In studying these activities as ways of constituting social worlds, students are learning to examine

Structure and Agency in Medical Case Presentations Catherine F. Schryer, Lorelei Lingard*, Marlee Spafford**, and Kim Garwood*** Department of English *Faculty of Medicine and the Centre for University of Waterloo Research in Education Waterloo, Canada M5S 1A1 University of Toronto cschryer@watarts.uwaterloo.ca Toronto, Canada M5S 1A1 lorelei.lingard@utoronto.ca **School of Optometry ***Hospital for Sick Children University of Waterloo Toronto, Canada M5S 1A1 Waterloo, Canada M5S 1A1 kim.garwood@utoronto.ca mspaffor@sciborg.uwaterloo.ca Abstract This study investigated the role that medical case presentations play in the renegotiation or reconstruction of agency that occurs between medical students and physicians. Medical case presentations perform a dual function in teaching hospitals. They constitute formalized ways that physicians convey complex information about patients, and they are educational vehicles which medical students use to demonstrate their medical problem-solving abilities. This study observed and transcribed 16 oral case presentations performed by third-year medical students in a children’s hospital. As part of an interview protocol, two transcripts, one from a less and one from a more expert student, were turned into scripts, dramatized and videotaped. Ten faculty and 11 students were interviewed and asked to identify the differences between a more or less expert student performance. Data were analyzed using modified ...