Designing an ESP Course on Engagement in Nursing Communication: A Study of Nursing College Students in Mainland China


Student thesis: Doctoral Thesis

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Award date26 Oct 2021


Effective nurse-patient communication can be achieved in a number of ways, one of which is the nursing professional’s engagement with patients during their medical care. Engagement is characterized as a nurse’s efforts to interact with a patient, to see beyond the patient’s immediate symptoms or pain. To engage with patients better, nurses need to employ a variety of communication skills, particularly strategies that enable them to understand and elicit patient concerns. These communication strategies that promote engagement are essential to developing good patient-centered care.

Engagement is a task that often demands advanced or complex communication skills and may be more challenging when a foreign language is involved. Nurses in China, as elsewhere, are having to interact with ever-increasing numbers of patients in English as a result of globalization. Thus, English for specific purposes (ESP) courses that explicitly teach engagement and related communication skills to nurses are needed. The skills learned in such courses are also transferrable to the students' first language (e.g., Mandarin) or any other language that they use to interact with patients.

This PhD is the result of a research project where I modified an existing ESP nursing course in a nursing college in China so that the course more clearly and effectively addressed spoken communicative engagement strategies for better patient care. Hospital nurses were interviewed and observed to explore their understanding of engagement in clinical practice at hospitals. The data on nurses’ perceptions and practices of engagement helped to refine the existing ESP course that was basically only a non-discourse-level English proficiency course built around typical nursing subject matter. The course was modified to focus on communication strategies that promote engagement in nursing practice. Changes in the nursing students’ perceptions, and their use of engagement strategies in role-played interactions before and after the remodelled course, were analyzed to determine the effectiveness of the modified ESP course.

The modified ESP course was evaluated, and the student feedback was positive. After the modified course, students’ perceptions of engagement and their practice of it (as observed in role-played interactions) showed significant improvement, as indicated by quantitative and qualitative analyses. When compared with their counterparts in a traditional ESP course, the students who attended the modified ESP course outperformed significantly in their perceptions and practices of engagement in terms of: (1) improving patients’ understanding, (2) eliciting patients’ concerns and (3) establishing empathy and rapport with patients. Pedagogical and clinical implications were generated about what the findings mean for the syllabus design of ESP nursing communication courses and how training in engagement strategies can lead to better nursing and better patient care. The research findings will be of interest to ESP practitioners, nurse educators in China, and non-native English-speaking nurses who need to communicate in English with their patients.

    Research areas

  • engagement, communication strategies, English for specific purposes (ESP), course development, nursing students, mainland China