Practical Tips for Teaching nursing abroad when the students have some English but not quite fluent

Seen ’em come and seen ’em go

Over the past eleven years I have watched others come to Nepal to try to teach something, and not succeed. Maybe they don’t assess the audience before preparing teaching methods, or maybe they overestimate the English language comprehension, or some other unexpected issue. There is a long list of pitfalls. We assume an expert clinician somehow knows how to teach.

This is not limited to westerners trying to teach. I recently spoke with a Nepali doctor who decided to teach the nursing staff a new skill by assigning all of them to read a certain book in English, after which he would administer a written test. Yes, that might have worked in Medical College, but it’s not the best strategy for nurses.

I am not an English teacher, I don’t teach English per se. I teach content related to cardiac resuscitation and nursing, to classrooms of people who can speak some English. The people in my class sometimes possess excellent English proficiency and sometimes very little at all.  It is not my goal to make them speak English, but the goal is to help them  do better resuscitation using critical care skills.

Having said the above, I do find that my background in teaching ESL students is very handy.  Look at it this way: I


The View from the front of the classroom.

n Nepal I am always teaching an entire class of ESL students. Many of them already speak Nepali, and Hindi, and perhaps a third language such as Newari or Maithili, prior to taking up English.

“You can be excellent at this even if you speak no English”

My own list:

  1. start off by going around the room to determine the English language level of each person present.
  2. speak in English using the grammatical structure of the local language especially if it is an Asian language.
  3. learn a few phrases in the local language and especially learn the top ten body language gestures used by the host culture.
  4. don’t use PowerPoint but do use a Whiteboard
  5. don’t use vocabulary words longer than two syllables
  6. stop and define specialized words
  7. don’t speak more than three sentences at a time
  8. don’t bring a pile of handouts
  9. do have a FaceBook page for the class that helps people learn in advance what will happen in class.
  10. build in class activities for small group discussion about the content in the local language
  11. think of an exercise or game to accompany each little segment of learning.
  12. assign the better speakers to buddy up with those who have less comprehension

I learned a new definition of “scaffolding” while researching this blog entry. Scaffolding definition

List of websites to study

I gave my off-the-top-of-the-head list above, but there is already a lot of material out there. Here is a list of URLs I found useful I thought this one was terrific inasmuch as I already use many of these techniques! My sessions rely heavily on simulation and use of medical equipment like Bag-Valve-Mask devices and cardiac monitors. This was a good review of classsroom teaching for those who do not often stand at the head of the room trying to deliver content. another list of things to consider. This one also talked about “scaffolding” which is a fancy way of saying, allow the person to speak their own language as part of the learning.   Another worthwhile read.

When is the longterm outcome?

For nurses who teach overseas, I think there is some expectation that somehow they will return a wiser, more well-rounded person with deeper understanding of the human condition and a more articulate way of expressing the universal truths of life on earth.  This idea of examining your own assumptions of teaching and learning is a prime vehicle for that realm of self-discovery.

About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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1 Response to Practical Tips for Teaching nursing abroad when the students have some English but not quite fluent

  1. Gaynor Sheahan says:

    Great article Joe! Distilled wisdom and experience

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