Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Instructional Design, Development and Evaluation


DeVault, Marjorie L.


border crossing, deaf studies, grounded theory, healthcare instruction, symbolic interactionism, user design


The Deaf population faces substantial communication barriers in accessing quality health care. Many healthcare professionals struggle to communicate with Deaf individuals because they have little awareness of how to interact with these patients in culturally sensitive ways. This study sought to understand the perspectives and experiences of hearing border-crossers -- hearing people who cross "borders," figuratively, to interact and communicate with Deaf people. Hearing border crossers hold useful knowledge that will shed light in facilitating communication between Deaf patients and hearing healthcare professionals. Using symbolic interactionism as the epistemological framework, qualitative interviews were conducted with three clusters of hearing border crossers--those with deaf family members, those who work professionally with deaf people, and those who interact with deaf people in everyday community settings. Direct observations of hearing-Deaf interactions at public spaces offered further insight into hearing border-crossers' experiences. Focus group data from Deaf consultants were combined with interview and observational data to include at least a partial Deaf perspective on hearing border crossers' accounts. The analysis examines how hearing border crossers enter Deaf worlds, how they gain competence and negotiate difficulties, and what strategies they offer for successful interactions. The dissertation offers an instructional design planning approach that incorporates community perspectives. Ideas from this study were extended and the analysis generated the elements of a learning environment where hearing and Deaf people might interact and learn to communicate effectively. Implications from the study are developed for healthcare instruction


Open Access