Under the rapid advances of digital technology, traditional paper-based forms of reading and writing are steadily giving way to digital-based literacies, in theory as well as in application. Drawing on a study of literacy in a medical workplace context, this article examines critically the shift toward computer-mediated textual practices. While a considerable body of research has investigated benefits and issues associated with digital literacy tools in medicine, we consider the affordances of paper-based practices. Our analysis of verbal interaction and textual artifacts drawn from a qualitative study of oncology visits indicates that the uses of pen and paper are advantageous for both doctor and patient. Specifically, they allow doctors to process and package information in ways that are favorable to their personal modus operandi, and they enable patients to participate in the medical visit and take an active role in managing their medical treatment. Understanding the affordances of paper-based literacy provides insights for refining digital tools as well as for motivating the design of possible hybrid forms and digital-analog intersections that can best support medical practices.

This article uses the notion of genre repertoire to examine electronic-mail communication exchanged in a period of three years by an interorganizational community of software developers (727 e-mail messages in total). It analyzes the development of this virtual work community by considering the use of communicative genres with respect to (1) the resources offered by the electronic-mail system, (2) the temporal development of the project in which the participants were engaged, and (3) the developing relationship between community members. The study shows that the community organized its communicative interactions mainly as informal exchanges between peers rather than as formal exchanges that followed the structure of an interorganizational project. The messages were strongly affected by the use of a system of electronic mail and changed as the community members' relationships developed.