Vaccination is power—power to prevent disease, power to shape populations, power to define sickness and health, and power to compel scientific beliefs into the bodies of people around the globe. It is unsurprising, therefore, that vaccinations have garnered centuries of dissent. Specifically, the conscience—the parent or patient’s perceived right to make vaccination decisions based on personal perceptions of acceptable risks—has been used since vaccination’s inception as a rationale for individual rights to refuse vaccines in the face of the very public health goals that vaccinations aim to achieve. Existing studies of vaccine disputes in medical literature have understood vaccine questions to be a problem of scientific knowledge or literacy, claiming largely that vaccine skepticism arises from a lack of proper comprehension or understanding of the scientific and medical bases for vaccination or statistical evidence proving vaccines are safe and effective. Studies of vaccination controversy in social science, communications, and historical literatures have largely examined the role that alternative notions of risk valuation, sources of trusted health information (such as preferring the advice of friends and neighbors to doctors), or conceptions of uncertainty have played in largely parental decision making about childhood vaccinations. Despite these extensive studies of vaccine sentiment, vaccine skepticism and refusal remains a small, though significant, voice in public debate. This dissertation examines vaccine discourses as object-oriented rhetorics—as rhetorics shaped and defined by the physicality of the vaccine’s operation—as a way of re-conceptualizing the vaccine debate. Using object-oriented theories from computer programming, philosophy, and rhetoric, this research examines the professional and public voices that make up contemporary vaccine controversy. Through three data sets, including interviews with physicians, parent discourses produced on the Internet, and survey responses from young adults, this dissertation observes that vaccines function as objects that have multiple, coexisting operations for different actors across the medical system. Consequently, vaccination controversy can be conceptualized not as accurate versus inaccurate understandings of science or as a conflict of perspectives, but instead as a by-product of multiple ontologies of vaccines at work under competing disease exigencies. / Ph. D.

This dissertation explores how various versions of a university's identity"including the leadership-sponsored brand as well as alternate rhetorics of organizational identity"shape the policies and practices of the university itself through the lenses of rhetoric and power. While the concept of organizational identity has been studied from a variety of disciplinary perspectives, including marketing, organizational communication, graphic design, and organizational behavior, they all seem to have a common goal: maintaining the status-quo of management's control over all perceptions of the organization's identity. Most organizations however, do not have a single monolithic identity, especially large, decentralized organizations like universities. Alternate rhetorics of identity exist, but these management-centered approaches do not allow for their role in shaping organizational identity or practice. The rhetorically-grounded approach that guides this dissertation, however, which is based on identity-formation through identification as well as the role of rhetoric as a method of determining the most appropriate and effective ways of moving people to action, acknowledges the role of these alternate identity-rhetorics in organizational life and recognizes their potential impact on organizational activity. Through three cases of organizational decision making and policy creation at Virginia Tech, this dissertation explores the ways that the various rhetorics of identity within the university (including the official, leadership-sponsored brand and other versions of organizational identity held by university members) contradict, reflect, and co-construct each other and organizational practice. Through ethnographic interviews with members of the Virginia Tech community, participant-observation of a brand training program, and analysis of various visual, verbal, and multimodal texts related to each case study, this project explores these many rhetorics of organizational identity as they struggle for the power to shape the institution. This dissertation encourages researchers, teachers, and practitioners of professional and technical communication to recognize alternative organizational identity-rhetorics because of their potential power to shape the organization. Specifically within educational institutions, this project suggests that branding initiatives be critiqued as potentially hegemonic forces that repress these alternative identity perspectives, which may provide necessary incentives or conduits for organizational growth. / Ph. D.

This dissertation is a microanalytic investigation of professional communication in beauty salons in the United States and Japan. In particular, it centers on the analysis of a common, yet very important occurrence found in cosmetology sessions: what I call the "service-assessment sequence", in which service-provider and client determine whether or not the completed work in a given session is adequate. This is a crucial moment in the haircutting activity (and in other fields of the service industry) in order to bring a satisfactory closure to the session, as well as maintain a healthy relationship for future sessions, retain clients in general, and ensure client satisfaction overall. Using the methodological frameworks of microethnography and conversation analysis, I examine the moment-by-moment unfolding of interaction, focusing on how participants smoothly conduct the service-assessment sequence and how they achieve the successful completion of a service encounter through a number of tactics. The findings include: the participants' systematic coordination of talk and physical inspection through multiple second pair parts; the participants' coordination of talk and action to negotiate sequence closure; the participants' professional use of head nods in the middle of physical inspection and at sequence completion during service encounters in Japan; and the participants' employment of a unique combination of verbal and embodied actions to transform the event of revision into a mutual decision. These findings suggest several important aspects of professionalization in beauty salons. Notably, the professionals' ability to harmonize talk and action is a special trait. Also, despite the fundamental regularities, the service-assessment sequence is frequently adapted to specific circumstances of each beauty salon that may vary across different services and cultures. Finally, the production of professional assessments and agreements are achieved by the participants' constant work on dramatization through the use of various communicative resources. The study is applicable not only to the field of cosmetology, but to a range of professional-client interactions where people evaluate the quality of service with their subjective perspectives, enhancing our understanding of negotiation-in-interaction in the workplace and what it means to professionalize communication in such situations. / text

Background: Studies show that healthcare professionals often experience ethical difficulties in their relations with patients, relatives, and other professionals and in relation to organisational issues, and these can sometimes be difficult to handle. Failing to act or to relate in accordance with one’s values for what is good and right might cause a troubled conscience that is connected to feelings of guilt and ill-being. Ethical issues related to the care of patients with end-stage renal disease have been described, but no studies in this context have been found that explore registered nurses’ (RNs’) and physicians’ experiences of being in ethically difficult situations that give rise to a troubled conscience. The importance of communicating ethical issues in order to understand and handle ethically difficult care situations has been emphasized. Various forms of clinical ethics support (CES) have been described and evaluated, but studies on the communication processes and the organisation of CES interventions are sparse and no study describing a CES intervention based on Habermas’ theory of communicative action has been found. Aim: The overall aim was to increase our understanding about being in ethically difficult care situations and about how communication concerning ethical issues in healthcare can be promoted. More specifically, the aim of studies I and II was to illuminate experiences of being in ethically difficult situations giving rise to a troubled conscience among RNs and physicians, while studies III and IV aimed to describe the communication of value conflicts (III) and the organisation and performance of a CES intervention (IV). Methods: In studies I and II narrative interviews with ten RNs (I) and five physicians (II), were performed in a dialysis care context. The interviews were analysed using a phenomenological hermeneutic approach. In studies III and IV, eight audio- and video-recorded and two audio-recorded sessions of the CES intervention, were conducted and sorted by the data tool Transana and analysed in accordance with a qualitative content analysis (III) and a qualitative concept- and data-driven content analysis (IV). Results: The RNs’ narratives (I) resulted in the theme ‘Calling for a deliberative dialogue’. Their narratives expressed feelings of uncertainty, solitude, abandonment, and guilt in complex and ambiguous ethically difficult situations. The narratives concerned the value conflict between preserving life by all means and preserving life with dignity. The physicians’ narratives (II) resulted in the themes ‘Feeling trapped in irresolution’ and ‘Being torn by conflicting demands’. Their narratives expressed feelings of uncertainty, solitude, abandonment and guilt related to the obligation to make crucial decisions and in situations when their ideals and the reality iii clashed. The analysis of the communication of value conflicts during the CES intervention inspired by Habermas’ theory of communicative action (study III) revealed a process of five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, revelation of the value conflict, enhancing realistic expectations of the patients and relatives, and seeing opportunities to change the situation instead of obstacles. The CES intervention (study IV) was organised as a framework with a given structure and an openness for variations to facilitate communicative action. Three courses of actions to reach a communicative agreement were identified and concerned the approach to achieve a permissive communication, opening up for extended views, and enhancing mutual understanding (IV). Conclusion: The results show that both RNs and physicians expressed feelings of uncertainty abandonment and loneliness in similar ethically difficult situations but from different points of view. They struggled with the same value conflicts and feelings, but they did not share their struggles with each other. The lack of communication and confirmation led to distrust and increased feelings of uncertainty. The CES intervention, inspired by Habermas’ theory of communicative action, offered the possibility of dealing with experiences of ethically difficult care situations. In the permissive atmosphere, the professionals helped each other to balance their ambiguity, frustrations, and powerlessness and came to an agreement about how to handle the value conflicts and how to act. The findings from this CES intervention constitute a step towards a CES method that is clearly described so that leaders can be educated and extended intervention studies with different kinds of data can be conducted in order to further develop knowledge about how to promote an inter-professional dialogue about ethical difficulties.

Teachers are required to constantly change their pedagogy throughout their career, either in response to new theoretical approaches or new technological innovations. It is a profession that is characterised by dynamism and constantly strives to advance its practices to improve outcomes in student learning. However, current professional development programs are seen to be failing to meet the needs of the teachers, students and education policy. Research has shown (Huberman, 1995; Richardson, 1990), there has been little discernible change in teaching practice from current professional development programs, thus an alternative solution is needed. The premise underlying this study is that the use of online communities of practice may present a solution to the failure of current professional development programs in effecting change to teaching practice. Thus it is the intention of this thesis to investigate if online communities of practice can realise this potential. The research was conducted within the paradigm of qualitative analysis. The study was conducted as a multiple explanatory case study also known as a collective case study (Yin, 2003) and this approach reflects the current shift in trends of research in education. As Richardson (1994) stated, it has shifted &quotfrom a focus on effective behaviours toward the hermeneutic purpose of understanding how teachers make sense of teaching and learning" (p. 5). The approach used in this thesis provided insights into the value of online communities as authentic contexts for supporting professional development particularly in relation to relationships, communication and collaboration between teachers around professional inquiry, problem solving and emotional aspects of teaching. The results of the study show that online communities of practice are a valuable source of continuous professional development for teachers. They have the ability to provide support as teachers accommodate the constant changes and the need to acquire new skills and knowledge. The strength of this method of PD lies in its ability to be self-sustaining and generative. Teachers have access to authentic, relevant and flexible learning that is not constrained by time and can be accessed according to members needs.

The transnational diasporas in a technological world that is postmodern and posthuman mean both exciting diverse communities and challenging problems. On the one hand, globalization brought human beings the convenience of exchanging ideas, doing business, and building a better world together. On the other hand, the political economy of nation states that shaped non-translational ideologies, created at the same time conflicts and misunderstandings among citizens from different parts of the world. Responding to the current transnational clashes in flow (information dissemination) and contra flow (surveillance and control of information flow) of our information age, this dissertation builds up a transnational rhetoric and communication model that can be used to examine the curriculum design, teaching materials, and pedagogy in communication and writing studies, especially in technical communication. In addition, this study investigates the present state of curriculum design, teaching materials, and pedagogies in a southeastern higher education institution. Empirical data was collected from students, instructors, and administrators from different departments of this institution to determine whether and how do curriculum design, teaching materials, and pedagogies frame and teach transnational literacy. Further, to engage the conversation with a national audience, major introductory technical communication textbooks were analyzed based on both the empirical data and the transnational rhetoric and communication model using content analysis. The findings indicate that although curriculum design, textbooks, and pedagogies have transnational components, they generally reply on traditional models and stereotypical examples that cannot meet with students’ needs in order for them to become genuine world citizens with transnational awareness and competence. The transnational rhetoric and communication model helps to fill the gaps in curriculum design, textbook revision, and pedagogies in cultivating world citizens.

The study of communication was born with the study of rhetoric, and scholars have been examining the creation and reception of messages for thousands of years. However, the term rhetoric often has negative connotations, as we hear people label some statement as “just rhetoric” or we hear them say, “The action doesn't match the rhetoric.” However, rhetoric is a style of communication that takes into account the effective use of both verbal and non-verbal languages, and it is one of the main ingredients in the day to day communication in organizations, healthcare organizations being no exception. It is virtually impossible to communicate without the use of rhetoric. This study focused on healthcare organizations because the delivery of healthcare is built on communication, and there is more to understand about the usage of language and organizational rhetoric in healthcare organizations. To these effects, the study examined communication in healthcare organizations and the perceived use of rhetoric among healthcare professionals; it explored how healthcare professionals perceive communication with their audiences, how the use of rhetoric, as perceived by healthcare professionals, affects communication in healthcare organizations and the contribution of rhetoric, as perceived by healthcare professionals, in motivating healthcare audience in healthcare organizations. The five canons of rhetoric were employed as a theoretical framework, and semi-structured interviews were used as tools for data collection. While contributing to existing literature on health and organizational communication, this study will also contribute in providing both government and private organizations insights into the use of rhetoric in professional communication with the hope of enhancing the quality of communication in the workplace.

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This study looks at what happens in informal conversations between three people with learning difficulties (intellectual impairment) and a range of non-disabled partners. It takes a participatory approach using data collected by the participants with learning difficulties who chose their communication partners; these partners included family and staff who were paid to support them. The study uses descriptive statistics to highlight areas where there was apparent asymmetry in the conversations. Conversation Analysis combined with features taken from Systemic Functional Linguistics is then used to look in detail at some of these aspects. Important features identified include turn design, repair, and the use of evaluative language and the contribution of non-verbal aspects in particular eye gaze, gesture and the use of artefacts. The study highlights possible strategies for assessing and supporting more effective and equitable interaction for those with learning difficulties and communication impairment and identifies features that should be considered when training professionals working in the field of learning difficulties.

My study explores the characteristics of remote performance feedback that professional examiners working in the Oxford, Cambridge & RSA (OCR) awarding body communicate to each other. Drawing on sociocultural theories, I argue that this interaction possesses learning potential because between-professional communication supports the development of participants’ reasoning through the alignment of culturally appropriate collective thinking. My data consists of 991 feedback messages that were captured during two examination sessions (between May and July 2014, and between May and July 2015). These remote interactions (either email or telephone) involved three senior examiners and 27 examiners. These feedback interactions have an important quality assurance function as they help to ensure that the examiners carry out marking practices to an agreed standard. My research explores two interlinked research questions: ‘What are the characteristics of examiner feedback?’ and ‘What are the characteristics of effective examiner feedback?’ For the first research question I develop a methodology that extends the Sociocultural Discourse Analysis (SCDA) approach developed by Neil Mercer; I call this approach Augmented Sociocultural Discourse Analysis (ASCDA). My methodology allows me to investigate the features of interaction at both a particular and a general level, and clusters my analysis into four specific feedback discourse themes: feedback content, the development of discourse over time, evidence of joint intellectual action within feedback, and the impact of feedback. In order to address the second question I hypothesise that effectiveness relates to how feedback features support or undermine examiners’ common ground building. I synthesise the findings from these analyses to consider the lessons for examiner practice in particular, and for other professional feedback practices more generally. Taken together, these analyses suggest that feedback-giving is an intellectually challenging process. My analyses also suggest that this complexity involves the participants establishing and maintaining an Intermental Development Zone through their feedback communication, and that this entails them manipulating discourse features whilst simultaneously attending to a variety of contextual features of the professional environment.