Toward Audience Involvement: Extending Audiences of Written Physician Notes in a Hospital Setting

Lee Ann Kastman Breuch, Abigail Bakke, Kimberly Thomas-Pollei, L. Elizabeth Mackey, Craig Weinert

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


This article explores rhetorical implications of extending the audience of written physician notes in hospital settings to include patients and/or family members (the OpenNotes program). Interviews of participating hospital patients and family members (n = 16) underscored the need for more complex understandings of audience beyond “universal” and “particular” explanations. Interviews were organized around the aspects of comprehension, affect/emotion, and likes/dislikes about receiving notes. Results from these interviews indicated that participants understood the notes overall but had questions about abbreviations and technical terms. Many participants felt reassured about the care they were receiving, and many liked having the notes as a reference and springboard for further discussion with health care staff. A more detailed content analysis of the interview data yielded themes of document use, readability, involvement, and physician care. Findings from this study reveal an expansion of audience in this case to include both universal and particular audiences. Also, findings point to the possibility of audience involvement among patients and family members through activities such as asking questions about the physician notes. This study has implications for other forms of written communication that may extend readership in novel ways.

Original languageEnglish (US)
Pages (from-to)418-451
Number of pages34
JournalWritten Communication
Issue number4
StatePublished - Oct 1 2016


  • OpenNotes
  • adherence
  • audience
  • health literacy
  • medical rhetoric
  • patient-centered care
  • physician notes
  • physician–patient communication
  • written communication

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