By Danielle D. Brighton
Manuals are one of the most ubiquitous deliverables of technical communication. They are often thought of as how-to guides or a set of instructions. They teach a user how to correctly engage with a particular system or technology, whether a computer, software, or Lego set. Is that all that manuals are capable of doing? Is a manual’s only purpose to teach a user how to use a system, or is there something more that manuals can do? More importantly, is there something more that manuals should do?
In some instances, manuals should do more than teach a user how to engage with a system. For instance, consider Marika Seigel’s example of learning how to navigate the technological system of prenatal care (what she defines as the system comprising the pregnant body, fetus, technological implements and procedures of prenatal care, and prenatal testing) via pregnancy manuals. In her book The Rhetoric of Pregnancy, Seigel shares her story of consulting a variety of pregnancy manuals to find information about how to manage her pregnancy. Although by usability standards the manuals she consulted were good, she was left feeling like something was lacking. She discovered that these feelings came from her perception of usability—her perception that despite measuring up to technical communication’s current usability standards, the manuals still lacked usability because they held “a functional rather than a critical orientation to the technological system of prenatal care” (20). Borrowing from the terminology of Adam Banks, Professor and Faculty Director of the Program in Writing and Rhetoric at Stanford University, Seigel uses the term “functional access” to describe when a user knows how to engage with a system, while critical access is reserved for a user who “knows how to engage strategically with, disengage from, and negotiate a technological system” (20).
In the case of prenatal care, manuals should do more than teach users how to comply with the existing system because, as Seigel explains, “[I]t is important for users to have a critical understanding of the purpose for which they are disciplining their bodies and submitting to such discipline, especially when the technological system with which they are engaging has the potential to have material effects on their physical and mental well-being, as does the prenatal care system” (14). Seigel argues that this is not limited just to pregnancy manuals, however, as manuals should provide users with critical access to systems whenever “bodies are explicitly components of those [technological] systems (or even when they are implicitly components, as in computer systems)” (14).
Using Seigel’s work as a guide, I explored the pregnancy manuals I recently consulted during my own first pregnancy, and I identified some ways in which my manual selections helped me to engage critically with the system that I encountered during my own prenatal care. Drawing from the strengths of those pregnancy manuals, I offer specific suggestions for technical communicators about how to craft manuals that facilitate critical access—rather than merely functional access—to a particular system. By incorporating these suggestions into practice, technical communicators have the tools necessary to both empower their users to think more critically and to disrupt mainstream monolithic systems and ways of thinking, should that be their goal.
Discuss Options Rather Than Make Assumptions
In Dianne E. Moran and G. Byron Kallam’s manual The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth, there are times throughout the manual where the user sees different options discussed rather than assumptions being made, such as in a section that explains what to consider when choosing a hospital or birthing center. Rather than merely assume that women will give birth in a hospital, Moran and Kallam take the time to at least list another alternative (i.e., a birthing center) and what to consider when making that choice. The authors do this again in a section that describes several people who might be a part of a woman’s circle of care, including a midwife and doula. Moran and Kallam take a few paragraphs to explain what both of these roles are, as well as the possible benefits of including them in the circle of care. In this way, the manual makes an effort to mention several roles that are not often included in the system of prenatal care, thus allowing women to critically consider options they otherwise might not have considered.
Sometimes the different options and opinions available will vary greatly, and that is okay. As authors Rallie McAllister and Jennifer Bright Reich write in their manual, The Mommy MD Guide to Pregnancy and Birth, “Pregnancy and birth are filled with issues that people feel very strongly about….We’ve presented many different viewpoints—but not with the intent to confuse or to offer conflicting advice. Instead, we wish to present many different options so that you can choose what’s best for you and your family” (ix). Technical communicators can similarly incorporate this tactic into their own manuals. Rather than make an overriding assumption about a course of action, they should first consider other possible options that might benefit the user, include some of those options and descriptions in their manuals, and then let the user decide which options are most appropriate for them.
Provide a Section with More Comprehensive Information
If it seems impossible to weave in information that facilitates critical access throughout the entire manual, a good step in the right direction is including a specific section that helps users reach the level of critical access. This section could be placed near the end of the manual, behind the information that teaches how to functionally engage with the system, so as to not overwhelm the user. The manual could also include an introduction that explains this section and its purpose. That way, users who are interested in functional access can easily use the manual, and those who are interested in gaining a deeper, more critical understanding can also easily access that information.
The Mayo Clinic Guide to a Healthy Pregnancy, authored by the pregnancy experts at Mayo Clinic, achieves a large degree of critical access by providing a specific section titled “Important Decisions of Pregnancy.” Although many of the topics were covered on a basic (and functional) level in other, earlier parts of the manual, this section is comprehensive and thorough, devoting an entire chapter each to various topics, such as genetic screening, prenatal testing, and contraception after delivery. Most of these chapters provide an overview of the topic and then cover information, such as what options women have, what issues they should consider to help them make a decision, and key questions they should ask themselves before making their decision. Although users were not provided with information that granted critical access throughout the entire manual, they were at least provided that information in a section of the manual, which is much better than nothing.
Teach Users How to Question the System
One way to help users gain a critical understanding of the system with which they are involved is by teaching them how to question the system, rather than merely comply with it. Although this may be difficult to do and may seem counterintuitive to some users, it can be an important way to help them understand when it may be desirable or necessary to disengage from the system. Not all standard policies and procedures of a system are always in the best interest of all the system’s users, and as such, teaching users how to question the system will help them know when it is in their best interest to not engage with the system.
The Gift of Motherhood teaches its users how to question the system of prenatal care by providing a graphic labeled “Informed Consent Questions for Labor and Birth.” This graphic encourages women who are making decisions to consider the benefits, risks, and alternatives of suggested procedures, to rely on their intuition, and to take the necessary time to fully consider any decision. The Mayo Clinic Guide similarly teaches users to question the system. For example, in this manual’s chapter about prenatal tests, women are introduced to a list of questions that they might consider before scheduling a certain test (306):
- What will you do with the information once you have it?
- How will it affect decisions regarding your pregnancy?
- Will the information provide better care or treatment during pregnancy or delivery?
- How accurate are the results of the test?
- Will undergoing a test be worth the anxiety it may cause?
- What are the risks of the procedure?
- How much does the test cost? Is it covered by your health insurance?
These manuals teach users that they have a right to ask questions and should not passively accept any information that is given to them. Furthermore, they also teach users how to ask questions by providing specific examples of questions for them to ask. Technical communicators can likewise encourage their users to think critically and provide specific questions for users to ask themselves in an effort to elevate manuals from facilitating functional access to critical access.
Use Narratives and User Knowledge
The most interesting and defining feature of The Mommy MD Guide is the use of narratives by what are called “Mommy MD Guides.” Not only are the Mommy MD Guides doctors with medical knowledge, but most importantly they are also mothers—users of the system themselves. The manual is arranged so that the authors cover a topic, and then they include additional comments from the Mommy MD Guides.
For example, after the authors cover the topic of choosing a healthcare provider, they give the Mommy MD Guides a chance to share what they chose for their pregnancies and why they made those decisions. One Mommy MD Guide wrote that she had her first two babies delivered by midwives and her last two by a family doctor. Regarding her family doctor she wrote, “I looked for a doctor who understood that I wasn’t diseased, only pregnant. He was willing to be there during my deliveries just in case he was needed—not to intervene” (35).
Another Mommy MD Guide chose to have midwives deliver her babies at home. She said that even though her father was a doctor, she wanted a different approach to her pregnancies, one that didn’t view birth as a medical emergency or illness. I share a large passage here to demonstrate the power of allowing users to share their knowledge through narrative. She wrote, “To me, the birth process is very normal and natural. I felt much more comfortable with midwives, who are highly trained in the process of vaginal births. At the end of the day, my fellow obstetricians are trained surgeons. They are excellent at what they do, but it was important for me to try and have a natural birth if I could. I feel it is healthier for us, and for our children. I wanted to avoid medical intervention unless my midwife thought it was important…. I feel very blessed that I was able to have my children the way nature intended” (36−37).
By taking the time to enumerate some different choices and perspectives on pregnancy and childbirth by actual users of the system, the manual incorporates types of knowledge that are often excluded from manuals. Technical communicators should also consider other types and sources of knowledge when writing manuals rather than assume that they are the only experts on a subject. Including personal narratives or user comments is one way technical communicators can incorporate additional voices and sources of knowledge.
There are several specific strategies I recommend that technical communicators consider adopting when crafting manuals that facilitate critical, rather than functional, access to a system. They can:
- Provide and discuss options rather than make assumptions for users;
- Include a special section dedicated to providing detailed and comprehensive information;
- Teach users how to question the system; and
- Include narratives and user knowledge.
It is important that technical communicators consider these various methods when writing manuals, because manuals carry power, and they have potential beyond enabling users to “correctly” use a system or technology. Manuals also have the power to disrupt existing systems and ways of knowing and to empower their users. Seigel calls these types of manuals “system-disrupting,” as opposed to the more common “system-maintaining,” model of manuals that allow functional access. As we have seen in the case of pregnancy manuals, these manuals have the power to disrupt mainstream medical discourse and the institution of medicine by allowing various interpretations of prenatal care and the work of pregnancy to emerge from the sidelines. This is important, because technical communicators should always be aware of the voices that they let speak in their manuals—that in the constant tug and pull of competition between time, resources, and competing priorities, they do not neglect to focus on empowerment, and that they consider whether they are giving a voice to all the populations that deserve to speak.
DANIELLE D. BRIGHTON (danielle.downs@aggiemail.usu.edu) spent several years in journalism before earning a Master’s degree in technical communication from Utah State University, which she completed this year. She lives with her family in Dallas, TX.
References
Mayo Clinic. Mayo Clinic Guide to a Healthy Pregnancy. Boston, MA: Da Capo Press, 2011.
McCallister, Rallie, and Jennifer B. Reich. The Mommy MD Guide to Pregnancy and Birth. Hellertown, PA: Momosa Publishing LLC, 2010.
Moran, Dianne E., and G. Byron Kallam. The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Arlington, TX: Customized Communications, Inc., 1997.
Seigel, Marika. The Rhetoric of Pregnancy. Chicago, IL: University of Chicago Press, 2014.
