{
  "package" : "hl7.terminology.r4@6.3.0",
  "definition" : "Can advise, persuade, negotiate, or counsel effectively. Can participate in or give a formal speech at a conference, lecture, or debate. Can advocate a position at length and represent a point of view other than one’s own, both in prepared and unprepared remarks. Employs discourse strategies to organize thoughts and present them in a convincing manner, such as appropriate rhetorical speech devices or intentional shifts of topic and tone. Can use many rhetorical devices for targeted effect or emphasis. Vocabulary is consistently extensive and includes low frequency items. Uses cultural references appropriately to further an argument or add emphasis. Controls many complex structures, including complex embedding. Errors are sporadic and may be part of acceptable language use in certain contexts. Pronunciation, stress, intonation, and tone (in tonal languages) do not hinder communication. Can speak on many social, cultural, and theoretical topics, including those which do not bear directly on a professional specialty. May incorporate another relevant topic or make additional informative points to present a broader view. Presents information to support ideas clearly and extensively. Able to fulfill many cultural norms and expectations in a variety of interactions, although there may be instances of awkwardness. Demonstrates an ability to shift register or tailor speech to meet many situational norms and expectations, though may not sustain shifts under all circumstances. Adheres to most social conventions of conversations and presentations. Able to engage with interlocutor's contributions and develop a joint discourse. Is generally able to verbally convey mood, feeling, emotion, or stance to add effect, such as emphasis, certainty, uncertainty, or authority. Speaks effortlessly and smoothly.",
  "system" : "http://terminology.hl7.org/CodeSystem/ILRSpeakingSkillScale",
  "property" : [ ],
  "codesystem" : "23d36b1d-52e5-5f27-abf5-3c14661a992e",
  "concept_id" : "3ad26198-c87b-51ed-bd00-c59e12d55ed3",
  "ancestors" : {
    "Level 4" : 0
  },
  "id" : "13533583-4f14-4212-9304-d1c77e1dbc4f",
  "code" : "Level 4",
  "display" : "Able to speak with considerable precision using culturally appropriate language tailored to a variety of audiences on a wide range of topics.",
  "version" : "May 2021 Edition"
}