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English for Nurse:
A curriculum Design and Material Development for a Nursing Program
at University of SingaperbangsaKarawang
A nurse is a person who, having been formally admitted to a nursing education
programme duly recognized by the Member State in which it is located, has successfully
completed the prescribed course of studies in nursing and has obtained the required
qualifications to be registered and/or legally licensed to practise nursing. Nurses help
patients, families and groups to determine and achieve their physical, mental and social
potential, and to do so within the context of the environment in which they live and
work. Nurses require competency to develop and perform functions that promote and
maintain health as well as prevent illness. They also assess, plan, give and evaluate their
professional care during illness and rehabilitation, which encompasses the physical,
mental and social aspects of life as they affect health, illness, disability and dying. They
may practise in hospitals and the community. They are competent to work autonomously
and as members of the health care team. In certain circumstances they may delegate care
to health care assistants, but they retain responsibility for care, supervise where necessary
and are accountable for their decisions and actions. (WHO : 2001)
Nursing is both an art and a science. It requires the understanding and the
applicationin practice of specific nursing knowledge and skills, which, wherever
possible, areresearch- and/or evidence-based. It draws on knowledge and techniques
derived fromthe humanities, from the physical, biological and behavioural sciences,
frommanagement and leadership theories and from theories of education (WHO 1996a).
The role and function of nurse which was released by WHO (World Health
Organization) requires nurses to achieve both art and science. In term of art, nurses
which spend most of their time to help patients, families and groups to determine and
achieve their physical, mental and social potential, and to do so within the context of the
environment, need such a competence to communicate well with peoples. They need
English, which has been an international language, to get a better interaction and
Nowadays, competence in English has become an urgent need for nurses whoare
involved in medical services. It is due to the fact that they are required to have theability
to communicate with the other people in their field including doctors and patients.There
are demands of professional nursingwhich includes English Competence in listening,
reading, speaking and writing (Indah D. Pratiwi: 2010). In matter concerning this
issue, curriculum design and material development on this program should follow
the procedures and techniques with the underlying ground and teaching principles.
To design a curriculum, teacher should pay attention to the principles of
curriculum design. A curriculum is an attempt to communicate the essential features and
principles of an educational proposal in such a form that it is open to critical scrutiny and
capable of effective translation into practice ( Stenhouse: 1975).
To design a curriculum is exactly to develop its contents based on students’ need.
Curriculum development is an essential component of an educational programme.
Richards states that “Curriculum development focuses on determining what knowledge,
skills, and values students learn in schools, what experiences should be provided to bring
about intended learning outcomes, and how teaching and learning in schools or
educational systems can be planned, measured, and evaluated”(2001, p. 2).
Let's see some steps in designing curriculum and developing its material for
English for nurse to help students bridge the English skills gap.
1. Needs analysis
2. Define programme goals and objectives of the instruction
3. Data Analysis
4. Findings: Curriculum design and material development
2. NEED ANALYSISMETHODOLOGY
In conducting need analysis, a designer should remember that the course has to fulfill
students’ expectation, and they want a course that relates to their professional language
needs. Richard, Platt and Weber in Brown define: “the process of determining the needs
for which a learner or group of learners requires a language and arranging the needs
according to priorities“.
The target population of this study was 5 professional nurses and 5 nursing students
in practitionerlevel of RSUD Karawang. They were working in nursing units,which
weredispersed all over the hospital.
Five professional nurses and five nursing students were randomly selected from
nursing units to representthe total number of nurses. Random sampling was claimed
to be the best method inselecting samples because all population of the target group
had an equal chance to beselected (Pleansaisurb. 1984: 30). The selection criteria
were focused early on the nursingunits’ head, followed by the staff in each nursing
The questionnaire is constructed to study English speaking skill ofnurses at RSUD
Karawang consisted of five parts.
Part 1: General Information of Respondents
This part only required the respondents to indicate their personal data; age,
position,office, the highest education and time spent in working.
Part 2: Frequency of English Speaking Skill Used at Work
This part only required the respondents to specify how often they spoke
English intheir work. There were four choices: often (20 – 30 times a month),
sometimes (10 – 19times a month), rarely (1 – 9 times a month), or never (0
times a month).
Part 3: Frequency of the Use of English Speaking Skill in DifferentContact
A question covered data regarding the use of speaking skill. Four-point
scales(often, sometimes, rarely and never) were used. This part only asked the
respondents tospecify how often they spoke English in different contact
situations. Eight sub-items wereincluded. An open-ended statement was also
provided if the respondents would like to add
Part 4:Nurses’ Speaking Problems
This part included open-ended questions regarding speaking problems
therespondents faced when using English at work concentrating on
pronunciation, vocabulary,grammar and confidence in speaking.
Part 5: Types of English Speaking Courses Preferred by Nurses
This part only required the respondents to specify the nurses’ opinions about
theirneeds concerning the English syllabus, and contents.
The questionnaire was constructed based on the informal interview questions
withthe nurses at RSUD Karawang because the results from the interviews revealed
the day today real work done by such nurses, but not the theoretical ideas presented
in textbooks.The first draft was translated from Indonesia into English in order to get
clear understandingamong the respondents. Then the bilingual questionnaires were
distributed to 5 professional nurses 5 nursing students. In some cases if the nurses or
students were unclear, the researcher guidedlyinterviewed them to get detailed
answers as well as related examples.
After collecting the completed questionnaire, the researcher categorized the
data,tabulated and analyzed them by using percentage to identify the current English
uses,problems and types of the needed English syllabus.
The findings of the data analysisconsist of narrative andtables. Five main sections are
discussed 1) general information of respondents 2) frequencyof English speaking skill
used at work 3) frequency of the use of English speaking skill indifferent contact
situations 4) nurses’ speaking problems and 5) types of speaking coursespreferred by
A. Analyzing Data
General Information of Respondents
Ten copies of questionnaire were distributed to the nurses and nursing students
at RSUD Karawang.The respondents’ information was classified in Table 1.
TABLE 1 GERNERAL INFORMATION OF RESPONDENTS
17 – 25
26 – 35
41 – 50
Practitioner (Professional Nurse)
Nursing Students as practitioner
Below a Bachelor degree
Bachelor degree or any equivalent degree
Experience in Working
6 – 10 years
10 – 15 years
16 years or more
The sample in this study compiled 10 professional nurses from 5
practitioners and 5nursing students in different nursing units. Their age levels
werecategorized as between 17 – 25 years (50%), 26 – 35 years (20%) and 36
– 45 years(20%). They had bachelor degree or any equivalent degree (50%),
and Below a bachelor degree(50%). For experience in working, there were
50% of respondents, who have not experiencesbefore, they were the nursing
students, 30% of respondents who have been working between 6 – 10years,
and 20% of respondents who have been working between 10 – 15 years .
As shown in Table 1, 50% of the respondents were 31 – 40 years of
age and had6 – 10 years experience in working, but 50% of the respondents
have not graduated from Nursing School. This inferred that the nurses had
nursing experience, butthey might lack of technical vocabulary because
Bachelor of Nursing Sciences studentsmostly used Indonesian language to
study nursing course, so they rarely speak English asinterviewed from Ms.
EkaPuspitaMerdeka, the nurse at RSUDKarawang.
Additionally, the samples were composed of 50 to 50 percent of the
practitioner andnursing students working for different department. Therefore,
the English speakingproblems revealed in this research were equally faced by
practitioner and managerialnurses.
Part II: Frequency of English Speaking Skill Used at Work
The respondents were asked about the frequency of usage in their work. The
datawere then classified and summarized in Table 2.
TABLE 2 A FREQUENCY DISTRIBUTION OF ENGLISH SPEAKING
SKILL USED AT WORK
Table 2 shows the frequency and percentage of English speaking skill
usage ofnurses at Rajavithi hospital. It can be concluded from Table 2 that the
respondents ”often”used speaking skill for a value of 5% (20 – 30 times a
month), followed by ”sometimes” for55% (10 – 19 times a month), by "rarely"
for 40% (1 – 9 times a month), and by "never" for0% (0 times a month)
As shown in Table 2, it was found that 55% of the respondents
sometimes spokeEnglish at work. Consequently, speaking played important
roles for nursing careers. Thisassumption was in compliance with the research
of Ruth (1998: 31) stated that speakingwas a key tool that medical needed to
call for cooperation among individuals in the deliveryof health care services.
Part III: Frequently of the Use of English Speaking Skill in Different Contact
The respondents were asked the percentage of situations in value use
speakingskill. The data were then classified and summarized in Table 3.
TABLE 3 A FREQUENCY DISTRIBUTION OF THE USE OF
ENGLISHSPEAKING SKILLIN DIFFERENT CONTACT SITUATIONS
Asking foreign patients’
Asking foreign patients’ signs
Giving information to foreign
Informing patients of your
intended nursing care if taking
care of foreign
Discussing with doctors and
other nurses to find treatment
or taking care of patients
if working with foreign
Giving instructions and health
education about the disease
patients have if taking
care of foreign patients
Asking doctors about the
patients’ progress if working
with foreign doctors
Asking patients to get the
results of treatment or nursing
Table 3 indicates the frequency and percentages in using English
speaking skill ofnurses at Rajavithi Hospital in different contact situations. It
shows that the nurses rarelyspoke English to communicate with the foreign
patients, doctors and nurses. However, 50%of therespondents revealed that
they sometimes spoke English to foreign patients with thecase to give
information and inform them of the nursing care.
Part IV: Nurses’ Speaking Problems
The respondents were asked about their speaking problems the respondents
facedwhen using English at work.
The most important aspect of this problem was mispronunciation.
They wereworried about pronunciation and they often pronounced words
incorrectly.For example, the nurse would like to ask foreign doctor "Could
you pleasecheck this pharmacy label?”, but they mispronounced "label” as
"level”. Then, the doctor didnot get this message correctly.
The problem was vocabulary. They were unable to use proper
words to expresstheir ideas fluently. This was due to their limited
knowledge of the meaning of words,technical terms and vocabulary an
especially roots,prefixes and suffixes. There were twoexamples to clarify
The first example was the word "chripodist". This word derived
from threewords combined together: chiro, podium and ist. Chiro is the
prefix means arm or head.Podium is the Greek root means foot, and ist is
the suffix means a person practicing orstudying an art or science. The
nurses didn’t know the structure of this word that it camefrom prefix, root
and suffix attached together. Therefore, it was difficult for them to
analysethe word structure and guess the meaning of words or medical
The second example was that the nurse didn't realize the real
meaning of "OR".Once the doctor told the nurse that "the patient needs
legs OR”. Even if the nurse knewthat "OR" technically means operation,
they didn’t know that "operate" was the verb form.Then, they said to the
patient, "the doctor needs to cut your legs". This might shock thepatient.
The major problem was grammatical errors including errors in tenses,
active andpassive voice. It was difficult for them to speak the most suitable
words to express theirideas clearly and correctly.For example, the nurse
said, "today you has fever high". As seen, the sentencewas incorrect in
terms of subject and verb agreements and part of speech. The nurse
alsofelt less confident in speaking English.
4. Confidence in Speaking
Lack of self – confidence was the biggest problem in speaking English.
Theyoften pronounced words incorrectly. Therefore, they were reluctant to
speak Englishbecause they felt embarrassed. They felt excited when they
were asked to show their ideasin English and they were not confident to
show their ideas at meetings because they hadproblems in pronunciation,
vocabulary and grammar.
Types of English Speaking Courses Preferred by Nurses
The respondents were asked the frequency of their English speaking course to
beprovided for them. The data were then classified and summarized in Table
TABLE 4 A FREQUENCY DISTRIBUTION OF ENGLISH SPEAKING
Table 4 shows the frequency and percentage of English speaking
course for nurses.The findings in this study clearly revealed that 100% of the
respondents needed theirorganization to provide the English speaking training
for them. It can be concluded fromTable 4 that the speaking course should be
provided "often" by the respondents for a valueof 20% (20 – 30 times a
month), followed by "sometimes" for 40% (10 – 19 times a month),by "rarely"
for 40% (1 – 9 times a month), and by "never" for 0% (0 time a
month)respectively. It could be assumed that the nurses were willing to take
English speakingcourse. This support the research of Siriwong (1984: abstract)
stated that nurses wanted tolearn English, which emphasized speaking skill.
A speaking training program should focus on related health contents.
They preferredto study with native speakers and the training should be offered
regularly every month orevery 3 months.
They had an opportunity to speak English for their routine service.
Therefore, theypreferred to have an opportunity to practise speaking. To
develop their effectivecommunication skill in speaking, authorities concerned
should take this into consideration.
B. Planning a Program
a. Goal and Objective
The goals should provide a clear definition of the purpose of the programme; they
should be a guideline for designer, the students and the organization requesting
The goals can be established in terms of extension or diversification of
communicative language competences, or in terms of the enrichment of strategies,
or in terms of the fulfilment of tasks. They are determined by the information you
gathered during the needs analysis.
According to Brown (1995, pp. 71-73) Goals is general statement about what must
be accomplished in order to attain and satisfy students’ need. Objectives are
Precise statements about what contents or skill the students must master in order
to attain particular goal.
Based on the findings data in need analysis, the designer formulates the goal of
this program (English for Nurse) as below: “To facilitate the student to acquire
the abilityto perform their duties in an environment where English especially
speaking is used and needed”
In order to gain this target the designers formulate the objective of this
program as below:
To introduce the students to some glossaries related to the need of their
To acquire some useful expression they usually use in accomplishing their
To give authentic teaching material which is practiced directly in class
finishing each topic
b. Programs Needed
The specific teachers or lecturers needed for this program is atleast 30
years age of graduate of master program of English language education who
has passed for IELT program and get a recent certificate.
The teachers or lecturers also are suggested to join or at least to have a
background of knowledge related to NCLEX-RN (National Council Licensure
Examination for Registered Nurses) NCLEX-PN (National Council Licensure
Examination for Practical Nurses)
2. Time Allotment
As this program is planned to be implemented at the nursing program
of UNSIKA, the time allotment of this will be based on rules and regulation of
the nursing program department of UNSIKA. There will be 16 sixteen meeting
for the overall teaching and learning in class includes mid test and final test.
The duration of each meeting will spend the time of 3 credits point or
in another word in will spend 150 minutes of teaching and learning. This
duration includes the overall phases of teaching in classroom.
a. Needs of students
The student needs is to acquire the abilityto perform their duties in
an environment where English especially speaking is used and needed.
b. Age of students
The students participate in this program is undergraduate students
of nursing program at University of UNSIKA with the age around 15 up
twenty years old
c. Number of students
The students participate in this program is the first semester of
undergraduate students of nursing program at University of UNSIKA
which consist of 245 students divided into 8 classes
c. Material (Course book)
Based on the analysis that has been achieved, the designer of this curriculum
use the concept of Brown (2005) to set the syllabus for this program (English
for Nurse) as below:
University of SingaperbangsaKarawang
Semester/ Year of
Title of Course
SYLLABUS OF ENGLISH FOR NURSE
1/ 2012 – 2013
English for Nurse
Nursing and Midwifery Program
YousefBani Ahmad, S.S., M.Hum.
This course is a basic material for nurse. It facilitates the student
to acquire the abilityto perform their duties in an environment
where English especially speaking is used and needed”
To facilitate the student to acquire the abilityto perform their
duties in an environment where English especially speaking is
used and needed”
To introduce the students to some glossaries related to the
need of their work
To acquire some useful expression they usually use in
accomplishing their duty
To give authentic teaching material which is practiced
directly in class finishing each topic
Intro to course and syllabus content
Vocabulary for nurse
English Greeting For Nurse
Day 4-5Giving Direction In Hospital
Day 6-7Parts Of The Body And Health Problem
Day 8 Mid Test
Day 9Health Problems Diagnose
Day 10Making Observation
Day 11General Assessment
Type Of Symptoms
Day 13Patient Assessment
Day 14-15 Checking Vital Sign
2. Lesson Plan
Based on the need analysis, the designer of this program use the theory of
National Capital Language Resource Center (NCLRC) by Catharine Keatley
and Deborah Kennedy to construct the lesson plan of this program. The
following is the sample of lesson plan taken from one the topic in the syllabus
which use the theory of Scot Thornbury (2005) in implementing teaching
speaking for nurse.
University of SingaperbangsaKarawang
Semester/ Year of
Title of Course
1/ 2012 – 2013
English for Nurse
Giving Direction In Hospital
After completed this chapter, students will be able to:
1. Use expressions related to giving directions correctly
2. Give directions to a certain place in or out of hospital
(Scot Thurbury: 2005)
As students are arriving, chat with them about kinds of
department and rooms in hospital
Ask how they find out the rooms in hospital
Review on preposition; for example asking them the location
of certain room in hospital
Outline goals for today’s class
Discus with students the vocabularies related to the topic and
the usage of the word in the field of nursing activity
Provide them such an authentic learning: video of nurse
giving information or direction in class
Provide them some useful expression used for giving
information or direction in hospital
Explore more the use of preposition in expressing the detail
location of room in hospital
Provide them a sample of conversation related with giving
information or direction to people in hospital
Task repetition, reading aloud and dialogue using the sample
Practice the dialogue in pair
Role play 1: students are given such a map of hospital
building from the first and the second floor then the teacher
ask them to direct him to certain places written on the map
Role play 2: students are directed to go outside the class and
ask them to give direction and information of certain building
or room in the school or campus or if can, the teacher can
invite students to visit a hospital and ask them to give
direction or information related with the location of
departments or rooms in building
Before leaving the class teacher gives students a kind of
assignment. It is a worksheet paper.
Students are to work in pair
Each of them given a paper contains a map of building (sheet
A and B)
There are rooms with no name on each paper
Students A should ask students B to complete the name of
room in building of hospital using the expression of direction
and vice versa
(homework for next
Media and tools
Based on the setting of syllabus and lesson plan above, this program will
elaborate two methodologies of teaching:
1. Teaching vocabulary (Apthorp : 2006)
Research suggests that although many students acquire vocabulary
naturallythrough activities at school, this cannot be left to chance in the case
of childrenwith low vocabularies.
Duke and Moses (2003) concluded that reading is the basis of
vocabulary growth, together with engagingchildren in rich oral language and
encouraging reading and talk at home.
The National Reading Panel’s review (2000) identified five basic
approaches tovocabulary instruction which should be used together:
explicit instruction (particularly of difficult words and words that are
notpart of pupils’ everyday experience),
indirect instruction (i.e. exposure to a wide range of reading materials),
multimedia methods (going beyond the text to include other medias
suchas visual stimulus, the use of the computer or sign language),
capacity methods (focusing on making reading an automatic activity),
association methods (encouraging learners to draw connections
betweenwhat they do know and unfamiliar words).
Evidence from Apthorp (2006) supports and extends the National
Reading Panel’sconclusions. She concluded that there was a solid evidence
base supporting threekey elements of vocabulary instruction:
defining and explaining word meanings;
arranging frequent encounters with new words (at least six exposures to
encouraging pupils’ deep and active processing of words and meaningsin
a range of contexts.These kinds of activities are effective for
vocabularydevelopment and improved reading comprehension.
2. Teaching speaking (Scot Thornbury edited by Jeremy Harmer : 2005)
Essentiallly, there are kinds of knowledge that speakers bring to the
skill of speaking. First, it is Extralinguistic knowledge.it is sociocultural
knowledge that learners use when they communicate each others. Second
isLinguistic knowledge. It consists ofgenre knowledge, discourse knowledge,
pragmatic knowledge, Grammar, vocabulary, phonology
So, In order to activate both knowledge (Extralinguistic and Linguistic
knowledge), learners need experience three stages:
Awarness-raising:It is to help learners fill gap in theirknowledge,
process:Attention – Noticing – Undertsanding. To raise the
awareness of learners about feature of speaking can be done
by:Using recordings ang transcripts, Using live listening or it also
can be enhanced by noticing the gap activities
Appropriation: It is a repetitive practice of language items in
conditions where the possibility of making mistakes is minimized.
This stage can be done through, drilling and chants, writing task,
reading aloud, assisted performance and scaffolding, dialogue,
communicative tasks, task repetation.
Autonomy: It is the capacity to self regulate performance as a
consequence of gaining control over skill that were formally otherregulated. This phase of learning can be done through: giving
presentation and talks, telling stories, jokes and anecdotes, drama
activities, including role-plays and simulation, discussion and
debate, conversation and chat
The type of test that will be applied in this program is mostly role play.
Role-playing as a teaching strategy offers several advantages for both teacher
andstudent. First, student interest in the topic is raised. Research has shown that
“integratingexperiential learning activities in the classroom increases interest in
the subject mater andunderstanding of course content” (Poorman, 2002, pg. 32).
Fogg (2001) tells of a collegeprofessor who felt that his history classes were
boring and not involving the students.After trying out a role-playing type game
one semester, he observed that students weremuch more interested in the
Secondly, there is increased involvement on the part of the students in a
roleplayinglesson. Students are not passive recipients of the instructor’s
knowledge. Rather,they take an active part. Poorman (2002) observes that “true
learning cannot take placewhen students are passive observers of the teaching
process” (p. 32). One student atBarnard College who was enrolled in a roleplaying history class said, “This class trickyou into doing so much work” (Fogg,
2001). The result of the involvement is increasedlearning (Fogg, 2001).
A third advantage to using role-playing as a teaching strategy is that it
teachesempathy and understanding of different perspectives (Poorman, 2002). A
typical roleplayingactivity would have students taking on a role of a character,
learning and actingas that individual would do in the typical setting. Poorman
(2002) found “a significantincrease among students in feeling another’s distress
as their own” (pg. 34). Role-playinghas also been seen to be effective in reducing
racial prejudice (McGregor, 1993).
The competence in English has become an urgent need for nurses whoare
involved in medical services. It is due to the fact that they are required to have
theabilityto communicate with the other people in their field including doctors and
patients. This research have follows several procedures and steps in order to gain the
target on how to facilitate the student to acquire the abilityto perform their duties in an
environment where English especially speaking is used and needed”. As a result, the
writer or the designers of this program concludes their research as follow:
a. The role and function of nurse which was released by WHO (World Health
Organization) requires nurses to achieve both art and science. In term of art,
nurses which spend most of their time to help patients, families and groups to
determine and achieve their physical, mental and social potential, and to do so
within the context of the environment, need such a competence to
communicate well with peoples. They need English, which has been an
international language, to get a better interaction and communication.
b. Based on the findings data in need analysis, the designer formulates the goal
of this program (English for Nurse) as below: “To facilitate the student to
acquire the abilityto perform their duties in an environment where English
especially speaking is used and needed”
c. The students participate in this program is undergraduate students of nursing
program at University of UNSIKA with the age around 15 up twenty years
old consist of 245 students divided into 8 classes
d. Based on the result of need analysis the course contents of this program
comprise: Vocabulary for nurse, English Greeting For Nurse, Giving
Direction In Hospital, Parts Of The Body And Health Problem, Health
Problems Diagnose, Making Observation, General Assessment, Type Of
Symptoms, Patient Assessment, Checking Vital Sign.
e. Based on the setting of syllabus and lesson plan, this program will elaborate
two methodologies of teaching: Teaching effective vocabulary (Apthorp
:2006) and Teaching speaking (Scot Thornbury edited by Jeremy Harmer :