Background: Efforts to better understand and improve letters of recommendation (LORs) in the resident selection process have identified unwritten rules and hidden practices that may limit their effectiveness. The objective of our study is to explore these unwritten rules and hidden practices more fully in one Canadian academic medical community. -/- Methods: We conducted semi-structured, discourse-based interviews with 18 faculty members from the departments of Internal Medicine and Psychiatry at the University of Manitoba, Canada. Interviews were guided by sample LORs (...) and were focused on experiences with either writing or reading LORs. We analyzed interviews using key concepts from genre theory and Aristotle’s appeals to ethos, logos, and pathos. -/- Results: Participants described how the practices surrounding LORs are guided by unwritten rules. These practices contributed to writers’ use of visible strategies and textual silence to establish credibility, build a strong case, and appeal to readers. Readers rely on similar strategies, but not always as intended by the writers. -/- Conclusions: The unwritten rules of one academic community can impede a nationally-facilitated resident selection process. Our findings highlight how critiques and potential improvements to LORs could benefit from considering the use of visible and invisible rhetorical strategies in specific contexts. (shrink)

Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in different social contexts and communication environments, and present creative responses that may help counter the negative trends. As traditional methods of communication have in many (...) ways failed the public, changes in approach are required, including the creative use of narratives. (shrink)

The growth of consumer DNA ancestry testing has resulted in questions and critiques being raised in social and research contexts. This study examined individuals discussing their ancestry DNA testing results on YouTube by searching for the two most popular testing companies (23andMe; Ancestry) and the phrase “DNA results.” The finalized dataset consisted of 117 videos, on which directed content analysis was performed. In the videos, individuals used results to clarify, confirm, question, and re-evaluate their previously held conceptions of racial/ethnic identities. (...) Reactions were more positive than negative (88.1% vs. 8.1%), and results more commonly reaffirmed (77.8%) than re-conceptualized (40.0%) one’s racial/ethnic identity. Ancestry testing and personal social media accounts were commonly promoted, demonstrating biotechnological hype where promotion abounds and critiques are scarce. Questions persist around the impact of ancestry DNA testing in reifying a scientifically inaccurate conception of race and what impact YouTube videos might have on audiences. (shrink)

Stem cell tourism is a form of medical tourism in which patients travel to receive unproven or untested stem cell-based interventions for many different diseases and conditions. A few studies indicate that patients and the public have several reasons for seeking these treatments for themselves or for their loved ones. Among these are the feeling of not having any other clinical options left, distrust of or frustration with their home country’s health care system, and a perception that their home country (...) has a burdensome or sluggish regulatory system for the approval of novel stem cell therapies. These last two viewpoints may contribute to a certain sense of distrust of regulatory agencies governing the conduct of clinical research, and perhaps the perception of a health care system that seems unresponsive to the needs of patients suffering from severe conditions. (shrink)