2011 Demand of English Skills For Thai Nurses Working

5 2 2 1 0 3 0 0 5 8
DEMAND OF ENGLISH SKILLS FOR THAI NURSES WORKING IN AN

INTERNATIONAL HEALTHCARE ORGANIZATION: A STUDY IN A
PRIVATE HOSPITAL IN THE SILOM AREA
WANWISA WAIDARP
Advisor: Supanee Jivasak-Apimas, Ph.D.
A RESEARCH PAPER SUBMITTED IN PARTIAL FULFILLMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
IN
ENGLISH FOR CAREERS
LANGUAGE INSTITUTE, THAMMASAT UNIVERSITY
BANGKOK, THAILAND
MARCH 2011
DEMAND OF ENGLISH SKILLS FOR THAI NURSES WORKING IN AN
INTERNATIONAL HEALTHCARE ORGANIZATION: A STUDY IN A
PRIVATE HOSPITAL IN THE SILOM AREA
WANWISA WAIDARP
Advisor: Supanee Jivasak-Apimas, Ph.D.
A RESEARCH PAPER SUBMITTED IN PARTIAL FULFILLMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
IN
ENGLISH FOR CAREERS
LANGUAGE INSTITUTE, THAMMASAT UNIVERSITY
BANGKOK, THAILAND
MARCH 2011
ABSTRACT
English as a Foreign Language (EFL) refers to learning and teaching English

in countries where the majority of the population do not use English as the main
language. Thailand is one of EFL countries where English has been taught as the first
foreign language. In the age of globalization, the use of the language has become
important in both the private and public sectors. This is also the case in medical
settings, as the Thai government is now promoting the country to an Asian medical
hub. Health personnel, nursing professionals in particular, whose jobs are dealing
directly with patients, have to improve their English skills in order to meet that
requirement. In order to do so, it is necessary that nurses should know their potential
regarding language utilization and understand to what extent the language is required
in their career. This study aimed to investigate the demand of English skills that were
necessary for Thai nurses working in an international medical setting in the Silom
area. Eighty nurses comprising registered nurses, practical nurses, and nurse aides,
both in the inpatient and outpatient departments, were purposely selected to answer
the self-administered questionnaire which was used as a research instrument. In this
cross-sectional study, the Statistical Package for the Social Sciences (SPSS) version
number 15.0 was used to analyze of data in terms of frequency, percentage, mean and
the level of needs. The study showed that the participants perceived that listening,
speaking, and reading skills were needed extensively for the nursing profession.
Moreover, English language was needed the most in various activities related to
nursing tasks. Surprisingly, the nurses perceived themselves as having a moderate
ability to use English in all four skills. In conclusion, the participants in this study
were aware that English skills are essential for their job and underestimated
themselves in terms of their actual English language ability. In order to compare and
contrast the general English skills required by individuals working in international
medical settings, further research studying the needs of English skills for non-medical
workers is recommended.
ii
ACKNOWLEDGEMENTS
This independent study has been completed with assistance from many
individuals. First of all, I would like to express my sincere gratitude to my advisor,
Dr. Supanee Jivasak-Apimas, Ph.D. for her kind guidance, advice, time, and effort
regarding this study. Her extensive knowledge and professional experience have
helped me to finish this study.
I also would like to extend my thanks to all my professors and staff at the
Language Institute, Thammasat University who have provided me with very useful
knowledge and support during my course of study in the English Careers program.
I would further like to acknowledge all of my classmates for their friendship

and cooperation. Because of them, my time spent in class was a wonderful
experience.
Furthermore, my gratitude is also extended to the hospital director of the

participating hospital who allowed me to conduct this research study and to all the
participants in this study for their time and kind cooperation.
Lastly, my deepest appreciation goes through my family, friends, and

colleagues for their care, love, encouragement, and kind support.
Thammasat University Wanwisa Waidarp
Bangkok, Thailand March 2011
iii
CONTENTS
PAGE
ABSTRACT ………………………………………………………………...……… ii
ACKNOWLEDGEMENTS ………………………………………………..……….. iii
CONTENTS …………………………………………………..…………………… iv
CHAPTER
1. INTRODUCTION …………………………………………………….....1
1.1 Background ……………………………………………………...........1
1.2 Statement of the Problem ……………………………………….…… 5
1.3 Objectives of the Study …………………………………………….... 6
1.4 Definitions of Terms ……………………………………………….... 6
1.5 Scope of the Study ………………………………………….…… …..7
1.6 Significance of the Study ………………………………………..…....7
1.7 Organization of the Study …………………………………………….8
2. REVIEW OF LITERATURE ……………………………………….....… 9
2.1 The Concept of English as a Foreign Language (EFL)………………. 9
2.2 Theories of Needs Analysis …………………………….……..…….11
2.3 The Theory of English for Specific Purposes (ESP) …………….…..15
2.4 The Concept of ESP Course Design …………………..…….…….....18
2.5 Relevant Research ………………………………...………….….…..22

2.6 Summary …………………………………………………..………..23
3. METHODOLOGY ………………………………………..………..... ... 25
3.1 Subjects …………………………………………………….….…… 25
3.2 Materials …………………………………………………….…....… 25
3.3 Procedures …………………………………………………..……… 27
3.4 Data Analysis …………………………………………….……..…...27
4. RESULTS ………………………………………………………...…..… 29
4.1 General Background Information ……………………………......… 29
4.2 Experiences With English Skills …………………………..….……. 32
4.3 Opinions on Needs and Abilities of English Skills in the Job …….... 35
4.4 Opinions and Suggestions for Teaching-Learning Activities for
Nurse’s English Course Design. …………………………..…….…. 44
5. CONCLUSION, DISCUSSION AND RECOMMENDATIONS …..…..49
5.1 Summary of the Study ………………………………………...……. 49
5.2 Summary of the Findings ……………………………………..……. 50
5.3 Discussion ………………………………….…………..…..………. 52
5.4 Conclusion ……….……………………………………….…..…..… 57
5.5 Recommendations for Further Research ……………………..…. … 57
v
REFERENCES ……………………………………………………………….…...... 59
APPENDICES ………………………………………………………………..….…. 63
A. Questionnaire (English version)…………………………...…….……… 63
B. Questionnaire (Thai version) ……………………………….……..……..71
vi
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND
In the age of globalization, it cannot be denied that the English language has
become an instrument of global communication and has been playing a significant
role in various activities, locally as well as globally, in acquiring scientific and
technical knowledge, exploring global information, and facilitating international
cooperation (Liu, 2010, p.136). People get to know one another across the world
through internet technology using the English language as a medium for bilateral
understanding. In other word, people interact with one another using English language
as the instrument to share a mutual understanding or interest. English language has
therefore become essential in the daily life of people. This is especially significant
among people whose mother tongue is not English. Therefore, people nowadays
should be able to use this language to enable communicative understanding. Thailand
is no exception as the English language is not the mother tongue. In order to open the
country for international investment, promote tourism and bilateral cooperative
investment, encourage agricultural exports as well as the international medical
services of local hospitals, the Thai government has been making every effort to
encourage people involved in these activities to be well equipped with the English
language (Attapol Khamkhien, 2010). Besides, many government and non-
governmental sectors involved in international activities have also advocated this
concept and have implemented English supplementary courses for their personnel.
Nowadays, English language can be classified into two main areas based on
pedagogy and usage: English as a Second Language (ESL) and English as a Foreign
Language (EFL). The former refers to learning and teaching English in a country
where English is already used as the main or official language. The major locations of
ESL learning and teaching are in the United States, Canada, the United Kingdom and
Australia. On the other hand, the latter refers to learning and teaching English in
countries where the majority of people do not use English language as the main or
official language (Cautrell, 2011). Most countries where English has been taught as a
2
primary foreign language are in Asia. The examples include China, South Korea,
Japan, Indonesia, Vietnam, and Thailand. In EFL communities, there are various
problems related to English proficiency that people in the EFL environment have
encountered. Firstly, EFL learners commonly lack opportunities to use the language
outside the classroom (Sawir, 2005; Wong, 2004). Since they are not native English
users, there is less opportunity to use the language in real life situations. Wong
suggests that this problem could be solved but it is necessary that the learners have a
willingness to change their habits in using English. Although they only use English in
classes, it is important that they pay more attention in classes and try to participate as
much as possible in group discussion. The latter would allow them to practice their
oral skills.
Secondly, EFL has placed too much emphasis on grammar, especially reading
and writing skills, instead of focusing on oral communication, which is considered
useful for professional life at the present time (Sawir, 2005; Wong, 2004). According
to Sawir, most EFL learners have been taught in a passive way or based on a teacher-
centered style. Teachers still believe that reading and writing skills are the most
important skills for English teaching. However, there is a large amount of research
showing that English language has been become more important in the business world
(Hart-Rawung & Li, 2008; Kameda, 2005; Marschan, Welch, &Welch, 1997). Hence,
in order to work effectively with coworkers from various countries, oral
communications skills are required. Many multinational companies have encouraged
their employees to improve their English communications skills by providing them
with supplementary classes in English for Specific Purposes (ESP).
The last common problem that EFL users worldwide are facing today is the
ability to make a message intelligible (Jamshidnejad, 2010). This problem is related to
cultural differences, which, in this context, refers to the differences in decoding the
meaning of messages among English language users living in different countries. For
example, when a speaker says “Don‟t forget to send mail to me”, English users from
American culture will think of sending a “letter” to the speaker, while some Thai
English users may think of sending only an “electronic mail” to the speaker. Many
EFL users often make mistakes when transferring the meaning of language 1 (L1) into
3
language 2 (L2) communication. Since English is not their primary language, EFL
users need to adjust themselves by practicing the language skills more and
understanding the cultural differences (Wong, 2004).
Since Thailand is an Asian country where English has been taught as a

primary foreign language, Thai-English speakers also experience limitations in
restricted contact with English native speakers and lack adequate opportunities to be
exposed to an English language environment (Attapol Khamkhien, 2010; Busayanee
Getmanee, 2005). Many international organizations whose management has realized
this fact have been encouraging their employees to have more opportunities to be
exposed to practicing the English language in their professional daily life (Hart-
Rawung & Li, 2008). For example, Kone Elevators, a Finish multinational company,
has set English as the “company language” and Finnish as “language of the parent
country” (Hart-Rawung & Li, 2008).
Thailand‟s educational system generally puts much more emphasis on reading

and academic writing skills rather than paying attention to oral communication skills
(Busayanee Getmanee, 2005). This has discouraged many Thai students‟ ability to
express themselves. Since the solution to this problem would require great attention
from the governmental level, a large number of multinational companies are seeking
their own solutions. Many of them have set English communication skills as the top
recruitment criteria and encourage their staff to use English in their professional
communication, especially oral skills (Hart-Rawung & Li, 2008).
Lastly, one interesting challenge that Thai learners are now facing is the
attitudes toward fluent speakers of English. Pintip Tuaycharoen (2003) as cited in
Tagsina Sripracha (2005) stated that most Thai English speakers still have a strong
“Thai accent.” Many of them feel very reluctant to shed their Thai accent because of
peer group pressure (i.e., they are afraid that other people will think that he or she
would like to show off or be different in the classroom when they speak with a native-
like accent.). In order to deal with this challenge, Thai English speakers with a good
accent should insist on practicing it and not feel bad about criticism or an unkind
reaction from peer groups.
4
This phenomenon has not been limited to the government educational system,
but is also seen in the private sector, such as the industrial sector, tourism and service
sectors, and business settings where English language has been utilized as a
“commercial language.” English has become the medium of communication for
business people including those working in a medical setting. This can be seen by the
growth of international health businesses in developing countries, especially in EFL
countries, during recent years.
In Thailand, many sectors, including private medical hospitals, have become

aware of this issue and have been developing their business to reach the international
level. Many international bilateral investments have been promoted and encouraged in
order to create a more international environment in the Thai business sector. The
medical business is among the top priorities as the government wants Thailand to
become a hub for medical services, especially for general and cosmetic surgery along
with medicine and the rehabilitation of patients in the next decade. The medical sector
has put their best effort toward enhancing the English language of their health
personnel, especially nurses working in international medical services. Emphasis has
been placed on their communicative skills, so they can understand thoroughly what
their patients may convey and speak clearly and understandably to make patients
understand in order to provide the best medical services for foreign clients.
Still, there are many obstacles for nurses regarding the English language.
Despite being well qualified, many nurses still possess inadequate training in the
language. This has thus made their work more difficult when they encounter foreign
patients. Sometimes, misinterpretation of what patients express has led to problems in
communicative understanding and has lead to stories of „chaos‟ (Yongyuth
Chalamwong & Paradon Tansaewee, 2005). According to the study of Yongyuth
Chalamwong and Paradon Tansaewee (2005), the most important barrier facing Thai
nurses who would like to work internationally or overseas is their weakness in
English language usage. For example, in an international private hospital in Bangkok,
some nursing staff with a limited ability to use English encountered interpretation
problems, as many Thai EFL speakers do. One day, a foreign patient made an
international phone call to a department. Since the line was not clear, he asked the
5
staff to speak louder. Unfortunately, the staff interpreted what he had said in a totally
different way. Instead of speaking with a louder tone, they asked another staff who
could speak Laotian to talk to the patient. That day, the patient was very upset and
sent a letter of complaint to the hospital.
Barriers to language proficiency affect work performance despite nursing

services being up to international standards. Moreover, medical terminology has
sometimes created problems as some terminology is similar in spelling but totally
different in meaning, such as „Cholecystectomy” and “Choletithotomy”. The former
refers to the surgical removal of the gallbladder, whereas the latter refers to the
surgical removal of the gallstone. If precautions are not taken, serious problems could
occur. In this case, a patient may risk losing his or her internal organ. Another existing
problem regarding Thai nurses‟ English proficiency at the present time is the lack of
self-assessment of their English communication problems and demand for English
skills. Many nurses may want to enrich their English language skills, but only very
few know what skills they may need. However, many are unsure about the kind of
skills they should acquire. This study will examine the nurses‟ demand for English
skills to enhance their communicative skills in dealing with foreign patients in an
international private hospital in Bangkok. The results of the study will enable the
administrative section of the hospital to establish appropriate supplementary English
courses for nurses and also provide insights regarding the kinds of skills demanded by
nurses working in an international setting.
1.2 STATEMENT OF THE PROBLEM
Since the English proficiency of Thai nursing professionals working in

international settings definitely affects the quality of their professional performance,
this study aims to answer the following research questions:
1.2.1 What English skills are necessary for Thai nurses working in
international healthcare providers in order to prepare them to meet their professional
needs?
6
1.2.2 How do nursing professionals in the participating hospital perceive

their English ability?
1.2.3 What kind of course design do nurses working in international hospital

want for supplementary English courses?
1.3 OBJECTIVES OF THE STUDY
The objectives of this study are the following:
1.3.1 Main Objective
To investigate the demand of English skills necessary for Thai nursing

professionals working in an international medical setting.
1.3.2 Sub-Objectives
1. To find out nursing professionals‟ perceptions about their own English

ability.
2. To compare demand for English skills required by the nursing profession

and the English ability that nurses perceived in themselves.
3. To provide the participating hospital with suggestions related to its internal

English course design.
1.4 DEFINITION OF TERMS/VARIABLES AND DEFINITIONS
The definition of the terms of this study is as follows:
Hospital is an international medical service located in the Silom area.
Nurses are health service workers taking care of the foreign patients in an
international hospital located in the Silom area. They are Thai Registered nurses
(RN), Practical nurses (PN) and nurse aides (NA).
7
Problems related to English proficiency are the difficulties in using English

in various contexts while nurses are on duty with foreign patients at an international
hospital located in the Silom area.
English skills refer to all of the English skills used in communication,

including listening, speaking, reading and writing.
English abilities refer to the level of English skills that Thai nurses working
in an international hospital located in the Silom area perceive in themselves.
1.5 SCOPE OF THE STUDY
This study is limited to investigation of the demand for English skills required
by Thai nursing professionals working in an international hospital in the Silom area.
The number of target respondents was 80, including registered nurses, practical nurses
and nurse aides.
1.6 SIGNIFICANCE OF THE STUDY
This study of the demand of English skills for Thai nurses working in an
international medical setting is significant in several aspects:
1.6.1 Thai nurses working in an international medical setting can realize the
demand for English skills required by their profession and understand their own
necessity to use English, thus enabling them to use English effectively in their
professional performance.
1.6.2 The information from this research can be useful as a guideline for
Human Resources Development Department (HRD) of the participating hospital to
design appropriate English courses for their nursing staff.
8
1.6.3 For other health workers who are interested in working in an

international hospital, the information from this research can serve as a tool for self-
evaluation and as a guideline for preparing themselves for a similar position.
1.6.4 Nursing schools may apply the information from this study to design
their own English courses.
1.7 ORGANIZATION OF THE STUDY
This research study is divided into five chapters. The first chapter gives the
introduction consisting of the background of the study, the statement of the problem,
objectives of the study, the definition of terms, the scope of the study, and the
significance of the study. The second chapter provides a review of literature
comprising the problems related to English proficiency encountered by EFL learners,
the theory of needs analysis, and the concept of English for Specific Purposes (ESP),
including relevant studies. The third chapter describes the methodology used for this
research study. It includes the selection of subjects of the study, materials, data
collecting procedure, and data analysis procedure. The fourth chapter presents the
study‟s findings, which include the demographic information, raw data collected from
questionnaires and personal interviews, and the results of data. The fifth chapter offers
a summary of the entire study, a discussion of the findings, suggestions and
recommendations for further research and conclusions.
CHAPTER TWO
REVIEW OF LITERATURE
This chapter reviews related literature in five main areas along with a
summary: (1) the concept of English as a Foreign Language (EFL) and problems
related to English proficiency that people in EFL environments have encountered, (2)
theories of needs analysis, (3) the theory of English for Specific Purposes (ESP), (4)
the concept of ESP course design, (5) relevant research, and (6) summary.
2.1 THE CONCEPT OF ENGLISH AS A FOREIGN LANGUAGE (EFL)
English as a Foreign Language or EFL refers to learning and teaching English

in countries where English is not used as the primary language (Cautrell, 2011). In
academic communities, the current hot spots for EFL include South Korea, Japan,
Taiwan, China, and Thailand. Students in EFL countries have to study English in their
own countries as part of academic requirements in their school systems. Sometimes
they study English in order to prepare themselves for travel or study in English-
speaking countries such as the United States, the United Kingdom, Australia and etc.
Since most EFL students’ English learning experiences put great emphasis on
grammar and vocabulary practices while the current demand for English skills
required by the business sector focuses more on English communicative skills, it is
necessary that EFL students improve themselves in order to acquire the best job
opportunities. However, before they can achieve career advancement, there are a large
number of problems related to English proficiency that the people in EFL
environments have to overcome.
Problems related to English proficiency that people in EFL environments have

encountered.
The common problems related to English proficiency faced by EFL students

can be classified into three groups: communicator based problems, meaning creation
problems, and contextual problems (Jamshidnejad, 2010)
10
1) Communicator Based Problems
These problems are concerned with the perception of English

communicators with regard to the ideal L2 speakers. Most EFL learners perceive that
an ideal English user should be able to speak fluently with correct grammar and a
native-like accent. For this reason, there has been an excessive emphasis on grammar
in EFL learning and teaching. According to Wong (2004) and Sawir (2005), instead
of focusing on the communicative skills are useful for professional life, EFL
instruction spends more time on grammar and academic writing. In addition, many
people still do not know the necessity of analyzing their needs in terms of English
skills required by current or future jobs. Hence, they may not be able to improve the
right skills. Furthermore, many EFL learners tend to consider “face concern” as
another major problem when using English in their daily life. For example, most Thai
EFL users do not want to speak English in front of other Thais because they are afraid
of their English accent. According to Pintip Tuaycharoen (2003) as cited in Tagsina
Sripracha (2005), if the accent of a Thai English speaker is good, there might be some
peer pressure.
2) Meaning Creation Problems
These problems are about making a message intelligible. Since English

is not the mother tongue for EFL learners, there is always a possibility that
miscommunication will occur. For EFL communication in which people use L2
symbols with different perceptions, the problem of misunderstanding can be serious.
According to the study of Jamshidnejad (2010), EFL learners were concerned about
the accuracy and quality of utterances in meaning transfer and they focused too much
on the structure of the language when translating from L1 to L2 and vice versa.
Moreover, the fact that many EFL learners still have a low level of English
proficiency is another key factor that can limit the ability to communicate in English
with accuracy.
11
3) Contextual Problems
One of the most important factors that cause problems for EFL learners
is related to the lack of opportunities to use the language outside the classroom
(Sawir, 2005; Wong, 2004). Since English is not the primary language in EFL
countries, there are very few opportunities for people to practice English in their daily
life. When one hardly uses English in his or her daily life, he or she will be afraid of
using the language and will not be able to perform well in some situations that require
English communication. The contextual problems also include the fact that there is a
lack of qualified English teachers, especially in the Thai context.
Since Thailand is considered an EFL country, these kinds of problems cannot

be ignored. Instead, it is necessary to realize the significance of these problems and
find solutions to overcome them.
2.2 THEORIES OF NEEDS ANALYSIS
2.2.1 Definitions of Needs and Needs Analysis
The answer to how teachers or educators can develop effective English

curricula often lies in needs analysis. Needs analysis is a powerful tool that helps
practitioners clarify and validate true needs (Akyel& Ozek, 2010). Many theorists
have defined “needs analysis” in various ways. The following are some examples:
According to Brown (1995) as cited in Alharby (2005), the term needs

analysis, which is also called “needs assessment”, is defined as “the activities
involved in gathering information that will serve as the basis for developing a
curriculum which meets the learning needs of a particular group of students.” In
language programs, the needs are language related. Once needs are identified, they
can be stated in terms of goals and objectives that can be used as the basis for
developing tests, materials, teaching activities, and evaluation strategies for language
classes. The purpose of conducting needs analysis in language programs is to fill the
“gap” of what a language program “lacks.” Brown’s definition differentiates between
12
needs analysis and evaluation. It is important to note that the aim of needs analysis is
to determine the needs for a defined group of people, whereas an evaluation aims at
determining to what extent a language program meets these needs.
Robinson (1991) divided needs analysis into two categories. One is a “Target
Situation Analysis” (TSA) and another is “Present Situation Analysis” (PSA). TSA
emphasizes the students’ needs at the end of a language course, whereas PSA is aimed
at discovering what the students are like at the beginning of their language courses.
Analysts have to investigate their strengths and weaknesses. To analyze nurses’
English proficiency, needs analysis is a great foundation. It has been extensively used
as a basic tool to study the abilities of nursing professionals’ English proficiency and
to develop English courses that will be effective enough to improve the English skills
required by their job (Bosher & Smalkoski, 2002; Lee, 1999; 2002; Miyake &
Tremarco, 2005).
According to Hutchinson and Waters (1987), language needs are divided into
two types: the target needs and the learning needs. The target needs place an emphasis
on language use, and have three sub-categories consisting of necessities, lacks and
wants. Necessities or “objective needs” are needs determined by the requirement of a
target situation. It is what the learner has to know in order to use language effectively
in the target situation. Lacks are what learners do not have and must try to acquire in
order to function effectively in the target situation. Wants or “subjective needs” refer
to learners’ perception: what they feel and what they need. Hutchinson and Waters
also suggested a framework for target situation analysis in the form of simple
questions:
- Why is the language needed for the learner?
- How will the learner use the language?
- What will the content areas be?
- Who will the learner use the language with?
- Where will the language be used?

13
- When will the language be used?
The learning needs are concerned with what learners need to do in order to
learn. Hutchinson and Waters (1987) focused on the “lacks” representing the gap
between the required proficiency in the target situation and the existing proficiency of
the learners.
For Witkin and Altschuld (1995), needs analysis refers to a systematic set of
procedures undertaken for the purpose of prioritizing tasks and making decisions
about programs or organizational improvement and allocation of resources.
According to Dudley-Evans and St. John (1998, p. 122), needs analysis is not
only essential for language teaching and training, but also “the cornerstone of ESP
that can lead to a very focused course”. Kaur (2007) stated that although there were a
variety of interpreting “needs”, the concept of “learner needs” was often interpreted in
two ways:
- Goal-oriented definition which refers to what the learner wants to do with

the language. This relates to terminal objectives or the end of learning; and
- A process-oriented definition which refers to what the learner needs to do to

actually acquire the language. This relates to transitional or means of learning.
Traditionally, the first interpretation has been widely used and accepted.
However, in the present teaching and learning contexts, ESP courses relate to both
interpretations at the same time, but tend to focus more on the process-oriented
approach in aligning students’ needs with their current working environment (Kaur,
2007).
In this research, a goal-oriented definition is focused on in order to study

demand for English skills required by nurses’ routine work and to seek English skills
that nursing professionals participating in this study do not have. Furthermore, the
focus of target needs in this study will use Hutchinson and Waters’ definition. The
necessities, lacks and wants of nursing professionals in the participating hospital will
be analyzed respectively. This research study also focuses on the needs definition of
14
Robinson (1991): “Target Situation Analysis” (TSA) and “Present Situation Analysis”
(PSA). This study will cover the needs of what English usage is required in target
situations of nursing profession, the English abilities of the learners in the present
time, the discrepancy between English skills required in the target situations and the
nurses’ current English ability, the effective ways of language learning that will lead
to English improvement, and opinions on what the nurses want to learn and want the
hospital to support.
2.2.2 Needs Analysis/Assessment Method
In order to discover who the learners are, what they already know, and what
they want from the class, Medlin (2009) stated that it is important to conduct some
type of needs analysis.
According to Cohen, Manion, and Morrison (2000) as cited in Yuwaree

Tongvivat (2008), needs analysis is comprised of four main steps: the first step is
defining needs and selecting the definitions to be used; the second step is identifying
the focus of needs analysis. The third step is to decide what research methodology and
analysis procedure is to be applied; the fourth step is to report the results.
In order to know the demand of English skills for Thai nurses working in an
international healthcare organization, a survey strategy (which is a kind of needs
assessment method) was applied to gather information from participants. This method
was suitable for the study because the participants were free to comment and their
data were kept confidential.
Apart from needs analysis theory, English for Specific Purposes (ESP) is
another conceptual framework needed for this research study.
15
2.3 THE THEORY OF ENGLISH FOR SPECIFIC PURPOSES (ESP)
2.3.1 Definitions of ESP
English for Specific Purposes (ESP) arose as a term in the 1960’s as educators
started to be increasingly aware that General English courses frequently did not meet
the learners’ or employers’ wants (Brunton, 2009). ESP has been widely mentioned in
language teaching and learning areas. Under the umbrella term of ESP, there are a
large number of sub-divisions such as English for Academic Purposes (EAP), English
for Business Purposes (EBP), English for Occupational Purposes (EOP), and English
for Medical Purposes (EMP), with numerous others being added annually to the list
(Brunton, 2009). In this study, English for Nursing Purposes (ENP) will be focused
on. However, before going further into that, it is important to learn what ESP is. This
term has been referred to by many educators and ESP practitioners.
ESP refers to “An approach to language teaching in which all decisions as to

content and method are based on the learner’s reason for learning” (Hutchinson &
Waters, 1987). Widdowson (1983) as cited in Lee (1999) stated that ESP signified
professional-oriented teaching or learning of English. ESP was given as an intensive
training course and based on identifiable group needs.
Since there are some arguments over the definition of ESP in academia, many
people in the language field have tried to create their own definitions or
characteristics that best describe the term. Dudley-Evans and St. John (1998, pp. 2-5)
attempted to apply a series of characteristics of ESP: absolute characteristics and
variable characteristics.
Absolute Characteristics
1. ESP is defined to meet specific needs of the learners.
2. ESP utilizes underlying methodology and activities of the discipline it

serves.
3. ESP is centered on the language appropriate to these activities in terms of

grammar, lexis, register, study skills, discourse and genre.
16
Variable Characteristics
1. ESP may be related to or designed for specific disciplines.
2. ESP may use, in some specific teaching situations, a different methodology

from that of General English.
3. ESP is likely to be designed for adult learners, either in language

institutions or in a professional work situation. However, it could sometimes be taught
at secondary school level.
4. ESP is basically designed for intermediate or advanced students.
5. Most ESP courses assume some basic knowledge of the language systems.
This description is an attempt to help clarify to a certain degree what an ESP

course constitutes. There are a number of other characteristics of ESP that several
educators have put forward. For example, Belcher (2006), claimed that ESP assumed
that the problems were unique to specific learners in specific contexts and thus must
be carefully delineated and addressed to fit instruction.
Kennedy and Bolitho (1984) stated that it was logical to base ESP courses on
the needs of learners. Once the learners’ needs were discovered, this information
would be useful as a guideline to develop appropriate courses for learners. Likewise,
it is important to study “English for Nursing Purposes” in order to know what English
skills or special language requirements that nurses working in international settings
should have for their nursing profession. Then, appropriate English courses that
respond to those needs can be designed.
2.3.2 English for Nursing Purposes (ENP)
Over the last two decades, English for Specific Purposes (ESP) has been
viewed by many language scholars as having significant effects on meeting learners’
career needs (Lee, 1999). Based on this recognition, English for Nursing Purposes
(ENP) can also have similar functions in vocational nursing programs. Nowadays,
language scholars should place more emphasis on specific English for nursing
17
professionals since nursing personnel are required to converse with many different
types of people on various topics (Medlin, 2009). Nursing professionals usually
function as a liaison, communicating with patients, physicians, family members, and
other staff. Nurses have to remember lots of medical information and organize work
within time constraints while at the same time being responsible for many tasks. In
order to design English courses which will effectively respond to their professional
and individual needs, it is necessary to understand some factors influencing ENP.
Nursing staff working in the same organization and wishing to study English
for the healthcare profession in the same language class normally have different
personal and professional backgrounds. The California State Department of Education
(CDE, 1990) (as cited in Medlin, 2009) described the needs of learners in the ESL
Handbook for Adult Education Instructors. One consideration was educational
background. The educational system and personal learning styles of the students
influence the way they learn English in class. Hence, instructors have to observe the
students and conduct a needs assessment in order to understand the learners’
individual learning needs (Bosher & Smalkoski, 2002; Medlin, 2009). If learners have
limited English skills, teachers may need to utilize visuals, props, or learning-
materials to encourage them to be more confident about learning and want to study
English. Another consideration is the learners’ personal background. Nurses may
come from different socioeconomic backgrounds; some are brought up in rural areas
and others grow up in urban environments. There are many factors in nursing
professionals’ personal lives that can affect their ability to learn successfully in a
classroom, such as cultural background, family and/or personal responsibilities, and
physical and emotional health. Some of them may be tired and stressed from clinical
work or personal responsibilities. Once these basic factors are taken into account, it is
time to assess the learners’ needs of English skills in terms of listening, speaking,
reading and writing in a clinical environment.
After getting some idea about what ESP and ENP are, it is necessary to learn
more about how to design English courses that will effectively respond to nursing
professionals’ needs.
18
2.4 THE CONCEPT OF ESP COURSE DESIGN
Before establishing an ESP course, many issues should be taken into

consideration. According to Kennedy and Bolitho (1984), there are many factors
influencing ESP teaching and learning. Normally, these factors are numerous and
their inter-relationships are complex. However, four of the most important issues are
discussed here: the role of English, resources and administrative constraints, the
learner, and linguistic aspects.
Firstly, ESP programs are often the indirect result of political decisions made
at a governmental level about the role of English within the country where the learner
is studying. If the learner is in a country whose official language is English, he or she
will realize the importance of learning English and be motivated to practice it.
Secondly, ESP practitioners should think about the number and nature of
facilities utilized in ESP courses. Kennedy and Bolitho (1984) stated that the size of
classes, the degree of homogeneity within classes with respect to abilities and subject
discipline, and the quantity of instruction must all be taken into account. Another
related aspect is the role of the subject teachers. This aspect is important since any
decision to make use of an ESP approach relating to a specific subject will certainly
demand some degree of co-operation between language and subject specialists.
Thirdly, ESP practitioners should concentrate on the issues related to the

learner such as age, level of English proficiency, motivation, attitudes to learning, etc.
The older learners are, the more likely they are to have definite ideas on why they are
learning English. In fact, most of ESP learners are adults. At the adult level, there is
likely to be more agreement on needs between teacher and students since the purposes
of learning English are more clearly defined. As for the level of English proficiency, it
is important that there should be a balance between the linguistic and the conceptual
level of the learner. For example, the learner may be a trained scientist who is able to
operate well within his field in his own language but not in English. The task of the
ESP teacher here is to teach him or her language, but the texts chosen must be
significant to the student in their context. The learner’s motivation is another crucial
aspect that we have to consider. If it is possible for the teacher to find out a student’s
19
motivation for learning English and match the content of the course to this motivation,
this increases the chance of successful language learning. With high motivation, a
learner is much more likely to succeed. Roe (1977) as cited in Kennedy and Bolitho
(1984) suggested three levels of motivation to learn English. Level one, the highest
level, when English was required to obtain a degree or a desirable job or to get
promoted; Level two, to improve exam grades or influence career advancement; and
Level three where English could increase the student’s status, be useful if he or she
goes abroad, or widen his or her knowledge and interests. It is worth noting that levels
of motivation in individuals and groups may fluctuate from one lesson to the next,
with the teacher learning when to take advantage of an upturn in his or her learners’
motivation. Similar to the learner’s motivation, it is useful for ESP teachers to
consider the attitudes to learning of the students. Attitudes to an ESP course can be
influenced by a student’s previous learning of English. If this learning has not been
successful, there may be a negative feeling towards continuing something he or she is
not satisfied with (Medlin, 2009).
The last important issue related to factors influencing ESP teaching and
learning according to Kennedy and Bolitho (1984) is about linguistic aspects,
comprising the language and activities. In any ESP situation, there are three questions
to be answered. (1) What sort of English will the learner need? (2) What is his or her
purpose in learning? (3) How specific is his or her purpose? The three questions can
be answered by considering various aspects of the learning situation and the language
to be learnt by the student. Concerning the language, it is necessary that any analysis
of needs should have the type of English which will be necessary to teach if the
learner would like to achieve his or her purpose. Very often, the learner may need to
be taught a certain vocabulary, specific forms and functions, and how these functions
interrelate to produce coherent texts. As for the activities, types of exercise and
activity should be appropriate to particular requirements. For example, “writing” may
refer to note-taking or completing a technical report.
Apart from Kennedy and Bolitho (1984), there are other practitioners who
have offered opinions about designing ESP courses. Dudley-Evans and St. John
(1998) discussed criteria for ESP course design and developed useful steps for ESP
20
teachers and course designers to consider. They listed these concerns related to course
design in the form of the following questions:
- Should the course be intensive or extensive?
- Should the performance of the learners be assessed or non-assessed?
- Should the course deal with immediate needs or with delayed needs?
- Should the role of the teacher be that of the provider of knowledge and
activities, or should it be as facilitator of activities arising from learners’ expressed
wants?
- Should the course have a broad focus or narrow focus?
- Should the course be pre-study or pre-experience or run parallel with the

study or experience?
- Should the materials be common-core or specific to learners’ study or work?
- Should the group taking the course be homogenous or should it be

heterogeneous?
- Should the course design be worked out by the language teacher after
consultation with the learners and the institution, or should it be subject to a process
of negotiation with the learners?
According to Kaur (2007), ESP experts usually recommended the following

aspects to those who would like to tailor ESP courses:
- Placement testing (administering tests designed to assess general English

ability and ability to perform competently in a working environment). This might be
useful for determining the starting level of courses in ESP.
- Linguistic needs analysis (identifying skill development, linguistic structures,

lexical items, language functions and level of formality).
- Learning needs analysis (identifying attitudes of learners towards different

kinds of methodology, learning tasks and activities); and
21
- Learning perceptions analysis (discovering learners’ perceptions of

themselves and others as part of their organizational culture, and their relationships
with people from different organizational cultures).
Gatehouse (2001) stated that when developing an ESP curriculum, the

designer needed to integrate three abilities into it for the purpose of successful
communication in occupational settings. The three abilities consist of the ability to
use particular jargon in a specific occupational context, the ability to use a more
generalized set of academic skills, and the ability to use daily informal language to
communicate effectively in any context, not only occupational ones.
Many educators in nursing education have tried to develop English curricula

that would best suit the specific needs of nursing students (Bosher & Smalkoski,
2002; Lee, 1999; Medlin, 2009). Most of them usually start with addressing the
learners’ needs to use English focusing on particular jargon, English skills required by
their job, language abilities as perceived by themselves, and communication
difficulties in their occupational settings. Once their needs are analyzed, the educators
utilize the information in designing English courses for nursing students. Then at the
end of the courses, the students are required to evaluate the courses and the instructors
will use the evaluation information to adjust future courses.
Brindley (1989) claimed that one of the principles underlying learner-centered

systems of language learning was that teaching or learning programs should be
responsive to learners’ needs. It is now widely accepted as a principle of program
design that needs analysis is a vital prerequisite to the specification of language
learning objectives. In order to establish realistic and acceptable objectives for ESP
courses, it is important that the syllabus designer have comprehensive information
about the learners’ language needs (Oranute Tatti, 2007). Therefore, it is crucial for
syllabus designers, especially of ESP courses, to analyze learners’ present and future
needs before starting to design the syllabus. As for the participating hospital, an
English needs analysis will be important to assist the Human Resources Development
(HRD) to tailor its internal supplementary English courses for nursing personnel. In
22
order to provide a context for this research study, the relevant research is reviewed in
the next section.
2.5 RELEVANT RESEARCH
Aree Suwaroporn (1998) conducted research entitled “Job Analysis as a Basis

for Determining Needs and Problems in the use of English Language for Nurses” and
found that the necessary skill for nursing professionals at King Chulalongkorn
Memorial Hospital, a public hospital in Bangkok, was reading skills. The study found
that reading skills were most needed because nursing staff had to use this skill in
improving their professional knowledge by reading nursing textbooks and journals.
This finding is contrary to the study of Yuwaree Tongvivat (2008), who found that the
foremost skills needed for the nurses in a private hospital were listening and speaking.
This research study seeks to determine which language skills are needed the most by
nursing professionals.
Naruemol Siriwong (1984) conducted a survey about needs, wants and

expectations for the use of English for nursing students at Mahidol University,
Thailand. Though the study results revealed that reading was the most needed skill
required by their profession, the findings showed that in terms of wants for an English
course, the respondents would like their English course to focus more on listening and
speaking skills. This is because they personally want to communicate better in
English.
Lee (1999) conducted survey research in Taiwan concerning English on

“Nursing Purposes: A Needs Assessment for Professional-Oriented Curriculum
Design”. The primary purpose of her research study was to gain insight into nursing
students’ needs for ENP. In the past, it was believed that an ENP courses should focus
mainly on teaching terminology and prefixes/suffixes of medical jargon to fulfill
students’ needs. Furthermore, ENP courses were not easily accessed at that time.
According the research study of Lee, a majority of the subjects comprising full-time
nursing students and in-service students had a positive attitude towards English for
23
Specific Purposes or “ENP courses”. Moreover, three-fourths of in-service students in

her study strongly agreed that they needed ENP to function in their daily tasks. Lee
suggested that ENP courses should be divided into three levels: essential,
communicative and advanced. The essential level should include the contents and
skills used to understand doctor’s orders, chief complaints and symptoms,
terminology and diagnosis reports. Next, the communicative level can cover
conversation in an outpatient environment, nursing procedures, ways to comfort and
greeting, completing medical forms, and keeping records. Lastly, the advanced level
should contain critical reading in professional texts, briefing of equipment and work,
and doing nursing assessment and projects.
Concerning language components, Lee (1999) found that both groups of

subjects appeared to be more interested in improving their communicative
competence. This is because both groups perceived that the most important
components for their profession in the future are competence in making conversation
in English and listening comprehension.
2.6 SUMMARY
To sum up this chapter, Thailand is one of the Asian countries where English
is taught as a first foreign language and has an important role in the society. Since
English is not their mother tongue, Thai EFL users often encounter common
problems: communicator based problems, meaning creation problems, and contextual
problems. The first ones are concerned with communicators’ opinions toward ideal
English speakers. It has been found that Thai ELF has focused unnecessarily on the
use of grammar while ignoring communicative skills. Moreover, EFL learners often
make mistakes when they try to transfer the meaning of their L1 into English and vice
versa. The last common problem is that Thai EFL users cannot use English
effectively. This may be due to the lack of opportunity to use English in their daily
activities. These kinds of problems occur in almost every context including academic
fields, the business arena, the tourism and service sector, as well as the medical and
nursing fields. However, the problems can be solved gradually if EFL learners
24
understand the situation and realize what kind of English skills they need for their
professional life. In order to evaluate oneself, the theory of need analysis can be
applied. In this research study on the focus of nursing professionals’ English
communicative skills, if nurses who have to use English during their daily work know
their own language abilities and understand what English skills are required by their
job, they will be able to improve themselves significantly and be well-prepared for
their job. One effective method to enhance the English language abilities of the
nursing staff is to provide them with appropriate English supplementary course. Since
nursing profession require more complicated English skills, English for Specific
Purpose (ESP) appears to be appropriate for this situation. In this research, once the
study of the demand of English skills for Thai nurses working in an international
healthcare setting is completed, the management of the participating hospital can
utilise the information from this study to organize appropriate English courses for
their nursing staff. Furthermore, it will benefit people working in similar
environments.
CHAPTER THREE
METHODOLOGY
This chapter describes: (1) subjects, (2) the materials, (3) the procedures used
in the data collection, and (4) the data analysis.
3.1 SUBJECTS
The population for this research study is registered nurses, practical nurses,
and nurse aides working in the participating hospital, including all the inpatient and
outpatient departments. It is worth noting that both nurses and nurse aides working in
the hospital in this study had an equal chance to use English in their job. The
respondents in this study were 80 registered nurses, practical nurses, and nurse aides.
3.2 MATERIALS
The instrument of this research study was a set of self-administered

questionnaires. A pre-test of the study was performed before the actual questionnaire
was used to determine if all the questions could be easily understood by the
participants.
Pre-test of the questionnaire as pilot study
After reviewing the literature to acquire knowledge concerning the practices

and barriers of users who used English language as a primary foreign language among
different professionals, the questionnaire was developed for the field work.
Thereafter, the first draft of the questionnaire was used for the pre-test by asking a
group of 10 nurses from different departments to respond. The pilot study aimed to
check whether the terms, concepts and questions in the questionnaire were appropriate
and precise and that the questionnaires were not difficult to understand. During the
period of the pilot study, the respondents gave feedback to the researcher and the
questionnaire was adjusted accordingly.
26
Questionnaires
The questionnaire used in this research was developed from the previous study
of Yuwaree Tongvivat (2008). However, the rating scale was different. In this study, a
four-point scale was used whereas the one used in the previous study was a five-point
scale. After the pre-test of the questionnaire, the content of the questionnaire was
adjusted accordingly. The questions were formulated both in closed-ended and open-
ended formats. The questionnaire consisted of four principal parts:
Part I: General Background Information of the respondents
Part II: Experiences with English skills. This part included closed-ended
questions concerning the nurses’ experiences of using English language.
Part III: Opinions on Needs and Abilities of English skills in the job. A four-
point Likert scale was used in the questionnaire to assess the skills required by
nursing jobs and to indicate the nurses’ English abilities in particular activities. The
questionnaire covered questions concerning general English skills, activities that
required English proficiency and specific situations in listening, speaking, reading and
writing skills. The four-point Likert scale included the following criteria:
4 = Very extensive need/ability
3 = extensive need/ability
2 = Little need/ability
1 = Very little need/ability
Part IV: Opinions and suggestions for teaching activities for nurse’s English
course design. In this part, the respondents were questioned about their suggestions
and expectation of English courses provided by the participating hospital. The
questions were about the English skills that they would like to be taught in class. At
the end of the section, an open-ended question related to English course design was
posed to the respondents. The 4-point Likert scale was employed to rate the opinions.
The criteria used in this section were:
27
4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
3.3 PROCEDURES
This section describes the procedure for this research study.
3.3.1 Research Design
The research design of this study was a descriptive survey. It was conducted in
order to describe the demand of English skills for Thai nurses working in an
international healthcare organization and the opinions of the nurses on appropriate
internal English class design.
3.3.2 Data Collection
After receiving permission from the hospital director of the participating

hospital, the first version of questionnaire was administered to 10 nurses working in
different departments to test its comprehensibility. Then the researcher adjusted the
questions used in the questionnaire. After that, the completed version of questionnaire
was delivered to 80 respondents. The data collection period was January-February
2011.
3.4 DATA ANALYSIS
Data obtained was statistically analyzed using the Statistical Package for the
Social Sciences (SPSS) version number 15.0.
3.4.1 The data collected from the first part of the questionnaire was analyzed
using frequency distribution and percentage.
28
3.4.2 The data received from the second part of the questionnaire was
presented in the form of frequency, percentage, means and standard deviation.
3.4.3 The third part of the questionnaire using a Likert scale was analyzed in
the form of descriptive statistics (frequency, percentage, means and standard
deviation).
3.4.4 The data from the fourth part of the questionnaire was also analyzed in
the form of frequency, percentage, means and standard deviation.
CHAPTER FOUR
RESULTS
The previous chapter described the methodology of the study. This chapter
reports the results of the survey conducted among nursing professionals working in an
international hospital in Bangkok. The survey is divided into four parts based on the
questionnaire comprising:
4.1 General background information;
4.2 Experiences with English skills;
4.3 Opinions on needs and abilities of English skills in the job; and
4.4 Opinions and suggestions for teaching-learning activities for nurse’s

4.1 GENERAL BACKGROUND INFORMATION
This part describes the general background information of the subjects.
Although there were some male nurses in the participating hospital, all of the
respondents in this study were female nursing professionals, totaling 80 female
nurses.
Table 1. Age Group of Nurses
Age group (yrs) Frequency %
20-25 23 28.8
26-30 28 35.0
31-35 17 21.3
36-40 10 12.5
≥41 2 2.5
Total 80 100.0
30
With regard to the age of the subjects, the majority of respondents were aged
between 26-30 years, which constituted 35%. However, there were no nurses whose
age was more than 46 years participating in this survey as shown in Table 1.
Table 2. Education of Nurses
Education Frequency %
Associate Degree 30 37.5

Bachelor’s Degree 44 55.0
Master’s Degree 6 7.5
Total 80 100.0
Table 2 shows the education of the nurses, 55% of the nurses possessed a
Bachelor’s degree, 37.5 % had an Associate degree and only 7.5 % had a Master’s
degree.
Table 3. Classification of Respondents
Classification Frequency %
Registered nurse 44 55.0

Practical nurse 11 13.8
Nurse aid 25 31.2
Total 80 100.0
Table 3 shows the positions of the respondents; most of them were

registered nurses (RN), 55.0%, 13.8 were practical nurses and 31.2 % were nurse aids.
31
Table 4. Position of Respondents
Position Frequency %
Head of department 7 8.8

Member of department 73 91.2
Total 80 100.0
As can be seen in the Table 4, most of the respondents were members of a

department, at 91.2 %, while 8.8 % were heads of departments.
Table 5. Years of Experience as A Nurse in This Hospital
Years of experience Frequency %
1-5 years 57 71.3

6-10 18 22.5
11-15 4 5.0
≥16 1 1.3
Total 80 100.0
As shown in the Table 5, the highest proportion, 71.3 %, of nursing

professionals working in this international setting had work experience of 1-5 years.
22.5% of them had work experience of 6-10 years and those with work experience of
16 years and over accounted for 1.3 %.
32
Table 6. Experience in Training or Observing Work Abroad
Experience Frequency %
Yes 6 7.5
No 74 92.5
Total 80 100.0
In terms of working experience abroad, almost all of the subjects, 92.5 %, had
never been trained or observed work in medical settings abroad as shown in Table 6.
Table 7. Experience in Working Abroad
Working abroad Frequency %
Yes 5 6.3
No 75 93.8
Total 80 100.0
Table 7 shows that only 6.3 % of the nurses working in this hospital
had worked abroad before joining their current workplace.
4.2 EXPERIENCE WITH ENGLISH SKILLS
This part shows the details related to experience with the English skills of the
subjects.
33
Table 8. English Courses Since Working in This Hospital
English course Frequency %
No 26 32.5
Yes 54 67.5
Total 80 100.0
Table 8 shows that 67.5 % of health personnel had had English courses to
enrich their English knowledge since they came to work in this hospital.
Table 9. Self-study for English Skills Development
List of self-study approaches N %

Listening to English music 40 50.0
Listening to English conversations on cassette tapes or CD/MP3 22 27.5
Listening to English news on radio or on True Vision 18 22.5
Using the internet 17 21.3
Reading English newspapers 13 16.3
Reading English magazines 17 21.3
Reading English novels 7 8.8
Watching English movies 56 70.0
Chatting with foreign friends 18 22.5
Talking to Thai friends in English 40 50.0
Writing in a diary 1 1.3
Table 9 shows how respondents engaged in self-study of English language. It

is interesting to note that 70% of the respondents learned their English through
watching English movies, 50% listened to music and another 50% practiced their
English through having conversations in English with Thai friends. Those who
listened to English conversations on cassette tapes or CDs/MP3s constituted 27.5%,
followed by listening to English news on the radio or on True Vision, using the
34
internet, reading English magazines and reading English newspapers, at 22.5%,

21.3%, 21.3% and 16.3 %, respectively.
Table 10. Experience in Participating in an International Conferences
Participating in Conferences Frequency %
Yes 9 11.3
No 71 88.8
Total 80 100.0
Table 10 illustrates the percentage of respondents who had participated in

international conferences. 11.3 % of them had had a chance to attend a scientific
conference, whereas 88.8% had never had this opportunity.
Table 10.1. Frequency of Participating in an International Conferences
N %
Valid 1-2 times/a year 9 100.0
Total 9 100.0
Asked about the frequency of attending conferences, 9 respondents said that

they had attended them between 1 to 2 times annually as shown in Table 10.1.
35
Table 11. Range of Latest TOEIC Scores
Range of TOEIC scores Frequency %
Had never taken 14 17.5

Lower than 200 3 3.8
201-250 12 15.0
251-300 10 12.5
301-400 10 12.5
401-450 4 5.0
451-500 6 7.5
501-550 10 12.5
551-600 5 6.3
601-650 4 5.0
≥701 2 2.6
Total 80 100.0
As shown in Table 11, the largest percentage of the respondents had not taken
a TOEIC examination recently. Respondents whose TOEIC scores were below 400
constituted 43.8% of the total respondents and those whose TOEIC scores were
between 401-650 accounted for 36.3 %. 17.5 % of the respondents had never taken a
TOEIC exam at the time this survey took place. Finally, 2.6% of respondents had
TOEIC scores of 701 or more.
4.3 OPINIONS ON NEEDS AND ABILITIES OF ENGLISH SKILLS IN THE

JOB
In this part, the respondents were asked to identify the extent of needs and
English proficiency or abilities in using the four skills of English language, as well as
the situations in which they used those skills in their working environment. The data
obtained from part three of the questionnaire were computed into means and
interpreted at the following scale values:
36
Scale Value Level of Needs Level of Ability

1-1.99 Little Little
2-2.99 Moderate Moderate
3-4 Extensive Extensive
The mean scores of the respondents’ needs and abilities of English skills are
presented together for each particular skill.
4.3.1 Needs and abilities of English Skills in General
Table 12. Means of Needs of English Skills in Their Nursing Profession
English skills Needs

Mean SD Level of Needs
Listening 3.64 0.509 Extensive
Speaking 3.55 0.593 Extensive
Reading 3.09 0.750 Extensive
Writing 2.88 0.848 Moderate
Total 3.10 0.648 Extensive
Table 12.1. Means of Ability of English Skills in their Nursing Profession
English skills Ability

Mean SD Level of Ability
Listening 2.78 0.656 Moderate
Speaking 2.71 0.679 Moderate
Reading 2.56 0.672 Moderate
Writing 2.29 0.732 Moderate
Total 2.50 0.595 Moderate
With regard to the needs of English skills, the respondents had extensive needs
for English skills in their nursing profession. Considering individual skills, it can be
seen that the subjects had the highest need for three English skills, namely listening,
speaking and reading. The listening skill was the greatest need compared to other the
37
skills at the extensive level, whereas the need for writing skills was at the moderate
level.
Regarding ability of English skills, the respondents had a moderate level of

ability of using English in the four skills. Among the four skills, their listening and
speaking ability were better than reading and writing.
From Tables 12 and 12.1, there was a slight discrepancy between the needs
and ability of English skills in general. However, English writing skills were rated
equally both in terms of needs and ability.
4.3.2 Needs and ability of English Skills in different activities
Table 13. Means of Needs of English Skills in Different Activities
Activities Needs
1) Make small talk to foreign patients (face-to-face 3.23 0.826 Extensive
communication)
2) Talk to patients on telephone 3.51 0.636 Extensive
3) Work with foreign doctors 2.63 1.072 Moderate
4) Study and intern in English 2.49 1.158 Moderate
5) Do presentations in English 2.48 1.180 Moderate
6) Participate in international conferences 2.28 1.201 Moderate
38
Table 13.1. Means of Ability of English Skills in Different Activities
Activities Ability
1) Make small talk to foreign patients(face-to-face 2.71 0.697 Moderate
communication)
2) Talk to patients on telephone 2.73 0.675 Moderate
3) Work with foreign doctors 2.20 0.802 Moderate
4) Study and intern in English 2.08 0.839 Moderate
5) Do presentations in English 1.98 0.842 Little
6) Participate in international conferences 1.86 0.853 Little
With regard to the needs of using English in various activities, the respondents
used English skills in daily communication, especially in making small talk to foreign
patients and talking to patients on the telephone. As for other situations such as
working with foreign doctors, studying and doing internships in English, doing
presentations, and participating in international conferences, there were moderate
needs for using English skills with a mean of 2.35 as shown in Table 13.
Regarding the ability to use English skills in different activities, the

respondents perceived that their ability was at a moderate level in almost all of the
activities. They also considered their ability to study and intern in English and to
participate in international conferences at the little level.
According to the results presented in Tables 13 and 13.1, there were gaps
between needs and ability in almost all activities, especially in daily communication,
which required a high level of need to use English.
39
4.3.3 Needs and ability of Using individual English Skills in Various

Activities
4.3.3.1 English listening skill
Table 14. Needs of Using Listening Skill in Different Activities
Activities Needs
1) Patient histories and their needs 3.56 0.592 Extensive
2) Doctors' diagnosis and symptom management 3.45 0.654 Extensive
3) Doctors’ orders 3.38 0.682 Extensive
4) English conferences 2.68 1.065 Moderate
5) English lectures 2.74 1.064 Moderate
6) Various dialects and accents 3.43 0.776 Extensive
Table 14 shows that the priority of respondents’ need for listening was for
patient’s histories taken with the mean of 3.56, followed by diagnosis and symptom
management with the mean of 3.45. Overall, the respondents had high demand for this
need for various activities during management of the patients, with the average need
at 3.19, which is extensive.
Table 14.1. Ability of Using Listening Skill in Different Activities
Activities Ability
1) Patient histories and their needs 2.89 0.675 Moderate
2) Doctors' diagnosis and symptom management 2.85 0.677 Moderate
3) Doctors’ orders 2.84 0.683 Moderate
4) English conferences 2.16 0.719 Moderate
5) English lectures 2.19 0.748 Moderate
6) Various dialects and accents 2.66 0.810 Moderate
40
Regarding the respondents’ ability of using English listening skills in different

activities as seen in Table 14.1, the respondents perceived that they had the ability in
such activities at moderate levels with the mean of 2.66.
4.3.3.2 English speaking skill
Table 15. Needs of Using Speaking Skill in Different Activities
Activities Needs
1) Engaging in general conversations with 3.48 0.636 Extensive
foreign patients
2) Asking patients about chief complaints and 3.63 0.560 Extensive
symptoms
3) Explaining doctor' orders to foreign patients 3.43 0.689 Extensive
4) Giving bad news to patients 2.69 1.121 Moderate
5) Explaining how to use medicine to patients 2.93 1.077 Moderate
6) Explaining procedures 3.26 0.896 Extensive
7) Giving presentations in English 2.56 1.135 Moderate
8) Giving medical suggestions 3.19 0.915 Extensive
9) Teaching or lecturing in English 2.60 1.121 Moderate
Table 15.1. Ability of Using Speaking Skill in Different Activities
Activities Ability
1) Engaging in general conversations with 2.81 0.748 Moderate
foreign patients
2) Asking patients about chief complaints and 2.85 0.695 Moderate
symptoms
3) Explaining doctor' orders to foreign patients 2.73 0.693 Moderate
4) Giving bad news to patients 2.11 0.795 Moderate
5) Explaining how to use medicine to patients 2.54 0.871 Moderate
6) Explaining procedures 2.71 0.889 Moderate
7) Giving presentations in English 2.01 0.819 Moderate
8) Giving medical suggestions 2.59 0.852 Moderate
9) Teaching or lecturing in English 2.11 0.871 Moderate
41
With regard to needs of using English speaking skills, the results from Table
15 show that more than half of the speaking activities were rated at the extensive
level. These activities comprised engaging in general conversations with foreign
patients, asking patients about chief complaints and symptoms, explaining doctors’
orders to foreign patients, explaining procedures, and giving presentations in English.
Table 15.1 shows the ability of using English speaking skills in various
activities where respondents perceived that their English speaking proficiency in
different situations was at the moderate level.
According to the results shown in Tables 15 and 15.1, there were five
speaking activities that the respondents should pay more attention to. This was due to
the discrepancy between their needs and ability. These activities included engaging in
general conversations with foreign patients, asking patients about their chief
complaints and symptoms, explaining doctors’ orders to foreign patients, explaining
procedures, and giving presentations in English.
4.3.3.3 English reading skill
Table 16. Needs of Using Reading Skill in Different Activities
Activities Needs
1) General Publications 3.10 0.722 Extensive
2) Journals and articles 2.90 0.866 Moderate
3) Medical charts, patient histories 3.38 0.663 Extensive
4) Manuals and instructions 3.19 0.797 Extensive
5) Orders from doctors 3.33 0.725 Extensive
6) Nursing-related textbooks and references 2.94 0.847 Moderate
7) Patients' email inquiries 3.25 0.803 Extensive
42
Table 16.1. Abilities of Using Reading Skill in Different Activities
Activities Ability
1) General Publications 2.60 0.686 Moderate
2) Journals and articles 2.44 0.793 Moderate
3) Medical charts, patient histories 2.79 0.724 Moderate
4) Manuals and instructions 2.64 0.733 Moderate
5) Orders from doctors 2.75 0.738 Moderate
6) Nursing-related textbooks and references 2.43 0.823 Moderate
7) Patients' email inquiries 2.66 0.745 Moderate
Concerning the respondents’ needs for reading skills in different activities as

illustrated in Table 16, they had extensive needs for reading skills in almost every
activity, especially those concerned with their daily communications. These activities
included reading general publications, medical charts, patient histories, manuals and
instructions, orders from doctors and patients’ email inquiries.
From the data shown in Table 16.1, the ability of using English reading skills
of the respondents in various activities was at the moderate level.
According to the results illustrated in Tables 16 and 16.1, there were

discrepancies in almost all reading activities about which the respondents were asked.
The reading activities that the respondents should pay attention to were reading
general publications, medical charts, patient histories, manuals and instructions,
doctors’ orders, and patients’ email inquiries.
43
4.3.3.4 English writing skill
Table 17. Needs of Using Writing Skill in Different Activities
Activities Needs
1) Medical charts 2.85 0.943 Moderate
2) E-mails to patients 2.91 0.917 Moderate
3) Notes for patients 2.99 0.834 Moderate
4) Preparation for a medical procedures 2.91 0.874 Moderate
5) Medicine instructions 2.88 0.973 Moderate
6) Medical forms 2.95 0.855 Moderate
7) PowerPoint Presentations 2.65 0.956 Moderate
8) Memos 2.71 0.970 Moderate
9) Incident reports 2.61 0.987 Moderate
10) Résumés 2.80 0.933 Moderate
Table 17.1. Ability of Using Writing Skill in Different Activities
Activities Ability
1) Medical charts 2.34 0.745 Moderate
2) E-mail to patients 2.34 0.728 Moderate
3) Notes for patients 2.51 0.711 Moderate
4) Preparation for a medical procedures 2.48 0.779 Moderate
5) Medicine instructions 2.35 0.858 Moderate
6) Medical forms 2.48 0.811 Moderate
7) PowerPoint Presentations 2.14 0.868 Moderate
8) Memos 2.23 0.886 Moderate
9) Incident reports 2.18 0.823 Moderate
10) Résumés 2.40 0.805 Moderate
The results in Table 17 show that respondents perceived that the needs of
English skill in their profession were only at the moderate level.
44
With regard to the respondents’ ability of using English writing skills

presented in Table 17.1, the nurses perceived that their English writing proficiency
was at the moderate level with the total mean of 2.69.
According to the information illustrated in Tables 17 and 17.1, there was no

discrepancy between the level of needs and ability of the respondents.
4.4 OPINIONS AND SUGGESTIONS FOR TEACHING-LEARNING

ACTIVITIES FOR NURSE’S ENGLISH COUURSE DESIGN
In this part, the respondents gave both opinions and suggestions regarding
teaching-learning activities for nurse’s English course design. This part was divided
into three subcategories comprising teaching-learning and materials, duration and
time for organizing supplementary English courses for nursing professionals in the
participating hospital, and suggestions about structuring or designing the English
course. The opinions on teaching-learning and materials were computed into means
and were interpreted into three scale levels ranging from the disagree, moderate to
disagree levels, whereas the opinions on duration and time for English course design
were analyzed in the form of percentage.
4.4.1 Teaching-Learning and Materials
Scale Value Level of Opinion

1-1.99 Disagree
2-2.99 Moderate
3-4 Agree
45
Table 18. Opinions on Teaching-Learning and Materials
Teaching-learning and Materials Mean SD Level of Opinion

1) Four skills should be taught equally. 3.34 0.779 Agree
2) The course should emphasize listening. 3.44 0.633 Agree
3) The course should emphasize speaking. 3.58 0.612 Agree
4) The course should emphasize reading. 3.14 0.670 Agree
5) The course should emphasize writing. 3.09 0.715 Agree
6) The course should include technical terms. 3.45 0.549 Agree
7) The course should focus on grammar. 3.20 0.664 Agree
8) The course should include role plays. 3.21 0.706 Agree
9) The teaching method should be a monologue from 3.04 0.737 Agree
the lecturer.
10) The teaching can be based on textbooks. 2.99 0.720 Moderate
11) The teacher should provide a variety of media. 3.54 0.526 Agree
12) English tests should be provided at the end of the 3.49 0.551 Agree
course.
13) English certificates should be given at the end of 3.51 0.595 Agree
the course.
Total 3.30 0.488 Agree
As can be seen in Table 18, respondents agreed with almost all of English
teaching and learning activities and materials to be used in the supplementary English
classes. They agreed with teaching the four English skills equally with the mean of
3.34 and would like to be taught both grammar and technical terms with the mean of
3.20 and 3.45, respectively. Concerning teaching style, the respondents agreed with
applying role plays in teaching with the mean of 3.21 and most of them still preferred
passive learning style such as listening to a monologue from the lecturer with the
mean of 3.04. Furthermore, they thought that a variety of media should be provided
during the English courses with the mean of 3.54. However, the mean was 2.99 at the
moderate level among respondents who thought that the teaching should be based on
textbooks. Besides, the respondents agreed with having pre-tests and post-tests if they
had to attend English classes with the mean of 3.49. It is interesting to note that the
respondents with the mean of 3.51 would like to obtain English certificates at the end
of the course.
46
4.4.2 Duration and Time for Organizing Supplementary English Course
Table 19. Duration of Prospective English Course

N %
One month 2 2.5
Two months 13 16.3
Three months 46 57.5
More than three months 19 23.8
Total 80 100.0
As can be seen from Table 19, 57.5% of the respondents, the highest
proportion, expected the duration of supplementary English courses to be
approximately three months.
Table 20. Frequency of Prospective English Course

N %
Once a week until the course is done. 14 17.5
Twice a week until the course is done. 38 47.5
Three times a week until the class is done. 22 27.5
Four times a week until the course is done. 6 7.5
Total 80 100.0
Table 20 shows that 47.5% of the respondents expected that English

supplementary courses should be organized twice a week until the completion of the
course. In addition, 27.5% and 7.5% of them would like the class to be taught three
times and four times a week, respectively.
47
Table 21. Preference Regarding English Lecturers

N %
A native speaking instructor only 34 42.5
A Thai instructor only 2 2.5
Native speakers and Thai instructors 28 35.0
A native instructor with a Thai instructor as an
16 20.0
assistant teacher
Total 80 100.0
Table 21 shows that 42.5% of the respondents expressed their preference of

English native speaking instructors only, whereas only 2.5% would like to study with
a Thai instructor. It is interesting to note that 35% of them would like a combination
of a native speaker and a Thai as their instructors.
4.4.3 Suggestions About Structuring or Designing an English Course
In this part of the questionnaire, the subjects were asked to respond to an

open-ended question about structuring or designing internal English courses. There
were nineteen nurses expressing opinions. The suggestions can be classified into four
main areas: teaching-learning materials, duration of the course, instructor, and
learning environment. Concerning teaching-learning materials, many of the
respondents thought that four English skills and medical terminology should be taught
at an equal amount. Moreover, they suggested that various kinds of teaching materials
such as electronic devices and techniques such as role play and international songs
should be utilized effectively during the course.
Regarding the duration of the course, most of the respondents who gave an
answer would like every staff to be involved in arranging the time of attending the
course. In addition, they would like the supplementary class to be provided
continuously.
With regard to the instructor of the course, the respondents preferred an

English native speaker as their instructor. They also suggested that the organization
arrange a study tour abroad or an international seminar to provide them with more
opportunities to practice English with native speakers.
48
As for working environment, a number of the respondents would like the

hospital to promote bilingual communication among the local staff and the foreign
staff, i.e., there should be direct communication between individual Thai staff at each
section rather than discussing their wants and needs with local executives.
Furthermore, the respondents agreed that the staff should use both Thai and English in
internal written communication.
To sum up this chapter, the respondents had extensive needs for almost all of
English skills in their nursing profession, especially for listening, speaking and
reading skills, whereas their ability to perform those English skills were at a moderate
level. The nursing professionals need to improve listening, speaking and reading skills
due to the discrepancy between their needs and ability to use those English skills. In
terms of using English skills in different activities, there were gaps between needs and
ability in almost all activities, including daily communication and nursing-related
activities. Concerning course design, the majority of respondents would like
supplementary English courses to focus on the four English skills. At the same time,
they would like to learn both English grammar and nursing terminology. The largest
proportion of the respondents would like to study twice a week in a three-month
course. Furthermore, a large number of them preferred to study English with English
native instructors. Many of the respondents also would like the hospital management
team to encourage their staff to communicate more in English in their daily working
environment.
The findings of the study will be summarized and discussed in the next
chapter.
CHAPTER FIVE
CONCLUSION, DISCUSSION AND RECOMMENDATIONS
This chapter presents (1) a summary of the study, (2) a summary of the
findings, (3) discussion of the results, (4) the conclusion, and (5) recommendations
for further research.
5.1 SUMMARY OF THE STUDY
This section summarizes the study of demand of English skills for Thai nurses
working in an international healthcare organization focusing on a study in a private
hospital in the Silom area.
5.1.1 Objectives of the Study
The objectives of this study were divided into one main objective and three
sub-objectives. The main objective was to investigate the demand of English skills,
which were necessary for Thai nursing professionals working in an international
medical setting. The sub-objectives of this study were to find out nursing
professionals’ perception about their own English ability, to compare demand of
English skills required by the nursing profession and English ability that nurses
perceived in themselves, and finally to provide the participating hospital with
suggestions related to its internal English course design.
5.1.2 Subjects, Materials, and Procedures
Subjects: The population for this study was registered nurses, practical nurses,
and nurse aides working in both inpatient and outpatient departments of the
participating hospital. It is significant to note that both nurses and nurse aides working
in the hospital in this study had equal chances to use English in their daily job. The
respondents of this study were 80 nurses, comprising registered nurses, practical
nurses and nurse aides.
50
Materials: The instrument used in this study was a set of self-administered

questionnaires consisting of multiple choice questions and four-point Likert scale
items. The questionnaire was divided into four main parts: general background
information of the respondents, their experiences with English skills, their opinions on
needs and ability regarding English skills in the job, and their opinions and
suggestions for teaching-learning activities for nurse’s English course design. The
pre-test of the study was performed before the actual questionnaire was used to
determine if all the questions could be easily understood by the participants.
Procedures: The research design of this study was a descriptive cross-section

or survey. It was conducted in order to describe the demand for English skills required
by Thai nursing professionals working in an international healthcare organization and
the opinions of the nurses on appropriate internal English class design; only one
assessment was used. After receiving permission from the hospital director at the
participating hospital, the first version of the questionnaire was distributed to 10
nurses working in different departments to pre-test the questionnaire for
comprehensibility. Then, some questions were adjusted accordingly. After that, the
completed version of the questionnaire was administered to 80 respondents during
January-February 2011. After checking for the completion of the questionnaire, the
data obtained were statistically analyzed using the Statistical Package for the Social
Sciences (SPSS) version 15.0. The analysis was presented in the form of frequency
distribution, percentage, means, and standard deviation.
5.2 SUMMARY OF THE FINDINGS
The results of the study can be summarized as follows:
5.2.1 General Background Information
Although there were a few male nurses working in the participating hospital,
only female nurses responded to the questionnaires in this study. Most of nurses in
this study were between the ages of 26-30 years old and most had experience as a
nurse in this hospital between 1-5 years. They also held Bachelor’s degrees or higher.
51
However, most of them did not have experience observing or training in medical
settings abroad.
5.2.2 Experience With English Skills
According to the data obtained, the majority of the respondents reported that
they had continuously studied English when they had free time. The most popular
English self-study activity of nurses participating in this study was watching English
movies. This finding was the same as reported in that of the study of Yuwaree
Tongvivat (2008). The second most popular activities were listening to English music
and talking to Thai friends in English. Concerning the experience in participating in
international conferences, most of the respondents had rarely attended such
conferences. However, those attending reported that they had participated in
international conferences approximately 1-2 times a year.
5.2.3 Opinions on Needs and Ability of English Skills in the Job
Based on the results of the data analysis, it was found that the level of the
respondents’ needs of using English skills in their nursing profession was extensive,
especially in listening, speaking and reading skills. The greatest need was for listening
skills at the extensive level, whereas the need for writing skills was at the moderate
level. This finding was different from the finding of Yuwaree Tongvivat (2008), who
found that only English listening and speaking skills were at the extensive level in
terms of need. Moreover, the findings of this study appear to be somewhat contrary to
the findings of Naruemol Siriwong (1984) and Aree Suwaroporn (1998), which
indicated that English reading skills were most needed. Regarding the ability of
English skills, it was found that the respondents had a moderate level of ability of
using English in every skill. Among the four skills, their listening and speaking
abilities were found to be better than reading and writing. It is worth noting that there
was a slight discrepancy between the needs and ability of English skills in general.
Since the gap between needs and ability in terms of listening skills was the widest,
improvement in listening skill ability should be emphasized. In terms of using English
skills in different activities, the study found that there were gaps between needs and
52
ability in almost all activities, including daily communication and nursing-related

activities.
5.2.4 Opinions and Suggestions for Teaching-Learning Activities for

Nurse’s English Course Design
According to the data obtained from part 4 of the self-administered

questionnaire, the majority of the respondents agreed with almost all of English
teaching-learning activities and materials to be used in the supplementary English
classes. The designer of internal English courses should pay attention to teaching the
four skills equally. At the same time, the respondents agreed that the content of the
course should combine knowledge of English grammar and nursing jargon. Regarding
the style of teaching, the respondents would like the teacher to use both active and
passive techniques. For example, the teacher may use role play in class in
combination with lecture. The respondents also wished that various kinds of teaching
materials be provided. However, the respondents agreed that the teaching should be
based on textbooks at a moderate level. Finally, the respondents preferred to study
English with native instructors.
5.3 DISCUSSION
This section contains the discussion of the significant findings of the research
study. For the overall picture, only female nursing professionals responded to the
questionnaires. Although there were a few male nurses working in the participating
hospital, during the data collection period there were only female nurses on duty.
However, this is of no significance as the survey was intended to study the needs and
ability of English skills required by the nursing profession irrespective of gender.
5.3.1 Nursing Professionals and the Role of English in Their Job
According to the results shown in Table 12, the respondents perceived that
almost all of the four English skills are needed extensively for the nursing profession.
This can imply that the nurses working in the participating hospital realized that
53
English language was an important part of their career as it could strengthen the
quality of their nursing care. Since the hospital management understood the role of
English, they had set criteria for English proficiency based on TOEIC scores (Test of
English for International Communication) for individual positions. Personnel
attaining specific English skill levels normally received incentives from the
organization. This language requirement also applied to the nursing staff in the
participating hospital and their English scores required by their job were
approximately 400-500. Surprisingly, the results obtained from this study showed that
there were only a few staff members reaching those criteria. This finding corresponds
to the study of Yongyuth Chalamwong and Paradon Tansaewee (2005), which
reported that the most important barrier for Thai nurses wishing to work in
international settings was their weakness in English language. One underlying reason
that can explain why many Thai nurses had low proficiency in English is that Thai
people have few chances to use English in their daily life (Jamshidnejad, 2010). Since
English is not Thailand’s official language, there are few opportunities for
international medical and nursing conferences to be organized in Thailand, resulting
in nursing professionals’ having limited chances to participate in such events. In this
study, a large number of the respondents had never participated in international
nursing conferences. However, nursing professionals in this study appeared to realize
these problems. That was the reason why a large number of the respondents tried to
create their own way of learning English and practiced their English skills by using
various self-study approaches during their free time. This is a good sign for the
nursing staff and the management team as there is the possibility that the nurses will
improve their English skills eventually. This will guarantee better quality care,
resulting in a better reputation for the organization.
5.3.2 Level of Needs and Ability of English Skills of the Nursing

Professionals
From the findings of this study, in nursing jobs there were three English skills
that were rated at the extensive level of needs: listening, speaking, and reading skills.
However, listening skills were rated at the highest level of needs among the three
skills within the extensive level of needs. This finding was contrary to that of
54
Yuwaree Tongvivat (2008), who reported that English listening and speaking skills
were most needed for the nursing profession. Furthermore, the results of this study
differed from those of Naruemol Siriwong (1984) and Aree Suwaroporn (1998),
which indicated that English reading skills were the most needed. These differences
could have resulted from the situation at the hospitals being studied. Naruemol
Siriwong and Aree Suwaroporn conducted their research in public hospitals in
Thailand where almost all of the patients are local people, whereas this study was
conducted in an international private hospital where English language is used as the
means of communications. Although Yuwaree Tongvivat also did a survey in a
private hospital, the different results may be due to the number of respondents and the
departments being observed. The study of Yuwaree Tongvivat was done based on 22
respondents and focused only on inpatient nurses working in Intensive Cardiac Care
Units (ICCU). However, in this study, the respondents were 80 nurses working in
both inpatient and outpatients departments. Those working in outpatient departments
had more chances to use English during their working hours; therefore, the opinions
on needs of English skills varied.
In terms of the ability of using English skills, the nurses in the participating
hospital perceived themselves as having a moderate ability to use English in all four
skills. The results showed that almost all respondents thought that their English was
not at the extensive level, implying that they underestimated their English capability,
especially their speaking skills. Moreover, they may have had an ideal image of
people who can use English fluently and may not have wanted to compare themselves
to those with outstanding English. For these reasons, the respondents rated their
ability lower than their real capability. According to Wong (2004), most EFL learners
perceived that an ideal English user was able to speak fluently with correct grammar
and a native-like accent.
One explanation for the nurses’ perception of themselves as having a moderate

level of English ability is that they had lost confidence in their English
communication skills. According to Wong (2004) and Sawir (2005), a large amount
of EFL teaching focuses on grammar study and less so on communication skills such
as listening and speaking. The nurses in this study, who had a background as EFL
55
learners, may have been reluctant to rate themselves at the level of extensive English
ability.
Regarding the discrepancy between nurses’ needs and abilities of English

skills, the findings revealed that there was a slight discrepancy for almost every
English skill in the overall picture. However, the gap between necessity of using
English in the nursing profession and the ability of the nurses to perform listening
skills appeared to be the widest. For this reason, some academic approaches to
strengthen this skill should be provided to the nurses. The necessity to improve
listening skill was also mentioned in the study of Yuwaree Tongvivat (2008), which
showed that improvement of listening was greatly needed by ICCU nurses.
5.3.3 Nurses’ needs of English Listening Skill in Various Activities
Regarding the needs of English skills in various activities, the results in Table
14 of chapter 4 indicated that listening in the following activities were extensively
needed in terms of listening to patient histories and their needs, doctors’ diagnosis and
symptom management, as well as doctors’ orders. All of these activities are nursing
related tasks. This finding corresponds to the results of the study of Lee (1999) and
Yuwaree Tongvivat (2008), which showed that the activities mentioned were
extensively needed for nursing professionals.
5.3.4 Nurses’ needs of English Speaking Skill in Various Activities
From the findings shown in Table 15 of chapter 4, speaking skills relating to

daily tasks were rated as the most extensive need. These speaking activities include
engaging in general conversations with foreign patients, asking patients about chief
complaints and symptoms, explaining doctor’s orders to foreign patients, explaining
procedures, and giving medical suggestions. Again, the findings in this part were
similar to those of Lee (1999). According to Lee’s study, professional needs for ENP
(English for Nursing Purpose) were categorized into nineteen specific task items.
Many of these tasks were also found in the results of this research study.
56
5.3.5 Nurses’ needs of English Reading Skill in Various Activities
According to the results of this study, English reading skills were one of three
skills extensively needed for nursing professionals. One interesting finding is that the
nurses have an extensive need for reading patients’ email enquiries. In the
participating hospital, medical e-mail correspondence had become more important
and the nurses were supposed to be able to read queries carefully and understand what
the patients wanted so that they could respond appropriately. This finding is
significantly different from other studies because it shows the influence of
information technology on the nurses’ needs for English skills.
5.3.6 Nurses’ needs of English Writing Skill in Various Activities
Among nursing professionals in the participating hospital, English writing

skills were rated as a moderate need for both nursing related tasks and general
writing. This finding corresponded to the study of Yuwaree Tongvivat (2008). Since
long medical reports are normally written by doctors and the writing tasks for nurses
are often short, the nurses may not think this skill is necessary for them. However,
nursing professionals still need to take this skill into account.
5.3.7 Preferences for Nurse’s English Course Design
With reference to the results in Table 8 of the previous chapter showing that
almost 70% of the respondents still study English during their professional life, this
implies that nurses placed great importance on English study. Moreover, the activities
reported in Table 9 of chapter 4 indicate that the nurses have tried to improve their
English skills through their daily activities.
As shown in Table 18, the nurses would like their internal English course to
focus equally on the four skills. This result correlates to the finding that the
respondents perceived that almost all English skills were rated as extensive needs.
However, this finding is different from the results of Yuwaree Tongvivat’s study in
2008, which showed that nurse’s English teaching should focus mostly on speaking
skills.
57
The results in part 4 of the questionnaire showed that the nurses would like
their English classes to be equipped with a variety of media and focus on technical
terms. These findings correspond to the suggestions from many educators (Bosher &
Smalkoski, 2002; Lee, 1999; Medlin, 2009), who recommend that a good English
course should be tailored to the learners’ needs by focusing on particular jargon,
English skills needed for their job, and communication difficulties in their
occupational settings. Once internal English teachers of the participating hospital
understand these needs, they will be able to find appropriate methods to gain the
nurses attention during the course.
5.4 CONCLUSION
The following conclusions can be drawn from the discussion above.
5.4.1 The areas of English skills which are necessary for Thai nurses
working in international settings who would like to prepare themselves to meet their
professional needs include listening skills, speaking skills and reading skills.
5.4.2 The nursing professionals in the participating hospital were aware that
English skills were important for their careers. However, they perceived their ability
in English language to be lower than their actual capability.
5.5 RECOMMENDATIONS FOR FURTHER RESEARCH
Based on the findings and conclusions of this study, the following

recommendations are made for future research.
5.5.1 Since medical staff consist of several groups of people including

medical physiotherapists, technicians, audiologists, nutritionists, and pharmacists, it
would be interesting to conduct further research on the needs of their English skills in
order to compare and contrast the results.
58
5.5.2 There should be further research studying the needs of English skills
for non-medical staff working in international settings in order to compare the general
English skills that are important for everyone who works in the same environment.
5.5.3 Other strategies for needs assessment such as observation and direct
interviews should be applied in further research in order to obtain more details.
5.5.4 After an internal English supplementary course is developed based on

this study, a follow up study should be conducted to evaluate the course and to
improve the content.
REFERENCES
Akyel, A. S., & Ozek, Y. (2010). A language needs analysis research at an English
medium university in Turkey. Procedia Social and Behavioral Sciences, 2, 969-
975.
Alharby, M., & Harklau, L. (2005). ESP target situation needs analysis: The English
language communicative needs as perceived by health professionals in the
Riyardh area (Unpublished doctoral dissertation). University of Georgia,
Athens.
Aree Suwaroporn. (1998). Job analysis as a basis for determining needs and
problems in the use of English language for nurses (Unpublished master’s
theses). Mahidol University, Faculty of Graduate Studies.
Attapol Khamkhien. (2010). Thai learners’ English pronunciation competence:
Lesson learned from word stress assignment. Journal of Language Teaching
and Research, 1(6), 757-764.
Belcher, D. (2006). English for specific purposes: Teaching to perceived needs and
imagined futures in worlds of work, study and everyday life. TESOL Quarterly,
40 (1), 133-156.
Bosher, S., & Smalkoski, K. (2002). From needs analysis to curriculum development:
Designing a course in health-care communication for immigrant students in the
USA. English for Specific Purposes 21, 59-79.
Brindley, G. (1989).The role of needs analysis in adult ESL programme design. In R.
K. Johnson (Ed.), The second language curriculum. Cambridge: Cambridge
University Press.
Brunton, M. (2009). An account of ESP- with possible future directions. English for
Specific Purposes Issue 3, 24(8), 1-15.
60
Busayanee Getmanee. (2005). Components contributing to English oral proficiency:

A case study of the undergraduates of King Mongkut’s institute of technology
North Bangkok. The Journal of Industrial Technology, 1(1), 52-59.
Cameron, R. (1998). A language-focused needs analysis for ESL-speaking nursing
students in class and clinic. Foreign Language Annuals, 31(2), 203-218.
Cautrell, A. (2011). ESL vs EFL: What’s the difference? Retrieved from
http://www.associatedcontent.com/pop_print.shtml?content_type_art
Divi, C., Koss, R. G., Schmaltz, S.P., & Loeb, J. M. (2007, February 2). Language
proficiency and adverse events in US hospitals: A pilot study. Journal of
Quality in Health Care, Advance Access, 1-8.
Dudley-Evans, T., & St. John, M.-J. (1998). Developments in ESP: A multi
disciplinary approach. Cambridge: Cambridge University Press.
Gatehouse, K. (2001, October). Key issues in English for specific purposes (ESP)
curriculum development. The Internet TESL Journal, 7(10). Retrieved from
http://itesl.org/Articles/Gatehouse-ESP.html
Hart-Rawung, P., & Li, L. (2008). Globalizatuon and business communication:
English Communication skills for Thai automotive engineers. World Academy
of Science, Engineering and Technology, 48, 320-330.
Hutchinson, T., & Waters, A. (1987). English for specific purpose: A learning
centered approach. Cambridge: Cambridge University Press.
Jamshidnejad, A. (2010). The construction of oral problems in an EFL context: An
innovative approach. Studies in Literature and Language, 1(6), 8-22.
Kameda, N. (2005). A research paradigm for international business communication.
Corporate Communications, 10(2), 168-182.
Kaur, S. (2007). ESP course design: Matching learner needs to aims. Retrieved from
http://www.espworld.info/Articles_14/DESIGNING%20ESP%20COURSES.htm
Kennedy, C., & Bolitho, R. (1984). English for specific purposes. London: Macmillan
Publishers.
61
Lee, C. (1999). English for nursing purposes: A needs assessment for professional
oriented curriculum design. Academic Journal of Kang-Ning, 1(1), 55-72.
Liu, X. (2010). Arousing the college students’ motivation in speaking English through
role-play. International Education Studies, 3 (1), 136-144.
Marschan, R., Welch, D., & Welch, L. C. (1997). Language: The forgotten factor in
multinational management. European Management Journal, 15(5), 591-598.
Medlin, L. (2009). English for specific purposes (ESP): Nursing in the U.S. hospital
(Unpublished master’s thesis). California State University, Chico.
Miyake, M., & Tremarco, J. (2005). Needs analysis for nursing students utilizing
questionnaires and interviews. Kawasaki Journal of Medical Welfare, 11(1),
23- 34.
Naruemol Siriwong. (1984). A survey of needs, wants and expectations for the use of
English of nurses: Undergraduates at Mahidol University (Unpublished
master’s theses). Mahidol University, Faculty of Graduate Studies.
O’Neil, T. R., Tannenbaum, R. J., & Tiffen, J. (2005). Recommending a minimum
English proficiency standard for entry-level nursing. Journal of Nursing
Measurement, 13 (2),129-146.
Oranute Tatti. (2007). A study of the needs of Thai dance instructors in using the
English language as a basic for course design (Unpublished master’s research
paper). Thammasat University, Language Institute, English for Careers.
Robinson, P. C. (1991). ESP today: A practioner’s guide. London: Prentice Hall
International.
Sawir, E. (2005). Language difficulties of international students in Australia: The
effects of prior learning experience. International Education Journal, 6 (5),
567-580.
Tagsina Sripracha. (2005). Intelligibility of English speech between Singaporean and
Thai English speakers (Unpublished master’s thesis). Chulalongkorn
University, Graduate School, English as an international language.
62
Widdowson, H. G. (1983). Learning purposes and language use. Oxford: Oxford

University Press.
Witkin, B. R., & Altschud, J. W. (1995). Planning and conducting needs assessment:
A practical guide. Thousand Oaks: Sage.
Wong, J. K. (2004). Are the learning styles of Asian international students culturally
of contextually based? International Education Journal, 4(4), 154-166.
Yongyuth Chalamwong, & Paradon Tansaewee. (2005). Movement of healthcare and
information technology professionals in Thailand: Impact implications of
AFAS. TDRI Quarterly Review, 20 (2), 15-2.
Yuwaree Tongvivat. (2008). Needs assessment for English skills of ICCU nurse in a
private hospital in Bangkok (Unpublished master’s research paper). Thammasat
University, Language Institute, English for Careers.
APPENDIX A
QUESTIONNAIRE (English Version)
Demand of English skills for Thai nurses working in an international healthcare

organization: A study in a private hospital in the Silom area
This questionnaire is part of research for the purpose of fulfillment of the independent
study, which is required for the Master of Arts (English for Careers) Program,
Language Institute, Thammasat University. The information you contributed will be
used only for the survey of demand of English skills for Thai nurses who work at
international healthcare providers in order to find what English skills are needed for
nursing professionals. Please be assured that the information will also be treated with
the highest confidentiality and used for the purpose of this research study only. Your
cooperation in answering this questionnaire is greatly appreciated.
Part One: General Background Information
Instruction: Please cross X all that apply to you.
1. Gender: ( ) male ( ) female
2. Age (yrs): ( ) 20-25 ( ) 26-30 ( ) 31-35 ( ) 36-40
( ) 41-45 ( ) 46-50 ( ) 51-55 ( ) 56-60
3. Education: ( ) Associate Degree ( ) Bachelor’s Degree
( ) Master’s Degree ( ) Doctorate Degree
4. You are a ( ) registered nurse ( ) practical nurse ( ) nurse aide
5. Position: ( ) Head of department
( ) Member of department
6. How many years have you been working in this hospital?
( ) 1-5 yrs ( ) 6-10 yrs ( ) 11-15 yrs ( ) 16-20 yrs
( ) 21-25 yrs ( ) 26-30 yrs ( ) 31-35 yrs ( ) more than 35 yrs

64
7. Have you ever been trained/observed work in medical facility abroad?
( ) Yes ( ) No
8. Have you ever worked abroad?
( ) Yes ( ) No
Part Two: Experiences with English skills
9. Since you started working here, how many hours have you studied English?
( ) Never ( ) ………hrs/week
( ) ………hrs/month
( ) ………hrs/year
10. In what way do you practice English? (More than one answer is allowed.)
( ) Listening to English music
( ) Listening to English conversation in cassette tapes or CD/ MP3
( ) Listening to English news on radio or on True Vision
( ) Using the internet
( ) Reading English newspapers
( ) Reading English magazines
( ) Reading English novels
( ) Watching English movies
( ) Chatting with foreign friends
( ) Talking to Thai friends in English
( ) Others (Please specify ……………………………………….)
11. Have you ever participated in an international conference?
( ) Yes ( ) No (please go to item 12)
11.1 How often have you been to international conferences?
( ) 1-2 times/ a year ( ) 3-4 times/ a year ( ) more than 4 times/ a year
65
12. What is the latest range of your TOEIC scores?
( ) Lower than 200 ( ) 201-250 ( ) 251-300
( ) 301-400 ( ) 401-450 ( ) 451-500
( ) 501-550 ( ) 551-600 ( ) 601-650
( ) 651-700 ( ) 701-750 ( ) 751-800
( ) 801-850 ( ) 851-900 ( ) More than 900
Part Three: Opinions on Needs and Abilities of English skills in the job.
Instruction: Please check X in the boxes on the left to rate your needs and check X in
the boxes on the right to rate your skill proficiency.
4 = very extensive need/ ability
3 = extensive need/ ability
2 = little need/ ability
1 = very little need/ ability
13. To what extent do you need to use the English skills, and to what extent do you
rate your proficiency in these skills?
Needs Proficiency
Very Very Very Very
Extensive Little Skills Extensive Little
extensive little extensive little
3 2 3 2
4 1 4 1
Listening
Speaking
Reading
Writing
66
14. To what extent do you need to use English in the following activities, and to what
extent do you have ability to carry out these activities.
Needs Ability
Very Very Activities Very Very
Extensive Little Extensive Little
3 2 3 2
4 1 4 1
1) Make small talk to foreign
patients (face-to-face
communication)
2) Talk to patients on
telephone
3) Work with foreign doctors
4) Study and intern in English
5) Do presentations in English
6) Participate in international
conferences
7) Others (Please
specify)………………
15. To what extent do you need to use English skills in the following activities, and to
what extent are you able to do these activities.
15.1 Please rate your opinion about your English needs and your existing ability on
English Listening Skill.
Needs Ability
Very Very Very Very
Extensive Little Activities: Listening to… Extensive Little
3 2 3 2
4 1 4 1
1) Patient histories and their
needs
2) Doctors' diagnosis and
symptom management
3) Doctors' orders
4) English conferences
5) English lectures
6) Various dialects and
accents
7) Others (Please
67
English Speaking Skill.
Needs Ability
Very Very Very Very
Extensive Little Activities Extensive Little
3 2 3 2
4 1 4 1
1) Engage in general
conversations with foreign
patients
2) Ask patients about chief
complaints and symptoms
3Explain the doctors’ orders to
foreign patients
4) Give bad news to patients
5) Explain how to use medicine
to patients
6) Explain procedures
7) Give presentations in
English
8) Give medical suggestions
9) Teach or lecture in English
10) Others (Please
English Reading Skill.
Needs Ability
Very Very Very Very
Extensive Little Activities: Reading… Extensive Little
3 2 3 2
4 1 4 1
1) General Publications
2) Journals and articles
3) Medical charts, patient
histories
4) Manuals and instructions
5) Orders from doctors
6) Nursing- related text books
and references
7) Patients' email inquiries
8) Others (Please
68
English Writing Skill.
Needs Ability
Very Very Very Very

Extensive Little Activities: Writing… Extensive Little
3 2 3 2
4 1 4 1
1) Medical charts
2) E-mails to patients
3) Notes for patients
4) Preparation for a
medical procedures
5) Medicine instructions
6) Medical forms
7) Powerpoint
Presentations
8) Memos
9) Incident reports
10) Résumés
11) Others (Please
Part Four: Opinions and suggestions for teaching-learning activities for nurse’s
16. In order to organize an English course that can be useful for the nursing staff in
the hospital, please provide us with the opinions on the following topics and cross X
on the given boxes that represent your opinions:
4 = Strongly agree
3 = Agree
2 = Disagree
1 = Strongly disagree
69
Needs Rate
Strongly Strongly
Teaching and learning materials Agree Disagree
agree disagree
3 2
4 1
1) Four skills should be taught equally.
2) The course should emphasize listening.
3) The course should emphasize speaking.
4) The course should emphasize reading.
5) The course should emphasize writing.
6) The course should include technical terms.
7) The course should focus on grammar.
8) The course should include role plays.
9) The teaching method should be a lecture.
10) The teaching can be based on text books.
11) The teacher should provide a variety of
media.
14) English tests should be provided at the end
of the course.
15) English certificates should be given at the
end of the course.
16) Other (Please specify)
…………………………………………….
17. Please cross X in the parentheses to identify your expectation.
17.1 How long should an English training course be?
( ) Two months
( ) Three months
( ) More than three months (Please specify)……………….
17.2 You want the course schedule to be
( ) Once a week until the course is done.
( ) Twice a week until the course is done.
( ) Three times a week until the class is done.
( ) Four times a week until the course is done.

70
17.3 You want to study with
( ) A native speaking instructor only
( ) A Thai instructor only
( ) A native and Thai instructor
( ) A native instructor with a Thai instructor as an assistant teacher
18. Do you have any suggestions about structuring or designing the English course for
the nursing staff?
1) …………………………………………………………………….
2) …………………………………………………………………….
3) …………………………………………………………………….
Thank you for your time for completing the questionnaire.

APPENDIX B
QUESTIONNAIRE (Thai Version)
แบบสอบถามภาษาไทย
การสารวจ ความต้องการและความจาเป็นในการใช้ทักษะภาษาอังกฤษของพยาบาลชาวไทยที่ทางานใน
โรงพยาบาลที่มีสิ่งแวดล้อมในการทางานแบบนานาชาติ :การศึกษา ณ โรงพยาบาลเอกชนแห่งหนึ่งในย่านสีลม
วัตถุประสงค์ แบบสอบถามนี้ สร้างขึ้นเพื่อศึกษาเกี่ยวกับความต้องการและความจาเป็นในการใช้ทักษะ

ภาษาอังกฤษของพยาบาลชาวไทยที่ทางานในโรงพยาบาลที่มีสิ่งแวดล้อมในการทางานแบบนานาชาติ คาตอบ
ของท่านจะเป็นประโยชน์อย่างยิ่งในการนามาวิเคราะห์เพื่อหาแนวทางในการวางแผนการพัฒนาภาษาอังกฤษ
และจัดหลักสูตรการสอนภาษาอังกฤษของพยาบาลและผู้ช่วยพยาบาล ผู้วิจัยขอรับรองว่าคาตอบของท่านจะถือ
เป็นความลับ การนาเสนอข้อมูลจะนาเสนอโดยภาพรวมเท่านั้น ดังนั้นจึงขอความกรุณาท่านช่วยตอบทุกข้อความ
ตามความเป็นจริง และหวังเป็นอย่างยิ่งว่าจะได้รับความร่วมมือจากท่านเป็นอย่างดี และขอขอบคุณท่านมา ณ
โอกาสนี้ แบบสอบถามนี้ประกอบด้วย 3 ตอนดังนี้
ตอนที่ 1 ข้อมูลทั่วไปเกี่ยวกับผู้ตอบแบบสอบถาม
ตอนที่ 2 ข้อมูลเกี่ยวกับประสบการณ์ในการใช้ทักษะภาษาอังกฤษของผู้ตอบแบบสอบถาม
ตอนที่ 3 ความคิดเห็นเกี่ยวกับความต้องการและความจาเป็นในการใช้ทักษะภาษาอังกฤษของพยาบาลชาวไทยที่
ทางานในโรงพยาบาลที่มีสิ่งแวดล้อมในการทางานแบบนานาชาติ
ตอนที่ 4 ข้อคิดเห็นและข้อเสนอแนะในการจัดการเรียนการสอนภาษาอังกฤษสาหรับพยาบาลและผู้ช่วยพยาบาล
--------------------------------------------------------------------------------------
ตอนที่ 1 ข้อมูลทั่วไปเกี่ยวกับผู้ตอบแบบสอบถาม
คาชี้แจง: โปรดใส่เครื่องหมายกากบาท X ลงในวงเล็บที่ตรงกับท่านมากที่สุด
1. เพศ: ( ) ชาย ( ) หญิง
2. อายุ (ปี): ( ) 20-25 ปี ( ) 26-30 ปี ( ) 31-35 ปี ( ) 36-40 ปี
( ) 41-45 ปี ( ) 46-50 ปี ( ) 51-55 ปี ( ) 56-60 ปี

72
3. วุฒิการศึกษา (กรุณาตอบทุกข้อที่มี):
( ) อนุปริญญา ( ) ปริญญาตรี ( ) ปริญญาโท ( ) ปริญญาเอก
4. ปัจจุบันท่านเป็น ( ) พยาบาลวิชาชีพ, RN ( ) ผู้ช่วยพยาบาล, PN ( ) ผู้ช่วยพยาบาล, Nurse Aide
5. ตาแหน่งงานปัจจุบันของท่านคือ: ( ) หัวหน้าแผนก
( ) เจ้าหน้าที่ระดับผู้ปฏิบัติการ
6. ท่านทางานที่โรงพยาบาลแห่งนี้มานานกี่ปี
( ) 1-5 ปี ( ) 6-10 ปี ( ) 11-15 ปี ( ) 16-20 ปี
( ) 21-25 ปี ( ) 26-30 ปี ( ) 31-35 ปี ( ) มากกว่า 35 ปี
7. ท่านเคยได้รับการอบรมหรือดูงานในสถานพยาบาลในต่างประเทศหรือไม่
( ) เคย ( ) ไม่เคย
8. ท่านเคยทางานในต่างประเทศหรือไม่
( ) เคย ( ) ไม่เคย
ตอนที่ 2 ข้อมูลเกี่ยวกับประสบการณ์ในการใช้ทักษะภาษาอังกฤษของผู้ตอบแบบสอบถาม
9. ตั้งแต่ท่านเริ่มทางานเป็นพยาบาล/ผู้ช่วยพยาบาลในโรงพยาบาลแห่งนี้ ท่านได้ศึกษาหาความรู้เกี่ยวกับ
ภาษาอังกฤษ ประมาณกี่ชั่วโมง
( ) ไม่เคย ( ) ...............ชั่วโมง/สัปดาห์
( ) ...............ชั่วโมง/เดือน
( ) ...............ชั่วโมง/ปี
73
10. ท่านศึกษาและฝึกฝนทักษะภาษาอังกฤษเพิ่มเติมด้วยตนเองด้วยวิธีใด (สามารถตอบได้มากกว่า 1ข้อ)
( ) ฟังเพลงสากล ( ) ฝึกฟังบทสนทนาภาษาอังกฤษผ่านเทป ซีดี/ MP 3
( ) ฟังข่าวภาคภาษาอังกฤษจากวิทยุหรือ ทรูวิชั่น
( ) ฝึกภาษาอังกฤษผ่านอินเตอร์เน็ต ( ) ฝึกอ่านหนังสือพิมพ์ภาษาอังกฤษ
( ) ฝึกอ่านนิตยสารภาษาอังกฤษ ( ) ฝึกอ่านนวนิยายภาษาอังกฤษ
( ) ดูภาพยนตร์ภาษาอังกฤษ ( ) สนทนาออนไลน์กับเพื่อนชาวต่างชาติ
( ) สนทนาประจาวันกับเพื่อน/ เพื่อนร่วมงานเป็นภาษาอังกฤษ
( ) อื่นๆ (โปรดระบุ ................................................................)
11.ท่านเคยเข้าร่วมประชุมสัมมนาทางวิชาการนานาชาติหรือไม่
( ) เคย ( ) ไม่เคย (กรุณาข้ามไปตอบข้อ 12)
11.1 ท่านเคยเข้าร่วมประชุมสัมมนาทางวิชาการนานาชาติกี่ครั้ง
( ) 1-2 ครั้งต่อปี ( ) 3-4 ครั้งต่อปี ( ) มากกว่า 4 ครั้งต่อปี
12. ผลการทดสอบภาษาอังกฤษ TOEIC ของท่านครั้งล่าสุดอยู่ในช่วงคะแนนใด
( ) ต่ากว่า 200 คะแนน ( ) 201-250 คะแนน ( ) 251-300 คะแนน
( ) 301-400 คะแนน ( ) 401-450 คะแนน ( ) 451-500 คะแนน
( ) 801-850 คะแนน ( ) 851-900 คะแนน ( ) มากกว่า 900 คะแนน

74
ตอนที่ 3 ความคิดเห็นเกี่ยวกับความต้องการและความจาเป็นในการใช้ทักษะภาษาอังกฤษของพยาบาลชาวไทยที่
ทางานในโรงพยาบาลที่มีสิ่งแวดล้อมในการทางานแบบนานาชาติ
คาชี้แจง: โปรดใส่เครื่องหมายกากบาท X ลงในช่องว่างทางซ้ายมือเพื่อระบุความจาเป็นในการใช้ภาษาอังกฤษ

ของท่านในสถานการณ์ต่างๆ และโปรดใส่เครื่องหมายกากบาท X ลงในช่องว่างทางขวามือเพื่อระบุความสามารถ
ในการใช้ทักษะภาษาอังกฤษของท่านในสถานการณ์ดังกล่าว
13. ท่านมีความจาเป็นในการใช้ทักษะภาษาอังกฤษต่อไปนี้มากน้อยเพียงใด และท่านมีความสามารถมากน้อย

เพียงใดในแต่ละทักษะ
ระดับความจาเป็น ความสามารถในการใช้ทักษะ
มากที่สุด มาก น้อย น้อยที่สุด ทักษะ มากที่สุด มาก น้อย น้อยที่สุด
4 3 2 1 4 3 2 1
ฟัง
พูด
อ่าน
เขียน
14. ท่านมีความจาเป็นในการใช้ทักษะภาษาอังกฤษในสถานการณ์ต่อไปนี้ในระดับใด และท่านมีความสามารถใน

การใช้ภาษาอังกฤษในแต่ละสถานการณ์อยู่ในระดับใด
น้อย น้อย
มากที่สุด มาก น้อย สถานการณ์ มากที่สุด มาก น้อย
ที่สุด ที่สุด
4 3 2 4 3 2
1 1
1) ใช้สื่อสารในชีวิตประจาวันทั่วไป
2) สนทนากับผู้ป่วยทางโทรศัพท์
3) ทางานกับแพทย์ต่างชาติ
4) ศึกษาดูงานเป็นภาษาอังกฤษ
5) นาเสนอผลงานเป็นภาษาอังกฤษ
6) เข้าร่วมประชุมสัมมนา นานาชาติ
7) อื่นๆ (โปรดระบุ
..........................................................)
75
15. ท่านมีความจาเป็นต้องใช้ทักษะภาษาอังกฤษในสถานการณ์ต่อไปนี้ในระดับใด และท่านมีความสามารถใน

การใช้ภาษาอังกฤษในแต่ละสถานการณ์มากน้อยเพียงใด
15.1 กรุณาระบุระดับความคิดเห็นเกี่ยวกับความจาเป็นในการใช้ทักษะการฟังภาษาอังกฤษและความสามารถใน
การใช้ทักษะการฟังภาษาอังกฤษ
4 3 2 4 3 2
1 1
1) ฟังเกี่ยวกับประวัติ อาการและความ
ต้องการของผู้ป่วย
2 ฟังการตรวจวินิจฉัยและการรักษา
อาการของแพทย์
3) ฟังคาสั่งแพทย์
4) ฟังการประชุมสัมมนา
5) ฟังการบรรยาย (lecture)
6) ฟังภาษาอังกฤษสาเนียงต่างๆจาก
ผู้ป่วย
7) อื่นๆ (โปรดระบุ เช่น ฟังอาการหรือ
คาถามจากผู้ป่วยทางโทรศัพท์ เป็นต้น
.......................................................)
76
15.2 กรุณาระบุระดับความคิดเห็นเกี่ยวกับความจาเป็นในการใช้ทักษะการพูดภาษาอังกฤษและความสามารถใน
การใช้ทักษะการพูดภาษาอังกฤษ
4 3 2 4 3 2
1 1
1) พูดคุยทั่วๆ ไปกับผู้ป่วยต่างชาติ
2) สอบถามประวัติ อาการ และความ
ต้องการของผู้ป่วยต่างชาติ
3) อธิบายคาสั่งแพทย์ให้ผู้ป่วยทราบ
4) แจ้งข่าวร้ายกับผู้ป่วย
5) แนะนาวิธีการใช้ยา
6) อธิบายหัตการให้ผู้ป่วยทราบ
7) พูดนาสนอในการประชุมต่างๆ
8) แนะนาวิธีการปฏิบัติตัว
9) สอนงานพยาบาล ที่มาดูงาน
10) อื่นๆ (โปรดระบุ เช่น พูดกับผู้ป่วย
ทาโทรศัพท์ เป็นต้น.............................)
77
15.3 กรุณาระบุระดับความคิดเห็นเกี่ยวกับความจาเป็นในการใช้ทักษะการอ่านภาษาอังกฤษและความสามารถใน
การใช้ทักษะการอ่านภาษาอังกฤษ
4 3 2 4 3 2
1 1
1) อ่านสิ่งพิมพ์ทั่วๆไป
2) อ่านบทความวิชาการ
3) อ่านแฟ้มประวัติผู้ป่วย
4) อ่านข้อกากับการใช้ยา
5) อ่านคาสั่งจากแพทย์
6) อ่านตาราและหนังสืออ้างอิง
7) อ่านอีเมลคาถามจากผู้ป่วย
..........................................................)
78
15.4 กรุณาระบุระดับความคิดเห็นเกี่ยวกับความจาเป็นในการใช้ทักษะการเขียนภาษาอังกฤษและความสามารถใน
การใช้ทักษะการเขียนภาษาอังกฤษ
4 3 2 4 3 2
1 1
1) เขียนแฟ้มประวัติทางการแพทย์ของ
ผู้ป่วย
2) เขียนอีเมลหาผู้ป่วย
3) เขียนโน้ตให้ผู้ป่วย
4) เขียนการเตรียมตัวก่อนทาหัตถการ
5) เขียนอธิบายการใช้ยา
6) กรอกแบบฟอร์มต่างๆ
7) เขียนเพื่อนาเสนอผลงานในรูปแบบของ
Powerpoint
8) เขียน Memo
9) เขียนรายงานอุบัติการณ์
10) เขียนประวัติส่วนตัว (Resume)

..........................................................)
ตอนที่ 4 ข้อคิดเห็นและข้อเสนอแนะในการจัดการเรียนการสอนภาษาอังกฤษสาหรับพยาบาล
16. หากทางโรงพยาบาลจะจัดให้มีการเรียนการสอนภาษาอังกฤษสาหรับพยาบาล ท่านมีความคิดเห็นอย่างไรใน

หัวข้อต่อไปนี้ กรุณาทาเครื่องหมายกากบาท X ในช่องว่างที่ตรงกับความคิดเห็นของท่านมากที่สุด
4 = เห็นด้วยอย่างยิ่ง 3 = เห็นด้วย 2 = ใม่เห็นด้วย 1 = ใม่เห็นด้วยอย่างยิ่ง

79
ระดับความเห็นด้วย
เห็นด้วย ไม่เห็นด้วย
การเรียนการสอนและสื่อการเรียนการสอน เห็นด้วย ไม่เห็นด้วย
อย่างยิ่ง อย่างยิ่ง
3 2
4 1
1) ท่านต้องการให้มีการสอนทักษะการฟัง พูด อ่าน เขียน ใน
อัตราส่วนเท่ากัน
2) ท่านต้องการให้สอนโดยเน้นทักษะการ ฟัง มากที่สุด
3) ท่านต้องการให้สอนโดยเน้นทักษะการ พูด มากที่สุด
4) ท่านต้องการให้สอนโดยเน้นทักษะการ อ่าน มากที่สุด
5) ท่านต้องการให้สอนโดยเน้นทักษะการ เขียน มากที่สุด
6) ท่านต้องการให้สอนโดยเน้นคาศัพท์ทั่วไปและคาศัพท์เฉพาะทาง
7) ท่านต้องการให้สอนโดยเน้นไวยากรณ์
8) ท่านต้องการให้สอนโดยใช้บทบาทสมมุติ
9) ท่านต้องการให้สอนโดยการบรรยายจากอาจารย์
10) ท่านต้องการให้สอนเน้นที่หนังสือที่ใช้ประกอบการเรียน
11) ท่านต้องการให้สอนโดยใช้สื่อการเรียนการสอนที่หลากหลาย
12) ท่านต้องการให้มีการทดสอบประเมินผลการเรียน
13) ท่านต้องการให้มีการมอบใบประกาศนียบัตรหลังการอบรม
14) อื่นๆ (โปรดระบุ)
……………………………………………...….
17. กรุณาทาเครื่องหมายกากบาท X ในช่องว่างที่ตรงกับความคิดเห็นของท่านมากที่สุด
17.1 ท่านต้องการให้หลักสูตรการอบรมภาษาอังกฤษมีระยะเวลานานเท่าไหร่ต่อหลักสูตร
( ) สองเดือน
( ) สามเดือน
( ) มากกว่าสามเดือน (โปรดระบุ)............................................
( ) อื่นๆ (โปรดระบุ)......................................................
80
17.2 ท่านต้องการให้ตารางเรียนเป็นอย่างไร
( ) เรียนสัปดาห์ละครั้งจนครบหลักสูตร
( ) เรียนสัปดาห์ละสองครั้งจนครบหลักสูตร
( ) เรียนสัปดาห์ละสามครั้งจนครบหลักสูตร
( ) เรียนสัปดาห์ละสี่ครั้งจนครบหลักสูตร
17.3 ท่านต้องการเรียนกับใครมากที่สุด
( ) อาจารย์เจ้าของภาษาเท่านั้น
( ) อาจารย์ชาวไทยเท่านั้น
( ) อาจารย์เจ้าของภาษา และอาจารย์ชาวไทย
( ) อาจารย์เจ้าของภาษา และ อาจารย์ชาวไทย เป็นผู้ช่วยสอน
18. ท่านมีข้อเสนอแนะอย่างไรในการจัดการเรียนการสอนและอบรมหลักสูตรภาษาอังกฤษสาหรับพยาบาล และ

ผู้ช่วยพยาบาลในองค์กรที่ท่านทางานอยู่
1) …………………………………………………………………….
2) …………………………………………………………………….
3) …………………………………………………………………….
ขอขอบคุณที่ท่านสละเวลากรอกแบบสอบถามนี้อย่างครบถ้วนสมบูรณ์

2011 Demand of English Skills For Thai Nurses Working

Uploaded by

Copyright:

Available Formats

You might also like

2011 Demand of English Skills For Thai Nurses Working

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

2011 Demand of English Skills For Thai Nurses Working

Uploaded by

Copyright:

Available Formats

5 2 2 1 0 3 0 0 5 8

DEMAND OF ENGLISH SKILLS FOR THAI NURSES WORKING IN AN

Advisor: Supanee Jivasak-Apimas, Ph.D.

A RESEARCH PAPER SUBMITTED IN PARTIAL FULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

ENGLISH FOR CAREERS

LANGUAGE INSTITUTE, THAMMASAT UNIVERSITY

Advisor: Supanee Jivasak-Apimas, Ph.D.

A RESEARCH PAPER SUBMITTED IN PARTIAL FULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

ENGLISH FOR CAREERS

LANGUAGE INSTITUTE, THAMMASAT UNIVERSITY

English as a Foreign Language (EFL) refers to learning and teaching English

I would further like to acknowledge all of my classmates for their friendship

Furthermore, my gratitude is also extended to the hospital director of the

Lastly, my deepest appreciation goes through my family, friends, and

Thammasat University Wanwisa Waidarp

Bangkok, Thailand March 2011

ACKNOWLEDGEMENTS ………………………………………………..……….. iii

1.1 Background ……………………………………………………...........1

1.2 Statement of the Problem ……………………………………….…… 5

1.3 Objectives of the Study …………………………………………….... 6

1.4 Definitions of Terms ……………………………………………….... 6

1.5 Scope of the Study ………………………………………….…… …..7

1.6 Significance of the Study ………………………………………..…....7

1.7 Organization of the Study …………………………………………….8

2. REVIEW OF LITERATURE ……………………………………….....… 9

2.1 The Concept of English as a Foreign Language (EFL)………………. 9

2.2 Theories of Needs Analysis …………………………….……..…….11

2.3 The Theory of English for Specific Purposes (ESP) …………….…..15

2.4 The Concept of ESP Course Design …………………..…….…….....18

2.5 Relevant Research ………………………………...………….….…..22

3. METHODOLOGY ………………………………………..………..... ... 25

3.1 Subjects …………………………………………………….….…… 25

3.2 Materials …………………………………………………….…....… 25

3.3 Procedures …………………………………………………..……… 27

3.4 Data Analysis …………………………………………….……..…...27

4.1 General Background Information ……………………………......… 29

4.2 Experiences With English Skills …………………………..….……. 32

4.4 Opinions and Suggestions for Teaching-Learning Activities for

Nurse’s English Course Design. …………………………..…….…. 44

5. CONCLUSION, DISCUSSION AND RECOMMENDATIONS …..…..49

5.1 Summary of the Study ………………………………………...……. 49

5.2 Summary of the Findings ……………………………………..……. 50

5.3 Discussion ………………………………….…………..…..………. 52

5.4 Conclusion ……….……………………………………….…..…..… 57

5.5 Recommendations for Further Research ……………………..…. … 57

A. Questionnaire (English version)…………………………...…….……… 63

B. Questionnaire (Thai version) ……………………………….……..……..71

Since Thailand is an Asian country where English has been taught as a

Thailand‟s educational system generally puts much more emphasis on reading

In Thailand, many sectors, including private medical hospitals, have become

Barriers to language proficiency affect work performance despite nursing

1.2 STATEMENT OF THE PROBLEM

Since the English proficiency of Thai nursing professionals working in

1.2.2 How do nursing professionals in the participating hospital perceive

1.2.3 What kind of course design do nurses working in international hospital