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.
BartonE. (2011). Speaking for another: Ethics-in-interaction in medical encounters. In CandinC.SarangiS. (Eds.), Handbook of communication in organizations and professions (pp. 215–234). Berlin, Germany: Mouton de Gruyter.
2.
BartonE.EgglyS. (2009). Ethical or unethical persuasion? The rhetoric of offers to participate in clinical trials. Written Communication, 26(3), 295–319.
3.
BatesD.EbellM.GotliebE.ZappJ.MullinsH. (2003). A proposal for electronic medical records in U.S. primary care. Journal of the American Medical Informatics Association, 10, 1–10.
4.
BergM. (1996). Practices of reading and writing: The constitutive role of the patient record in medical work. Sociology of Health and Illness, 18, 499–524.
5.
BergM. (2001). Implementing information systems in health care organizations: Myths and challenges. International Journal of Medical Informatics, 64, 143–156.
6.
BergM.BowkerG. (1997). The multiple bodies of the medical record: Toward a sociology of an artifact. Sociological Quarterly, 38, 513–537.
7.
BezemerJ.KressG. (2008). Writing in multimodal texts: A social semiotic account of designs for learning. Written Communication, 25(2), 166–195.
8.
BleichH.SlackW. (2010). Reflections on electronic medical records: When doctors use them and when they will not. International Journal of Medical Informatics, 79, 1–4.
9.
Breuch KastmanI.-A.BakkeA.Thomas-PolleiK.MackeyE. L.WeinertC. (2016). Towards audience involvement: Extending audiences of written physician notes in hospital setting. Written Communication, 33(4), 418–451.
10.
ChartierR. (1992). Laborers and voyagers: From the text to the reader. Diacritics, 22, 49–61.
11.
CoulterA.EllinsJ. (2007). Effectiveness of strategies for informing, educating, and involving patients. British Medical Journal, 335, 24–27.
12.
EcoU. (1984). The role of the reader: Explorations in the semiotics of texts. Bloomington: Indiana University Press.
13.
EcoU. (2005). Vegetal and mineral memory: The future of books. Alexandria, Egypt: Bibliotheca Alexandrina.
14.
FatiganteM.AlbyF.ZucchermaglioC.BaruzzoM. (2016). Formulating treatment recommendations as a logical consequence of the diagnosis in post-surgical oncological visits. Patient Education and Counseling, 99, 878–887.
15.
FatiganteM.ZucchermaglioC.AlbyF. (2015, June). Being in the right place: The participation of the patient’s companion to “first time” oncological visits. Paper presented at the Revisiting Participation: Language, Body and Interaction conference, Basil, Switzerland.
16.
FishmanJ. A. (1991). Reversing language shift: Theoretical and empirical foundations of assistance to threatened languages. Clevedon, UK: Multilingual Matters.
17.
FraenkelB. (1992). Le partage de l’énonciation écrite dans un service hospitalier [Sharing written texts in the context of an hospital]. Langage & Travail, 5, 62–78.
18.
GillumR. (2013). From papyrus to the electronic tablet: A brief history of the clinical medical record with lessons for the digital age. American Journal of Medicine, 126, 853–857.
19.
GreatbatchD.HeathC.CampionP.LuffP. (1995). How do desk-top computers affect the doctor-patient interaction?Family Practice, 12, 32–36.
20.
GreatbatchD.LuffP.HeathC.CampionP. (1993). Interpersonal communication and human-computer interaction: An examination of the use of computers in medical consultations. Interacting with Computers, 5, 193–216.
21.
HaasC. (1996). Writing technology: Studies on the materiality of literacy. Mahwah, NJ: Lawrence Erlbaum.
22.
HaasC. (1999). On the relationship between old and new technologies. Computers and Composition, 16, 209–228.
23.
HeathC. (1982). Preserving the consultation: Medical record cards and professional conduct. Sociology of Health & Illness, 4, 56–74.
24.
HeathC.LuffP. (1996). Documents and professional practice: “Bad” organisational reasons for “good” clinical records. In Proceedings of the 1996 ACM Conference on Computer Supported Cooperative Work (pp. 354–363). New York, NY: ACM Press.
25.
HeritageJ.RaymondG. (2005). The terms of agreement: Indexing epistemic authority and subordination in assessment sequences. Social Psychology Quarterly, 68, 15–38.
26.
HsiaoC.-J.HingE. (2014). Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2013. National Center for Health Statistics Data Brief, 143, 1–8.
27.
LatourB. (1986). Visualisation and cognition. Knowledge and Society, 6, 1–40.
28.
LatourB. (1987). Science in Action. Milton Keynes, UK: Open University Press.
LuffP.HeathC.GreatbatchD. (1992). Tasks-in-interaction: Paper and screen based documentation in collaborative activity. In Proceedings of the 1996 ACM Conference on Computer Supported Cooperative Work (pp. 163–170). New York, NY: ACM Press.
31.
MondadaL. (2006). Video recording as the reflexive preservation/configuration of phenomenal features for analysis. In KnoblauchH.SchnettlerB.RaabJ.SoeffnerH.-G. (Eds.), Video analysis: Methodology and methods (pp. 51–68). Frankfurt-am-Main, Germany: Peter Lang.
32.
NaikA.SinghH. (2010). Electronic health records to coordinate decision making for complex patients: What can we learn from Wiki?Medical Decision Making, 30, 722–731.
33.
NielsenS. B. (2014). Medical record keeping as interactional accomplishment. Pragmatics & Society, 5, 221–242.
34.
Osservatorio ICT in Sanità. (2012). ICT in Sanità: Mettere in circolo l’innovazione [ICT in Healthcare: disseminating innovation]. Rapporto 2012.
35.
PriorP.ShipkaJ. (2003). Chronotopic lamination: Tracing the contours of literate activity. In BazermanC.RussellD. (Eds.), Writing selves, writing societies: Research from activity perspectives (pp. 180–238). Fort Collins, CO: WAC Clearinghouse.
36.
ReynaV. F.NelsonW. L.HanP. H.PignoneM. P. (2015). Decision making and cancer. American Psychologist, 70, 105–118.
37.
RobinsonJ.StiversT. (2001). Achieving activity transitions in primary-care encounters: From history taking to physical examination. Human Communication Research, 27, 253–298.
38.
SafranC.GoldbergH. (2000). Electronic patient record and the impact of the Internet. International Journal of Medical Informatics, 60, 77–83.
39.
SchegloffE. A. (2007). Sequence organization in interaction. Cambridge, UK: Cambridge University Press.
40.
ScollonR. (1998). Reading as social interaction: The empirical grounding of reading. Semiotica, 118, 218–294.
41.
ScribnerS.ColeM. (1981). The psychology of literacy. Cambridge, MA: Harvard University Press.
42.
SegalJ. Z. (2005). Health and the rhetoric of medicine. Carbondale: Southern Illinois University Press.
43.
SegalJ. Z. (2009). Internet health and the 21th-century patient. Written Communication, 26(4), 351–369.
44.
SinghH.NaikA. D.RaoR.PetersenL. A. (2008). Reducing diagnostic errors through effective communication: Harnessing the power of information technology. Journal of General Internal Medicine, 23, 489–494.
45.
StarL. S.GriesemerJ. R. (1989). Institutional ecology, “translations” and boundary objects: Amateurs and professionals in Berkeley’s museum of vertebrate zoology, 1907–39. Social Studies of Science, 19, 387–420.
46.
StreetB. V. (1984). Literacy in theory and practice. Cambridge, UK: Cambridge University Press.
47.
SwinglehurstD.RobertsC.GreenhalghT. (2011). Opening up the “black box” of the electronic patient record: A linguistic ethnographic study in general practice. Communication and Medicine, 8, 3–15.
48.
TestonC. B. (2009). A grounded investigation of genred guidelines in cancer care deliberations. Written Communication, 26(3), 320–348.
49.
TestonC. B. (2012a). Investigating usability and “meaningful use” of electronic medical records. In SIGDOC ’12 Proceedings of the 30th ACM International Conference on Design of Communication (pp. 227–232). New York, NY: ACM Press.
50.
TestonC. B. (2012b). Moving from artifact to action: A grounded investigation of visual displays of evidence during medical deliberations. Technical Communication Quarterly, 21(3), 187–209.
51.
TopolE. (2012). The creative destruction of medicine. New York, NY: Basic Books.
52.
UNESCO Ad Hoc Expert Group on Endangered Languages. (2003, March). Language vitality and endangerment. Presentation at the International Expert Meeting on UNESCO Programme Safeguarding of Endangered Languages, Paris, France.
