changing the paradigm for medical english language teaching

8/11/2019 Changing the Paradigm for Medical English Language Teaching

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The importance of English LanguageTeaching (ELT) in medicine studies

Shifting the Paradigm for Medical English Language Teaching

Summary: Medical English should be taught from the standpoint of medicine and healthcare primary and foremost while enhancing vocabulary acquisition, grammar and structurefinally. The traditional view to English language training has done fine to meet the needs of non-professional students. Today s world wide economy requires career-specific languagethat includes wor!place culture and "argon for safe, effective delivery of professionalservices and the ability to coordinate research and treatment across borders. The ability of

internationally acclaimed English e#ams of competency to instruct for or measure this isquestionable, Even though, they serve their goal as preparation for advance languagetraining. $urrent methods of instruction most frequently used today for health professionalsfocus mainly on English language while secondarily within health care terminology in thelessons. These teaching strategies of lessons stuffed with medical terminology and simpledialogues about visits to the doctor s office and minor sic!nesses fail to meet the needs of the profession. % have developed a new methodology: a paradigm shift. Medical English iscommunicated from the perspective of medicine and health care first and foremost whileenhancing vocabulary acquisition, grammar and structure finally. The focus is safety-to- practice, a central part of international nursing and medical licensing: a standard of practice. Teacher-tutors are required to be health trained professionals as well as languageinstructors in English for Specific &urposes. 'essons, interactions, and case studiesrepresent simple and comple# medical practices, pharmacology, anatomy and physiology, pathology, treatment.

(dult education, language acquisition and training are the focus of this paper mainly asthey relate to the teaching of Medical English. % will review core components of theories by&ratt, )armer, *enner and others as a foundation to the presentation of my own perspective.The need for changing the paradigm for Medical English language teaching will be centralto this discussion.


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The western view of adult education is one of andragogy. This science and art of teachingadults is based on two concepts: the adult learner is self-directed and autonomous+ theteacher is a facilitator rather than presenter of content. There is an assumption that thelearner arrives in the classroom with a s!ill set and !nowledge base that will be enhanced by the new learning e#perience. evelopmental learning theory derives from cognitive psychology and believes that adult students have already developed their own cognitivemaps and strategies to guide their interpretation of the world. They learn by doing andlearning new !nowledge and s!ills which they then associate with previous learning ande#perience. &rior learning is ac!nowledged as well as assumed. This is a core component of my methodology for teaching English for Medicine students. %t also forms the basis ofothers wor! such as that of r. (rsenau of the aculty of Medicine, niversity of *ritish

$olumbia /as cited in &ratt, 01102 who utili3es this teaching perspective with medicalstudents and r. &atricia *enner /45672 in her famous wor!s in nursing. *enner e#ploreshow teaching and learning occur as both the student nurse and professional career nurse "ourney from novice to e#pert.

The relevance of andragogy to the teaching of Medical English cannot be ignored. %t is thewriter s belief Medical English cannot be taught at the level of or in the same methods of basic English language teaching. $areer-specific, highly technical language must beconte#tually based. %t is advanced English. Students come with a wealth of !nowledge ands!ills in their career fields. The goal of learning English at this level is not to learn grammar and structure primarily, but to acquire and use the language of practice and social relationswithin the career. $onte#tually based learning is crucial. The research of &ratt and*roo!field /01102 in $anada, S(, )ong 8ong, $hina and Singapore identified that trades people for e#ample, found traditional learning in a classroom to be artificial and devoid of the realities essential to learning that career-specific language in any way that would ma!e

it meaningful and useful. This most certainly applies to the study of Medical English. 9ftenreferred to as English for Specific &urposes, curricula of this sort requires the teacher havea similar career bac!ground to the student.


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Goal of Curriculum

hen the curriculum designer begins to develop a course or series of courses in MedicalEnglish, he;she must consider who the students are, what their motivations will be, and

identify which perspective they wish their teachers to have. The curriculum framewor! must be developed to meet the needs of the educational institution, the students, relevantlegislation, and any other sta!eholders such as employers of the students. undamental tothe curriculum is the legal requirement for the practice and licensing of any and all health professionals such as in $anada


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Teacher Motivation

&ratt and *roo!field /01102 firmly state that teaching is guided by the trainer The viewpoints are quite different and the lessons that flow fromeach can be diametrically opposed for reasons to be discussed later in this paper.

Language Acquisition versus Language Learning

$urrently, language learning and language teaching is a combination of behaviorism andcognitivism. These comprise the audio-lingual method of language acquisition. Teaching based in behavioral psychology focuses on stimulus-response-reinforcement as the methodfor promoting learning. The student is presented with a great deal of material over theduration of a course, and frequently drilled or given oral;written feedbac! to reinforceaccuracy and s!ill. There is a strong focus on repetition with the belief that this will create ahabit of using language in certain ways: in response to certain stimuli. The drawbac! is thatthis does not foster thin!ing, generali3ation, or application of language in other than thestructured, memori3ed stimulus-response form. Many schools around the world are usingthis method for teaching Medical English. Their focus is on the presentation of reams of medical terminology with very little application to the real world of medical practice. %neffect, it is a method of rote memori3ation, and the actual benefits of acquiring languagethat can be used in the career remains questionable.

Students who have been trained in the behavioral method of language learning tend to do

very well on written e#ams of language proficiency. That is because, in this writer sopinion, the e#am format is quite similar to that of the language classroom. The stimulus isfamiliar. The appropriate response is triggered. Success on written e#ams does notguarantee success with language in the wor!place. The writer s e#perience with medicaland nursing students studying English for ?urses and Medical &urposes supports this.Some arrived in the class as a direct result of action by the professional practice committees


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of local registering bodies concerned with that professional s ability to safely practice inhealth care in the English language /ie: the =egistered ?urses (ssociation of *ritish$olumbia, the =egistered &sychiatric ?urses (ssociation of *ritish $olumbia, the 'icensed&ractical ?urses (ssociation of *ritish $olumbia2.

$ognitivism is another theory which is based on the audio-lingual method of languageacquisition. (lso based in psychology, this theory asserts that people acquire language bylearning and internali3ing the rules of that language s structure /)armer, 455@2. Theassumption is that if a student is given sufficient vocabulary they will be able to create their own sentences, convey messages, and ma!e meaning. %n this method, rules become paramount and it is possible to teach language lessons based solely on rules and formulae.)ence, this is a very popular practice today. 'essons are created with a focus on the rule or structure for the day, ie: the sub"unctive clause. (ny new vocabulary or e#ercises aredesigned around identifying and using the rule correctly.

The cognitive approach is in opposition to my theory related to acquisition of career-specific language. Students of Medical English should begin these studies only after thefoundations of the language have been laid. The writer appreciates the importance of thatfundamental learning and has the e#pectation that students have achieved this. The goal of

Medical English should be acquisition and application of language, not rote memori3ationor direct focus on vocabulary, grammar and structure.

(cquisition is a process that occurs subconsciously and results in the actual !nowledge of alanguage. )armer /455@: AA2 points out that acquiring language is more successful andlonger lasting than learning. )e also notes that currently oreign 'anguage /E '2 teachingseems to concentrate on getting the adult student to consciously learn items of language inisolation: the classroom rather than the real life environment. )armer claims that language

acquisition is the theory of choice for teaching English for Specific &urposes. % agree witthem. (cquisition means that vocabulary and language are acquired through a multitude of means, the most importance of which is access to the language in use: in conte#t. $ertainlythis is the basis of immersion courses in foreign languages. %t is neither essential to !nowthe rules of the language nor to be drilled on it prior to actually learning it. E#posure is


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critical. Similarly to the popular methods of instruction li!e those found at *erlit3 schools,it is not necessary for the teacher to !now the students< language. Thus, it is not even seenas particularly beneficial to the learning needs of the student. 'anguage and culture cannot be separated. hen teaching Medical English, the very career-specific content is designedand delivered by those familiar with that career, with adult teaching and learning principles,and training as an English Second 'anguage or English oreign 'anguage instructor.

Methodolog ! the ne" paradigm

'anguage acquisition must be a combination of academic preparation that includes behavioral and cognitive approaches that are secondary to the focus or conte#t of thelesson. The design of this paradigm reflects this. 'essons are conte#tually and

e#perientially based to provide hands-on opportunities to apply or use the languageimmediately. $lasses are interactive and promote e#ploration and discovery of languagethrough discussions and e#ercises based on the focus of the lesson. The curriculum designis based on health care, not English language structure or rules. %t follows an ( - * format.'esson ( finds its focus on vocabulary presentation and acquisition. 'esson * to follow provides opportunities to apply learning from the previous lesson into conte#t. 'earningactivities in 'esson * can include using actual hospital charts and forms, role-playing

assessment, use of medical equipment, open e#ploration of treatments and interventionsrelated to the main sub"ect. nderstanding that all students have medical bac!grounds,discussions are enhanced as health professionals attempt to confer and consult+ sometimesdebate medical-health conditions and best practices. The structure of language acquisitionis less acute. *ro!en English is accepted.

Students are encouraged to try to use language to search for synonyms, abbreviations, andalternative ways of e#pressing meaning to communicate with each other. Students are

encouraged to support and encourage each other in language correction. The %nstructor becomes the facilitator or guide. 9nce the message is communicated and the entireinteraction is complete, the %nstructor will review with the students as a group, strengthsand wea!nesses of that e#ercises. %f corrections need to be made in structure and form, it isdone in the feedbac!, debriefing session following each e#ercise if and when peers have not


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assisted each other with this during the activity. This is supported by the wor! of 8rashen,&rabhu B (llwright /$ited in &ratt, 01102 who spea! to the importance of comprehensibleinput: acquisition occurs from hearing or needing language to communicate. This paper appreciates the importance of an immersion or pseudo-immersion e#perience for thelanguage learner. Structure is incidental to the focus of the lesson. %t is a subset of thelearning.

This paper aims to e#tend its resources to E-learning, such as the use of moodle to carry outseveral online tas!s such as the creation of a mind map about the treatments of a possibledisease, also provides an opportunity for self-directed learning and is based on the principles of autonomy. Students can set their own goals and pace for learning. 'ocalclasses in non-English spea!ing countries can be greatly enhanced by this type of access.

&ratt B *roo!field /01102 identify a number of perspectives on teaching in adult education.The Transmission &erspective is the stereotypic view of the teacher in the classroom inwhich he;she imparts information in a top-down method of dissemination of material. This perspective is not used as such in this paper. %nstead it is used as a technique. %n this modeteachers are e#pected to be content e#perts in what they teach. This is important to theteaching of Medical English: students e#pect content credibility. % believe that the teacher

should be a content e#pert in medicine and health care, first and foremost.

The (pprenticeship &erspective /&ratt, et al., 01102 reflects teaching outside of theclassroom. %t is a process of acculturating the learner into a specific community. This is paramount in the design of any Medical English course. 'anguage in conte#t cannot beignored in this highly speciali3ed, career-specific focus. The main course of English for Medical &ersonnel is taught in immersion but the curricula have been e#panded to includee#posure and e#perience in health care settings for the student. 9nce again, the belief that

acquisition occurs from hearing or needing language to communicate is supported by thisdelivery model.

(ccording to &ratt B *roo!field /01102, the ?urturing &erspective is the philosophicalunderpinning for adult education in the S( for at least the past 0C years. This perspectivetheori3es that self-concept and self-efficacy are fundamental to the ability of the learner to


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learn or to even believe he;she can learn. The learner wants to become confident that theycan learn the material and that learning the material will be useful and relevant to their lives. /&ratt, et al., 0110: 752 The teaching of Medical English can most certainly includethis perspective when the instructor encourages, supports and mentors their peers into theacquisition and use of English. They have vested interest in the career as well as in teachingthe student.

Argument

% agree with Swan /455D2 that some styles of speech and writing have their own rules andstructure. This is most certainly the case in the Medical English. )ealth


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enhance the actual learning e#perience for students. % claim that what is needed is to reversethis thin!ing. $onte#t e#perts need to consult with language e#perts to develop appropriate, purposeful curricula.

%t is my contention that medical professionals interested in learning Medical English aremore motivated to learn, acquire and use language when the entire conte#t of the learning iswithin the field of their interest, medicine and health care. (lready well-educated, these professional people bring with them a wealth of !nowledge and s!ills in medicine andhealth care. (ll learning activities are greatly enhanced by the opportunities provided by the%nstructor and within the classroom to enter into e#changes of ideas and health care practices while using new language. % state that this ability to wor! through language, addvocabulary and, to coin a term from nursing, thin! on your feet in an e#periential way willestablish a much stronger base of learning and recall.

(ll in all, the method of curriculum design and delivery for Medical English needs to shiftfrom the traditional audio-lingual method to being conte#tually-based and e#periential. %tneeds to be delivered at the level of advanced English training where focus can bededicated to the language of the career rather than the structural foundations and rules of learning a new language. The provision of this type of course or curriculum will improve

the student s motivation to learn and participate in learning activities. %mmersion activitiesand e#posure to non-native English spea!ers who are also health professionals are crucialelements in acculturating the Medical English student into the way career-specific languageis actually used. oundational underpinnings of the curriculum and overall course goalsshould be lin!ed to legal and ethical parameters for the health professions to providecredibility for the course provider and value for the health profession, the student, and the public. esigners and teachers need to be cogni3ant of the purpose and philosophy of thecurriculum, and the goals of their students. $onte#t of lessons needs to be relevant to thewor! the health professionals are doing and will be doing in the future to ma!e it valuableto them.


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#$AP English as a %oreign Language programs for medicine

(s far as the ultimate programs of English 'anguage Teaching /E'T2, !nown as lenguae#trangera ingles %, %%, %%%, %F< were coined following the $ommon European rame

=eference for all 'anguages /$E =2 levels and its corresponding can do

changing the paradigm for medical english language teaching

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