The International Research Foundation for English Language Education



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Title of Report: Nursing and medical technology Case Report Author: Najma Janjua, Ph.D., Professor Training Organization: Kagawa Prefectural University of Health Sciences 1 Kagawa, Japan Date of Publication: May 2012 Takamatsu, 1. Identify and describe the training program. This is a two-semester undergraduate course in English for medical purposes (EMP) for Japanese nursing and medical technology majors. The program consists of two courses that run two hours a week for fifteen weeks. The instructor s qualifications include a PhD in Human genetics, and nineteen years of experience in EMP curriculum development and implementation at undergraduate and postgraduate levels at three Japanese universities. 2. Describe the target audience for the training program. The students in this four-year undergraduate program consisted of ninety freshmen, seventy of whom were nursing majors and twenty of whom were medical technology majors. The context is the Kagawa Prefectural University of Health Sciences. The University offers four-year undergraduate and two-year masters degrees in nursing and medical technology. 3. Describe the needs assessment procedures utilized to develop the program. The needs assessment was based directly on the Japanese Ministry of Education s 2003 Action Plan to Cultivate Japanese with English Abilities. The action plan describes the needs as follows: Cultivating Japanese with English Abilities is an extremely important issue for the future of our children and for the further development of our country. In addition, the plan emphasizes the development of English language skills required for specialized fields. It directs Japanese universities to establish attainment targets from the viewpoint of fostering personnel who can use English in their work. 4. Explain the English language training program s over-arching goals and specific objectives. As specified in the Japanese Ministry of Education s 2003 Action Plan, there are two overarching goals. The first is the development of English language skills required for specialized fields or for those active in international society. The second goal is that on graduating from university, graduates can use English in their work. During the first semester, the specific objectives are to enable the students to express themselves and communicate in English on a series of topics related to basic medicine and health care, through the acquisition of new medical terminology and the development of reading, writing, listening and speaking skills. In the second semester, the objectives are to enable the students to express themselves and communicate in English in a variety of real-life medical settings related to their future workplace through the acquisition of relevant medical terminology and the development of reading, writing, listening, and speaking skills. 1 Terms of Use and Disclaimer: TIRF is providing this information as a service to our constituents, and no endorsement by TIRF of the program described in this case report is intended or implied. The information is made available free of charge and may be shared, with proper attribution. If you have reprint questions, please contact the training organization identified above. 1

5. Describe the teaching methods and training procedures used in the program. Each week during the first semester, students are introduced to a topic in basic medicine and healthcare in the class through an interactive approach. The lessons involve students first watching and listening to the material via PowerPoint projection while orally answering questions about the content elicited by the teacher. Students then write answers to a set of questions about the lesson content and prepare a short presentation for the next week s class. Students practice pronunciation in the classroom and also for homework as guided and advised by the teacher. Special emphasis is placed on learning basic terminology in medicine and healthcare, and using it effectively for both written and verbal expression and communication. During the second semester, students are introduced to an authentic real-life case study in medicine each week. First, the teacher explains the scenario and/or the context of the case study as well as the meanings of all medical and non-medical terms necessary for comprehension. Students then read the text of the case study silently for a thorough understanding of the content. They listen to an audio recording of the text for listening comprehension and answer a set of questions about the case study content. Next they write a dialogue in pairs based on the case study for homework. They will act out the dialogue in pairs in the following class. Students also practice pronunciation using various multimedia tools and references. Special emphasis is placed on learning medical terminology related to the students major fields and developing effective communication skills for their future workplace settings. 6. Describe the teaching materials used in the program. During the first semester, the teaching materials consist of websites on basic medicine and healthcare topics. On-line resources for pronunciation practice are also utilized. In the second semester, students read case studies adapted from Delmar s Nursing Surgical Nursing (Anker, 2008). Other materials include online and multimedia resources for pronunciation practice. 7. Explain the content of the English language training program. A. What written and spoken genres are covered in the training program? Written and spoken genres in the first semester include the following: diagrams and descriptions of human body systems, common medical conditions, medical tests, and medical and surgical procedures, medical instruments, medical specialties, and oral presentations on medical and healthcare topics. There are also written dialogues between patients or their families and healthcare professionals, based on the case studies. Students also act out dialogues based on the case studies during the second semester. B. What communicative functions are covered in the training program? During the first semester, the communicative functions include explaining medical conditions, tests, procedures and techniques; providing instructions; and asking and answering questions. During the second semester they include introducing, greeting, requesting, taking medical history, referring, making an appointment, getting and giving information, explaining details, conveying test results, giving instructions, and giving advice. C. What speech events are covered in the training program? 2

Medical staff meetings, patient management sessions, meetings with patients, and interactions in the clinical laboratory are the main speech events dealt with in the first semester. In-patient wards, out-patient clinics, emergency department interactions, medical emergency settings outside the hospital and in the ambulance, and interviews with patients, families, and friends are covered in the second semester. 8. Explain the delivery mechanisms employed by the program. This program includes face-to-face classroom lectures and PowerPoint presentations with handouts. There are also recorded lectures that students access through a university website. 9. Explain the assessment procedures used in the program. This program uses oral tests in class as well as pronunciation tests to assess the students progress. It also grades individual students on their oral presentations and pair-presentations of dialogues based on case studies, as well as on term-end oral and written exams. 10. Explain the program evaluation mechanisms used. Student grades are used to evaluate student performance and improvement in their proficiency levels. Thus, consistently poor student grades and performance may reflect inappropriateness of teaching methods and materials used and call for their improvement/modification/adjustment to match the students proficiency level. On the other hand, higher student grades may be an indication of suitability of the pedagogical approach and the course content and allow a gradual shift to more advanced curricula. Together with the use of student grades as a program evaluation mechanism, significant value is attached also to student opinions of the course content and teaching methods. Student feedback is obtained through surveys using questionnaires that ask students to reflect on various aspects of the course. The surveys are generally conducted at the end of each semester. An additional survey is done at the end of the whole year, which may involve getting student feedback in comparing the first- and second-term courses. The results of both evaluation mechanisms, namely the student grades and the student survey from each school year, are considered in determining the suitability of course content, materials and methods, delivery mechanisms, and assessment procedures. Modifications and improvements in the program for the subsequent school year are then made as necessary. 11. Discuss the challenges involved in offering this English training program. In Japan, English is taught for at least six years, up to the high school level. However, the method of instruction is mainly based on grammar-translation, and most Japanese high school students enter university with minimal oral communicative competence in English. Moreover, they typically do not possess the level of English writing skills that is expected of university students. At the same time, the study of ESP or discipline-specific English language requires a minimum level of English proficiency. Without having acquired that minimum proficiency level, it is difficult for students to proceed to specialized language learning in their professional field of study. As a result, advanced-level ESP activities can be overwhelming and frustrating for them. 3

In addition to lacking a minimum level of English proficiency, most Japanese students have little or no motivation to learn the language further upon entering university. After having gone through six years of English classes in high school that are based on the grammar-translation method, which they usually find boring, most Japanese students develop a dislike for English. Until high school, the primary motivation to study English for virtually all students is the pressure of having to sit for the university entrance examinations, in which English is a required section. Once that obstacle is removed and students have gained entry into a university, the reason for studying English ceases to exist for most students. Given the above realities of Japanese EFL education, the challenges for an ESP educator designing and implementing an English for medical purposes curriculum at a Japanese university are fourfold. First, the teacher must bring the students out of their state of disinterest and lack of motivation. Second, the instructor needs create in the students a sense of awareness of the need to study the language of their future profession. Third, the teacher must try to get them to participate actively in the class. Finally, it is important to provide the students with the tools and the guidance to achieve their learning goals. Another challenge is that the teaching materials and methods must take into consideration the realities of the learners background. They must also be tailored to meet the students needs in order to make ESP learning a meaningful experience for the students. 12. Describe the successes of the program and explain how they are documented. The program described in this case report was initiated in 2010-2011 school year. The first semester ran from April 2010 to July 2010 and the second from October 2010 to February, 2011. At the end of the second semester, students were surveyed through a questionnaire that asked their opinions concerning various aspects of the program. As the course had barely ended at the time of writing of this report, results of the student survey as well as student grades are still in the process of being compiled. However, preliminary findings from the student survey indicate that the number of students who liked the course content in the first semester (47/90) was roughly the same as that for students who preferred the second semester course material (43/90). The following are unedited student comments in response to a survey question that asked them about their preference of lesson content in semester 1 versus semester 2, and to give reasons for their choice. The quotes are provided as preliminary indicators of the success of the program. Reasons given by students who liked the lesson content in semester 1 1. This class increased a lot of knowledge. 2. Because content like Human Body Systems is basis of nursing. 3. Because we need basic medical procedures and knowledge. 4. To study about general medical topics was interesting for me. 5. This lesson is for our sake. And it is fun for me. Reasons given by students who liked the lesson content in semester 2 1. It was interesting for me to study actually story. 2. Because I understand easy by a case study. 3. I will be nurse, so medical case studies are used every day. 4. Because I like story in English and enjoy classes. 5. Because I can learn case of various disease and it was interesting. 4

References Ankner, G. M. (2008). Delmar s nursing Surgical nursing. Clifton Park, NY: Thomson Delmar Learning. 5