Trabajo final para Diplomado: Actualización de Contenidos Académicos para la enseñanza del idioma inglés

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Reinforcing communicative skills thought Task-Based Learning approach (TBL) in the teaching of English for Medical Purpouses (EMP) at "Manuel Fajardo" Medical School.
Mercedes Aluart Rodríguez, BEd. Associate Professor. Havana Medical Sciences University. “Manuel Fajardo” Medical Faculty. Havana. Cuba. E-mail: 
MARCH 2012


This essay deals with the implementation of different types of tasks aimed at reinforcing communicative skills and fostering quality of oral interaction in the teaching of English for Medical Purposes in the 5th Year Medical Students at ¨Manuel Fajardo¨ Medical School. Research partial results presented in this essay conclude that different types of tasks illustrated by Willis (1996), most of them based on real facts, can reinforce the communication process giving the students the opportunity to express their own ideas and comment on their experiences in the English language in real life contexts.
Task-Based Approach, Method, Approach, Tasks, listing, comparing, creative task, values.
English as a foreign language (EFL) is one of the curriculum disciplines of the different Biomedical Science courses in Cuban Medical universities.  Besides, the health care professionals need to develop English language skills to get a comprehensive development as health professionals because, most of them, will get involved in different medical situations when they approach to medical collaboration services in many English-speaking countries. On the other hand, as part of their professionalactivities, they also need to make oral presentations in workshops or scientific events and, in some cases, they have to make Case Presentations and Case Reports in this foreign language.
Different methods and approaches for the teaching of English as a foreign language have been considered since this discipline was included in the Curriculum in 1963. Among them I can mention the ¨translation method¨ which was implemented in the 1963-1975 academic years in response to the doctors´ need to translate medical essays and reprints into Spanish, being this the main objective of the English lessons at that time. Later, the ¨Carlos J. Finlay Detachment¨ was instituted and the main aim in the teaching of English as a foreign language was to develop the four basic language skills (listening, speaking, reading and writing); so, the ¨Communicative Approach¨ was considered necessary. After that, it was necessary to introduce new texts because the existing ones (¨Practical Medicine¨, ¨Practical Surgery¨ and ¨Medically Speaking¨ were obsolete. It was in the year 2009 when the series ¨English Through Medicine I and II were implemented as the main textbooks to be used for the English lessons in the 4th and 5th years of Medicine. As the authors comment ¨these course books are task-based and are aimed at linking classroom situations with real world tasks from the specialities¨. Then, the teaching of English starting being based on two main approaches: The Communicative Approach and the Task Based Leaning Approach. But, other types of task-based activities have also been carried out in class in the teaching of the English subjects ¨English IX and X¨ in Manuel Fajardo Medical Faculty to reinforce effective communication, increase students confidence, accuracy and range vocabulary to express themselves in the medical contexts.
Presentation of thesis:
This essay reports on the importance of the Task Based Learning (TBL) Approach in the teaching of English for Medical Purposes (EMPs) to develop skills in this foreign language with a non-linguistic outcome. After interviewing medical doctors who had worked in English-speaking countries and knowing students expectations, I identified a need to introduce new tasks in the Lesson Plans corresponding to the 5th year medical students in order to help and facilitate the oral production of their ideas and experiences in English.
Purpose and reasons:  
I hope the essay will provide information about the need to do different types of tasks in the teaching-learning process mentioned above to reinforce skills and to help students comprehend information as well as interact meaningfully and spontaneously.
Research methods:
After observing the students’ performance in class and interviewing some health care professionals that had worked in English-speaking countries and knowing about the difficulties they faced while working in those regions, I identified the following problematic situation:
There are deficiencies related to the communicative competences the students should develop in class in relation to their needs to express their points of view, and the possibility to refer to real life situations when dealing with the medical practice in a determined linguistic context.
Consequently, I decided to start investigating about this topic. So, I started to do a diagnostic, exploratory research and I identified the following scientific problem:
How can I develop communicative skills based on real life situations as a response to students own communication needs and interests in my English lessons in the English subjects: English IX and  X ( ¨English Through Medicine II¨)?   
Then, I started doing research with this main objective:
To design different types of tasks to improve oral communication and practice language in real life situations in the teaching of the English Subjects ¨English IX and X¨ in the ¨Manuel Fajardo¨ Medical School in an specific linguistic context, considering the Communicative Approach and the Task Based Learning Approach.
A hypothesis came to my mind:
The implementation of some other types of tasks than the ones presented in the course book ¨English Through Medicine II¨ could improve oral communication and provide the students other opportunities to express themselves about real life situations in the medical practice.
To fulfil the main objective of this Project, I carried out the following investigation tasks:
  • Analysis of the theoretical data that sustain the proposal including the study of a specific bibliography on this topic.
  • Reflection of the situation according to my own experience.
  • Documentary review(analysis of the Curriculum corresponding to the English language discipline, English IX and X subjects)
  • Assessment of the students’ communication skills and their possibilities to interact among themselves referring to real life situations. This assessment is achieved through classroom observation.
  • Assessment of the students and health care personnel opinions about the need to introduce tasks related to real situations they will have to face in their professional work when working in English-speaking countries. This assessment is achieved through interviews.
  • Experts’ assessment of a proposed set of tasks to improve oral communication regarding real life situations.
In my opinion, I consider that the idea about the implementation of new types of tasks can be used for incorporating authentic and personally relevant content-based materials, so as offering support for the implementation of strategies that enhance oral interaction in English for Medical Purposes (EMPs) lessons. Moreover, activities that involve combinations of the ¨known¨ and the ¨new¨ tasks are particularly helpful in terms of encouraging meaningful and authentic oral communication.
Sample units of study:
Population and sample: a group of 36 Fifth Year Medical students who study at ¨Manuel Fajardo¨ Medical School.
Presentation of data:
González, L.E. & Arias, N. (2009) in the article: ¨Enhancing Oral Interaction in English as a Foreign Language through Task-Based Learning Activities¨ show the importance of the TBL Approach to gain capacity for oral interaction in the English language and highlight the importance to carry out real-life situation activities using information based in the students´ own experiences and interests.
Also, as Nunan, D (1991) says the ¨ The TBL Approach makes emphasis on learning to communicate through interaction in the target language¨.
Moré, M. & Bueno, C. (2008) explain in their course books English Through Medicine I and II  that ¨the books are both designed to be used in a class setting or for extra class activities. They provide a set of tasks to develop listening, speaking, reading and writing skills and include forms and functions that allow students to gain communicative competence in English in real life situations¨. Some of the activities presented in these course books to develop the four language skills are ward rounds, case presentations and case discussions. Nevertheless, other types of tasks can also be included to give more possibilities to the students to practice language based on other real situations which are not included in the books. We can also introduce cultural aspects which are important when dealing with language practice among people from different regions and cultures, their values and lifestyles what contributes to a better and more respectful doctor-patient relationship.
Willis (1996) describes tasks as “activities where the target language is used by the learner for a communicative purpose (goal) in order to achieve an outcome” In his thesis, he refers to six different types of tasks which are: listing; ordering and sorting;  comparing; problem solving; sharing personal experiences, anecdote telling; and creative tasks, project work.
Further, I am going to refer to the implementation of some of these types of tasks in the English for Medical Purposes lessons (EMPs lessons) in a group of 5th year medical students at ¨Manuel Fajardo¨ Medical School. 
Tasks developed in class:
  • Listing:
Outcome: List of useful questions to interview patients.
Participative technique: Brainstorming.
Starting point: The teacher encourages students to make questions about the most important aspects to consider when interviewing patients. These questions may refer to: general data, chief complaint, present history, etc.
(All the questions provided by the students are written on the board)
  • Ordering and sorting:
Outcome: Set of information ordered and sorted according to specified criteria.
Starting point: Using the questions provided by the students in the previous task, this other task is assigned:
                Sample task: (see appendix 1)
(These two first tasks are recommended to write patients psychosocial histories). 
  • Comparing:
Outcome: Identification of some similarities and/or differences between cultures in relation to health matters.
Starting point: The teacher presents fragments about the topic of health practices in the African and the Cuban cultures. After finding the similarities and/or differences, the students write their versions using their own vocabulary and cultural background. Finally, they exchange information and comment among themselves expressing their opinions about the most significant similarities and/or differences.
                Sample task: (see appendix 2)
(This task is suggested to improve students’ oral skills and develop intercultural communication).
  • Creative Task:
Outcome: Oral Presentation of a selected topic to a greater audience. This type of task has more stages than the usual ones that are developed in class and links the 4 language skills of listening, speaking, reading and writing. Participative techniques and actions such as brainstorming, ordering and sorting, classifying, comparing and solving problems among others can be developed.
Steps to follow in the creative task:
1.      Idea selection: The students are assigned to gather in groups. The students select and present the topics to the teacher which should be in relation to real medical situations or any other important cultural aspect in which health matters are analyzed. Here, brainstorming and note taking can be developed as a result of students´ reflection on the selected topics.
2.     Free writing or fast writing: “an initial exploration of the ideas that you have about a topic” (Brown 1994, 334). The students write their first drafts.  It is when the students start developing their ideas and presenting their points of view. 
3.      Drafting: The students begin to structure writing and make it more coherent.
4.    Peer editing and peer evaluation: The students exchange their versions what promotes discussion and feedback.
5.       Final version: It is presented after consecutive versions, editions and revisions.
                 (This task is recommended for Extra class work and Project Works).
To obtain better results in Extra class activities, I plan monitoring activities and 
supervise the work the students are doing with the information that has been obtained, give advices in regards to note-taking and   paragraph structuring and also check if the students have taken down the necessary notes regarding any information obtained from Web sites so as the data about the day each of these sites were visited and other important details.
Analysis of data:  
In this stage of research, the partial results have proved my hypothesis because the implementation of these tasks has shown a reinforcement of the knowledge  through debate about some medical, cultural and health-related topics in general; some tasks have been useful to reinforce knowledge about useful questions used to interview patients in the English language; others have provided a feedback in regards to medical practices in different regions and cultures and have  increased skills and knowledge of the different steps to carry out research. I have also observed that the students feel motivated doing these types of tasks. Also, when they analyze paragraph in groups, they help each other and know their opinions and points of view.
They also have the possibility to develop independent skills and show creativity when preparing project works (creative task). This task also develops Interdisciplinarity when referring to real medical situations seen in the hospital or studied in class and when they have to develop computing skills to search information in Web sites and prepare PowerPoint presentations.
Furthermore, I can also say that, through the implementation and development of these tasks, we can develop participative techniques such as pair work, group work and others. In my opinion, I also consider that this research is ethical because it gives the students the opportunities to develop some values such as: 
  • Relationship between affective and cognitive development, which is achieved through group work.
  • Foreign language learning motivation.
  • Assessment of topics linked to the medical practice.
  • Self-assessment of the learning process.
  • Reflective attitude towards reality.
  • Individual and collective decision-making.
However this evidence is based on a very small sample and more research would have to be done for definitive conclusions to be derived from these findings, I can conclude that the Task Based Learning Approach (TBL Approach) has provided opportunity to use the English language in real life situations, thus fostering the students interests to participate actively in the teaching learning process. This approach has also given the opportunity to develop oral interaction which is one of the most difficult competences to develop in learning a foreign language. Furthermore, I want to emphasize that, with the implementation of different types of tasks from the ones presented in the course books, we both, teachers and students can include topics which can be selected from the students’ real needs to use the English language, thus encouraging the oral communication.
·      Akpeneye, G. PhD. (2012). Academic Writing and Research. Course 1. Diploma Course on Academic Writing. Lecture notes. Havana. Cuba.
·       Bueno, C. et al. (2008). ¨English Through Medicine II¨. Editorial Ciencias Médicas. La Habana. Cuba.
·      Caballero, José E. (2000)Análisis del Perfil del Egresado de la Carrera de Medicina en la Universidad Médica CubanaRevista Cubana de Educación Médica Superior. Cienfuegos. Cuba.
·   Ferriols, R. & Ferriols, F. (2005). Escribir y publicar un artículo original. Ediciones Mayo, S.A. Barcelona/Madrid. España.
·    González Humanez, L.E. & Arias, N. (2009). Enhancing Oral Interaction in English as a Foreign Language through Task-Based Learning Activities. Latin American Journal of Content & Language Integrated Learning.
·        Moré. M. et al. (2008). ¨English Through Medicine I¨. Editorial Ciencias Médicas. La Habana. Cuba.
·     Nunan, D. (2001). Aspects of Task- Based Syllabus Design. The English Centre, University of Hong Kong. Disponible en URL:
·     O’Brien, R. (1998). An Overview of the Methodological Approach of Action Research. Faculty of Information Studies. University of Toronto.
·    Rojas, T. (2011). El desarrollo de la comunicación intercultural en estudiantes de Medicina a través de las asignaturas inglés VII y VIII.   Centro de Estudios para el Perfeccionamiento de la Educación Superior. Universidad de La Habana. Cuba.
·      Ruso, N. (2007). The Influence of Task Based Learning on EFL Classrooms. The EFL Professional’s written forum. Eastern Mediterranean University. Turkish Republic of Northern Cyprus.
·       Teaching English. (2001). TKT EssentialsPresentation Techniques. British Council Cuba. . Module 1.
·      Velazco, C. (2002). Aprender y enseñar inglés: cinco siglos de historia. Revista Humanidades Médicas. Vol.2, No 1. Ciudad de Camaguey. Cuba. Versión ONLINE: ISSN: 1727- 8120. Disponible en URL:
·        Willis,J. (1996). A Framework for Task-based Learning. Longman Handbooks for Language Teachers.
Appendix 1:

Ordering data in logical or chronological order.
1. General data.
2. Chief Complaint.
3. Present history.
Classifying questions according to different criteria.
Name, occupation, marital status, religion, …
Categorising data in groups or under some specific headings
Present history
Past history
Family history
Social history
Classifying data from less formal to more formal ones.
Your name, please?
Can you tell me your name, please?
What´s yor problem?
What brings you to the clinic today?

Appendix 2:
Analyze the following paragraphs dealing with some aspects about African culture and Cuban culture. Spot the differences and/or similarities among them. Feel free to give your personal opinion about the topic. 
         East Africans generally believe that there are multiple causes of poor health. Some illnesses are perceived to have tangible, external causes like a poor diet. However, other conditions are the result of fate, destiny, negative energy, bad spirits, God’s will, or the breaking of social taboos.
         Traditional medicines have been used for centuries by East Africans and vary by geography and culture. They are far too numerous to discuss, be aware that patients will likely be interested in using a variety of herbal, plant or food remedies if available as a supplement to Western medicine.
(Taken from: Yehieli,M. (2005). Health Matters. A Pocket Guide for Working with Diverse Cultures and Underserved Populations. Intercultural Press. Page: 67)
         The majority of the Cuban population has been instructed and educated on the basis that the medical problems should be properly treated by doctors and other health care personnel. Preventive medicine has become one of the most important issues in the National Health System.
         Herbal medicines have also been used as an alternative medicine in the treatment of some diseases. A lot of research has been done on this matter. Nevertheless, some Cuban people think that they have to use these remedies first and then, if the result is unsuccessful, they should seek medical advice.