each use of the computer conferencing system as well as interviews and observations indicate that the FAHC consulting trauma specialists and the remotely located physicians felt the linkups do not interfere with standard ER procedures, that communication was at least adequate for all consultations, and that the consults improved the quality of care, for over half of the cases. Furthermore, interviews with rural ER physicians indicated that they saw the program operating as the first stage of FAHC's management of a patient to be transferred to that facility.

Washington DC: Panel Discussion about Usability in Healthcare

The Washington D.C. Usability Special Interest Group teamed up with the local Usability Professionals Association to present a panel discussion about usability in healthcare. Did you know that rising costs, an aging population and pressure to adopt new technologies increasingly strain the healthcare system? At the same time, patients and their families have ever-more access to health information, and many want healthcare to become more patient-centered.

The Association of Medical Illustrators

The professional objectives of the AMI are to promote the study and advancement of medical illustration and allied fields of visual communication, and to promote understanding and cooperation with the medical profession and related health science professions. Its members are primarily artists who create material designed to facilitate the recording and dissemination of medical and bioscientific knowledge through visual communication media. Members are involved not only in the creation of such material, but also serve in consultant, advisory, educational and administrative capacities in all aspects of bioscientific communications and related areas of visual education.

Medical Writers Give Career Changers Plans of Action

Those who are interested in breaking into medical writing received the inside scoop from L. Megan Day and Dr. Susan Dakin, the panelists at the chapter meeting on January 9 at Dreyfus Auditorium at Research Triangle Institute. Day has a bachelor's degree in chemistry, a master's degree in anatomy and has written for pharmaceutical companies for 10 years. Dakin has a bachelor's degree in biology and psychology and a Ph.D. in zoology. Self-employed since 1984, her specialties are scientific writing and proposal writing.

Contribution of the Indian Medical Service to the Documentation of Materia Medica, Medicinal Plants and Medical Topography of India, 1750-1925

India's medical tradition and knowledge base can be traced back to the Vedas (c.5000 BC), especially the Atharvaveda. The works of Charaka and Sushruta (c.2000 years ago) are well known. Parts of this ancient knowledge have been passed down generations by word of mouth and through the gurukula system. However, documentation about the incidence of diseases, the state of health of the people, medical practices and health care delivery in India during the period prior to the 18th century is meager, the sources being mainly the notes, memoirs and travelogues of visiting travelers. During the colonial period (c.1615-1930) western medical practices took roots in the country. The colonial powers recognizing that 'knowledge is power', commissioned surveys and studies about the terrain, fauna, flora, climate, environment, customs, and indigenous health practices, etc. in different parts of India. Officers of the Indian Medical Service (IMS) wrote over 1400 books, reports, tracts and papers covering a wide range of medical and health topics. Such sources together with the tacit knowledge of the officers involved contributed to the 'colonial knowledge base'. This paper discusses briefly this knowledge base and lists the writings of the IMS officers in the fields of (1) materia medica, (2) botanical studies including Indian medicinal plants, and (3) medical topography of India.

Issues in Medical Writing

Look Who's Talking: Teaching and Learning Using the Genre of Medical Case Presentations

In a pediatric teaching hospital, the authors examined 16 novice medical case presentations that were classified as instances of a hybrid apprenticeship genre. In contrast to strict school and workplace genres, an apprenticeship genre results from the sometimes competing activity systems of student education and patient care. The authors examined these novice case presentations for the amount and patterns of time devoted to student learning and expert teaching, the difficulties created for participants, the sometimes misunderstood implicit messages delivered by experts, and the opportunities to address educational objectives. This study offers professional communication researchers a model that combines quantitative and qualitative methodologies to assess the effects of competing activity systems in the development of communication expertise.

Knowledge Roles in the Workplace: an Example from HVAC

The following paper discusses my experiences with knowledge management at a large pharmaceutical company. I will begin with a brief description of the operation of my department. Then I will go into some detail about the knowledge market at my job. I will continue with a discussion on knowledge mapping and finally the importance of a common language.

Methods of Knowledge Transfer: an Example from the Pharmaceutical Industry

Knowledge management plays a very critical role in the day-to-day operations of my organization. The transfer of knowledge is shared verbally through casual conversations, meetings, conference calls, brainstorming sessions, and voice mail. Written communication appears daily in the form of memos, sticky notes, and e-mail. Documents such as records, change control forms, policies and standard operating procedures must be retained by my company. These papers often contain business critical data that needs to be stored and referenced at a later time. In order to manage this extensive list of documents, there are several management systems implemented throughout the corporation. Areas such as Human Resources, Finance, Clinical Research and Content Management utilize these systems to support their business activities. As a content specialist in the Pharmaceutical industry, I am responsible for supporting some of these systems. Some of the content that I support can be considered simply data. This type of material includes image files, such as GIFs and JPEGs, javascripts and customized ASP or JAVA files. These files are not referenced by employees and are used to support the functionality of the management systems. The primary system used throughout the organization for managing content is Documentum.

AMWA Position Statement on the Contributions of Medical Writers to Scientific Publications

AMWA formed a new task force in 2001 to develop a statement regarding AMWA’s position on the contributions of biomedical communicators to scientific publications.

Medical Usability: How to Kill Patients Through Bad Design

A field study identified twenty-two ways that automated hospital systems can result in the wrong medication being dispensed to patients. Most of these flaws are classic usability problems that have been understood for decades.

Usability Testing of Medical Instrument Instruction Manuals

This panel will discuss usability analysis, user testing, and revision of a medical instruments manual. The study showed that a hidden audience constituted the real users of the manual and that that audience served as an unintended intermediary between the writers of the manual and the users of the instruments. Usability testing showed the merits of a design for the manual that served both the intended and unintended audiences.

Disease Classification and the Organization of Large-Scale Web Sites

The International Classification of Diseases (ICD) has been employed by the world's public health officials to chart the nature, frequency, and geographic origins of diseases and causes of death in human populations since the late nineteenth century. The ICD has been modified every decade since the 1890s, and a study by Bowker and Star of these changes, in concert with the work of others on the practices employed in information mapping, can be used to better understand the organization of large-scale web sites. Specifically, web designers must adapt classification schemes to fit multiple social worlds. Additionally, we need to understand that these systems can become so entrenched in our thinking that they become "invisible," thus undermining our ability to adapt them as future needs or insights arise.

Improving Medical Treatment Procedures

Technical writers should be alert for opportunities to improve documentation in one technical field by using appropriate techniques from other fields. In this paper, the author presents ways of improving medical treatment procedures by using elements from engineering procedures, including introductions, safety sections, warnings, conditional (branching) statements, and notes.

Health Risk Communication

With government getting more involved with healthcare and organizations collecting information about the risks of some diseases, there is a plethora of information about heath risk that must be made accessible to the general public.

Design in Observational Research on the Discourse of Medicine: Toward Disciplined Interdisciplinarity

This article turns to the concept of interdisciplinarity as a framework for the design and development of observational studies investigating the discourse of medicine in language-based fields such as linguistics, rhetoric, composition, and professional communication. It argues that observational studies be designed as disciplined interdisciplinary studies, defined as research that makes an acknowledged contribution to both medicine and language studies. It proposes two guiding principles for the design of observational studies in medicine, both of which focus on issues of prospective design.

Patients, Medicines, and Information

Van der Waarde summarizes the reasons why medicinal information provided to patients is often confusing and describes a method for evaluating its effectiveness.

An Examination of Factors That Affect the Credibility of Online Health Information

The study reported in this article examined the effect of street address and external links on perceptions of credibility of a Web page. The study attempted to determine how readers process these cues by drawing on key theories in both technical communication and psychology, including the Elaboration Likelihood Model. The article includes a review of relevant literature on which the experiment reported here was based, hypotheses concerning the expected outcomes of the experiment, the methodology, the results, and a discussion of the results. Finally, conclusions and implications for future research are discussed.

Visual Information about Medicines for Patients

In Europe, when someone gets ill, it is common to visit a doctor. Most consultations end when a doctor prescribes a medicine that can be obtained from a pharmacy. After collecting the medicine a patient has to decide if the use of this medicine is more beneficial than not taking it. In order to make this decision, and in order to take medicines effectively, information is essential. Not only the instructions about how much to take and at what times, but also the potential risks caused by interactions with other medicines and common behaviour (eating, smoking, drinking, sleeping, exercising). It also becomes necessary to know how to recognize that a medicine does what it supposes to do. Historical developments have led to a tightly regulated situation in which the patient gets a clear message that health care providers (pharmaceutical industry, pharmacists, prescribers, etc) do not care very much about informed patients.

The Key to Mayo's Successful Publications? Dave Swanson

Mayo wants to give people actionable, not merely interesting, information.

Interface Design as a Life or Death Proposition

While the FDA has always required thorough documentation of product development, recent initiatives have instituted a more prescriptive, design-focused procedure encouraging extensive user research at the beginning of the development process.

Single Sourcing: Benefits to the Life Sciences

Life sciences companies are experiencing many pressures including electronic initiatives like eSubmissions and the eCTD, regulatory controls like 21 CFR Part 11, and decreasing times to market. Life Sciences companies are looking for ways to improve the way they create and manage content. Developing reusable content (single sourcing) is one solution. This session looks at the benefits single sourcing can bring to the life sciences industry.

Teaching Technical Writing to University Students Using the Medical Report

Technical and medical writing share many similar properties. Using a medical report assignment, in which students research and write about a physical or mental disease, is an effective tool that introduces the principles of technical writing. The assignment for lower division students is to write in the IMRAD format, while upper division students compose a report integrating multiple sources cited in CBE documentation style. In each case, adhering to fact-based, clear, audience-appropriate language in a technical format provides the student with valuable practice writing in this important genre.

Lessons Learned from Building a HealthWeb Site: Implications for Technical Communicators

The presentation reports on an iterative design process using formative evaluations to develop a user-oriented nutrition education Web site, 5-a-Day, The Rio Grande Way, for a rural multicultural population in the Upper Rio Grande River Valley in Southern Colorado and Northern NewMexico. The presentation will outline the overall project and then focus on three studies. Study One, used a card-sorting process, to generate the basic structure and labeling of the Web sites. Study Two, using verbal protocol analysis and a questionnaire evaluated the prototype for the Web site. Study Three, using verbal protocol analysis, evaluated the redesigned Web site. The presentation will share the lessons learned in developing the Web sites and the share the lessons learned for conducting usability testing and technical communications. The presentation will close by highlighting the technical communication and usability lessons learned.

Essential Pharmaceutical URLs and Organizations

Systems and network engineers, developers, project managers, and technical staff have been hit hard since the technology bubble burst. Since Y2K there has been an influx of competitive workers on H1B visas who have stayed and now have green cards. Now there is also outsourcing to India, Bulgaria, Russia, Ireland, the Philippines etc.

Medical Writing in Drug Development: A Practical Guide for Pharmaceutical Research

When I first saw this book, I was surprised that it was so slim. When you think of medical texts, you immediately imagine a volume of 600 pages or more. But Robert Bonk has been able to distill his information into a readable volume. All of the information is right there, easy to access, with no jargon cluttering the way.

Challenges for Technical Communicators in Bioinformatics

Bioinformatics, a specialized field in the area of biotechnology, has been a major growth market for the last decade. Generally, bioinformatics companies serve pharmaceutical and other life science research institutes by providing powerful computational solutions for the analysis, storage, and integration of molecular data. The project-oriented organizational structures, international environment, and interdisciplinary approaches that characterize bioinformatics companies provide a wealth of challenges and opportunities. Technical communicators who want to work in this field must be willing to apply strategies and techniques that enable them to streamline communication channels and write effective documentation.

Online Reference: The Ultimate in User-Friendly Documentation

This teaching hospital in Texas has successfully implemented an online reference system that allows access to nearly 14,000 employees in more than 20 cities. A cross-functional project team was formed to address the needfor immediate access to current policies and procedures across the entire enterprise. This team researched, developed, and implemented an effective and successful system that was also easy to learn and use.

Turbulent Times in Health Care: Creating a Flexible Document Management System

Imparting knowledge effectively both internally and externally is a challenge for any company. Within the health care industry, communication is further challenged as scientific and technological advancement, increased consumer expectations, and the initiation of health care reform keep the industry and knowledge within health care organizations in a flux. To communicate effectively to external customers, Blue Cross Blue Shield of Iowa has created a group of internal documents to manage the information necessary to create the documents customers receive. These internaI documents integrate the basics of information design and technical communication, color, styles, consistent structure, document relatedness, and a flexible document management system to make the creation of benefits policies (the external documents) better, faster, and cheaper.

Medical Writing Forum

Forum for the discussion of medical writing.

Drug Information Association: XML Resources for Life Sciences Pro

The Drug Information Association (DIA) has compiled a series of useful articles designed to help you understand XML and related technologies. Don't worry! You don't have to be an IT guru to understand XML. The resources provided are written in laymen's terms and geared towards life sciences professionals, but may prove beneficial to professionals in other industries and vertical markets.

A Case Study of Health Risk Communication: What the Public Wants and What it Gets

The task of informing the public about various health risks is fraught with many problems. It is essential to overcome them if risk communication is to be improved. In 1989, the National Research Council (NRC) released a report that is important for many reasons. In particular, it helped establish a conceptual framework for risk communication and identified a research agenda to improve risk communication practices. One area of need identified by the report was better use of case studies to understand, e.g., 'how people react to different types of messages and channels; [and] what their actual concerns, frustrations, and data needs are' with regard to particular health risks.

Risk Communication for Clinicians

This briefing covers the use of risk communication principles in a clinical setting to improve communication between health care providers and patients, especially in situations involving patients with high levels of concern and low trust. The briefing defines risk communication, explains how it can improve clinical care, and offers tools to help clinicians communicate more effectively.

When the Doctor and Patient Don't See Eye to Eye

Learn how to handle the struggle that develops between the patient and the clinician when the patient is feeling uncertain and anxious.

Communicating in a Crisis: Risk Communication Guidelines for Public Officials

Sound and thoughtful risk communication can assist public officials in preventing ineffective, fear-driven, and potentially damaging public responses to serious crises such as unusual disease outbreaks and bioterrorism. Moreover, appropriate risk communication procedures foster the trust and confidence that are vital in a crisis situation.

Health Risk Communication

A bibliography of 847 citations in health risk communication.

Risk Communication

All medical procedures carry a risk; there is no such thing as a risk-free intervention. It is important for doctors and other health professionals to understand how risk is measured, since they have to interpret information coming from Government Agencies and from drug companies. It is also important for health professionals to be able to communicate the magnitude of the risk of an intervention so that patients can meaningfully appraise their treatment options. Thus there are two aspects of risk communication: communicating with other professionals and communicating with patients.

Risk Communication in the Context of Consumer Perceptions of Risks

One goal of risk communication on food safety issues (among many) is communication between risk assessors and risk managers and the average citizen. This dimension includes both communication with the citizenry as a whole, through the mass media and other widely disseminated information, and communication with consumer organizations that participate in the risk analysis/risk management process.

Kairos in the Rhetoric of Science

If there is a canonical text in this still-early period of the rhetorical criticism of science, it is the 1953 Nature paper in which James D. Watson and Francis H.C. Crick proposed the double helix structure for DNA.

The Sociobiology of Information Architecture

Long before anyone was looking for 'godfathers' of information architecture, our fellow species were wrestling with some of the same problems we face today. The real godfathers of information architecture, as it turns out, emerged a very long time ago with the earliest origins of life on this planet.

Use of Race and Ethnicity in Biomedical Publication

Researchers, clinicians, and policy makers face 3 challenges in writing about race and ethnicity: accounting for the limitations of race/ethnicity data; distinguishing between race/ethnicity as a risk factor or as a risk marker; and finding a way to write about race/ethnicity that does not stigmatize and does not imply a we/they dichotomy between health professionals and populations of color. Josurnals play an important role in setting standards for research and policy literature. The authors outline guidelines that might be used when race and ethnicity are addressed in biomedical publications.

Empirical Studies Assessing the Quality of Health Information for Consumers on the World Wide Web: A Systematic Review

The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed.

Guidelines for Medical and Health Information Sites on the Internet

Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

Resources for Medical Writers: More Web Resources

Here are practical resources for medical communicators.

AMWA Journal

The AMWA Journal is the official publication of the American Medical Writers Association. Delivered quarterly to AMWA members and Journal subscribers, the AMWA Journal aims to be an authoritative, comprehensive source of information about the knowledge, skills, and opportunities in the field of biomedical communication worldwide.

Distinguishing Characteristics of Medical Writing

Medical writers and editors need to understand medicine as a discipline, its nature as a science, its humanitarian rather than commercial goal of alleviating pain and suffering, the sensitive nature of some subjects, and the reduced or distorted cognitive abilities of some patients. They need to understand medical terminology, the nature of truth, the scientific method, the primary research paper, numbers, probability, risk, statistical significance, and some specific language issues.

Personal Identifiability in the Icelandic Health Sector Database

Personal identifiability is a fundamental question in the ongoing debate about the Icelandic Bill and Act on the Health Sector Database (HSD). If the data are personally identifiable, Iceland's international legal commitments indicate that a priori consent must be obtained from patients for the use of their personal medical information. The HSD Act presumes that one-way coding of personal identifiers renders the data non-personally identifiable and that therefore a priori consent is not required. The history of the debate on the HSD shows that the concept of personal identifiability was initially based on a notion of 'considerable amount of time and manpower' as a criterion for defining personal identifiability. This definition comes from Recommendation R(97)5 of the Committee of Ministers of the Council of Europe on Medical Data. As a result of the Icelandic Data Protection Commission's opinion on the HSD, that concept was rejected and the resulting Bill and HSD Act adopted a definition from the European Data Protection Directive (95/46). The rejected concept, however, reentered with the idea that one-way coding of personal identifiers means there is no key that can be used to trace the identity of a person in the database. The question of what constitutes a key in this context is of fundamental importance. The database will collect and link data from different sources on individuals over time and therefore the method of coding must remain stable. It is possible therefore to construct a look-up table, which constitutes a key. Keys can also be built from comparisons of patterns of family trees as well as by putting generally available information into context The information in the Health Sector Database is personal information. Therefore reason and justice require that a priori consent be obtained from patients for the transfer of their health data to the database as Iceland's international legal obligations stipulate. Anything less is unreasonable and unjust.

Health and Safety Information for Specialized Vocational Audiences

Using examples from commercial fishing and farming, this article shows how models of health beliefs and risk communication can inform the creation of health and safety materials and campaigns for specialized vocational audiences. These models state that risk communication efforts must balance strong statements of risk with equally strong statements of ways to reduce or avoid risk if they are to motivate change. Audience research can help communicators address attitudes that impair workers’ perceptions of risk, as well as workplace practices, norms, and conditions that the limit the methods that can be used to reduce risk.

Medical Technical Writing

In a multibillion-dollar-per-yearcindustry, medical technical writers are well situated between companies that manufacture drugs and medical equipment and the federal government, which regulates the manufacture of drugs and medical equipment. The government requires that these companies produce specific types of documents, which must be of a very high standard. This situation creates lucrative opportunities for technical writers.

Making the Rules: A Day in the Life of a Regulatory Drafter

David Spicer, Senior Regulatory Drafting Officer with the CFIA, discusses the regulatory drafting process, writing complex texts in the context of federal plain language principles, and what it’s like to write the words that define and protect Canadians.

Nontraditional Communication about Health Risks: Hired Farm Laborers

This paper presents a variety of nontraditional risk communication techniques developed by faculty at the University of Washington Department of Environmental Health and its partner agencies. The common thread of their projects is to communicate with migrant agricultural workers about pesticide hazards through techniques such as home parties, educational outreach, a health adviser network, Hispanic theater, fluorescent imaging, and icon-based health histories. Initial results indicate behavior may change as a result of these forms of risk communication. Similar techniques could be adapted to other populations that are difficult to reach with traditional risk communication methods.

Toolkit for New Medical Writers

Medical writing is a great career! The work is interesting and often lucrative, and the demand for medical writers is high. Few people start out to be medical writers; most of us fall into it. Some of us have scientific or medical degrees (e.g., MD, PharmD, PhD in a scientific field) and have worked in the field (e.g., as an academic, bench scientist, physician, pharmacist) or in administration and somehow find ourselves doing medical communications work. Some of us have Journalism or English degrees, work in communications, and end up writing about health and medicine. There are two basic types of medical writer: scientific and non-scientific or marketing. In general, scientific medical writers have advanced science-based degrees (science, medicine, pharmacy, etc.) and often learn about writing by becoming a medical writer. Marketing medical writers have a journalism or English degree and often learn about medicine by becoming a medical writer. Scientific medical writers generally do more scientific/technical writing for professional audiences. Marketing medical writers do marketing-oriented writing, often for consumers or lay audiences.

Doc, I've Been Looking at Some Web Sites--So What Should I Believe?

Because anyone, from nationally renowned physicians to your next-door neighbor, can post health information online, readers need to be selective when taking advice from medical web sites. Several non-profit and government agencies have developed guidelines to help readers as they evaluate health and medical information online. Some researchers have also begun to study the ways that readers actually judge the credibility of web sites. Recommendations from heuristic guidelines and recent empirical research have been distilled into a list of guidelines for writers and editors.

Anthrax Case Research

Compare the Anthrax technical information offered at the three major sites below. Where does the information seem most credible? Where is it the most complete and detailed? Where is it the easiest to navigate and read? Write a detailed analysis report comparing the information at the three different sites.

Issues in Medical Writing

In this country several factors influence the medical writing of medical professionals, professionals in a field that prides itself on combining art with science. The fairly exclusive culture of the medical professional, the power and highly competitive nature of publishing within that discourse community, and the need for accurate, reliable information for immediate use in solving problems, and a strong inclination to put medical 'facts' first and communication of those facts second create interesting dynamics and rhetorical complexities in medical writing. For over a century the quality of medical writing has been a great concern to both medical professionals and lay readers. According to Dr. Lester King, physician and retired, long-time editor of the Journal of the American Medical Association (JAMA) 'more than a century ago critics deplored the repulsive quality of medical prose' to such an extent that the AMA set up committees to evaluate the problem of medical literature as early as 1851.

Latino Culture and Health Communication

Many Latinos face barriers to receiving health care in the U.S. These barriers can include lack of English and literacy skills, as well as cultural differences in the communication styles used by Latino patients and non-Latino health care providers and communicators. Simply translating health materials into Spanish may not be enough to overcome these communication barriers. However, research has shown that oral forms of communication such as Spanish-language radio broadcasts, lectures in English-as-a-second-language classes, or small-group discussions led by Spanishspeaking leaders can be very effective in disseminating health information to Latino audiences.

Technical, Medical, Science Writing Links

A collection of links to advertising, business, technical, science, medical writing and editing services.

Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust

The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.

Medical Communications

In order to promote the results of their medical research to other healthcare professionals, researchers must publish their work. This is usually done by publishing manuscripts in medical journals and by presenting papers and posters at conferences. Medical writers may write these documents on behalf of the researchers that carried out the studies. This is termed ghostwriting. This is most common when studies are sponsored by pharmaceutical companies, but academic researchers sometimes also use the services of medical writers. The medical writer and researchers collaborate to determine what should be written and the researchers gain from the expert writing skills of the medical writer.

Instructions to Authors in the Health Sciences

These pages contain links to Web sites which provide instructions to authors for over 3,500 journals in the health and life sciences. All links are to 'primary sources,' that is to publishers or organizations with editorial responsibilities for the titles.