Journalism defined itself as a profession in opposition to sensationalism and propaganda at the beginning of the 20th century. The American Society of News Editors statement of principles was written to codify “sound practice and just aspirations” of journalism after the public learned how the press was complicit in misinforming and deceiving the American people during World War I. As part of a massive propaganda campaign to win support for the war, the government fed false information and misleading stories to the press to make the public see the war as they desired it to be seen. Most definitions of propaganda converge toward the idea of organized influence on group attitudes through manipulation of symbols for a desired purpose of propagandist. The ASNE 1923 statement of principles clearly differentiated journalism from propaganda by its processes (to inform and scrutinize) and its purpose (to hold power accountable). However, many times since then the news media have been often accused of unintentionally becoming one of the most effective vehicles of political propaganda. Journalism’s proximity to the political world, and at the same time its obligation to bring independent and impartial scrutiny to that world, creates a set of contradictions and opens cracks where propaganda can get a foothold. In the political world, truth is to a large degree subjective and irreducible to facts. Journalistic practices that equate truth to a collection of facts, without questioning of why these particular facts are chosen and how they are presented, introduce various biases that amount to propaganda. Subtle suggestions based on facts, and faulty interpretations that do not follow from facts make propaganda truly dangerous because it is hidden behind ideologies of a free and objective press. With the growing mastery of media technology, propaganda is becoming an even more formidable force, perhaps easier to detect but more difficult to combat.
Bruce W. Hardy
The relationship between public opinion and journalism has long been a considered a cornerstone of modern functioning democracies. This important relationship has been the focus of scholarship across broad disciplines such as journalism studies, communication, sociology, philosophy, and political science. One hundred and twenty years ago, French sociologist Gabrielle Tarde outlined the press–conversation–opinion–action model to illustrate the role that the press and journalists have on initiating conversation among citizens, forming public opinion, and how this opinion translates into civic action that fosters social change. Highly related to Tarde’s press–conversation–opinion–action model are current theories of journalism and public opinion such as agenda-setting, priming, the two-step flow hypothesis, diffusion of innovation, and the spiral of silence. All of these theories relate to how the press can inform citizens, foster interactions with others, shape their opinions, and mobilize citizens into civic engagement and political action. However, in today’s mobile, digital, and highly segmented communication landscape defined by “post-truth” and “alternative facts” and where emotions resonate more than evidence because of audience biases and identity protective cognition, the problem of the spread of misinformation has caused a great deal of consternation among journalists, pundits, and public opinion scholars, leading to a global rise in fact-checking. But because much of the misleading and deceptive claims in today’s communication environment appear first on social media, there is currently a fervent quest for automated computational fact-checking.
Merryn Sherwood, Timothy Marjoribanks, and Matthew Nicholson
The relationship between journalism and public relations in the 21st century has been mostly marked by tension, at least publicly. Many journalists’ accounts of public relations portray it as “the dark side” and characterize public relations practitioners as purveyors of “spin.” However, extensive research examining the input of public relations practitioners into the news has found that the products of their work—such as media releases or media conferences—are crucial in facilitating the news cycle. As one of the classic studies of news production identified, “News is, after all, not what journalists think, but what their sources say.” Decades of research have established that news sources are often likely to be public relations practitioners, with anywhere between 40% and 75% of news originating from public relations practitioners or the products of their work. Public relations is, therefore, critical to the work of journalism; however, journalists often deny this as part of publicly upholding the standards of their profession and building and maintaining boundaries of control over their work.
However, the symbiotic relationship that formed the basis of news production in the 20th century is being upended in the 21st century as organizations become their own media producers. This means the lines continue to blur between journalism and public relations, both for individuals working across once clear occupational and professional boundary lines and for organizations adopting the functions of both.
For some scholars, the role of public service journalism is profoundly ethical, though it exists amidst a diversity of incommensurate but not necessarily incompatible views and values. Public service journalism exists as part of a global media that has been referred to as a “mediapolis”: descriptively, a place, a communicative system where the world is constituted, and by means of which we learn about Others. Normatively it is an ideal of communication, a place where information and opinion may be expressed civilly to enable good choices to be made and public concerns to be thoughtfully addressed. As such, it is a place of equal expression. However, practically it must contend with finding a way to identify, value and integrate a wide array of voices. A mediapolis needs to become a place where a just and hospitable media enables the fundamental process of finding ways of living together.
A key principle for the governance of mediapolis concerns “journalism”: uncensored, diverse, reliable journalism is essential to the making of well-informed decisions and a healthy political life. To this end and in order to anticipate a digital future where there exists an ethical mediapolis for global public benefit and where the internet and good journalism go hand in hand and are no longer antagonistic, contemporary public service journalism should reconceive the news as discursive rather than monological and informational, and the public as consisting of an interpreting, acute audience of citizens, rather than one of informed readers. If such a consummation were to be achieved then critical news judgements would be the norm, no matter how large or small the audience. Journalism would be an effective watchdog because government would be perpetually aware that a sufficient number of confident, attentive citizens is following the news and that, in consequence, it must function knowing that there is a constant risk of shame, disgrace, conviction and loss of popularity and office. In sum, public service journalism consists of civil expression of information, accommodating a multiplicity of voices, the news conceived of as discursive rather than merely informational, and the public conceived of as critical interpreting citizens rather than informed readers.
The public sphere is a social entity with an important function and powerful effects in modern, democratic societies. The idea of the public sphere rests on the conviction that people living in a society, regardless of their age, gender, religion, economic or social status, professional position, sexual orientation, ethnicity, race, or nationality, should be able to publicly express their thoughts, ideas, and opinions about issues that matter to them and impact their lives. This expression should be as free as possible in form and function and should operate through means and methods that people themselves deem suitable, so not via channels that are official or state-sanctioned. The classic Habermasian idea of the public sphere is that it is used by private individuals (not officials or politicians) who should be able to converse with each other in a public-spirited way to develop opinions that impact state or public-body decisions and policies. Also contained within this classic idea is the conviction that public sphere conversations should be rational (i.e., logical, evidence-based, and properly motivated and argued using an acceptable set of rhetorical devices) in order to convince others of the usefulness of a position, statement, or opinion. In commonsensical, political, and journalistic understandings, the public sphere is a critical component of a democracy that enables ordinary citizens to act as interlocutors to those who hold power and thereby hold them to account. As such it is one of the elements whereby democracy as a system is able to claim legitimacy as the “rule of the people.”
Journalism’s imbrication in the social imaginary of the public sphere dates back to 17th- and 18th-century Europe when venues like coffee houses, clubs, and private homes, and media like newspapers and newsletters were being used by a mixture of gentry, nobility, and an emerging middle class of traders and merchants and other educated thinkers to disseminate information and express ideas. The conviction that journalism was the key vehicle for the conveyance of information and ideas of public import was then imbedded in the foundations of the practice of modern journalism and in the form exported from Western Europe to the rest of the world. Journalism’s role as a key institution within and vehicle of the public sphere was thus born. Allied to this was the conviction that journalism, via this public sphere role and working on behalf of the public interest (roughly understood as the consensus of opinions formed in the public sphere), should hold political, social, and economic powers to account. Journalists are therefore understood to be crucial proxies for the millions of people in a democracy who cannot easily wield on their own the collective voices that journalism with its institutional bases can produce.
Discourse of “Asian values” in journalism is commonly contrasted with non-Asian or Western/Occidental libertarian values. This dualistic treatment of Asian versus Western journalism implies a professional and cultural dichotomy when in actuality the forms and methods of journalism are two sides of the same coin. Regardless of cultural contexts, journalists essentially address the who, what, where, when, why, and how questions in their reporting. Journalists react to events and issues. They source for credible reactions, fact check, and construct their news narratives in the interests of the general public. Reporting fairly, accurately, and truthfully are universal journalism principles. The issues that journalists in Asia confront daily are not radically different from journalists in the West. There are, nonetheless, variations of emphases in the goals, motivations, methods, and content in journalism as practiced in the West and parts of Asia. These variations are manifested in the practice of development-oriented journalism, which media scholars in parts of Asia deem to be more in line with the nation-building priorities of developing economies. It is worth revisiting the debates for a New World Information and Communication Order in the 1970s when responses to the normative theories of the press by media institutions and agencies in developing countries led to the conceptualization of “development journalism,” which, as an alternative to the adversarial journalism practice of media agencies in the West, was theoretically more reflective of the “Asian values” for social harmony, collective well-being, and deference to authority. Even as the binary perception of journalism practices by media scholars in the West and parts of Asia remains contentious, it is less about Asian cultural values per se that influence the methods, form, and substance of journalism but the political system, stringent media laws, public expectations of the media, role perception of the journalists, and power relation structure that ultimately shape journalism practices in Asia.
The analysis of journalism and religion emerges from two different research paradigms: a post-positivist and a culturalist. The primary debate in the field stems from the two paradigmatic orientations. Post-positivist journalism and religion research argues that religious topics are already complex and so by simplifying, researchers can help explain the topic for broader consumption. Yet culturalist journalism and religion research argues that there is little to be gained from attempting to simplify religion in this way—it is better to represent religion as it is, rather than to make it palatable. The topic developed in the 1980s largely as a result of contributions from Edward Said, Judith Buddenbaum, Stewart Hoover, Mark Silk, and David Nord. Three primary approaches have become dominant. In effects-oriented research, religion serves as a variable in helping explain a phenomenon. In the culturalist approach, the journalism and religion phenomenon is examined through the lens of structure and agency—the power relations integral to the phenomenon. Finally, in the literary criticism approach, religion is examined as the phenomenon being represented in journalism. As paradigms would indicate, the post-positivist paradigm is most interested in predicting the religious representations and the culturalist paradigm is most interested in understanding the representations. Broadly, this subfield is situated within the larger umbrella of journalism and minority concerns. Implicit in this research is Said’s orientalism, a theoretical tradition that emphasizes the “othering” of minority groups, making them appear as if they are in need of being “oriented” to fit ideas of what is normal and acceptable within a society. It similarly builds on Gramsci’s hegemony, which conversely examines how a society proliferates ideas of that which is normal and acceptable practice.
For millennia, the idea that rituals create a shared and conventional world of human sociality has been commonplace. From common rites of passage that exist around the world in various forms (weddings, funerals, coming-of-age ceremonies) to patterned actions that seem familiar only to members of the in-group (secret initiations, organizational routines), the voluntary performance of ritual encourages people to participate and engage meaningfully in different spheres of society. While attention to the concept was originally the purview of anthropology, sociology, and history, many other academic disciplines have since turned to ritual as a “window” on the cultural dynamics by which people make and remake their worlds. In terms of journalism studies in particular, the concept of ritual has been harnessed by scholars looking to understand the symbolic power of media to direct public attention, define issues and groups, and cause social cohesion or dissolution. Media rituals performed in and through news coverage indicate social norms, common and conflicting values, and different ways of being “in the world.” The idea of ritual in journalism is accordingly related to discussions around the societal power of journalism as an institution, the ceremonial aspects of news coverage (especially around elite persons and extraordinary “media events”), and the different techniques journalists use to “make the news” and “construct reality.” Journalism does more than merely cover events or chronicle history—it provides a mediated space for audiences and publics that both allows and extends rituals that can unite, challenge, and affect society.
Edson C. Tandoc, Jr. and Andrew Duffy
News routines refer to patterns of outcome-oriented behavior, structured by ideological and organizational contexts, regularly enacted or invoked by newsworkers engaged in constructing the news, acting individually but thinking collectively. They are enacted by journalists to make their daily work more efficient and invoked to preserve their autonomy. They help make newswork more predictable and journalism more stable. Studies have documented various routines at different stages of news construction. In the access and observation stage, studies have focused on the beat system and journalists’ sourcing patterns, which determine the range of information and events they get to know about. In the selection and filtering stage, studies have examined how news values shape news selection and even deselection of articles. In the editing and processing stage, studies have examined practices associated with writing, such as the use of the inverted pyramid format and the use of direct quotes, as well as with editing and verification. Scholars have also focused on the impact of automation on news writing and editing. In the distribution stage, studies have explored live coverage as well as the use of social media to disseminate news. Finally, in the interpretation stage, studies have explored the tracking and monitoring of audience feedback via web analytics and social media, which also affect editorial decisions. But aside from making work more manageable, news routines also have two main consequences on news work: They drive newsworkers into the arms of authorities who are set up to give them information, and they increase the risk of compromising journalists’ autonomy. While they structure how journalists do their work, news routines are also structured by larger forces. The need for efficiency stems from the motivation for profitability in market-oriented news organizations. News routines also prescribe how news processes ought to be done, distinguishing news construction from other forms of work but also functioning as a form of control. Since they arise out of the practical needs of the organization and the field, news routines will adapt and emerge as journalists are confronted by a changing set of practical needs. Such adaptation opens the way to new information structures and new ideologies.
Jason Peifer and Taeyoung Lee
Satire represents a form of public discourse that invites critical judgment of some sociopolitical folly, absurdity, or contradiction. Through devices like exaggeration, irony, and imitation, a satirical text aspires to cut through spin, deception, and misrepresentation in order to spotlight a given state of affairs as they are or could be. That is, satire is propelled by an impulse to elucidate; to highlight some truth. In many respects, journalism’s normative aspirations are similar to that of satire. Journalism’s guiding principles are commonly discussed in light of a central mission to seek and report the best obtainable version of the truth. Though satirical and journalistic endeavors are often carried out with contrasting tones of sobriety, both forms of discourse exhibit idealism in offering unblinking assessments of social realities. Accordingly, it is hardly surprising that satire and journalism have an extensive history of interplay, dating back to some of the earliest venues of modern journalism. Given satire’s penchant to freely draw from the conventions and norms of a wide range of cultural practices in its pursuit of mounting social critiques, it follows that satire would frequently leverage the tools of journalism for its purposes. The journalism profession has long laid claim to privileged legitimacy in the public sphere, positioning itself as a voice of authority in interpreting public affairs events and issues. Journalism’s traditional (though certainly not uncontested) position of privilege has proven useful to satirists. Likewise, satire’s entertaining and attention-getting qualities have long enticed news media actors.
Academic scholarship centered on the interplay of satire and journalism emanates from a variety of research orientations, employs a diversity of methods, and focuses on a wide range of topics and cultural contexts. The bulk of this body of research highlights satirical work that draws from journalism-based conventions and practices (for example, The Daily Show with Jon Stewart), but pockets of scholarship also consider conventional journalism’s engagement with satire. Still other scholars focus more on how the convergences of journalism and satire spawn hybrid forms of discourse that contribute to public culture in meaningful ways. Building on the insights afforded by these diverse lines of research, future satire–journalism scholarship would be well served by continuing to draw from across these multifaceted research streams.
Science journalism is a specialized form of journalism predominantly covering issues such as science, medicine, and technology; it only professionalized in the second half of the 20th century. For many people, print, audiovisual and online media are the main source they use to get to know something about these fields; hence, science journalism has an important role for the society. However, when looking at science journalism and the research in that area more closely, then a variety of different approaches paint a rather dark picture. Firstly, there is a lot of research criticizing science journalism and science journalists. What these studies focus on is science journalists’ work and role for the society, their routines and practices, their reporting on specific scientific issues, as well as the relationship between journalists and scientists. Secondly, in some countries, science journalism seems to be in a crisis due to increasing digitization and changing media landscapes. Science journalism is declining in these countries and many journalists have lost their jobs. However, assessing the quality and appropriateness of science journalism should be based on journalistic and not on scientific criteria, and these criteria should be used when trying to describe what science journalism is and what not, how science journalism operates and how not, and how best to describe the role science journalism has for the society. In addition, although increasing digitization may change routines and practices of science journalists, these specialized journalists may be able to adapt to new media landscapes and still maintain their important role for the society as the most disinterested source that informs about science, medicine, and technology.
What skills do journalists need? Why do they need them? What do we even mean by “skill” in the first place? In journalism research, the issue of skill has mainly been studied as an applied issue closely linked to journalism education. The main concern has been whether journalism education equips students with the skills they need to succeed in the job market, as well as with the skills they need to fulfill journalism’s democratic function. There is a long-standing conflict between these two “skill goals” of journalism education, where vocational or practical skills are often viewed as (at least potentially) in opposition to academic or theoretical skills. Journalism students need vocational skills in order to satisfy employer needs, and academic skills in order to satisfy wider societal needs.
Another key research concern in this area has been the issue of de-skilling: the idea that journalistic work gradually becomes less and less skilled as employers mainly demand quicker outputs across different media platforms, rather than the production of quality content. Another element of the deskilling idea is that experienced (older) journalists are phased out and/or replaced with less experienced (younger) and therefore cheaper journalists who do not necessarily possess specific or very in-depth training in journalism. This process is mainly linked to the ongoing commercialization and digitalization of journalism. Empirically, however, many research results point instead either to a general upskilling of journalism (a higher and higher share of the workforce have a university degree, for example) or to the fact that deskilling may occur in parts of the occupation, whereas other parts may experience upskilling.
All of this research has in common that skill is rarely defined and that analyses of skill rarely reference the wider sociological and psychological literature on skill, expertise, and competence. A few scholars have analyzed skill among journalists at a higher level of abstraction, attempting to define what the core expertise or skill of journalism actually is. This research direction is key to the future development of research on journalism and skill.
Sports journalism is a popular area of contemporary media that has a long history of delivering results, analysis, and opinion to both broad and specialized audiences. Like other media, it has had to adapt consistently with technological developments and demands but continues to gain widespread coverage across print, broadcast, and digital platforms. Sports journalism has often been viewed as “the toy department,” a place of trivial pursuits instead of the chasing of hard news. As a result, its journalists are viewed as having low professionalism and status and are often accused of being controlled by sources. What these criticisms overlook is the value of this significant subfield in relation to the amount of sports content produced across media, the large numbers of journalists involved in producing the news, and its power in attracting readers and viewers. These elements combine to make sports journalism a rich area for academic scholarship. However, in comparison with its place in newsrooms, this topic has also been criticized in research and has not been treated as seriously as a space for scholarship. While there have been recent increases in scholarly work, sport has been described as an underresearched area of the journalistic field.
The field’s literature has streams dedicated to practical, instructional texts and scholarly analysis of contemporary and historical issues. Key areas of investigation involve content within the sports pages, which can involve as much as 30% of editorial material in a media publication, and work exploring the perceptions, routines, and practices of sports journalists. The role of the sports journalist has also been examined, with descriptions often focusing on a tendency to operate as cheerleaders with a home-team bias. However, the position of sports journalist also involves aspects of critical, watchdog-style coverage, including through investigative reporting. Much of the academic work involving sports journalism has been descriptive in scope, which leaves space for greater analysis through a theoretical lens. An important future topic of research is the increasing commercialization of sport, which has implications for journalists, publications, and audiences.
Armin Scholl and Maja Malik
Observing, describing, and analyzing journalism as part of society requires theories on a macro level. Unlike normative theories, which criticize journalism with respect to its achievements and failures within society, systems theory operates with the concept of function in a non-normative sense. Based on the groundwork of Talcott Parsons’ theory of social systems, Niklas Luhmann developed systems theory further and radicalized it by strictly avoiding any kind of structural conservatism. His approach is built on the assumption that social systems operate autonomously on the basis of the functional differentiation to their environment. Macro-level systems, i.e., societal systems, fulfill unique functions for and within society. Functional autonomy and singularity make a modern society highly efficient but force each system to rely on the functional performances of all other societal systems. Hence, societal systems are structurally coupled and interdependent. Epistemologically, systems do not exist as ontological units but are strictly observer-related, be the observer the system itself or an external observer, such as the scientific community is.
In journalism research, Luhmann’s systems theory has been applied to journalism as a societal system. Several competing approaches with different perspectives on the system observed (journalism, the mass media, or the public sphere) have been developed with respect to identifying the basic characteristics on which the system operates. Despite their differences they have this in common: journalism is not considered the sum of individual journalists and their (individual) way of working, instead, the systems-theoretical perspective is holistic. However, compared to theories of professionalism, which is also a holistic concept, systems theory neither identifies journalism with the profession of journalism, nor commits it to professional journalism. Instead, the structure of journalism is flexible, i.e., functionally equivalent, as long as its function is fulfilled. This function can be specified: journalism provides society periodically with current, independent, factual, and relevant information.
Empirically, systems theory helps defining the population of journalists by deducing it from its function. Unlike mere empirical approaches, which arbitrarily draw samples from an unknown population, it is possible to clearly draw distinctions between journalism and other forms of public communication, such as public relations, advertising, propaganda, or lay communication. Still, it is challenging to operationalize such an abstract theory, as it is not specially made for hypothesis-driven research.
Stephen D. Reese
Journalism seeks to observe and communicate what it learns of social importance, something called news, and in doing so is always in the process of creating a public by bringing it into synchronized conversation with itself. Theories of journalism provide explanatory frameworks for understanding a complex combination of social practice, product, and institutional arrangement. Journalism’s late 20th-century professionalized, high modern version, which is still recognizable today, has continued to change, particularly with the disruptive effect of the Internet, as it has evolved to absorb other forms. The boundaries of profession and news organization have been destabilized within this rapidly shifting media terrain, but still there remain productive approaches for systematically organizing knowledge around the concept of journalism.
The early 20th-century perspectives on journalism—before becoming linked to the communication field and a more narrow media effects focus—were at home in the University of Chicago school of sociology, which emphasized community-based, multi-method participant observation. A sociology of news perspective resurfaced with more ethnographic research in newsrooms in the 1950s, and theories of journalism have continued to highlight the ethnographic method, especially in understanding the impact of technology on a more digitally-oriented journalism practice. A hierarchy of influences perspective, developed by Shoemaker and Reese, incorporates other perspectives beyond the ethnographic by considering factors at multiple levels of analysis that shape media content, the journalistic message system, from the micro to the macro: individual characteristics of specific newsworkers, their routines of work, organizational-level concerns, institutional issues, and the larger social system. At each level, one can identify the main factors that shape the symbolic reality constituted and produced by journalism, as well as how these factors interact across levels and compare across different contexts (e.g., national, technological).
A hierarchy of influences model worked well to disentangle the relationships among professionals and their routines, and the news organizations that housed them, which cohered into institutions. But journalism has been newly problematized, destabilizing and restructuring both the units and levels of analysis in journalism theorizing. The networked public sphere is constituted with new assemblages: of newswork, institutional arrangements, and global connections, which give rise to new emerging deliberative spaces. Journalism theories now have as much interest in process as product, in assemblage as outcome, but still need to be concerned with the nature of quality of these spaces. What shape do they take on and with what implications for healthy democratic discourse?
Maria Konow-Lund, Amanda Gearing, and Peter Berglez
The journalism industry has used technology and cooperation to convey information around the world since the mid-1800s when six American newspapers aligned to form the Associated Press. The nonprofit news agency was a business collaboration that allowed members to share content with one another. Cooperation in journalism was not always compatible with the industry’s traditional business model, however, which valued exclusivity. As technology progressed, cooperation grew ever easier and more productive. The ultimate emergence of the internet has consummated this trend, facilitating collaborations among groups of reporters across the globe. These collaborations allow individual groups to retain and capitalize upon their geographical exclusivity while enhancing their collective ability to provide domestic stories with a transnational context or to cover cross-border or even global issues.
Daya Kishan Thussu
The international flow of news has traditionally been dominated by that from North to South, with the West being at the core. Within the West itself, news flow is dominated by Anglo-American media, a situation which has its roots in the way that journalism developed historically. The historical context of global news begins with the introduction of the telegraph and undersea cables in the nineteenth century, which created a global market for news. Major players emerged—including news agencies—and shaped the transnational news flows. What emerges is that, in all ages, key innovations in transnational news flows have been closely linked to commerce, geopolitics, and war, from the telegraph to online news outlets. The increasing availability and use of news media, from major non-Western countries, are now affecting transnational news flows. Global journalism has been transformed in the digital age by internet-based communication and the rise of digital media opportunities—allowing for multi-directional news flows for growing global news audiences.
Katherine E. Rowan
Explanations designed to teach, rather than to support scientific claims in scholarly works, are essential in health and risk communication. Patients explain why they think their symptoms warrant medical attention. Clinicians elicit information from patients and explain diagnoses and treatments. Families and friends explain health and risk concerns to one another. In addition, there are websites, brochures, fact sheets, museum exhibits, health fairs, and news stories explaining health and risk to lay audiences. Unfortunately, research on this important discursive goal is less extensive than is research on persuasion, that is, efforts to gain agreement. One problem is that explanation-as-teaching has not been carefully conceptualized. Some confuse this communication goal and discursive type with its frequent verbal and visual features, such as simple wording or diagrams. Others believe explanation-as-teaching does not exist as a distinctive communication goal, maintaining that all communication is solely persuasive: that is, designed to gain agreement.
Explanation-as-teaching is a distinct and important health communication goal. Patient involvement in decision making requires that both clinicians and patients understand options underlying health-care choices. To explore types of explanation-as-teaching, research provides (a) several ways of categorizing health and risk explanations for lay audiences; (b) evidence that certain textual and graphic features overcome predictable confusions, and (c) illustrations of each explanation type. Additionally, explanation types succeed or fail in part because of the social or emotional conditions in which they are presented so it is important to note research on conditions that support patients, families, and clinicians in benefiting from explanations of health and risk complexities and curricula designed to enhance clinicians’ explanatory skill.