Student and teacher reflections on

indirectness as a pragmatic feature

of pharmacist- patient simulations
By : Virginia Hussin

Siti Murshida Hasni

Contents
Introduction
Research Methodology
Results and Discussions
Participants explanation for indirectness in
students language use
Participants view on developing pragmatic
competence in relation to directness and
indirectness
Implications of the study
Conclusions

Introduction
Pharmacy students whom English in an Additional Language (EAL).
Majority stays in Australia to work as pharmacists after completing their studies.
Prior to this, the Australian Pharmacy Boards has set the requirement for the
registration of pharmacists.
Graduates are required to have an IELTS score of 7.5 and professional
communication is the key criterion ~ major focus in degree programs and it
includes the assessment of students performance in pharmacist patient
simulations (March,2005).
Pharmacist patient simulations(March,2005).
A scenario-based patient counseling with the course lecturers and tutors role
playing the part of the patient.
School of pharmacy and Medical Sciences Staff requested a language
development program for 3rd year EAL students who were struggling with the
communication demands of the pharmacy simulations and the experiential
placements.

Introduction
Lave &
Wegner (1991)

Pharmacy students in training are still novice professional

and may be cognisant of knowledge of the profession will
unable them to display their knowledge within practical
interactions.

Bardovi
Harlig (1999)

There is a firm evidence that high levels of

grammatical competence do not guarantee high
levels of pragmatic competence.

Kasper (2001)

L2 learners may possess pragmatic knowledge but

they may be unable to act that knowledge through
performance

Bardovi
Harlig (2001)

Erikson (1999)

Learner needs targeted instruction for successful

acquisition of particular pragmatic practices.
In order to become more expert , medical interns learn
through their observations of, and communication with,
the more experienced professional with whom they work
with.

Introduction
Two aspects of the discourse of expert health
professionals are central to this study.
1) Recipient designed
The experts responses are
oriented towards the patients
expectation
at any point
within
the
interaction
(candlin&candlin,2002;
cicourel,1999;
Drew&Heritage, 1992)

2) Effective & concurrent

management of both the
informational and the
relational aspects of patient
interaction (LoCastro,2003;
Sarangi,1998)

To balance both aspects are a challenge for EAL students

as Locher (2006) notes, achieving the appropriate level
of relational work, including level of directness, depends
on experience and adjustments to cultural norms.

Introduction
This article will demonstrate how a reflective data generation process
Used as a research method in a larger study,
served as an instructional intervention to students participants
Led to curriculum change

The guided reflection within the research process enabled the students : To become aware of their language choices had on the patients
To develop a meta-pragmatic language for describing and explaining their
choices
To identify areas for language improvement
To strengthen pragmatic competence (Hussin, 2011)

The reflective process assisted staffs participants:To clarify their concerns about key pragmatic weaknesses in students which led
to
Suggestions for teaching activities.

Research Methods
Participants
20 international EAL students from Malaysia
First language ~ Mandarin & Cantonese
Advanced L2 learners ~ coped well with
written component of the pharmacy
program
Spend 2 years in Malaysia, 7 months in
Australia to complete 3rd and 4th semester.

Research Methods
Data collection
Video-tapes of pharmacist-patient simulation
Play back interviews
Focus group discussion

~with each method building on the previous

one

Research Methods
Video-tapes of pharmacist-patient simulation
Based on experience and suggestion from Gumpers
(1999), analysis on video-tapes was done by identifying
common types of encounters that cause problem and
investigating how interactants cope with such problems.
Three critical pragmatic features
1. The use of indirectness
2. The use of technical jargon
3. Failure to respond to the emotional content of a statement or
question.

These findings becomes the focus of the questions in

the semi structured , play back interviews based on
Gumperz(1999).

Research Methods
Play back interviews
The staffs/patients and students/pharmacists
were interviewed separately after viewing
their own simulation.
The playback interview were analyzed in two
ways: 1- participants perceptions
2-convergence and divergence

Research Methods
Focus group discussion
Collected a year later
Two separate groups were held to discuss a
presentation using prompts for guided
reflection adapted from Nunan(1996).
These discussions were audio taped and data
were analyzed

Participants explanation for

indirectness in students language use

Indirectness was due to:1. Difficulty in finding the right words

2. Culturally based attitudes
3. Teaching induced errors and pragmatic
overgeneralization.

Participants view on developing pragmatic

competence in relation to directness and indirectness

Learning through reflection and

discussion and video simulations
Learning from reflection on
classroom experience
Suggestions for teaching activities

Implications of the study

1. Teaching program need to give EAL
students more opportunities to have their
simulations taped and, if possible, to
interview the patients to obtain invaluable
feedback from them.
2. The use of transcripts and written
reflections.
3. The collaboration in the research process
4. Reflective activities at every level.

Implications of the study

Researchers point of view:1. Learners as active participants
2. Incorporate a reflective approach into the
curriculum
3. ESP practitioner and discipline specialist to
work together.

To address students associated language

requirement
To teach skills of reflection that will help them to
become independent language learners.

Conclusions
This study has attempted to identify and explain some
issues for EAP and ESP course design and explain how
involving the learners in the learning process can yield
positive learning experiences among learners as they
bring rich work experiences which should be tapped into
as effective learning resources.
By involving students in some elements of course
design, ESP teachers can look forward to enhancing
their students English literacy development as an aid to
developing success in their future career.
Teaching approaches should tailor made to suit learners
needs and wants and contribute to a positive learning
experience for the learners.