English and Medicine

Peih-ying Lu, PhDProfessorDepartment of Medical Humanities and EducationSchool of MedicineKaohsiung Medical University

Outline

Course Rationale

Goals and Objectives

Course Framework

Materials and Teaching Strategies

Teaching Team

Student Outcome

Obstacles

Prospects

Background

Medical students who are non-native speakers of English (NNSs) face a number of challenges; they need to acquire a level of competence that enables them

1. to cope with course materials

2. to engage proficiently with their fellow students,

3. instructors and those patients they encounter in clinical settings, and

4. in the future in international academic circle.

Current approaches to EMP

There have been two main approaches to enhancing the linguistic competence of NNS medical students.

1. long lists of technical terminology to be memorized and slotted into prescribed grammatical patterns.

2. the specific types of discourse that medical students must acquire in order to function as competent members of their particular discourse communities.

Medical Professionalism

Professionalism involves the development of the personal resources of insight and wisdom that can be drawn upon to deliver ethical and altruistic practices.

These personal resources also demand a high degree of cross-cultural competence, that is, the insight that healthcare providers and their patients very often operate with diverse belief systems and attitudes to issues of authority, illness and the negotiation of care (Betancourt, 2003).

Our thought is.

The medical English or EMP component of the medical curriculum opens up a potential space, still largely neglected and underdeveloped, for engaging directly with issues of medical professionalism.

English for Medical StudentsBefore.

Chalk (ppts) and Talk lecture

Reflections

What does Medical English neglect fully to address?

Medical terminology? Medical Conversation in English? Or, is there a place for professionalism?

Ways to redesign the course,

Medical English in a Crowded Curriculum

A thought to change..How?

informal interviews with students

skepticism about the value of the terminology-rich Medical English course

articulating a desire for a more general set of instructional topics.

Interviews with clinical teachers

lacked readiness for cross-cultural care. They also thought language is an issue in medical communication

What to change

Ways to change..

Ways to change.

Task based learning (TBL)

use the language in a meaningful context

provide the chances for exploring values;

Problem based learning

the generic template of a PBL session was used to raise and discuss professional issues

Hybridized PBL

information sharing

Problem solving

Decision Making

Opinions Exchange

information gap

Active learners

Our argument is ..

Drawing upon some of the insights of register and genre analysis

Attending to the debates in medicine around the teaching of professional values

English for Medical Students

Lecture

154 students

TBL / PBL

Framework: topics and tasksTopics (lectures) TBL / Mini-projects (PBL)1. Roots of Medical English Greek Mythology and Medicine Approach to Medical Terms and

Medical Professions

a. Medicine in Mythology (tracingthe origin)

b. How Doctors Think (Findingmedical terms)

2. Learning about the Body TED Talk / Health Education3. Learning about the Brain4. Learning about Childrens and Womens Health

a. Birth Planb. Morning Songc. Unwanted Pregnancies

5. Medical Communication Doctor/Patient CommunicationActing and Analysis

6. Getting Academic Abstract Writing WorkshopMini-project 1 PBL Medicine and SocietyMini-project 2 Good Patients

Introducing Medical Humanities

Medical communication

Birth planMedicine

If these wallscould Talk

Medicine andthe society

Good patients

Mythology and Medicine

If these walls could talk

Medicine and thesociety

Medicine and Mythology

Morning SongThe year of my birthThe GatekeeperGood Patients

Materials

Lecture ppt TBL/PBL task design

Process

Material Design

In-class activity

LecturePre-readingIn class assigned task

PBL/TBL

In class presentation

Group outcome and individual essay upload

Outcome

Lecture example

Process TBL 2TEDMED and Health education

Lecture

internal medicine

surgery

brain

Pre-class

Choose a Tedtalk (5 assigned topics) to watch and turn it into a health education talk

TBL 2

Conference Template+ Q & A Teacher Feedback

Preparation + TA consultation

Overall FeedbackMade Feedback Videoand Uploaded to thecourse website Feedback video

Your Birth Plan

Birth Plan

1. Where would you like to give birth?In hospital? At home?

2. Who would you like to be with you?3. What position would you like to be in during labour?4 Would you like pain relief?5 Where do you want your birth partner to stand?6. What kind of music would you like played?7. Who should cut the umbilical cord?

Birth Plan Writing and Movie Observation Discussion

Presentation and Group Discussion Upload

TBL 4 Medical Communication

Medical CommunicationRole-playing : Similar scenario in the Taiwanese context

Analyzing the communication style

PBL example:Good Patients ranking patients Connie is a quiet Filipino woman, who works as a maid. She attends the clinic and says very little. She

does exactly what the doctor advises. She never asks questions and is always grateful for any treatment suggested.

Jin is from mainland China. He smokes a lot and refuses to give up. This is not helping his condition. He makes jokes and is very easy to get along with, but sometimes he does what he is told, and sometimes he just doesnt.

Betty is a well-educated woman from Brazil. She checks out her symptoms on the internet and always has questions when she attends the clinic. If she doesnt understand why the doctor is giving her certain advice, she is not afraid to challenge it. Sometimes she suggests a course of treatment before the doctor does. Once she agrees to an action plan, though, she sticks to it.

Tony is from Italy. He is a manual worker and he is not very communicative in the clinic. He says he is following the doctors advice, but you cannot be sure that he is. He says his English is poor but he seems to understand more than he claims to.

Theresa is a wealthy and well-educated Turkish woman. She has health insurance and you know that she consults several doctors, including you, about her condition. She seems to listen to several medical opinions and then she chooses the treatment that she prefers.

Please refer to the reading attached for the description of the patient and the patients family. (This patient case is from The Spirit Catches You and You Fall Down). This novel explores the clash between a small county hospital in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy. Lias parents and her doctors both wanted what was best for Lia, but the lack of understanding between them led to tragedy.)

PBL in action

Discussion Presentation

Methods

End of course questionnaire on TBL/PBL was conducted.146 set of anonymous responses were collected.

Participant teachers feedback and researchers observation were analyzed.

Student essays were collected and analyzed with Grounded Theory.

Quantitative Data

Qualitative Data

English Skills Professional valuesIntegration of medical terminology and knowledge

Critical thinking / self reflection

Communication in medical context Problem Identifying and solving

Negotiating Collaboration

Presentation skills Doctor-patient relationship

Critical writing Multiple Perspective of medicine and society

Identifying key points/issues in reading

Cross-cultural understanding

Awareness of empathy and ethics

Participants Researchers observation

Qualitative Data

Students essays showed

1. Critical reflection (medicine and society)

2. Research and Analytical ability (medicine and society)

3. Cultural Awareness (good patients)

4. Reflection of professional value (medicine and society)

5. Empathy (good patients)

Examples of Student Essays

On an episode of Mystery Diagnosis, June, a middle-age woman who exercised regularly, expected a clean bill with her annual mammogram. The result, however, drew her doctors attention to the two mass that her breasts had developed onto the image. (Medicine and Society)

A patients attitude can be divided into involving and indifferent. From the description, both Betty and Theresa possess the characteristics of an involving patient. (The good patient)

After the PBL and perspectives sharing, negotiation, maybe we should consider why he does not discuss with doctors. He is a physical worker, and he might not have time or the knowledge required to discuss with the doctors. Maybe doctors should also try to listen to the patients.

Before After

Students as passive receiver

Students memorized terminology or studies related medical issue.

Students role-played the medical conversation

Students submitted homework and prepared for the exam.

Were active learner

used knowledge and medical related terminology acquired in the task

identified learning issues and collaborated

Students listened to other perspectives and articulated their own.

Learned to challenge and negotiate

Reflected upon professional issues emerged in the task

Teaching Team8 Physicians and 2 language and humanities teachers

ObstaclesAnatomy

Biochemistry

Prospects

Should the training be incorporated into later stages of studies

Presentation, Problem based learning and History taking in English

Should this training include interprofessional training

Dental English and Nursing English

Conflict of interest: NoneFunding: None

Seminar (at KMU MARCH 12, 2016)

Thank You!

COURSE WEBSITEhttp://esp.kmu.edu.tw

Emailpeyilu@kmu.edu.tw

http://esp.kmu.edu.tw

English and MedicineInsoluble Problem-Based Learning? When doctors need to draw on cultural competences & professional valuesOutline BackgroundCurrent approaches to EMP Medical ProfessionalismOur thought is.English for Medical StudentsBefore.Reflections Medical English in a Crowded CurriculumA thought to change..How?What to changeWays to change..Ways to change.Hybridized PBLActive learnersOur argument is ..English for Medical StudentsFramework: topics and tasksIntroducing Medical HumanitiesMaterialsProcessLecture exampleProcess TBL 2 TEDMED and Health educationTBL 2 Overall FeedbackYour Birth Plan 27TBL 4 Medical Communication Medical CommunicationPBL example:Good Patients ranking patients PBL in actionMethodsQuantitative DataQualitative DataQualitative DataExamples of Student EssaysBefore AfterTeaching TeamObstaclesProspects 41Seminar (at KMU MARCH 12, 2016)Thank You!