Understanding Reading
I will focus on what is presumed the ultimate goal of reading medical records; understanding or comprehension. Reading that does not leads to comprehension is not covered here.
Understanding text is the conversion of text to a representation of it in our brains. This representation can be multilevel. The lowest is the surface drawings of letters. The highest representation is commonly called situation model (SM).(Graesser, Millis and Zwaan 1997) Situation model is a multidimensional representation of the text that is formed by the interaction of the text and the reader’s previous knowledge. The reader performs different inferences based on the text and his or her previous knowledge to create this high level representation. There is agreement on the content of this representation as proved by empirical evidence. The structure and storage location of this representation is still debatable.
Here is an illustration of the presence of situation model (SM). Read the following two sentences: (Zwaan 2003, p94)
Harry put the wallpaper on the table. Then he put his mug of coffee on the paper.
Harry put the wallpaper on the wall. Then he put his mug of coffee on the paper.
You probably balk with the second sentence. The reason is as you were creating a representation (unconsciously) of the text, the formed SM is impossible. It is impossible to have a mug of coffee on a vertical surface. If readers did not create this representation and only rely on the surface meaning of text they would not balk with the second sentence.
Empirical evidence illustrates five dimensions or contents of situation model. These are:
· Space (location)
· Time (sequence and duration)
· Protagonist (entities and objects)
· Causality (cause and effect)
· Intentionality (goals and motivation)
(Therriault, Rink and Zwaan 2006)
Two of the methods used to test for the presence of these dimensions are:
1. Participants read text where information about a dimension is not explicitly present. Readers then, need to answer questions that require them to make inferences based on the read text.
2. Participants read text with shifting in a given dimension as a shift in space or time. The reading time will be compared to similar text where there is no such shift. Readers usually take longer to read the text with shifts. The following passage is from a research conducted by Therriault, Rinck and Zwaan (2006). You can notice continues shifts in protagonist, location and time. Such text takes longer to read when compared to text that does not contain all these shifts.
Paul took care of the garden, which he had declared his territory, whereas Frieda started to tidy up the house. The morning air was pleasant and refreshing, so she opened all the windows and let spring reach every corner of the house. Then, in a spirit of adventure, she climbed up to the attic. There she searched old boxes and shaky cupboards, and she checked for mice. At noon, she cleaned the winter dust out of the hall and tidied up her beloved cabinet. The noon sun was quite warm already, so she interrupted this work for some time while she closed all the windows to keep the house pleasantly cool.
Readers strive to create a coherent representation or SM. (McNamara 2001) (McNamara and Kintsch 1996) (McNamara et al, 1996) As there will never be a text that ‘tells’ everything readers will always need to fill in gaps based on the text they just read and based on previously held knowledge. (Walsh 2006) McNamara conducted three studies to assess the relationship of the level of coherences (less gaps within text) and level of readers’ comprehension. Coherence was improved by adding more explanations and definitions to possibly unfamiliar text. McNamara studies showed that for answering questions that require making inferences, knowledgeable readers did better. On the other hand, readers with less background knowledge did better with the more coherent text.
In conclusion, reading that leads to understanding is a process of creating a coherent multidimensional representation (situation model) by combining what is read and the readers’ previous knowledge.
Walsh (2006) went further in pointing out the shift in today’s readers and learners. Today’s, readers and learners receive multimodal inputs. Text is only one mode. Graphs, images and multimedia are other modes. Walsh also describes this interaction as being dynamic. Walsh points out that all these inputs will play a role in forming SM. I will go a bit further is stating that for clinicians there is even more input modes. When a clinician is assessing a patient, all senses are providing inputs. Therefore, all these inputs are probably playing a role in creating the representation of reality; situation model.
Graesser, A.C., Millis, K.K. & Zwaan, R.A., 1997. Discourse comprehension. Annual Review of Psychology, 48, 163-189.
McNamara, D.S., 2001. Reading both high-coherence and low-coherence texts: effects of text sequence and prior knowledge. Canadian Journal of Experimental Psychology = Revue Canadienne De Psychologie Expérimentale, 55(1), 51-62.
McNamara, D.S. & Kintsch, W., 1996. Learning from Texts: Effects of Prior Knowledge and Text Coherence. Discourse Processes, 22(3), 247-88.
Mcnamara, D.S., Kintsch, E., Songer, N., Kintsch, W., 1996. Are good texts always better? Interactions of text coherence, background knowledge, and levels of understanding in learning from text. Cognition and Instruction. Vol. 14, No 1.
Therriault, D.J., Rinck, M. & Zwaan, R.A., 2006. Assessing the influence of dimensional focus during situation model construction. Memory & Cognition, 34(1), 78-89.
Walsh, M. 2006. The ‘textual shift’: Examining the reading process with print, visual and multimodal texts.Australian Journal of Language & Literacy.Vol. 29, No.1, p24-37
Zwaan, R., 2003. Text comprehension. Handbook of Discourse Processing, Lawrence Erlbaum Associates. Mahwah, New Jersey, USA.
