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Frustrated readers at Khon Kaen Medical School
559
Frustrated
readers
at Khon WREN
Technical
Co-operation
Officer,
Kaen Medical
Schoolt
HOSKYNS”
Overseas Development
Administration
Summary Ability in English is essential for Thai medical students. 34 fifth-year students completed two cloze tests from two standard English language text-books to assess their comprehension. One of these tests was from a recommended text-book. 65% of students had poor understanding of the recommended text (Text A). Results were significantly better from the other text (Text B), but only one student had good understanding. The medical course needs more appropriate English teaching and more appropriate English text-books. More information is needed about which books students learn from. about tuberculosis were selected from two recogmzed text-books (Texts A and B). Text A was taken from a U.S. postgraduate textbook which is recommended reading for medical students. Texr B was taken from a standard U.K. undergraduate text. The rest was in rhe form of a cloze rest (see appendix). Each student was given either Text A or B at random. After finishing the student was given the other paper. The test was anonymous so it was not possible to match scores between
Introduction Thai medical students need to have a good understanding of English. Many of the recommended text-books are in English. If they do residency training they will have to read and understand English journals. This test was given to see if the fifth-year students can understand standard medical texts and to compare comprehension of two different texts on the same subject.
the tests.
‘Correspondence Go K. R. Cripwell, 56 Park Meadow, Old Harfiled, Herts. AL9 SHB, UK. tThis work was undertaken as part of rhe NottinghamKhon Kaen University link in Community Medicine.
Methods
The lest was given to fifth-year medical students at the end of the academic year in May. These students have approximately one more year before qualifying as docrors. Passages Graph
of number
8 Text A
X
x
x
X
X
X
5
x
x
x
4
x
x
x
x
X
x
x
x
x
X
X
X
X
x
x
X
x
x
x
x
x
n = 34 mean = 35% SD = 10.7%
6
3 2 1
X
x
8
X
X
Text B
7
n = 34 mean = 45% SD = 10.9%
6 No. of students
60 % score
X
7
No. of students
of students against score for Test 1 and Test 2 10 20 30 40 50
5 4
X
3
X
X
X
X
x
x
x
X
X
X
X
X
X
X
X
X
x
x
x
x
x
X
1
X
X
20
X
X
X
10
X
X
2
0
X
x 30
40
50
x 60 % score
FRUSTRATED
560
READERS
AT
Cloze Test A general description of the technique is given in CRIPWELL (1983), see p. 00 above. In the present study synonyms were marked as wrong. This makes the test easy to mark but does not alter the groupings much because the test is a very crude assessment. Three groups can be identified: (i) less than 40%-poor understanding; (ii) 40-60%-some understanding but need further training; (iii) more than 60%-good understanding. For an example of one of the passages, see appendix. Results The frequency distribution of the scores is shown in the graph. The distributions are approximately normal with a long tail of poor results. As the papers were not named the scores can not be matched between the 2 tests.
Mean S.D. Total number students No. <40% No. 40-60% No. >60%
Text A
Text B
35% 10.7%
45% 10.9%
of
34 2: 12 0
ii
1
S.E, of the difference in means = 262% P60%) from either test. 29% from Test 1 and 65% from Test 2 had poor understanding. There seems to be a group of six or seven students whose English is much worse than the other students. However intelligent the students in this group are, it is likely that they will do badly in medical school and in post-graduate training. From this study, all the students have some difficulty understanding text-books in English but understanding was better using a British undergraduate level text. In fact, many of the students use Thai text-books (often translated and abridged English language books) for much of their studying. This may be acceptable for undergraduates but is likely to leave them at a disadvantage at postgraduate level. It is important to promote understanding of English in the medical school. This can be done by: (i) Making English teaching more relevant to the needs of the students. In effect this means teaching some of the clinical course in English; (ii) Finding easier English texts. It is better to have a general book in simple English than a more detailed book with complicated syntax. To assess the problem better it would be helpful to know which books are recommended for reading and which for reference. These could then be compared with what the students actually find useful and comprehend. Acknowledgements I would like to acknowledge the help of the staff of the Health Science Centre and in particular the Dean, Dr. Vanchai Vatanasapt, in organizing this study.
KHON
KAEN
MEDICAL
SCHOOL
Appendix Example of Cloze Test Choose one word to go in each blank space. Text B Although tuberculosis is a problem of rapidly diminishing proportions in Western Europe and North America, it remains, in the words of a World Health Organization Report, ‘the most important snecific communicable disease in the world’. (1) is by far the largest single (2) of death in the developing countries, (3) although the death rate in Britain (4) fallen to an almost negligible figure, (5) less than 9,000 new cases of (6) were notified during 1973. These are (7) good and sufficient reasons for retaining (8) this book a detailed account of this dangerous but now eminently curable disease. (9) must also be borne in mind (10) as the disease decreases in frequency (11) will be a tendency for tuberculosis (12) be overlooked in differential diagnosis. The (13) that tuberculosis is a specific infective (14) was first proved by Koch’s discovery (15) the tubercle bacillus in 1882. Tuberculosis (16) unlike other infections in that while (17) members of the -popula-. tion become infected (18) early life only a relatively small 119) develoo clinicallv recoanisable evidence of disease, (20) at Xthe time of the (21) (‘primary’) infection or in later years. (22) is possible by means of the tuberculin (23) sensitivity test to determine whether or (24) a person has at any time (25) a tuberculous infection. Periodic surveys of (26) proportion of positive tuberculin reactors in (27).communitv mav thus nrovide a valuable (28) indication of the efficacy of the’ (29) employed to control the disease. In Scotland, (30) example, the number of positive reactors (31) 13-year-old children fell from 56 (32) cent in 1952 to less (33) 5 per cent in 1972. The Heaf tuberculin (34) is commonly used to detect reactors (35) if low-grade reactors are accepted as (36), many children who in fact have 137) infected with atvuical mycobacteria will have (38) ’ included erroneously. The proportion infected with mammalian tubercle bacilli may thus be as low as 2 per cent. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) @
It cause and has no tuberculosis considered in It that ihere 0
(13) fact (14) disease i::j (17) (18) (19)
f many in number
Accepted for publication
Text B Anszoers (20) either (21) first (22) It (23) skin (24) not (25) contracted (26) the (27) a (28) long-term (29) measures (30) for (31) amongst (32) per (33) than (34) test (35) and (36) positive ;;;I
i?z: e
17th December, 1982
Frustrated
readers
at Khon WREN
Technical
Co-operation
Officer,
Kaen Medical
Schoolt
HOSKYNS”
Overseas Development
Administration
Summary Ability in English is essential for Thai medical students. 34 fifth-year students completed two cloze tests from two standard English language text-books to assess their comprehension. One of these tests was from a recommended text-book. 65% of students had poor understanding of the recommended text (Text A). Results were significantly better from the other text (Text B), but only one student had good understanding. The medical course needs more appropriate English teaching and more appropriate English text-books. More information is needed about which books students learn from. about tuberculosis were selected from two recogmzed text-books (Texts A and B). Text A was taken from a U.S. postgraduate textbook which is recommended reading for medical students. Texr B was taken from a standard U.K. undergraduate text. The rest was in rhe form of a cloze rest (see appendix). Each student was given either Text A or B at random. After finishing the student was given the other paper. The test was anonymous so it was not possible to match scores between
Introduction Thai medical students need to have a good understanding of English. Many of the recommended text-books are in English. If they do residency training they will have to read and understand English journals. This test was given to see if the fifth-year students can understand standard medical texts and to compare comprehension of two different texts on the same subject.
the tests.
‘Correspondence Go K. R. Cripwell, 56 Park Meadow, Old Harfiled, Herts. AL9 SHB, UK. tThis work was undertaken as part of rhe NottinghamKhon Kaen University link in Community Medicine.
Methods
The lest was given to fifth-year medical students at the end of the academic year in May. These students have approximately one more year before qualifying as docrors. Passages Graph
of number
8 Text A
X
x
x
X
X
X
5
x
x
x
4
x
x
x
x
X
x
x
x
x
X
X
X
X
x
x
X
x
x
x
x
x
n = 34 mean = 35% SD = 10.7%
6
3 2 1
X
x
8
X
X
Text B
7
n = 34 mean = 45% SD = 10.9%
6 No. of students
60 % score
X
7
No. of students
of students against score for Test 1 and Test 2 10 20 30 40 50
5 4
X
3
X
X
X
X
x
x
x
X
X
X
X
X
X
X
X
X
x
x
x
x
x
X
1
X
X
20
X
X
X
10
X
X
2
0
X
x 30
40
50
x 60 % score
FRUSTRATED
560
READERS
AT
Cloze Test A general description of the technique is given in CRIPWELL (1983), see p. 00 above. In the present study synonyms were marked as wrong. This makes the test easy to mark but does not alter the groupings much because the test is a very crude assessment. Three groups can be identified: (i) less than 40%-poor understanding; (ii) 40-60%-some understanding but need further training; (iii) more than 60%-good understanding. For an example of one of the passages, see appendix. Results The frequency distribution of the scores is shown in the graph. The distributions are approximately normal with a long tail of poor results. As the papers were not named the scores can not be matched between the 2 tests.
Mean S.D. Total number students No. <40% No. 40-60% No. >60%
Text A
Text B
35% 10.7%
45% 10.9%
of
34 2: 12 0
ii
1
S.E, of the difference in means = 262% P
KHON
KAEN
MEDICAL
SCHOOL
Appendix Example of Cloze Test Choose one word to go in each blank space. Text B Although tuberculosis is a problem of rapidly diminishing proportions in Western Europe and North America, it remains, in the words of a World Health Organization Report, ‘the most important snecific communicable disease in the world’. (1) is by far the largest single (2) of death in the developing countries, (3) although the death rate in Britain (4) fallen to an almost negligible figure, (5) less than 9,000 new cases of (6) were notified during 1973. These are (7) good and sufficient reasons for retaining (8) this book a detailed account of this dangerous but now eminently curable disease. (9) must also be borne in mind (10) as the disease decreases in frequency (11) will be a tendency for tuberculosis (12) be overlooked in differential diagnosis. The (13) that tuberculosis is a specific infective (14) was first proved by Koch’s discovery (15) the tubercle bacillus in 1882. Tuberculosis (16) unlike other infections in that while (17) members of the -popula-. tion become infected (18) early life only a relatively small 119) develoo clinicallv recoanisable evidence of disease, (20) at Xthe time of the (21) (‘primary’) infection or in later years. (22) is possible by means of the tuberculin (23) sensitivity test to determine whether or (24) a person has at any time (25) a tuberculous infection. Periodic surveys of (26) proportion of positive tuberculin reactors in (27).communitv mav thus nrovide a valuable (28) indication of the efficacy of the’ (29) employed to control the disease. In Scotland, (30) example, the number of positive reactors (31) 13-year-old children fell from 56 (32) cent in 1952 to less (33) 5 per cent in 1972. The Heaf tuberculin (34) is commonly used to detect reactors (35) if low-grade reactors are accepted as (36), many children who in fact have 137) infected with atvuical mycobacteria will have (38) ’ included erroneously. The proportion infected with mammalian tubercle bacilli may thus be as low as 2 per cent. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) @
It cause and has no tuberculosis considered in It that ihere 0
(13) fact (14) disease i::j (17) (18) (19)
f many in number
Accepted for publication
Text B Anszoers (20) either (21) first (22) It (23) skin (24) not (25) contracted (26) the (27) a (28) long-term (29) measures (30) for (31) amongst (32) per (33) than (34) test (35) and (36) positive ;;;I
i?z: e
17th December, 1982