Ninth Conference on English StudiesCenter for Studia on Langwge and Culture - Atma Jayo Cotholic University of Indonesia

MISCONCEPTIONS ON COMPREHENSION OF ENCLISH MEDICAL TEXTS

Ira Rasikawatiiraras@ukida.ac. id; irarasjapan@gmai l.com

Univers itas Kristen KridaWacana

Abstract

A profound understanding of the students' reading comprehension process is crucial toelfectively address the most urgent problems in an academic readinginstruction. Thispaper reports partialfindings of a study on the medicine students'reading comprehensionproblems. The data gathered from the protocol analysis and observations revealed the

exlent of comprehension problems across the proJlciency levels. Most students however

demonstrated similar dffictlty in using prior knowledge to understand the texts.

Inadequate and inappropriately utilized prior knowledge interfered with lhe students'comprehension of tuts. Insights into the misconceptions identified were described. The

study suggests that a minimum proficiency level in L2 acquisition is necessary for lhestudents to function well in ihe academic contexl.

Keywords: EAP reading, comprehension problems, misconceptions, prior knowledge

INTRODUCTION

Proficiency in English for Academic Purposes (EAP) reading is significant for medicine students

to cope with the extensive use of English references and to keep abreast of the current

development in medical field. English for Academic Purposes instruction focusing on reading

skills is therefore paramount. This study aims at gaining insights into the medicine students'

reading comprehension problems to tailor appropriate instruction addressing the most urgent

needs in academic reading.The research participants were thirty medicine faculty students in one of private

universities in Jakarta. They were of different proficiency levels: beginner, intermediate, high.

The participantsread and retold two reading texts taken from the Human Physiolory textbook

with the tities of "The (Jps and Downs of Hypertension and Exercise"and "Strokes: A Deadly

Domino Efect." The research question raised was what are the comprehension problems that

medical students have when they read academic medical texts in English?

The comprehension problems wereidentified by investigating the students' interaction

with the texts through the data derived from retell protocol, interview, and observation.Two stages

of coding were applied. The first-stage included studying the students' retellings in light of the

idea uniis found in the two texts. The second stage was locating the ideas stated signaling

comprehension problems.The research method employed was qualitative in nature as it involved

the analysis of transcriptions (Patton,2002; Strauss & Corbin, l99S). Answers to the research

question were interpretive, in which the data coding results from three data types were integrated

and explained to offer insights into the identified problems.

MISCONCEPTIONS ON ENGLISH MEDICAL TEXTS COMPREHENSION

Three major comprehension problems found concerned with vocabulary insufficiency, complex

syntax, and misconceptions. This paper presented the last problem mentioned on the

misconceptions of the medical texts.The idea units coding revealed that the students' guesses of

words or ideas were at some point inaccurate. The inaccuracies were due to the preconceptions

that the students brought to the texts concerning certain words or ideas'

The presencelf prior knowledge was occasionally useful in assisting comprehension ifthe knowledge were inadequate or inappropriately utilized. Two examples about the Jerm

drugand

the conceptTf increasfng'physical exircise to reduce hypertension show the inadequacies and

inappropriate use of priorknowledge leading to misconceptions of the texts.

The low "nd

int"r*"diate groups iemonstrated misconceptions about the idea found in

Text I.3.8-9.The excerpst below unraveled the misconceptions.

131

Text I.3.8:

Text I.3.9:

The risks of taking the drugs may outweigh the benefits gained fromloweringthe blood pressure.Because of the drug theropy's possible side effects, nondrug treatment of mild

hypertension may be most beneficial.

Ninth Conference on English StudiesCenter for Studies on Langrcge ond Culture - Atma Jaya Catholic (/niversity of Indonesia

A7: [...] resiko-resiko orang [...] memakai drug - mm - memakai [...] narkoba - [...] terapi

dengan narkoba - dapat - mempunyai efek er efek samping - (3) - dengan memakai

treatment yang tidak er tidak narkoba - L...1 (the risks- of people [...J taking drug- [ ...Jnarcotics and illegal drugs- [...Jbecause- therapy using illegal drugs'can- hsve side

efects -(3)- by using treatment that do noteruse narcolics and illegal drugs- [...J)

A8: ((membaca dari teks)) - (3) - er - (6) - er terapinya itu - dia gak boleh - ngedrug-

((readingfrom text)) -(3)- er -(6)- er the therapy- he/she cannot take illegal drug)

A7 was unaware that one of drug's meanings is medicine. The ambiguity could be due to

the word drug that is most often refered to as illegal subslance such as narcolics, mariiuana orcocainein Indonesian context. A8also understood the word drug as illegal substance. Although

the term narcotics was notexplicitly stated, ngedrugrefers to people taking drugs illegally. This

inaccurate interpretation resulted in a misconception that illegal drugs could be used as a therapy

for hypertension, which could be fatal if practized in the real context.Intermediate students also demonstrated similar misconceptions as shown in the

following excerpts:

Bt: er ada yang ternyata tuh - buat nurunin hipertensi itu - bisa dengan narkoba - drug gitukan

-Cuma ada efek sampingnya (er in fact- decreasing hypertension- can be done throughnarcoticsand otlw illegal drugs - because it'sdrug- right- but there are side efects)

Bl misinterpreted the worddrugor lrypertensive medicatron found in idea 4 asnarkoba,which means illegal drugs. 81 inferred from the text that antihypertensive medicatloz was the

same as the term drug, the meaning of which she knew was illegal drug or narcotic.83 also confirmed his difficulty understanding the term antihypertensive medication. He

interpreted drugs as illegal medicine when he stated: "er drugs - mungkin ini obat- seperti

narkotilra [...J-drugs soalnya"(er drugs- may be this drug- is t.-.] like narcotic- because

it'sdrugs).Another kind prior knowledge resulted in comprehension difliculties occurred when the

students read new information contradictory to what they believed or previously learned. The new

concept of "increasing pltysical activity level to reduce high blood pressure " as illustrated belowis one example.

Textl.l.l: When blood pressure is up, one way to bring it down is to increase the

level of physical activity.Text I.5.14: It is wise, therefore, to include a regular aerobic exercise program along with

other therapeutic measures to optimally reduce high blood pressure.

A4: jadi ketika darah naik itukan - menambah... ini... er level aktivitas fisiknya (so whenthe blood is up- it adds... this... er the physical activity level)

[...] sama... sama iatihan fisik - biasanyakan - kalau latihan fisik itukan bisa membawa

- tapikan bisa memicu- memicu yang lainnya - apakah kadar gulanya kayakgimana...(and... physical exercise - usually it can lead to - it can csuse another((problem)) -for instance glucose level...)

The inappropriately used prior knowledge about the relationship between exercise and

hypertension also resulted in misconceptions. 44 stated hesitantly the phrases "When bloodpresstlre is up," and "increase the level of physical activity. "She indicated her doubt about therole of exercise to reduce high blood pressure by suggesting that doing physical exercises led toanother problem such as increased glucose level. Her using prior knowledge that one's bloodpressure increases after doing exercise hindered her from understanding the Text I. l.l.

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Ninth Conference on English StudiesCenter for Studies on Language and Culture - Afma Jaya Catholic lJniversity of fndonesia

Cl and C2 explanations below explained the content schema that ,{4 used to understand

the idea in Text I.l .1.

Cl: karena... yang saya tahu - kalau hipertensi itukan tekarnn darah tinggr - tapi kalau

misalnya oiah raga - tekanarurya bisa tambah tinggi? Tapi ini malah nyuruh olah raga

supaya mengurarigi tekanan darah darah tinggi (because... what I lcnow- hypertension ofhigh- blood pr"riru- but if we exercise- the blood pressure can increase- but this

laittclel suggesting exercise to reduce high blood pressure)

c2: yang saya agak kaget justru paragraph pertama- er apa [...] untuk supaya tekanan itu

turun - tekanan darah itu turun dingan physical activity [...] padahal gak - kita tadi

baru percobaan - orang habis olah raga - jelas tekanan darah naik - t- .l (I was surprised

to read thefirst paragroph- er what is it- to reduce the blood pressure- reducing blood

pressure ,iu7 6e o"ii"r"d by physical activityf .-.J in fact it did not work,l.ike that - we

did an experiment earlier - "fti, doing exercise- blood pressure increased-)

The idea that physical exercise reduces high blood pressure was considered contradictory to the

concept learned that doing physical activity increasei blood pressure' A4 expressed her confusion

understanding the text t.t.t ihut *u, in contrast with her prior knowledge as indicated by her

statement during the interview below.

44: paragraph pertama - itu agak rancu [... ]kan- inikan when blood pressure naik... tekanan

darah naik - itukan one way - sat; jaian membawa turun - menambah level physical

activity ((tertawa)) itu - kalau satu salu - itu mungkin mengerti - tapi kalau dijadiin satu

menjadi kalimat - itu agakbingung - (firstparagraph- that is ambiguous ["'Jftt says)

when blood pressure iiup-.. itooi prutture is up- one way- one way to bring down-

adding the fhysicat activity level ((iughing)) the - if one by one- maybe I understand -

but if (theyi are cornbined into one sentence - it was rather confusing)

44 managed to decode the literal meaning of the in Tgxt I.1.1. However the information did not

meet her expectation that physical exercises increase blood pressure' She failed to understand the

idea in Text I.1 . I aPProPriatelY.

The misconc.ptio* on the ideas described earlier resulted from the students' inability to

cope with new information that contradicted with their existing knowledge' Students in the

beginner. and intermediate levels demonstrated inability to monitor their comprehension and were

g*tly affected by the information they believed was true'

Although the previou, "*"."pi,

indicated much hesitation as the students were trying to

interpret the meaning if d*gr,none of them made effort to consult the dictionary to repair their

comprehension. The! befiev&ihe meaning of drugthey knew was accuratg thus felt unnecessary

to checkits mearung. The students could-have fried the misconception if they monitored their

"ompr"h"osion andlxed the misconce,ption as demonstrated by c2.

C2:-|...]setelahkitapikirlagi-[...]kitagakbicarajangkapendek[...]untukbanyakorangdisini akan U"rpit i, - dalam-jangka pendek - orang terolah raga tekanan darah turun-

[...] orangkan'- mestinya oiu"i utu" t"tptlq iTgk apendek- - padahal.inikan jangka

panjang - tadi saya juga berpikirl;angka pendek? Ja gak bisa dong

: j*Fku panjang - (-

[...J after rethinking about it- t. .i i ai"'t talk aboit short term- but ["']people might

think of it as short-term- bloo'l piie"ure !ecr91s? :ftn exercise- thus many people will

think of it as a short term ((elfit)) - infact tltf il lons term efect 'I also thought short

term aifirst- later- I didn't think so - it (must) be long term)

High proficiency students fxed their comprehension by adjusting the c9l:ept^ ft"y acquired

earlier. c2 identified this part of the text could be tricky as readers might think,of the short term

impacr of o(ercise.-afitt"itgt C2 initiait *Jottooa 'iot t.t'tti*ilarly to A4' he managed to

repair his miscomprehe,nsiois and acquired the information presented in the text'

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Ninth Conference on English StudiesCenter for Studies on LanEnge ond Culture - Atma Jaya Catholic lJniversity of fndonesia

Many students admitted during the interview that using prior knowledge was one ofimportant strategies they ernployed in understanding the texts. Using prior knowledge was one ofthe top two strategies stated by most students across the proficiency levels in addition to using

dictionary. The data gathered showed that at least 90% of the students statedthey had content

schemata: background knowledge and subject matter knowledge, of texts I and II. The

misconceptions could had been avoided or repaired if students activated other relatd knowledge

and context clues. 83 for instance demonstrated understanding that although hlpertensionmedications were available, non-drug therapies should be first recommended.

83: jadinya di sini - kita ditekankan untuk - exercise-nya[...] kalau kita olah raga kan -otomatis - berat badan kita bisa turun - nah itu sudah mencakup yangpertama - cara

paling utarra (so- exercise was emphasized here- if we do exercise - our weight will be

automatically reduced- that's the most important method)

Althcugh 83 understoodthe role of exercise on reducing hlpertensior\ he seerned to view it as an

indirect impact. E}3 stated that a patient could lower his hypertersion if he could reduce his weightthrough exercises. The weight loss was considered as the k-ey to reduce hlpertension. He did not

consider the direct impact of exercise on reducing high blood pressure.Scherna often referred to as background knowledge, was claimed to affect the success or

failure of reading comprehension. A large body of literature supported the importance of schema

in reading comprehension (Anderson & Pearsor\ 1984; Carrel 1981, 1983; Carrel & Eisterhold1983; Hudson, 1982). Knowledge that readers bring to a text usually has a significant impact ontheir understanding of the text (Aebersold& Field, 1997). The readers' prior knowledge however,is sometimes usedinappropriately. The inappropriate uses of prior knowledge or misconceptionscould interfere the acquisition of new, related inforrnation from the texts (Alvermarur et al., 1985;Maria &MacGinitie, 1987; Peeck 6 al., 1982). Another research confirmed that problemsresulting from misconceptions commonly occurred when students learned from science texts(Broek&Kendeou, 200 8).

CONCLUSION

This study found that prior knowledge when used inappropriately hindered students'comprehension. The beginner and intermediate students wereunable to apply appropriatestrategies to monitor their conprehension and fix thet predictions of the texts' content.Preconceptions that they brought to the texts were sometimes inaccurate or contradict theinformation in the texts. Without the skills to monitor their understanding and expectations of thetexts, they tend to misunderstand the information.

Students could avoid misconceptions if they were able to integrate their prior knowledgeand other reading strategies. The limited skills to appropriately activate prior knowledge and torevise preconceptions were wident :rmong low and intermediate students but not among the highproficiency ones. Medicine students must surpass a minimum English proficiency requirement togain satisfactory acade,mic reading comprehension In this researctu the minimum proficiency isequal to a minimum score of 550 on the TOEFL prediction test.

Reading instruction should cover the teaching and practice of prior knowledge activationand cornprehe,lrsion monitoring. Exposing the students to comparison-contrast and problemsolving kinds of text will provide them with the opportunity to see differing information andexplanations of ideas for comparison purpose.

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Center for Sfudi* on Langwge ond Culture - Atma Jaya Catholic l/niversity of fndonesia

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CONEST 9The Ninth International Conference on Engtish Studies

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