Over the past two decades, reflective writing has occupied an increasingly prominent position in composition theory, pedagogy, and assessment as researchers have described the value of reflection and reflective writing in college students’ development of higher-order writing skills, such as genre conventions (Yancey, Reflection ; White). One assumption about the value of reflection has been that skill in reflective writing also has a positive connection with lower-order writing skills, such as sentence-level conventions of academic discourse. However, evidence to confirm this assumption has been limited to small qualitative studies or deferred to future longitudinal research (Downs and Wardle). In the mixed methods assessment study presented here, we first investigated this assumption empirically by measuring the relationship between evaluative skills embedded in the genre of reflective writing and lower-order writing skills that follow sentence-level conventions of academic discourse. We found a high-positive correlation between reflection and writing assessment scores. We then used qualitative methods to describe key features of higher- and lower-scored reflective essays.

Phase 1 cancer clinical trial consultations are fraught with ethical and rhetorical issues. Phase 1 trials are designed to test the toxicity, and not the efficacy, of therapeutic agents. Fewer than 5% of patients benefit from their participation in a Phase 1 trial, and over 75% of experimental drugs do not become approved cancer medicines. Bioethicists have long debated the ethics of recruitment consultations for Phase 1 trials solely in terms of the need for patients to make a rational decision based upon enough information to avoid what are called therapeutic misconceptions and/or unrealistic optimism as motivations to participate in Phase 1 trials. We argue here, however, that the ethical challenges in Phase 1 consultations go beyond providing information about the (unknown) risks and (unanticipated) benefits of a Phase 1 clinical trial. In this article, we present a rhetorically oriented case study of a Phase 1 consultation, followed by a rhetorically informed critique of the rationality of bioethics. We use Lauren Berlant’s (2011) concept of “cruel optimism” to develop a more complete account of the rhetorical and ethical nexus of patient motivations in Phase 1 consultations by creating a discursive space to explore the concerns, hopes, and motivations of cancer patients considering participation in the earliest phase of clinical research in cancer medicine. The goal of our study is to propose a framework aimed at achieving Lisa Keränen’s (2007) concept of relational integrity applied to Phase 1 consultations.

Using concepts and methods from technical and professional communication and linguistics, the authors conducted an observational study of the voice of community members (CMs) in the deliberation of a behavioral institutional review board (IRB). In the discourse of deliberation, they found that CMs had an effective voice in constructing the compliance of individual research protocols under IRB review. But they also found that CMs had an ineffective voice in representing their African-American community, particularly in their efforts to advocate for more consideration of minority research sites and subjects and a fuller consideration of minority community attitudes.

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.

Telemedicine has been shown to be an effective means of managing follow-up care in chronic diseases such as depression. Exactly why telemedicine calls work, however, remains largely unknown because there are no adequate research tools to describe the complex communicative interactions in these encounters. We report here an ongoing project to investigate the efficacy of telemedicine in depression care, arguing that technical communication specialists have unique contributions to make to this kind of research.

In this essay, I propose that the field of composition/rhetoric can make important contributions to the understanding of ethics based on our critical perspective on language as interactional and rhetorical. The actual language of decision making with ethical dimensions has rarely been studied directly in the literature, a crucial gap our field can usefully fill.

A set of discourse-based methods—genre theory, genre analysis, and discourse analysis—can provide a descriptive basis for a critical analysis of the multiple connections between discourse practices and their underlying concepts and categories within professions. To illustrate this theoretical and methodological project, this article analyzes prognosis in the discourse of medicine. Using Goffman’s (1959) distinction between front-stage and back-stage discourse, the author suggests that a back-stage discourse of prognosis points to problems with prognosis in the front-stage discourse of medical encounters between oncologists and patients who have been diagnosed with cancer. The analysis shows that the oral genre of treatment discussion in oncology encounters is organized to allow practitioners to do, appear to do, or avoid doing difficult work like presenting a prognosis. The article suggests that discourse-based methods have the potential to become the basis for productive critical engagement between practitioners and researchers in professional communication.

This article offers a retrospective case study of a service learning project in a technical writing class. For this project, students were asked to develop a communication tool with information about consent rates in organ donation to use in an academic medical center. In contrast to the service learning literature, which notes that students often resist the professionalizing move that service learning offers, this study shows that students in this project actually overprofessionalized, constituting themselves as one more party vying for control over the communication of organ donation. This embrace of professionalism via service learning raises as many issues as the resistance to professionalism that is more commonly documented.

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.

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Negative argumentation about methodological approaches threatens to limit the field of composition: it exacerbates the tension concerning the place and value of empirical studies in research; it potentially limits the field’s ability to ask certain kinds of research questions; and it risks impoverishing the methodological education offered to new practitioners in the field.

The famous Awk is a well-known designation, but this label does not refer to a well-defined concept. The authors report here on an empirical study of the predominant types and patterns of awkward sentences in student writing. They suggest that four general types of syntactic problems—mismanagement of clause structure in errors of embedding, of syntax shift, of parallel structure, and of direct/indirect speech—are associated with four general patterns of semantic problems—mismanagement of idea structure in errors of subordinating ideas, of starting and finishing ideas, of adding ideas, and of incorporating ideas from sources. The authors argue that awkward sentences arise from a complex combination of semantics and syntax, as student writers struggle to manage the relationships among multiple ideas as well as the relationships among multiple clauses. These findings are used to suggest a number of possible pedagogical approaches to the problem of awkward sentences, including the use of read-aloud editing, the targeted teaching of grammar for syntactic editing, and the separation of ideas from sentence form for semantic editing.

Ruth Ray, Ellen Barton, Response to Christina Haas and Linda Flower, "Rhetorical Reading Strategies and the Construction of Meaning", College Composition and Communication, Vol. 40, No. 4 (Dec., 1989), pp. 480-481

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