http://hdl.handle.net/1842/1787 Mon, 20 May 2013 09:21:13 GMT 2013-05-20T09:21:13Z http://hdl.handle.net/1842/5878 Title: Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication. Authors: Holst, Mark Anthony Abstract: This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication influence the institutional discourse. Audio recordings of 72 doctor-patient interactions were collected at the outpatient department of a Japanese teaching hospital. All consultations involved new cases. There were two kinds of consultations: a preliminary history-taking interview with an intern and a diagnostic consultation given by an experienced doctor. After transcribing the recordings sequences of the discourse were analysed qualitatively on a turn-by-turn basis and a corpus of the data was analysed quantitatively to establish frequencies of discourse features related to patientcentredness. A review of literature (Chapter 2) establishes the standard structure of medical consultations and the relationship of the doctor and patient during consultations in terms of the asymmetry of speaking initiative according to consultation phases. The second part of Chapter 2 is an examination of Japanese communication style, attested to be influenced by culturally specific norms of behaviour that are demonstrable through verbal interactions. Chapter 3 describes the research method, and this is followed by four chapters of analysis. Chapter 4 describes the nature of the two kinds of consultations; the phases they include, and how the participants shift from one phase to the next with phase transition markers. Particular attention is paid to opening and closing phases, as they are most relevant to the establishment and consolidation of a patient-centred relationship. Chapter 5 investigates patterns of questioning by doctors, identifying functional categories of questions to see how they are used to coax information from the patient. Chapter 6 examines how the doctor encourages the patient’s narrative through backchanneling; how the doctor accommodates the patient through sensitive explanations of treatments and procedures; and how the voice of the patient emerges through calls for clarification, and voicing concerns. Chapter 7 highlights discourse sequences that may indicate culturally specific influences, and examines the emergence of laughter as an indicator of Japanese interpersonal interaction. The features of these Japanese consultations are consistent with medical consultations described in English speaking settings regarding phases and the discourse strategies used to achieve patient-centredness. While there appear to be Japanese cultural influences in the interactions consistent with previous cross-cultural studies the author argues that the institutional setting (clinical framework) is more immediately relevant to the conversational dynamics of the interactions than the Japanese cultural setting. Finally, medical consultations involving new cases have more features of service encounters and therefore not controlled by the guidance-cooperation model of doctor-patient interaction. Wed, 06 Oct 2010 00:00:00 GMT http://hdl.handle.net/1842/5878 2010-10-06T00:00:00Z http://hdl.handle.net/1842/5269 Title: English as a lingua franca in a Japanese context: an analysis of ELF-oriented features in teaching materials and the attitudes of Japanese teachers and learners of English to ELF-oriented materials Authors: Takahashi, Reiko Abstract: As a result of the spread and growth of English as a global means of communication, a new approach to teaching and learning English has recently emerged: ELF – English as a lingua franca (ELF). Graddol (2006: 87) claims that "some of its [ELF] ideas are likely to influence mainstream teaching and assessment practices in the future". Indeed, a shift from traditional EFL goals to ELF has been observed in the documents of the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan. Jenkins (2004) suggests that applied linguists and publishers will need to find ways of promoting a more ELF perspective in teaching materials. However, to begin with, the reason why the ELF approach is necessary for Japanese learners of English should be adequately discussed. Also, how people are likely to respond to the new materials in the future should be investigated. The aim of this thesis is two-fold: (1) to examine current English language teaching practices in Japan from an ELF perspective, and (2) to examine the attitudes of Japanese people towards the new ELF-oriented practice. More specifically, the current study will focus on the teaching materials that are currently being used within the country. The research consists of three parts: (1) the identification of the characteristics of ELF; (2) an analysis of the EFL coursebooks and audiovisual materials according to those traits; and (3) an investigation of the attitudes of Japanese learners and teachers of English to ELForiented coursebooks and audiovisual materials by means of questionnaires and focusgroups. EFL coursebooks and audio materials employed in the state and private sectors were analysed. ELF-orientation was found in different forms and to different degrees according to the level and the objectives of individual materials: this was apparent in the nationalities and contexts represented, in the content of texts, and in English varieties in audio materials. There were some differences between publishers in the degree of ELF orientation. 717 students and 28 teachers were involved in the questionnaire survey. Sixteen students and nine teachers participated in the focus-group discussions. The survey data revealed that the informants showed strong reactions to certain ELF features in materials. They had little objection to ELF-features which were related to contextual factors of ELF (e.g. representation of characters in a dialogue). In contrast, they expressed more opinions regarding ELF-features which were closely related to the issues of a target model (e.g. written forms of non-standard English, and audio recordings which included NNS English). The findings are discussed with regard to the implementation of ELF-oriented materials. Pedagogical implications are proposed for the further development of ELF-oriented materials and for possible changes in English language teaching in the Japanese educational system. Wed, 29 Jun 2011 00:00:00 GMT http://hdl.handle.net/1842/5269 2011-06-29T00:00:00Z http://hdl.handle.net/1842/2674 Title: Systematising EAP Materials Development: Design, Evaluation and Revision in a Thai Undergraduate Reading Course Authors: Sudajit-apa, Melada Abstract: Materials design and evaluation have been regarded as inseparable processes for a systematic approach to materials development. But much less attention has been paid to the role and process of revision. This study reports a two-cycle approach to reading materials development for Thai undergraduate students: a first cycle of needs analysis, initial design, implementation and evaluation; and a second cycle of revision, implementation and re-evaluation. The two cycles involved both learners and teachers in providing feedback on the materials post-use, in order to enhance learners’ involvement and motivation and maximise their learning opportunities. The materials integrated the learners’ specific needs, (i.e. poor L2 reading behaviours) within a theoretical framework of cognitive/metacognitive strategy instruction and collaborative work that informed the selection of reading strategies, reading texts and pedagogical tasks. In the first cycle, six units of material were implemented with reading classes in Thailand for a period of six weeks. Evaluation involved students’ tasks-in-process, end-of-unit and use-of-Thai-or-English questionnaires, teacher’s questionnaires, learning journals, interviews and classroom observations. In addition to users’ positive comments on the usefulness of strategies, collaborative work, text topic and a variety of learning tasks, analysis of the findings indicated linguistic difficulties, insufficient amount of time and support from the teacher, difficulties in expressing ideas in English and uncertainty about reading purposes and task procedures. This led to two versions of materials revision—text simplification (TS) and procedural modification (PM). In the second cycle, the materials, revised in response to the first-cycle users’ feedback, were re-implemented and re-evaluated through the same procedures, with the addition of pre-and post-tests, by four groups of Thai students taught by two different teachers. Analysis of the learners’ perceptions showed that the second-cycle materials had met their learning needs, in reference to their comments about reading improvements and the usefulness of reading strategies, and that collaborative work helped increase their awareness of strategy use, text understanding and motivation. Classroom variables, particularly teachers’ scaffolding, played a significant role in enhancing learners’ motivation in terms of their perceptions of text difficulty, text understanding, and text and task enjoyment, as well as positively affecting their task performance. There was no significant difference between the students’ perceptions of the TS and PM materials, except that the TS groups had significantly more perceived text understanding, as they found language use in the texts significantly more accessible. In terms of progress, all TS and PM groups made improvements in their post-test, with Group 1 (PM) and Group 4 (TS) gaining significantly higher means in the post-test. These two cycles of implementation and evaluation offer clear evidence that the reading materials featuring explicit strategy training and collaborative work could raise the Thai students’ awareness of reading strategy use, enhance their reading performance and increase the level of task enjoyment. The present study also suggests the benefits of integrating text simplification and the use of L1 in the reading materials and instruction, as these two measures could build up the students’ motivation as well as level of text understanding. Additionally, to increase motivation and involvement, it is worthwhile focusing on the selection of interesting and challenging text topics, on the design of a task response format which does not require grammatical knowledge and on producing materials with colourful illustrations. Teachers’ careful scaffolding and the clarity of task purposes and procedures were shown to be important variables affecting the classroom atmosphere and the students’ level of task achievement, and thus, need to be taken into consideration when planning guidance for teachers involved in teaching reading course such as that investigated in this study. Tue, 01 Jan 2008 00:00:00 GMT http://hdl.handle.net/1842/2674 2008-01-01T00:00:00Z