- Resumen
- The lesson plan & the foreign language learning cycle
- Activities to develop
- Cited bibliography
El aprendizaje del Idioma Inglés con Fines Médicos adquiere características especiales, para las que el inglés General no es suficiente. Los profesores de idiomas han tenido que enfrentar la enseñanza de idioma Inglés con fines médicos a partir de su auto preparación y el aprendizaje de forma autodidacta y empírica no solo en contenidos, así como también en el ciclo del proceso de enseñanza aprendizaje. Por eso, este articulo tiene como objetivo presentar una revisión bibliográfica relacionada con el ciclo de enseñanza aprendizaje de la lengua extrajera, sus etapas o pasos y como llevar este aprendizaje al inglés con fines médicos, partiendo del ciclo elaborado por el Dr.C. Sergio Font en su defensa doctoral en el 2006.
Palabras claves: ciclo, enseñanza-aprendizaje, idioma inglés, plan de clases
Abstract
English language learning for medical purposes acquire special characteristics, for that reason the knowledge of general English is not sufficient. Professors of English Language have had to face English language teaching for medical purposes from self-preparation, self-learning and empirical point of view, not only in content, but also in how to prepare their lessons. That"s why this article is aimed at presenting a bibliography research of literature related to the foreign language learning cycle, how to plan the lesson planning for medical purposes; the steps that should be followed by the teachers and how to carry out this learning was took from Dr.C. Sergio Font
Key words: cycle, teaching-learning, English language, lesson plan
The lesson plan & the foreign language learning cycle
Lesson plans have been described by many authors as a "scheme of work" or a "map" which indicates to the teacher the work which has to be covered in the brief time allowed. This "map" also shows how to carry out the assignment. During the actual lesson the teacher has to make innumerable decisions and they must be made fast. Without previous planning teacher will probably not find the best linguistic examples or be able to foresee, on the spur of the moment, which activity best suits the learning needs of a particular group.
One lesson does not exist by itself. It is related to the aims of the curriculum and to the lesson that precedes and follows. It is more efficient to think in terms of preparing a series of connected lessons- commonly called a "teaching unit". This unit could represent the work covered in the language class over an extended period- say three weeks or months. It is then broken down into daily lesson plans. Only individual lessons will be discussed here, but it should be borne in mind that they form part of a greater whole.
We are going to focus on foreign language learning cycle. Specific steps need to be followed in a certain order, and the ordering needs to be cyclical. The cyclical succession of interrelated steps in the process of learning is what we call a learning cycle. The steps should be interrelated in such a way that they facilitate the gradual transformation of linguistic knowledge into free and spontaneous use of communicative skills.
Many authors have described the foreign language learning cycle in different ways; this means that they have included different steps. For example: Keith Johnson (1982), includes three steps to move from mechanical to communicative exercises, Hector Hammerly (1982), has based his classification on the distinction between form and meaning, and on transition from mechanical to meaningful exercises, and then to communicative activities, David Nunan (1989), considered two main types of tasks: skill getting tasks and skill using tasks, Crookes and Chaudron (1991), put three steps: controlled techniques, semicontrolled techniques and free techniques, Penny Ur (1996), includes three steps: presentation, explanation and sequential and progressive practice.
Font (2006) put forward a foreign language learning cycle in the light of a problem-solving perspective of the communicative approach. Understanding what the communicative approach is and what its principles are is crucial to organize the language learning process, but these aspects will be content in another article.
Calixto Garcia Medical School began to use Font"s cycle in its Foreign language Department because it is intended to guide both teachers and students better in their teaching and learning, as steps are quite clearly defined.
The cycle includes six steps:
I- Initial communicative practice:
II- Description and analysis of the new language content.
III- Controlled practice
IV- Guided practice
V- Integrated communicative practice
VI- Creative application
It is very important for teachers to understand the role each of these steps, (or stages), play in the learning process and to know how to design activities for each of them. Some experienced teachers declare that the distinction the steps that involve practice of different types is sometimes hard to define and this causes teachers not to know how to tell a controlled activity from a guided one.
INITIAL COMMUNICATIVE PRACTICE:
In this step the goal is to cause the students to feel the need to communicate using what they already know. Motivate them to learn the new content. The students" freedom to choose linguistic structures is for the most part high, because they can use the language they know to express meaning. It is medium when the teacher induces them to feel the need to use new language items. The teacher"s role is to encourage, motivate, interact, elicit.
DESCRIPTION AND ANALYSIS OF THE NEW LANGUAGE CONTENT:
The main goal is to cause the students to discover regularities in the linguistic phenomena, as well the interrelation between culture and language. The students" level of involvement is high, of course, in a conscious process of discovery and generalization. The students" freedom to choose linguistic structures is high. In discovering regularities, students are not expected to use specific language items. The teacher"s role is to encourage students to disclose and define, ask guide.
CONTROLLED PRACTICE:
Develop linguistic habits, (accuracy). Imitation, substitution and sentence enlargement drills are very useful in this step. The students" level of involvement is high (imitative, reproductive and conscious). The students" freedom to choose linguistic structures is low. The teacher controls the students" output. The teacher"s role is to show, listen, model, correct. Error correction is of paramount importance in the step.
GUIDED PRACTICE:
Develop accuracy and fluency: gradually move from sentence to text/discourse structure, this will be the main goal. The students" level of involvement is high: conscious and gradually coming from reproductive to productive. The students" freedom to choose linguistic structures is medium. The teacher allows certain freedom, but still guides the students" output. The teacher"s role is to monitor, ask, interact, correct. Correction in this stage focuses on sentence- level accuracy and beyond-sentence fluency.
INTEGRATED COMMUNICATIVE PRACTICE:
The main goal in this step is to cause the students to interact fluently using the new language content. Students" level of involvement is high, (productive). The students" freedom to choose linguistic structure is high. At this stage, the tasks designed focus on what to say, and not on how to say it. The new language content will be used in communication. The teacher"s role is to monitor, interact, correct for the sake of effectiveness in the process of communication (linguistic, sociolinguistic, discourse issues).
CREATIVE APPLICATION: The main goal is to cause the students to communicate on their own outside the classroom environment. Students" level of involvement is high (creative). This step may involve student-generated projects in whose design teachers may have little or no participation. The students" freedom to choose linguistic structures is very high and teachers are not generally present.
We adapted specifically this step in our lesson plan from Font"s foreign language learning cycle, taking into account the needs of our students have. For example, the main goal is to cause the students to communicate on their own not only outside the classroom environment but also inside the wards on the-job training sessions.
It is the step where the students are rewarded for their efforts. They have had considerable preparation during controlled and guided practice steps. Creative application is a "skill-using" stage during which student should be prepared to take risks. They will try to incorporate their recent language acquisitions into their existing repertoire in order to help produce the original, creative discourse appropriate to the needs of the particular activities.
These activities at this step often take the form of task. This type of learning activity allows group work and problem solving. Students will concurrently develop their own strategies to ensure successful communication and interaction. Students need to know how to put into effect such strategies as paraphrasing, defining, explaining, opening and closing conversations, and interrupting in order to assure a conversational turn. That"s why the teacher"s role in this step is a supportive one. He must suppress the urge to correct and interrupt unnecessarily.
The teacher should listen to what the students are really trying to say. He may have to guess at the students" meaning and encourage reformulation of the message in some cases.
During the course of the interactions, he could also note which linguistic or pragmatic mistakes really impeded meaningful interaction. Such mistakes should be dealt with later during another "controlled and guided practice" session, let teacher review the main points.
From these general considerations, the teacher now moves on to the preparation of the lesson itself. The needs of the learners and the demands of the program have been taken into account. At this point the creativity, intelligence, and imagination of the teacher come into play. Hard work and talent also help.
Here is a list of some the advantages to be gained from thorough planning of each individual lesson:
To collect and organize the most suitable materials.
To clarify terminal and enabling learning objectives.
To vary methodological practice activities and to order their best sequencing from easy to difficult, from the known to the unknown.
To foresee types of student behavior, this may emerge in class during learning activities.
These are only some of the advantages to be derived from lesson planning. Let"s say, in summary, that it enhances our sense of professionalism, that it increases our control of teaching and learning and that, last but not least, it allows us greater enjoyment of teaching.
Furthermore, in the light of what the professional educators tell us, we have no choice. As Edwin Ralph (1989:140) puts it "…to fail to plan is to plan to fail".
Example of the Lesson Plan of Unit 1 at "Gral. Calixto García" Hospital Medical school
WEEK: 2
ACT: 7/8 UNIT I HYPERTENSION
TOPIC: Interviewing a patient
GOAL: Students will ask for information focusing on the language used in doctor-patient interview.
OBJECTIVES:
Terminal: Students will develop abilities and vocabulary that enable them to interview a patient.
Enabling: Student will:
Comprehend and produce necessary vocabulary for this topic.
(each student) work out doctor- patient interview
Comprehend cultural and linguistic schemata regarding doctors" office and hospital.
Roll call
Brief introduction to the semester. Explain objectives and evaluation system. Assign extra.class work
I. - INITIAL COMMUNICATIVE PRACTICE
WARM UP:
"Cardiovascular problems are a major cause of disability and death. Hypertension is one of the most common conditions and nowadays affects approximately one billion individuals worldwide"
Do you agree with the statement?
Don"t you agree? Why?
(The answers should be brief and don"t get into details)
Have the Sts. recall the case of Vision II, when they were on 2nd year. The 5th year student reported the case to the teacher:
"A 50 year-old woman visited the ER yesterday. She complained of blurred vision, palpitations and chest pain. Her problem started a week ago. Since the problem began, she has felt very worried and upset. This woman enjoys sweets and candies and eats them all the time. When she is anxious at work or has a lot to do, she drinks coffee six or seven cups a day and smokes cigarettes. She smokes a pack daily. Her father suffers from blood pressure and her mother is healthy."
.
What do these words or phrases have to do with?
What do you think was the diagnosis?
Do you know what this condition means? (Elevation of the arterial BP above the normal range expected in a particular age group. There are two types of hypertension: essential (unknown cause) and secondary or symptomatic hypertension: When it is a result from kidney disease, endocrine diseases, disease of the artery.)
What are the risk factors? (Family history, age, diabetes, weight, drinking, smoking, sedentary life-style)
How did the student do to obtain the information? (Interviewing the patient, doctor-patient conversation)
What types of questions do you do to interview the patient?
What do you ask the patient to obtain the information to diagnose him?
II. – DESCRIPTION AND ANALYSIS OF THE NEW LANGUAGE CONTENT.
Now, you"re going to listen to the dialogue bt. Doctor and patient
Pre-listening activities
Teacher"s reading 2 times
Checked the listening Write true or false:
1- The Dr greets the patient first.
2- The patient knows the doctor"s name
3- The doctor asks all the necessary questions to find out the patient"s identifying data.
Student"s reading in pairs
Ex. d) Listen to the conversation again while you look at the text. Find the synonyms of:
1- a little:
2- unexpectedly:
3- many:
4- it"s over
5- reasons:
6- solve it:
Ex. e) Answer these questions in pairs:
1- At the beginning of the interview the doctor asks: "What"s the problem" What similar questions could be used to obtain the chief complaint? You may consult Appendix 2 for help.
(What"s been bothering you most?
What seems to be the trouble?
What brings you to the doctor today?
What is your number one complaint?
What is the main problem you wanted to see me about?
How are you feeling?)
Role-play: (cards)
2- How does the doctor reassure the patient? (By saying "I"m afraid it"s a bit high at 160/100, but don"t worry. There are no grounds yet to believe that you"re a hypertensive (patient) person. And even if you"re, the good news is that together we can sort it out).
3- Is a single high reading enough to make a diagnosis of hypertension? Explain. (No, it isn"t. A diagnosis can not be based on a single high reading. Sometimes, even several high readings are nor enough to make the diagnosis, because for example, the readings may vary too much. If a person has initial high reading, BP is measured again during the same visit and then measured twice on at least two other days to make sure that the high BP persists.)
III CONTROLLED PRACTICE:
Substitution drills (cards)
I- A: Hello, Mr. Anderson. I"m Dr Smith.
B: Good morning Doctor.
A: Mr. Anderson, your family doctor says here you"re 48, a police officer and married. Is that correct?
B: Yes that"s right, doc.
1- Mr. Anderson 2- Dr. Smith 3- 50 4- Teacher
Mr. Mendez Dr. Rodriguez 44 cooker
Mr. Kovac Dr Martinez 62 female nurse
Mr. Edwards Dr. Gonzalez 70 sportsman
4- single
Divorced
Not married
Married
II A: What"s the problem?
B: Well, Look. I"ve had nosebleeds, now and then, but the one I had this morning is the worst one. I"ve ever had and I"m a bit worried about it.
1- What seems to be the trouble? 2- blurred vision
What brings to the Doctor today? Headaches
What is the main problem you wanted to see me about? Ankle edema
What is your number one complaint? Dyspnea on exertion
What"s been bothering you most?
2- in the afternoon 4- a little
At work
In the theater
Waiting for you
III A: Good morning Mr. Estrada. What seems to be the problem?
B: I"m not feeling well. I"ve been having trouble climbing stairs.
A: Is it something new?
B. No, but it"s never been this bad before.
1- Mr. Pichs 2- What can I do for you?
Mr. Alonso How are you feeling?
Mrs. Borges What kind of problems have you been having recently?
Mrs. Piera What kind of problems would you like to share with me?
3- I"ve been having headaches and dizzy spells.
I have been tense
I have been overweight
I have been having ankle edema
I have to stop and catch my breath, when I"m climbing up the steps at home.
IV A: I"m not feeling well, doctor, when I read the words run together.
B: Have you noticed that your vision is any worse lately?
A: I think I have.
1- When I climb up the steps at home, I have to stop
When I walk I have had pain in the small of my back
I feel as if the room is moving
I"ve been having the BP high
2- About how many steps can you make before you have to stop.
Have you had any burning when you urinate?
Have you been having headaches or dizzy spells?
Has anyone had hypertension, heart disease, or strokes in your family?
3- Oh, two or three flights.
No, except when I get kidney infection
No, I haven"t
Yes, my father died of stroke when he was 68
SUMMING UP:
A couple has to dramatize the dialogue:
CONCLUSION:
What did you learn today?
What kind of questions does the doctor ask the patient to interview him/her?
HOMEWORK
Exercise 2 item f and g
WEEK: 3
ACT: 9/10 Unit I Hypertension
TOPIC: Writing s referral letter
Informing the patient about the investigations the doctor is going to order.
Giving instructions for taking BP
Describing the procedure.
GOAL: Students will write a referral letter, inform the patient about the investigations,
Give instructions for taking BP and describe the procedure by means of
Connectors
OBJECTIVES:
Terminal: Students will use successfully abilities and vocabulary to write, inform and describe.
Enabling: Students will comprehend and write a referral letter using the necessary vocabulary.
Students will inform about the investigations.
Students will give instructions for taking BP
Students will describe the procedure by means of connectors.
ACTIVITIES TO DEVELOP:
Roll call
Check the Homework
Ex f) Use the ex. Of True or false from the dialogue to check hw ("Just let me ask you a few more qs.")
History of the present illness:
When did the chest pain begin?
How long have you had it?
When did you first notice it?
Have you had ringing in the ears?
Have you noticed pressure or tightness in your chest?
Have you had shortness of breath?
Have you been short of breath?
Have you been troubled with shortness of breath?
Medicine:
Do you take prescription medicines?
Are you taking any prescription medicines?
What is the dose and frequency?
Have you taken any medication for this problem?
Previous (past) history:
Have you ever had this problem before?
Have you ever been treated for something like this?
Have you ever hospitalized?
Have you ever had high BP?
Have you ever had a heart trouble?
Have you ever had angina pectoris or a heart attack?
Family History
Has anyone in your family ever suffered from diabetes, heart diseases?
Has any of your blood relatives had a heart attack?
Is there any history of hypertension in your family?
Is there any history of hypertension in your family?
Social History
Do you live alone?
Are you married?
How old did you say you were?
Are you having a difficult situation at home or work?
Do you have any problems with your marriage?
What sort of work do you do?
If retired, what do you do to stay busy?
Any hobbies?
Habits:
Do you smoke or drink?
How long have you been drinking?
How much do you usually drink?
Have you ever smoked cigarettes?
? How many packs? Do you drink alcohol?
Do you drink coffee/tea? How many cups a day do you drink?
g) What parts of the body is the physical examination confined to? (the chest, the heart, the brain, the abdomen, the extremities)
2- On the textbook
3- Inspection
Auscultation
Palpation
4- Blood test: blood glucose, hematocrit, serum potassium, creatinine and calcium, lipid profile, urinalysis, electrocardiogram, ultrasound, angiography.
IV- GUIDED PRACTICE
WARM UP: go back task 2
"The doctor asks all the necessary questions to find out about the patient"s identifying data"
Why does the doctor know the patient"s personal data?
He received a document, paper where the family doctor had written personal data.
What is the name of the document?
Referral letter: a letter used by doctor and other health professional to refer the patients to other colleagues or specialists.
Who is the referral letter addressed to?
Who do you think sends the letter?
What do you think, his specialty is?
He is likely to be a clinician.
The students have to write a referral letter, by team
You"re a family doctor and have to refer a patient to specialist. (10 minutes)
Now, work in pair and tray to recreate the consultation. "A" should start.
St "A": You are a doctor. Use the information in the doctor-patient dialogue and the questions inventory above to obtain as much information as possible from your patient. Inform the patient about the investigations you"re going to order.
St "B": You"re the patient. Answer the doctor"s questions using the information in the doctor-patient dialogue above. Use your medical knowledge and imagination to reply questions whose answers are not in the dialogue. If you are not sure about an answer you may simply say "I haven"t noticed" Try to be consistent with a positive diagnosis of hypertension
You can use: questions about PH, FH, SH, H see appendix 4
Explanations:
Urinalysis to detect RBC, WBC and bacteria in the urine.
Ultrasound to identify organs within the body.
Hematocrit to determine the RBC mass
Creatinine and calcium to measure the concentration of total creatinine and calcium in the blood.
Blood glucose to detect any disorder of glucose metabolism.
In the dialogue the doctor checked the BP. Let"s read this fragment:
Doctor: Let me check it now. Please roll up your sleeve, stretch your right arm and just fix this around here. Ok. All right. We"re through.
Patient: How is it, doctor? Is it normal?
Here the doctor gives instructions to take the BP:
-roll up your sleeve
-Stretch out your right arm
-just fix this around here
Role-play:
A: You"re the doctor on duty in the clinical ward. You are teaching a first- year nursing student how to test the BP. Give her/him instruction.
B: You"re a first-year nursing student you"re learning how to test the BP
Task 3
How to test a patient"s BP. Describe the procedure using connectors (first, next, then, after that, finally)
First, the patient should be seated or placed supine for at least 5 minutes. Second, the sphygmomanometer cuff is placed around the bare upper……
V- INTEGRATED COMMUNICATIVE PRACTICE.
Doctors often take part in health education programs and preventions campaigns to fight diseases. You are now involved in a HIGH BLOOD PRESSURE prevention movement. Work in teams and prepare a talk to be deliver in your community. You may use the questions as a guide such as:
What is a blood pressure?
What are the signs and symptoms of HBP?
Who is at risk for this condition?
How is treated?
How do you know you have HBP?
What happens when HBP is left untreated?
VI- Creative application
(Cards)
1-One of the most important activities of the on-the-job training is In-service training in the Casualty Unit. You have to interview patient, get information from him/her in order to know the chief complaint, HPI, PH, FH, SH, Habits and medication.
.2- You have to read the patient"s clinical records in order to know the diagnosis. Discuss with your partner investigations and diagnostic procedures.
3. – The nurse who is working with you at Casualty Unit is new (1st year).Teach him/her how to test the BP
1- Font Milian, Sergio A. Metodología para la Asignatura Inglés en la Secundaria Básica desde una concepción problémica del Enfoque comunicativo. Tesis en opción al grado científico de Doctor en Ciencias Pedagógicas. ISPEJV, Ciudad de La Habana 2006.
2- Johnson, Keith
3- Hammerly, Hector
4- Nunan, David
5- Crookes & Chaudron
6- Ur, Penny
7- Font, Sergio
8- Edwing, Ralph
Bibliography.
1- Font Milian, Sergio A. Metodología para la Asignatura Inglés en la Secundaria Básica desde una concepción problémica del Enfoque comunicativo. Tesis en opción al grado científico de Doctor en Ciencias Pedagógicas. ISPEJV, Ciudad de La Habana 2006.
2- Brown, Douglas. Teaching by Principles.- New Jersey: Prentice Hall, 1994.
3- Nunan, David. Designing tasks for the communicative classroom.- United Kingdom: Cambridge University Press, 1989.
4- Stevick, Earl W. Teaching Languages, A way and ways.- USA: Newbury A course in Language Teaching, Practice and Theory.- Cambridge University Press, 1996.
5- Stern, H. H., Fundamental Concepts of Language Teaching.- Oxford: Oxford University Press, 1987.
6- Richards, Jack C. & Theodore Rodgers, Approaches and Methods in Language Teaching. Second Edition. New York: Cambridge University Press 2001.
7- Crookes, G., Guidelines for Classrroom Language Teaching. In Teaching English as a second language, Marianne Celce- Murcia, Heinle & Heinle Publisher 1991
8- Nunan, David, Communicative Language Teaching: Making it work.
9- Acosta, Rodolfo & Alfonso, José, Didáctica Interactiva de la Comunicación.
10-Antich, Rosa, Metodología de la Enseñanza de las Lenguas extranjeras.- La Habana: Pueblo y Educación, 1987.
Autor:
Fausto Vladimir González Crespo (1)
Marta Plasencia Romero (2)
Lourdes Borges Oquendo 3)
Doris Y. Rubio Olivares 4)
(1) Licenciado en Educación en la Especialidad de lengua rusa y Lengua Inglesa. Asistente.
Facultad de Ciencias Médicas "Gral. Calixto García Iñiguez" La Habana
(2) Licenciada en Educación en la Especialidad de Lengua Rusa y Lengua Inglesa. Instructor. Facultad de Ciencias Médicas "Gral. Calixto García Iñiguez" La Habana
(3) Especialista de 1er grado en Bioestadística. Máster en Estudios de Población. Profesora Auxiliar. Facultad de Ciencias Médicas "General Calixto García". Cuba,
(4) Especialista de 2do grado en Higiene y Epidemiología. Máster en Educación Médica. Profesora Auxiliar. Facultad de Ciencias Médicas "General Calixto García". Cuba.