Problems and solutions in teaching and learning medical vocabulary at Thanhhoa Medical College = Thực trạng và giải pháp trong việc dạy và học từ vựng chuyên ng

VIETNAM NATIONAL UNIVERSITY, HANOI
UNIVERSITY OF LANGUAGES AND INTERNATIONAL STUDIES
FACULTY OF POST-GRADUATE STUDIES




NGUYỄN THỊ THU THUỶ



PROBLEMS AND SOLUTIONS IN TEACHING
AND LEARNING MEDICAL VOCABULARY
AT THANHHOA MEDICAL COLLEGE

(Thực trạng và giải pháp trong việc dạy và học
từ vựng chuyên ngành y tại trường
Cao Đẳng Y tế Thanh Hoá)



M.A. MINOR THESIS
Field: English Methodology
Code: 60 14 10
Course: K17
Supervisor: Kim Văn Tất


Hanoi, 2010

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TABLE OF CONTENT
Declaration……………………………………………………………………………
Acknowledgement…………………………………………………………………….
Abstract………………………………………………………………………………
List of abbreviations…………………………………………………………………
List of figures and tables……………………………………………………………
Table of content………………………………………………………………………
PART A: INTRODUCTION………………………………………………………
1. Rationale………………………………………………………………
2. Aims of the study……………………………………………………….
3. Research questions………………………………………………………
4. Scope of the study………………………………………………………
5. Method of the study…………………………………………………….
6. Design of the study……………………………………………………
PART B: DEVELOPMENT………………………………………………………
CHAPTER 1: LITERATURE REVIEW…………………………………………
1.1. General knowledge of English for Medical Purposes (EMP)………………
1.1.1. ESP vs EMP……………………………………………………………
1.1.2. Medical English………………………………………………………
1.1.3. Medical English courses………………………………………………
1.1.4. Subject knowledge……………………………………………………
1.2. Vocabulary teaching and learning in EMP…………………………………
1.2.1. Vocabulary and its role in language teaching and learning…………….
1.2.2. Techniques in presenting new vocabulary……………………………
1.2.3. Vocabulary practice…………………………………………………….
1.2.4. Vocabulary Consolidation………………………………………………
1.2.5. EMP vocabulary practice and consolidation……………………………
1.2.6. Difficulties in teaching and learning vocabulary……………………….
CHAPTER 2: CONTEXT OF THE STUDY……………………………………

2.1. The general review of the teaching and learning EMP at TMC……………
2.1.1. Teachers………………………………………………………………
2.1.2. Students…………………………………………………………………
2.1.3. Facilities………………………………………………………………
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2.2. Research Methodology………………………………………………………….
2.2.1. Respondents…………………………………………………………….
2.2.2. Research Instrument…………………………………………………….
2.2.3. Data collection………………………………………………………….
2.2.4. Data analysis……………………………………………………………
CHAPTER 3: RESULTS AND DISCUSSION…………………………………….
3.1. Results……………………………………………………………………………
3.1.1. Questionnaire for students……………………………………………
3.1.2. Interview for teachers…………………………………………………
3.2. Discussion………………………………………………………………………
3.2.1. Contextual problems……………………………………………………
3.2.1.1. Large and heterogeneous class……………………………………….
3.2.1.2. Poor facilities…………………………………………………………
3.2.2. Students’ problems……………………………………………………
3.2.3. Teachers’ problems……………………………………………………
CHAPTER 4: SOLUTIONS………………………………………………………
4.1. Towards the contextual problems……………………………………………
4.1.1. Poor facilities…………………………………………………………
4.1.2. Large and heterogeneous class…………………………………………
4.2. Towards the students……………………………………………………………
4.3. Towards the teachers……………………………………………………………

4.3.1. Teaching vocabulary in context………………………………………
4.3.2. Making use of visual aids………………………………………………
4.3.2.1. Pictures……………………………………………………………….
4.3.2.2. Objects……………………………………………………………….
4.3.3. Teaching word parts…………………………………………………….
4.3.4. Consolidating vocabulary………………………………………………
PART C: CONCLUSION…………………………………………………………
1. Summary of the study……………………………………………………
2. Limitations of the study…………………………………………………
3. Suggestions for further studies…………………………………………….
Reference
Appendix

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LIST OF ABBREVIATIONS
EGP: English for General Purpose
ESP: English for Specific Purposes
EMP: English for Medical Purpose
TMC: Thanhhoa Medical College

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LIST OF FIGURES & TABLES
Table 1: Students’ length of English learning
Figure 1: Ways of learning vocabulary
Figure 2: Students’ management when they meet a new word
Figure 3: Problems influenced on students’ motivation and interest
Figure 4: Student’s problems when learning vocabulary
Table 2: Ways of presenting new words

Figure 5: Student’s interest in ways of presenting new words
Figure 6: Ways of practicing new words
Figure 7: Students’ interest in ways of practicing new words
Figure 8: students’ interest in ways of consolidating new words



















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PART A: INTRODUCTION
1. Rationale
One of the main concerns for those of us working in an ESP context is how to help our
students deal with (i.e. understand, extract information, assimilate, evaluate, summarize)
authentic academic texts which by their nature require a fairly advanced level of
proficiency in order to be understood. By ‗advanced level of proficiency‘ it is meant, in

fact, a good vocabulary size, because although it‘s possible to find examples in texts
(especially scientific or technical texts) where grammatical structure is crucial to
understanding the subtle nuances of meaning, what seems more important for
comprehension is knowing what the words mean. (Coady, 1993; Grabe and Stoller ,1997).
As Vermeer (1992: 147) puts it: ―Knowing words is the key to understanding and being
understood‖.
Vocabulary is like the base of a high building. Without it, nothing can be built. Teachers
who have been teaching English in general and English for Specific Purposes in particular
must know that at the beginning or in the end, vocabulary is always one of the biggest
problems. The English for Medical purposes (EMP) field is no exception. Medical
language is a special language. It is made up of vast pool of words and terms that is
employed by doctors and nurses in writing medical records and communicating with each
other. Questions are increasingly being asked about the role played by the specialized
vocabulary needed for academic study.
At ThanhHoa Medical College, teaching and learning medical vocabulary are a really
challenging job. Medical vocabulary has long been considered a difficult and boring
subject by many ESP students at the college. It takes much time and energy to make
progress in this field. For ESP teachers, correspondingly, it is difficult task to get students
involved in vocabulary explanation even they devoted much time to vocabulary teaching,
the results have been disappointing. The question posed for ESP teachers now is how to
meet the needs of learners of ESP, especially the needs of improving their vocabulary
acquisition for communication.
Facing this situation, the teachers of English of ThanhHoa Medical College want to do
something new to help students develop vocabulary acquisition. Being one of the teachers
there, I would like to do a study to find out an effective way to claim a more satisfactory
standing for medical vocabulary for the second-year students at ThanhHoa Medical
College, as a result, the minor thesis title goes as:


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“Problems and solutions in teaching and learning medial vocabulary at Thanhhoa
Medical College”
2. Aims of the study
Medical Vocabulary consists of so many new words and terms that medical students often
have difficult time learning and understanding them. The main purpose of the study was to
probe problems in teaching and learning medical vocabulary among the teaching staff and
the second-year students at ThanhHoa Medical College. Within this purpose the three
central objectives were:
i) To give a brief overview about teaching and learning medical vocabulary at
ThanhHoa Medical College
ii) To describe the difficulties perceived by the ESP teachers and second-year students
when learning and teaching medical vocabulary.
iii) To suggest some solutions to stimulate students and give recommendation for the
teachers to improve the teaching of ESP vocabulary at ThanhHoa Medical College.
3. Research questions
To achieve these above aims, the following questions were proposed:
1. What are the difficulties perceived by the ESP teachers and second-year students
when learning and teaching medical vocabulary?
2. What solutions should be offered to stimulate students and give recommendation
for the teachers to improve the teaching of ESP vocabulary at Thanhhoa Medical
College?
4. Scope of the study
This minor thesis is conducted at Thanhhoa Medical College in order to perceive
difficulties in teaching and learning medical vocabulary of both teachers and second-year
students. The study focuses on describing the problems and factors causing such
challenges as, large-size class, facilities, materials, and students‘ vocabulary acquisition.
The researcher would like to offer some appropriate suggestions to better the current
context.
5. Method of the study
The study was designed to use a combination of various methods to achieve its aims and

objectives. To begin with, an extensive review of literature was conducted, critically
examining vocabulary‘s role in ESP teaching and learning.
Various sources of data were used, involving second-year students and teachers of ESP at
ThanhHoa Medical College in order to achieve the aims of the study:


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 Conducting a survey questionnaire to investigate students‘ evaluative comments
on and attitudes towards teaching and learning medical vocabulary at Thanhhoa
Medical College.
 Interviewing ESP teachers to get better insight into the research questions.
6. Design of the study
The thesis consists of three main parts. The first part introduces the rationale for the study
carried out by the researcher, the aims of the study, the research questions, the scope of the
study, and the method by which the study was conducted. The second part developed in
four chapters. The first chapter reviews relevant literature concerning the general
knowledge of English for Medical Purposes and the vocabulary teaching and learning. The
second chapter discusses the context and methodology of the study. The results and
discussion of the survey are presented in the third chapter, followed by the solutions in the
fourth, which are expected to improve the second year students‘ medical vocabulary
learning and the teachers‘ medical vocabulary teaching in TMC context. The conclusion
serves as a summary of the major issues involved and discusses the implications of the
study, limitations of the study and suggestion for further research.

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PART B: DEVELOPMENT
CHAPTER 1: LITERATURE REVIEW
1.1. General knowledge of English for Medical Purposes (EMP)
1.1.1. ESP vs. EMP
To talk about Problems in teaching and learning medical vocabulary (EMP vocabulary),
we need to begin with the definition of ESP or EMP. Pauline Robinson (1980) states that
the term of ESP itself has changed its signification during the past years. Formerly
standing for English for special purposes, the term now used by ―an increasing number of
scholars, practitioners and institutions‖ is English for specific purposes. English for special
purposes is thought to suggest special languages, i.e. restricted languages, which for many
people is only a small part of ESP whereas English for specific purpose focuses on the
purpose of the learner and refers to the whole range of language resources.
Ronald Mackay (1976) states that ESP is generally used to refer to the teaching/learning of
a foreign language for a clearly utilitarian purpose of which there is no doubt.
Brumfit (1979) says, ―First, it is clear that an ESP course is directly concerned with
purposes for which learners need English, purposes which are usually expressed in
functional terms‖. ―ESP thus fits firmly within the general movement towards
―communicative‖ teaching of the last decades or so.
Krashen (1982) identified what he calls a ―transition problem,‖ which he refers to a

perceived gap in the English language and study of learners who have passed through
traditional language classes, and those required for study purposes within universities. He
agues that subject content-based courses can impart both subject knowledge and language
competence at the same time. What he identified was actually what ESP is concerned with.
According to Perren (1974), an ESP course is purposeful and aims at the successful
performance of occupational or educational roles. It is based on a rigorous analysis of
students‘ needs and should be ―tailor-made.‖ Any ESP course may differ from another in
its selection of skills, topics, situations and functions, and also language. It is likely to be
limited duration. Students are more often adults but not necessarily so, and may be at any
level of competence in the language: beginner, post-beginner, intermediate, ect…Student,
may take part in their ESP course before embarking on their occupational or educational
role, or they may combine their study of English with performance of their role in English
as well as in their first language. According to this definition, EMP is a kind of ESP.


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We notice that attention to learners‘ needs is a key element in any definitions of ESP.
Therefore, EMP is intended to help the medical student who is planning to study medicine
in English. It is assumed that he will have some knowledge of general English but limited
experience of studying works in medical English.
1.1.2. Medical English
English for Medical Purposes (EMP) is one of the genres in English for Specific
Purposes (ESP). Class subjects in ESP have been getting widespread among
Vietnamese university. ESP has been trying to attain its popularity since the 1990s
among Vietnamese university in the growing necessities in ESP genres such as English
for economics, business, English for law, and English for Science and Technology
(EST). However, class subjects in EMP are still small in number in Vietnam
compared to other ESP genres despite the strong need of EMP.
Medical language is a special language. It is made up of vast pool of words and terms that
is employed by doctors and nurses in writing medical records and communicating with

each other. In fact medical students and nursing students have various reasons for
learning medical English (Kawagoe, 2009). Doctors need to learn to read and write
medical terminology in L2 to complete hospital admission notes, diagnosis, and orders,
which, later on, nurses must read, follow in order to carry out nursing interventions and
take care of their patients. For these medical and nursing professionals, their first step to
access medical language is to learn medical words. Besides, They also need to read
journals and books in medical genres to speak to colleagues on professional visits, to
make use of the expanding and increasingly important database available through the
Internet, to participate in international conferences, to write up research for journal
publication, to take postgraduate courses in the U.S. or in U.K. to work in hospitals
where English is the first language or the lingua franca.
1.1.3. Medical English courses
According to Higuchi Akihiko (2009) EMP is different from English for General
Purposes (EGP) in the selection of language that is to be taught. There is an overlap with
EGP course content (a common core), especially in grammar. EGP teachers who start
teaching EMP have to learn how to deal with the new are not included in the common
core – most noticeably vocabulary. They also have to get to know the classis ―genre‖ or
text types so that language work can be appropriately contextualized.
However, depending on the type of learner, EMP courses also differ from EGP courses in
that they may focus on specific skills: e.g. interviewing patients, or reading for


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information (as opposed to extensive reading of stories). Typically, grammar is taught
remedially, as arising from other work, rather than being an organizing focus.
1.1.4. Subject knowledge
How much knowledge and what kind of knowledge do EMP teachers need to know
about medical science, the work patterns of doctors and nurses, or the study modes of
medical and nursing students? This is one of the oldest and maybe traditional questions
in EMP. It is relevant to our choice of text, task and course design (Higuchi Akihido,

2009).
There are varied answers, and we cannot choose only one as its best answer. At the
one end of the spectrum is the view that no specialist knowledge is required or
desirable. EMP teaching roles, materials and techniques are not significantly different
from EGP. Moreover, EMP teachers should not put themselves in the false position of
seeming to teach medical subjects.
At the other end is the view that EMP teachers should have at least a lay knowledge of
medicine and an interest in the way in which doctors and nurses work or study; and that
they should ideally know as much as possible about the register of medical English.
For example, these are typical ‗genres‘ or text types, typical collocations and their use,
and the pronunciation of basic medical terminology etc.
Then to what extent do we take into account in our teaching the specialist knowledge
the learner brings to the EMP classroom? In most EMP classrooms, the medical
knowledge of the learners is the most important resource in the EMP classroom. In
order to best exploit this resource, EMP teachers need some understanding of basic
medical concepts and work patterns in medicine.
1.2. Vocabulary teaching and learning
1.2.1. Vocabulary and Its role in language teaching and learning
Words are the building blocks in a language. By learning the lexical items, we start to
develop knowledge of the target language. Based on our experience of being a language
learner, we seem to have no hesitation in recognizing the importance of vocabulary in L2
learning. Meare (1980) points out that language learners admit that they encounter
considerable difficulty with vocabulary even when the upgrade from an initial stage of
acquiring a second language to a much more advanced level. Language practitioners also
have reached a high degree of consensus regarding the important of vocabulary. The
findings in Macaro‘s survey (2003) indicate that secondary language teachers view
vocabulary as a topic they most need research to shed light on to enhance the teaching and


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learning in their classrooms. Therefore, it may be claimed that the role of vocabulary in L2
learning is immediately recognized and implications for teaching from substantial research
are in great demand.
1.2.2. Techniques in presenting new vocabulary
According to Ur 1996:63, there are different ways of presenting new vocabulary. In the
following, different techniques of presenting the meaning of new vocabulary are shown:
 Concise definition
 Detailed description (of appearance, qualities…)
 Examples (hyponyms)
 Illustration (picture, object)
 Demonstration (acting, mime)
 Context (story or sentence in which the item occurs)
 Synonym
 Opposite(s) (antonyms)
 Translation
 Associated ideas, collocations
Mucia 1991:301-302 lists different techniques used in presenting new vocabulary as
follows:
 Visual aids (Pictures, Objects)
 Word Relations (Synonyms, Antonyms)
 Pictorial Schemata (Venn diagrams, grids, tree diagrams, or stepped scales)
 Definition, Explanation, Examples, and Anecdotes
 Context
 Word Roots and Affixes
1.2.3. Vocabulary practice
Presenting a word in the class does not secure that it will be remembered for a long time.
There are many practice activities that include repeating of the new vocabulary to fix the
new words in the learners´ memory. The practice activities are divided into two main
groups: receptive and productive.
Receptive practice (the learner does not really produce the target words) includes these

types (Thornbury 94-99):


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1) Identifying – means finding words in a text or listening, e.g. underline specific
words or expressions in the text, or tick, put in the correct column or list items that
you hear.
2) Selecting – means recognizing words and making choices among them, e.g. circle
the odd word in the line.
3) Matching – includes recognizing words and than pairing them with their
synonym, antonym, definition, pictures to words etc. It can be intended to matching
parts of lexical items to create collocations (there is a very popular memory game
based on matching called Pelmanism).
4) Sorting – putting the lexical items into different categories, e.g. put these
adjectives in two groups – positive and negative.
5) Ranking and sequencing – putting the lexical items in some kind of order, e.g.
ordering items chronologically, ranking items according to personal preference etc.
Productive practice (the productive skills – writing or speaking – are incorporated in the
vocabulary teaching,) includes these types (Thornbury 100): completion and creation.
- Completion tasks (context is given), often called gap-fills, are widely used not only in
practice but also in revision stages. They include open gap-fills or closed gap-fills
(multiple choice activities), crosswords,
- Creation tasks: the learner use the word in a sentence or a story, in writing, speaking or
both forms, use affixes to build new naming units from given words.
Generally speaking, vocabulary practice is divided into controlled and free. Controlled
practice has to come first, because controlled activities require the student to produce a
certain structure, they practice accuracy and fix the pattern. The second phase, which
demands productive use of vocabulary, is free practice. The specialists point out the
usage of free practice in the class, because according to Lewis (151-152) ―to know a word
means how to use it in the real life to be able to communicate.‖ This is a typical example

of the lexical approach where is a primary role of words which determine grammar. Free
practice is aimed at fluency and is productive. However, Gairns and Redman warn against
―a certain degree of stress involved in productive practice‖ (137). According to them,
practice should be challenging, but not frustrating or stressful for the learner. They give
several arguments in favor of productive practice of vocabulary in the classroom (137),
above all, it promotes fluency and improves pronunciation, it helps the memory to store
words, and retrieve them later, conversation in English is very motivating and it builds
learner‘s confidence, learners expect to get the opportunity to practice new language.


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Another division includes spoken and written practice. Many vocabulary activities used
in the class are based on discussions, dialogues, descriptions, role-play activities, or
different written tasks. It has become a part of communicative classes, e.g. in the form of
an activity well-known as ´Find someone who…`, memory games and funny games (hot
seat) etc.
1.2.4. Vocabulary consolidation
As Thornbury (23) states, ―in fact, learning is remembering. Unlike the learning of
grammar, which is essentially a rule-based system, vocabulary knowledge is largely a
question of accumulating individual items.‖ He distinguishes three basic types of memory
(23):
 Short-term store – some information is held in memory for a very short time (a few
seconds). Students are able to repeat a word that they have just heard from their
teacher.
 Working memory – it is a space, where a student first places information for later
usage to recall a word repeatedly. It lasts about 20 seconds.
 Long-term memory – to compare working memory, where the capacity is limited with
long-term memory, where the capacity is wide and its contents are lasted over time.
The great challenge for learners is to transform vocabulary from the quickly forgotten
(short-term store) to the never forgotten (long-term store), and to turn passive knowledge

of vocabulary into an active form. Research into memory suggests that, in order to ensure
that information moves into permanent long-term memory, a number of principles must to
be followed. One of them is use. ―Putting words to use, preferably in some interesting way,
is the best way of ensuring they are added to long-term memory. It is the principle well-
known as Use it or lose it (Thornbury 24). For this reason, words must be presented in
their usual contexts, so that learners can get a sense for their meaning, their register and
collocations. In separated vocabulary activities, words are often presented in the form of
lexical sets. It is highly recognized that it is easier to learn the words that are thematically
arranged but have looser relation than lexical sets. The system of practical exercises should
be thoroughly organized so that the amount of new words does not discourage the student.
1.2.5. EMP vocabulary practice and consolidation
The students should be encouraged to think about the importance of the word, therefore the
examples in context are highly useful. Moreover, this approach must be focused


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predominantly on learners, each unit has to have clear aims, motivating topics and
challenging practical activities. The appropriate issues must be presented in the context of
the real life, in this case, of the present vocational school, where ―young people are given
numerous opportunities to follow purposeful learning‖ (Buchanan 6). As Maehr points out,
in this way, teachers can support the naturalness of learning vocabulary, and in such an
enriched atmosphere, learners find ideal authentic reasons for learning a foreign language.
ESP vocabulary can be presented, practiced and consolidated by similar methods and
techniques used for practicing and consolidation of general vocabulary. Writing tasks can
include reports and different instructions for medicine, making summaries from technical
journals, describing processes and techniques, labeling diagrams and pictures, describing
graphs and comments on charts etc.
1.2.6. Difficulties in teaching and learning vocabulary
Outside the classroom our students (and they are probably typical) do not engage in
extensive reading. It‘s very unlikely; in fact, they will do any reading at all: one reason is a

self-perceived lack of proficiency in reading which results in feelings of frustration,
demotivation and a strong desire to avoid such effort. Another is that they have very little
time free for extra reading. In any case, reading a word once is not usually enough for a
learner to retain it. Estimations in the literature of how many times we need to see a new
word before we learn it range from 5-17, averaging out at around 10 (cf. Saragi, Nation
and Meister 1978), so extensive reading is unlikely to result in large increases in
vocabulary knowledge unless students read the enormous amount necessary for new words
to be repeated in context a sufficient number of times for them to be noticed and acquired.
Time is also a factor within the classroom. Our medical students, for example can only
look forward to (!) a total of 60 hours of English or other L2 during the whole academic
year. As Sinclair and Renouf (1988: 143) point out, "it is exceptionally difficult to teach an
organized syllabus of both grammar and lexis at the same time". And we do need to teach
them grammar, for although it would make our task easier if we could assume our students
come from the same language learning background, unfortunately there are huge
differences in the linguistic and world knowledge they bring to the L2 class. Not all of
them have a complete grasp of the more complex syntactic structures (such as conditionals,
passives, embedding), precisely the range of structures which are more common in
academic texts.


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Then there is the size of the class and a range of factors which affect students‘ attendance.
Both large classes and irregular attendance make it extremely difficult to monitor a
particular student‘s development or provide adequate individual feedback.
There are other difficulties when we do decide to give time to specific vocabulary in class.
To the question: how many lexical items should be taught in a lesson? Gairns and Redman
(1986), for example, suggest 8-12 items. But, as Laufer (1997b) points out, this figure does
not take into account the level of difficulty of the target item. Laufer discusses several
what she calls ‗intralexical factors‘ of a word which may either facilitate or make more
difficult a word‘s learnability. These intralexical factors refer to a set of properties such as

the word‘s pronunciation (or rather its pronounceability), its orthography, the degree of
correspondence between how the word is written and how it is said (i.e. script and sound).
A new word in English may offer no clues to its pronunciation or, perhaps worse,
misleading clues (compare, for example, crow and cow; thrown and down; but then
crown). Other intralexical factors include: word length, number of syllables, morphology,
part of speech and semantic features such as abstractness, appropriateness, idiomaticity,
multiple meanings. The latter are a particulary rich area for confusion. Many learners fix
on one meaning they know and find it very difficult to use another – even if the one they
know has no sense in that new context.
Other factors affecting learnability may involve the target word‘s relationships to other
words (interlexical factors‘) and crosslinguistic influences or transfer from the learner‘s
L1. To give an example of the first, there could be dangers in teaching associated words,
such as synonyms or opposites, at the same time. For example, teaching ‗right‘ and ‗left‘
together could result in students confusing form and meaning and being unsure afterwards
whether left means ‗left‘ or whether it means ‗right‘. A similar confusion occurs with
words that share a number of semantic features (cf. Higa 1963; Nation and Newton 1997);
for example. rigid, stiff, unbending, inflexible, stubborn.
A quite important contributor to difficulty is what Laufer (1991) termed ‗synformy‘. This
is the visual or acoustic similarity of lexical forms which may cause learners to confuse
similar words. We will return to some of these points later with examples, but first we‘d
like to move on to the question of what it means to know a word.






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CHAPTER 2: CONTEXT OF THE STUDY
2.1. The general review of teaching and learning EMP at TMC

English for Medical Purposes (EMP) course is designed for EFL medical students
(sophomores) at Thanhhoa Medical college. EMP serves many purposes: to enhance the
medical entrants' reading comprehension skills as well as to provide them with the basic
vocabulary they need in the very beginning of their medical study; to develop the medical
students' basic academic and scientific writing skills; and to give the medical students an
introduction to the English medical terminology of medicine. The course consists
of seventeen modules organized around the reading and writing sub-skills and their
associated secondary skills such as vocabulary. The readings of this course are all about
medical topics to go with the medical students' major and to be appealing to them. The
topics will provide the students' with general knowledge about some of the important
health conditions, diseases and their treatment making it a survey of the opportunities and
problems inherent in the medical arena. The writing tasks presented in each module will be
linked to the reading topics in a complementary way. The writing sub-skills will help the
medical students' improve their academic and scientific writing skills. At the very end of
the course, the students will be given a glossary of specific medical terms appropriate for
students requiring a working knowledge of specialized medical terminology.
2.1.1. Teachers
A majority of English teachers at TMC are young and novice teachers. In general, these
teachers are well-qualified in terms of their proficiency in English and knowledge.
However, as I observed, traditional approaches including grammar-translation are the
major existing EFL approaches at TMC, aiming at language use. Most of the spoken
interaction in English classes is conducted in Vietnamese. Students read, listen, speak, and
write in English solely for the sake of learning English as a linguistic ‗code‘.
Furthermore, most of the teachers still adopted the more traditional teachers-centered and
lecture-type approach in their classroom practices whereas they held positive beliefs
toward CLT. They have never made teaching vocabulary interactive. New words or
structures are always written down on the blackboard and the meaning of every word is
provided right away without requirement for students‘ prediction or guessing from the
context. Actually, in all stages of the lesson, teachers remain the center of the class. As the
matter of fact, teachers did not have any creativeness or make a choice of using appropriate

activities that motivate students‘ attention and listening improvement.


13
It was observed by the researcher that some of the ESP teacher at TMC used techniques of
presenting new vocabulary in the following ways:
 Asking students to read new words after them, and then explain the words in their
Vietnamese one by one.
 Or asking students to copy words for many times without teaching how to use the
words in the real communicative situations.
 Or dealing with all words equally.
As mentioned above, the context of TMC reveals a situation whereby students are required
to learn English, but the English they have learned in traditional language classes may not
be used effectively in real life. It is apparent that student-centered approach has not been
widely used in teaching English at TMC. The teachers still take the key role in classroom
activities and corner the students to be active learners. Therefore, we should apply more
appropriate teaching techniques to improve the situation of teaching vocabulary at TMC.
2.1.2. Students
My students are non-English majors coming from different parts of the country. All have
developed English language skills during the first years of college study under formal
instruction. In the second year, students are expected to learn English for Medical purposes
and prepare for weekly tests and final examination essentially by themselves.
During the teaching, I heard from time to time students complain in puzzlement: ―I„ve
studied English for more than ten years but I don‟t seem to have noticeable progress in
English. I can only use more or less than the same words as I used before in speaking and
writing.‖, ― I know all the reading skills and grammar but still I can‟t understand the
exact meaning of this passage.‖ ―I recite fifteen words a day. It does help in reading
comprehension. But I always forget words I recited a week ago.‖ ―How can I remember
words and their meanings quickly and for a long time?", "How can I use words properly in
different contexts?", "Can you tell me an easy and simple way to retain the vocabulary that

I have learnt?‖. The above complaint is not a problem to one or two students but to the
majority of them-the problem of vocabulary.
The major problem in reading during the ESP course is vocabulary as ―word meaning
knowledge influence reading comprehension‖ (Harris & Sipay, 1990).
Poor vocabulary knowledge and lack of vocabulary learning strategies of the students are
the matter of serious concern among those in and around education, and their quest for
finding suitable remedies is getting more and more intense.


14
Having worked with the ESP courses for three years, the researcher realized from her
observation and experience for years that there are some factors account for the vocabulary
problem. For many years vocabulary was the poor relation of language teaching. Its
neglect has been in part due to a specialization in linguistic research on syntax and
phonology which may have fostered a climate in which vocabulary was felt to be a less
important element in learning a foreign language. In learning a foreign language, you will
find that vocabulary is comparatively easy, in spite of the fact that it is vocabulary that
students fear most. The harder part is mastering new structures in both content and
expression.
I once did a small survey on students‘ feeling on vocabulary learning to the second-year
students at my college. Two thirds of them said they were not taught enough words in
class, words they needed when communicating people, watching TV, and reading. They
felt their teachers were very keen on teaching grammar and improving their pronunciation,
but that learning words came a poor third.
Encountering and understanding a word are seldom enough: as with meeting people, there
needs to be depth and interaction for the encounter to be memorable. Some teachers do not
recognize or neglect such a need. They take it for granted that students should be able to
develop their own learning system, and thus put vocabulary at the disposal of students‘
memory capacity. Some teachers suggest that students should go home every evening and
learn a list of fifty words ‗by heart‘. Such a practice may have beneficial result, of course,

but it avoids one of the central features of vocabulary use, namely that words occur in
context.
In the syllabus, words are listed alphabetically with the correspondent Vietnamese
meaning. Students are required to master all these words that teachers teach them. The
main purpose of learning words in the syllabus is to pass the examination. Many words
recited appear only in the examination after which they will not be used again by students.
Therefore, many words are only stored in students‘ short-term memory as passive; words
and will never become active ones. The kind of vocabulary learning does not have much
long-term effect.
When being asked about the way of learning English vocabulary, most second-year
students in our classes said they just copied new words provided by teachers or looked up
words in the dictionary. Many of them marked or underlined words they did not know in
their textbooks and noted the meaning in Vietnamese. Some students noted the time they
had to copy lines and lines of new words in their notebooks which were forgotten soon. "It


15
was so boring. I hated learning new words that way!" Sometimes, students asked many
questions regarding learning vocabulary like "Teacher, how can I remember words and
their meanings quickly and for a long time?", "How can I use words properly in different
contexts?", "Can you tell me an easy and simple way to retain the vocabulary that I have
learnt?" etc. All of the learners expressed their wish to learn vocabulary effectively in more
interesting ways than the traditional ways that they knew.
2.1.3. Facilities
Large classes usually present special challenges in terms of EMP vocabulary teaching and
learning.
Ever since 2006, TMC‘s higher education has undergone a continuous expansion of
enrollment at a rate of about 35% every year, which has given rise to a noticeable shortage
of both English teachers and classrooms. Due to the very limited educational recourses,
teaching English to large classes is a common phenomenon in TMC. In TMC, non-English

majors are usually grouped into classes of about 80 each. Which meet two times weekly in
two-hours periods for English language instruction. It is obvious that students in a large-
size class have fewer opportunities to practice activities related to vocabulary acquisition.
And if the class is dominated completely by the teachers, students will have almost no
chance to use, practice, consolidate vocabulary. On the other hand, many teachers consider
that a large-size class, has brought about number a of problems concerning efficiency,
effectiveness, class management and so on, which not only make the use of certain
activities difficulties, but also affect the effectiveness and quality of teaching and learning.
Another factor that leads to the vocabulary problem involved the lack of teaching material.
Most materials applied nationally have been used for decades. The out-of date materials
obviously do not contain words appearing everyday with the development of the world.
Learners, thus, do not have the chance to absorb new words they urgently need to gain
access to new world and the new age. Many materials haven‘t become authentic only until
recently.
Although the important of vocabulary is typically recognized in vocabulary teaching and
learning, the actual acquisition of vocabulary presents significant challenges to the
language learners and teachers, especially in the earliest stages of the learning process.
Even though researchers have presented various ideas that provide insights into the
processes of improving language learning outcomes, a need to develop a more cohesive
picture of effective instruction and learning of vocabulary remains. More research is


16
essential if the profession is to increase its understanding of appropriate techniques for
effective vocabulary acquisition instruction and learning.
2.2. Research Methodology
2.2.1. Respondents
The respondents of the study were the second-year students of The Faculty of
Nursing taking ESP subject in the academic year of 2009-2010, Thanhhoa Medical
College, Vietnam. The study is conducted 140 students from two randomly-chosen

classes, who take English for Medical Purposes class related for their own field.
Students‘ age ranged from 18 to 21 years with an average age 18. The number of female
students was higher than that of male. The students in of Nursing Faculty get an ESP
course for 1 semester (75 hours), 10 meetings, and twice a week.
Besides the medical college students, the respondents of the study were 3 English
lecturers who are experts in teaching English for Specific Purposes (ESP) and teaching
those classes.
2.2.2. Research Instruments
Questionnaire and interview are mainly instruments to collect the data:
 The questionnaire was designed for students because it is a good way to access
the learner‘s point of view (Brace 2004:7). It is convenient and easy to conduct.
It contains of 10 items pertaining a) student‘s attitude toward vocabulary
learning and teaching, b) vocabulary learning strategies while studying their
academic texts, c) problems encountering in learning vocabulary. The
instrument required 15 minutes to complete and was administered in the
students‘ ESP class.
 The interview for teachers was intended to collect almost the same information
as the questionnaire. In other word, administration of theses type of interview
would enable the respondent to give their objective opinion about problems that
their students and they encounter in teaching and learning medical vocabulary.
Because only three teachers (including the teacher-researcher) are responsible
for teaching ESP course at TMC so it was just interviewed with two ESP
teachers. Despite that, useful comments were received and take into
consideration. The interview was conducted in the form of computer-accessed
personal interviewing. It is an interviewing technique that the interviewer and
the respondents sit in front of computer and communicative through chatting


17
software. Then interview of 8-10 minutes were conducted in English with those

teachers in a relaxing, friendly setting.
2.2.3. Data Collection
To collect the data of the study, the researcher used informal interview and
questionnaire to collect the data on their views, opinions, and perceptions of ESP
vocabulary as presented in ESP course. The two types were administered to them
under the consideration that they gave their responses more seriously and objectively.
2.2.4. Data Analysis
Before the data of the study was analyzed, the researcher tabulated the frequency of
responses to each option of every item given by the respondents. After tabulating the
frequency of responses to each option of every item, the percentages of responses were
counted by dividing the number of responses to each option in every item by the total
number of respondents who responded the item. The next task was classifying a group
of items that belong to a certain category. The data of the present study was analyzed
by means of both quantitative and qualitative statistics to reduce potential limitations
of relying on a single approach and enhance confidence in the data.
All the data collected from the instruments were grouped under two main areas: students‘
perception towards their problems in learning EMP vocabulary and the teachers‘
perceptions towards their problems for their second-year students in teaching EMP
vocabulary, which served to answer the research questions.

18
CHAPTER THREE: RESULTS AND DISCUSSION
3.1. Results
3.1.1. Questionnaire for students
Question 1: How long have you been learning English?

Length of English learning
Total
O years
14.2%
3-6 years
35.7%
6-10 years
42.8 %
More than 10 years
10.3 %

Table 1: Students’ length of English learning
Most ESP classes, as from the table, can be defined as heterogeneous, formed by students
with mixed capacities in English. The Table 1 demonstrated that 14.2 % of the students
didn‘t study English. While 35.7% of the students studied English for 3-6 years and 42.8 %
of the students studied English for 6-10 years. There were 14.3% of students who studied
English for ten years. This means that it is very urgent for the students who didn‘t study
English to enlarge vocabulary and master a certain number of English words as quickly as
possible so as to catch up with the others. As for teachers, who have been teaching for two
years have always faced additional difficulties including in vocabulary teaching, mainly
based on the number of students without previous considerable experience in English.

Question 2: Which ways of learning English vocabulary do you usually use?
100%
66%
22%
15%
85%
9%
5%
10%
0%
20%
40%
60%
80%
100%
find the meaning of new words by dividing them into
parts
connect the sound and the picture of the words to help
remembeing
review new words often
write/say new words several times
connect new word to its synonyms and antonyms to
remember it
make sentences with them
make a list of new words
write the words and Vitenamese equivalents
Figure 1: Ways of learning vocabulary
Figure 1 gives a summary of the subjects‘ opinion on vocabulary learning strategies. This
revealed that the major strategies for leaning vocabulary did not differ in general among
ESP students, that is, the most commonly used learning strategy was writing the words and

19
Vietnamese equivalents covering 100% and next is oral/written repetition (85%). The word
list was also widely used approach to vocabulary development (66%), followed by item
‗made sentence with new words‘ (22%). However, students seemed to have problems in
connecting new words to other words they knew with similar or opposite meanings (85%)
and students also encountered difficulties in analyzing words by breaking them into parts
(90%). In term of reviewing strategy, the figure indicates that fewer students knew the
importance of revision and reviewed the newly learned words actively, only 9 % of the
students reviewed new words often. The least preferred strategy are item ‗connected word
with pictures‘ (5%) This may be significant because the studies showed that higher
students tended to use memory strategies and cognitive strategies. Even they recognized
the value of the rest strategies, their action did not reflect their beliefs. All of the learners
expressed their wish to learn vocabulary effectively in more interesting ways than the
traditional ways that they knew. With regards to vocabulary learning strategies instruction,
therefore it might be anticipated that students should receptive to a program that included
those strategies.
Question 3: What do you often do when you meet a new word?
20%
10%
68%
32%
30%
5%
0%
10%
20%
30%
40%

50%
60%
70%
analyze affixes and roots
ask classmates for meaning
ignore it
ask the teacher for Vietnamese
explanation
try to guess the meaning from the
context
look it up in the bilingual
dictionary

Figure 2: Students’ reaction when they meet a new word
Students in this study usually (90%) did not use their background knowledge such as
experiences and common sense in guessing meaning of the words. They often proceed to
ask the teachers to explain it (68%). 27% of the students often asked their classmates for
explanation. Although the ESP teacher spoke English in the classroom and expected the
students to find the English meaning of the new words in monolingual dictionaries, a
number of students (20%) might share the same experience of looking up words in a
bilingual dictionary to find their meanings and definitions when they encounter new words.
There seemed to be some (32%) who did not concern when they encountered a new word.
5% of the students employed their knowledge of the word formation in deciphering the


20
meanings of the words. It meant that students were not confident of using analyzing the
word affixes and roots strategy in learning vocabulary.
The ways students often did when they meet a new word could be implied that many
students learned vocabulary passively, they just waited for teachers to provide new forms

of words then they wrote those words in their notebooks or complete exercises. Many
students did not think learning vocabulary in context was very useful, may be because their
poor background knowledge couldn‘t contribute much to guessing word meaning.
Working those ways, after a short period of time, many learners may find out that learning
vocabulary didn‘t satisfy them, and they thought the cause for it was just their bad
memorization.
Question 4: Which problems have influenced your motivation and interest in leaning
vocabulary at class?
85%
18%
30%
98%
20%
0%
20%
40%
60%
80%
100%
Requirements of the examinations
Teachers' teaching methods and
techniques
Students' low background
knowledge
Time-management (lack of time
for further practice)
Big size-class and poor facilities
Figure 3: Problems influenced on students’ motivation and interest
From the above chart, we found that things turned out to be encouraging and our efforts
did bring about some results.

Being asked about the factors have influenced their motivation and interest in learning
English vocabulary, most students (98%) in our classes at TMC said teachers‘ method and
techniques which provided them vocabulary instructions or presentations greatly
influenced on successful learning of vocabulary. It meant that while students mostly relied
on teachers‘ performance in the classroom, teachers‘ vocabulary teaching methods and
techniques did not satisfy students much. Many of them (85%) considered class-size and
poor facilities as their big obstacles in their learning process. The knowledge and usage of
English that students possessed gave rise concern (30%). Students found it very hard to
cope with learning ESP vocabulary basically because of the lack of the general English
which directly affected their confidence and activeness during classroom lessons. It was
also discovered that 20% responded one of their difficulties involved in requirement of