- Email: [email protected]
The language of medicine in english
The ESP Journal, Vol. 3, pp. 61-73, 1984 Pergamon Press Ltd. Printed in the USA.
0272-2380/84 $3.00 + .00 Copyright © 1984 The American University
Reviews Survey Review: T e x t b o o k s for ESP/Nursing S c i e n c e ENGLISH FOR NURSES. David Austin and Tim Crosfield. London: Longman
Group Limited, 1976. Student Textbook, pp. 138; Teacher's Notes (David Austin, Tim Crosfield, and Donald Dallas), pp. 30. ENGLISH FOIl THE MEDICAL P R O F E S S I O N S . Instrumental English.
Lorraine Beitler and Barbara McDonald. New York: McGraw-Hill, Inc., 1982. Student Textbook, pp. 251. ENGLISH IN BASIC MEDICAL SCIENCE. English in Focus. Joan Maclean.
Oxford: Oxford University Press, 1975. Student Textbook, pp. 112; Teacher's Edition, pp. 144. NURSING, BOOK 1. Special English. Donald Dallas. London: Collier Macmillan International, Inc., 1971. Student Textbook, pp. 119. NURSING SCIENCE. Nucleus: English for Science and Technology. Rosalie Kerr and Jennifer Smith. London: Longrnan Group Limited, 1978. Student Textbook, pp. 87; Teacher's Notes, pp. 43. THE LANGUAGE OF MEDICINE IN ENGLISH.
English For Careers.
Gretchen Bloom. New York: Regents Publishing Company, Inc., 1982. Student Textbook, pp. 116.
Reviewed by Toni M. Krochmal The focus in this survey is on nursing ESP. In addition to three textbooks intended specifically for nursing, three others have been included because of their relevance to the field of nursing science. Three of the six textbooks have audio programs, but this reviewer did not have access to them. The textbooks reviewed cover an eleven-year span (1971-1982). As can be seen in the summary chart (Table 1) at the end of the survey, there is a variety in the types of syllabuses and methodologies employed in the textbooks, as well as a range in the levels of curriculum for which they are intended. Rather than make comments on the overall quality of the textbooks, this review suggests that a textbook be considered in terms of its suitability for a particular teaching situation.
English for Nurses The purpose of this text is to take student nurses, nurses, and paramedics 61
62
The ESP Journal
with a high-beginning knowledge of English and make them functional in "a hospital or training school where English is used as the first or second language." (Teacher's Notes, p. 1). The focus of the text is to develop the speaking and reading skills, with limited development of the listening comprehension skill and no development of the writing skill. The course consists of a student text, a teacher's manual, and taped material. There are 24 teaching units designed to cover approximately 45 hours of instruction with each instructional period 45 minutes long. Unit 1 begins with a short dialogue followed by technical vocabulary exercises on the various hospital departments and specialties relating to these departments (e. g., pediatrics, pediatric, pediatrician). Unit 2 introduces the parts of the body followed by sample statements a patient might say to a doctor or a nurse (e. g., "I have a pain in my chest. My chest hurts. My chest aches." p. 11). The unit ends with grammar exercises on polite requests. Units 3, 4, 5, 8, and 14 each contain a reading selection, comprehension questions, and grammar exercises, while the remaining units each contain either a reading selection or a dialogue, comprehension questions (exceptions--Units 16, 19, 20, 21, 23, and 24), grammar exercises and vocabulary exercises. The reading selection or dialogue introduces the technical topic (e.g., Instruments), the grammar point, and the technical vocabulary. In general, the comprehension questions serve as a simple review of the technical material in the reading, while the grammar exercises do not necessarily relate back to the reading selection or illustrate technical structures (e.g., Drill 1, p. 19). Most of the Units between 2 and 13 contain brief explanations of the grammar points to be worked on. The vocabulary exercises provide for oral and written practice of the technical terminology introduced in the reading. There is a limited review of technical grammar in Units 12 and 15 and two short reviews of technical vocabulary in Unit 14. Technical terminology is defined in a glossary (preceded by a pronunciation guide) as well as being defined within the body of some of the teaching units. Although some situational features are apparent (p. 121), as well as some functional features (p. 103), the syllabus is very structure oriented. The emphasis is on technical grammar and vocabulary. The exercises are many but are very much limited to transformation drills, fill in the blanks, complete the sentences, and write the synonyms. One of the strong points of English for Nurses is the opportunities provided for the students to practice speaking through pair work, discussion, and role playing (Teacher's Notes, pp. 1 and 2). Topics for discussion are suggested in the Notes. At this high-beginning level, and with the emphasis on mechanical drilling, one can expect mistakes. However, this chance to incorporate use and usage should not be lost. A second strong point is the technical vocabulary. There are technicalcontent items specific to nursing/medicine (e. g., thrombosis, duodenum) as well as general scientific items (e.g., immerse, secretion). Two weak points are the limited types of grammar exercises described above and the writing component. In Unit 3 students are asked to "write a description of what you do during a typical working day." The only other writing students
Survey Review: ESP/Nursing Science
63
do in the remaining units is to write out the grammar and vocabulary drills previously done orally in class. It would be desirable to see a step by step program which takes the student from the sentence level to the first stage of the paragraph level. The technical terminology and structures do not appear to be graded. However, the topics of the reading selections gradually move from general themes (e. g., Where Do You Work?) to more specific topics (Respiration, the Cough, and Sputum). The selections are well written and the length of each one is approximately 200 to 300 words. Unfortunately, most of the comprehension questons can be answered by simply repeating the sentences from the reading selection. On rare occasions an inference question may be included. The technical terminology is authentic and the structures for beginning-level students also appear to be authentic, particularly in the later reading passages. As a first book to introduce nursing students to basic medical concepts and vocabulary, English for Nurses has some merit. There is a certain amount of British English, but not enough to prevent the use of the textbook in the United States.
English for the Medical Professions The purpose of this text is "to bring students rapidly to a point where they can read medical texts of increasing difficulty and density with relative ease and a high degree of comprehension." (Preface) The focus of the text is to develop the reading skill only. "Throughout, comprehension rather than production of language is stressed." (Preface) The authors do not state the English level of the students. Considering the heavy load of technical terminology and structure, this text is best suited for high intermediate and advanced-level students. The course consists of a student textbook only. The textbook is divided into three levels progressing from Level One (the easiest) to Level Three (the most difficult). Each level is further divided to cover three topics, with three teaching units per topic: Level One (83 pages) Diseases Anatomy and Physiology Genetics Level Two (78 pages) Chemistry Anatomy and Physiology Genetics Level Three (90 pages) Chemistry Anatomy and Physiology Genetics
Each of the 27 teaching units contains six sections: Vocabulary A, Vocabulary B, Vocabulary Exercises, Reading Selection, Reading Comprehension Exercises, and Answer Key. At the end of every third teaching unit are two additional sections: Structure Point and Structure Exercises. There is no review unit.
64
The ESP Journal
The Vocabulary A component introduces the student to Latin and Greek prefixes and suffixes common to medical terminology (e.g., myo- meaning muscle, page 44 and oxy pertaining to the concentration of oxygen, page 115). The affixes are used in one or more technical words, which are defined and then illustrated in one or more sentences. The Vocabulary B component is a listing of whole words of technical vocabulary (e.g., mandible, cortex) and follows the same format as described for the Vocabulary A component. Most of the glossary items in Vocabulary A and Vocabulary B can be found in the reading immediately following. In addition, both Vocabulary A and Vocabulary B attempt to clarify "specific meanings of a word when that word has multiple meanings in differing contexts." (Preface) The Vocabulary Exercises provide practice in understanding the new vocabulary. The exercises are graded in degree of difficulty moving from Level One (defining, multiple choice, and matching) to Level Three (defining, matching, true/false statements, and completion with no aids as in multiple choice). The Reading Selection contextualizes the technical vocabulary, some of which is introduced and defined within the reading. The Reading Comprehension component is an in-depth review of the reading using a variety of exercises depending on the level (e.g., multiple choice, matching, categorizing, identifying, completion, answering wh- questions with one or more sentences, and responding to sentences as true, false, or unanswerable because of insufficient data). The Answer Key for the vocabulary exercises and reading comprehension exercises immediately follows because it is assumed that many of the students will be using this text for self-study. The Structure Point is not a review of grammar but emphasizes selected difficult structures commonly found in medical writing (e. g., the passive voice, auxiliary verbs). The component gives a simple explanation of the particular structure plus examples of the structure point. The Structure Exercises provide the students the opportunity to practice the structure just explained using such exercises as transformation drills and sentence completion. An answer key for the grammar exercises immediately follows. There is no index listing the technical vocabulary and/or the page on which the lexicon first appears; nor is there a pronunciation guide. The syllabus is structural. The emphasis is on developing technical vocabulary and comprehending the use of (rather than producing) technical structures in medical writing. The Reading Selections are graded in degree of difficulty by the level as well as within each level. The selections in Level One (approximately 200-700 words) are well Written adaptations of authentic material found in medical textbooks (e.g., Diseases II, page 14), while the selections in Level Two (approximately 300-750 words) and in Level Three (approximately 540-1100 words) are excerpted from medical textbooks (e. g., Anatomy and Physiology II, page 118 and Chemistry III, page 181). The technical terminology is definitely authentic and the structures appear to be authentic. One of the strong points of English for the Medical Professions is the use of affixes in building technical vocabulary. By understanding the meaning of the many affixes in this text, students have the opportunity to decipher unfamiliar medical terminology they may face later on.
Survey Review: ESP/Nursing Science
65
Another strong point are the many and varied reading comprehension exercises mentioned above. They appear to do what the authors hope they will do, "concentrate on the comprehension skills of factual recall, finding the main idea, vocabulary in context, cause and effect, and making inferences." (Preface) One of the weakest points in English for the Medical Professions relates directly to the focus of the course--the development of the reading skill. The authors assume that many students will use the text for self-study but the text offers no guidelines to the student on such reading strategies as pacing, guessing the meaning of words based on the context, reading words in meaningful combinations, and looking words up in a dictionary. Without some kind of suggestions on how to read for meaning, it might be difficult for students to read medical texts with the ease and comprehension the authors hope for. Two other weak points are the emphasis on self-study and the placement of the answer keys. In many cases the answer keys are directly opposite the exercise page--a very tempting situation. It might have been better to put the answer key at the end of the text. In spite of the weak points mentioned above, the text has credibility, particularly from the point of view of the quality of the readings and of building technical vocabulary through the use of affixes.
English in Basic Medical Science The purpose of this text is to help high intermediate and advanced-level students "develop techniques of reading and to provide them with a guide for their own writing." (Teacher's Edition, p. xi) While all the skills are employed, the focus is on developing the reading and writing skills as they relate to the technical terminology and structure necessary in medicine. The course consists of a student textbook, a teacher's edition, and taped material. There are seven teaching units and one summary unit. Each teaching unit contains five sections: Reading and Comprehension, Use of Language, Information Transfer, Guided Writing, and Free Reading. The Reading and Comprehension component introduces the subject matter (e.g., The Compartments of the Body) and provides for built-in comprehension checks following each paragraph. These true/false statements are inserted within the reading "so that the learner is encouraged to think about what he reads as he reads." (p. xiii) Because it is important for the student to know why a statement is either true or false, solutions that refer back to the passage are provided after the reading. Three exercises follow the solution section: contextual reference, rephrasing, and relationships between statements. The Use of Language component provides for further written practice on the subject matter as well as possible exercises on "points of grammar which represent continuing 'trouble s p o t s , ' . . , special vocabulary, or language techniques such as listing" (p. xvi). The Information Transfer component and the Guided Writing component present the contextualization of the subject matter, the latter in four stages: sentence building, paragraph building, paragraph reconstruction, and free composition. The Free Reading component contains a much longer and more complex passage than that which began the unit. It "is intended to a p p r o x i m a t e . . , the kind of
66
The ESP Journal
language that the student will find in his medical textbooks." (p. xii) Unit 8 is entitled "Summary and Extension Exercises." It reviews all the material covered in the first seven units as well as introducing additional practice in medical areas having a specific language. It has four components: Comprehension Exercises, Use of Language, Information Transfer, and Essay Writing. English in Basic Medical Science does not contain a glossary of technical terminology. It is assumed "that students already have a knowledge of biology and science, and are acquainted with elementary anatomy and physiology." (p. xi) However, in Unit 8, p. 106, anatomical terms used to describe muscle action are listed and defined. The syllabus used in this text is a combination of the situational approach and the notional-functional approach. These approaches are integrated throughout the text by relating the technical terminology and structures from the Reading and Comprehension component and Use of Language component to the communicative concepts in the Information Transfer and Guided Writing components. One of the strong points in this text is the solutions to the built-in comprehension checks. "The purpose of the solutions is to make the learner aware of what is involved in reading with understanding . . . . " (p. xiv) Many of the solutions show the student how implied or stated information in one sentence relates to implied or stated information elsewhere, thus improving the student's reasoning abilities. An example from Unit 6, pages 69 and 71 is given below: Second Paragraph of Reading: 7 The heart is essentially a hollow muscle, a The wall of the heart is made up of three layers of tissue. ~A serous membrane, the pericardium, forms the outer covering of the heart. ~0The middle layer, the myocardium, is the heart muscle proper, n This consists of specialized cardiac muscle fibres. ~2Internally the heart is lined throughoutwith a serous membraneknownas the endocardium. Comprehension Check (one of three given): (d) The wall of the heart consists mainlyof specialized cardiac muscle fibres. Solution: (d) The heart is essentially a hollowmuscle. (7) i.e. The wall of the heart consists mainlyof muscle. The middle layer, the myocardium, is the heart muscle proper. (10) This consists of specialized cardiac muscle fibres. (11) Therefore: The wall of the heart consists mainly of specialized cardiac muscle fibres. Other strong points are the many and varied exercises (e. g., paraphrasing, information transfer, completion, sentence combining, sentence reordering, problem solving, multiple choice) and the well drawn visual aids (drawings, diagrams, graphs, tables). The exercises and visual aids complement each other in assisting the student to learn to contextualize the technical material. Without the visual aids, English in Basic Medical Science would be an uninteresting language course and difficult to teach.
Survey Review: ESP/Nursing Science
67
The Teacher's Edition is well thought out. The theory behind each component of a unit is explained and amplified. Teaching suggestions are given allowing for modification in the procedures to meet the needs of the students. A possible weak point for the teacher trained in the humanities is the omission of comments to help the teacher understand the medical content of the unit (e. g., the subtle difference in the use of such multiword verbs as consist of versus be composed of). It would also be helpful to have guidance as to what medical terminology to teach for recognition and what items to teach for production. "In order to ensure the natural communicative function of language, grading is by focus rather than by exclusion." (p. xii) The reading passage at the beginning of each unit is a simple treatment of the subject matter, while the passage in the Free Reading at the end of that unit is a more complex treatment of the subject matter approximating the writing in a medical text. The reading passages are adaptations of technical material and are well written. They gradually increase in length, moving from about 160 words in Unit 1 to about 600 words in Unit 7. As the reading passages become longer, so the comprehension checks become longer in order to develop the student's reasoning processes to a finer degree. The technical terminology is definitely authentic, and the structures appear to be authentic, both in the reading passages and the exercises. Because the materials contain tasks which require explanation and guidance from the teacher, the textbook is best suited for classroom use. The goal of English in Basic Medical Science is "to get the student to concentrate on the rhetorical features used in medical writing." (p. xii) The course does this reasonably well.
Nursing, Book 1 (Note: Nursing, Book 2 was not available to this reviewer.) The purpose of this text is very simply stated: to help student nurses "improve their knowledge of English and at the same time learn the new vocabulary and expressions they will encounter during their training." (p. vii) The text is intended for student nurses with a beginning knowledge of English and can be used concurrently with their nursing studies. The focus is on the development of the speaking and reading skills, with limited development of the listening comprehension and writing skills. The course consists of a student text and taped material. There are fifteen teaching units and no review unit(s). Each unit contains a dialogue, grammar exercises, a reading selection, comprehension questions, and vocabulary exercise(s). The dialogue introduces typical situations that may occur in the first six months of a nurse's training in Britain. It also serves to introduce the grammar point for the unit. The grammer exercises are used for oral practice with "the e m p h a s i s . . , on repetition until the student is entirely fluent and can make the appropriate changes quickly and accurately" (p. vii). The reading selection contextualizes the professional topic from the dialogue. The comprehension questions in the early units are a simple review of the material in the reading selection, while many of the questions in the later units require
68
The ESP Journal
the student to make a logical deduction by "reading between the lines." The vocabulary exercises provide for limited written and/or oral practice of the technical terminology introduced in the dialogue and the reading. (E.g., students are asked to use the words and phrases in sentences of their own creation.) Technical terminology is defined in a glossary as well as within the body of some of the reading selections. The glossary uses IPA symbols but does not give a pronunciation guide. The syllabus is very structure oriented. It is important to remember that this text is designed for student nurses who may be taking their training concurrently with English language studies. The majority of the grammar exercises pay special attention to asking questions and to giving instructions, using the following types of drills: substitution, transformation, and fill in the blank. The technical vocabulary focuses on the lexicon needed for the early stages of nursing studies. One of the strong points of Nursing, Book 1 is the dialogues. There is a realistic and natural use of language which represents the different types of discourse found in a hospital environment (e.g., student nurse/nurse, nurse/ patient, etc.). The dialogues easily lend themselves to students role playing their own experiences as student nurses, which would help in developing not only their speaking ability but also their listening comprehension. Another strong point is the readings. They are very well written for a beginning-level course and generally amplify and elaborate on the professional topic introduced in the dialogue of the unit. Three weak points are the predictable grammar exercises as mentioned above, the lack of a teacher's guide, and the limited writing component. In Unit 4 the students are asked to write a short paragraph choosing from a list of topics. The remaining writing is restricted to using a technical vocabulary item in a sentence. Considering that this text is intended for high-beginning students, it would be helpful to have a more developed writing program on the sentence level. The technical terminology and structures are not graded. However, the reading selections appear to be nicely sequenced to reflect the training progression made by a student nurse in Britain. Each reading is approximately 200 words long. The technical terminology is authentic and the structures in the readings appear to be authentic. As stated above, the book has its good points. However, it seems best suited for use in the United Kingdom. All the dialogues and the readings in Units 1-7 contain a great number of British expressons and lexicon. In addition, the type of training student nurses receive in England differs from nurses' training in the United States.
Nursing Science The purpose of this text "is to give practice in using English both actively and receptively, so that the student learns how to take information from both written and oral texts and from visually presented material, such as tables and
Survey Review: ESP/Nursing Science
69
diagrams." (Teacher's Notes, p. 1) While all the skills are employed, the focus in this text is to develop the listening comprehension and reading skills as they relate to the technical terminology and structures necessary for nurses. In the Teacher's Notes (p. iii), the authors state that "It [the Nucleus series] is intended for students with some knowledge of general English. . . . " This statement is misleading. Considering the heavy load of technical terminology and the emphasis on understanding scientific concepts as expressed in English, Nursing Science is better suited for intermediate and advanced-level students. The course consists of a student textbook, a teacher's guide, and taped material. There are eleven teaching units, with review units following Units 3, 6, 9, and 11. Each teaching unit contains four sections: Presentation, Development, Reading, and Listening. The Presentation component introduces the notional topic (e.g., properties, location, structure, etc.) and provides for oral and written practice of the technical terminology and structures. The Development component provides for further written practice on the notional topic as well as introducing more technical terminology. The Reading and Listening components present the contextualization of the topic through the description of a physical form (e. g., anatomy) or the description of a process (e.g., a procedure in nursing care). The review units are labeled A, B, C, and Consolidation. Units A, B, and C review the terminology and the concepts taught in the three lessons which precede each review unit, while the Consolidation unit reviews all the material covered in the text. In the student textbook, technical terms are defined in a glossary (preceded by a pronunciation guide) as well as within the body of some of the teaching and review units. An appendix of technical terms follows Unit 1 and another appendix of commonly used medical abbreviations follows Unit 4. There is also a short bibliography of books relating to nursing science. The syllabus used in the nursing science course is a combination of the situational approach and the notional-functional approach. These approaches are integrated throughout the text by relating the technical terminology and structures from the Presentation and Development components to the communicative concepts in the Reading and Listening components. In Nursing Science the exercises are many and varied (e.g., information transfer, completion, problem solving, writing sentences or answers to question, true/false statements with students correcting the false statements, multiple choice, ordering sentences). The well drawn visual aids are also many and varied (drawings, diagrams, graphs, tables, formulas). Throughout the text (particularly in the Presentation and Development components) the exercises and visual aids work "hand in glove" to assist the student in learning to contextualize the technical material. Unit 3 is an example of this. (Student Text, pp. 15-19) The Unit 3 Presentation component begins with five drawings. Each drawing is followed by three or four sentences introducing the technical usage of such multiword verbs as consists of, is divided into, is supported by, is made of, and are connected by. The skill in using the technical terminology is practiced through a completion exercise (in this case a paragraph), and again a visual aid is used. The Development component begins with a visual aid and, using the verbs
70
The ESP Journal
introduced and practiced in the Presentation component, students now write a descriptive paragraph about the visual aid. The Reading and Listening components, both containing visual aids, provide the written and spoken discourse necessary for the students to move from usage to use of the technical terminology and structures. The exercises and visual aids in this book are one of the strong points in this course. In fact without the visual aids, as a language course Nursing Science would be much more difficult to teach. A second strong point is the technical vocabulary. There are technical content items specific to nursing/medicine (e.g., subcutaneous, diastole, autoclave) as well as general scientific items (e. g., function, cylinder, external). Furthermore, a distinction is made in the Teacher's Notes (first mentioned on p. 9) as to what items to teach for recognition and what items to teach for production. A third strong point in the course is the Teacher's Notes. They are simple and practical. For each teaching unit and review unit the authors list: (1) the aims of the unit; (2) the main language item(s) of the unit; (3) notes to help the classroom teacher understand the medical content of the unit; (4) suggestons for teaching the unit; (5) the text of the listening component; and (6) the answer key to the exercises. For teachers trained in the humanities, this teacher's guide is invaluable. It assumes that "the teacher has no special knowledge of the subjects nurses have to study . . ." (Teacher's Notes, p. 1) and encourages the teacher to interact with a professional who teaches nursing subjects. There is one possible weak point which relates back to the focus of the course--the development of the reading and listening comprehension skills. The course provides little programmed opportunity for the students to ask questions. Communication between nurse and patient, and between nurse and doctor requires the ability of the nurse to ask logical questions, not just to understand questions asked. It would be useful to include a few more exercises which lend themselves to group work and the discussion of problems in nursing. The technical terminology and structures do not appear to be graded. However, the reading passages "are very short in the first few units of this course, gradually becoming longer, until [the Consolidation unit, which] consists chiefly of two reading passages." (Teacher's Notes, p. 1) The reading passages are adaptations of technical material, but on the whole are well written. As the reading passages become longer, so the comprehension questions following each passage require the students to move from "parroting" the information from the passage to "ferreting out" the information from the passage. The technical terminology is authentic and the structures appear to be authentic, particularly as found in the reading passages. Because the materials in Nursing Science contain tasks which might require explanation and guidance from the teacher, the book is best suited for classroom
Survey Review: ESP/Nursing Science
71
use. However, an advanced-level student from a technologically oriented society who has a degree in nursing might be able to use the book for self-study. All things considered, the course has a very good selection and blend of linguistic content and exercises. The course requires outside preparation work for the teacher (e.g., realia), but the Teacher's Notes abound in ideas and suggestions.
The Language of Medicine in English The purpose of this text is to give high intermediate and advanced-level students an overview "of the opportunities and problems inherent in the world of medicine" (Foreword), and at the same time to improve their ability to use English as related to a particular medical specialty. While all the skills are employed, the focus is on developing the speaking and reading skills. The course consists of a student textbook only. There are ten teaching units and no separate review units. Each unit contains five sections: Special Terms, Vocabulary Practice, Reading, Discussion, and Review. The Special Terms component is a glossary containing some of the technical vocabulary used in the Reading. The Vocabulary Practice uses a question and answer format to exercise the glossary items. The Reading component introduces the professional topic of the unit (e.g., Human Anatomy) and contexualizes the technical vocabulary, some of which is introduced and defined within the Reading. The Discussion component is an in-depth review of the Reading using not only whquestions but also an "explain/describe a process" format. The Review component contains a comprehensive review of technical vocabulary using a variety of drills (e. g., completion, matching, multiple choice, true/false statements with students justifying their answer). The Review component concludes with conversation exercise(s) in which the students are asked to relate to the topic of the unit (e. g., "Imagine that you are a general practitioner. What kind of work would occupy most of your time?" Unit 5, p. 60). At the end of the text is an index in alphabetical order of the special terms from all the glossaries and the page number on which each item first appears. There is no pronunciation guide. The syllabus used in this text is basically situational. The technical structure and vocabulary introduced are determined by the topic of the unit. However, a combination of the situational approach and the notional-functional approach is used in the conversation exercise(s) found in the Discussion component. One of the strong points in The Language of Medicine in English is the Readings. Although they are long (each approximately 1200 words), they are very well written and should be of interest to the students because of the validity and variety of the topics. Two examples are Unit 2 (Human Anatomy) and Unit 7 (Careers in Medicine). Unit 2 is an excellent overview of the human anatomy (e.g., skeleton, skin, muscles, heart, digestive system, nervous system, brain) while Unit 7 discusses the different health-related occupations now available in addition to those of doctor, dentist and registered nurse (e.g., vocational nurse, nurse practitioner, certified nurse midwife, physician assistant, etc.). Another strong point is the conversation practice at the end of each unit.
Good
200-300 Words
YES Fair
Use of Illustrations
Approximate Length of Reading Selections
Glossary Variety in Types of Exercises Knowledge of Nursing Desirable
YES
Fair
Fair YES Teacher Edition NO Structural
Speaking Reading High Beginning
Use of Charts
Audio Program Type of Syllabus
English Level of Students Teacher's Edition Answer Key
Skills Emphasized
Features
English for Nurses
YES
Level 1 None Level 2 Poor Level 3 None Level 1 Poor Level 2 Poor Level 3 Fair 1:200-700 Words 2:300-750 Words 3:540-1100 Words YES Very Good
High Intermediate Advanced None YES Student Edition NO Structural
Reading
English for the Medical Professions
TABLE 1
YES
NO Excellent
Graded 160-600 Words
Excellent
Reading Writing High Intermediate Advanced Very Good YES Teacher Edition YES Situational NotionalFunctional Excellent
English in Basic Medical Science
Summary of Features
NO
YES Poor to Fair
200 Words
Fair
None
None YES Student Edition YES Structural
Speaking Reading High Beginning
Nursing, Book 1
YES
YES Excellent
Graded 160-450 Words
Excellent
Listening Reading Intermediate Advanced Excellent YES Teacher Edition YES Situational NotionalFunctional Excellent
Science
Nursing
YES
YES Good
1200Words
Good
None
NO Situational
Speaking Reading Intermediate Advanced None NO
The Language of Medicine in English
tO
Survey Review: ESP/Nursing Science
73
The theme for the conversations contextualizes the topic of the unit and offers ample opportunity for expansion. An example is found in Unit 6, entitled "Surgery." Students are asked to describe an appendectomy (p. 72). Various points of view could be presented, depending on the makeup of the class--as seen through the eyes of the doctor, the nurse, and/or the lab technician. A possible weak point is the lack of a teacher's manual. Considering the length of the reading selections, it would be helpful to see some guidelines as to how much of the Reading to present at one time and how best to go about it. In addition, the text emphasizes the student's ability to "communicate naturally in English" (Foreword), but offers no suggestions on integrating the writing skill beyond the sentence level. The technical terminology is authentic and the structures appear to be authentic, particularly in the reading selections. Neither seems to be graded. All in all, this is a nice little text. It is a straightforward and practical presentation of the opportunities available in the field of medicine. Toni M. K r o c h m a l has an MA in Linguistics with specialization in TESOL. She is experienced in the supervision and development of curriculum for courses in both general English and ESP. She is currently the Director of Language Projects for Transemantics, Inc., Washington, DC.
0272-2380/84 $3.00 + .00 Copyright © 1984 The American University
Reviews Survey Review: T e x t b o o k s for ESP/Nursing S c i e n c e ENGLISH FOR NURSES. David Austin and Tim Crosfield. London: Longman
Group Limited, 1976. Student Textbook, pp. 138; Teacher's Notes (David Austin, Tim Crosfield, and Donald Dallas), pp. 30. ENGLISH FOIl THE MEDICAL P R O F E S S I O N S . Instrumental English.
Lorraine Beitler and Barbara McDonald. New York: McGraw-Hill, Inc., 1982. Student Textbook, pp. 251. ENGLISH IN BASIC MEDICAL SCIENCE. English in Focus. Joan Maclean.
Oxford: Oxford University Press, 1975. Student Textbook, pp. 112; Teacher's Edition, pp. 144. NURSING, BOOK 1. Special English. Donald Dallas. London: Collier Macmillan International, Inc., 1971. Student Textbook, pp. 119. NURSING SCIENCE. Nucleus: English for Science and Technology. Rosalie Kerr and Jennifer Smith. London: Longrnan Group Limited, 1978. Student Textbook, pp. 87; Teacher's Notes, pp. 43. THE LANGUAGE OF MEDICINE IN ENGLISH.
English For Careers.
Gretchen Bloom. New York: Regents Publishing Company, Inc., 1982. Student Textbook, pp. 116.
Reviewed by Toni M. Krochmal The focus in this survey is on nursing ESP. In addition to three textbooks intended specifically for nursing, three others have been included because of their relevance to the field of nursing science. Three of the six textbooks have audio programs, but this reviewer did not have access to them. The textbooks reviewed cover an eleven-year span (1971-1982). As can be seen in the summary chart (Table 1) at the end of the survey, there is a variety in the types of syllabuses and methodologies employed in the textbooks, as well as a range in the levels of curriculum for which they are intended. Rather than make comments on the overall quality of the textbooks, this review suggests that a textbook be considered in terms of its suitability for a particular teaching situation.
English for Nurses The purpose of this text is to take student nurses, nurses, and paramedics 61
62
The ESP Journal
with a high-beginning knowledge of English and make them functional in "a hospital or training school where English is used as the first or second language." (Teacher's Notes, p. 1). The focus of the text is to develop the speaking and reading skills, with limited development of the listening comprehension skill and no development of the writing skill. The course consists of a student text, a teacher's manual, and taped material. There are 24 teaching units designed to cover approximately 45 hours of instruction with each instructional period 45 minutes long. Unit 1 begins with a short dialogue followed by technical vocabulary exercises on the various hospital departments and specialties relating to these departments (e. g., pediatrics, pediatric, pediatrician). Unit 2 introduces the parts of the body followed by sample statements a patient might say to a doctor or a nurse (e. g., "I have a pain in my chest. My chest hurts. My chest aches." p. 11). The unit ends with grammar exercises on polite requests. Units 3, 4, 5, 8, and 14 each contain a reading selection, comprehension questions, and grammar exercises, while the remaining units each contain either a reading selection or a dialogue, comprehension questions (exceptions--Units 16, 19, 20, 21, 23, and 24), grammar exercises and vocabulary exercises. The reading selection or dialogue introduces the technical topic (e.g., Instruments), the grammar point, and the technical vocabulary. In general, the comprehension questions serve as a simple review of the technical material in the reading, while the grammar exercises do not necessarily relate back to the reading selection or illustrate technical structures (e.g., Drill 1, p. 19). Most of the Units between 2 and 13 contain brief explanations of the grammar points to be worked on. The vocabulary exercises provide for oral and written practice of the technical terminology introduced in the reading. There is a limited review of technical grammar in Units 12 and 15 and two short reviews of technical vocabulary in Unit 14. Technical terminology is defined in a glossary (preceded by a pronunciation guide) as well as being defined within the body of some of the teaching units. Although some situational features are apparent (p. 121), as well as some functional features (p. 103), the syllabus is very structure oriented. The emphasis is on technical grammar and vocabulary. The exercises are many but are very much limited to transformation drills, fill in the blanks, complete the sentences, and write the synonyms. One of the strong points of English for Nurses is the opportunities provided for the students to practice speaking through pair work, discussion, and role playing (Teacher's Notes, pp. 1 and 2). Topics for discussion are suggested in the Notes. At this high-beginning level, and with the emphasis on mechanical drilling, one can expect mistakes. However, this chance to incorporate use and usage should not be lost. A second strong point is the technical vocabulary. There are technicalcontent items specific to nursing/medicine (e. g., thrombosis, duodenum) as well as general scientific items (e.g., immerse, secretion). Two weak points are the limited types of grammar exercises described above and the writing component. In Unit 3 students are asked to "write a description of what you do during a typical working day." The only other writing students
Survey Review: ESP/Nursing Science
63
do in the remaining units is to write out the grammar and vocabulary drills previously done orally in class. It would be desirable to see a step by step program which takes the student from the sentence level to the first stage of the paragraph level. The technical terminology and structures do not appear to be graded. However, the topics of the reading selections gradually move from general themes (e. g., Where Do You Work?) to more specific topics (Respiration, the Cough, and Sputum). The selections are well written and the length of each one is approximately 200 to 300 words. Unfortunately, most of the comprehension questons can be answered by simply repeating the sentences from the reading selection. On rare occasions an inference question may be included. The technical terminology is authentic and the structures for beginning-level students also appear to be authentic, particularly in the later reading passages. As a first book to introduce nursing students to basic medical concepts and vocabulary, English for Nurses has some merit. There is a certain amount of British English, but not enough to prevent the use of the textbook in the United States.
English for the Medical Professions The purpose of this text is "to bring students rapidly to a point where they can read medical texts of increasing difficulty and density with relative ease and a high degree of comprehension." (Preface) The focus of the text is to develop the reading skill only. "Throughout, comprehension rather than production of language is stressed." (Preface) The authors do not state the English level of the students. Considering the heavy load of technical terminology and structure, this text is best suited for high intermediate and advanced-level students. The course consists of a student textbook only. The textbook is divided into three levels progressing from Level One (the easiest) to Level Three (the most difficult). Each level is further divided to cover three topics, with three teaching units per topic: Level One (83 pages) Diseases Anatomy and Physiology Genetics Level Two (78 pages) Chemistry Anatomy and Physiology Genetics Level Three (90 pages) Chemistry Anatomy and Physiology Genetics
Each of the 27 teaching units contains six sections: Vocabulary A, Vocabulary B, Vocabulary Exercises, Reading Selection, Reading Comprehension Exercises, and Answer Key. At the end of every third teaching unit are two additional sections: Structure Point and Structure Exercises. There is no review unit.
64
The ESP Journal
The Vocabulary A component introduces the student to Latin and Greek prefixes and suffixes common to medical terminology (e.g., myo- meaning muscle, page 44 and oxy pertaining to the concentration of oxygen, page 115). The affixes are used in one or more technical words, which are defined and then illustrated in one or more sentences. The Vocabulary B component is a listing of whole words of technical vocabulary (e.g., mandible, cortex) and follows the same format as described for the Vocabulary A component. Most of the glossary items in Vocabulary A and Vocabulary B can be found in the reading immediately following. In addition, both Vocabulary A and Vocabulary B attempt to clarify "specific meanings of a word when that word has multiple meanings in differing contexts." (Preface) The Vocabulary Exercises provide practice in understanding the new vocabulary. The exercises are graded in degree of difficulty moving from Level One (defining, multiple choice, and matching) to Level Three (defining, matching, true/false statements, and completion with no aids as in multiple choice). The Reading Selection contextualizes the technical vocabulary, some of which is introduced and defined within the reading. The Reading Comprehension component is an in-depth review of the reading using a variety of exercises depending on the level (e.g., multiple choice, matching, categorizing, identifying, completion, answering wh- questions with one or more sentences, and responding to sentences as true, false, or unanswerable because of insufficient data). The Answer Key for the vocabulary exercises and reading comprehension exercises immediately follows because it is assumed that many of the students will be using this text for self-study. The Structure Point is not a review of grammar but emphasizes selected difficult structures commonly found in medical writing (e. g., the passive voice, auxiliary verbs). The component gives a simple explanation of the particular structure plus examples of the structure point. The Structure Exercises provide the students the opportunity to practice the structure just explained using such exercises as transformation drills and sentence completion. An answer key for the grammar exercises immediately follows. There is no index listing the technical vocabulary and/or the page on which the lexicon first appears; nor is there a pronunciation guide. The syllabus is structural. The emphasis is on developing technical vocabulary and comprehending the use of (rather than producing) technical structures in medical writing. The Reading Selections are graded in degree of difficulty by the level as well as within each level. The selections in Level One (approximately 200-700 words) are well Written adaptations of authentic material found in medical textbooks (e.g., Diseases II, page 14), while the selections in Level Two (approximately 300-750 words) and in Level Three (approximately 540-1100 words) are excerpted from medical textbooks (e. g., Anatomy and Physiology II, page 118 and Chemistry III, page 181). The technical terminology is definitely authentic and the structures appear to be authentic. One of the strong points of English for the Medical Professions is the use of affixes in building technical vocabulary. By understanding the meaning of the many affixes in this text, students have the opportunity to decipher unfamiliar medical terminology they may face later on.
Survey Review: ESP/Nursing Science
65
Another strong point are the many and varied reading comprehension exercises mentioned above. They appear to do what the authors hope they will do, "concentrate on the comprehension skills of factual recall, finding the main idea, vocabulary in context, cause and effect, and making inferences." (Preface) One of the weakest points in English for the Medical Professions relates directly to the focus of the course--the development of the reading skill. The authors assume that many students will use the text for self-study but the text offers no guidelines to the student on such reading strategies as pacing, guessing the meaning of words based on the context, reading words in meaningful combinations, and looking words up in a dictionary. Without some kind of suggestions on how to read for meaning, it might be difficult for students to read medical texts with the ease and comprehension the authors hope for. Two other weak points are the emphasis on self-study and the placement of the answer keys. In many cases the answer keys are directly opposite the exercise page--a very tempting situation. It might have been better to put the answer key at the end of the text. In spite of the weak points mentioned above, the text has credibility, particularly from the point of view of the quality of the readings and of building technical vocabulary through the use of affixes.
English in Basic Medical Science The purpose of this text is to help high intermediate and advanced-level students "develop techniques of reading and to provide them with a guide for their own writing." (Teacher's Edition, p. xi) While all the skills are employed, the focus is on developing the reading and writing skills as they relate to the technical terminology and structure necessary in medicine. The course consists of a student textbook, a teacher's edition, and taped material. There are seven teaching units and one summary unit. Each teaching unit contains five sections: Reading and Comprehension, Use of Language, Information Transfer, Guided Writing, and Free Reading. The Reading and Comprehension component introduces the subject matter (e.g., The Compartments of the Body) and provides for built-in comprehension checks following each paragraph. These true/false statements are inserted within the reading "so that the learner is encouraged to think about what he reads as he reads." (p. xiii) Because it is important for the student to know why a statement is either true or false, solutions that refer back to the passage are provided after the reading. Three exercises follow the solution section: contextual reference, rephrasing, and relationships between statements. The Use of Language component provides for further written practice on the subject matter as well as possible exercises on "points of grammar which represent continuing 'trouble s p o t s , ' . . , special vocabulary, or language techniques such as listing" (p. xvi). The Information Transfer component and the Guided Writing component present the contextualization of the subject matter, the latter in four stages: sentence building, paragraph building, paragraph reconstruction, and free composition. The Free Reading component contains a much longer and more complex passage than that which began the unit. It "is intended to a p p r o x i m a t e . . , the kind of
66
The ESP Journal
language that the student will find in his medical textbooks." (p. xii) Unit 8 is entitled "Summary and Extension Exercises." It reviews all the material covered in the first seven units as well as introducing additional practice in medical areas having a specific language. It has four components: Comprehension Exercises, Use of Language, Information Transfer, and Essay Writing. English in Basic Medical Science does not contain a glossary of technical terminology. It is assumed "that students already have a knowledge of biology and science, and are acquainted with elementary anatomy and physiology." (p. xi) However, in Unit 8, p. 106, anatomical terms used to describe muscle action are listed and defined. The syllabus used in this text is a combination of the situational approach and the notional-functional approach. These approaches are integrated throughout the text by relating the technical terminology and structures from the Reading and Comprehension component and Use of Language component to the communicative concepts in the Information Transfer and Guided Writing components. One of the strong points in this text is the solutions to the built-in comprehension checks. "The purpose of the solutions is to make the learner aware of what is involved in reading with understanding . . . . " (p. xiv) Many of the solutions show the student how implied or stated information in one sentence relates to implied or stated information elsewhere, thus improving the student's reasoning abilities. An example from Unit 6, pages 69 and 71 is given below: Second Paragraph of Reading: 7 The heart is essentially a hollow muscle, a The wall of the heart is made up of three layers of tissue. ~A serous membrane, the pericardium, forms the outer covering of the heart. ~0The middle layer, the myocardium, is the heart muscle proper, n This consists of specialized cardiac muscle fibres. ~2Internally the heart is lined throughoutwith a serous membraneknownas the endocardium. Comprehension Check (one of three given): (d) The wall of the heart consists mainlyof specialized cardiac muscle fibres. Solution: (d) The heart is essentially a hollowmuscle. (7) i.e. The wall of the heart consists mainlyof muscle. The middle layer, the myocardium, is the heart muscle proper. (10) This consists of specialized cardiac muscle fibres. (11) Therefore: The wall of the heart consists mainly of specialized cardiac muscle fibres. Other strong points are the many and varied exercises (e. g., paraphrasing, information transfer, completion, sentence combining, sentence reordering, problem solving, multiple choice) and the well drawn visual aids (drawings, diagrams, graphs, tables). The exercises and visual aids complement each other in assisting the student to learn to contextualize the technical material. Without the visual aids, English in Basic Medical Science would be an uninteresting language course and difficult to teach.
Survey Review: ESP/Nursing Science
67
The Teacher's Edition is well thought out. The theory behind each component of a unit is explained and amplified. Teaching suggestions are given allowing for modification in the procedures to meet the needs of the students. A possible weak point for the teacher trained in the humanities is the omission of comments to help the teacher understand the medical content of the unit (e. g., the subtle difference in the use of such multiword verbs as consist of versus be composed of). It would also be helpful to have guidance as to what medical terminology to teach for recognition and what items to teach for production. "In order to ensure the natural communicative function of language, grading is by focus rather than by exclusion." (p. xii) The reading passage at the beginning of each unit is a simple treatment of the subject matter, while the passage in the Free Reading at the end of that unit is a more complex treatment of the subject matter approximating the writing in a medical text. The reading passages are adaptations of technical material and are well written. They gradually increase in length, moving from about 160 words in Unit 1 to about 600 words in Unit 7. As the reading passages become longer, so the comprehension checks become longer in order to develop the student's reasoning processes to a finer degree. The technical terminology is definitely authentic, and the structures appear to be authentic, both in the reading passages and the exercises. Because the materials contain tasks which require explanation and guidance from the teacher, the textbook is best suited for classroom use. The goal of English in Basic Medical Science is "to get the student to concentrate on the rhetorical features used in medical writing." (p. xii) The course does this reasonably well.
Nursing, Book 1 (Note: Nursing, Book 2 was not available to this reviewer.) The purpose of this text is very simply stated: to help student nurses "improve their knowledge of English and at the same time learn the new vocabulary and expressions they will encounter during their training." (p. vii) The text is intended for student nurses with a beginning knowledge of English and can be used concurrently with their nursing studies. The focus is on the development of the speaking and reading skills, with limited development of the listening comprehension and writing skills. The course consists of a student text and taped material. There are fifteen teaching units and no review unit(s). Each unit contains a dialogue, grammar exercises, a reading selection, comprehension questions, and vocabulary exercise(s). The dialogue introduces typical situations that may occur in the first six months of a nurse's training in Britain. It also serves to introduce the grammar point for the unit. The grammer exercises are used for oral practice with "the e m p h a s i s . . , on repetition until the student is entirely fluent and can make the appropriate changes quickly and accurately" (p. vii). The reading selection contextualizes the professional topic from the dialogue. The comprehension questions in the early units are a simple review of the material in the reading selection, while many of the questions in the later units require
68
The ESP Journal
the student to make a logical deduction by "reading between the lines." The vocabulary exercises provide for limited written and/or oral practice of the technical terminology introduced in the dialogue and the reading. (E.g., students are asked to use the words and phrases in sentences of their own creation.) Technical terminology is defined in a glossary as well as within the body of some of the reading selections. The glossary uses IPA symbols but does not give a pronunciation guide. The syllabus is very structure oriented. It is important to remember that this text is designed for student nurses who may be taking their training concurrently with English language studies. The majority of the grammar exercises pay special attention to asking questions and to giving instructions, using the following types of drills: substitution, transformation, and fill in the blank. The technical vocabulary focuses on the lexicon needed for the early stages of nursing studies. One of the strong points of Nursing, Book 1 is the dialogues. There is a realistic and natural use of language which represents the different types of discourse found in a hospital environment (e.g., student nurse/nurse, nurse/ patient, etc.). The dialogues easily lend themselves to students role playing their own experiences as student nurses, which would help in developing not only their speaking ability but also their listening comprehension. Another strong point is the readings. They are very well written for a beginning-level course and generally amplify and elaborate on the professional topic introduced in the dialogue of the unit. Three weak points are the predictable grammar exercises as mentioned above, the lack of a teacher's guide, and the limited writing component. In Unit 4 the students are asked to write a short paragraph choosing from a list of topics. The remaining writing is restricted to using a technical vocabulary item in a sentence. Considering that this text is intended for high-beginning students, it would be helpful to have a more developed writing program on the sentence level. The technical terminology and structures are not graded. However, the reading selections appear to be nicely sequenced to reflect the training progression made by a student nurse in Britain. Each reading is approximately 200 words long. The technical terminology is authentic and the structures in the readings appear to be authentic. As stated above, the book has its good points. However, it seems best suited for use in the United Kingdom. All the dialogues and the readings in Units 1-7 contain a great number of British expressons and lexicon. In addition, the type of training student nurses receive in England differs from nurses' training in the United States.
Nursing Science The purpose of this text "is to give practice in using English both actively and receptively, so that the student learns how to take information from both written and oral texts and from visually presented material, such as tables and
Survey Review: ESP/Nursing Science
69
diagrams." (Teacher's Notes, p. 1) While all the skills are employed, the focus in this text is to develop the listening comprehension and reading skills as they relate to the technical terminology and structures necessary for nurses. In the Teacher's Notes (p. iii), the authors state that "It [the Nucleus series] is intended for students with some knowledge of general English. . . . " This statement is misleading. Considering the heavy load of technical terminology and the emphasis on understanding scientific concepts as expressed in English, Nursing Science is better suited for intermediate and advanced-level students. The course consists of a student textbook, a teacher's guide, and taped material. There are eleven teaching units, with review units following Units 3, 6, 9, and 11. Each teaching unit contains four sections: Presentation, Development, Reading, and Listening. The Presentation component introduces the notional topic (e.g., properties, location, structure, etc.) and provides for oral and written practice of the technical terminology and structures. The Development component provides for further written practice on the notional topic as well as introducing more technical terminology. The Reading and Listening components present the contextualization of the topic through the description of a physical form (e. g., anatomy) or the description of a process (e.g., a procedure in nursing care). The review units are labeled A, B, C, and Consolidation. Units A, B, and C review the terminology and the concepts taught in the three lessons which precede each review unit, while the Consolidation unit reviews all the material covered in the text. In the student textbook, technical terms are defined in a glossary (preceded by a pronunciation guide) as well as within the body of some of the teaching and review units. An appendix of technical terms follows Unit 1 and another appendix of commonly used medical abbreviations follows Unit 4. There is also a short bibliography of books relating to nursing science. The syllabus used in the nursing science course is a combination of the situational approach and the notional-functional approach. These approaches are integrated throughout the text by relating the technical terminology and structures from the Presentation and Development components to the communicative concepts in the Reading and Listening components. In Nursing Science the exercises are many and varied (e.g., information transfer, completion, problem solving, writing sentences or answers to question, true/false statements with students correcting the false statements, multiple choice, ordering sentences). The well drawn visual aids are also many and varied (drawings, diagrams, graphs, tables, formulas). Throughout the text (particularly in the Presentation and Development components) the exercises and visual aids work "hand in glove" to assist the student in learning to contextualize the technical material. Unit 3 is an example of this. (Student Text, pp. 15-19) The Unit 3 Presentation component begins with five drawings. Each drawing is followed by three or four sentences introducing the technical usage of such multiword verbs as consists of, is divided into, is supported by, is made of, and are connected by. The skill in using the technical terminology is practiced through a completion exercise (in this case a paragraph), and again a visual aid is used. The Development component begins with a visual aid and, using the verbs
70
The ESP Journal
introduced and practiced in the Presentation component, students now write a descriptive paragraph about the visual aid. The Reading and Listening components, both containing visual aids, provide the written and spoken discourse necessary for the students to move from usage to use of the technical terminology and structures. The exercises and visual aids in this book are one of the strong points in this course. In fact without the visual aids, as a language course Nursing Science would be much more difficult to teach. A second strong point is the technical vocabulary. There are technical content items specific to nursing/medicine (e.g., subcutaneous, diastole, autoclave) as well as general scientific items (e. g., function, cylinder, external). Furthermore, a distinction is made in the Teacher's Notes (first mentioned on p. 9) as to what items to teach for recognition and what items to teach for production. A third strong point in the course is the Teacher's Notes. They are simple and practical. For each teaching unit and review unit the authors list: (1) the aims of the unit; (2) the main language item(s) of the unit; (3) notes to help the classroom teacher understand the medical content of the unit; (4) suggestons for teaching the unit; (5) the text of the listening component; and (6) the answer key to the exercises. For teachers trained in the humanities, this teacher's guide is invaluable. It assumes that "the teacher has no special knowledge of the subjects nurses have to study . . ." (Teacher's Notes, p. 1) and encourages the teacher to interact with a professional who teaches nursing subjects. There is one possible weak point which relates back to the focus of the course--the development of the reading and listening comprehension skills. The course provides little programmed opportunity for the students to ask questions. Communication between nurse and patient, and between nurse and doctor requires the ability of the nurse to ask logical questions, not just to understand questions asked. It would be useful to include a few more exercises which lend themselves to group work and the discussion of problems in nursing. The technical terminology and structures do not appear to be graded. However, the reading passages "are very short in the first few units of this course, gradually becoming longer, until [the Consolidation unit, which] consists chiefly of two reading passages." (Teacher's Notes, p. 1) The reading passages are adaptations of technical material, but on the whole are well written. As the reading passages become longer, so the comprehension questions following each passage require the students to move from "parroting" the information from the passage to "ferreting out" the information from the passage. The technical terminology is authentic and the structures appear to be authentic, particularly as found in the reading passages. Because the materials in Nursing Science contain tasks which might require explanation and guidance from the teacher, the book is best suited for classroom
Survey Review: ESP/Nursing Science
71
use. However, an advanced-level student from a technologically oriented society who has a degree in nursing might be able to use the book for self-study. All things considered, the course has a very good selection and blend of linguistic content and exercises. The course requires outside preparation work for the teacher (e.g., realia), but the Teacher's Notes abound in ideas and suggestions.
The Language of Medicine in English The purpose of this text is to give high intermediate and advanced-level students an overview "of the opportunities and problems inherent in the world of medicine" (Foreword), and at the same time to improve their ability to use English as related to a particular medical specialty. While all the skills are employed, the focus is on developing the speaking and reading skills. The course consists of a student textbook only. There are ten teaching units and no separate review units. Each unit contains five sections: Special Terms, Vocabulary Practice, Reading, Discussion, and Review. The Special Terms component is a glossary containing some of the technical vocabulary used in the Reading. The Vocabulary Practice uses a question and answer format to exercise the glossary items. The Reading component introduces the professional topic of the unit (e.g., Human Anatomy) and contexualizes the technical vocabulary, some of which is introduced and defined within the Reading. The Discussion component is an in-depth review of the Reading using not only whquestions but also an "explain/describe a process" format. The Review component contains a comprehensive review of technical vocabulary using a variety of drills (e. g., completion, matching, multiple choice, true/false statements with students justifying their answer). The Review component concludes with conversation exercise(s) in which the students are asked to relate to the topic of the unit (e. g., "Imagine that you are a general practitioner. What kind of work would occupy most of your time?" Unit 5, p. 60). At the end of the text is an index in alphabetical order of the special terms from all the glossaries and the page number on which each item first appears. There is no pronunciation guide. The syllabus used in this text is basically situational. The technical structure and vocabulary introduced are determined by the topic of the unit. However, a combination of the situational approach and the notional-functional approach is used in the conversation exercise(s) found in the Discussion component. One of the strong points in The Language of Medicine in English is the Readings. Although they are long (each approximately 1200 words), they are very well written and should be of interest to the students because of the validity and variety of the topics. Two examples are Unit 2 (Human Anatomy) and Unit 7 (Careers in Medicine). Unit 2 is an excellent overview of the human anatomy (e.g., skeleton, skin, muscles, heart, digestive system, nervous system, brain) while Unit 7 discusses the different health-related occupations now available in addition to those of doctor, dentist and registered nurse (e.g., vocational nurse, nurse practitioner, certified nurse midwife, physician assistant, etc.). Another strong point is the conversation practice at the end of each unit.
Good
200-300 Words
YES Fair
Use of Illustrations
Approximate Length of Reading Selections
Glossary Variety in Types of Exercises Knowledge of Nursing Desirable
YES
Fair
Fair YES Teacher Edition NO Structural
Speaking Reading High Beginning
Use of Charts
Audio Program Type of Syllabus
English Level of Students Teacher's Edition Answer Key
Skills Emphasized
Features
English for Nurses
YES
Level 1 None Level 2 Poor Level 3 None Level 1 Poor Level 2 Poor Level 3 Fair 1:200-700 Words 2:300-750 Words 3:540-1100 Words YES Very Good
High Intermediate Advanced None YES Student Edition NO Structural
Reading
English for the Medical Professions
TABLE 1
YES
NO Excellent
Graded 160-600 Words
Excellent
Reading Writing High Intermediate Advanced Very Good YES Teacher Edition YES Situational NotionalFunctional Excellent
English in Basic Medical Science
Summary of Features
NO
YES Poor to Fair
200 Words
Fair
None
None YES Student Edition YES Structural
Speaking Reading High Beginning
Nursing, Book 1
YES
YES Excellent
Graded 160-450 Words
Excellent
Listening Reading Intermediate Advanced Excellent YES Teacher Edition YES Situational NotionalFunctional Excellent
Science
Nursing
YES
YES Good
1200Words
Good
None
NO Situational
Speaking Reading Intermediate Advanced None NO
The Language of Medicine in English
tO
Survey Review: ESP/Nursing Science
73
The theme for the conversations contextualizes the topic of the unit and offers ample opportunity for expansion. An example is found in Unit 6, entitled "Surgery." Students are asked to describe an appendectomy (p. 72). Various points of view could be presented, depending on the makeup of the class--as seen through the eyes of the doctor, the nurse, and/or the lab technician. A possible weak point is the lack of a teacher's manual. Considering the length of the reading selections, it would be helpful to see some guidelines as to how much of the Reading to present at one time and how best to go about it. In addition, the text emphasizes the student's ability to "communicate naturally in English" (Foreword), but offers no suggestions on integrating the writing skill beyond the sentence level. The technical terminology is authentic and the structures appear to be authentic, particularly in the reading selections. Neither seems to be graded. All in all, this is a nice little text. It is a straightforward and practical presentation of the opportunities available in the field of medicine. Toni M. K r o c h m a l has an MA in Linguistics with specialization in TESOL. She is experienced in the supervision and development of curriculum for courses in both general English and ESP. She is currently the Director of Language Projects for Transemantics, Inc., Washington, DC.