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Vol 32 No 2, April - June 1994
Page 18

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Planning an English Course for Students of Health Care
by Deborah Mason

One of the aims of specialized language courses is often to prepare students for professional communication with other specialists worldwide. Successful communication involves more than simply being able to talk about a certain subject, and various language needs should be considered when planning any ESP course.

This article discusses the process of planning an ESP course for university students of Health Care. The students are studying one of three main subjects: Nursing Science, Health Care Administration, or Health Care Teacher Education. Although the article considers a particular situation and describes a course planned specifically for Finnish students, the planning process is applicable to many teaching situations around the world.

The target group

The first step in formulating a specialized course of any kind is to consider the nature of the target group. Almost all of the students of Health Care who attend ESP courses at Helsinki University Language Centre have worked as nurses or as other Health Care professionals before joining the course, so the age range is quite wide (students are between about 21 and 45 years old, with most in their late twenties or early thirties). They are nearly all women. The vast majority are Finnish-speaking, although there are occasional Swedish-speaking students. All of them have studied both languages, and some have also studied German or other languages. Depending largely on their age, they have studied English from three to ten years at school. The language level in each class ranges from lower intermediate to advanced, and the students motivation is variable, depending on their proficiency and self-confidence. Generally, though, their motivation is quite high.

Needs analysis

Every university in Finland has a language centre that provides students with specialized language courses. In addition to studying the other official language of the country (Finnish or Swedish), all Finnish university students must study at least one foreign language. The majority opt for English, since this is the most widely taught language in schools.

In 1987 a report entitled "Testing in Finnish University Language Centres" (Economou 1987) was produced at Jyv skyl University. This report included a general needs analysis for all the listening comprehension and oral skills courses offered by the language centres throughout Finland. This needs analysis suggested that most students had no immediate listening and speaking needs related to their courses.

The report states (1987:27):

The only target language needs they [students] have in the short term are in leisure contexts:- listening to music, television, or films- socialising with native-speaker visitors to Finland- travelling to other countries as a tourist

But as the report points out, the university (in this case the sponsor) prefers the language courses to be subject-specific rather than general. This being the case, long-term needs must be considered. The two long-term needs the report identifies are: (1) future needs in certain professions (e.g., dealing with clients who speak the target language), and (2) discussions with professionals from other countries at seminars or conferences. Since carrying out a detailed analysis of on-the-job language would be difficult to arrange, as most students do not know exactly what they will be doing when they graduate in about five years time, the report suggests that courses should be based on the professional conference or seminar model, and gives a context for this based on a Hallidayan model.

This needs analysis is clearly too general to give much guidance to the teacher of any particular university ESP course. In the case of Health Care students, many of them are working at the same time as studying, and they have specific on-the-job needs that can be taken into account. Confining the course to conference or seminar English to the exclusion of other domains of language use would not serve the needs of these students. Although it may be worthwhile to include some "conference English" in the course, there are other, more pressing, needs that should be considered.

Munby's Communicative Syllabus Design (1978) provides an exhaustive (and exhausting) model of the participant s needs, analysed in terms of the "Purposive Domain" (ESP classification), "Setting," "Interaction" expected of the participant, "Instrumentality" (medium, mode, and channel), "Dialect," "Target Level," "Communicative Event" (activities and subject matter), and "Communicative Key" (the manner in which communication needs to be carried out). Armed with this detailed list of needs, the teacher s task is to decide which language skills, micro-functions, attitudinal tones, and language forms to teach. Munby's application of "the operational instrument" to the case of a Venezuelan university student (Munby 1978:204 16) has some relevance to the needs of university students everywhere; and his taxonomies of social relationships and attitudinal tones are useful as a checklist for the teacher. However, it would be far too time-consuming to write down a profile of needs for each student in this way and unnecessary, too. When students are being taught in a group, the needs of the majority are paramount for much of the time, and common ground for discussion and group work must be found.

For all its detail and its influence on subsequent needs analyses, Munby's Communication Needs Processor (C.N.P.) has its limitations. It only produces an unordered list of linguistic features and, as Hutchinson and Waters (1987) point out, does not consider the target needs from different standpoints (of teacher, learner, and sponsor). It makes no distinction between necessities, lacks, and wants. Neither does it mention what the learner needs to do in order to learn (Hutchinson and Waters 1987:54).

Hutchinson and Waters provide a more manageable framework for analysing the target situation and also a parallel framework for analysing learning needs (1987:59-63). Both these frameworks make use of Kipling's "six honest serving-men Footnote 1 and so, although they are perhaps only superficially parallel, I am presenting them side-by-side (see Figure 1 ) to illustrate how I have used them to outline the listening comprehension and oral skills needs of my Health Care students, bearing in mind that there may be large variations in both perceived and actual needs between individuals in any one class.

The needs which are shown in italics in this outline are general rather than specific, but in my opinion they are of legitimate concern for most ESP courses. Any student who is going to use English in any context at all is bound to need a certain amount of general English to cope with social situations. The ESP teacher must be careful not to provide too narrow a focus when catering for specialized needs.

Course materials

Before the course starts, the English teacher should collect as much potential teaching material as possible. Even if s/he is not intending to use a specific textbook for the course, it is worth seeing what is on the market. There may be material available in the country in which the teacher works (e.g., Mason's English for Health Care: Teacher's Pack in Finland), and there are, of course, many internationally available course books in English (e.g., Glendinning and Holmstrom's English in Medicine ), although most of these are intended for doctors and nurses rather than other Health Care professionals.

If the teacher has the chance to travel to an English-speaking country in order to prepare for the course, s/he can contact various Health Care professionals by visiting hospitals and health centres. People are often willing to be interviewed about their jobs, and tapes of these interviews, when edited, can provide a good source of listening comprehension material.

Nursing journals and magazines are a good source of topics and can provide valuable background reading for both the teacher and the students. Some of these are sold on subscription only, but can often be found in libraries. Diagrams and charts are also useful teaching aids. It is a good if obvious! idea to get hold of a large diagram of the human body, so that students can learn the names of the parts of the body in English.

Student input

In planning the course, it should be remembered that a lot of the input for each class session can be provided by the students themselves. They can give mini-presentations on their work experience or on some aspect of their studies that they feel will interest their fellow students. With the right-sized class (not too large or too small), there is no reason why most of the course should not be organised around presentations. Chirnside (1986) describes a course for Nursing students at King Abdulaziz University, in which the focus of the course is on oral presentations, and the classes are organised on the principle of input (provided by teacher or students) --> questions --> feedback on errors --> reproduction (using diagrams and other visuals to stimulate oral production) --> expansion (research leading to a mini-presentation).


Whatever preparation the teacher has done before the course starts, the needs of any particular Health Care group cannot be outlined in great detail until the students arrive. The exact professional composition of the class (whether there are any physiotherapists/midwives/children s nurses in the group) and the amount of English they have studied are not known in advance.

In the first class the students can be asked to write down their expectations, needs, and wants to hand in to the teacher. They should be encouraged to voice their opinions on this matter at any time during the course. Needs are not static but constantly developing and changing, and this must be taken into consideration. If, for example, after a short exercise on pronunciation, certain students feel that they need to do more work on the pronunciation of medical terminology, this can be incorporated into the course; or the students having this need can be given material to work on by themselves or in a self-study lab. If they feel that they have particular difficulty understanding English speakers with unfamiliar accents, they can be provided with additional listening comprehension material and be given extra help in deciphering what they hear.

As McDonough (1984:38) points out, even with a group that is completely homogeneous in its learning goals, there will not necessarily be homogeneity of wants, demands, and attitudes to learning. Even when a course is tailored as far as possible to the students individual requirements, some compromises have to be made. These can, however, work to the students advantage. Students who may initially express interest only in topics that have a direct bearing on a particular area of study, like Nursing Science, may find that listening to a tape describing the administrative work of a Health Care manager provides them with useful information. The more Health Care students and indeed professionals in general know about the whole field of Health Care, the better able they will be to do their job. In my experience, Health Care students are generally interested in the wider aspects of their field and appreciate an introduction to a variety of topics. Most are also happy to improve their language skills by working with other people whose level of English may be different from theirs, but whose interest in communicating in English is the same.


  • Chirnside, A. 1986. Talking for specific purposes. In ESP for the university. E.L.T. Documents 123, British Council. Oxford: Pergamon Press.
  • Economou, D. 1987. Testing in Finnish university language centres. A report for the Language Centre for Finnish Universities, University of Jyvaskyla.
  • Glendinning, E. and B. Holmstr m. 1987. English in medicine. Cambridge: Cambridge University Press.
  • Hutchinson, T. and A. Waters. 1987. English for specific purposes: A learning-centred approach. Cambridge: Cambridge University Press.
  • Mason, D. 1991. English for health care: Teacher s pack. Language Centre Materials No. 90. Jyv skyl : University of Jyvaskyla.
  • McDonough, J. 1984. E.S.P. in perspective. London: Collins ELT.
  • Munby, J. 1978. Communicative syllabus design. Cambridge: Cambridge University Press.

Deborah Mason is an ESP teacher working at the Language Centre of Helsinki University. She has worked in Britain, the Netherlands, and Japan as well as in Finland.


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Vol 32 No 2, April - June 1994
Page 18

Figure 1



why is the language needed?
  • for study (to a limited extent)
  • for work (present and future)
  • for promotion possibly
  • for recreation
why are the learners taking the course?
  • it is compulsory for those who are not exempted by the pre-course test
  • it fills a perceived need
  • they hope to improve fluency
  • they have a positive attitude to ESP
how will the language be used?
  • medium: speaking, listening
  • channel: face-to-face, telephone
  • types of text/discourse: lectures, presentations,
    discussions, formal conversations with people in the same field,
    informal conversations in other contexts
how do the learners learn?
  • concept of teaching and learning: traditional or
    modern, depending on age and personality
  • communicative methodology (traditional grammar bores/ alienates)
what will the content be?
  • subject: Nursing Science, Health Care Administration, and Teacher Education, general/social
  • level: academic /professional
what resources are available?
  • one teacher, positive towards ESP with interest in the subject matter
  • materials provided jointly by teacher and students
  • aids: black/white board, O.H.P., slide projector, and video
who will the learner use the language with?
  • both native and nonnative speakers: experts, laymen, and students
  • relationships: student-teacher, peer (at work with visiting Health Care professionals, etc.), subordinates and superiors, English- speaking foreigners
who are the learners?
  • see target group information
where will the language be used?
  • physical setting: university, classroom, lecture theatre, Health Centre, laboratory, hospital, conference centre, cinema, hotel, travel contexts
  • human context: discussions, lectures, presentations,
    demonstrations, on the telephone, with foreign patients/doctors,
    socialising with foreigners, travel arrangements
  • linguistic context: Finland and/or abroad
where will the ESP course take place?
  • university classroom
when will the language be used?
  • concurrently in the ESP course for some, subsequently for others
  • seldom, in small amounts, for most
when will the course take place?
  • time of day: morning /afternoon, 3 hours a week either once a week or twice a week depending on timetable, for a term of 14 weeks

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Footnote 1

    1. This is a reference to Rudyard Kipling's verse in Just-So Stories:
       I keep six honest serving-men
       (They taught me all I knew):
       Their names are What and Why and When
       And How and Where and Who.

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Vol 32 No 2, April - June 1994
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