Applying content based instruction to motivate the reading interest to students at vinh medical university

MINISTRY OF EDUCATION AND TRAINING VINH UNIVERSITY NGUYEN THI HAI LAM APPLYING CONTENT-BASED INSTRUCTION TO MOTIVATE THE READING INTEREST TO STUDENTS AT VINH MEDICAL UNIVERSITY UNG DU

MINISTRY OF EDUCATION AND TRAINING

VINH UNIVERSITY

NGUYEN THI HAI LAM

APPLYING CONTENT-BASED INSTRUCTION TO

MOTIVATE THE READING INTEREST TO STUDENTS

AT VINH MEDICAL UNIVERSITY

UNG DUNG DUONG HUONG DAY TIENG ANH HƯỚNG VÀO NỘI DUNG

NHAM KÍCH THÍCH HỨNG THÚ HỌC ĐỌC CHO SINH VIÊN TẠI TRƯỜNG ĐẠI HỌC Y KHOA VINH

Master Thesis in Education

Vinh, 2013

MINISTRY OF EDUCATION AND TRAINING

VINH UNIVERSITY

NGUYEN THI HAI LAM

APPLYING CONTENT-BASED INSTRUCTION TO MOTIVATE THE READING INTEREST TO STUDENTS

AT VINH MEDICAL UNIVERSITY

UNG DUNG DUONG HUONG DAY TIENG ANH HUGNG VAO NOI DUNG

NHAM KÍCH THÍCH HỨNG THÚ HỌC ĐỌC CHO SINH VIÊN TẠI TRƯỜNG ĐẠI HỌC Y KHOA VINH

Field: Theory and Methodology of English Language Teaching

Code: 601410

Master thesis in Education

Supervisor: Ngo Dinh Phuong, Associate Prof Dr

STATEMENT OF AUTHORSHIP

I, Nguyen Thi Hai Lam, hereby would like to acknowledge that this study is mine I confirm that this work is submitted in partial fulfillment for the degree of master program in Vinh University and has not been submitted elsewhere in any other form for the fulfillment of any other degree or qualification

Author:

Nguyen Thi Hai Lam

ACKNOWLED GEMENTS First of all I would hike to express my sincere gratitude to my supervisor

Associate Prof Dr Ngo Dinh Phuong, for his excellent guidance, comments and enthusiastic encouragement during the completion of the thesis

Secondly, I would ike to thank my colleagues and my student doctors from classes Y2A and Y2B - Vinh Medical Unwersity for their help in doing the investigation and

trying the new way of learning reading tasks

My sincere thanks also go to my classmates for their encouragement and insightful

comments in completing the thesis

I wish to thank Sister Mat for her very useful advice in developing the thesis

Finally, I wish to give my special thanks to my beloved family for their warm support and encouragement during the time I conducted this thesis

ABSTRACT

In learning English as Foreign Language (EFL) at university level, among the four language skills, reading is always considered to be the most dominant and necessary one Some of the previous studies showed the effectiveness between the use of Content-Based Instruction (CBI) and reading comprehension CBI has been found effectively in developing students’ reading comprehension through the subjects chosen However, CBI has been under disputation because teachers lack specific linguistic knowledge and skills to help students deliver a language focus on reading Despite the fact that the utilization of CBI is a debatable issue, this study is aimed at attempting to investigate the effect of application with CBI on EFL students’ reading comprehension through the design and implementation of a content-based medical curriculum Subjects in this study were 173 student doctors from two classes Y2 A (the experimental group) and Y2B (control group) in VMU owning the same level of English proficiency as well as clinical experiences P value approach, T-test, classroom observations techniques were used to examine students’ learning attitudes and effect of CBI on reading performance Research results indicate that the application of content-based instruction into the medical class could enhance students’ reading comprehension as well as critical thinking ability Classroom observation results further support the experimental findings, providing more objective information about the students’ learning attitude under context of CBI use Based on the research results of this study, pedagogical implications and suggestions for future study are discussed

TABLE OF CONTENTS Contents

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CHAPTER2 LITERATURE REYVILIEWV e-5-s<e<ceeeseerseeerserseee 6 2.1 Teaching and learning foreign lang11age s55 xc>xscerxexxerxerrrrxe 6 2.2 Communicative language teaching

2.3 Integration of four skills

2.4 Content-based Instruction

2.4.1 Definition and characteristics of Content-Based Instruction 2.4.2 Models oŸ Content-based Instruction -52-55c+ 55s cccccscsrse 13 2.4.3 Content-Based Language Teaching 5: 5c c2 tre 15 2.4.4 Principles for Content-Based Instrucf1ion - 5-55 + sxszszcszcx+ 16 2.4.5 Content Based Syllabs cence ee eeseeeeeeeseeenseeeeeeeeeseneeeeneeeeenes 19 2.4.6 Other Researches on Content-Based Language Instruction and Reading 0u: 00: 22

2.5 Teaching ( on 23

VN i0 23 2.5.2 The Process of Reading - 6 22t St xé HH He 24

2.5.3 Bottom-up and top-down approaches to reading oo eect eee 25

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3.2 Research setting 29

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4.1.2 Classroom obserVation TeSUÏI 55+ +2 ‡teExtrkkrkertirrrsrrrrkerree 57 4.2 Pilot teaching - - +52 St ST x1 TH 1 11g 60 4.2.1 Designing 060) 5 60

4.2.2 Sample of CBI Lesson Plan -¿ ¿5+5 ++EEYEEktEkiEkerkirkrrrkrrkrrree 64 4.2.3 Sample of CBI Lesson in comparison with the six principles for CBI 75

4.3 DiSCUSSION 20 76

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5.2 Pedagogical mplications for language teaching . - 525cc sx+z+sxsz+2 80 b6" 82 5.4 Suggestions for further research - + 5+ SE tr xe 82

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LISTS OF TABLES AND FIGURES

Percentage of English learning preferences

The most difficult language skill when learning English

The most frequently used language skill in doctors' career

The students’ interest level in reading class time

Pretest Result of Experimental Group Y2A

Pretest result of control group Y2B

Posttest result of experimental group Y2A

Posttest result of control group Y2B

Differences of testing results between two tests - Y2A

Differences of testing results between two tests - Y2B

Classroom Observation Report - Experimental group vs Control group

The trial plan to be used for experimental group Y2A

The trial plan to be used for control group Y2B

English learning preferences

Pretest result (Experimental group Y2A)

Pretest result (Control group Y2B)

Posttest result of experimental group Y2A

Posttest result of control group Y2B

Comparison of levels of Students’ marks between pre-test and posttest Control group Y2A

Comparison of levels of Students’ marks between pre-test and posttest Control group Y2B

Experimental group Students’ results of test analyzed by Microsoft Excel Control group Students’ results of test analyzed by Microsoft Excel Classroom Observation Report in Comparison with Y2A and Y2B

Alternative Hypothesis

It means that Vinh Medical University

CHAPTER 1 INTRODUCTION

1.1 Rationale

It cannot be denied in the modern era the importance of English since it is the most common language spoken everywhere in the world English has been used as medium of communication between the people of different cultures and of travel and tourism That is genuinely true in Vietnam in the context of national industrialization and modernization along with the policies of international integration English has been playing a major role in various fields of life such as, economy, e-commerce, medicine, engineering, science and technology, and so forth English is also used in the field of education by universities and done scientific researches in institutes English has been teaching as a foreign language

in our school for years The four skills: listening, speaking, reading, writing are extremely focused on enabling students to communicate as we understand that just a single unified language skill cannot make the competence to use a language in a communicative way but the integration of the four skills Among those, however, the reading skill is used the most frequently in career by doctors in our school As a matter of fact, all the medical documents are mostly in English The doctors need to read much to do their job and do their scientific researches The reading skill therefore becomes the most dominant one The student doctors, who are staff doctors in the future, are well aware of the necessity of reading skill for their future job Meanwhile, in the reading class time, the students show less motivation to follow a long text with the current teaching methodology which has done in the following way: a handout of text is given to students; some new vocabularies are presented then Teacher lets students read the text and then do the translation together The lesson still finished but only with the exercises done Lesson by lesson, students inactively do what teachers asked them but the lesson is not in a good mood Sometimes, teachers heard the sigh students made when the text is too long with lots of difficult medical words Students find it difficult to memorize the

information and therefore they get many obstacles to recall it The learning results, consequently, does not satisfy the learners and teachers as well

Taking this fact into consideration, the author shows her endeavor to shed a light on finding any kind of learning strategy that can lead her to make her students responsible for their own knowledge and motivated to keep learning in spite of all the obstacles they would find in their way Motivation is the key to do any activity

It is important to find a motivation or anything that makes us keep doing something with the same enthusiasm as we started until finishing it The author decides to change the current-used teaching methodology by content-based instruction Content-based learning is a methodology to learn a foreign language by studying a specific subject in that language One day, author brings to class another thing to teach Teacher is more than a language teacher She acts as a teacher of public health care worker The author decides to teach what students knew in their language by contextualizing the long text with many medical jargons When teacher shows a picture of a dehydrated baby, students are immediately involved the language lesson by asking questions and giving answer about the dehydration, the knowledge of the text they already knew when they learned their school subjects Hence, the students make greater connections with the language

Keeping students motivated and interested are two important factors underlying content-based instruction The author catches this idea and makes it into a research namely “Applying content-based instruction to motivate the reading interest to students at Vinh Medical University” to see how students become interested in reading lesson with CBI to make progress and to see whether CBI can be applied more frequently in motivating reading skill for students in Vinh Medical University

1.2 Aims of the study and Research questions

The thesis was conducted with the aim of finding out an effective way to motivate the reading interest to student doctors at Vinh Medical University

Three research questions were posed as follows:

1.2.1 Can the application of content-based instruction motivate students’ reading interest so that they can make better progress in medical reading tests?

1.2.2 Is there a significant difference between the reading learning progresses of the experimental class and the control one?

1.2.3 What are students’ attitudes toward CBI?

These three research questions were formulated as three research hypotheses: 1.2.1 Students would be more motivated and interested in learning reading skill under the application of CBI approach so that they can score higher marks in medical reading tests

1.2.2 Students who took part in learning reading class with CBI approach would make better reading progress than those who did not participate

in such a reading teaching method

1.2.3 Students show positive attitudes toward the teaching strategies with CBI application which can facilitate students’ medical reading comprehension

1.3 Research methodology

The main research method employed in this thesis was a quasi-experiment which included the three basic components of an experiment: the sample (subjects are divided into two groups: experimental group and control group), the treatment (learning reading with application of CBI), and the measurement of the treatment (pretest and posttest) Additionally, the two tests were collected and analyzed in two ways: descriptive statistics and inferential statistics using p-value approach to achieve a better understanding of the presented issue, i.e., a paired- sample t-test was employed to determine if there is a significant difference between the pre- and post-test In order to explore the information regarding subjects’ attitude towards the conditions of CBI application, a classroom observation was employed in the study The researcher designed a classroom

checklist and invited other teachers of English from her faculty to join the classes for a full observation to evaluate students’ learning attitude in the reading class 1.4 Scope of the study

Due to time constraint, the study was conducted on students who are doctors in the future at VMU where two classes Y2A and Y2B were chosen at random to be the subject samples Student doctors of these two classes have just finished the General English course Therefore their English proficiency level is pre-intermediate They attend the clinical practice classes at school and at hospital At the moment, they are following a medical English course whose main language-used skill is reading skill which is dominantly used for their further study and scientific researches in the future CBI was applied in teaching and learning reading as an effective way to motivate the interest of reading skill to make higher progress in learning reading

1.5 Significance of the study

The study is significant for the following reasons:

Firstly, the study helps the author suggest an effective way to motivate the interest of reading so that students of the experimental group can make better progress with higher scores

Secondly, the study is endeavored to shed lights on developing reading skill for student doctors at VMU

Thirdly, the study also helps increase the effectiveness of teaching reading under the application of CBI

Finally, the study will be the initial suggestion for future studies on the similar issues not only student doctors but student nurses and other specialist students at VMU 1.6 Organization

The study consists of the following parts:

Chapter one consists of the rationale, aims, method, scope, significance, limitation, organization as well as the research questions of the study

Chapter two covers all the literature review relevant to the study containing: teaching and learning foreign language, communicative language teaching, integrations of the four skills and teaching reading

Chapter three presents a sample of reading syllabus designed basing on the principles of CBI as well as interactive reading techniques After that, the author took an investigation of applying the syllabus into school curriculum The chapter is

a detailed description of the study methodology which includes the need analysis, the setting, sampling procedure, data collection and data analysis

Chapter four deals with the findings and discussions of the study

Chapter five ends with the conclusion, limitations and some suggestions for further studies on the same matter

CHAPTER2 LITERATURE REVIEW

This chapter reviews theories related to theories of teaching and learning foreign language, also presenting that of content-based instruction under the communicative language teaching: the definition, the main characteristics, the models and the CBI syllabus It is also given to the thesis some background perception of reading teaching, the process of reading as well as models of reading All of these serve as a basis for measuring the effectiveness of CBI application to improving the learners’ reading proficiency which is carried out and presented in the next chapter

2.1 Teaching and learning foreign language

According to Brown, teaching cannot be fully defined beyond the regime

of learning By having notion of the way the learners learn can the teacher specify his philosophy of education, his style of teaching, as well as his approach, methods, and techniques used in classroom Importance of a judicious definition

of teaching may uncover the governing principles for selecting certain methods and techniques of teaching Teaching is guiding and facilitating learning, enabling the learner to learn, setting the conditions for learning Learning is the retention of information and skill, the retention implies storage systems, memory, and cognitive organization, learning involves active, conscious focus on and acting upon events outside and inside the organism Learning is relatively permanent but subject to forgetting Teaching and learning share a close-knit relation in which one can be understood by referring the other

There have been many definitions over the concepts of teaching and learning However, those definitions fall short in covering aspects of such complicated concepts Brown has delivered more appropriate definitions of learning and teaching According to Brown, learning is:

e “Acquisitions or getting

e Retention of information and skill

e Retention implies storage systems, memory, and cognitive organization

e Learning involves active, conscious focus on and acting upon events outside and inside the organism

e Is relatively permanent but subject to forgetting

e Involves some forms of practice, perhaps reinforced practice

e Isachange in behavior”

Brown views teaching in accordance with learning: teaching is guiding and facilitating learning, enabling the learner to learn, setting the conditions for learning Teaching cannot be fully defined beyond the regime of learning By having notion of the way the learners learn can the teacher specify his philosophy of education, his style of teaching, as well as his approach, methods, and techniques used in classroom Importance of a judicious definition of teaching may uncover the governing principles for selecting certain methods and techniques of teaching Teaching and learning share a close-knit relation in which one can be understood by referring the other

2.2 Communicative language teaching

Until late 1960s, language was seen as a system of rules and the task that language learners had to fulfill was to internalize these rules by whatever means were

at their disposal The learner’s emphasis was to “master the structures of the language, and in this process, considerations of meaning were seen almost as peripheral.” (Nunan, 1999) However, the 1970s saw a much richer conceptualization of language begin to emerge Language was viewed as a system for the expression of meaning, and linguists began to analyze language as a system for the expression of meanings, rather than as a system of abstract syntactic rules This view of language has laid foundation for Communicative Language Teaching, which has been an influential approach for over two decades now CLT is generally seen as the teaching that encourages learners to engage in meaningful communication in the target language -

communication that has a function over and above that of language learning itself hThis innovative approach derives from multidisciplinary perspectives such as linguistics, psychology, educational research, but its central concept is communicative competence, which was originally introduced in the early 1970s by the sociolinguist Hymes as a_ response to the perceived limitations in Chomsky’s competence/performance model of language (Savignon et al, 2002; Nunan 1999) It was further developed in the early 1980s by Canale and Swain, who hold that communicative competence refers to “the underlying systems of knowledge and skills required for communication.” (1983) Their model can be summarized as follows:

- Grammatical competence: using a structured comprehensible utterance (including grammar, vocabulary, pronunciation and spelling)

- Socio-cultural competence: using socially-determined cultural codes in meaningful ways, normally called “appropriacy”

- Discourse competence: shaping language and communicating purposefully in different genres, using cohesion and coherence

- Strategic competence: enhancing the effectiveness of communication, and compensating for breakdowns in communication

This is a very useful socio-linguistic model telling us what natural communication involves Although this model does not show how to teach in a class-room setting, it can serve as guidelines for language instruction It should be noted that CLT is a broad approach to teaching rather than a teaching method with a clearly defined set of classroom practices “There is no single methodology or fixed set of techniques in CLT.” (Savignon et al, 2002) As such, it is usually defined as a list of general principles of features, one of which is Nunan’s (1991) most recognized five features of CLT:

1 An emphasis on learning to communicate through interaction in the target language

2 The introduction of authentic texts into the learning situation

3 The provision of opportunities for learners to focus, not only on language but also on the learning process itself

4 An enhancement of the learner’s own experiences as important contributing elements to classroom learning

5 An attempt to link classroom language learning with language activities outside classroom

Owning to these five features CLT is documented as learner-generated It places importance on both the students’ needs and desires and the relation between language in class and in real life Both content-based and task-based programs see more successful realization of communicative principles In addition, Nunan believed that learner was to “master the structures of the language, and in this process, considerations of meaning were seen almost as peripheral” CLT has been

“generalized umbrella terms to describe learning sequences” with an aim to enhance student’s ability to communicative CLT sets purposes of making communicative competence the goal of language teaching and developing procedures for the teaching of the four language skills that knowledge the interdependence of language and communication In CLT learners are stimulated to involve themselves in meaningful communication using the target language It is advisable that students have a purpose for communicating, and focus on the content rather than language form, and use a variety of language rather than a language structure Added to this, activities in CLT appear to direct students to real or realistic communication In such communication, the success in achieving communicative tasks is acknowledged to be more significant than the accurate use of the language CLT has, in fact, been acknowledged to leave “an indelible mark on teaching and learning” Its results are realized in the utilization of communicative activities in classrooms all over the world

2.3 Integration of four skills

The ability to use a language in a communicative way, however, is not just a single unified skill Most recent thinking has divided language ability into four

separate skill areas; listening, reading, speaking, and writing Listening and reading are known as the receptive skills; while speaking and writing are known as the productive skills Most teachers try to incorporate all four skill areas into their planning, though some classes may focus more on one set of skills or the other, due

to the course and learner objectives (Oxford, 2001)

Thus, a reading lesson has now been taught in a correlation with speaking, listening and writing skills Brown demonstrated that a lesson of reading might include:

e “a pre-reading discussion of the topic to activate schemata

e Listening to a lecturer or a series of informative statements about the topic of

a passage to be read

e a focus on a certain reading strategy, say, scanning

e Writing a paraphrase of a section of the reading passage”

Content-based instruction is defined as one of the models to help teacher maintain an integrated-skills focus in his teaching The model distracts the learners from the isolation of the skills of language, and focuses them on the meaningful purposes of using language

This method focuses on communication, “the language that is being taught could be used to present subject matter, and the students would learn the language as a by-product of learning about real world - content” (Widdowson, 1978: 16)

While students acquire a real knowledge about the world through the different subjects they learn they are also developing the four skills, speaking, reading, writing and listening Students also learn using real material where the language is not reduced to the basic unit or to sentence level The information is presented in the same way as in their mother tongue Most of the books students use

to learn these subjects are designed for native speakers and this factor helps students

to learn more and not only a specific vocabulary and grammar structure

This method motivates students because they receive relevant information in another language and this constitutes a goal in itself, students learn two things at the same time and they do not question the importance of learning them

Not all the subjects are suitable to be used for content-based instruction purposes they depend on the students’ needs and interests

2.4.1.2 Characteristics

In CBI, the curriculum-organizing principle is subject matter, not language The content-based class is a language class where every effort is made to ensure that subject matter is comprehensible to students What this means is that pedagogical modifications in CBI courses take into account the language competence of the students, their needs and interests, and subject- area knowledge These modifications ensure a supportive and language-rich classroom environment, and they are necessary for effective simultaneous teaching of language and subject matter In the content-based class, students are tested on content, not language; thus the focus is always on meaning, not form Knowing that they will be tested on content, students will not be tempted to review their grammar and memorize long lists of vocabulary words, but rather will listen closely to lectures, participate in

discussions, do topic-related readings, and acquire a great deal of language in the process (Krashen 1991)

In CBI, instructors make every attempt possible shelter input so that it will

be comprehensible to students Native speakers of the L2 are generally excluded from the classroom, which ensures that instructors will speak at a language level comprehensible to the non-native speaker When addressing non-native speakers, instructors make speech adjustments, which often include simplification, well formedness, greater formal explicitness, and added redundancy Instructors also make use of facial expressions, gestures, and body language to help make input more comprehensible They rely extensively on graphic organizers such as tables, maps, flow charts, realia, timelines, and Venn diagrams to help students place information in a comprehensible context Last but not least, they sometimes provide students with readings in their native language for background knowledge Such a sheltered environment is conducive to a lowering of the affective filter (Krashen 1985a, 1985b)

The term of content-based instruction refers to an approach to integrate content and language learning (Brinton, Snow & Wesche, 1989) CBI is supported

by the second language acquisition research One central principle which supports the theory of second language acquisition is that “people learn a second language more successfully when they use the language as a means of acquiring information, rather than as an end in itself’ (Richards & Rogers, 2005) According to Met (1991), natural language acquisition occurs in context, which is never learned divorced from meaning, and CBI provides a context for meaningful communication

to occur To further understand the essential characteristics and instructional

implications of CBI, three models of CBI, including the theme-based model, the sheltered model, and the adjunct model, as well as its effect on reading enhancement are discussed below

2.4.2 Models of Content-based Instruction

2.4.2.1 Theme-based Model

Theme-based language course is structured around themes or topics such as

“pollution” or “women’s rights, “immigration” or “business”, etc Language analysis and practice evolve out of the topics that form the framework for the course A topic might be introduced through a reading, vocabulary developed through guided discussion, audio or video material on the same topic used for listening comprehension, followed by written assignments integrating information from several different sources

Major principles underlying theme-based model contain automaticity, meaningful learning, intrinsic motivation, and communicative competence (Brown, 2001) Its primary purpose is to help students develop second language competence within specific topic areas The topics chosen can be several unrelated topics or one major topic Language instructors are responsible for language and content instruction (Brinton et al., 1989) The theme-based model is mainly employed in adult schools, language institutions, and all other language programs It is suitable for low to advanced learners

2.4.2.2 Sheltered Model

The content of the courses is taught by area specialist to a group of ESL learners who have been grouped together for this purpose Since the ESL are not in

a class with native speakers, the instructors will be required to present the content in

a way which is comprehensible to second language learners and in the process use language and tasks at an appropriate level of difficulty Instructor will choose texts

of a suitable difficulty level for the learners’ language capacities

In other words, Sheltered instruction is an approach to use second language acquisition strategies while teaching content area instruction In the sheltered model, an academic subject matter is taught by content teachers in content areas, such as science, mathematics, history, medicine or literature via using

language and context to make the information comprehensible Characteristics of sheltered instruction include comprehensible inputs, warm and _ affective environments, high levels of student interaction, student-centered, hands-on tasks, and comprehensive planning (Echevarria & Graves, 2003) In the sheltered model, content courses are taught in the second language by a content area specialist to a group of ESL learners having been grouped together (Richards & Rogers, 2005) or

a language teacher with content-area knowledge (Gaffield-Vile, 1996)

2.4.2.3 Adjunct Model

Students are enrolled in two linked courses, one a content course and one a language course, with both courses sharing the same content base and complementing each other in terms of mutually coordinated assignments Such a program requires a large amount of coordination to ensure that the two curricula are interlocking and this may require modifications to both courses

Adjunct model constitutes a more sophisticated pattern for the integration of language and content It aims at connecting a specially designed language course with a regular academic course In the adjunct model, students enroll in two linked courses simultaneously - a content course and a language course The content instructor focuses on academic concepts while the language instructor emphasizes language skills using the content-area subject as a background for contextualizing the language learning process (Brinton et al., 1989) The rationale of this model is that the linked courses can assist students developing academic coping strategies and cognitive skills which can be transferred to other disciplines The adjunct model

is suitable for high intermediate to advanced levels (Brinton et al., 1989)

In summary, these three models of CBI share a number of common features First, authentic tasks and materials are used in the three models Second, they all share the principle that helps students deal with the content materials They also differ in several ways, including the course aim and learning objectives, instructor’s roles, students’ proficiency levels, and evaluation approaches

2.4.3 Content-Based Language Teaching

CBI allows for creating environments where learners can be effectively involved in using the target language for various communicative and meaningful purposes CBI is defined as - the integration of language teaching aims with subject matter instructional (Snow, 2001) Grabe and Stoller (1997) indicate that combining the development of language with content knowledge enhances the learning process They argue that content-based language instruction is supported by research done within the framework of educational and cognitive psychology and point to Anderson‘s research (1990, 1993) on learning and processing which emphasizes the importance of coherent and meaningful information for better learning and recall Similarly, Singer (1990) emphasizes that when learners are exposed to thematically organized materials they learn and remember better the information presented In CBI, materials are naturally presented around certain topics focusing on coherent and meaningful information as well as relevant language learning activities in a context CBI continually provides opportunities for learners to use their knowledge of content area and target language in increasingly complex tasks Integration of language and content provides a meaningful context for learners to foster their academic and cognitive development as well as the skills and proficiency in the target language

The development of CBI is derived from immersion programs in Canada to teach French as a second language to English speaking children in schools We observe three types of immersion programs: early immersion where the first three or four grades of schooling are done completely in the second language; delayed immersion where the fourth and fifth grades receive instruction in the second language, and late immersion where students in the seventh and eighth grades receive all instruction in the second language The programs are also categorized as total immersion or partial immersion depending on the amount of instruction done

in the second language (Genesee, 1985) In total immersion, all the instruction is conducted in the second language; while partial immersion means 30-70% of

instruction in the target language The immersion model has been adapted in the United States to enrich the school programs in terms of educational, cultural and linguistic levels, to establish a racial balance and to achieve bilingualism in minority populations Many programs at secondary school and university levels have been designed to address the needs of learners with limited English proficiency (Cantoni

- Harvey, 1987; Crandall, 1987, Crandall & Kaufman, 1998; Met, 1998; Snow & Brinton, 1988; Snow & Kambhi-Stein, 1997, Wegrzecka-Kowalewski, 1997) Models of content-based programs are distinguished from each other by the setting,

by the instructional level and by the degree of emphasis on language and content (Snow, 2001) Some of these models offer the majority of the education through the foreign language while the amount of time the foreign language is used for instruction might be much less in other models of content-based language teaching They are also different from each other in terms of the degree of emphasis on language and content since some are more content-driven and others are more language-driven Another variable is the setting; that is, whether the target language

is used naturally in the environment or it is taught as a foreign language in educational institutions

2.4.4 Principles for Content-Based Instruction

2.4.4.1 Base instructional decisions on content rather than language criteria Two issues that language course planners or materials designers face at the outset of the planning phase are selection (i.e., which items to include) and sequencing (.e., how to order these items) In the days of the grammar translation approach, it was thought that certain language items (e.g., simple present tense) were more easily acquired than others Thus, the decision was made to include these easier items in the beginner course and to sequence them at the beginning Content-based instruction takes a rather radical departure from this approach since it allows the choice of content to dictate or influence the selection and sequencing of language items

2.4.4.2 Integrate skills

Content-based instruction is defined as one of the models to help teacher maintain an integrated-skills focus in his teaching The model distracts the learners from the isolation of the skills of language, and focuses them on the meaningful purposes of using language

Rather than isolate skills in skill specific classes (e.g., "English Grammar",

"Writing", "Listening and Speaking"), CBI practitioners use an integrated skills approach to language teaching, covering all four language skills as well as grammar and vocabulary This reflects what happens in the real world, where interactions involve multiple skills simultaneously Also, unlike other approaches that dictate a specific skill sequence within each lesson (1.e., starting with listening, then reading, then writing, etc.), there is no set sequence of skills to be taught in CBI Instead, a lesson may begin with any skill or, alternatively, with a focus on grammar or vocabulary As we have seen in principle one, it is the content itself that influences the decisions about selection and sequencing

2.4.4.3 Involve students actively in all phases of the learning process

Because it falls under the more general rubric of communicative language teaching (CLT), the CBI classroom is learner rather than teacher centered (Littlewood, 1981) In such classrooms, students learn through doing and are actively engaged in the learning process: they do not depend on the teacher to direct all learning or to be the source of all information Central to CBI is the belief that learning occurs not only through exposure to the teacher's input, but also through peer input and interactions Accordingly, students assume active, social roles in the classroom that involve interactive learning, negotiation, information gathering, and the co-construction of meaning (Lee and VanPatten, 1995) Richards and Rodgers (1985) and Nunan (1989) characterize some possible roles played by students in the communicatively oriented classroom as follows: recipient/listener, planner, interactor and negotiator, tutor of other learners; and evaluator/monitor of his/her own progress All these roles are ones assumed by learners in the CBI classroom In

keeping with the multiple roles assumed by learners, the CBI teacher also assumes multiple roles She may serve as the primary resource for students, particularly where issues of language or culture are concerned But she also serves as the organizer of tasks, the controller or facilitator of student-centered activities, the prompter of student responses, and the assessor (both formal and informal) of student efforts

2.4.4.4 Choose content for its relevance to students’ lives, interests, and/or academic goals

The choice of content in CBI courses ultimately depends on the student and the instructional setting In many school contexts, content-based language instruction closely parallels school subjects Thus, in a middle school context, topics may be drawn from social science, history, and/or life science areas that students are studying in their subject matter classes Similarly, in the college or university setting, students may enroll in linked or adjunct language and content classes, with dual instructors covering the same content from a different perspective and with differing instructional objectives In other settings, topics may be drawn from students' occupational needs or be determined by general interest inventories In fact, this principle is often criticized as a potential weakness of CBI since determining what is of relevance or interest to students is notoriously difficult for both teachers and materials or curriculum developers However, because the introduction to content in CBI stretches over an extended period of instructional time, teachers have various opportunities to engage students' interest and to capitalize on students' prior knowledge about a given topic This mandates for the teacher to sell the students on the content that has been selected is an important basis of CBI teacher training

2.4.4.5 Select authentic texts and tasks

A key component of CBI is authenticity both of the texts used in the class- room and the tasks that learners are asked to perform To better understand this principle, we need to examine the meaning of authenticity Hutchinson and Waters

define authentic texts as those that are "not originally constructed for language teaching purposes" (1987) Thus, an extract from a content area textbook, a cartoon, the lyrics to a popular song, or a short story would all qualify as authentic texts However, as Hutchinson and Waters note, bringing an authentic text into the classroom alters its original purpose, which was not to teach language, but rather to inform (in the case of the textbook), entertain (in the case of the cartoon), or perhaps both (in the case of the song or die short story) In other words, the use of an authentic text in a language classroom implies that it has been removed from its original context and that its purpose in the language classroom is quite a different one indeed

2.4.4.6 Draw overt attention to language feature

The purpose of CBI is to expose learners to authentic input with the goal of their being able to use language for communicative purposes Texts form the primary input provided by the teacher (through the classroom language) and peers (in pair or group work) All of these provide comprehensible input However, CBI departs from some other approaches to language teaching in its belief that comprehensible input alone will not lead to successful language acquisition (Brinton and Holten, 2001) Instead, it makes use of awareness-raising tasks to draw attention to specific language features found in the authentic texts

2.4.5 Content Based Syllabus

Does content and language teaching at the same time be a problem? Does it make learning slow? (Lambert & Tucker, 1972) Generally it is said adults cannot acquire language as well as the young, but the research (California State Board of Education 1984, Genesee, Polich & Stanley, 1977) shows that adults can benefit more from immersion or content based instruction if immersion is preceded by a period of formal instruction in the language (Lupkin & Cummins 1984 - Swain 1984) (Cigdem Yukcu, Turkey)

Content Based Syllabus

e is intended to design a type of instruction in which crucial goal is to teach specific information and content using the language that learners are also learning

e learning occurs concurrently with the content learning

e isnot really a language teaching syllabus at all

e primary purpose is to teach content using the language

e language teaching is organized around the content teaching

e subject matter is primary and language happens concurrently

e The learning theory associated with content based instruction is an acquisition theory that accounts for learning without explicit instruction

e Teaching techniques are adjusted so that students can comprehend content; after comprehension, language acquisition occurs (Krashen

Examples of Content Based Syllabus

e Extensive reading of literature

e Social studies, science, medicine

e Inchemistry class linguistic adjustments are made to make the chemistry more understandable

Content should be chosen both according to students’ needs and teachers’ comfort Students:

e read authentic materials

e debate, make group projects, learn cooperatively

e integrate writing skills

e should have critical thinking skills through real life problem solving situations

Teachers

e can find it tiring and time consuming to prepare materials

e can be discouraged by limited content knowledge

Positive characteristics of Content Based Syllabus

e It allows students to learn subject matter and language simultaneously

e Language is learned in the context of its use

e Students learn exactly what they need to learn

e Content material makes students be interested in and motivated

e Content based syllabus can meet students’ needs linguistically and culturally with appropriate curriculum and teachers’ pedagogical training Negative characteristics of Content based Syllabus

Testing can be difficult

Adults may require some analytic and formal instruction (Because, while young learners use clues and try to gain access to the information, Adults do not frequently let themselves learn new information)

Easily applicable in primary and secondary schools

Content based instructions can be beneficial for adults in one language and content learning settings: refugees, immigrants, etc Vocational schools

Content based instruction does not guarantee successful communication ability especially productive ones (Mohan 1979)

Both Task Based Syllabus and Content Based Syllabus are process oriented syllabuses

e Meaning and comprehension is emphasized in both

e Students are waited to perceive language subconsciously while concentrating on task and content consciously

e Yet, as compared with Task Based Syllabus that is concerned with communicative and cognitive process, Content Based Syllabus deals with information

e While in Task Based Syllabus, learner should achieve goal by using the language; in Content Based

e Syllabus, acquisition of language form is subordinated to the acquisition of knowledge

2.4.6 Other Researches on Content-Based Language Instruction and Reading Comprehension

In recent years, increased attention has been given to the teaching of reading in foreign language acquisition Over the years, numerous approaches to teach reading and to examine the effectiveness of these approaches have appeared According to previous studies, relative effectiveness is found between the use of content-based language instruction (CBI) and reading development (Crawford, 2001, Kasper, 1994a; Kasper, 1994b; Kasper, 1995b; Kasper, 1997a; Kasper, 1997b) Many studies reveal that CBI results in not only content learning (Andrade & Makaafi, 2001; Daryl, 2006; Kasper, 1994a; Winter, 2004), but also improving students’ language acquisition (Daryl, 2006; Diaz et al., 2002: Kasper, 1994a; Kasper, 1997a), as well as students’ reading comprehension through the topics chosen (Kasper, 1994a; Kasper, 1995a; Kasper, 1995/96, Kasper, 1997a) and the systematic use of content-based instructional strategies (Kasper, 1995b) Just like the other teaching approaches, the perspective toward the effect of CBI is also various The doubt that teachers may lack specific linguistic knowledge and skills to help students deliver a language focus on reading is the main concern (Creese, 2005)

Research in reading has shown that schema plays an important role in helping the reader to comprehend a text

Reading is also defined basing on the matter of interaction between the thought and the language, between the reader and the text, between the eyes and the brain as Carrell, Devine & Eskey denote that there exits an important interaction between language and thought in reading Carrell, P.L.; Devine, J & Eskey, D E (editors) (1988) This is due to the fact that the writer represents the linguistic surface and the reader has to decode the meaning behind Likewise, reading is considered as a sort of conversation between the reader and the text Bamett, M A (1989) et Carrell, P L & Eisterhold, J C (1983) Harmer claims that reading is a mission carried out by the eyes and brain, in which the eyes receive messages and the brain interpret them Harmer, J (1983) Whatever definitions about reading are, they help to reveal the characteristics and nature of reading

2.5.2 The Process of Reading

Up to now, attempts to describe the interaction between reader and text have been numerous and different views of the reading process have been proposed These views are often grouped under three different reading models named the bottom-up, the top-down and the interactive ones According to Pham Phuong Luyén, Hoang Xuan Hoa (1999) in reality, we always have specific purposes when reading any texts, and the ways of reading varies accordingly to different reading purposes In addition, the writer usually produces texts that contain subliminal messages and the reader has to interpret them using their own strategies They, thus, have a variety of ways to decode the text so that they can discover the message behind the words Harmer, J (2001) Schema, i.e background knowledge, is of prime importance in which shared knowledge between the writer and the reader help to the comprehension of the text The writer uses his own background and linguistic knowledge to establish the message, meanwhile the reader uses them to decode and grasp the intended meaning from the text This is, in short, an active cognitive system that operates on printed material for understanding the text Chastain, K (1988) Similarly, Macleish indicates that it is the

reader who gets the sounds from the printed page and reading process has two correlated directions The writer encodes from the sounds to orthography and the reader decodes from orthography to sounds and a similar process from sound to meaning MacLeish, A (1968)

2.5.3 Bottom-up and top-down approaches to reading

2.5.3.1 Bottom-up

According to Paran and Alderson the bottom-up process of reading is described as a serial model in which the reader orderly manipulate such activities: starting with printed word, recognizing graphics stimuli, decoding them to sound, recognizing words, and decoding meanings Alderson, J.C (2000), Paran, A (1997)

In other words, the reader has to manage with each letter when he encounters There should be a matching between these letters, or graphemes with the phonemes of the language and reader are supposed to know this Words are forming basing on the coordination of these phonemes and only by translating from one form of symbolic representation to another can the meaning be exhibited Tran Ba Tién (2002) Hence, bottom-up model is a “data-driven operations” which have many calls on

“sophisticated knowledge of the language itself’ Brown, H.D (2001) In fact, by developing a “piece-by-piece mental translation” of the text information, the reader can undergo a mechanical pattern Grabe, W and Stoller, L F (2002) In this process, reader is supposed to notice the letters, then the words and grasp the meaning conveyed by the writer by create a link from those they have noticed In a word, reading process is fundamentally a matter of “decoding a series of reading symbols into their aural equivalents” Tran Ba Tién (2002) The following is an manifestation that illustrate for the working of bottom-up model (by Cambourne, cited in Nunan, D (1991)

Notwithstanding, this model reveals its shortcomings in accounting that reader has to undergo lower level decoding process before he can reach to the higher level process Thus, meaning is not paid much emphasis in this process

Nunan, D (1991) Additionally, there is a contrast to this process in recent research into human memory and speech processing Nunan, D (1991)

2.5.3.2 Top-down

Top-down model is described as conceptually driven It accounts for the fact that reader uses their own intelligence and experience to comprehending a text In contrast to bottom-up model, reader should utilize his background knowledge if he has a wish to understand the text The starting point may involve a set of hypotheses

or predictions or even expectation about the text meaning, and then there should be tasks for reader to sample information as well as to discover if his predictions and expectations should be confirmed or dismissed Hence, according to Tran Ba Tién reading is no longer a process of decoding form, but a process of reconstructing meaning and only when other means defeated, does the reader adduce to decoding process Tran Ba Tién (2002) Alderson believed that the focus of top-down approach is the crucial role of schemata, and the reader’s contribution to the incoming text The following is the illustration of top-down model (by Cambourne, cited in Nunan, D (1991)

Nonetheless, there are several limitations of top-down model Eskey 1988, figures out that thanks for the context clues, the reader can predict the meaning and link them to their own background knowledge (cited in Razi, S (2004) Notwithstanding, not all the readers can do this apart from those are skillful and fluent at reading Besides, Nunan added that this approach limit the lower level processes to the higher level ones Nunan, D (1991) Stanovic claims that in top- down model reading process undergoes many generation of hypotheses about up- coming text elements and that it is decoding process that requires less time than undergoing generation of hypotheses (1980, cited in Tran Ba Tién (2002) Therefore, Nunan assumes that at the early stage of reading, a phonics approach [bottom-up model] is seemingly “the most effective and efficient way to teach reading” Nunan, D (1999) Added to this, he confirms that each reader owns his

typical reading strategies and reading teacher had better varying the techniques to suit different tastes

Christine Nuttall exemplifies for the differences between bottom-up and top- down models Nuttall, C (1996) Bottom-up process is compared as a scientist investigates all the minute and tiny details of phenomenon with a microscope in hand Meanwhile, a top-down process is imaged with eagle’s eyes that observe the landscape below Similarly, Harmer denotes that difference Harmer, J (2001) According to him, the top-down is illustrated as wholly looking such as looking at a forest or looking down on something from above, while the bottom-up model as examining the individual trees in a forest

3.2 Research setting

The research was conducted from the first of January to the end of March

2013 at Vinh Medical University English is taught as a subject of foreign language

in the school curriculum The core for this course is Let’s exam the text edited by English sub-faculty, approved by specialists in medical area and has been used in Hanoi Medical University for years Student doctors at Vinh Medical University are following the course book under the traditional teaching method That is the reason why students find less motivation in the reading class time Students need something interesting to motivate their reading class, something should be new and strange to attract students to go to the class

Also, author implemented her research in such a place where reading skill is very necessary in the career of the staff doctors This fact added to the demand for developing reading skill to student doctors who will become staff doctors in the future 3.3 Sampling and population

The subjects in this study were 88 student doctors from class Y2A to be chosen as the experimental group and 85 from class Y2B treated as the control one from Vinh Medical University in Nghe An province located in the middle of Vietnam

These students have just finished their General English course and have been following clinical practice course in the hospital in Vietnamese Their English proficiency level in the research is pre-intermediate and clinical understanding in mother tongue is the same one as intermediate They are all following medical course in English as a required course

3.4 Data collection

3.4.1 Data collection instrumentation

Pre-&post-test and class observations would help the researcher collect the main data for the study Besides, small survey questionnaires with student doctors

and staff doctors were conducted so as to obtain more information in identifying the need for developing reading skill at VMU Last but not least, the course book namely “Let’s examine the text”, a medical course book is being taught in Vinh Medical College edited and pressed by Hanoi Medical College in 2000, plays so important role in implementing the trial experiment with CBI approach in improving the reading proficiency level It is edited by English sub-faculty, approved by specialists in medical area which has been used in Hanoi Medical University for years There are 30 units in this book Half of the book has just been taught at the first semester with not very high scoring of the student doctors

3.4.1.1 Pre- and post-test

Each test has 20 items designing into four types of exercise: choosing the best answer, True or False statements, give brief description of signs or symptoms

of some diseases (or answer the comprehension questions) and fill in the missing words (or word formation: prefix, suffix and stem) The pre-reading test was conducted during the first week of the course to figure out the subjects’ reading proficiency level before instruction After 8-week training, a post-reading test with the same types of test items was employed to investigate the learning outcomes In consideration of a standardized language proficiency test with high validity and reliability (Perkin et al., 1989; Read, 2000), the reading test items were adopted from the exercise part at the end of each unit

In order to evaluate the two research questions: (1) Can the application of content-based instruction motivate students’ reading interest so that they can make better progress in medical reading tests? (2) Is there a significant difference between the reading learning progresses of the experimental class and the control one? Another research instrumentation - quantitative approach was applied A paired- sample f-test was used to compare the difference between pre- and post-tests of the reading comprehension after the use of CBI The 05 level of confidence was used as the criterion level to determine the significant difference The p-value approach was

also used to reject the Null Hypothesis and accept the alternate hypothesis, then identify the claim and decide whether the test is left-tailed, right-tailed or two-tailed 3.4.1.2 Class observations

The effectiveness of the application with CBI into school curriculum has been proved with the results of pre- and post-test

In order to investigate the students’ learning attitude in the CBI reading class, author would like to carry several classroom observations She designed a classroom checklist and invited six teachers from English department to join her language classes to do the observations A pre-meeting among teachers and author was done with the aim of informing the purpose of the classroom observation which was stated that author is carrying out her graduation thesis in master program She endeavored to shed light on trying a new method of teaching and learning under the context of CBI with the hope of motivating the interest of reading to student doctors The trial had been done and showed the successful result However, author would like to learn more about the learning attitude of the students in the language class under CBI application Each teacher of English had been given classroom checklists and been asked to observe on at least three occasions, and the observer(s) should remain in the classroom for the full class period

Description of classroom observation checklist

Classroom observation checklist has been designed with many kinds of purpose, for instance: observe the classroom to find out the instructor’s performance, or to discover whether other factors inside a classroom (like color of walls, luminance of the lights, so on) affect to the learning result or not, and so forth Here in this thesis, author designed a classroom observation checklist to observe the learning attitude in the CBI and non-CBI language classes, after that, the comparison between those two classes should be carried out

The classroom observation has been done under the hypothesis that leaners in CBI context are more motivated to learn and score higher learning goals than those in the non-CBI context