A major change for ESP for nursing: Pivoting towards discourse through a new course design with communicative engagement as a focal concept

Abstract

This article describes how a new, discourse-focused course on English for nursing purposes (ENP) was developed from scratch to fill a critical needs gap: competence in what this article calls ‘nurse–patient communicative engagement’. A needs analysis conducted for this study revealed a gap between how experienced nurses and nursing students viewed engagement. This is a key concept that the present study amalgamated from various research sources. The present study newly defines the concept as the strategic communication moves used by experienced nurses to actively elicit patients’ concerns, proactively ensure their full understanding of what is said and done, and continually establish empathy and rapport. Engagement is currently not the focus of ENP courses globally, which instead focus on general language proficiency and rote learning of surface-level features (e.g. medical vocabulary, pronunciation of terms). What nursing students actually need, and ENP courses currently neglect, is training in dialogic communication strategies that promote engagement. A brand-new ENP course was created to scaffold students in acquiring these interactional strategies using custom-written, analytically rich learning materials based on authentic nurse–patient interactions. The new course was piloted and taught in parallel alongside an existing ENP course at the same institution. Through this control versus experimental group design, and using pre-, post-, and delayed post-test instruments, the new course was statistically and qualitatively evaluated. The new course proved successful in producing nursing students who demonstrated significantly improved perceptions and practices of engagement: they felt more positive and confident about engaging with patients, and could frequently and appropriately deploy a wide range of relevant strategies. ENP practitioners worldwide will benefit from examining this new course design, to pivot syllabuses away from piecemeal, surface-level features towards the teaching of the core discourse skill of nurse–patient engagement, a communicative practice that research shows facilitates better health outcomes for patients.