Teaching and learning communication in medicine: a rhetorical approach.

The language people use both makes possible and constrains the thoughts they can have. More than just a vehicle for ideas, language shapes ideas--and the practices that follow from them. Thus, in medical education, teaching students how to talk about medical cases also teaches them how to think about patients and medical work, and how to define their relationships to both. Without a theoretical model, however, teaching efforts in this domain tend to be implicit and ad hoc, which can lead to serious problems. Rhetoric is one science that can deepen understanding of communication and improve teaching of this clinical skill. Rhetoric systematically studies the relationships between communication and its effects, between how things are named and how they are experienced, between discourse and socialization. Bringing language to the foreground of education, rhetoric directs attention to the relationship between what medical students learn to say and what they learn to value, believe, and practice.