mazdayasna and tahririan

www.elsevier.com/locate/jeapJournal of English for Academic Purposes 7 (2008) 277e289

Developing a profile of the ESP needs of Iranian students: The caseof students of nursing and midwifery

Golnar Mazdayasna a, M.H. Tahririan b,*

a Yazd University, Yazd, Iranb Sheikhbahaee University, Iran

Abstract

The aim of conducting this study was to investigate the foreign language learning needs of undergraduate medical sciences studentsstudying in faculties of nursing and midwifery in Iran. A total of 681 undergraduate students as well as 168 subject-specific instructorsand 6 EFL instructors participated in the study, which was designed on a qualitative-quantitative survey basis using interviews andquestionnaires. Extensive qualitative and statistical analysis of the data revealed that most of the students perceived that they needed tomaster the foreign language before they attended their specialized courses because they needed to use Persian and English sources tostudy their subject. Over one-third of the students expressed their dissatisfaction with the number of students in each class, with theteaching methodology used, the method of evaluation, and the amount of foreign culture taught in the class and content of the textbook.Equally, the subject-specific instructors’ responses revealed total dissatisfaction with their students’ language skills.

It can be inferred that this course does not fully prepare the students to embark on their studies because it does not sufficiently takeinto account their (1) learning needs, (2) present level of foreign language proficiency, (3) objectives of the course, (4) resourcesavailable in terms of staff, materials, equipment, finances and time constraint, (5) the skill of the teachers and the teacher’sknowledge of the specific area.Crown Copyright � 2008 Published by Elsevier Ltd. All rights reserved.

Keywords: Academic learning needs; ESP content; EAP methodology; EAP instructors

1. Introduction

Although in Iran almost all undergraduate textbooks are in Persian, students are urged to also read other sourcesand professional journals in English. Thus, the main aim of English classes at undergraduate level is to help studentsimprove their technical vocabulary, reading, and translation skills. It has been hoped that if students improve theirgeneral language skills early in the course, and learn the relevant technical vocabulary of their discipline in their firstyear, they will be adequately equipped to handle subject-specific textbooks in their later specialized courses. However,the Ministry of Science, Research, and Technology’s high commission offers no clear guidance for selecting anddeveloping basic academic instructional materials related to the linguistic or communicative standards expected by

* Corresponding author.

E-mail addresses: [email protected] (G. Mazdayasna), [email protected] (M.H. Tahririan).

1475-1585/$ - see front matter Crown Copyright � 2008 Published by Elsevier Ltd. All rights reserved.

doi:10.1016/j.jeap.2008.10.008

mailto:[email protected]

mailto:[email protected]

278 G. Mazdayasna, M.H. Tahririan / Journal of English for Academic Purposes 7 (2008) 277e289

students. English for Academic Purposes (EAP) and English for Specific Purposes (ESP) are developing branches ofEFL instruction in Iran, and have a marginal status in the tertiary education.

Prior to the change of government in 1979e80, the British Council had sponsored a major ESP materials initiativein Iran which generated many textbooks targeted to this population (the Nucleus series, edited by Tony Dudley-Evansand Martin Bates, published by Longman from 1976e1980), but after this period EAP and ESP were no longera priority. In 1985 the responsibility of English language materials production fell on SAMT (the official Iraniancenter for materials development in humanities). In addition to 6 volumes of General English, SAMT has published110 volumes of so-called sub-technical and technical English textbooks in different areas of specialization. Thetextbooks follow a rigid format of such instructional exercises and activities as ‘pre-reading’, ‘reading’, ‘homework’and ‘language’ exercises for all academic disciplines, with the major focus on reading comprehension skills. In ouropinion, the contents of these textbooks are not designed to address the learning needs, wants and desires of Iranianstudents; the articles are selected mainly on the basis of topic, as being related to the students’ field of study, and not onthe basis of genre or discourse of the particular discipline. Of the four skills, only reading has been emphasized.

Although the bulk of undergraduate level English instruction in Iran deals with teaching EAP, this is of a limited scopeand has overlooked the principles underlying course design, which should be viewed as an on-going process to suit students’interests and needs (Sifakis, 2003). In addition, the course applies a text-centered approach and is examination-oriented.After completing their degree programs, most students lack the foreign language proficiency they are expected to have.

The main aim of conducting this study was to investigate the foreign language learning needs, wants and desires ofundergraduate medical sciences students studying in faculties of nursing and midwifery in various universities in Iran.The assessment of learners’ needs was performed by considering the views of various stakeholders including studentsand instructors. Efforts were made to find answers to the following questions:

1. What are the specific English language needs of Iranian nursing and midwifery students?2. What language skills do nursing and midwifery students need to develop?3. What types of content, methodology and class activities are appropriate for nursing and midwifery students?4. What factors should be considered in designing syllabii for nursing and midwifery students?

As for the possible implications, the results may be used as input documentation in making decisions concerningrefining, revising, and improving practice in discipline-related EAP instruction in Iran.

2. Method

2.1. Design of the study

This mixed methods study involved first, a small scale interview study with undergraduate students, EFL instructors,and subject-specific instructors in the medical faculties of three Iranian universities. The interview data provided inputto the design of a fairly large-scale questionnaire survey, administered to undergraduates and instructors. The mainpurpose of the study was to determine perceptions of the foreign language needs of first year undergraduate nursing andmidwifery students of various stakeholders including students, subject-specific instructors, and English instructors.

2.2. Instruments

Two instruments were used in this study: (1) interviews and (2) questionnaires. At the beginning of the study,interviews were conducted with undergraduate students, EFL instructors and subject-specific instructors at Isfahan,Shahr-e-Kord, and Yazd universities of medical sciences. A list of questions was prepared, regarding such issues as thelearning needs of the students, the language skills which the respondents thought students needed to develop, the areasof language difficulty which they experience, as well as the respondents’ attitudes towards language instruction,methodology, content and length of the English course. The main aim of conducting interviews was to personally elicitinformation regarding the interviewees’ perspectives concerning the learning needs of students, areas of difficultywhich students encounter as well as exploring the attitude and expectations of the participants regarding the ESPcourse. The interviewees’ opinions on the importance of proficiency in different areas of language skills, namelylistening, speaking, reading, and writing were elicited. The researcher also explored the interviewees’ views regarding

279G. Mazdayasna, M.H. Tahririan / Journal of English for Academic Purposes 7 (2008) 277e289

the kind of vocabulary, i.e. technical, semi-technical, and core vocabulary which they expected to be emphasized inthe course, their attitude towards language instruction, length of the English course, and their perceptions ofcommunication in the foreign language.

Heads of departments and subject-specific instructors were asked questions about their expectations concerning themedical terminology and expressions which they expect their graduates to know. They were also asked to express theiropinions about students’ competence in coping with their academic studies in English, and whether they felt thegeneral English course as well as the specialized English courses provided the English the students need for English intheir studies. Finally, they were also asked to express their views about class activities and methodology which areimplemented to develop the students’ English proficiency.

The second instrument consisted of two sets of needs analysis questionnaires: (1) Students’ questionnaire, (2)Language and special subject instructors’ questionnaire. These questionnaires were developed after the preliminaryinterviews with students, English instructors and subject-specific instructors.

Following six items which dealt with personal information such as name, sex, the department in which the studentswere studying, and whether they had passed their general English course, the student questionnaire had two sections.The first, which was composed of twenty-one items (items 1e21), was designed to explore the opinions of the studentsabout their expressed needs for English language skills in their academic studies. The second, which consisted offourteen items (items 22e35), explored the opinions of the students concerning language demands, their languageneeds, their attitudes towards language instruction, the length of the course, and the content, syllabus, and method-ology of the specialized English course (refer to Appendix A). The first section (items 1e21), required respondents toexpress their opinions about each statement by marking the options on a six-point Likert scale ranging from 6 (toa very great extent) to 1 (not at all). The first seven items of the second section (items 22e29) similarly used a Likertscale, while items 29e35 were multiple-choice format.

The instructors’ questionnaire (Appendix B) comprised three sections. The first section, items 1e37, explored theperspectives of the instructors about the foreign language learning needs of medical sciences students in using the fourmacro English skills and general study skills as relates to their academic studies. In the second section, items 38e42,instructors evaluated the English language proficiency of the students by indicating the extent they developed thedesired competence and performance after passing the ESP course. The third section of the questionnaire, items 43e47, used the multiple-choice format to explore their opinions concerning the students’ attitude towards languageinstruction, length of the course, the content, syllabus, and methodology used in their ESP course.

2.3. Participants

Table 1 shows the participants in the interview phase of the study.In the questionnaire phase of the study, a total of 681 undergraduate medical sciences students studying nursing and

midwifery participated in the survey: the sample comprised 623 females and 58 male students with an age range of20e25 years. In addition, 168 subject-specific instructors and 6 English instructors participated. The participants werefrom the faculties of nursing and midwifery at the seven medical sciences universities: Tehran, Shahid Beheshti, Iran,Isfahan, Yazd, Kerman, and Shahr-e-Kord, as well as 6 English instructors who taught ESP courses at theseuniversities. These universities were chosen in order to have representative views from different universities nation-wide. The ‘In-study Group’ comprised 243 undergraduate students (29 males and 214 females) who had enrolled for arequired ‘ESP’ course in the spring semester of 2005e2006 and were in their third to sixth semesters. The ‘Post-study

Table 1

Distribution of participants who took part in the interviews.

University In-study group Post-study group Subject-specific instructors English instructors

Shahid-Beheshti 5 6 4 1

Tehran 6 10 8 1

Iran 5 6 7 2

Isfahan 10 7 10 1

Shahr-e-Kord 5 6 4 eYazd 5 7 5 1

Kerman 6 8 2 e


Group’ comprised 438 undergraduate students (29 males and 409 females), who had passed the ESP course and werein their fourth to eight semesters. The distribution of the sample is shown in Table 2. It was noticed that at Tehran, Iran,Shahid Beheshti and Isfahan medical sciences universities, the ‘ESP’ courses were taught by EFL instructors;whereas, at Kerman, and Shahr-e-Kord universities, they were taught by subject-specific instructors. At YazdUniversity, two ‘ESP’ courses were conducted: one class was taught by an EFL instructor and the other by a subject-specific instructor.

3. Data collection and analysis

Data for the study were collected over the spring semester of 2005e2006. Once the first drafts of the questionnaireswere prepared, a pilot study was performed on fifteen nursing and midwifery students and six English instructors atIsfahan University of Medical Sciences in order to elicit information concerning the content of the items and clarity ofinstructions. After revising the questionnaires based on the pilot study and deleting three items, the final versions ofthe two questionnaires were translated into Persian and administered to the participants. The English languageinstructors were given the English version of the questionnaire.

3.1. The interviews

One of the researchers conducted and tape-recorded interviews with undergraduate students who were in their 3rd to8th semesters, EFL instructors and subject-specific instructors, as well as several heads of nursing and midwiferydepartments. The responses provided by the interviewees were recorded and then transcribed by the researcher.Quantitative and qualitative analyses of the responses of the two groups of students and the instructors showed that theywere quite similar, although the instructors provided more details than did the students. As relates to general foreignlanguage skills, both students and instructors reported that the students’ English language ability was insufficient tomeet the challenge of the large amount of English text they were expected to read in their specialized courses. Most ofthe instructors were particularly dissatisfied with the low reading ability of the students and indicated that they have noother alternative but to translate specialized English texts in order to put the message across to the students.

The subject-specific instructors felt that students should learn the organization of medical articles and texts andexpected them to know how to read, summarize, analyze, and interpret a piece of research done in their field. Subject-specific instructors also saw the need for students to practice how to write case reports and improve their writing andspeaking skills so that they could communicate more effectively with university personnel and doctors in hospitals.This is probably because despite the fact that the language of instruction in all Iranian Universities is Farsi, it hasbecome part of the hospital personnel culture not to write/speak about a patient’s case, disease /treatment in Farsi. Inaddition, subject-specific instructors admitted that the students commonly need to improve their general English to uselinguistic forms and the academic register appropriately.

Regarding students’ speaking ability, instructors and students alike reported that the students lack the experience orconfidence to speak; they need to improve their speaking skills for group discussion and presentations. They were of theopinion that the four skills of speaking, listening, reading, and writing should be integrated in the English course content.

Concerning the use of technical and semi-technical vocabulary, all the respondents believed that students only memorizethe limited amount of technical and semi-technical vocabulary which they are taught in the ESP course in order to succeed intheir examination. After they pass their English course, they still lack the ability to use grammatical structures and medicalterminology appropriately. They also have problems using semi-technical vocabulary in real contexts.

Table 2

Distribution of participants who took part in the questionnaire survey.

University In-study group Post-study group Subject-specific instructors English instructors

Shaheed-Beheshti 43 62 27 1

Tehran 15 75 28 1

Iran 31 56 36 2

Isfahan 38 58 30 1

Shahr-e-Kord 37 62 16 e

Yazd 24 53 24 1

Kerman 55 72 7 e


Most respondents were of the opinion that the students need to develop their communicative competence, and thatthe general and the specialized English courses do not develop the students’ level of proficiency enough to use Englishin real contexts. The students reported that they encounter serious problems in the 6th and 7th semesters when theyhave to work in hospitals. For example, students have problems understanding instructions and technical words usedin doctors’ prescriptions and hospital orders.

Most of the respondents thought that EFL instructors should be familiar with the medical terminology, so thatthey would be in a better position to impart the relevant knowledge to students. They felt it would be beneficialfor EFL instructors to receive extra instruction regarding medical terminology used in the academic texts beforethey begin teaching their ESP course. Students reported, overall, the view that subject-specific English coursesshould be offered throughout the four years of their study, and that they should be provided with other languagelearning opportunities such as watching films and using the Internet. They also suggested that English classesshould be conducted in the language laboratory in order to help them improve their speaking and listeningskills.

Some of the subject-specific instructors suggested that EFL teachers should assign relevant topics related tothe students’ special subjects for oral presentations. They thought that students should select articles frommedical journals or collect information from the Internet concerning the topic about which they have volunteeredto give oral presentations. As a student is presenting their lecture in the class, other students could listen andwrite notes, and after the presentation is over, they could ask questions so that while they get more informationthey can also improve their oral skills. While subject-specific instructors could see the value of these practices,they did not employ them in their courses. Some of the subject-specific instructors also suggested that the mid-term and final examinations for English could be based on topics discussed in the class, and that in the finalexamination, students could be given some questions to be answered in English. As a result, they would seea stronger link between their English classes and their subject studies, and develop an greater motivation forlearning English.

All the respondents believed in the necessity of change in their students’ English education. The specializedEnglish courses, according to them, should provide students with authentic academic language experiences. Forexample, students should be provided with opportunities to listen to long lectures and conversations involvingmultiple participants, to write longer papers, to participate in group discussions, and to give class presentations. TheEnglish curriculum, they emphasized, should integrate strategy training into the lessons so that students can developeffective language use strategies.

3.2. The questionnaires

In order to collect the required questionnaire data, all seven medical sciences universities in Iran (Tehran, ShahidBeheshti, Iran, Isfahan, Yazd, Kerman, and Shahr-e-Kord) were visited by one of the researchers, who was givenaccess to classes in order to administer the questionnaires. For the ‘In-study’ group, the questionnaire was admin-istered during ESP class sessions to ensure the highest possible rate of return. For the ‘Post-study’ group, the ques-tionnaire was administered during one of the subject-specific class sessions. In two instances the data were collected inthe hospitals from students in their 7th or 8th semesters who were doing practical experience. The aim of collectingdata from students who had already passed the subject-specific English course was to find out (1) whether theirobjective and subjective needs had been fulfilled, (2) whether they had gained sufficient proficiency to use academicEnglish in their specialized studies, and (3) whether their language needs and perceptions of needs had changed duringtheir four years of study.

In order to ensure a high rate of return by subject-specific instructors and EFL instructors, the researchersdistributed and collected the questionnaires in each university in person. One of the researchers visited each instructorin their office, informed them about the aim of the research project, and requested them to fill out the questionnaires.Some respondents returned the questionnaire on the same day; others returned them one to three days later by mail.

The Statistical Package for Social Sciences (SPSS) was used for statistical operations needed for data analysis. As nosignificant between-group variation was found between the seven universities, the statistics related to the responses fromall seven universities were added up, forming a single dataset to compare the views of the three groups of respondents.

As shown in Table 3, Pearson Chi-square values were computed for each question. The minimum expectedfrequency for each cell was 800 or more. The values indicate that while there were similarities in the response


patterns of individual members within each group, the total group responses were, nevertheless, independent ofone another.

The responses of the three groups of respondents were then cross-tabulated for each question. To aid display of thecomparisons between the group responses, the data was summarized. Table 4 presents the percentile frequencies ofresponses on each question by members of the three groups.

Many of the students in the ‘In-study’ and ‘Post-study’ groups and most of the instructors perceived thatstudents ‘greatly’ need to develop their listening and speaking skills for participating in academic discussions,speaking at seminars, meetings and presentations (cf. items 1e12 of the questionnaires for details of the items).

Most of the students in both groups of students and instructors group perceived that the students ‘greatly’ need todevelop all their reading skills. Likewise, the majority of the instructors agreed that the students ‘greatly’ need todevelop all their reading skills (cf. items 13e17 in Appendix A).

Nearly all subject-specific instructors indicated that the students ‘greatly’ need to develop their reading skills to beproficient enough to perform their duties in their workplace with regard to reading clinical laboratory reports, readinginstructions for patient care, and reading doctor’s prescriptions (cf. items 18e20 in Appendix B).

Most of the subject-specific instructors agreed that students have a ‘moderate’ need to improve their writing skills,for taking lecture notes, taking notes from textbooks, writing papers for oral presentations and writing term papers (cf.items 18e21 of Appendix A and 21e24 of Appendix B).

Table 3

Pearson chi-square test results for questionnaire.

Item # Value df Asymp.Sig. (2-sided) Obs. count

Less than 5

Min.expected count

Q1 74.905 10 .000 1 4.59

Q2 66.708 10 .000 0 5.47

Q3 26.549 10 .003 1 4.46

Q4 21.934 10 .015 0 6.39

Q5 9.819 10 .546 1 4.98

Q6 36.290 10 .000 0 9.76

Q7 9.307 10 .503 0 5.69

Q8 51.731 10 .000 0 5.84

Q9 45.577 10 .000 0 7.06

Q10 47.650 10 .000 0 7.24

Q11 21.355 10 .019 1 4.59

Q12 44.880 10 .000 0 6.53

Q13 239.285 10 .000 3 2.9

Q14 58.218 10 .000 2 2.30

Q15 22.343 10 .013 3 2.48

Q16 62.292 10 .000 2 2.65

Q17 51.225 10 .000 7 0.18

Q18 182.519 10 .000 0 7.76

Q19 130.238 10 .000 0 7.24

Q20 62.928 10 .000 0 5.82

Q21 262.133 10 .000 0 8.80

Q22 82.165 10 .000 0 11.80

Q23 32.488 10 .000 0 11.62

Q24 173.456 10 .000 0 7.87

Q25 75.620 10 .000 0 6.09

Q26 78.886 10 .000 0 6.22

Q27 29.294 10 .001 1 3.55

Q28 70.284 10 .000 0 5.60

Q29 256.553 10 .000 1 4.44

Q30 55.922 8 .000 0 7.64

Q31 186.984 6 .000 1 3.17

Q32 638.821 10 .000 0 10.34

Q33 534.755 10 .000 0 11.21

Q34 621.524 10 .000 1 4.53

Q35 625.926 10 .000 1 4.31

Table 4

Cross-tabulation results of the questionnaires for the three groups.

Item # Group Not at all % A little % To some

Extent %

To a moderate

Extent %

To a great

Extent %

To a very

great extent %

Total count

Q1 In-study 3.3 9.3 10.6 24.0 28.0 24.8 246

Post-study 2.6 7.9 10.6 47.6 23.8 7.5 454

Instructor 4.0 12.7 4.0 34.0 21.3 24.0 150

Q2 In-study 5.3 10.6 12.6 30.9 22.4 18.3 246

Post-study 4.0 10.6 16.3 25.6 20.7 22.9 454

Instructor 0.0 0.0 11.3 14.7 44.0 30.0 150

Q3 In-study 1.2 3.3 11.8 22.0 30.6 31.0 245

Post-study 3.1 8.1 9.2 26.1 30.6 22.9 445

Instructor 5.3 2.7 8.0 17.3 35.3 31.3 150

Q4 In-study 5.0 11.2 13.2 24.8 21.9 24.0 242

Post-study 4.9 7.7 13.2 23.4 23.4 27.4 453

Instructor 1.3 10.7 5.3 30.7 32.0 20.0 150

Q5 In-study 3.3 4.5 8.2 23.0 25.0 36.1 244

Post-study 3.6 6.0 9.8 19.6 26.7 34.3 449

Instructor 2.7 6.0 3.3 26.7 26.0 35.3 150

Q6 In-study 4.1 10.3 14.4 21.4 23.5 26.3 243

Post-study 7.1 11.1 14.6 23.0 19.0 25.2 452

Instructor 8.7 11.3 6.7 12.0 39.3 22.0 150

Q7 In-study 3.3 11.5 10.2 21.7 29.5 23.8 244

Post-study 4.5 8.7 11.1 27.6 27.2 20.9 449

Instructor 2.7 10.0 8.0 22.7 35.3 21.3 150

Q8 In-study 6.1 11.1 14.8 25.4 25 17.6 244

Post-study 4.0 8.2 17.7 25.6 23.8 20.8 253

Instructor 0.0 16.7 4.0 18.0 43.3 18.0 150

Q9 In-study 2.5 10.7 12.3 27.5 27.5 19.7 244

Post-study 5.3 14.9 14.9 29.4 20.6 14.9 456

Instructor 6.7 23.3 6.0 14.0 36.0 14.0 150

Q10 In-study 6.9 6.5 17.5 26.4 22.8 19.9 246

Post-study 5.3 12.3 16.3 23.3 20.7 22.0 254

Instructor 0.0 7.3 10.7 18.0 44.0 22.0 150

Q11 In-study 4.9 6.5 10.2 22.9 26.9 28.6 245

Post-study 3.1 5.7 12.8 20.7 24.7 33.0 454

Instructor 0.0 7.3 7.3 15.3 37.3 32.7 150

Q12 In-study 6.1 6.5 13.0 28.9 24.8 20.7 246

Post-study 4.8 7.9 13.2 27.3 23.8 22.9 454

Instructor 0.0 14.7 4.0 14.7 32.7 34.0 150

Q13 In-study 1.2 4.5 8.5 16.7 32.1 37.0 246

Post-study 2.2 3.9 7.0 45.6 31.6 9.6 456

Instructor 0.0 0.0 0.0 0.0 43.3 56.7 150

Q14 In-study 2.9 4.5 8.2 20.9 29.5 34.0 244

Post-study 1.3 4.0 7.9 16.7 30.4 39.6 454

Instructor 0.0 0.0 0.0 4.0 36.7 59.3 150

Q15 In-study 3.3 4.9 5.3 13.5 37.3 35.7 244

Post-study 1.3 3.1 7.5 12.8 36.6 38.8 454

Instructor 0.0 0.0 6.7 6.7 41.3 45.3 150

Q16 In-study 2.9 5.7 7.4 23.0 27.9 33.2 244

Post-study 1.8 4.4 7.0 23.3 27.3 36.1 454

Instructor 0.0 0.0 0.0 6.7 50.0 43.3 150

Q17 In-study 1.2 2.9 4.5 14.7 29.0 47.3 245

Post-study 1.3 3.1 6.2 13.2 28.6 47.6 454

Instructor 0.0 0.0 0.0 0.0 45.3 54.7 150


Most of the subject-specific instructors perceived that the students ‘moderately’ need to improve all their writingskills for writing articles for medical journals, writing medical reports, writing case reports, writing a medicalprescription, and writing instructions to patients (cf. items 25e29 of Appendix B).


Most of the instructors were of the opinion that the students ‘moderately’ need to develop all general study skills(cf. items 30e35 of Appendix B).

4. Summary and conclusion

A needs analysis study was undertaken in the Iranian medical sciences universities with the aim of investigatingundergraduate students’ foreign language learning needs, wants and lacks. The assessment of learners’ needs wasperformed with the help of various stakeholders including students who were enrolled in ESP courses, those who hadpassed their ESP courses, and EFL and subject-specific instructors.

The first research question explored the views and perceptions of the students as well as instructors concerning the ESPneeds of students. The findingsof the study support theviewthat the students ‘greatly’ need to increase theirgeneral proficiencyin English. Most of the students felt that the current two-credit ESP course is insufficient and reported that they had expected tobe offered specialized English courses throughout their undergraduate studies in order to fulfill their short- term needs.

There was a consistency of opinions among instructors across different universities that the students ‘moderately’need to develop their general study skills. A solid majority of the instructors also reported that the students need todevelop their general reading skills and oral communication skills, and they agreed that the students should be helpedto increase their repertoire of vocabulary in order to be able to read extensively in their specialized classes. Thisindicates that in spite of the fact that the students take a general English course before their subject-specific Englishcourse, their level of general English proficiency (GEP) is low. This is in line with what has also been echoed in theliterature on EFL/ESP in Iranian settings (Alavi & Tahririan, 1996; Atai, 2000; Tahririan, 1987, 1990).

Most of the students in the two groups perceived that they needed to master an appropriate level of English beforethey attend their specialized courses, although some felt that they could wait and master English at the same time asstudying their specialized subjects. More significantly, most of the students reported that they needed to use bothPersian and English sources when studying their subject courses. The students seemed to have clear perceptions oftheir language needs for academic study and their future careers.

The students’ wishes on the amount of time they expected to be allotted to their English courses per week varied.Most of the respondents stated that they preferred to have the specialized English course in three one-hour sessions perweek while others preferred to attend the English course in two 90 minute sessions a week. Students also perceivedthat English instructors lack sufficient expertise and background knowledge required for teaching specialized Englishcourses. Nevertheless, all subject specific instructors indicated that EFL instructors should teach ESP courses.Additionally, half of the subject-specific instructors were of the opinion that EFL instructors must have sufficientknowledge of the specialized medical vocabulary, while the rest perceived that EFL instructors should haveknowledge of specialized medical vocabulary as well as general vocabulary. This confirms the recommendation ofAtai (2002, p. 13) that ‘‘EAP instructors reconsider their roles in struggling with EAP contexts and to widen theirrepertoires of language teaching strategies’’. It does not, of course, in any way address the impracticality of theseexpectations.

The second research question sought information about the types of skills which nursing and midwifery students need todevelop. Subject-specific instructors’ assessment of students’ language skills revealed their dissatisfaction. They contendedthat, after passing the ESP course, the students do not have sufficient proficiency in reading, writing, speaking or listening;therefore, they encounter difficulties in dealing with tasks they are expected to perform in English. A vast majority of thestudents in the ‘In-study’ and ‘Post-study’ groups agreed that reading comprehension, followed by listening, speaking andwriting are the most important skills needed for their medical studies. Likewise, almost all subject-specific instructors statedthat students ‘greatly’ need to improve their reading skill, followed by listening, speaking and writing skills. The subject-specific instructors consistently ranked the importance of the four skills higher than the students did. Additionally, the majorityof the respondents believed that there was ‘a great need’ to develop every sub-skill of the four skills in the ESP course content.

The third research question dealt with finding out what type of content, methodology and class activities are appropriatefor nursing and midwifery students. Almost one-third of the students in both groups expressed their dissatisfaction with thenumber of students in each class, the teaching methodology used, the method of evaluation, the amount of foreign culturetaught in the class, and the content of the textbook. At the same time, one-third of the students in both groups felt that theywere moderately satisfied with the aforementioned issues. More attention needs to be paid to course design.

As has been echoed in the literature, ESP courses are not designed and/or implemented consistently in termsof syllabus, materials, methodology, and expected English proficiency level on entry. Each university offers


these courses independently of others. Likewise, although the textbook, English for the Students of Nursing andMidwifery, has been published under the supervision of the Iranian Center for Studying and CompilingUniversity Books (SAMT), the instructors in different medical sciences universities do not use their materialsuniformly and in some departments, especially where the instructors are subject specialists, instructors eithercompile their own materials or select articles to adapt for their classes at their own discretion. As we saw above,these courses may either be conducted by EFL instructors or by subject-specific instructors. Clearly, someexpertise must be brought to the scene to make the ESP teaching practice more consistent with meetingstudents’ needs.

The fourth question dealt with factors that should be considered in designing the syllabus for nursing andmidwifery students. Similar to many other researchers’ findings (cf. Chantrupanth, 1993; Deutch, 2003; Nation, 2000)the findings revealed that there are many factors one should take into account including: (1) the learning needs of thestudents; (2) learners’ present knowledge and knowledge gaps; (3) the objectives of the course; (4) the resourcesavailable in terms of staff, materials, equipment, finance and time constraints; (5) teachers’ skills and knowledge of thespecific area. If such factors are not considered, the design of the course may be unsuitable for the situation and theexpected results may not be achieved.

Based on what was revealed by the study, the EAP-ESP course for nursing and midwifery students, similar to othersubject-specific English courses in Iranian universities, is conducted without consultation or collaboration with thecontent departments, and without having assessed students’ learning needs – which is the indispensable first step incurriculum development for academic or specific academic purposes. The results of this study suggest that the goals ofthe course are unrealistic, and its provision inadequate to prepare the students to face the challenges and demandsposed by their specialist departments, unless serious measures are taken to resolve some major problems revealed bythis study.

Appendix A

Students’ Questionnaire

Dear Participants,The following questionnaire is part of a research project that investigates the needs of medical sciences students

taking English as a required course.

Background Information

1. Name and family name: (optional) ———————————————————2. Age ————————— years

Please tick (O) the relevant choice for each question

3. Sex: (a) male (b) female4. Department in the Medical Sciences University

(a) Nursing (b) Psychiatric nursing (c) Surgical nursing (d) Midwifery(e) Health (f) Pediatrics

5. Have you passed the General English course?(a) Yes (b) No

6. Have you enrolled for specialized English course?(a) Yes (b) No

The first section of the questionnaire aims to explore the opinions of the medical sciences students on theirexpressed needs in using the four macro English skills for their studies. Please tick (O) the relevant choice for eachquestion.


Listening skills

As a medical science student, Not at all A little To some To a moderate To a great To a very

I need English for:
extent extent extent great extent
1. listening to conversations on general topics.

2. listening to lectures

3. listening to presentations in class

4. listening to English mass media

5. listening to instructions in real situations (hospitals)

6. listening to students, colleagues and patients

Speaking skills


I need English for:
7. participating in academic discussions

8. speaking at seminars, meetings and presentations

9. asking and answering questions in class

10. asking and answering questions in seminars

11. talking with professionals in real situations

12. talking with lecturers, students and patients

Reading skills


I need to develop my reading skills for:
13. reading medical textbooks

14. reading articles in professional journals

15. reading medical reports

16. reading English newspapers and magazines

17. reading texts on the Internet

Writing skills

The medica As a medical science student, Not at all A little To some To a moderate To a great To a very

I need to develop my writing skills for:
18. taking lecture notes

19. taking notes from textbooks

20. writing a paper for oral presentation

21. writing term papers

The second section aims to explore the opinions of the medical sciences students concerning their languagedemands, language needs, attitudes towards language instruction, length of the course as well as the content,syllabus, and methodology of the specialized English course. Please tick (O) the relevant choice for eachquestion.

Not at all A little To some To a moderate To a great To a very

extent
extent extent great extent
22. I feel satisfied with the number of students in my class

23. I feel satisfied with the topics included in the textbook

24. I feel satisfied with the methodology utilized in my class

25. I feel satisfied with my teacher’s evaluation method

26. I feel satisfied with the present textbook

27. I feel satisfied with the amount of foreign culture taught in my class

28. I feel satisfied with the content of the textbook

Please tick (O) the relevant choice for each question

29. I prefer to work and study ————(a) individually (b) in pairs (c) in small groups


30. The specialized English course should be offered in the ———(a) 2nd semester (b) 3rd semester (c) 4th semester(d) 3rd year (e) 4th year

31. How long should specialized English courses be offered to students of medical sciences?(a) one semester (b) two semesters(c) through out the four years of their studies.

32. How often do you like to study the specialized English course?(a) once a week (3 hours)(b) twice a week (1.5 hours)(c) three times a week (1 hour)

33. I prefer to be taught by —————(a) Native English instructors(b) Iranian English instructors(c) Subject specialist instructors

34. I prefer to master my English —————————(a) before starting my specialized subject courses(b) at the same time that I am taking my specialized subject courses(c) after completing my specialized subject courses

35. It is important for me to learn my subject lessons —————————(a) through Persian books and sources (b) through English books and sources(c) through Persian and English sources

Appendix B

Subject-Specific Instructors’ Questionnaire

Dear Participants,The following questionnaire is part of a research project that investigates the needs of medical sciences

students taking English as a required course. The first section of the questionnaire is designed to explore theopinions of the special subject instructors about the expressed language needs of medical students in usingthe four macro English skills for their academic studies. Please tick (O) the relevant choice for eachquestion.

Listening skills

The medical Not at all A little To some To a moderate To a great To a very

sciences students need English for:
1. listening to conversations on general topics.

2. listening to lectures

3. listening to presentations in class

4. listening to English mass media

5. listening to instructions in real situations (hospitals)

6. listening to students, colleagues and patients

Speaking skills

The medical sciences students need English for:
Not at all A little To some
extent

To a moderate

extent

To a great

extent

To a very

great extent

7. participating in academic discussions

8. speaking at seminars, meetings and presentations

9. asking and answering questions in class

10. asking and answering questions in seminars

11. talking with professionals in real situations

12. talking with lecturers, students and patients


Reading skills

The medical sciences Not at all A little To some To a moderate To a great To a very

students need English for:
13. reading medical textbooks

14. reading articles in professional journals

15. reading medical reports

16. reading English newspapers and magazines

17. reading texts on the Internet

18. reading clinical laboratory reports

19. reading instructions for patient care

20. reading doctor’s prescriptions

Writing skills

The medical sciences students need Not at all A little To some To a moderate To a great To a very

English for:
21. taking lecture notes

22. taking notes from textbooks

23. writing a paper for oral presentation

24. writing term papers

25. writing articles for medical journals

26. writing medical reports

27. writing case reports

28. writing medical prescriptions

29. writing instructions to patients

General study skills

The medical sciences students need Not at all A little To some To a moderate To a great To a very

English for:
30. learning common core vocabulary

31. learning semi-technical conversation

32. learning technical conversation

33. learning medical technology

34. learning new words in sentences, synonyms,

and paraphrases

35. learning technical reading skills

of skimming and scanning

36. practicing how to use medical vocabulary in real

settings and hospitals

37. attending ‘Grammar Workshop’ (remedial language practice)

where common difficulties of students can be explained

The second section aims to explore the special subject instructors’ views in terms of what the medical sciencesstudents lack after passing the specialized English course. ‘Lacks’ are reflected in special subject instructors’ assessmentof their students’ language skills on the scale as described below. Please tick (O) the relevant choice for each question.

Not at all A To some To a moderate To a great To a very

little
38. I judge the medical sciences students’ listening ability has been improved

39. I judge the medical sciences students’ speaking ability has been improved

40. I judge the medical sciences students’ writing ability has been improved

41. I judge the medical sciences students’ reading ability has been improved

42. I judge the medical sciences students’ communicative competence

has been improved

The third section aims to explore the opinions of the special subject instructors, concerning the medical sciencesstudents’ language demands, language needs, attitudes towards language instruction, length of the course as well asthe content, syllabus, methodology of the specialized English course. Please tick (O) the relevant choice for eachquestion


43. The medical students prefer to work and study ————(a) individually(b) in pairs(c) in small groups

44. The specialized English course should be offered in the ———(a) 2nd semester(b) 3rd semester(c) 4th semester(d) 3rd year(e) 4th year

45. How long should specialized English courses be offered to students of medical sciences?(a) one semester(b) two semesters(c) through out the four years of their studies.

46. English should be taught by ————————————————(a) English teachers(b) Subject-specific instructors(c) Both English language teachers and subject-specific instructors

47. What do you expect English teachers who teach you English to know?(a) general vocabulary and expressions(b) specialized medical vocabulary(c) both general vocabulary and expressions as well as specialized medical vocabulary

References

Alavi, S., & Tahririan, M. H. (1996). EFL learners’ proficiency and their performance on GPE and ESP collocations. Indian Journal of Applied

Linguistics, 22(2).

Atai, M.R. (2000). ESP revisited: a reappraisal study of discipline-based EAP programs in Iran. Unpublished Ph.D. dissertation, University of

Esfahan, Esfahan, Iran.

Atai, M. R. (2002). Iranian EAP programs in practice: a study of key methodological aspects. Sheikhbahaee ELT Journal, 1(2), 1e15.

Chantrupanth, D. (1993). In designing a short course in ESP. Paper presented at the Annual SEAMEO Regional Language Center Seminar (28th,

Singapore, April 19e21, 1993), (pp. 1e11). Retrieved December 18, 2006, from (ERIC Document Reproduction Service No. ED 367 189).

Deutch, Y. (2003). Needs analysis for academic legal English courses in Israel: a model of setting priorities. Journal of English for AcademicPurposes, 2, 125e146. www.elsevier.com. Accessed 18.12.06.

Nation, P. (2000). Designing and improving a language course. English Teaching Forum, 38(4), 2e11.

Sifakis, N. C. (2003). Applying the adult education framework to ESP curriculum development: an integrative model. English for SpecificPurposes, 22, 195e211.

Tahririan, M. H. (1987). ESP Yes, But for What Learners? Esfahan: IAPE. 3.

Tahririan, M. H. (1990). A summative evaluation of teaching English in Iranian universities. Research Bulletin of Esfahan University, 6(2).

Esfahan.

Mrs. G. Mazdayasna is an assistant professor of Applied Linguistics at Yazd University, Iran. Her main interest is teaching English for academic

purposes and has published a few articles in national and international journals in this relation.

M.H. Tahriria is professor of applied linguistics at Sheikhbahaee University, Baharestan,Iran. He has published articles in foreign/second

language teaching and ESP, and is the corresponding author of this article: he can be reached at: Dept. of English, Sheikhbahaee University,

Baharestan, Isfahan, Iran 8179735296.

http://www.elsevier.com

mazdayasna and tahririan

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