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

∗ mcfarland.jonathan@gmail.com

∗ 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.

Contact