English for Specific Purposes
Wrld

Learning Strategies of English Medical Terminologies in the Students of Medicine

Jafar Asgari Arani : Faculty Member Of Kashan University of Medical Sciences, English Department

Askari@kaums.ac.ir

INTRODUCTION: There has been a prominent shift within the field of language learning and teaching over the last twenty years with greater emphasis being put on learners and learning rather than on teachers and teaching. In parallel to this new shift of interest, how learners process new information and what kinds of strategies they employ to understand, learn or remember the information has been the primary concern of the researchers dealing with the area of foreign language learning.

OBJECTIVES: This paper tries to explore the learning of medical terminology by Iranian students of medicine. It focuses on the frequency of use of strategy by them in learning medical terminology and to identify the strategies related to success or failure in learning the target. In brief, this study attempts to clarify the strategies used most and least frequently by the learners ; a comparison is also made between high level and low level students in the least and most frequently used medical terminology learning strategies .

METHOD&MATERIALS: Participants in the current study were 46 students of medicine from two second-year classes at Kashan University of Medical Sciences, Iran. The test for evaluating the subjects' proficiency level in the current study was the Medical Terminology mid-term exam administered by English teacher in the faculty of medicine. This is a curriculum-specific achievement test, rather than a general proficiency test. There were 50 questions in total in the test. The instrument employed for collecting data on strategy is the medical terminology learning strategies questionnaire developed by the researcher. The categories of medical terminology were based on Schmitt's (1997) taxonomy for studying vocabulary strategies. The students were required to answer questions on their strategy use on a five-point Likert scale.

FINDINGS: The results of this study indicated that students in general prefer to use written repetition, verbal repetition, and bilingual dictionary strategies. In addition, the students most proficient in medical terminology used various kinds of strategies more often than the less proficient students did. Implications of these and other findings are discussed and suggestions are made regarding the teaching of learning strategies in medical terminology courses.

CONCLUSION: We found significantly greater overall use of learning strategies among more successful learners and significant differences by proficiency level in students' use of four strategy categories: determination, memory, cognitive and metacognitive. However, neither the high-level learners nor the low-level learners are good at employing social strategies to discover new meanings.

KEYWORDS: Medical terminology, Bilingual dictionary strategies, L2 vocabulary learning strategies, EMP.

Introduction

There has been a prominent shift within the field of language learning and teaching over the last twenty years with greater emphasis being put on learners and learning rather than on teachers and teaching. In parallel to this new shift of interest, how learners process new information and what kinds of strategies they employ to understand, learn or remember the information has been the primary concern of the researchers dealing with the area of foreign language learning.

In Iran, students of medicine are required to take the course "Medical Terminology "as a complementary section of E M P course to meet the demands of their future jobs. In order to help teachers to overcome the challenge of teaching medical terminology and help students of medicine learn medical terminology more effectively, the researcher is motivated to explore the learning of medical terminology strategies.

According to Gylys and Wedding (1983), medical terminology is a specific terminology used to achieve the purpose of communication in the health care field efficiently and precisely, such as in writing diagnosis and doctors' notes. Medical terminology has two characteristics. First, most medical words are made of roots and affixes ( Yang 2005 ). Any single medical term has at least one root determining its meaning and one or more affixes to change the part of speech or change the meaning of the word.

Schmitt (2000) warned when students use word parts as an initial word-guessing strategy, they must be careful to check the surrounding context to see if their guess makes sense. Haynes and Baker (1993) also found that students sometimes made an incorrect guess about what an unknown word meant in a given text, and then stuck with that erroneous meaning in other context even though the surrounding context made clear it make no sense.

Second, medical terminology is an open set with a large number of low-frequency words and newly created words. Since teaching and learning all the words seem to be an impossible task teaching learners vocabulary learning strategies for inferring the word meanings is more efficient than teaching every vocabulary item encountered. As Nation (1994) suggested, teaching students strategies is especially important when it comes to dealing with low frequency words. Indeed, following Nation, Schmitt also suggested that high-frequency words should probably be taught, whereas learning low-frequency words will require strategies for determining their meaning.

Definition of a Language Learning Strategy

The term language learning strategy has been defined by many researchers. Wenden and Rubin (1987) define learning strategies as "... any sets of operations, steps, plans, routines used by the learner to facilitate the obtaining, storage, retrieval, and use of information." Richards and Platt (1992) state that learning strategies are "intentional behavior and thoughts used by learners during learning so as to better help them understand, learn, or remember new information." Faerch Claus and Casper (1983) stress that a learning strategy is "an attempt to develop linguistic and sociolinguistic competence in the target language." According to Stern (1992), "the concept of learning strategy is dependent on the assumption that learners consciously engage in activities to achieve certain goals and learning strategies can be regarded as broadly conceived intentional directions and learning techniques." All language learners use language learning strategies either consciously or unconsciously when processing new information and performing tasks in the language classroom. Since language classroom is like a problem-solving environment in which language learners are likely to face new input and difficult tasks given by their instructors, learners' attempts to find the quickest or easiest way to do what is required, that is, using language learning strategies is inescapable.

Could learners use appropriate learning strategies based on the characteristics of medical words, such as guessing from context and using word parts when learning medical words? Chamot and Kupper (1989) indicated that high proficiency language learners know how to use appropriate strategies to reach their learning goals. Oxford (1985) asserted that successful learners use a wide range of strategies which are appropriate for their learning tasks. Do high proficiency students use different strategy patterns from those used by low proficiency students as revealed by the above-mentioned studies? To get more insights on the use of learning strategies of successful students, the strategy patterns used by successful and unsuccessful learners are also the focus of attention in the present study.

Study Purpose

The purpose of this study is to explore the learning of medical terminology strategies used by Iranians students of medicine. It concentrated on the frequency of use of strategy by students of medicine in learning medical terminology and to identify the strategies related to success or failure in learning the target. In brief, this study attempts to clarify the strategies used most and least frequently by the learners ; a comparison is also made between high level and low level students in the least and most frequently used medical terminology learning strategies .

Background of Language Learning Strategies

In most of the researches on language learning strategies, the primary concern has been on "identifying what good language learners report they do to learn a second or foreign language, or, in some cases, are observed doing while learning a second or foreign language." (Rubin and Wenden 1987). The findings of Fan's (2003) study indicated that the students used the strategies for reviewing and consolidating their knowledge of known words and perceived them as useful, and that they preferred dictionary strategies. The most proficient students depended much more on sources, guessing, dictionary, and known words strategies than the less proficient students. Regarding the discrepancies between frequency of use and perceived usefulness in learning L2 vocabulary, the findings revealed the complexity involved in strategy use.

Schmitt (1997) also found that the learners used more repetition and dictionary strategies and considered them more useful than other strategies. Semantic grouping and imagery strategies were less used and regarded the least useful. There was also some evidence that more advanced learners tended to use more complex and meaning-focus strategies than less advanced learners. A number of studies have sought to examine the effectiveness of some specific strategies for learning medical terminology (Fang, 1985; Troutt, 1987; Dunkle, 1983).

Fang and Troutt studied the effectiveness of two strategies; however, two learning strategies alone are not enough for us to get the whole picture of how students learn medical terms more effectively. To achieve a general picture of the optimal use of learning strategies for medical terminology learning, studies that deal with all the strategies as a group are a supplement to Fang's and Troutt's approaches.

Methodology

Participants in the current study were 89 students of medicine from two second-year classes at Kashan University of Medical Sciences, Iran. Medical terminology is a required complementary section in EMP course so all of the students were supposed to take and pass Medical Terminology. The class met two hours a week.

The test for evaluating the subjects' proficiency level in the current study was the Medical Terminology mid-term exam designed and administered by English teacher in the faculty of medicine which was a curriculum-specific achievement test containing 50 questions in total. The students were required to write medical words based on the English definitions of each test item.

The instrument utilized to collect data on strategy is the medical terminology learning strategies questionnaire developed by the researcher .The categories of medical terminology were based on Schmitt's (1997) taxonomy for studying vocabulary strategies. The students were required to answer questions on their strategy use on a five-point Likert scale ranging from 1 ("never or almost never ") to 5 ("always or almost always") .The English questionnaire was made of two sections. Part one contained five questions, the purpose of which was to collect such background information as student' English proficiency and mid-term score of medical terminology. The second part included 42 items grouped into six categories of medical terminology learning strategies:

I. Discovery Strategies

1. Determination Strategies (To discover new word's meaning by guessing and using reference materials)
2. Social Strategies (To discover new word's meaning by asking someone who knows)

II. Consolidation Strategies

1. Social Strategies (To learn and practice vocabulary, such as cooperative group and interacting with native speakers)
2. Memory Strategies (such as grouping, imagery, rhyming, moving physically, and reviewing in a structured way)
3. Cognitive Strategies (such as repetition and using mechanical means to study medical terminology)
4. Metacognitive Strategies (To control and evaluate one's own learning, search for practice opportunities and plan for learning tasks).

Survey Analysis

All data were gathered after the midterm exam of the 2005 autumn semester. Before the questionnaire was administered, a brief explanation of the purpose of the study was provided to the subjects. Each subject's responses to the medical terminology test were given scores. A correct answer was assigned 2 points and incorrect answer was given no point. The total possible points were 100. The participants were grouped into three proficiency levels based on their test scores. The high-level group refers to those who score higher than 80, the low-level group refers to those who score lower than 60 and the intermediate-level group who score between 80 and 60. Consequently, 36 subjects were defined as high-level learners, 28 intermediate-level ones and 25 low-level ones.

Results

Table 1

Most and Least Used Strategies by All Subjects

Item	Rank	Category	Strategy	Mean
28	1	Cognitive	Written repetition	4.21
29	2	Cognitive	Verbal repetition	4.01
7	3	Determination	Bilingual dictionary	3.79
21	4	Cognitive	Vocabulary section in textbook	3.22
31	5	Cognitive	Take notes in class	3.01
4	38	Social (consolidating)	Ask teacher for synonym	1.49
34	39	Cognitive	Put medical words on physical objects	1.42
8	40	Social (discovery)	Discover new meaning from group activity	1.33
34	41	Cognitive	Listen to tape of list	1.21
12	42	Social (discovery)	Ask teacher for a new sentence including new medical word	1.08

The table indicates that item 28 (4.21, written repetition) has the highest average frequency, and next is item 29 (4.01, verbal repetition), followed by item 7 (3.79, using bilingual dictionary), item 21 (3.22, vocabulary section in the textbook). The least preferred strategies are item 12 (1.08, ask teacher for a new sentence including the new medical word), and next is item 34 (1.21, listen to tape of word lists), followed by item 8 (1.33, discover new meaning from group activity), item 34 (1.42, put medical words on physical objects), item 4 (1.49, ask teacher for synonym of new medical word).

Table 2

Most and Lest Used Strategies by High-level Learners

Item	Rank	Category	Strategy	Mean
21	1	Cognitive	Vocabulary section in textbook	4.44
31	2	Cognitive	Take notes in class	4.30
7	3	Determination	Bilingual dictionary	4.20
29	4	Cognitive	Verbal repetition	4.10
28	5	Cognitive	Written repetition	4.01
34	38	Cognitive	Put medical words on physical objects	1.30
38	39	Cognitive	Listen to tape of word list	1.29
8	40	Social (consolidating)	Discover new meaning from group activity	1.20
12	41	Social (discovery)	Ask teacher for a sentence including the word	1.09
23	42	Social (consolidating)	Interact with foreign medical staff	1.09

The data in table 2 shows that the most preferred strategies for high-level learners are item 21 (4.44, vocabulary section in the textbook), item 31 (4.30, take notes in class), item 7 (4.20, bilingual dictionary), item 29 (4.10, verbal repetition), and item 28 (4.01, written repetition). The least preferred strategies are item 23 (1.09, interact with foreign medical staff), item 12 (1.09, ask teacher for a sentence including the new medical word), item 8(1.20, discover new meaning from group activity), item 38 (1.29, listen to tape of word lists), and item 34 (1.30, put medical words on physical objects).

Table 3

Most and Least Used Strategies by Low-level Learners

Item	Rank	Category	Strategy	mean
28	1	Cognitive	Written repetition	4.7
29	2	Cognitive	Verbal repetition	3.65
16	3	Social (consolidating)	Ask classmates for meaning	3.41
21	4	Determination	Guess from textual context	3.27
7	5	Determination	Bilingual dictionary	3.27
34	38	Cognitive	Put medical words on objects	1.49
3	39	Memory	Use new medical word in sentences	1.49
38	40	Cognitive	Listen to tape of word lists	1.30
12	41	Social (discovery)	Ask teacher for a sentence including the word	1.10
23	42	Social (consolidating)	Interact with foreign medical staff	1.07

The most preferred strategy for low-level learners are, as revealed in Table 3, item 28 (4.07, written repetition), item 29 (3.65, verbal repetition), item 16 (3.41, ask classmates for meaning), item 21 (3.41, guess from textual context); and item 7 (3.27, bilingual dictionary). The least preferred strategies are item 23 (1.07, interact with foreign medical staff), item 12 (1.10, ask teacher for a sentence including the new medical word), item 38 (1.30, listen to tape of word lists), item 3 (1.49, use new word in sentences), item 34 (1.49, put medical words on physical objects).

Discussion

Research into the medical terminology learning strategies revealed a number of positive strategies used by high- level learners so that such strategies could also be used by low -level language learners trying to become more successful in language learning. However, there is always the possibility that low- level language learners can also use the same good learning strategies while becoming unsuccessful owing to some other reasons. At this point, it should be strongly stressed that using the same good language learning strategies does not guarantee that low -level learners will also become successful in language learning since other factors may also play role in success.

The results indicate that there exist major differences in patterns of learning strategy use among students of two proficiency levels. High-level learners are better at gaining knowledge of a new word; they remember more effectively, control, and evaluate their own vocabulary learning better than low-level learners do. However, both levels are poor at utilizing social strategies to discover new meanings in terminology learning. Social strategies involve asking for clarification or verification, cooperating with peers, and interacting with native speakers of the target language. Iranian teachers mainly employ a teacher centered approach in classes so that students rarely have opportunity to discuss and cooperate with peers and few students have courage to ask questions in class. The lack of use of item 9 (ask teacher for a sentence including the word) by the students has also been influenced by the same factor i.e. educational system and cultural background .Also many students prefer to ask after class in order to minimize the loss of face (Scarcella, 1990) if the question seems foolish to others. In addition, in Iran students do not have enough chances to communicate with English medical personnel, so that the item 'interact with foreign medical staff or native speakers' is relatively unemployed by both level learners.

Comparing the strategies used by high-level learners to those used by low-level learners, we find that written verbal repetition were the most and the second most popular strategies among both levels. This finding is in accordance with Schmitt (1997) and Yang (2005), which showed that repetition of a word's verbal or written form was used frequently in Japan and in Taiwan. This can be attributable to the learning style encouraged by the Asian school system. Asian students are commonly required to memorize vocabulary and grammar through repetition.

According to Sheridan (1981) the practice of modeling and repetition is usually applied in some classrooms so as to help students develop particular language skills. The practice of memorization is also linked to the Confucian tradition of reverence for authority (Yang 2005). Therefore, when students face questions or difficulties, they would look up dictionary to find the answer instead of resorting to the authority, represented by their teachers.

None of the textbooks taught in EMP and Medical Terminology courses in Iran has included an audiotape or CD on which word lists had been recorded to improve pronunciation and aural understanding of the words. This is why item 34 (listen to tape of word lists) is one of the least used strategies by all students of medicine. This finding is consistent with Yang and Su's study (2003), which points out that the main difficulty students encountered in speaking, is their poor pronunciation.

Many teachers feel that they will lose control of the class if the employ team work in teaching foreign language; they can not monitor all groups at once and students' errors will be enhanced in small groups. This could explain why item 11 (discover new meaning from group activity) is the 40^th strategy used by all students learning English medical terminology.

Conclusion

Language learning strategies, being specific actions, behaviors, tactics, or techniques, facilitate the learning of the target language by the language learner. All language learners, needless to say, use language-learning strategies in the learning process. The study indicated that students of medicine in general prefer to use written repetition, verbal repetition, and bilingual dictionary strategies. In contrast, asking teacher for a new sentence including the new medical word, listening to tape of word list, and discovering new meaning from group activity are the strategies least used by learners. In general, neither low-level nor high-level learners utilize social strategies to find out new meaning. The study revealed significantly greater overall use of learning strategies among high-level learners. Considering Cohen & Aphek, (1980) and O'Malley, Chamot, Stewner-Manzanaraes, Russo, & Kupper, (1985) the English teachers of medical terminology can teach learning strategies. However, they should raise the awareness of learners, recognize the suitable strategy for every situation, and suggest learners a variety of strategies and let learners decide which ones are right for them.

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