English 3010 Portfolio Project

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FALL 2011

English 3010 Portfolio

Reflective Argument

Guy Gardner





Contents Page


Reflective Argument

(pp. 3





Rhetorical Analysis



Data Collection Report



Discourse Community Synthesis Project



a Collection Report Interview (pp.29


Paper 3&4



I. Reflective Argument

Writing is a powerful tool to exp
ress oneself and offer new intellect

to conversations. It
is also a powerful vehicle of communication that when used properly can sway a whole audience
or gain

respect. Personally,
learning to view

writing this way has given me motivation
to choose my words carefully and actually construct
something that contributes to the academic
community or
another discourse community
Since my English 1020 class with Wen

I now
write to contribute to intellectual conversations
of my interest
and not to simply fulfill
assignment requirements
Writing is not simply
rambling of prose to
turn in an assignment.

me, it

rather an
ongoing and invested
process that is al
ways being reconstructed as
I come

with new ideas.

Since I adopted this new perspective and awareness of writing in my English
1020 class, I was able to identify my profile as a writer as I entered into English 3010.

Upon ent
ering English 3010,
I strug
gled with finding an

process and
using extensive evidence to back up my claims. I used to think my words and a few citations
were enough to gain the audience’s trust. Even in my personal reflective paper for the semester,
I noticed I did not describe specific examples to sup
port my claims as a writer. In fact, I
struggled with specificity in general and always just reasoned that my audience will know what I
mean by this. However, that was not always the case and I was always getting feedback such as,
“what do you mean by th
at” and “explain further.”
In regards to my complications with utilizing
an efficient writing process, I could just not seem to settle down on a strategy that worked for
me. I was constantly changing my brainstorming habits from free writing to a specifi
c outline or
even a generalized list and writing from there. It seemed I had so much to say I just could not
convey it in an organized fashion in my paper or my pre writing. My writing was constantly
changing and I often deleted whole documents to start
over on my new idea. Eventually my


piece was produced, but I was still never fully satisfied. It was obvious that I needed a new and
proficient approach to writing to wrangle in all of my roaming thoughts.

It was my English 3010
class that helped me
assess myself fully as a writer and develop my constant inconsistencies
I held within my


Wendy’s section of English 3010 allowed me to reach this point of
progression by centering the curriculum on the four learning outcomes stated in the syl
Also, analyzing different texts in my medical discourse as well as reading writing studies
literature greatly attributed to my progression as a writer. Furthermore, it allowed me to apply
my learned connections between writing studies and my medic
al discourse. For example,
Beaufort’s five domains of knowledge proved to be the universal method to writing for a
particular discourse and Brandt offered light onto how doctors act as literacy sponsors for their
Ultimately, m
y English 3010 cla
ss has a unique approach that allowed me to actually
accomplish mastery over the four learning outcomes, which is evident throughout my texts
en this semester,
enhanced use of rhetorical appeals,
more efficient writing strategies, and
of my
l discourse.

In order to prove my gain of proficiency, I will organize the next paragraphs in sequential
order of the learning outcomes noted on the syllabus. I will provide evidence of my writing to
support my claim of competency in those specific
areas. Specifically, I will reference the writing
assignments I completed this semester such as: Rhetorical Analysis, Data Collection Report, and
Discourse Community Synthesis Project.
Then, I will
conclude with
how I can use this
knowledge of writing for

future endeavors as well as the adaptability of the curriculum.

In reflecting on L
Outcome 1, I have succeeded in locating, comprehending,
analyzing, and understanding texts from my

My success
in locating
is att
ributed to the tutorial my class had with Wayne State librarian, Judith Arnold.


Judith navigated the class through the multitude of Wayne State’s databases and academic
journals. Importantly,

taught me to distinguish
scholarly texts

such as,


from not so academic ones

uch as,

Physician’s Journal
. Furthermore, my compliance
with Judith’s lesson is evident from the sources I chose to analyze in the Rhetorical Analysis
Project such as from the
American Journal of Medical
Quality, American Family Physician, and
Journal of Biomedicine

and Biotechnology.

Next, my comprehension and analysis of
medical texts is apparent throughout my Rhetorical Analysis Project.
Using Beaufort’s five
domains of knowle
dge as a framework to dissect the texts, I was able to effectively conclude
what distinguished medical communities’ texts
from other discourses

and felt confidence in
possibly reproducing a medical text
upon the foundational basis of the five domain
s of
As I read through my three medical texts, I noticed they all draw upon common
values such as,

human health, acknowledgment of scientific ownership, accuracy, and the
scientific method.

Also I was able to
draw conclusions of authorship

values from

analyzing the three texts in my Rhetorical Analysis Project

and specifically examining the
reference and acknowledgement pages

of the three texts

In fact, my

of numerous
authors, acknowledgment pages, and the presence of authors who did not perform the study
sparked my interest in the way that authorship is defined within the medical community

and it



topic for the
Discourse Community Synth
sis Project. Since I was

able to
draw my final project idea

from my

one observation of
acknowledgments within
the medical
texts, it is clear that I grasped an understanding of the text and even the medical discourse itself.
In addition to defining simila
rities and discourse connections between the medical texts, I was
about to point out their diversity. For example, I examined the different audiences of the texts
and showed how they use specific rhetorical appeals such as ethos, logos, and pathos.


example is “the
American Journal of Medical Quality

article strongly utilizes the results of
surveys, statistics, and other primary observations throughout the
entire text.”

While the
three texts are articles within the medical co
mmunity, I found the texts were more specified to a
more specific community within the broad range of a medical discourse. Also, I found diversity
within the genre of three medical texts and were able to attribute these differences to
contradicting functi
ons the articles were

written for.

It was the differences of these texts that
allowed me to understand the immense diversity of complex medical subject matters and make
sense of what unifies all of these different subsets of the
medical community

Ultimately, this
comprehension fulfilled my progress in Learning Outcome 1.

Upon reviewing Learning Outcome 2, I can confidently say that I was able to produce an
extended research question that was both applicable to writing stu
dies explored throughout
English 3010 and my medical discourse.

I accomplished
upon my incorporation of
rhetorical strategies

and relevant literature

into the Discourse Community Synthesis Project.

While examining this research question for the Disco
urse Community Synthesis Project, I was
able to use research from primary
sources such as interviewing my genetics professor, Dr.
Tucker, and Dr. Diwadkar, head of my research lab at the University Health Center in regards to
who should hold authorship. Ad
ditionally, I incorporated
ary sources

diverse specialties among the medical community such as research, genetics, medical writers,
and pharmaceutical companies.
, I


writing studies literature used both in
and outside of the English 3010

My rese
arch question that
relevant to both the
course and my community

is, “How does the medical community reco
gnize sponsors,
, and medical writers

involved in constructing a medical paper and how does
the new era of literacy Brandt mentions apply to the medical community’s evolution of




My question takes a literary term such as “auth
orship” and applies it to the
conversation the medical community is discussing about it.

It is in my investigation of this
question that I employ rhetoric strategies. Initially
, I establish

credibility by use of an article
written by Brandt, who is widel
y accepted upon the writing community. I used her article,
“Who’s The President” to support my eccentric idea that
the definition of authorship is

with the
addition of ghostwriters and medical writers to the


Since Brand
t proposes in her
article that literacy has emerged into a new definition and has become a product of the so
Information Age, my proposal does not sound as foreign or
unacceptable. Also, my literature
review within my introduction is aimed to build credibility of myself as the writer as well as
inform r
eaders of the conversations
are having about authorship within the medical
discourse. The literature review

by confirming my proposal that authorship is emerging
into a new definition and has different meanings in different contexts such as
in different
discourses. For example, my

literature review on
, “Time to redefine authorship: a conference to

Horton and Savage
discusses a need to address the variances in assigning
authorship within the medical community and the new employment of
medical writers

Next, my use of evidence in specifying my claim is evident t
hroughout my Discou
Community Synthesis Project. For example, I utilize a study done by Natasee on medical
writing acknowledgements from 2000
2007 and then compare it with another done by Leo and
Lacasse in 2010. Specifically, I say “In Nastasee’s stu
dy she found that there was a two
increase in the number of acknowledgments of medical writers from 2000 to 2007, however the
percentage is still only at 11.3

Additionally, I provide emotional appeal to my
bringing English discourses into the controversies of false authorship by stating,
“The humanities argue that mere acknowledgement of a medical writer is not enough because it


undermines the prestige of writing as a discipline and even attributes to aca


Furthermore, I fulfill the last component of Learning Outcome 2 by drawing on
concepts from Gee, Penrose, Geisler
, Beaufort, and Brandt. I utilize Gee’s statement that,
“someone cannot engage in a Discourse in a less than fully fluent

To explain I say,
“This lack of fluency and knowledge of some medical writers only involved in the

does not give readers a fair interpretation of what the actual medical Discourse intended to


Specifically, I use Beaufort’s five domains to explain how medical writers
can write for the medical community
that they are not entirely apart


Penrose and
Geisler’s proposal to writing with authority as a thinker can translate over into the medical
discourse. I demonstrated this in my Synthesis Project by writing, “Penrose and
Geisler offer
ways in which medical writers can appear as insiders in the medical community by writing with
more authority such as Roger, a graduate student, in their

In sum
, I was able to
effectively incorporate my vari
ous sources into my

research project and fulfill the objective for
Learning Outcome 2.

Upon reflecting on Learning Outcome 3, I realized English 3010 made me aware of new
writing process strategies and forced me to be open to different processes.

e this class I
consistently utilized the same writing process, which was brainstorming/research, constructing a
vague outline, draft, another draft,

making sure it fits the writing assignment, peer

and then the final text.
While m
y consistent
process earned me a hundred percent

the individual
Rhetorical Analysis

it was not applicable for my group project.

I now know
that the writing process must be tweaked for different writing assignments and I just cannot
assume my generic format will translate smoothly to all writing task. This was evident in my
Data Collection Report, in which I worked with a group of

five students in t
he diverse medical


discourse. My group

constructed a vague outline
in which everyone was expected to analyze
their interview or observation in terms of Beaufort’s five domains of knowledge.
Then, my

assigned each person either th
e introduction, conclusion, or critical reflection. The
problem was that my group did not discuss what each of us would be discussing about the five
After everyone completed their own separate outlines, drafts, revisions, and final copy,
it was
inserted it into the larger

document. Also, transitional

such as “Next, Brooklynn
will discuss her interview with Dr. Tucker” and the introduction informed the reader of the order
of the speakers.

However, the paper was about 20 pages long and
somewhat repetitive. I guess
I did not think how a reader would approach this massive paper because Wendy
read the first
couple pages and was already overwhelmed. From talking with Wendy, my group devised a
plan to condense our material and incorporate
the best points of each interview/observation into
the five domains of knowledge framework. We went through each of our sections with a
different colored highlighter in hand searching for the best examples of the medical
communities’ five domains. Specif
ically, we assigned each domain a color and quickly
condensed our monotonous paper. Then my group had to tackle the most difficult task, putting
the fragments together. I wouldn’t allow my group to make the same mistake as previously, so
my group met up f
or three days to reconstruct our work. Our strategy was having one person
type while everyone else giving feedback on what to take from our highlighted portion and put
into new words. Basically, we wrote it collectively while everyone was physically pres
Even after that everyone revised the paper separately while tracking changes. As a result my
group received an A and produced a successful paper due to our collective writing process
, I am now more aware of group writing strat
egies and the severe need to be
specific and collaborate when in a group.


In regards to Learning Outcome 4, I am able to show what types of writing strategies I
used and reflect on their rhetoric and universal usage.

Continuously I utilize the framewor
k of
the prompt to construct my paragraphs and logic. For example, this reflection paper is based
upon the framework of the 4 Learning Outcomes and I provide evidence explaining each one.
Also, I utilized
the five domains of knowledge as

a framework for
my Data Collection Report
and have one body paragraph for each


Importantly, I find it effective t
o situate my
reader with
what I will be talking about, how I am


to approach it, and to articulate

a good thesis statement.

This strategy of a specific thesis is evident in my Data Collection Report
when I state, “Through these domains and different perspectives we will ultimately reflect on our
insights and prove that the medical community values pati
ent care, humanities health in general,
scientific based analytical practices, accuracy, and importance of innovation of

In my Discourse Community Synthesis Project, my road map paragraph articulates my research
ion, what methods I will employ, what patterns I will look for, and ultimately the
organizational map for my


Another successful strategy I employ in order to stay on
task is to keep reverti
ng back to the thesis and make

connection with it in the body paragraphs. I
do this in my Rhetorical Analysis by saying, “Similarly, all of their goals match the general goal
of the medical community which is to benefit human health and medical

adding headings is
sometimes appropriate to direct a

reader if it is hard to distinguish between
. It is especially

for the
IMRAD format
, in which the Discourse Community
Synthesis Project was formatted
. However, I also utilized this strategy in my Data Collection
. Lastly, a new strategy I acquired was to offer something new in my conclusion as
opposed to just doing a summation of what I just said. This is evident in al
l of my papers written
this semester; however the best example would be that of my Rhetorical



Basically, these writing strategies are essential to construct a cohesive, logical paper and I utilize
them continuously.

s well as

proficiency of the 4 Learning Outcomes

my own
discourse, I believe English 3010 has prepared

me to tackle any writing situation.
Since I can
now identify myself as a writer based on the 4 Learning Outcomes, I can ana
lyze my writing in
any context. After all, producing texts that show intensive examination of research,
comprehension, rhetorical appeals, cohesiveness, organization, and incorporation of appropriate
writing strategies are necessary for writing in any dis
course. Also,
s five domains of
knowledge approach to analyzing texts will allow me to derive the important information from
practically any discourse that is needed to construct a text such as discourse community goals,
subject matter, genre, an
d rhetorical strategies. Overall, this course has provided me tools with
universal application
, which will strengthen me as a writer.




Rhetorical Analysis

As in any particular community, the medical community seeks to contribute to the wealth of
knowledge of their discourse. However, the medical community has their unique approach to
reaching this goal as well as different values that shape their discourse.

In my attempt to
articulate these ultimate values, goals, and direction of the medical community I will dissect the
texts: “An Assessment of Patient Sign
Outs Conducted by University at Buffalo Internal
Medicine Residents”, “Approach to Septic Arthritis”
, and “Gene
Gene Interaction in Maternal
and Perinatal Research.” These texts come from credible, popular journals within the
community such as,
The American Journal of Medical Quality, American Family Physician, and
Journal of Biomedicine and Biotechnolo
. In comparing and contrasting these texts I will
organize my argument by Beaufort’s five domains of knowledge: Subject matter, genre,
rhetorical, writing process, and discourse community. Through these domains I will analyze the
three texts and ultima
tely prove that the medical community values human health,
acknowledgment of scientific ownership, accuracy, and the scientific method with emphasis on

Arguably, the most significant component of knowledge is that of the discourse community
itself. This aspect contains all the goals, values, and direction that guide the remaining domains.
By simply scanning the three texts it is apparent that accuracy a
nd method shape the way the
medical discourse communicate. In all three articles there is extensive use of the words,
“analyze,” “method,” “observe,” and “conclusion.” Even the titles such as,
An Assessment of
Patient Sign
Outs Conducted by University at
Buffalo Internal Medicine Residents,
are very


articulate and convey this accuracy (Wheat et al, 2011). More indirectly, the medical
community’s value on author recognition is portrayed. Notably, there are numerous authors,
acknowledgements, and funding p
resent in all three texts, but the articles do not articulate what
part each of them contributed. Some doctors or sponsors could have done a very small part, but
still have authority to put themselves on the publication. This concept attributes the discour
value of authorship by respecting that it is the main performance indicators for doctors and
scientists. It seems the more publications they contributed to or have their name on, the better
their performance. As a result, many articles feature anyone w
ho added knowledge to the text,
whether large or small. Also, another more indirect but identifiable goal of the medical
community is to benefit human health through research. In particular, the text in the
Journal of Medical Quality
states, “th
e medical community remains acutely aware that a high
quality sign
out at change of shift is extremely important for patient care,” and furthers the
article by finding solutions to this problem (Wheat et al, 2011). Additionally, the other articles
talk ab
out patient treatments for various medical complications which suggests a large goal of
the medical community is to benefit human health. Furthermore, in the following paragraphs I
will emphasize the values with more indirect evidence from the other domain
s of knowledge.

Foremost, as one can imagine knowledge of subject matter is crucial to writing or analyzing
any medical written document. These medical terms are not everyday terminology for the
public, but part of a language constructed by scientific exp
erts as the medical field continues to
evolve. Doctors and experts study medicine for 10 years or more to learn the vast medical
language, so they cannot help but to incorporate it into their writing. These medical terms are
often abbreviated such as in
the article,
Approach to Septic Arthritis
, when they discuss PCR,
WBC, and PMN (Horowitz et al, 2011). Also, abbreviations are also present in the other two


texts such as, “MFG” in Gene
Gene Interaction in Maternal and Perinatal Research (Sinsheimer
et al,

2010). These abbreviations make articles more efficient by not having to repeat long words.
It is crucial that everyone in the medical community understand these terms otherwise confusion
results. Also, medical words have very accurate meanings and arti
culate a particular thing or
idea. Unlike the humanities where some words have multiple meanings, every word articulates
a specific thing or idea in the medical community. In
the Approach to Septic Arthritis

text the
word “virus” instead of bacteria is
crucial in articulating the correct treatment of a patient and
there are similar examples in the other articles (Horowitz et al, 2011). Hence knowledge in the
medical subject matter prevents professionals from potential inaccuracy, which is highly

Since I have established the relevance of accuracy, I will discuss how subject matter
knowledge influences the type of questions medical professionals ask as well as their approach to
them. Undoubtedly, the medical community is bound to ask scientific

questions based on the
origin of their expertise. These scientific questions are precise and allow for experimentation as
an answer. The article from the
American Journal of Medical Quality
demonstrates this by
questioning the quality of sign out quali
ty in internal medicine and then conducting an analytical
experiment utilizing the scientific method to explain the answer (Wheat, 2011). However, the
other two texts did not have an experiment associated with their question instead they simply
examined e
vidence from other studies and references to prove their point.
Approach to Septic

organized the evidence under headings such as “Evaluation,” “Synovial Fluid
Analysis,” “Management,” and “Prognosis” (Horowitz et al, pg. 1
12, 2011). In contras
t, the
article in Journal of Biomedicine and Biotechnology does not have these discrete headings or
experiment conductions, however the article still makes reference to analytical methods in the


body of their paragraphs that is used to prove their point th
at gene interactions can occur in the
placenta to produce disease or mutations (Sinsheimer et al, 2010). Although the authors take a
different approach, they still maintain the medical value of scientific examination techniques
while also focusing on ben
efiting human health based on their research topics.

In addition to the subject matter knowledge, genre knowledge plays an important role in
stabilizing the goals and values of the medical community. Each text has a different structure
making it more sp
ecialized genre than the broad medical genre. For example, the text in the
American Journal of Medical Quality
is more of a research/assessment subgenre that is
constructed by

headings such as “Methods, results, discussions, conclusion, acknowledgements,
funding, and references” and contains graphs and charts displaying the raw data (Wheat et al,
2011). On the other hand,
Approach to Septic Arthritis

takes a more educational/informative
approach to the broad genre of medical writing. The article is still

organized by headings similar
to the scientific method approach of the previously mentioned article; however the main points
are organized throughout paragraphs into tables in a way that would be easier to learn. An
example is a table that has one column

of the test result and another of the antibiotic that should
be used (Horowitz, 2011). Also, this article demonstrates an extensive list of instructions
throughout the article as well as references. In contrast to both the articles,
n in Maternal and Perinatal Research

offers no headings or tables and can be
classified as more of an editorial that delivers the content in a paragraph format while still
offering a long list of references. Despite the variations in the structure of the
texts, the content
and title are still an example of a broad medical genre of concise, evidence based writing.
Similarly, the articles also all have some a labeled abstract which is concise in categorizing the
subject matter and ultimately confirms the va
lue of accuracy and method in the medical field.


Another key feature the subgenres or text had in common was having several pages of
references, acknowledgements, and all being copyrighted. As a result, this observation
reinforces the importance of owner
ship of a text and scientific performance. Since these basic
similarities emerge between the texts, the differences should not be solely attributed to diverse
topics, but to the fact that they are addressing different audiences. In having different audie
the medical professionals had to specialize their genre in order to adapt to their audience.

On a similar note, rhetorical knowledge also falls into examining the audience’s needs which
determines the genre type or in this case the usage of audience a
ppeals. Generally all three text’s
purposes are to convey their main claim to the audience of medical professionals. However,
each text concentrates on a more specialized audience of the medical community, which in turn
affects the goals of writing. The

article in
American Family Physician
is directed obviously
towards practicing family physicians and its goal is to teach the physicians and have their article
act as a learning tool. On the contrary, the article in the
Journal of Biomedicine and

aims to persuade biomedical professionals in order to fire up the innovative topic
rather than just teach it. Then the third article from the
American Journal of Medical Quality

intends to inform internal medicine doctors and residents the positive

effects of the new
implementation so that they continue to execute these actions. Similarly, all of their goals match
the general goal of the medical community which is to benefit human health and medical

As a result of the audience shaping th
e goals of the text, it is sensible that they also shape the
appeals such as ethos, logos, and pathos. All three texts provide credibility by their extensive
scholarly reference pages and stating the doctorate statuses of the authors. Also, the articles
feature a collaboration of authors and researchers indicating there is less room for error and bias


seeing that all of these professionals played a role in the final result. Furthermore, the texts
appeal to their audience by compiling extensive evidence t
o support their claim made in the
abstract. Although they share this similarity, they focus on varying types of evidence that
comprise the majority of the text. The
American Journal of Medical Quality

article strongly
utilizes the results of surveys, stat
istics, and other primary observations throughout the entire
text. Whereas the article in the
American Family Physician

puts a focus on physician expertise
and laboratory evaluations done by other professionals. It is not until the reader encounters the
extensive list of references that they value the evidence as valid because credit is not distributed
within the paper. In opposition once more, opinion and research articles comprise the evidence
within the
Gene Interaction in Maternal and Perinatal

article. In regards to
emotional appeal, the texts satisfy the human health and method based values of the medical
audience and this can be observed simply by reading the title of these texts.

Based on solely observing the final product of the wr
iting process it is rather challenging to
formulate how it came together. Nevertheless, I am almost certain the authors followed a
process similar to the scientific method which includes: formulating a question, developing an
experiment or research method
, recording raw data, analyzing, and conclude. This scientific
approach coincides with the other domains of knowledge I have explored so it is only
appropriate for the writing process to maintain that continuity. Also, based on the numerous
authors, ther
e must have been regular collaboration occurring amongst the writers and/or
researchers. Notice my distinction between collaboration partners because not all researchers
write their own articles but instead recruit a professional medical writer to do it f
or them. An
example of this is the text,
An Assessment of Patient Sign
Outs Conducted by University at
Buffalo Internal Medicine Residents
, where the residents who conducted the research were


present within the body of the paragraphs but not the authors’ page. This break of ownership
probably influences the writing process, but based on my resources I was unable to tell. Despite
the lack of observation of the writing process, it is rather evi
dent that the scientific method and
analytical values are reflected from the process.

In conclusion, the domains of knowledge demonstrated throughout the texts work in
conjunction to shape goals and values of the medical community. However, the function
of the
writing process domain is less clear than the others. As a result I need to further analyze the
writing process in action in order to reach a better understanding of how it exactly relates
holistically to the knowledge domains and more specificall
y the discourse community
knowledge. Upon noting the lack of author ownership in the experiments the authors wrote
about, I am eager to interview someone from the medical community and see how their writing
process and publishing findings operate. It wou
ld be helpful to converse with both a medical
writer and research professional in that discourse to see how the two interact in constructing final
written work. Importantly, the introduction of a middle man or medical writer complicates and
questions my p
revious view on the five knowledge domains and the goals of the medical


Horowitz, D., Katzap, E., Horowitz, S., & Labarca, M. (2011). Approach to Septic Arthritis.
American Family Physician
(6), 1
12. Retrieved September 27, 2011,
from the MD
consult database.

Sinsheimer, J., Elston, R., & Fu, W. (2010). Gene
Gene Interaction in Maternal and Perinatal
Journal of Biomedicine and Biotechnology
(8), 1
4. Retrieved September
27, 2011, from the Academic OneFile database.


at, D., Co, C., Monochakian, R., & Rich, E. (2011). An Assessment of Patient Sign
Conducted by University at Buffalo Internal Medicine Residents.
American Journal of
Medical Quality
, 1
9. Retrieved September 27, 2011, from the SAGE database.


Data Col
lection Report


As in any particular community, the medical community seeks to contribute to the wealth
of knowledge of their discourse. However, the medical community has their unique approach to
reaching this goal as well as different values

that shape their discourse. Among these values are
high quality of patient care, humanities health in general, scientific based analytical practices,
accuracy, and importance of innovation of knowledge. In our attempt to articulate these ultimate
, goals, and direction of the medical community our group will observe and dissect various
perspectives of the medical discourse. Brooklynn will offer an academic research based approach
through her interview with John Tucker who has a PhD in Human Genetic
s and is a researcher at
Wayne State University. Also, Maria introduces a medical writers’ view through analyzing
works written by medical writers, Maureen Devlin and John Simpson. Among the articles are
“Why Does Starvation Make Bones Fat” and “The Role

of Telemedicine in a Fetal Cardiology
Service.” In contrast, Roger takes a direct, clinical approach by interviewing Susan Owens, a
registered nurse who has 12 years experience as an assistant clinical manager in the advanced
progressive medical unit. T
hen, more indirectly as a volunteer at Children’s Hospital Tsitsi
observes medical professionals interaction with patients in various departments. Then, Marissa
examines medical records of her sister from her care at University of Michigan Hospital. These


texts provide direct evidence of patient and doctor interaction and portray how doctors
communicate with outsiders of their community such as their patients. Specifically, Marissa will
focus on the discharge summaries from Dr. Ronald B. Hirschl, who perfo
rmed her sister’s
intensive surgery. In proving the values of the medical community we will organize our
argument by Beaufort’s five domains of knowledge: Subject matter, genre, rhetorical, writing
process, and discourse community. Each of us will analyz
e these domains as they pertain to our
own data collection and utilize the five domains of knowledge as a framework. Through these
domains and different perspectives we will ultimately reflect on our insights and prove that the
medical community values pa
tient care, humanities health in general, scientific based analytical
practices, accuracy, and importance of innovation of knowledge.

Thematic Analysis

From observing and analyzing a geneticist, medical writers, a registered nurse, a hospital
volunteer and a medical record, the results confirm the values and goals we stated in our
introduction. As a volunteer from Children’s Hospital Michigan, the goals
and values of the
hospital are to attend and cater to patients’ needs through the use of accuracy. Seeing their work
ethic and how they follow procedures truly shows the extent and magnitude of dedication they
have for their patients. When interviewing Dr.

Tucker, he said the intentions of the medical
community are, “To make the human population understand genetics as it pertains to their life
and to ultimately benefit humanity.” This broader statement is consistent with the fact that the
medical community

values human health. Susan Owens, a registered nurse, demonstrates how
this community values patient care by how she treats and interacts with her patients. She does
this by taking into account the family’s emotions while performing her daily nursing duti
Furthermore, the value of accuracy is demonstrated by evaluation of medical writers. Medical


writers value writing with conformity and consistency in the medical community. They translate
researched information into a professional, coherent, and organ
ized document. Additionally,
medical records prove how this discourse values accuracy. The precision necessary when
recording patient data is seen in a discharge summary. Mariah Ford’s discharge summary not
only mentions her name, but also a “REG#

8367,” “Birthday: 01/02/1991,” “Sex
Sur Pediatric,” and a “Report Date
8/20/2008(1).” This patient data is exceptionally
crucial in providing the correct medical care to the appropriate patient. However, in order for the
community to achi
eve these goals and values, they require extensive subject matter knowledge.


Discourse Community Synthesis Project


In Brandt’s work, “Who’s the President,” she poses that the term ‘literacy’ has emerged into
a new definition and has become a
product of the so
called ‘Information Age’. Brandt uses the
Internet as an example and explains that “it [literacy] seems to be favoring a less original form of
writing; creation by citation, sampling, cutting and pasting, the blurring of the roles of wri
and readers” (Brandt, 2000, pg. 567.) The name of the author is often left anonymous on the
Internet as today’s society works quickly to converse. Essentially, a separation between
authorship and literacy is loosening. Brandt argues this could also

be a result of corporations or
high power figures that employ people to write for them, whom the writing community terms
‘ghostwriters’. Presently writing has become a commodity where “writing can be sold and
authorship can be bought” (Brandt, 2000, pg.5
52). Since writing is now made into a product,


ideas of authorship and literacy that were once so tightly connected to writing need to be

According to the United Nations’ Educational, Scientific and Cultural Organization, medical
literacy is currently being defined

as "the ability to identify, understand, interpret, create,
communicate and compute using printed and written materials associa
ted with varying contexts”
UNESCO Education Sector Position Paper,2004, pg.13

However, the medical community as
well as the writing discourse is undergoing a new era of redefining literacy particularly with
deciding who holds authorship. Although the

definition still holds true, it is the identity of the
person who is supposedly “identifying, understanding, interpreting, and creating” that is
changing. Ironically, UNESCO, who declared this definition of literacy does not even
acknowledge that there w
as a specific author of this definition, but rather claimed it as a whole
organization. The author is no longer the author in terms of the now obsolete definition of
literacy. In past times, the author was the person who carefully composed the work of wr
nowadays the author has become the institution that employs the writer or has power over them
through status. This change has catalyzed a constant lending of power and status among
institutions and ghostwriters. Companies and professionals lend th
eir power to ghostwriters,
which in turn are able to display their writing or partial voice. In fact, industries such as
pharmaceutical companies, medical researchers, doctors, and many other professionals from
various discourses employ ghostwriters to do

their analyzing and writing of the raw data for
them. Actually, there is a whole field of employed medical writers and associations such as
International Committee of Medical Journal Editors and American Medical Writer’s Association.
The fact that ther
e are such large associations of medical writers sends a signal for a revival in
the term ‘authorship’. This revival sparks several controversies that need to be addressed,


including the false authorship and failure of acknowledgement in academic papers w
ithin the
medical community.

This new era of literacy that Brandt recognizes has been emerging for quite some time.
In an article written in 1996 by Horton and Savage for the
British Medical Journal

titled “Time
to redefine authorship: a conference to d
o so” expresses the idea that authorship was always a
struggle within the medical community and other academic communities. Furthermore, this
article dissects the definition of authorship and explains that this definition is often neglected. On
the contra
ry, Horton and Savage explain other group definitions that encourage unethical
behaviors in authorship. The two group definitions that Horton and Savage mention are from the
Vancouver group and the International Committee of Medical Journal Editors (ICJME
). The
Vancouver Group’s response to authorship is "credit should be based only on substantial
contributions to (a) conception and design, or analysis and interpretation of data; and to (b)
drafting the article or revising it critically for important inte
llectual content; and on (c) final
approval of the version to be published" (Horton and Savage, 1996). This article references two
studies that show this definition being ignored and the least compliance with this definition was
found to be done by post
doctoral fellows who cited authors if they were the head of a lab,
funding the project, or a well
known academic. They found that the reason for this was the
result of ICJME’s lax standards for authorship. In conclusion, ICJME was prompted to make

universal standards for authorship. From reading more current papers I have seen this
organization take a stronger role in creating ethical uniformity within the medical writer’s
community. Furthermore Horton’s and Savage’s approach to the issue of auth
orship in 1996 will
highlight the ongoing problem of changing authorship and offer an historical perspective to the


The research question I will examine is how does the medical community recognize
sponsors, contributors, and authors involved in c
onstructing a medical paper? I will also
question the new era of literacy Brandt mentions and apply it to the medical discourse in order to
better understand authorship. Essentially, my main aim is to help the audience understand
ghostwriting and medical

writers increasing role within the medical community. In a broader
sense I will discuss ways in which the medical community is making a transition into the new
definition of authorship and the implications and controversies surrounding it. The investigat
of these topics will allow me to suggest ways to address and prove the emergence of this new era
of authorship as it pertains to the medical community.

This latest era of authorship consists of the integration of ghostwriters, medical writers,

other contributors into an academic medical paper. With this integration they may or may
not be recognized as having any involvement in the writing process, however more frequently
they lack acknowledgement. This lack of acknowledgment is becoming more
normal within the
medical community as industries employ writers to engage in the tedious writing process
medical professionals do not have time for. Foremost, I will prove that this new era of
redefining authorship is emerging by dissecting it into its c
omponent parts: the new definition of
authorship within the medical community, what controversies does ghostwriting spark, how are
these controversies being dealt with, and why this change of authorship is emerging. In doing
so, I will utilize studies fro
m Nastasee,

Lacasse, and Leo to directly prove an increase in
ghostwriting and incorporation of writing experts. Next, I will fully explain what the new
definition of authorship is as defined by various medical writing organizations, as well the
sies it instigates.
The works of Brandt, Penrose, Geisler, Beaufort, and Gee will help


me analyze authorship as a whole and describe complications that can arise. Importantly, I will
continue my argument by utilizing a methods, results, analysis, and dis
cussion format. This
argument format will thoroughly examine the new era of authorship emerging within the
medical community.

Also, from analyzing Nastasee as well as Leo and Lacasse’s studies I have found
conflicting results. In Nastasee’s

study she found that there was a two
fold increase in the
number of acknowledgments of medical writers from 2000 to 2007. However in Leo and
Lacasse’s experiment done in 2009
2010, it states that only 6 percent of the top fifty medical
institutions ban g
hostwriting completely. This shows variance that needs to be analyzed further.
Regardless of variances, authorship is taking a new face and is evident because of different
controversies surrounding the topic such as the small compliance rate with initiat
ing ghostwriting
bans as seen in Leo and Lacasse’s study and the small amount of acknowledgement of the true
medical writer. Also, when I searched the words “medical” and “authorship” on the Google
search engine,
25,600,000 results appeared and most of th
em had headings related to ethical
issues surrounding the terms. Some of the controversies of ghostwriting and guest authorship
being argued by various parties are that is promotes academic dishonesty, allows for less careful
articulation of writing, and
that new standards make it difficult to get published anywhere.
Basically, I found that there are ethical issues surrounding this new articulation of authorship by
the medical community.


Gee’s article, “Literacy, Discourse, and Linguistics” indirectly

questions the validity of
medical writer’s work since they are not fully fluent in the medical community’s language or
entirely apart of the community. It is in his segregation of the terms “Discourse” and
“discourse” that Gee indirectly proposes a separ
ation of medical writers and medical
professionals such as doctors. Specifically, Gee argues that “someone cannot engage in a
Discourse in a less than fully fluent manner” (Gee, 2011,pg. 487).This lack of fluency and
knowledge of some medical writers only

involved in the discourse does not give readers a fair
interpretation of what the actual medical Discourse intended to communicate. He also continues
to say that it results in failure to fully communicate the medical identity to the rest of the
, which questions the accuracy of medical writers’ capabilities. Gee’s concepts begin
to question the dangers of employing medical writers and redefining the term authorship by
determining whether medical writers or ghostwriters in general are a part of t
he discourse or
Discourse they are writing for.

However, Beaufort offers methods to how medical writers can fake fluency into the
medical discourse. Contrary to Gee’s perspective that limits entrance into the Discourse,
Beaufort invites shortcuts that m
edical writers can take to become a part of the Discourse or at
least be a good pretender of doing so. Beaufort allows acceptance by proposing her conceptual
model of the five domains of knowledge: subject matter, genre, rhetorical, writing process, and

discourse community (Beaufort, 2007). Although Beaufort initially applied these domains to
students learning academic writing, it can be translated to the medical discourse. In fact,
Beaufort notes that the five domains are
“empowering all across gender,

race, ethnic, and class
lines to write effectively in a range of social contexts” (Beaufort, 2007, pg.22). Beaufort’s
proposal here is what allows medical writer’s to fake admittance into the medical discourse they


are not physically apart of. Once the m
edical writer can grasp understanding of the medical
discourse values, subject matter knowledge, terminology, different genres, rhetorical prose, and
preferred writing process that is usually modeled after the scientific method; they can write with
se for the medical discourse. Although it seems like a lot for medical writers to learn, it is
a tiny amount compared to what the medical doctor or professional needs to know gain
admittance into their discourse.

Also, Penrose and Geisler’s proposal to wr
iting with authority as thinker can translate
over into the medical discourse and medical writers. Essentially, medical writers or ghostwriters
have to act as reporters of someone else’s work. However, they have to cleverly and carefully
transfer a less
effective information transfer method into that where they construct knowledge.
Penrose and Geisler offer ways in which medical writers can appear as insiders in the medical
community by writing with more authority such as Roger, a graduate student, in th
eir study.
Penrose and Geisler’s observation of the effect of authority allows medical writers to appear that
they are capable participants of the medical community instead of workers for the community

Although this versatility of authorship is b
ecoming applicable in the sciences, it is not
visibly translating over to other fields such as the humanities. In discussion with my English and
communication professors, performance and credibility is often measured by authorship. The
content of article
s or books one produces determines their academic status. This is also true in
the sciences; however authors are not always entirely responsible for achieving their status since
others are employed throughout the writing process. In contrast, the humanit
ies have articles
often authored by one to three people who legitimately compiled their ideas into writing. The
humanities would argue that mere acknowledgement of a medical writer is not enough because it


undermines the prestige of writing as a discipline
. I am curious how other discourse view this
change in authorship and if this employment of writers is universal. In further research I hope to
evaluate how this idea of authorship translates over to other communities and how the medical
discourse itself

is dealing with the transition.


American Medical Writers Association. (n.d.).
American Medical Writers Association
. Retrieved
November 29, 2011, from

Beaufort, A. (2007). College Writing and Beyond: A New Framework for University Writing

Instruction. Logan: Utah State UP.

Brandt, D. (2007). ''Who's the President?'': Ghostwriting and shifting values in literacy.

(6), 549+.

Gee, J. P.

(1989). Literacy, discourse, and linguistics: introduction.
Journal of Education


Horton, R., & Savage, R. (1996, March 23). Time to redefine authorship: a conference to do


Medical Journal

(7033), 723.

ICMJE: Uniform Requirements for Manuscripts Submitted to Biomedical Journals. (n.d.).

ICMJE: Uniform Requirements for Manuscripts Submitted to Biomedical Journal

Retrieved November 29, 2011, from


Lacasse, J. R., & Leo, J. (2010).
Ghostwriting at elite academic medical centers in the United


Matheson, A. (2011). How industry uses the ICMJE guidelines to manipulate authorship

how they should be


PLoS Medicin


Nastasee, S. A. (2010, March). Acknowledgment of medical writers in Medical Journal Articles:
a comparison from

the years 2000 and 2007.

American Medical Writers Association

(1), 2+

Penrose, A., & Geisler, C. (1994).

Reading and Writing without Authority.
College Composition
and Communication
(4), 505

"The Plurality of Literacy and its implications for Policies and Programs"

Position Paper
: 13. 2004.



Data Collection Report Transcript

Interview with John Tucker who has a Ph.D. in Human Genetics from Oregon Health Sciences
University. Conducted by Brooklynn Yanos

1.) What professional community do you identify
yourself with? What does literacy mean in this

* Human Genetics Community

* Literacy means being able to read and interpret pedigrees, chromosome maps, chromosomes
through the microscope, and the ability to read and record findings.

2.) Does wri
ting play a big role in your community? How often is it used? Why is it generally

* Yes, articles of research are always published to communicate to other geneticists. No one
wants to redo something that has already been done. It is used on a daily b
asis to track your

3.) What are the intentions or goals of your community? How are the goals of it shaped?

* To make the human population understand and deal with genetics as it pertains to their life.
Also, to help treat genetic disorders and stu
dy patterns, but basically it is to benefit humanities
health and wealth of knowledge. Also, specific intentions change as need changes. For example
cancer outbreaks and histone coding research is huge currently.

4.) Who has authority in the Wayne State re
search department? Even broader who has authority
in your community?

* The authority changes bases on who has the leading edge and new innovation. If I had to say
someone it would be David Njus who is the chair of the biology department. However, I am in
harge of my own lab in the biological sciences building.

5.) When is it appropriate, in your opinion to break the rules of the community? Are there even
specific limiting rules in your community?

* If new information arises and disproves other findings it is appropriate to research and possibly
disprove that law or rule. As in everything in science. When asked to elaborate on his rules he
said listed off Mendel’s laws of inheritance, central dogma,

human ethics, and respect for life.

6.) What is one thing a person in your community should never forget to do when writing?

* Be very accuate with the terms “genes” and “chromosomes.” These should never be confused
for the same thing. He gave an example
of this by an article in the Detroit Free Press he read a


week prior to the interview. Also, he said to make sure to record every result because it could be
a possible mutation or rare finding that could contribute to a scientific breakthrough.

7.) Do you
ever find yourself in a conversation where someone does not understand you because
of your terminology? Name a particular instance.

* Yes, my wife has just begun to understand me, but I still have to remember to talk in more
common terms.

8.) Are there dif
ferent genres or writing styles in your community? If so, what are they? Are they
produced individually, collectively? How important is each one and what is its individual

* Results/raw data

* Published article complete with an abstract and conclu

* Experimental

* Informative (clinical genetic counseling)

9.) How do texts in this medical community get published and produced? More, importantly how
does the community gain access to them?

* It is easy for me. I can just submit it through Wayne res
earch or I could submit it to a journal
such as, Environmental Health. They review it, ask you to change a few things, and publish it.
However, for undergraduate students you have to talk to someone higher up or with high
academic status to get published t
hrough them and have their name as an author.

E. R
eflection Paper 3&4

Ultimately, the synthesis project and panel presentation proved a difficult but necessary
task to tie in all the concepts learned throughout the semester. In the following paragraphs

I will
reflect on my process of writing, writing strategies I learned, the difficulties that arose, what I
learned that can be applied to future assignments, and finally how it helped me prepare for my
panel presentation.


My idea for the synthesis proje
ct was initiated through researching for other writing
projects such as the rhetorical analysis and data collection report. In the process, I stumbled
upon the association of medical writers’ website and was interested that medical professionals
employ other people to write for them. I looked into it more and even found evidence
that there was a shift in the way authorship is being defined. Furthering my knowledge I
researched ‘medical writers’ in academic onefile, an online database. I just ke
pt reading
different articles on authorship and medical writers until I found something worth using. Then, I
wrote an annotated bibliography on all of my eight sources I found that would be helpful. As I
actually started to compose the introduction for my

paper I cut out some of my less important
sources as they were unnecessary. To help generate ideas for the actual paper I began free
writing any idea that came into mind and ultimately came up with my research question and a
vague outline. My initial rese
arch question was defining the role of medical writers and after
extensive research I found out whole concept of authorship is under debate. I found that medical
writers are just a small subset underneath the term authorship. After that insight, I compose
d a
rough draft in the IMRAD format and through much revision I composed my final draft. I had
one person peer review my entire paper, but I should have recruited more. However, about four
other people read over my introduction as well as my instructor,
Wendy. Consequently, my
writing process lacked efficiency because I did not write a well defined outline to keep myself on
track. Specifically, my outline approached the subject at a different angle and aimed to define
authorship more so than explain how

authorship works in the medical community. It also was
not specific enough on what each section would entail. Adding to the complications, new ideas
kept arriving in my head after I had written the section. Instead of revising the section I would


e the entire thing and start over. The organization of my paper might have suffered because
of my constant change of mind; however I was pleased with the final outcome.

In regards to learning how to write through the synthesis report, I did not directl
y take
any writing strategies away from it. My topic on authorship was a bit different and focused on
how the term literacy is defined. Rather than referencing actual writing processes and practices,
it made more aware of meaning of authorship within t
he medical community. However, I have
learned more about writing throughout the length of the course. From reading writing studies
literature, especially Beaufort’s five domains of knowledge concept, I have seen general
approaches to writing in particul
ar discourses. Once one can master subject matter, rhetorical,
writing process, genre, and discourse community knowledge, they can effectively write for their
discourse of interest. So, I learned how to examine these aspects in the medical community and
now feel that I can conquer writing within the medical community or any other community that I
can examine using Beaufort’s five domains of knowledge. Additionally, Penrose and Geisler
taught me the importance of authority in academic writing. Rather t
han just being a reporter of
details, a successful piece of writing incorporates the writer into the conversation between their
sources and acts as a mediator between them. All in all, I have learned approaches from writing
studies that will allow me to t
ackle writing projects in my major such as: research papers, patient
charts, and even reflection papers on my residency training.

Overall, this synthesis writing project was difficult because of the topic I chose and my
inability to directly convey what
I wanted to say. Other classmates chose topics on expertise,
terminology, and identity, which was more direct. On the other hand, I chose a topic that was of
great interest to me and a bit more abstract. My topic was on the definition of literacy shiftin
g as
Brandt suggests. This was harder to pinpoint and go about because authorship is such a


controversy within the medical community and is lacking a clear definition. Although it was
difficult, choosing the topic was well worth it because I learned to c
hallenge myself by
investigating a useful topic for my medical discourse community membership. While I am very
interesting in this topic and how the medical community defines authorship and deals with it’s
now evolving values; it was difficult to directly

formulate what I wanted to say. Basically, I
have an interesting topic, but I just was not quite sure what to do with it. To conquer this I tried
free writing different ideas and then formulating the ideas I liked into an outline. This seemed to
however I kept finding different things to say as I read more articles and my outline kept
changing. It got to a point that I was so tired of writing the same thing that I just left it at my
current submission. I believe I struggled so much because I am
a perfectionist and realized I did
not have an unlimited amount of time to complete this project. So, one strategy I did learn is to
acknowledge the constraints of any writing task and to consciously state “this is the extent of my
research on authorship,
at this point in time, and based on this extensive research I will explain
my argument. Also, I should devote a whole week to just thinking about my topic and construct
a definite outline after much thought. With this approach, I hope to write my paper m
efficiently without doing unnecessary work as I did in this synthesis project. The discourse
community synthesis project introduced me to the IMRAD format which I soon found out is
essential to the scientific community. Before this project, I have nev
er even heard of this format
or an annotated bibliography. Wendy, my instructor walked me through the steps and the various
importances each section held. For my final paper in speech I was also assigned a paper in the
IMRAD format and an annotated bibli
ography. Without first learning about this format in
English 3010, I would have never been able to compose the vaguely explained assignment my


speech teacher gave. Also, the synthesis project allowed me to have a more holistic view of the
community I wi
ll enter into and made me more aware of guest writing in the medical profession.

Regarding the panel presentation, the synthesis project definitely prepared me for that
and in fact was what I based my discussion upon. I utilized the analysis of my source
s and
statistical studies I found for my synthesis paper in my presentation. Simply, I focused on how
the medical community defines authorship and it was able to produce conversations among the
other class members. For example, the business community sa
ys that ghostwriters write up
emails or letters to the corporation and are signed by the CEO. However, in humanities
authorship is preserved for the person who actually wrote the material and it distinguishes the
academic status of the person. The variou
s discourse community perspectives on authorship, as
revealed in the panel presentation, allowed me to bring in other discourses into my synthesis
paper. So not only did the synthesis paper support my presentation, but the student responses
during the pre
sentation offered more content to my paper. I felt confident as I did my panel
presentation in my ability to discuss writing studies literature and how it applies to my specific
topic of authorship within the medical community.