RESEARCH
I study how and why people make decisions about health care. My focus is on shared decision-making, which involves equal participation between patients and health care providers in their discussions about treatment and management options. I am particularly interested in using deliberative documents such as patient decision aids to investigate relationships between practitioners’ knowledge of evidence-based medicine and patients’ experiential and embodied knowledge. By using these dimensions as a rhetorical framework, I address the communication disparities of traditional patient and provider roles.
My ongoing research project explores how health information technology can contribute digital tools that access and deliver information to balance the contributions of all stakeholders in medical decision-making. I am leading an interdisciplinary study with physicians and computer scientists to develop an mHealth app for people who need information about the causes, prevention, diagnosis, and treatment of osteoporosis. Research team members are working with information technology administrators to integrate the app into patients’ electronic health records. Our goal is to begin a clinical trial in the next year.
RESEARCH AGENDA
My studies follow interdisciplinary paths in the clinic and the classroom and include STEM pedagogy.
Health Communication
My health communication research supports diversity, equity, and inclusion. I am writing a monograph that investigates the rhetorical contexts of patient decision aids in health care. The chapters include the history of the genre, the role of patient decision aids in shared decision-making, patient and provider literacies, intercultural communication, visual design, and achieving informational balance. The audiences are healthcare professionals, technical communicators, and undergraduate students interested in pursuing those careers. I also use intercultural communication theory to argue that emphasizing relational empathy may assist in shared decision-making between patients and providers.
This area of my research has three implications. First, it establishes a bioethical groundwork from which practitioners can begin a communication process with patients who choose to participate in shared decision-making. Second, it provides a theoretical basis for technical communicators to create rigorous medical documents such as patient decision aids. Third, it may assist scholars in analyses of texts that include biomedical information.
I have four additional goals after I publish the monograph.
Working with researchers in other disciplines on a study of patient decision aids that combines quantitative and rhetorical methods
Using the rubric for analysis that I have developed to analyze other genres of patient decision aids
Reaching out to biomedical practitioners who are interested in improving existing documents or assisting them in writing new documents
Continuing to refine theory associated with understanding patient decision aids and shared decision-making, including the meanings of uncertainty
STEM Pedagogy
My pedagogy research combines my interests in health communication and information technology. I have seen the need to further develop and assess the course I am now teaching, Technical Communication Strategies for Computer Science Majors. I have initiated two projects toward this goal. First, I am beginning a case study for submission to IEEE Transactions on Education analyzing the documents that students in the course produce. Second, a team of computer science undergraduates and I are writing an autoethnography about the development and usability testing of a patient decision aid app for osteoporosis
DISSERTATION
A Rhetorical Analysis of Patient Decision Aids For Genetic Testing: Scientific Knowledge, Embodiment, and Problematic Integration in Biomedicine
Committee: Amy Koerber (Chair), Joyce Carter, Rebecca Rickly
I considered how patient decision aids (PDAs)—technical communication documents created by biomedical practitioners—worked to help people decide whether they should request genetic tests. I sampled a genre of non-commercial PDAs that I termed gateway documents written to introduce information, benefits, and disadvantages related to genetic testing for cancer and prenatal diagnostic situations. I developed a rhetorical framework that included elements of deliberation, epideixis, scientific knowledge, and embodied knowledge. I incorporated into these elements the theory of problematic integration, which describes the interrelationships between probabilistic orientations—the scientific knowledge of biomedical practitioners—and evaluative orientations—the embodied knowledge of people seeking genetic testing. My analysis of the sample sets described the benefits and disadvantages constructed by the document authors’ use of embodied knowledge, scientific knowledge, or a combination of both. My conclusions revealed that the authors had constructed arguments using veiled paternalism and that the benefits and disadvantages were imbalanced. I offered a rubric using the criteria of the rhetorical framework that may assist patient decision aid authors in creating balanced argumentation that includes benefits and disadvantages using embodied knowledge and scientific knowledge. I concluded with advocacy for critical bioethical communication: the leadership of technical communication and rhetoric in the interdisciplinary study of decision-making for genetic testing.