1. Clinical Sessions in
English in a Spanish
setting
Jonathan McFarland
Medical English Coach
Saturday 13th September 2014

2. INDEX
1)Background and Introduction
(including my personal background and the local
context)
2)Why Clinical Sessions
i) Hypothesis
ii) The needs of Spanish doctors
iii)History
iv)Composition
3)Results and Feedback
4)Future Projects

3. 1) PERSONAL
BACKGROUND
Why Medical English?
An epiphany (from
the Ancient Greek
ἐπιφάνεια, epiphaneia,
"manifestation, striking
appearance") is an
experience of sudden and
striking realization.

4. Work background
English
teaching

5. Grandfather -
Professor of
Orthopaedics
Family Medical
background
Grandmother-
Paediatrician
Father -
General
Surgeon
Grandmother
Non Medical
Grandfather
Eye surgeon
Mother
Non
Medical
Uncle
Veterinary
surgeon
Uncle
Physician
Cousin
Obstetrician
Cousin
GP

6. Where do I work?
The Balearic Islands
(Population: 1,111,000)

7. Mallorca
Menorca
Balearic Public Health System
3 health areas
Staff: 14,300
10,676 health professionals
Ibiza-Formentera
7 hospitals
56 primary care centres
HUSE
HSLL
HUSE - Son Espases University Hospital
HSLL - Son Llatzer University Hospital

8. Son Espases University Hospital
* A referral hospital for the
Balearic Islands
* Inaugurated in 2010 ( formerly
Son Dureta University
Hospital)
* Around 1,000 beds, 26
operating theatres, with all the
specialities (including cardiac,
paediatric and neurosurgery)
covering a population of
around 350,000 inhabitants

9. Son Llatzer University Hospital
* Opened in 2001
* Around 400 beds, with
the majority of
specialities
* Pioneer in Europe in the
use hospital
Informatization systems

10. The Importance of
English in Medicine
“We have entered the era of
medical English,which
resembles the era of medical
Latin in that,once
again,medical doctors have
chosen a single language
for international
communication”
“The Language of Medicine” – Henrik R.Wulff, 2004

11. The Importance of
English in
Medicine
The representation of German-,French-,and
English-language journals in the Index Medicus and
Medline, 1879–2007, ( Baethge C , 2008 )

12. The “English
Barrier” in Spain
CAN YOU SPOT
SPANISH DOCTOR ?

13. BACKGROUND AND INTRODUCTION
The “English Barrier” in Spain
* “The level of English of Spanish doctors is still
well below the European average.”
* “All is a question of motivation and the
appropriate strategy. This could be summarised
by two ideas: incorporating the practice of
English into daily activities and studying English
as though it were a living language.”
“English for doctors” Gonzalo Casino, 2006
(translated from Spanish)

14. The needs of Spanish
doctors
* English is the language
of:

15. 2) Why Clinical Sessions?
Hypothesis

16. i)Hypothesis
*Educational analysis:-
*The great desire/need of Doctors
to learn English
*The busy timetable of Doctors

17. i)Hypothesis
*The three E´s
Embed – the learning experience into a clinical setting
Engage – busy clinicians with English
*Encourage –Doctors to break
the English barrier
*Facilitating – The Right Conditions for the learning, motivate
and “incorporating the practice of English into daily work
activities”

18. i)Hypothesis
Lev Vygotsky, Soviet Belorusian
psychologist.
-Social Learning theory
-ZPD ( Zone of Proximal
Development )

19. Social Learning Theory
- posits that people learn from one
another, via observation, imitation, and
modelling.
– Bandura, 1977

20. i) Hypothesis
* Educational Technology–
* Critical from the start
* 2004/2005 – Gmail
* 2007- Google docs
Google Drive
* 2013 - Whatsapp
CCOOMMMMUUNNIITTYY
OOFF PPRRAACCTTIICCEE

21. ii) Needs of Spanish Doctors
* A strong realization that English is the lingua franca
for Biomedicine
* But……
* Historical “fear” of English
* Shyness of public speaking
* Older Doctors learnt French
* Specific difficulties, eg. Word order, false Friends,
verb tenses, phrasal verbs, pronunciation etc

22. Specialist training – Residency
programme
* The Spanish residency
training is normally 4
years ( 5 years in
Oncology)
* English is stressed in all
the programmes
* In Oncology – it is NOW a
requirement
* A “sign of the times”

23. iii) History
The path towards Clinical Sesssions
2002- Son Llatzer Hospital (HSLL)-Medical English
2005- Son Dureta Hospital ( now Son Espases Hospital
–HUSE)- Medical English
2008- HUSE – Clinical sesssions – ENT & Paediatrics
2010 – HSLL – Clinical Sessions – Surgery and Oncology
2012 – HSLL and Aintree Hospital ( Liverpool) 2
International Video Conferenced Clinical Sessions

24. * Sep 2014 -Clinical sessions now taking
place in the following departments :-
* HUSE
Current situation
Dermatology Haematology Immunology
Infectious
Diseases
Laboratory
Medicine
Maxillofacial
surgery
Microbiology Nephrology Neurosurgery
Paediatrics Pulmonology Oncology
Orthopaedics Psychiatry Radiology
Research
Institute
Urology

25. *In HSLL – Oncology and Pulmonology
Strong collaboration with Bibliosalut
(Virtual Health Sciences Library of the
Balearic Islands)

26. Current situation
Important to state that –
Individual initative
long struggle
Support of Doctors and Heads of Departments
But NOT necessarily support of Management
Still working as “Freelancer”
NO established official position

27. iv) Kinds of sessions
* TOPIC PRESENTATIONS
* INFOBIOGRAPHIES
* REVIEW OF MEDICAL TERMS and PRONUNCIATION
* BIBLIOGRAPHIC REVIEWS
* WRITING WORKSHOPS
* DUTY HANDOVER
* ROLEPLAYS
* DEBATES
* EXTERNAL SPEAKERS
* CLINICAL CASES

28. TOPIC PRESENTATIONS
Many sessions are dedicated to
presentations of specific topics,
such as in this example on
“Diffuse Glioma Growth”
presented by a 3rd year
Resident in Neurosurgery

29. INFOBIOGRAPHIES
For example one given by the
Head of the Microbiology Dept
on -
“Egon Schiele and the Spanish
Flu epidemic on 1918”

30. REVIEW OF MEDICAL TERMS
A review of the names and
pronunciation of antibiotics
was recently given in the
Infectious Diseases unit of Son
Espases, in June 2014

31. BIBLIOGRAPHIC REVIEWS
This is regularly performed
in the Pulmonology Dept.
and this is also a regular
feature of the sessions in
the Dermatology
department amongst others

32. WRITING WORKSHOPS
Doctors/ researchers read
out their articles, abstracts
to their colleagues, and we
discuss them and criticise
them where appropriate
(both content and
language)

33. DUTY HANDOVER
This is a session that takes place on
a monthly basis in the following
departments:-
Neurosurgery
Nephrology, Oncology
Haematology, Urology

34. ROLEPLAYS
Useful activity, and is used in
many departments, for
example in the Paediatric
department, where we role-play
the Doctor – patient
interview between the Doctor –
the mother and the child

35. DEBATES
In the last months I have had
successful debates in the Laboratory
medicine department, Microbiology
dept. and others.
Topics –
“The future of clinical microbiology”
“Challenges of Clinical analysis”

36. EXTERNAL SPEAKERS
I have been lucky enough to have
had the chance to collaborate with
different services.
One of the most important
collaborations is with Bibliosalut,
and their team have given
presentations in English to some of
the Depts.

37. CLINICAL CASES
This kind of clinical session has
been taking place within the
Infectious Diseases dept. since
2010 .
In the next slides I will show
three short videos that
demonstrate the format.

38. Clinical Sessions in
Infectious Diseases
Service, HUSE – May
2014

39. Case studies
This video shows the
resident explaining the
clinical case
https://www.youtube.com/watch?v=eU
poa4_mKAY

41. Case studies
This video shows the
consultants and head of
department discussing
and debating the case
with the residents
https://www.youtube.com/watch?v=3I
4pp90NX3I&feature=youtu.be

43. Case studies
This video shows my role in
the sessions-
Comment on the language
used, correct mistakes in
pronunciation, lexical use,
grammar etc.
https://www.youtube.com/watch?v=4
MwleKZx6u0&feature=youtu.be

44. Results and feedback
* The results of the “Clinical Sessions in English” project are
per se subjective.
* However, in January 2014 I sent a small group of physicians
a short set of questions and the following where the
answers:
* 1) How are original an idea do you think it is to
have clinical sessions in English in a Spanish Hospital?
* “To my Knowledge there are none or few hospitals
doing clinical sessions in English, thus I guess it is
original and very important”
* ( Chest Physician)

45. * 2) What are the pros & cons of this idea?
* ”The pros are that the residents and young staff have
a continuous stimulus to improve their English skills,
which have a direct impact on their communications
abilities with patients and foreign colleagues.” (ENT
Consultant)
* “The pros are evident, we will learn more English and
more acquainted with medical English.” ( Chest
Physician)

46. * “Mainly, there is the need, almost an obligation for
professional survival, to be able to speak/understand
English that is already the lingua franca in medicine. I
think that nowadays, at least in the Spanish public
hospitals, we have already a good level of reading
comprehension of all English medical journals.
* However, things change in relation with writing papers
in English, and even in an informal correspondence
with colleagues abroad. Unfortunately, the oral
communication level is poor or very bad.”
* (Immunologist )

47. * “ I can’t find any cons to this project” ( Nephrologist)
* “English is the universal language for science nowadays.
Especially because we are in a "Spanish hospital" it is
much easier to be in our comfortable
language zone and turn our back on English language,
everybody speaks Spanish …. But then one day we will
find that we need an important English level to read
or to write a paper, to understand seminars, prepare a
poster or to give a talk at an international congress.”
* ( Microbiologist)

48. * 3) How successful do you think the project has been so
far ?
* So far the success is evident. The expansion of
the clinical sessions in English is a reflection of it. (ENT)
* Very successful. I´d start from one at month and I´d
increase progressively. ( Chest Physician)

49. 3) Future projects

50. Future projects
* i) Objective analysis of results ( possibly in the form of a
comprehensive questionnaire)
* ii) “The clinical sessions in English along with the new
technologies, allow the institutions to hold
International Clinical Sessions. I think this should be the
next step” ( ENT surgeon)
* iii) In the pipeline –HUSE ( Paediatric Dept.) Alder
Hey Hospital ( In Liverpool)

51. * iv) Continued and
further collaboration
with Bibliosalut

52. v) medicalenglishblog.com

53. * vi) Dr Exchange Project – In the pipeline ( along with International
Video conference sessions)
* - HUSE Alder Hey Hospital
* Ninewells Hospital
* vii) The Networked Doctor – A Social Media project with Annalisa
Manca from University Of Dundee – ( Oct 2014)
* viii)

54. ix) Men's App – The medical App to take care of your health
* A collaboration with 2 urologists
* A new app for men's health!
“This App fills a very important
gap that existed in Medical Apps -
Men's Health - and I think it does
it so well that it will in time
become a classic”. Read QR code or search for
“Men’s App” in the
App Store / Play Store

55. x)College of Doctors- Balearic Islands
* In 2012 – start of Medical
English courses for the
COMIB
* With “Clinical Sessions”
dynamic
* Interesting – NON
hospital specialists in the
courses (GPs etc)

56. Sir William Osler, the Father of
Modern Medicine
"He brought
medical students
into the wards for
bedside
teaching.“
Emphasis –
student learning
from observing
and participating

57. *My aim has been to use the
same
*Approach

59. Thanks for your kind attention

60. Acknowledgements
* Thanks to my wife, Polimnia and my two daughters,
Aina and Bianca.
* And to all the doctors, researchers, nurses and
health professionals who have helped me “tune” my
ideas.

61. Contact
* mcfarland.jonathan@gmail.com
* Linkedin - http://es.linkedin.com/pub/jonathan-mcfarland/
4/593/b40/
* Twitter – JonMcF@Medicalenglishb
* This presentation is dedicated to the memory of John Bryan
McFarland(1930-2013) a constant source of inspiration for my work.