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Clinical Sessions inEnglish in a Spanishsetting
Jonathan McFarland
Medical English Coach
Saturday 13th September 2014
1)Background and Introduction
(including my personal background and the local context)
2)Why Clinical Sessions
i) Hypothesis
ii) The needs of Spanish doctors
iii)History
iv)Composition
3)Results and Feedback
4)Future Projects
INDEX
An epiphany (from
the Ancient Greek
ἐπιφάνεια, epiphaneia,
"manifestation, striking
appearance") is an
experience of sudden and
striking realization.
1) PERSONAL
BACKGROUND
Why Medical English?
English
teaching
Work background
Family Medical
background
Grandfather -
Professor of
Orthopaedics
Grandmother-
Paediatrician
Father -
General
Surgeon
Grandmother
Non Medical Grandfather
Eye surgeon
Mother
Non
Medical
Uncle
Veterinary
surgeon
Uncle
Physician
Cousin
ObstetricianCousin
GP
The Balearic Islands(Population: 1,111,000)
Where do I work ?
Mallorca
Menorca
Ibiza-Formentera
Balearic Public Health System3 health areas
Staff: 14,30010,676 health professionals
7 hospitals56 primary care centres
HUSE
HSLL
HUSE - Son Espases University HospitalHSLL - Son Llatzer University Hospital
Son Espases University Hospital
∗ A referral hospital for theBalearic Islands
∗ Inaugurated in 2010 ( formerlySon Dureta UniversityHospital)
∗ Around 1,000 beds, 26 operating theatres, with all thespecialities (including cardiac, paediatric and neurosurgery) covering a population ofaround 350,000 inhabitants
Son Llatzer University Hospital
∗ Opened in 2001
∗ Around 400 beds, withthe majority ofspecialities
∗ Pioneer in Europe in theuse hospital Informatization systems
“We have entered the era ofmedical English,whichresembles the era of medical Latin in that,onceagain,medical doctors havechosen a single languagefor internationalcommunication”
The Importance ofEnglish in Medicine
“The Language of Medicine” – Henrik R.Wulff, 2004
The Importance ofEnglish in Medicine
The representation of German-,French-,and English-language journals in the Index Medicus and Medline, 1879–2007, ( Baethge C , 2008 )
CAN YOU SPOT
SPANISH DOCTOR ?
The “EnglishBarrier” in Spain
∗ “The level of English of Spanish doctors is still
well below the European average.”
∗ “All is a question of motivation and the
appropriate strategy. This could be summarisedby two ideas: incorporating the practice of
English into daily activities and studying Englishas though it were a living language.”
BACKGROUND AND INTRODUCTION The “English Barrier” in Spain
“English for doctors” Gonzalo Casino, 2006 (translated from Spanish)
The needs of Spanishdoctors
∗ English is the language
of:
2) Why Clinical Sessions? Hypothesis
∗Educational analysis:-
∗The great desire/need of Doctorsto learn English
∗The busy timetable of Doctors
i)Hypothesis
i)Hypothesis
∗The three E´s
Engage – busy clinicians with English
Embed – the learning experience into a clinical setting
∗Encourage –Doctors to break
the English barrier
∗Facilitating – The Right Conditions for the learning, motivateand “incorporating the practice of English into daily work
activities ”
Lev Vygotsky, Soviet Belorusianpsychologist.
-Social Learning theory
-ZPD ( Zone of Proximal Development )
i)Hypothesis
- posits that people learn from oneanother, via observation, imitation, andmodelling.
– Bandura, 1977
Social Learning Theory
i) Hypothesis
∗ Educational Technology–
∗ Critical from the start
∗ 2004/2005 – Gmail
∗ 2007- Google docsGoogle Drive
∗ 2013 - Whatsapp
COMMUNITY COMMUNITY
OF PRACTICEOF PRACTICE
∗ A strong realization that English is the lingua franca
for Biomedicine
∗ But……
∗ Historical “fear” of English
∗ Shyness of public speaking
∗ Older Doctors learnt French
∗ Specific difficulties, eg. Word order, false Friends,
verb tenses, phrasal verbs, pronunciation etc
ii) Needs of Spanish Doctors
Specialist training – Residencyprogramme
∗ The Spanish residencytraining is normally 4 years ( 5 years in Oncology)
∗ English is stressed in allthe programmes
∗ In Oncology – it is NOW a requirement
∗ A “sign of the times”
iii) HistoryThe path towards Clinical Sesssions
2002- Son Llatzer Hospital (HSLL)-Medical English
2005- Son Dureta Hospital ( now Son Espases Hospital
–HUSE)- Medical English
2008- HUSE – Clinical sesssions – ENT & Paediatrics
2010 – HSLL – Clinical Sessions – Surgery and Oncology
2012 – HSLL and Aintree Hospital ( Liverpool) 2
International Video Conferenced Clinical Sessions
∗ Sep 2014 -Clinical sessions now taking
place in the following departments :-
∗ HUSE
Current situation
Dermatology Haematology Immunology
InfectiousDiseases
LaboratoryMedicine
Maxillofacialsurgery
Microbiology Nephrology Neurosurgery
Paediatrics Pulmonology Oncology
Orthopaedics Psychiatry Radiology
ResearchInstitute
Urology
∗ In HSLL – Oncology and Pulmonology
Strong collaboration with Bibliosalut
(Virtual Health Sciences Library of the
Balearic Islands)
Current situation
Important to state that –
Individual initative
long struggle
Support of Doctors and Heads of Departments
But NOT necessarily support of Management
Still working as “Freelancer”
NO established official position
∗ TOPIC PRESENTATIONS
∗ INFOBIOGRAPHIES
∗ REVIEW OF MEDICAL TERMS and PRONUNCIATION
∗ BIBLIOGRAPHIC REVIEWS
∗ WRITING WORKSHOPS
∗ DUTY HANDOVER
∗ ROLEPLAYS
∗ DEBATES
∗ EXTERNAL SPEAKERS
∗ CLINICAL CASES
iv) Kinds of sessions
Many sessions are dedicated to
presentations of specific topics,
such as in this example on
“Diffuse Glioma Growth”
presented by a 3rd year
Resident in Neurosurgery
TOPIC PRESENTATIONS
For example one given by the
Head of the Microbiology Dept
on -
“Egon Schiele and the Spanish
Flu epidemic on 1918”
INFOBIOGRAPHIES
A review of the names and
pronunciation of antibiotics
was recently given in the
Infectious Diseases unit of Son
Espases, in June 2014
REVIEW OF MEDICAL TERMS
BIBLIOGRAPHIC REVIEWS
This is regularly performed
in the Pulmonology Dept.
and this is also a regular
feature of the sessions in
the Dermatology
department amongst others
Doctors/ researchers read out their articles, abstracts to their colleagues, and we discuss them and criticise them where appropriate
(both content and language)
WRITING WORKSHOPS
This is a session that takes place on
a monthly basis in the following
departments:-
Neurosurgery
Nephrology, Oncology
Haematology, Urology
DUTY HANDOVER
Useful activity, and is used in
many departments, for
example in the Paediatric
department, where we role-
play the Doctor – patient
interview between the Doctor –
the mother and the child
ROLEPLAYS
In the last months I have had
successful debates in the Laboratory
medicine department, Microbiology
dept. and others.
Topics –
“The future of clinical microbiology”
“Challenges of Clinical analysis”
DEBATES
I have been lucky enough to have had the chance to collaborate with different services.
One of the most important collaborations is with Bibliosalut, and their team have given presentations in English to some of the Depts.
EXTERNAL SPEAKERS
This kind of clinical session has
been taking place within the
Infectious Diseases dept. since
2010 .
In the next slides I will show
three short videos that
demonstrate the format.
CLINICAL CASES
Clinical Sessions in
Infectious Diseases
Service, HUSE – May
2014
This video shows the
resident explaining the
clinical case
Case studies
https://www.youtube.com/watch?v=eUpoa4_mKAY
This video shows the
consultants and head of
department discussing
and debating the case
with the residents
Case studies
https://www.youtube.com/watch?v=3I4pp90NX3I&feature=youtu.be
This video shows my role in
the sessions-
Comment on the language
used, correct mistakes in
pronunciation, lexical use,
grammar etc.
Case studies
https://www.youtube.com/watch?v=4MwleKZx6u0&feature=youtu.be
∗ The results of the “Clinical Sessions in English” project are per se subjective.
∗ However, in January 2014 I sent a small group of physicians a short set of questions and the following where the answers:
∗ 1) How are original an idea do you think it is to have clinical sessions in English in a Spanish Hospital?
∗ “To my Knowledge there are none or few hospitals doing clinical sessions in English, thus I guess it is original and very important”
∗ ( Chest Physician)
Results and feedback
∗ 2) What are the pros & cons of this idea?
∗ ”The pros are that the residents and young staff have a continuous stimulus to improve their English skills, which have a direct impact on their communications abilities with patients and foreign colleagues.” (ENT Consultant)
∗ “The pros are evident, we will learn more English and more acquainted with medical English.” ( Chest Physician)
∗ “Mainly, there is the need, almost an obligation forprofessional survival, to be able to speak/understandEnglish that is already the lingua franca in medicine. I think that nowadays, at least in the Spanish publichospitals, we have already a good level of readingcomprehension of all English medical journals.
∗ However, things change in relation with writing papersin English, and even in an informal correspondencewith colleagues abroad. Unfortunately, the oral communication level is poor or very bad.”
∗ (Immunologist )
∗ “ I can’t find any cons to this project” ( Nephrologist)
∗ “English is the universal language for science nowadays. Especially because we are in a "Spanish hospital" it is much easier to be in our comfortable language zone and turn our back on English language, everybody speaks Spanish …. But then one day we will find that we need an important English level to read or to write a paper, to understand seminars, prepare a poster or to give a talk at an international congress.”
∗ ( Microbiologist)
∗ 3) How successful do you think the project has been so
far ?
∗ So far the success is evident. The expansion of
the clinical sessions in English is a reflection of it. (ENT)
∗ Very successful. I´d start from one at month and I´d
increase progressively. ( Chest Physician)
3) Future projects
∗ i) Objective analysis of results ( possibly in the form of a comprehensive questionnaire)
∗ ii) “The clinical sessions in English along with the new technologies, allow the institutions to hold International Clinical Sessions. I think this should be the next step” ( ENT surgeon)
∗ iii) In the pipeline –HUSE ( Paediatric Dept.) Alder Hey Hospital ( In Liverpool)
Future projects
∗ iv) Continued and
further collaboration
with Bibliosalut
v) medicalenglishblog.com
∗ vi) Dr Exchange Project – In the pipeline ( along with International
Video conference sessions)
∗ - HUSE Alder Hey Hospital
∗ Ninewells Hospital
∗ vii) The Networked Doctor – A Social Media project with Annalisa
Manca from University Of Dundee – ( Oct 2014)
∗ viii)
ix) Men's App – The medical App to take care of your health
∗ A collaboration with 2 urologists
∗ A new app for men's health!
“This App fills a very important gap that existed in Medical Apps -Men's Health - and I think it does it so well that it will in time become a classic”. Read QR code or search for
“Men’s App” in theApp Store / Play Store
x)College of Doctors- Balearic Islands
∗ In 2012 – start of Medical English courses for theCOMIB
∗ With “Clinical Sessions”dynamic
∗ Interesting – NON hospital specialists in thecourses (GPs etc)
"He brought medical students into the wards for bedside teaching.“
Emphasis –student learning from observing and participating
Sir William Osler, the Father of Modern Medicine
∗My aim has been to use the same
∗Approach
Thanks for your kind attention
∗ Thanks to my wife, Polimnia and my two daughters,
Aina and Bianca.
∗ And to all the doctors, researchers, nurses and
health professionals who have helped me “tune” my
ideas.
Acknowledgements
∗ Linkedin - http://es.linkedin.com/pub/jonathan-
mcfarland/4/593/b40/
∗ Twitter – JonMcF@Medicalenglishb
∗ This presentation is dedicated to the memory of John Bryan McFarland(1930-2013) a constant source of inspiration for my work.
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