Exploring the Social Action of Genres in Physical Therapy In recent years, research has introduced individuals to a new and

improved understanding of the word genre that goes above and beyond the standard textbook definition. In particular, the standard definition of genre that many individuals are familiar with is mainly focused on content and form. Our perspectives as writers have since changed. We are now aware that genres are a complexity of characteristics. Authors Anne Beaufort, Kerry Dirk, Carol Berkenkotter, and Thomas Huckin are four very influential writers on this topic. These authors set out to inform readers about genre awareness in order to distinguish how genres function in social settings and how genres pertain to our everyday lives. In “Transferring Writing Knowledge to the Workplace, Are we on Track?,” Anne Beaufort argues that the education received by students in their high school and college level composition classes is not enough to prepare them for the type of writing they will being doing in real world writing situations (p.180). Beaufort goes on to explain how the work done by students throughout these classes is irrelevant to the type of writing that these students will move on to do in their professional fields. The value of the skills taught to students at these levels is minimal in comparison to the knowledge and skills they will acquire actually being in the work place. Exposure to the environment in which an individual will be working in reveals how a specific discourse community functions. The success of an individual in their professional field ultimately depends on their ability to write within several different genres, their understanding of how each genre functions within the discourse community, and their comprehension of the discourse community as a whole.

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Throughout this analysis I will be investigating the genres of an initial evaluation note and of patient goals that are specifically used in the field of physical therapy. An initial evaluation note written by the physical therapist is not only insightful for the physical therapist, but also the physical therapist assistant, the patient, and the patient’s practitioner. By using an initial evaluation note, all the information one would need to identify about a certain patient is in one localized document. Initial evaluations also lay out the ground work for the use of another type of genre in the physical therapy setting known as patient goals. Patient goals are an essential aspect of the physical therapy process. They target the ambitions that the physical therapist has for the patients and also the aspirations the patient desires for his or her self. Throughout my analysis, I will be further investigating genre as a social action within the setting of physical therapy while also determining how Berkenkotter and Huckin’s concept of “situatedness” functions in order to establish community ownership throughout the discourse community. Physical therapists work with patients who have functional limitations, impairments and disabilities. These changes in physical function and health status may result from injury, disease or other causes. Physical therapists work towards helping patients accomplish several goals. These include assisting the client in order to help them regain full functional ability, improve mobility, relieve pain and prevent permanent physical disabilities. In doing so, the physical therapist will have to provide an examination, evaluation, diagnosis, prognosis and interventions that will work toward these goals. For each step of the physical therapy process documentation is required. Documentation is one of the most important aspects of the field of physical therapy. Physical therapists often times are working as a team with several different staff members as well as the patient. Therefore, all documentation must be able to effectively communicate

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between all members of the team. To do so, the writer must understand how the genre they are writing within functions. Due to the fact that there are multiple persons interacting with the patient, initial notes must be able to effectively communicate a message between all who are involved. As referred to by Carol Berkenkotter and Thomas Huckin, “situatedness” is best described as when, “we use genres to package our speech and make of it a recognizable response to the exigencies of the situation” (482). In basic terms, this means that when a certain situation arises for the first time a response is desired. When this situation happens again, the first response will become the basis for every response there on after. In “Navigating Genres” (1990), Kerry Dirk further reinforces Berkenkotter and Huckin’s concept of “situatedness” by articulating that different situations require different responses (pp. 259). Therefore, in turn, it is imperative that individuals in the field of physical therapy are able to distinguish what genres are the most applicable under any given circumstance. As well as being able to distinguish what genres are the most applicable for a given situation, it is vital to understand why that genre is appropriate and the role that specific genres play as a written document within the discourse community. A key factor to the success of an individual within the field of physical therapy is the use of written communication and being able to comprehend its importance. An initial evaluation note is one of the most important forms of written communication used in the field of physical therapy. Physical therapists and physical therapist assistants are not always continuously working with the same patients and may be working with different people at different times. This particular “situatedness” makes verbal communication difficult and sheds light onto why physical therapists and physical therapist assistants rely on written documentation to communicate vital patient information. Often times, a
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physical therapist will perform the initial evaluation and then the initial evaluation note is used to communicate between the physical therapist and the physical therapist assistant. Reading the initial evaluation note, the physical therapist assistant is able to see why the patient was referred to physical therapy, what interventions the physical therapist recommends, and what type of plan the patient is supposed to follow until the end of their treatment. Common characteristics for the genre of an initial note are that the document should use proper anatomical terminology such as proximal describing something closer to the trunk, distal describing something further away from the trunk, superior describing something close to the head, many more. Documents, especially an initial evaluation note, will often times include physical therapy jargon and abbreviations such as IE, for initial evaluation, Hx for history, LOS, length of stay, ROM for range of motion and numerous other examples. Individuals working within the field of physical therapy have to be able to understand these terms in order to fully comprehend the genres used within the discourse community. Another crucial aspect of this genre is that the documentation stays organized, legible, clear, to the point, and follows correct grammar and spelling. If done correctly, and understood by all parties involved, the genre of an initial evaluation note allows for an ease of operational communication between all staff members and genres written after the initial evaluation note. All information included in this documentation needs to be recorded appropriately and accurately for the sake and benefit of the patient. Every document written after the initial evaluation note is written in reference back to the initial evaluation note. If one piece of information is recorded erroneously, the documentation following the initial evaluation is also inaccurate. All genres within the field of physical therapy are interrelated. The genre of patient goals are directly associated with the genre of an initial evaluation note. Throughout the initial
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evaluation, the physical therapist and the patient work together to establish obtainable short and long term goals. These goals should be concentrated on working towards the functional limitations of the client. Typically, short term goals are no longer than two weeks in length and often times are designed to help the patient progress closer to reaching their long term goal. When the time has come for the patient to be discharged, the will have hopefully reached their long term goals. An example given in a note writing document by the Washington School of Medicine in St. Louis, Program in Physical Therapy Education was that, “The patient will climb stairs, with one rail, independently for 1 flight, by 9/30/04 (p.88)” As in the genre of an initial evaluation note, characteristics such as organization, legibility, clarity, and correct grammar and spelling are still emphasized. Short term and long term goals however, need to be written in terms that not only the physical therapist and physical therapy assistants comprehend, but also the patient. The sample patient goal stated above is clear and concise for all parties involved. In this particular rhetorical situation, it is not appropriate to use anatomical terms and physical therapy jargon. Individuals outside the discourse community may not understand these expressions. Again, “situatedness” plays a big role in determining what genre a document should be written in. In order for the patient to understand what the physical therapist wants them to do, the genre of patient goals must be clear and concise to the client. These goals are meant for the patient to be working on throughout their time spent in physical therapy. If the patient is not able to identify with what the members of the physical therapy team are trying to tell them, chances are, they will not be working towards their goals because they did not know what the physical therapist was asking of them. As an end result, the patient would not be benefiting from their patient goals and would not be receiving the best quality of care possible.

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“Community ownership,” as described by Berkenkotter and Huckin is being able to identify the standards and norms of the discourse community as a whole by studying the use of genres within the field (p. 498). Ideals and beliefs of a discourse community are not always spelled out in black and white. However, working in many different genres and knowing how they function within the field of physical therapy provides some insight as to what members of the physical therapy community value. Individuals who have been working within the field are then able to associate these common assumptions with the profession. For example, the initial evaluation note and the set of patient goals are centered on the well-being of the patient. It is evident within most, if not all, health related occupations that these given discourse communities highly value the quality of care that the patient is receiving. Without patients, these people would not have jobs. Documentation through genres such as the initial evaluation note and patient goals are necessary in order for the patient to receive the highest quality of care possible. Due to the “situatedness” of the rhetorical situation, written documentation allows members of the discourse community to effectively communicate vital information to each other with ease. This information is always accessible, and essentially keeps track of everything that happens while the patient is in treatment. These records and documents have the patient and discourse communities best interest at heart. They keep the quality of care of the patient as priority and also keep members of the physical therapy team up to speed. If the individual working within the discourse community does not understand how these genres function then they will not accurately represent the discourse community as a whole. Working in the health profession, documentation can make or break your career. Misrepresenting the discourse that you work within could be detrimental to your future as a professional in your field. One mistake recorded within these genres, could potentially harm the patient and thus you for having been responsible. Any

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member within the field of physical therapy must know how important written genres are to their discourse community. Each document within the field of physical therapy has a specific purpose. Genres function as social actions. It is the writer’s job to make sure that the document within the genre articulates what it is supposed to. In order to do so, the individual must understand the context in which it is being used. When writing documentation within this field, it must be able to communicate within all members of the team and the patient. The “situatedness” of a genre within the physical therapy field acts to help reinforce “community ownership.” Knowing how genres function and how they reflect the values and goals of a physical therapist is imperative to one’s career.

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Appendix https://pt.wustl.edu/education/forclinicalinstructors/documents/notewriting.pdf Works Cited Beaufort, A. (1999). Learning new genres: The convergence of knowledge and action. In Beaufort’s Writing in the Real World (pp. 103-137). New York: Teachers College Press. Beaufort, A. (1999). Learning new genres: The convergence of knowledge and action. In Beaufort’s Transferring Writing Knowledge to the Workplace, are we on Track? (pp. 179-199). New York: Teachers College Press. Berkenkotter, C. and Huckin, T. (1993). Rethinking genre From a sociocognitive perspective. Written Communication, 10(4), 475-509. . Dirk, K. (2010). Navigating genres. Writing Spaces: Readings on Writing, Volume 1. Retrieved from http://www.writinginspaces.org/essays

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