SỬ DỤNG tài LIỆU CHÂN THỰC NHẰM bổ TRỢ SÁCH GIÁO KHOA trong chuong trinh day hoc tieng anh chuyen nghanh cho sinh vien y khoa nam thu 2 truong dai hoc y thu 2

Given that materials development is an essential process in any language teaching program, this study is conducted to investigate and assess authentic materials use whichgive assistance

CHAPTER ONE: INTRODUCTION

This chapter aims at presenting the rationale for the field-study, its aims and scope, theresearch questions, significance, methods, and design of the field-study

1.1 Introduction

It is a common assertion that materials in general play a crucial part in language learning(Robinson, 1991; Nunan, 1991) This accounts for the fact that discussions of the roles ofmaterials appear in almost all books on course design Materials not only provide learnerswith a wide range of useful and fascinating information but also can play a part inenhancing learners’ motivation- thus, facilitate their acquisition (Dudley- Evans& St John,1998; Nonaka, 2001)

On materials, it can be seen that the textbook is the ‘visible heart’ of any ELT (EnglishLanguage Teaching) program Several advantages of using textbook have been suggested

by researchers For example, textbooks help to standardize instruction and assessment That

is, by giving students in different classes the same textbook, teachers can teach and testthem in the same way (Richards, 2005) Textbooks also provide syllabus for a program,thus supporting novice teachers, training them in methodology and saving their time andeffort for more worthwhile pursuits than material production (Cunningsworth, 1995) What

is more, since textbooks are always carefully tested before being brought into the market sothey give students credibility Students also often expect to use a textbook in their learningprogram (Sheldon, 1998)

In spite of the aforementioned positive view of textbooks use, however, there have alsobeen certain reservations about this use One of the most cited concerns is that textbooks areoften implicitly prescriptive and thus might control the methods, process and procedures ofclassroom practice and ‘deskill’ teachers (Allwright, 1982) Another concern is that sincetextbooks are often written for global markets, they may not suit all classrooms and mightrequire adaptation to better meet students’ true needs (Richards, 2005) Non-authenticity isalso the most limited feature of almost text books Due to teaching purpose, both contentand language are presented in idealized and standardized ways rather than they are in reallife (Cunningsworth, 1995)

Many experts have written on how to choose or develop materials, which are relevant tolearners, so that materials can give assistance to learners’ language learning process Indeveloping materials for ESP, it is advisable from many experts to use authentic materials

because they can provide students with up-to -date knowledge, expose them to the world ofauthentic target language, can bring the real world into the classroom and significantlyenliven the class (Martinez, 2002; Kaprova, 1999; Leloup& Prnterio, 2000; Dumitrescu,2000) By this way, authentic materials can motivate students, give them more stimulation

in learning a language

1.2 Rationale for the study

In Vietnam, ESP has become an indispensable branch in English language teaching inalmost all universities to meet the growing demand for communication in many fields such

as tourism, banking, science and technology and especially medicine Therefore, selecting,using and adapting textbooks for ESP course are much concerned issues to ESP teachers

Given that materials development is an essential process in any language teaching

program, this study is conducted to investigate and assess authentic materials use whichgive assistance to students of medicine in ESP program Before the field- study is discussedfurther, it would be helpful to provide some background for the situation of ESP program inVietnam in general and at Hanoi Medical University in particular

So far English has been kept its dominant role among worldwide languages In Vietnam,English is considered as a key instrument in training human resource, especially, peopleworking at high levels need to be equipped with the English proficiency to engage inglobalize work context Therefore, teaching and learning English, especially, ESP is anecessity in tertiary, yet ESP is still new and very challenging to instructors At HanoiMedical University, ESP has been paid more attention to recently (French used to be mainlyemployed in medicine area in Vietnam) Being aware of English serving as a bridge toconnect Vietnam’s medicine to world’ advanced medicines, much attempt has been made toimprove the teaching and learning English in medicine The principal purpose is to helpstudents cope with materials on Medicine in English, thus they can read medical books,journals and other related reference materials for their further study and for their work aftergraduation

However, after some years, the materials, which has been used revealed failure to meetstudents’ need and to be not very motivating to them The materials do not appear helpfulenough to assist students to improve their medical English in terms of grammar structureand vocabulary They have difficulties in memorizing and using the language due to theshort diversity of grammar structures and system of content Thus, students are not usuallyengaged in the reading activities, or they do not concentrate on or involve in the readingtasks This existing fact has caused a headache to all teachers and some solutions have been

applied such as giving them some extra reading materials from some other books, but thesituation has not been significantly improved.

In an effort to search for a solution to this situation, the researcher has found that manyauthors have asserted that authentic materials have a positive effect on learners’ motivationand their language acquisition in foreign language classroom Nevertheless, research to date

of this topic is inadequate and the researcher suggest that testing these subjectiveimpression- the positive effect of authentic materials on Medicine on students’ learningprocess and their motivation, will result in a better guidance for the selection andexploitation of reading materials used in ESP program

1.3 Aims and objectives of the field-study

This field-study is firstly aimed at supplementing the findings of the earlier study byproviding empirical evidence for the effect of authentic materials on the students’ readingproficiency and their involvement levels in class activities Secondly, it is an attempt tomeet the need of the students at HMU for a way to access real- life language Lastly, it isexpected that the results of the study would serve as a useful source of reference forteachers who are teaching ESP or/ and interested in material development for ESP

Specifically, researcher’s main objectives in carrying out this field-study are as follows:

- To introduce authentic materials as a tool to supplement the course-book to thesecond year students at HMU

- To examine the effect of the authentic materials on the students’ languageacquisition

- To elicit students’ opinions of the authentic material use and to lay grounds for thefurther research

1.4 The scope of the study

As this is only a small- sized scale study, a number of issues, though intriguing, would bebeyond the scope of inquiry and would be best deal with in a further study, for example,using authentic materials for other objects such as specialists, nurses or medical technicians

or designing supplementary materials on ESP program, and so on Also, I will only focus onthe influence of authentic materials on the reading proficiency by second year students whoare trained to be general doctors at HMU

1.5 Research hypotheses and questions

In order to achieve the above - mentioned scope, this study was designed to test the

following hypothesis:

H1: Students who do medical English course with the textbook and supplementary authentic materials will make more improvement in reading proficiency measured by a proficiency test than those who do the course with the textbook only.

The acceptance of this hypothesis would result in the injection to the following nullhypothesis or vice versa:

Ho: There is no difference in reading proficiency as measured by a proficiency test between students who do medical English course with the textbook and supplementary authentic materials and those who

do the course with the textbook only.

In order to reach the conclusion on which hypothesis would be accepted, the answers to theresearch questions that are presented below would be found

(1) Is there a significant difference between the reading proficiency scores of the controlgroup (students who do the course with the textbook only) and those of theexperimental group (students who do the course with the textbook andsupplementary authentic materials)?

(2) What are students’ opinions of the use of authentic materials in extensive readingprogram?

The first question is the focal point The answer to it would yield empirical evidence for theeffect of the use of authentic materials on students’ reading proficiency The answer to thelast question would provide invaluable information about students’ evaluation of the use ofauthentic materials as supplement source on their ESP program

1.6 Significance of the study

It has long been believed that material development plays an essential role in Englishteaching Therefore, it is hoped that the authentic materials to be used will help to facilitateand motivate students better in ESP classes and the results of this experiment will supportthe suggestion of using authentic materials and give a guidance to select and exploitauthentic materials in order to improve ESP teaching materials

1.7 Methods of the study

The major method employed in this study to find out the answers to the proposed research

questions within the scope of the study is a quasi- experimental design which involves the

three basic components of experiments as presented by Selinger and Shohamy, that is, thepopulation ( second year students at HMU), the treatment ( the authentic materials use ) andthe measurement of the treatment (t- test) ( 1998, p.136) Under the present teaching and

learning conditions in Vietnam such as the grouping of students in advance, this method hasproved to be the best choice to yield the empirical results for this study.

Besides this main method, the class journals are collected and unofficial interviews alsocarried out to students taking part in the program as well as other teachers of English andmedical specialists as a complementary tool to obtain their feedback on the program andtheir suggestions for future programs

1.8 Design of the study

The study is divided into five chapters as hereunder:

Chapter one presents an overview of the study in which the introduction, the rationale for

the study, the aims and objectives, the research hypothesis and questions, the scope, thesignificance, the research method as well as the design of the study are briefly presented

Chapter two reviews the literature relevant and closely related to the study including the

textbook evaluation, textbook use and adaptation, the features of ESP and OEP in generaland medical English in particular, authentic materials and the effect of using authenticmaterials on ESP teaching and learning

Chapter three is a detailed discussion of the method used in the study with all of its

components encompassing the justification for using the quasi- experimental design, thevariables, the participants, the design of pretest and posttest, a detailed description ofexploited authentic materials and the designing of based- task authentic materials

Chapter four, which is the most important part of the study, presents significant findings of

the study

Chapter five, which is not less important than the preceding one, presents a discussion of

the major findings from which some pedagogical implications were derived from Thischapter also points out some limitations of the study that serve as the basis for theresearcher’s recommendations for further study

1.9 Conclusion

In this chapter, an overview of the study has been presented including the rationale for thestudy, the aims and objectives of the study, the scope of the study, the research hypothesesand questions, significance of the study, the research method employed by the researcher aswell as the design of the study The next chapter will review the relevant, closely relatedliterature to provide a theoretical framework for the study

CHAPTER TWO: LITERATURE REVIEW

2.1 Textbook Evaluation

English language instruction has many important components but the essential constituents

to many ESL/ EFL classrooms and programs are textbooks and instruction materials that areoften used by language instructors As Hutchinson and Torres (1994) suggest: “Thetextbook is an almost universal element of [English language] teaching Millions of copiesare sold every year, and numerous aid projects have been set up to produce them in variouscountries… No teaching-learning situation, it seems, is complete until it has its relevanttextbook.” (p.315) Other theorists such as Sheldon (1988) agree with this observation andsuggest that textbooks not only “represent the visible heart of any ELT program” (p 237)but also offer considerable advantages for both students and teachers when they are beingused in the ESL/ EFL classroom Haycroft (1998), for example, suggests that one of theprimary advantages of using textbook is that they are psychologically essential for studentssince their progress and achievement can be measured concretely when they use them.Second, as Sheldon (1988) has pointed out, students often expect to use a textbook in theirparticular language classroom and program and believe that published materials have morecredibility than teacher- generated or “in-house” materials Third, as ONeill (1982) hasindicated, textbooks are efficient in terms of time and money, and they can and shouldallow for adaptation and improvisation Finally, textbooks may constitute an effectiveresource for learning in classroom and self-directed learning (Cunningsworth, 1995) Alearner without a textbook might be out of focus and teacher- independent

In spite of aforementioned benefits of textbooks, however, some reservations can be found.Some well-founded reservations pointed out by Allwright (1982), for instance, suggest thattextbooks are inflexible and generally reflect the pedagogic, psychological, and linguisticpreferences and biases of their authors Subsequently, the educational methodology that atextbook promotes will influence the classroom setting by indirectly imposing externallanguage objectives and learning constituents on students as well as potentially incongruentinstructional paradigms on the teachers who use them In this fashion therefore, textbooksessentially determine and control the methods, processes and procedures of languageteaching and learning Moreover, the pedagogic principles that are often displayed in manytextbooks may also be conflicting, contradictory or even out-dated depending on thecapitalizing interests and exploitations of the sponsoring agent

Other researchers such as Prodromou (1988) and Alptekin (1993) pointed out that textbooksare often cultural artifacts because it is impossible to teach a language without embedding it

in its cultural base However, in many instances this might alienate learners if they areforced to express themselves within a culture they have hardly had any experience with andbeen prepared for

In addition, recent appraisals of commercially produced textbooks have also suggested thatmany textbooks tend to offer classroom learners little opportunity for learning how toproperly communicate intentions such as requesting, disagreeing, complaining, and so on inthe second language (L2) (Bardovi- Harlig, 2001; Vellenga, 2004) This is firstly becausemany textbook either do not present or they present communicative function (i.e speechacts) unrealistically Boxer and Pickering (1995), for example, found that textbooksgenerally do not contain indirect complaints (i.e complaining about oneself or someone/something that is not present in the conversation) as a solidarity-establishing strategy.Bouton (1996) pointed out that the textbook that he investigated taught invitations thatrarely occur in published native speaker (NS) corpora The reason for the unrealisticdescription of communicative functions in many textbooks is textbooks are often basedlargely on NS intuition about how communicative functions are linguistically expressedinstead of making use of authentic speech (Boxer and Pickering, 1985) As research hasshown, in contrast to intuition about language forms or grammar, NS intuition aboutlanguage use is generally unreliable (Wolfson, 1988) and therefore cannot adequatelyinform instructional material (Boxer and Pickering, 1995)

Secondly, what also adds to the difficulty in learning how to communicate intentions viatextbooks is many textbooks seem unhelpful in teaching appropriate rules of using differentcommunicative functions In order to use a communicative function appropriately, learnersneed to know not only linguistic resources to express it but also the rules of use However,previous research has indicated that textbooks generally provide insufficient informationregarding when and for what purpose it is appropriate to make use of a communicativefunction and which expressions would be appropriate in a particular situation (i.e meta-pragmatic information) (Crandall and Basturkmen, 2004) Teacher’s manuals,unfortunately, rarely supplement this information (Vellenga, 2004)

Similarly, proponents of authentic classroom language models such as Brazil, Coulthard,

and Johns (1980), Levis (1999), Cathcart (1989), Bardovi-Harlig et al (1991), and Yule,

Matthis and Hopkins (1992) have also pointed out that many scripted textbook language

models and dialogues are unnatural and present an oversimplification of language Thusthey tend to inadequately prepare students for the types of pronunciation, vocabulary,grammar and discourse that are used in real world communication While authentic material

do not automatically bring about effective learning and definitely should not be consideredmore important than their relevance to learners’ needs and experience (Day, 2003), anunrealistic and oversimplified presentation of language use can be more inhibiting thanhelpful in developing learners’ language proficiency and communicative competence

Hence, the textbook evaluation presented above has brought about an overview of benefitsand reservations textbook use that helps teachers identify the strength and weakness of aparticular textbook that is already in use (i.e in use or retrospective evaluation) This is toinform teachers in the process of textbook adaptation and decision- making for the nextcourse (Ellis, 1997)

2.2 Textbook use and adaptation

Material adaptation is one of the most concerned issues to teachers who desire to makestudents’ needs and materials as well as learning process well matching Material adaptation

is especially significant in ESP teaching where textbooks do not appear to catch up withquick changes in terms of content and no textbooks are well- fitted enough to everyparticular situation

Various problems with materials have been addressed by a number of researchers O’Neill(1982: 153) suggest that the textbook can only provide props and framework for classroomteaching and no textbook can expect to appeal to all teachers or learners at a particular level.McDnough and Shaw (1993: 83) as well propose that textbooks, internally coherentalthough they may be, they may not be totally applicable Swales (1980) contends that anygiven course-book will be incapable of catering for the diversity of needs which exists inmost language classroom Allright (1981: 9) also maintains that given the complexity of thewhole business of the management of language learning, even with the best intentions nosingle textbook can possibly work in all situations Sheldon (1988:239) addresses a lack ofcultural appropriateness of some of some textbooks, i.e, the thinking underlying thetextbook writing may be different from or event in conflict with the assumptions held by theteachers

The problems mentioned above are by no means exhaustive, but the key point remains:

teachers, with the practical personal knowledge of their classroom teaching, should seetextbooks as their servants instead of their masters; as resource of an “ideal bank” whichcan stimulate teachers’ own creative potential (Cunningsworth, 1984: 65) Adapting theirmaterials allow them to achieve more compatibility and fitness between the textbooks andteaching environment, and maximize the value of the book for their benefit of theirparticular learners and for the most effective teaching outcome to be achieved It wouldconsequently lead to an improvement of the textbook in sense of being able to suit theparticular situation and empowering and reskilling the teachers (Apple and jungck, 1990;Shannon, 1987) Richards (1998: 135) argues that teachers should approach textbooks withthe expectation that deletion, adaptation, and extension will be normally needed for thematerials to work effectively with their class

For these and other reasons, there is already an established tradition of ESP teachersadapting materials Being aware of the crucial role material adaptation and in a big effort touse the textbook as a resource for creativity and inspiration, a learning tool for the studentsand a mean to an end in the teaching, the researcher has tried using authentic materials toremedy weaknesses of the textbook so as to assist the students in improving their readingproficiency as well as raise their positive attitude to authentic materials

2.3 Materials for ESP

2.3.1 The role of materials

Since materials have a significant role, almost all methodologists have spent time talkingabout materials Mentioning the role of materials in a curriculum, Nunan (1991: 209)asserted that:

“Materials, whether commercially developed or teacher – produced, are an importantelement within the curriculum, and are often the most tangible and visible aspect of it”The important role of teaching materials was once more confirmed by Robinson (1991)when the author said that many writers “are in no doubt that teaching materials areessential”

Materials not only play an active part in a curriculum, but also are one of decisive elements

in enhancing students’ motivation According to Dudley-Evans & St John (1998), there are

4 reasons why materials are used, which are really significant in the ESP context:

- As a source of language

- As a learning support

- For motivation and stimulation

- For reference

Kennedy and Bolitho (1984), on their comments on a case if the course content and thelearner’s motivation do not match, or if the level of motivation is low in the first place,suggest that materials have to be carefully designed to raise this motivation In another case,these two authors also advised to develop materials in a way that they could motivate alearner who had some initial reluctance and help him overcome the reluctance to studyEnglish

Especially, in some situations, where English ‘materials then play a crucial role in exposinglearners to the language, which implies that the materials need to present real language, as it

is used, and the full range that learners require’ (Dudley-Evans & S John, 1998) Forexample, learners extract information from English medium subject textbooks However, ifindividual texts come from magazines, content and style will be journalistic Therefore, thematerials need to maximize the exposure of students to the language, for instance, byproviding additional materials

It can be concluded from the above discussions that materials are of an importanceespecially in increasing student’s motivation in language learning To do that, materials

need to expose learners to the real language, real world in which the target language is used Authentic materials are believed by many authors (Martinez, 2002; Kaprova, 1999; LeLoup & Ponterio, 2000; Dumitrescu, 2000) to be the one that provides students with opportunity to expose themselves to the real language.

2.3.2 Authentic materials

There have been a number of books and journals containing the explanations of whyauthentic materials should be included in the lessons, and how it should be selected andused or best exploited Authentic materials should be included because they have a lot ofadvantages

2.3.2.1 Advantages of authentic materials.

The authors who support the use of authentic materials, although express in different ways,have in common one idea: “exposure”- the benefit students get from being exposed to the

language in authentic materials (Martinez, 2000) The following are the benefits studentscould gain from authentic materials:

First, students are exposed to real discourse (Martinez, 2002), because authentic materialsprovide close contact with the language (Kaprova, 1999) In addition, language change isreflected in the materials so that students and teachers can keep abreast of such changes So,

it makes good sense to give our students exposure to authentic texts in the target language,both written and oral (LeLoup & Ponterio, 2000)

Second, authentic materials introduce life into the classroom (arm students with facts Kaprova, 1999) as authentic materials keep students informed of what is happening in theworld, so they have an intrinsic educational value As teachers, we are educators workingwithin the school system, so education and general development are part of ourresponsibilities (Martinez, 2002 cited Sanderson, 1999)

-Third, they can produce a sense of achievement (Martinez, 2002), provide a bridge betweenthe linguistic skills of learners and their professional knowledge goals (Dumitrescu, 2000),help to substantially recognize the real language use (as a result, they could increase theirvocabulary and language structures) (Nonaka, 2001)

Fourth, authentic materials, in their various formats, can provide a wealth of linguistic andconceptual content to learners who are focused on specific application of their linguistic

skills (Duquette et al, 1987) Books, articles, newspapers, and so on also contain a wide

variety of text types, language styles not easily found in conventional teaching materials(Martinez, 2002) Therefore, it is advisable to use authentic materials because they providethe variety, which is essential in any language class, but we feel that it is particularlyimportant in an ESP class as there is sometimes the danger of the ESP class becoming rather

a dry affair that fails to motivate learners (Dudley-Evans & St John, 1998)

What is more, the same piece of material can be used under different circumstances if thetask is different (Martinez, 2002) and can be used to develop tasks that depart from theformulaic language learning (Dumitrescu, 2000) and can be used at all levels (Kaprova,1999)

In addition, they can enliven the classroom and are a powerful motivating factor (provide

motivation through enjoyment) (Kaprova, 1999) They can encourage reading for pleasurebecause they are likely to contain topics or kinds of authentic materials to be used in class(Martinez, 2002).

Finally, they can help increase student cultural background (Kaprova, 1999) and have aneffect on cultural identification (Nonaka, 2001)

In sum, this kind of materials if updated with the latest information on every aspect of life,therefore, have sufficient and accurate explanations and examples Moreover, authenticmaterials present the real language, real type of materials that they will have to work with inthe future job, therefore avoid word limits and provide genuineness As s result, authenticmaterials can enliven the class and create a more positive attitude toward learning (Nonaka,

2001 quoted Duquette et al, 1987; Kaprova, 1999; Kelly et al, 2002).

Although authentic materials have plenty of advantages as discussed earlier, there remainsome reasons for that people are against the use of authentic materials

2.3.2.2 Limitations of authentic materials

Although authentic materials have numerous advantages, they still disclose somedisadvantages One common complaint is that authentic materials are more difficult thannon- authentic materials because of some reasons as follows according to Martinez (2002):First, they may be too culturally biased, so unnecessarily difficult to understand outside thelanguage community

Second, the vocabulary might not be relevant to the student’s immediate needs

Third, the many structures are mixed so lower levels have a hard time decoding the texts.Fourth, there are many abbreviations, slang, signs and the like that can require goodknowledge of the cultural background to understand

Besides the claim of being difficult, some teachers are against the use of authentic materialsbecause the special preparation is necessary which can be time consuming and the materialscan become outdated easily, e.g news, etc

Nevertheless, these limitations can be minimized by choosing the materials selectively andexploiting them appropriately Many authors have given instructions on how to select and

use authentic materials effectively.

2.4 Features of ESP in general and medical English in particular

2.4.1 ESP in general

Dudley- Evans and St John (1998: 4-5), in a more recent study, have modified Strevens’definition and exposit their review on the essence of ESP from the following twoperspectives: absolute and variable characteristics of ESP from that differentiate it fromGeneral English

“Absolute characteristics

 ESP is defined to meet specific needs of the learner;

 ESP makes use of the underlying methodology and activities of the discipline itserves;

 ESP is centred on the language (grammar, lexis and register), skills, discourse andgenres appropriate to the activities

Variable Characteristics:

 ESP may be related to or designed for specific disciplines;

 ESP may use in specific teaching situations, a different methodology from that ofgeneral English;

 ESP is likely designed for adult learners, either at the tertiary level institution or in aprofessional work situation It could, however, be for learners at the secondaryschool level;

 ESP is generally designed for intermediate or advanced students;

 Most ESP courses assume some basic knowledge of the language system, but it can

be used with beginners.”

The absolute characteristics refer to the teaching methodology as well as the languageelements ESP makes use of an underlying methodology and activities of the discipline itserves Both the methodology and activities used in the ESP classroom, therefore, aredifferent from that of GE ESP is also different GE in that it is centered on the language that

is appropriate to these activities especially with respect to grammar, lexis, register, studyskills, discourse and genre

The teaching procedures of ESP are linked to a view of language and learning, all activitieshave to be linked to a view of text ESP has in its brief history adopted various approaches

to text analysis, from the early register analysis associated with the identification of keygrammatical elements of scientific communication (Barber, 1962; Swales, 1971) torhetorical analysis associated with functional/notional approach (Trimble (1985) andLackstrom, Selinker, and Trimble (1972)) and to the dominant approach of today, genreanalysis (Swales, 1990; Bhatia, 1993) The register analysis shows an ability to use certainkey grammatical features is vital in ESP work and that other grammatical features of littlerelevance to ESP work can be ignored The rhetorical analysis first introduced the idea thatgrammatical features found in specific contexts, such as an academic textbook, mightfollow rules that in certain subtle ways differ from the general rules as set out in generalgrammar books This work also stresses the predominance of rhetorical considerations indetermining the grammatical choice The notional/ functional approach at its best appears avery fruitful method of bringing together lexical items that co- occur naturally, i.e, verbs

such as consist of and contain, with passive constructions such as attached to, connected to, mounted on in describing the notion of structure, or items associated with the notion of quantity, such as adequate, sufficient, enough, too much, excessive etc The genre analysis

brings together the insights of these earlier approaches to text analysis, but also a greatersophistication in the examination of the writers’ purpose For example, both Fahnestock(1986) and Myers (1990) have shown that writers in academic journals will make guarded

claims about their findings using many hedged statements (the results suggest that , the findings appear to support the claim that ) but will use more confident statements in

popular journals tending to present claims as established facts It can be seen thatdifferences in the use of epistemic modality such as down-toners, or boosters betweengenres and between different disciplines create a special feature of ESP

2.4.2 Characteristics of English for medical purposes

The theory of text analysis shed a light on identifying features of medical English as follow:

2.4.2.1 Characteristics of medical terminology

1 English medical terms derive from Greece and Latin, especially derivatives andcompound words Quite a few elements forming word originated from Greece such as:

Prefixes: anti, auto, hyper, neo, hypo, meta, para etc

Suffixes: ism (e), ize, logy, ma, ema, oma (carcinoma, sarcoma, neuroma)

2 Medical term are compound nouns of Latin origins:

Noun + noun: e.g ilio-costal, laterro - abdominal

Multi: multinuclear

3 Medical terms are French origins

E.g poison, physician, malady, plaque

a Besides, we can find some other English medical terms that originate fromItalian, Spanish, German etc

E.g influenza, epidemic, malaria, scarlet, mosquito, Fahrenheit, protein, etc

b Medical terms are derivatives that consist of one, two, three, four or evenfive affixes

E.g endocardium; three affixes included:

1 endo

2 cardi

3 umPneumohemopericardium; 5 affixes included:

c Medical terms are compound nouns

E.g sore-throat, cross-eye, outpatient

d Medical terms are syntactic groups of noun without prepositions

E.g Noun + noun: lungs congestion, health condition, blood transfusion

Adj + noun: spinal cord, hepatic abscessOrdinal number + noun: first labour, first aidP1 + noun: whooping cough, dryheating sterilizationAdv + P2 + Noun: badly fed children, sexually transmitted diseases

e Medical terms are syntactic groups of noun with prepositions

E.g resistance against medicine

Confinement to bedVaccination against the smallpox

f Medical terms in abbreviation

E.g SARS, AIDS, DOA (dead on arrival),

FUO (fever of unknown origin)

2.4.2.2 Grammatical features of English for medical purpose

Grammatical items which are dominantly employed in medical English:

1 Tenses, mood and speech

1.1 Tenses

According to the time axis, tenses in English include past tense, present tense and futuretense Tenses show the time of the actions In the other words, tenses indicate that theactions happen with time

ESP in medicine, present simple, present perfect and progressive are commonly used to describe diseases, medical history and medical procedures To describe diseases such as,present simple is used like this “cholera is a serious bacterial disease spread through foodand water which has been infected by Vibrio cholerae” (Collin, 2004:71) To ask formedical history of a woman who is in the Family planning clinic, a sentence “How long hasthe coil been fitted?” is used And to describe medical procedures doctors often say topatients these sentences “Now the anaesthesia has worn off We’ll give you some strongpainkillers It’s normal to have a lot of pain at this stage.”

1.2 Mood

Mood is a set of contrasts which are often shown by the form of the verb and which expressthe speaker’s or writer’s attitude to what is said or written Three moods have often beendistinguished: indicative, imperative, subjunctive moods

Indicative mood is the form of the verb used in declarative sentences or questions In

medical English, declarative sentences or questions are commonly used in conversationsbetween doctors and patients as follow

Doctor: How long have you got sore- throat?

Patient: For two days My throat has swollen and it hurts when I swallow

Doctor: Have you taken any medicine?

Patient: Not yet, I just gargle with some mouth rinse

Imperative mood is the form of the verb in imperative sentences which are mainly used in

giving medical orders or instructions such as a doctor asks a nurse to take her patient to thelab to do some tests or she/ he instructs her/his patient when performing a physicalexamination For instance, imperative sentences “Put your tongue out and say Ah ah!”, to apatient or “ Take her /his temperature, please!”, to a nurse

Subjunctive mood is the form of the verb often used to express uncertainty, wishes, desires,etc In contrast to the indicative mood, the subjunctive usually refers to non- factual or

hypothetical situations In English, little use of the subjunctive forms remains Therefore, inmedical English subjunctive sentences are hardly used due to its nature.

1.3 Voice

According to Richards and Platts (1992: 402), voice is the way in which a languageexpresses the relationship between a verb and the noun phrases which are associated with it.Two sentences can differ in voice and yet have the same basic meaning; active voice andpassive voice However, there may be a change in emphasis and one type of sentence may

be more appropriate Passive voice appears the most predominant grammatical item found

in medical English It can be seen in treatment; patient- care procedures, prevention, diseasedescription or diagnosis

2.4.2.3 Syntax

Syntactically, English includes basic noun phrase and complex noun phrase, simplesentences and complex sentences, superordinate clause and subordinate clause and mainclause which consists of clause of time, clause of condition and clause of cause and effectand so forth Basic noun phrase and complex noun phrase are discussed in 2.3.2.1

Simple sentence which covers all seven structures is employed in English for medicalpurpose: (I) SVO; (II) S V C; (III) SVA; (IV) SVOO; (V) S V O C; (VI) S V O A; (VII)SV

- Shock is a life- threatening condition

- Tuberculosis is preventable and curable

3 S V A

Cancer can appear anywhere in the body (41)

Herniated disks are most common in the lower spine (lumbar)

The patient is wheeled into the operating room (English for nurses)

4 S + V + O + O

- Can you prescribe something for me?

- I’ll give you some herbal medicine ((25) English for medical personnel)

- You’ll have to give them a blood sample, and bring the results immediately back to

me (231)

5 S + V + O + C (positions)

I’m going to take a small sample of blood from your middle finger (138)

- He is taking the patient to the E.N.T ward (24).English for nurses

Kinds of complex sentence are commonly used in English for medical purpose:

According to Cob build (1990) conditional clause is used to talk about a possible situationand its consequences Sentences containing conditional clauses are called conditional

sentences and usually begin with if or unless These clauses are often used to give

instructions or warning in medical English If you have fever, unexplained weight loss,night sweats and a persistent cough, see your doctor immediately If you have a parent orsibling with type 1diabetes, your chance of developing the disease increases

Reason clauses are used to indicate the reason for something These main conjunctions used

in reason clause are as, because, in case, just in case or since…….are often used to give

explanations on causes of diseases such as lack of insulin results in diabetes because insulin

plays an important role in making glucose – the body’ s fuel available to cells

Time clauses are used to say when something happens by referring to a period of time or to

another event Such adverbs of time as when, while, after, before, until… are often used to

describe symptoms or nursing, treating procedures or development of diseases Forexample, one or two days after the fever begins, painful sores develop in the mouth (Pagina,2000) When fluid ceases to flow, remove both the needle and the syringe together(Dougherty and Lister, 2006) You may need to lower your insulin dose before an unusualphysical activity (Epstein and Perkin, 2003)

CHAPTER THREE: METHODOLOGY

This chapter consists of six sections Section 1 provides the rationale for using experimentalmethod and describes the research method Section 2 presents the variables in details.Section 3 makes the description of the participants in the experiment Section 4 introducesthe program of authentic materials in which some descriptions of authentic materials andextensive reading program with the materials are presented Section 5 introduces the datacollection instrument; reading proficiency test and attitude questionnaire Section 6 refers tothe students and teacher’ role

3.1 Research method

3.1.1 Rationale for using experimental method

As started in 1.3, this study is an attempt to investigate the cause- and - effect relationshipbetween supplementary authentic materials and the student’s reading proficiency, it can

therefore, be best assisted by an experimental research method This choice can be justified

by the fact that this method offers the luxury that others can not According to Nunan(1990), experiments are often carried out to explore the strength of the relationship betweenvariables Also, Salkind pointed out that causal relationship between variables areestablished

It is by virtue of the experimental method itself, which allows for the control of potentialsources of differences (or variance), that the following can be said: One factor is related toanother in such a way that changes in that factor are causally related to another So, it is notjust a relationship where two variables share something in common (as is the case with a co-relational relationship); it’s much more They share something, but one directly affects theother (Salkind, 2006: 217)

To put it in another way, an experimental method, when done correctly, can provide atremendous amount of power and control over the understanding of the causal relationshipbetween variables

Another consideration taken by the researcher is in opting out the experimental design that

is most appropriate for the study Selinger and Shohamy (1989) and Salkind (2006)identified three designs within the scope of experimental method which are true-experiment,quasi-experimental and pre-experimental designs They are different from one another interms of the degree to which they impose control over the variables being studied and thedegree of randomness that enters into the design (Salkind, 2006: 218)

Considering those differences in combination with the present conditions in which the study

would be carried out, we decide to choose the quasi-experimental design In detail, the

choice of the design was determined by the following factors

In the first place, the researcher has no control over who would be in each group becausethe students who would take part in the study have already been assigned prior to the study(Salkind, 2006: 234) In this study, two groups of second- year students were assigned to the researcher as well as a teacher by a person who is in charge of arranging the teachingschedule for the teaching staff Furthermore, the quasi-experimental design is more likely tohave external validity because “it is conducted under conditions closer to those normallyfound in educational contexts” (Selinger & Shohamy, 1989: 149) Considering the twogroups selected in the study, they were not removed from the normal teaching and learningcontext This intactness helps to increase the validity of the later generalization of theresults to the population Furthermore, since this design is less intrusive and disruptive thanthe true-experimental design, it is easier to gain access to the subject population and thuseasier to conduct such research (Selinger & Schohamy, 1989: 149) As a result, it saved theresearcher a lot of time and effort in grouping the participants, which was impossible underthe present conditions In short, the quasi-experimental design is the most practical andfeasible for the researcher, all above factors are under consideration

3.1.2 Research methods

In the researcher’ attempt to conduct valid research, some measures were taken Twogroups of student were chosen as a control group and an experimental one And to minimizethe limitations; the differences of knowledge background and the levels of English, twogroups selected have similarities such as they are both students trained to be general doctorsand they are in groups whose English scores of the first year are not very different Thecontrol group did medical English course with the textbook only while the experimentalgroup did the course with the textbook and authentic materials as a supplement Thedifferences in score between the pretest and posttest were taken into consideration whencomparing the reading proficiency in the two groups Apart from the quasi- experimentaldesign that acts as the major method, class journals and unofficial interviews with students,medical specialists were made use to collect their opinions on the valuation of the currenttextbook as well as their feedback on the used authentic materials

3.2 Variables

As mentioned earlier in 3.1, the quasi- experimental research design was used in this study

as a mean to establish the cause- and effect relationship between authentic materials and thestudents’ reading proficiency Therefore, a detailed discussion of those variables isnecessary The treatment and the outcome were measured respectively by the authenticmaterials use (time spent on dealing with authentic materials and the quality of authenticmaterials) and the students’ reading proficiency) To put it technically, the study was

designed to examine the relationship between the independent variable (authentic materials) and the dependent variable (the second year students’ reading proficiency and the students’

positive attitude to authentic materials)

With regard to the experimental treatment, authentic materials realized by authenticmaterials program were measured by the time for dealing with authentic materials and thequality of materials read by the students However, our choice of the latter at the expense ofthe former was determined by the following consideration

It cannot be denied that material selection is one of the decisive factors in any languagesyllabus, thus the researcher took a great care on the authentic material selection Theadvantages and disadvantages of textbooks and authentic materials are presented in 2.1 and2.3.2 It is noted that these are the advantages and disadvantages of their own and if anydecision of which type of materials should be used has to be made, it is compulsory to takelearners into consideration That is why learners and the relationship between learners’conceptual and linguistic competence are discussed here

To discuss for whom and which materials, authentic texts or simplified texts, should beused Kennedy and Bolitho (1984) wrote that the decision of which approach to adoptdepends on the relationship between the conceptual and the linguistic competence of thelearner, and also on the role of the English program in relation to the subject program of thelearner

They are then further elaborated on the relationship between concepts and language If bothconcepts and language are at a low level, i.e if the learner is a freshman in science andlanguage learning, then there may be a justification for using simplified materials

If the conceptual knowledge of the learner is higher than his linguistic level, then usingsimplified materials may cause offence to the learner because if the language is simplified,the subject content is usually simplified as a result In this case, the two authors, Kennedy

and Bolitho (1984) strongly suggested the use of authentic materials appropriate to theconceptual level of the learner.

However, as suggested by Kennedy and Bolitho (1984), as much support as possible shouldthen be provided for the linguistic content by offering explanations in the learner’s firstlanguage, by using diagrams and by devising carefully graded exercises

It can be inferred that in the case of most of second year students at HMU, their conceptsand language are at a low level It is because they have not studied their specialist subject intheir second year while their English level is supposed to be pre-intermediate Therefore,authentic materials must be carefully sorted out and given some adaptations

From the above discussions, some criteria for the authentic materials could be proposed asfollows

 First, the topics must be among the range of topics students have learnt in thecourse-book to assure that they do not have to cope with both specialist knowledgecomprehension and language acquisition at the same time

 Second, the linguistic level of the authentic materials must be a little challenging,but achievable so that the students have to make effort in order to complete thetasks The appropriate linguistic level was assured by the researcher and hercolleagues when choosing the authentic materials based on their teaching experienceand their awareness of the students’ level of English

 Third, the text types of the authentic materials need to be the genres that the studentswill have to deal with in their future employment The information about theappropriate text types was found through unofficial interviews to the medicalspecialists

 Fourth, the tasks accompanying these materials to be authentic, that is, the activitiesthe students will have to do in their future work

In this study, the values of this independent variable were defined from the students’ classjournals and their post reading activities which include summary, role play, history cases,diagnosis report or close exercises All these post class values were then summed up toyield the final one for later analysis

In reference to reading proficiency, there were not many choices of variable as authenticmaterials since the reading proficiency test score has been widely assumed to be valid.What mattered, if there was, would be the construction of the proficiency test used Toensure the reliability and validity of measurement of reading proficiency, a test that isconsidered to be standard for doing this job was designed and administered (see 3.5.1 fordetailed description of the test)

3.3 Participants

The sample included two groups of second- year Vietnamese students who are trained to begeneral doctors and study English as a foreign language at HMU They were selected firstly

on the basis of cluster sampling

This method of sampling had some advantages given the conditions under which the studywas carried out On the one hand, since students were enrolled from a wide residential andfamily background and homogeneously grouped, the relatively high degree ofrepresentatives was ensured This contributed to the increased validity of the latergeneralization to the whole population On the other hand, since students were already pre-assigned to groups prior to the study, the removal of any individual from one group toanother was impossible Therefore, cluster sampling proved to be convenient, inexpensiveand time- saving (Salkind, 2006: 92-93)

As a result of cluster sampling, the two sample groups were, however, not the same in size,which numbered 32 and 29 respectively The participants were relatively homogeneous inage which was ranged from 18 to 20 and all of them did English course of general science

in medicine Nevertheless, their starting point of learning English at HMU was medicalEnglish so we have no chance to balance their general English therefore, some extragrammar and vocabulary home work given as a remedy measure Moreover, those medicalEnglish courses are often provided before the participants study their specialist subjectpresents both advantages and disadvantages Almost the participants appear curious and areeager to explore their specialist knowledge in English The new and interesting explorations

do enhance their motivation in learning English yet unfamiliar topics create somedifficulties in their language learning In sum, these students’ features were representative

of the second-year students who were studying English as foreign language at HMU whomade up the targeted population of the study

3.4 Reading materials

3.4.1 Non - authentic materials

As mentioned in 3.2, the non- authentic materials employed in this experiment were the

reading texts taken from the textbook, units taken from Let’s Examine the Text by David

Werner (1977) were chosen for the study A sample for reference is provided inAppendix… Basically, each unit has a reading text accompanied by the same kinds ofexercises and it organized as follows:

The pre- reading stage starts with some words as clues for students to predict the content ofthe text, or some pre- reading questions to generate interest and give students a reason forexploring the topic

In the while- reading stage, the exercises are designed to give students chances to practicenew words in the context of the reading or to identify word types and to recognize referencewords The part of this stage is a series of comprehension questions which ask for specificinformation from the reading to help students review the main points of the reading Some

of the questions require students to make inferences based on the information presented inthe reading

Since all of the texts in the textbook do not have post- reading activities, in all the textchosen for this experiment, post- reading activities are designed to remedy the weakness ofthe textbook The detailed description of the extra reading materials is presented in 3.4.2

3.4.2 Authentic materials

As mentioned in 3.2, authentic materials were the reading texts collected from differentsources; medical journals, American doctors’ handbooks and the internet by the researcherwith the help of medical specialists at HMU and Vietduc hospital

However, there are two types of language that medical materials written in are thelanguages for the professional and non-professional The materials for specialists are likelymuch more difficult to understand due to not only professional language but alsocomplicated content Accordingly, it is so hard for teacher of English and the students whohave not had much medical knowledge to digest That is the reason why authentic materialsfor the non-professional were chosen for the program

The criteria for selecting the authentic materials are mentioned in 3.2 In this part, theresearcher would like to summarize them as follows:

 The topics must be among the range of topics students have learnt in the book to assure that they do not have to cope with both specialist knowledgecomprehension and language acquisition at the same time

course- The linguistic level of the authentic materials must be a little challenging, butachievable so that the students have to make effort in order to complete the tasks.The appropriate linguistic level is assured by the researcher and her colleagues whenchoosing the authentic materials based on their teaching experience and theirawareness of the students’ level of English

 The text types of the authentic materials need to be the genres that the students willhave to deal with in their future employment The information about the appropriatetext types was found through unofficial interviews to the medical specialists

 The tasks accompanying these materials to be authentic, that is, to be the activitiesthe students will have to do in their future work

All the chosen reading materials based on the students’ language proficiency and themedical specialists’ recommendation weekly provided for students as “at home” reading Comprehensive reading exercises are also included in each reading text that help students toget information, contact, predict new medical terms then remember them after the lesson After students reading thoroughly and writing summary of these readings, post- readingactivities are organized to get them involve as well as for teacher to check how well theyread at home Post- class journals were collected to get students’ feedback for materialsadjustments

3.4.3 Applying authentic materials in extensive reading program

As Nuttall suggested (1982) “the best way to improve your knowledge of a foreignlanguage is to go and live among its speakers The next best way is to read extensively init” And in fact, authentic materials has traditionally been defined as that written for nativespeakers, that is, ordinary everyday materials not provided specially for language teachingpurpose Therefore, authentic materials are a useful, appealing resource for people who readextensively to explore and expose themselves to the target language