Investigating verbal-visual mode interaction in medical audio-slide presentations

This study examines 26 student-produced audio-slide presentations from an academic writing course at a medical university in Taiwan. The analysis focuses on the interaction between verbal and visual modes in this format, which features pre-recorded oral narration synchronized with static slides. Using Systemic Functional-Multimodal Discourse Analysis, three distinct presentation patterns—slide-based, poster-style, and text-based—were identified, each reflecting different configurations of academic discourse features and digital affordances. Slide- and text-based formats tended to rely on dense scriptural visuals and verbal-visual repetition, while poster-style presentations demonstrated more deliberate visual composition and rhetorical structuring. Although students exhibited emerging multimodal awareness, many struggled with elaborative intersemiotic relations, such as meronymy, hyponymy, and collocation. These findings suggest that students are in a transitional stage of developing genre-specific multimodal literacy. The study concludes with pedagogical implications for supporting the development of coherent and rhetorically effective multimodal academic communication.