This paper provides a theoretical explanation for lobbying as interpersonal rhetorical communication based on the tenets of symbolic convergence theory (SCT). SCT is a general theory of communication in the symbolic interactionism paradigm. Nowhere in the extant communication literature, including the scholarly public relations research, is lobbying explicated in this way. This paper utilises a health care public policy case study to illustrate SCT in lobbying practice. The emphasis here is on how lobbyists use homo narrans, or human storytelling, in influential face‐to‐face information exchange with public policy decision makers to be persuasive on behalf of their clients. The ultimate aim of this paper is to build the current body of theoretical and practical knowledge about lobbying, to advance more positive perceptions of lobbyists and lobbying and to improve the practice of lobbying in producing effective public policy outcomes. Copyright © 2001 Henry Stewart Publications

Problem assessment (problems can include issues that are primarily biomedical or issues that are psychosocial)  Shared assessment of level of control  Trajectory of condition (this includes relevant history, current condition status, condition outlook)  Shared goal  Psychosocial influences (including patient strengths and barriers)

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This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Northeastern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. Commentators brainstormed "what's next" with learning analytics in medical education, including advancements in interaction metrics and the use of interactivity analysis to deepen understanding of perceptual, cognitive, and social learning and transfer processes.

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Phenomenon: Chronic disease is a leading cause of death and disability in the United States. With an increase in the demand for healthcare and rising costs related to chronic care, physicians need to be better trained to address chronic disease at various stages of illness in a collaborative and cost-effective manner. Specific and measurable learning objectives are key to the design and evaluation of effective training, but there has been no consensus on chronic disease learning objectives appropriate to medical student education. Approach: Wagner's Chronic Care Model (CCM) was selected as a theoretical framework to guide development of an enhanced chronic disease prevention and management (CDPM) curriculum. Findings of a literature review of CDPM competencies, objectives, and topical statements were mapped to each of the six domains of the CCM to understand the breadth of existing learning topics within each domain. At an in-person meeting, medical educators prepared a survey for the modified Delphi approach. Attendees identified 51 possible learning objectives from the literature review mapping, rephrased the CCM domains as competencies, constructed possible CDPM learning objectives for each competency with the goal of reaching multi-institutional consensus on a limited number of CDPM learning objectives that would be feasible for institutions to use to guide enhancement of medical student curricula related to CDPM. After the meeting, the group developed a survey which included 39 learning objectives. In the study phase of the modified Delphi approach, 32 physician CDPM experts and educators completed an online survey to prioritize the top 20 objectives. The next step occurred at a CDPM interest group in-person meeting with the goal of identifying the top 10 objectives. Findings: The CCM domains were reframed as the following competencies for medical student education: patient self-care management, decision support, clinical information systems, community resources, delivery systems and teams, and health system practice and improvement. Eleven CDPM learning objectives were identified within the six competencies that were most important in developing curriculum for medical students. Insights: These learning objectives cut across education on the prevention and management of individual chronic diseases and frame chronic disease care as requiring the health system science competencies identified in the CCM. They are intended to be used in combination with traditional disease-specific pathophysiology and treatment objectives. Additional efforts are needed to identify specific curricular strategies and assessment tools for each learning objective.

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