Teacher Training in EMP


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Some important differences relating to the teaching of medical English.

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Teacher Training in EMP

  1. 1. Putting Communication First in Medical English Teacher Training Seminars in EMP Virginia Allum Oxford , Feb 25 2012
  2. 2. Virginia Allum• Background in nursing –currently RGN in SW England• Co-author ‘Cambridge English for Nursing’ books• Author EMP materials (journals, online course, EMP books )• Development of teacher training resources – Teachers Without Borders• Consultant in English for Nursing and Healthcare
  3. 3. Contact me…Email: virginia.allum@gmail.comBlog www.englishfornursingandhealth.blogspot.comWebsite: www.e4nursingandhealthcare.comFacebook: English for Nursing and HealthcareSkype: virginiajaneallum
  4. 4. Background to the need for EMP• Changes in language testing• Change to language testing of ALL doctors• ? testing of ALL nurses as well – current status to be maintained• Currently non-EU testing only• Nursing and Care Quality Forum – improvements in nursing care
  5. 5. EU Nurses and language testing• Pressure from NMC and RCN• Restriction of free movement challenge• Currently under review at EU Parliament level• Cambridge ESOL – nurse-specific test
  6. 6. Despite this..• EU nurses - hard to work in UK because of language and cultural issues• Some return home or• Work as carers for poor wages• UK nursing bodies – pressure for safe practice
  7. 7. Which groups of nurses?• Registered Nurses• Health Care Assistants (HCAs)• Carers in Nursing Homes
  8. 8. What do stakeholders expect?• Effective communication• Safe practice• High standards of technical knowledge• Cultural sensitivity and awareness• Good teamwork
  9. 9. Here to Stay? International Nurses in the UK 2003 (NMC)• Retirement of Baby Boomers → gap in market• Traditionally nurses have always moved around• Movement now for economic reasons
  10. 10. English for Nursing can be..• Workplace orientated course (overseas nurses who work in the UK)• Workplace orientated course (nurses who care for English-speaking patients in their own country)• PAL training for university course (degree, Masters)• Part of Nursing curriculum e.g France• Online course + or – f2f sessions
  11. 11. What type of course• PAL - optimal• Courses need to fit in with shifts• Online courses – access any time• f2f – essential for communication scenarios• Blended learning – time to ‘think about’ and review content
  12. 12. English for Nursing – workplace oriented course• Communication focus (patients, colleagues, other HCPs)• Appropriate writing focus (hospital documents, charts, patient record)• Medical terminology and everyday health terminology• Appropriate reading focus (care pathways, drug info, policies and procedures)
  13. 13. Why an EMP course?• Specialised vocab• Need for accuracy in communication (safety)• Gen Eng courses – limited use in healthcare environment• Healthcare environment can be pressured – need for confidence which comes from rehearsal and practice
  14. 14. Other industries specialise..• Recent specialty ‘English for…’ books – need for industry-based courses• Aviation Industry has ICAO language matrix – to ensure safety• Oil and Gas Industry – RIGTALK testing• Military – STANAG• Medical ??? – no dedicated language test (CELBAN in Canada)
  15. 15. What is the communication focus? ..withpatientsAsking for information (on admission) Giving instructions (medication use, wound care) Asking about past habits (ask about past medicalhistory) Talking about pain level (location, intensity)Asking about feelingsAsking for co-operation (lift your arm, bend yourknee)
  16. 16. Other communications… with colleagues• Handovers (stressful, frequent during each shift)• Passing on patient info e.g after medical review, return from a test• Talking on the phone – talking messages, phoning other departments• Procedures e.g checking drugs
  17. 17. Best way to practise communication?• Role play is perfect for all situations• Helps reduce stress – especially for handovers• Helps improve pronunciation• Set up a dialogue template• Video with consenting students• Can be practised at home
  18. 18. Difficult communications 1 : handovers• Provide information about patient care• Provide information about changed patient care status• Pass on messages e.g test times• Remind staff about future activities e.g discharge planning information Stress! Can be given to a group in a staff room or as a bedside walk-around
  19. 19. Difficult communications 2: telephone calls• Asking for info e.g lab results• Making a referral e.g. to a peripheral hospital• Making an appointment• Taking calls from friends and relations – Data Protection• Calling for medical assistance – using SBAR
  20. 20. A word about correct pronunciation• It is important!• Balance between over-emphasis and under- emphasis• Can be a safety issue e.g drugs, patient status, numbers• ↓patient frustration Was that 40units of insulin or 14?• ↓colleague frustration
  21. 21. What kinds of Writing? Formula-based charts /forms Writing short messages e.g phonemessages Writing patient notes – use ofterminology e.g acronyms,abbreviations
  22. 22. What about Reading? Work related• Patient info -notes• Pharma information• Lab results• Policies and Procedures Academic• Professional Development• Conferences, academic journals
  23. 23. What is EMP?medical terminology (prefixes, suffixes) everyday health termsabbreviations ‘Can you TWOC him in the morning thenacronyms bladder scan for residual after he PU’s’nursing jargon
  24. 24. So .....What are thechallenges for EMPstudents and teachers?
  25. 25. Balance Sheet of EMP students strengths Challenges• Already know • Terms may have med terms in own different language pronunciation • Role of nurse and doc• Already have may be different nursing skills - • Healthcare Culture global standard differences
  26. 26. Balance Sheet of EMP teachers strengths Challenges• Already teach • contextualise in healthcare functional language environment • May feel unsure of medical• Inpatient experience terms and procedures- not• May have medical or teaching nursing nursing background • May not have ability to• Lots of medical develop materials – consider course book resources available
  27. 27. My initial advice• Course book or develop own• Use students’ knowledge and experience• Learn medical terminology with your students• Role plays are vital to develop confidence in speaking – convince students of this• Use online resources• Use ‘real’ resources e.g invite a local nurse to speak to students
  28. 28. Feedback from previous workshops..• EMP Needs are changing.. courses must be appropriate to the market-place• f2f time is short so students need to do a lot of self study• Use online materials as much as possible• Course books are useful for reviewing material• Link up to blogs, online practice sites
  29. 29. Most difficult areas anecdotal evidence suggests…• Use of medical terminology versus everyday expressions• Managing handovers• Telephoning e.g referring a medical problem• Many difficult conversations
  30. 30. Before you start, understand• Greater use of acronyms and abbreviations in English – e.g BP not blood pressure• Less use of medical terminology in everyday use – e.g everyday use ‘fast pulse’ versus ‘tachycardia’• Important to use appropriate language – patient expectation of inclusion in treatment• Inappropriate use of terminology → communication barriers
  31. 31. Now, we’ll look at these areas..1. Pronunciation2. Teaching medical terminology3. Role play for Handovers4. Role play using SBAR for telephoning
  32. 32. Online resources: pronunciation• www.thefreedictionary.com – for individual terms and encyclopaedia• www.merriam-webster.com/medical/• Make your own free flashcards with audio (watch some of the pronunciations)• Vocab Trainer- vocab in context
  33. 33. Pronunciation:Vocab Trainer www.ck-translations.eu/php/pages/start.php• terms are translated into German / French /Spanish or whichever language needed• term placed in context- in a sentence• added access to Bus Eng, Tech Eng, Gen Eng
  34. 34. To try out Our Demo of Vocab Trainer (German)www.ck-translations.eu/php/pages/index.php• Deutsch• Demo• Pick option in the drop down box (M-1)• Select Klassisch-Block• Read the list of terms with meanings then when you are ready click TRAINING
  35. 35. Vocab Trainer Demo Menu – 10 terms Eng→German
  36. 36. First option: term only Second option: in context
  37. 37. Teaching medical terminology: start smalland build up gradually Organise according to systems of the body e.g.cardiac, respiratory medical terminology for body parts, diseases,tests and equipment Use terms in context – build dialogues aroundterms Review terms frequently – use games, gap fills,flashcards
  38. 38. Resources 1: Quizlet to make flashcards• www.quizlet.com• Free flashcards with audio (US pron)• You can make your own or share others• Ask students to make their own set• Lower level: prepare terms in class- make flashcards at home• In pairs, students do another student’s flashcards• Other related activities automatically generated
  39. 39. http://quizlet.com/8568101/blood-pressure-terms-flash-cards/audio Single side or both sides No of termsOther activities
  40. 40. Quizlet –automaticallygeneratedtestsTaken from flashcardsImmediatefeedbackCan be as easy ordifficult as youlike
  41. 41. Create your own crosswords• www.puzzlemaker.discoveryeducation.com• A bit of fiddling required – print out and enlarge• Easy to make – great revision• Get students to register and make their own for the class use• Note: do not use compound words- it confuses it• Find-a-word generator also available
  42. 42. Check for errors before printing e.g8. should be ‘heart attack’Does not like compound words!
  43. 43. Tools for English• www.toolsforenglish.com/• Free exercise generator• Gap fill – use with health articles to recycle medical terms• Make sure you re-write the text as 7th or 12th word is blanked automatically
  44. 44. Gapfill : use with articlesor sentences making sureto select Easy/Mediumor DifficultScramble sentences –good for definitionsrather than matching Match pairs- good for definitions, prefixes and suffixes
  45. 45. I used an online article from BBCHealthAdapted as a clozeSave Worksheet as a pdfBack to save Answer sheet as a pdfMarked automatically
  46. 46. Tools for English • Unscramble words • Choose level of difficulty • Can generate Answer sheet • Marked for instant feedback
  47. 47. Column sorting activities:Tefl.net• www.tefl.net/esl-lesson-plans/worksheet-generator• Make column sorting activity• Can be saved as an html document – print out and scan.• Worksheet + Answer sheet facility• Students can write in terms under correct column
  48. 48. Drag and drop Column Sorting: Webducate• Dragster 2 – free use to make drag and drop columns• www.webducate.net/dragster2/dragster_list.php• Make online activities 1. labelling an image activities.2. classifying activities where elements are dragged on to a table or matrix.
  49. 49. Dragster 2 Activity: example of types of medical terminology
  50. 50. Make your own Mind maps• ‘FreeMind’ software www.freemind.sourceforge.net/wiki/index.php/Main_ Page• free mind-mapping software written in Java• Start off mind map for students to continue• Leave some boxes blank or initial letter only• Students develop own mind map to review terms• Down-side – writing very small
  51. 51. Example of mind map: The Body
  52. 52. Labelling activities• English360• Webducate• Make your own – using line drawings or simple sketches
  53. 53. Page from online nursingcourse – English forHealthcare Professionals:labelling drag and dropexercise
  54. 54. Make your own activity1.ECG machine 2.Adhesive dots3.leads 4. plug
  55. 55. Using a labelling activity Check knowledge of terms Review medical terminology e.g. electro + cardio + graph Check pronunciation of terms appropriate to level ( describe, explainprocess, explain use)
  56. 56. Develop a template for other activities:explaining a procedure to a patient Doing a dressing Taking vital signs Taking out sutures Collecting a urine sample Doing a blood test
  57. 57. Free online nursing practice resources• Learners TV : www.learnerstv.com/Free-Nursing-video-lectu• Nursing Quizzes Procedures www.learningnurse.com/content/view/25/39/• Use for own background research• Students can view videos → feedback procedure to class
  58. 58. HANDOVERS‘The nursing change of shift report or handover is a communication that occurs between two shifts of nurses whereby the specific purpose is to communicate information about patients under the care of nurses (Lamond, 2000)’• Verbal handover• Tape recorded handover• Bedside handover• Written handover
  59. 59. Handovers …• type of oral presentation• talk about past history , procedures, tests• patient’s present status - vital signs, IVs, medications, dressings, drains• patient’s future needs – for oncoming shift
  60. 60. Handovers= past + present + future• Name, diagnosis, doctor, past history• Reason for admission or date post op• Present restrictions – NBM, diet, non-weight bearing• Present plan of care – pain relief, dressings, medication, IV fluids• Patient’s future needs – needs a blood test at 5pm
  61. 61. Handovers: opportunity for grammar practice• Past History: He had a …. 6 years ago, He’s got a …… He’s had (hypertension) for 2 months. He’s got (Type 2 diabetes)• Present restrictions: He’s on free fluids, He’s Nil By mouth, She can partial weight-bear only, He mustn’t have more than 2 litres a day• Future: He’ll have a CT scan tomorrow, He’s for a blood test in the morning, She needs a specimen sent this afternoon
  62. 62. Communication skill: telephoning
  63. 63. Developing skills for telephoning Use SBAR as a template assists students to organisethoughts remember calls may be to report anemergency – pressure!
  64. 64. SBAR stands forSituation – What has happened?Background – Patient’s past historyAssessment – Vital signs or nurseconcernsRecommendation - what help isneeded
  65. 65. Develop guided role plays using SBAR• Develop gap fill dialogues which follow SBAR• Use suggested language functions (see template)• Use simple situations e.g patient’s BP is dropping, Pt is in a lot of pain a few hours after an operation, pt’s dressing has an offensive discharge, patient is vomiting, pt has a fever
  66. 66. References• Nursing Handover for Adult Patients http://www.wales.nhs.uk/sitesplus/documents/86• Brainshark: www.my.brainshark.com