Using rhetorical genre theory and research on reported speech, this study investigates the citation practices in 81 forensic letters written by paediatricians and nurse practitioners that provide their opinion for the courts as to whether a child has experienced maltreatment. These letters exist in a complex social situation where a lack of clarity exists as to which professional group (healthcare providers, police, social workers) is primarily responsible for gathering accounts of children’s injuries. Yet physicians need these accounts into order to compare them to actual injuries. The study documents the direct and indirect citations that occur in the letters, observes documentation strategies, notes the instances in which partial breakdowns in citation occur, and points to the linguistic factors contributing to these breakdowns.

Physicians write child abuse forensic reports for nonphysicians. We examined 73 forensic reports from a Canadian children's hospital for recurrent strategies geared toward making medical information accessible to nonmedical users; we also interviewed four report writers and five readers. These reports featured unique forensic inserts in addition to headings, lists, and parentheses, which are typical of physician letters for patients. We discuss implications of these strategies that must bridge the communities of medical, social, and legal practice.

This article reports on forensic letters written by physicians specializing in identifying children who have experienced maltreatment. These writers face an extraordinary exigence in that they must provide an opinion as to whether a child has experienced abuse without specifically diagnosing abuse and thus crossing into a legal domain. Their credibility was also at issue because, in this jurisdiction, child abuse identification was not recognized as a medical subspecialty and because the status of expert witnesses is currently being challenged. Through an analysis of 72 forensic letters combined with interview data from six letter writers and five letter readers, we determined that these writers used linguistic and rhetorical strategies that allowed these letters to function as boundary objects or objects that traverse several communities of practice. The most salient strategy was the use of evaluative lexis—adjectives and adverbs which allowed for a range of interpretations and constrained those interpretations at the same time.

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.

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.

This article explores the value of rhetorical genre theory for health care and professional communication researchers. The authors outline the conceptual resources emerging from genre theory, specifically ways to conceptualize social context, professional identity formation, and genres as functioning but hierarchical networks, and discuss the way they have used these resources in two separate but complementary health-care studies: a project that documents the ways regulated and regularized resources of the genre of case presentations shape the professional identity formation of medical students and a project that extends this theoretical work to observe that genres, especially policy genres, function to regularize or control other genres and shape the identity formation of midwives in Ontario, Canada. The authors also observe that the implications of rhetorical genre theory have impelled both of these studies to develop an interdisciplinary trajectory that includes members of health-care communities as participating researchers.

This limited case study examines the situated-language practices associated with the production of negative letters in an insurance company. Using genre and sociocultural theories, the study combines textual analyses of a set of negative letters together with writers’ accounts of producing these letters to identify effective (as defined by the company) strategies for composing this correspondence. These letters are examples of generic action, and they demonstrate that genres function as constellations of regulated, improvisational strategies triggered by the interaction between individual socialization and an organization. Moreover, these constellations of resources express a particular chronotopic relation to space and time, and this relation is always axiological or value oriented. In other words, genres express space/time relations that reflect current social beliefs regarding the placement and actions of human individuals in space and time. The article identifies some of the strategies that characterize effective negative messages in this organization. It also critiques this text type for enacting a set of practices and related chronotopic orientation that are against the interests of its readers and writers.

This study reworks the concept of genre from rhetorical, dialectical, and dialogic perspectives. From these perspectives, genre is redefined as a stabilized-for-now or stabilized-enough site of social and ideological action. This definition is then applied to a specific literacy practice—medical record keeping—evolving in a specific context—a veterinary college. Data were gathered during a 6-month ethnographic study of the college. The larger research project focused on the teaching and learning practices that constituted literacy, i.e., the ways of speaking, reading, writing, and listening characteristics of veterinary medicine. The project consisted of interviews, observation, and document collection. Triangulation was achieved both within and between methods. Data were analyzed using Glaser and Strauss's “grounded theory” techniques. When the concept of genre is applied to medical record keeping, the complexity of this literacy practice becomes apparent. A specific record-keeping system—the Problem Oriented Veterinary Medical Record (POVMR) system—was the site of intense controversy at the college. The system articulated a set of values that one group of faculty and clinicians espoused and another group rejected. The system itself was embedded in the exam structure of the college, and a good deal of evidence emerged that the POVMR itself was promoting certain types of literacy abilities and making others less likely.