The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

1

The power of podcasting: creating opportunities
for medical students to speak with creativity andconfidence
Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad
Nara Medical University
Abstract
The world is becoming increasingly globalized, and the medical field is nodifferent. This trend has substantial implications for medical professionals inJapan who communicate and collaborate with their counterparts from othercountries. Not to mention the recent trend of increased foreign immigrationand tourism, which requires Japanese doctors to communicate with patientsin English. English education is compulsory from the 5th grade of elementary
school through the 3rd year of high school. However, the classes primarily
focus on textbook learning and less on a communicative approach; students
thus graduate high school but lack the ability and confidence to speak
English. The Clinical English Department at Nara Medical University has
created a curriculum that focuses more on creating opportunities for medical
students to build up their English speaking skills and to provide multiple
ways for the students to regularly communicate in English inside and outside
the traditional classroom-setting to foster self-efficacy. One example is the
Podcasts and Podcasting course that records and publishes student-created
podcast episodes focusing on student storytelling, crafted monologues, andimpromptu conversations on topics related to their studies, extracurriculars,
and Japanese culture. The unique course was imagined and birthed during the2Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

start of the COVID-19 pandemic in 2020 and has continued since. This paper
discusses the set-up and purpose of the podcast class, shares one studentʼsviews on this unique course, and describes some of the unexpected benefits
and incredible potential of podcasting.
Keywords: podcast, podcasting, speaking competence, storytelling, motivation

Introduction

In today's medical field, doctors and other medical staff are increasingly
expected to be able to communicate with patients in English. Furthermore,
many of the most important medical research papers are written in English,
and understanding and using these papers is an essential skill for healthcare
professionals worldwide (Mayers et al., 2023). Not to mention that English has
become the lingua franca of medicine. Baethge (2008) explains, “International
communication among clinicians and scientists is now almost exclusively inEnglish” ( p.37). In the past, it may have been believed by many that this trend
did not affect Japanese doctors who lived and worked in a predominantly
Japanese country. However, Japan has become increasingly internationalized
in the last decade, with the population of foreign residents in Japan hittinga record level of 3.2 million (Number, 2023). Inbound tourism to Japan has
also returned to all-time monthly highs following a temporary dip during the
pandemic (Monthly, 2023). There is just no way around it. Japanese medical
professionals need an understanding of English and, more importantly, theskill of communicating in English at a high level. It can also be said for the
medical students studying to be professional doctors and researchers at Nara

The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

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Medical University.
Much like other skill-based activities such as sports and music, becoming
proficient in English requires not only a large quantity of time but, more
importantly, regular practice (Haith et al., 2018). The majority of students
who have entered Nara Medical University have spent the past several yearsof their education (elementary, junior high, and high school) taking English
classes where they focused on learning the fundamentals of English grammar
and memorizing vocabulary (Ikegashira, 2009). These are the building blocksof the language, and undoubtedly, obtaining this knowledge has assistedthem in passing a complex English university entrance examination. On thecontrary, all that knowledge alone does not translate to communication ability
in English, as can be witnessed when they are directed to speak in pairs for 10
minutes in the first classes at the start of the semester. The apprehension ispalpable as the students attempt to talk with their partners while the teacher
observes them.
In recent years, the Department of Clinical English (DoCE) at Nara Medical
University has primarily taught twice-weekly compulsory English courses
for first-year medical students. Understanding the importance of habitual
practice in the classroom, the curriculum for these classes has been designed
to allow for ample amounts of productive tasks that use all four skills(speaking, listening, writing, and listening), but with particular attention toregular communicative tasks that require the students to speak in pairs or
small groups. Each class has multiple opportunities to speak freely about
student-chosen topics or discuss teacher-directed academic topics. The initial
uneasiness that came with being asked to speak English with, and in frontof, their peers due to a lack of previous experience gives way to active and4Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

frequently fruitful conversations or discussions as the speaking practiceactivities become second nature for our students. By the end of the academic
year, the students who merely participate regularly in these twice-weekly
compulsory classes see real progress in their speaking abilities.
However, some obvious limitations present themselves in the traditionalclassroom setting when it comes to practicing English conversations anddiscussions that must be addressed. One is that speaking practice activities
are highly structured, and the classroom environment lacks authenticity. In
other words, practice is just practice, and feels like practice. The students
are keenly aware of this controlled and safe environment. Once they getpast the initial jitters of speaking in English with their classmates, they relax
into a setting that does not require them to take risks, and frequently, theconversations become somewhat formulaic and stale. Although they makeprogress within this controlled environment, they often are not ready toreliably use their newfound English speaking skills in real-world situations
with other native and non-native English speakers, which will be unavoidable
in their future medical profession. As one of their instructors who sincerely
wants to see the students succeed in real-life English-speaking situations,
I have occasionally felt stymied by the limitations of teaching English to
medical students in the classroom. Surprisingly, I found one intriguingsolution to this dilemma when the world was flipped upside down with the
COVID-19 pandemic.
As the spring semester of 2020 was set to begin, the university notified usthat all compulsory classes would go online and all elective classes would bepostponed indefinitely. Many of the teachers had limited to no experience
with teaching online classes. In addition, the students also had virtually no

The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

5prior experience with taking online classes. The incoming first-year students
would also not have the opportunity to meet their classmates in person
before or even during that first semester. These new circumstances presented
tremendous challenges to carrying out a curriculum designed to offer multiple
chances to practice speaking. In other words, speaking practice within theclassroom setting has inherent limitations, as I previously stated. Furthermore,
the situation brought on by the pandemic made it much more challenging
to provide the necessary practice required for students to excel in English
communication.
Although it felt dire, the situation allowed me to reflect more deeply on what
I felt students needed to communicate well and prepare themselves for reallife situations. Considering regular classes were put on hold, I wanted to dosomething to make up for what these new students would be missing out
on in their first year. Those difficult circumstances eventually inspired me
to brainstorm unconventional ways of teaching, and a light-bulb moment
occurred. Holiday states, “The obstacle in the path becomes the path. Neverforget, within every obstacle is an opportunity to improve our condition” (2014,p. 7). The challenge brought on by the pandemic ended up being the key tothe solution.

The birth of the podcast

Several years ago, I purchased my first smartphone. As I was attempting tofamiliarize myself with the device, I noticed that there were already many
pre-installed apps, including one titled “Podcasts.” I did not know what that

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Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

word meant at the time, but rather quickly, it became one of the apps I usedmost regularly. The word podcast combines “pod” from the Apple product
iPod and “cast” from broadcast. It is an audio file uploaded to the internet
and then downloaded freely to audio-playing devices such as smartphones orcomputers (Jordan, 2007). In most cases, it tends to be a show with regularepisodes devoted to themed content. The millions of podcasts broadcasted
today cover an infinite number of topics.
I started out listening to podcasts as a form of entertainment. Still, I quickly
realized that podcasts might serve some purpose for language study andsearched for some that focused on studying Japanese. These podcasts
provided hours and hours of free Japanese instruction that I could listen
to on my daily train commute to work. After several months of listening tothese podcasts, I realized I could combine my interests with Japanese study
and sought out comedy and sports podcasts in Japanese. It turned out that
podcasts explicitly created for Japanese listeners could also provide excellent
listening practice for Japanese language learners. I realized I could alsosuggest that the medical students start listening to podcasts as a supplemental
form of English study. Furthermore, it sparked the idea that rather than justhaving students listen to podcasts, what if we produced our own?
The pandemic took away most of the opportunities for our students topractice English. Still, it also introduced us to the video-conferencing platform
ZOOM, allowing us to meet online and record our conversations. I began torealize that a podcast-making class had the potential for increased speaking
practice in an authentic environment with the possibility of real-life listeners
from around the world. However, I did not initially grasp that making a
podcast could provide so much more for the students. The real potential of

The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

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the podcast class was revealed only after recording several podcasts withvarious students. The results have been encouraging.

Student perspective

The Department of Clinical English at Nara Medical University offers a variety
of English classes and activities, and “Podcasts and Podcasting” is one of thehigher-level classes that some students can join voluntarily in addition toregular lectures. Several fifth-year medical students, a couple of third-year
medical students, and a fourth-year nursing student join this class weekly. We
record our conversations and monologues during the class, which our teacher
subsequently edits into a podcast program. Although this may sound similar
to daily conversations, podcasting has more exciting and challenging aspects.
It also contributes to the improvement of various abilities other than English,
and students can learn numerous things through it. I will highlight the powerof podcasting in the context of education.
Unlike many other medical universities, Nara Medical University (NMU) has
an independent department for English education called The Department ofClinical English (DoCE). This department has a lot of non-Japanese teacherswith diverse backgrounds and offers many chances for medical students to
use English in various ways, especially speaking. DoCE is running regularclasses for first-year medical students, and during class, students are required
to have discussions mainly on scientific topics. This class is regarded as one of
the most difficult at NMU and one of the highest levels of English lectures atmedical schools in Japan. Moreover, DoCE has extra non-credit elective classes

8Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

called “Advanced Classes, 〝including the Podcasts and Podcasting class.
These electives give motivated students more chances to use English and help
them better understand it. Meanwhile, there are some additional situations
where students can utilize English outside the classroom. NMU has an
English club called "English Speaking Society (ESS)," and students in this clubvoluntarily learn, speak, and use English in many ways. Another example of an
unofficial system is the NMU Organization For International Students (NOFIS)
organization, which creates opportunities to interact with international
students. More and more international students are coming to Nara Medical
University Hospital for internships, and that number has reached more than
20 annually. NOFIS functions as a bridge between Japanese students/doctors
and international students, and is helping both sides build up a mutual
understanding of both cultures.
Why is English so important for doctors or medical students? Why does NMU
emphasize English education? Most students and teachers now recognizethat English is one of the keys to successful careers, as it gives us far more
opportunities to exchange precious opinions with global scientists anddoctors. With high-level English capabilities, we can easily cross borders andwork or research overseas. Western countries, including the United States
and the United Kingdom, often arrange better research situations than Japan.
Besides, since Japan is rapidly aging and its market is expected to shrink,some people, including me, believe that English ability may save our working
future by increasing the possibility of obtaining better jobs outside Japan.
At the same time, however, we must acknowledge that some students anddoctors have little confidence in their English abilities and that the perceptionof English and its value seems to vary from individual to individual.

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Next, let me explain what the Podcasts and Podcasting class is. It is one of
the Advanced Classes at NMU where a teacher and students record theirconversations and later upload them to the web. Jordan (2007) states that
"Podcast" is a combination of "pod" and "broadcast"; it is an audio-delivering
service that broadcasts lots of programs in various fields such as music,
news, comedy, and so on. In short, it is a contemporary radio program format
where we can acquire information from sources worldwide. We can also share
information and our own stories worldwide through it. In short, "podcasting"means recording and sharing information. During the class, we simply record
our daily communications. Usually, we do not prepare drafts but speak
spontaneously, except on special occasions requiring advanced vocabulary or
intricate background knowledge. Therefore, what is the relationship between
regular courses and the Podcasts and Podcasting class? Due to the high-level
English lectures during our first year of medical college, the average English
level of first-year students is quite advanced. As such, NMU successfully
maintains and even raises the English ability of its students after admission. In
contrast, in most universities, students' English levels significantly fall shortly
after entering college as they stop using English following their entrance
examinations. Nevertheless, there is no denying that these regular classes
have some limitations; classes are primarily an extrinsic motivation to use
English, and usually, teachers assign topics. Also, we have a limited length oftime in class. The Podcasts and Podcasting class can compensate for theselimitations and offer more authentic chances to communicate in English. With
that, podcasting has excellent potential to improve students' speaking skills(Iskandar, 2017).
Next, let me describe what makes podcasting different from daily
conversation. Since podcasting means recording conversations, most people

10Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

may believe it must be identical to daily communication. However, podcasting
incorporates additional factors beyond speaking English, giving us extra
challenges: nervousness, intensity, and imagination, leading to carefulness andmindfulness. First of all, we feel more pressure and tension when recording a
podcast since we potentially want to avoid making mistakes that may be heard
by thousands of people worldwide. However, nervousness ironically causes
mistakes and errors, one of the most challenging parts of podcasting, yet thisauthenticates our English ability. In the future, as a doctor, medical students
have to speak English under some pressure, and it is always important to getback on track quickly when making a mistake; for example, when making apresentation in front of dozens of people or when giving a short, accurate
summary of patients to our seniors. Therefore, podcasting improves ourEnglish skills, which will be useful in the future. I have good reason to believethat podcasting cultivates authentic English ability. Secondly, we must employ
our imagination and add explanations so listeners can understand and enjoy
our episodes. Since podcasts do not possess the visual information we usually
rely heavily on when communicating, conveying information in podcasts ismore complex than other visual social media such as YouTube or Instagram.
Moreover, of course, people all around the world can listen to our stories,
and actually, the variety of listeners’ backgrounds is far more diverse than we
expected. Hence, we always need to pay attention to how we explain thingsand often add some explanations for listeners across the ocean with different
cultures, ideas, and backgrounds to easily understand and feel as if they wereright there with us. Thirdly, these two factors, nervousness and imagination,lead to carefulness and mindfulness. It is essential to be as careful andconsiderate as possible so the listener will not feel uncomfortable or possibly
offended. Since Japan is an island nation with less diversity than continental
nations, such as many countries in Europe or the U.S., we sometimes assume a

The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

11

shared understanding and tend to be careless and thoughtless. Such being thecase, we have to pay more attention to our remarks than usual when speaking
to people from different backgrounds. In conclusion, through podcasting,
we can learn numerous things that we would not otherwise be able to learn
through daily conversation. Fitria et al. (2015) point out that podcasting can
improve students' speaking. Authentic practice and student storytelling are
essential.
Despite the various difficulties mentioned above, why are students attracted
to podcasting? The answer is simple. It is attractive for several reasons. One
is our desire to be listened to; another is exposure to the world. Podcasting
fulfills our potential desire to be listened to and understood. Hughes et al.
(2022) explain, “ Storytelling is a way that people can relate to each other,and stories have long been used as a way to get people thinking about
viewpoints beyond their own as well as to express our experiences to others.”
Unfortunately, in Japan, we have few chances to express ourselves anddiscuss various issues in class, although English classes at our university
are one of the few exceptions. Perhaps the right way to put it is that we are
reluctant to voice our opinions in public, especially in front of large groups ofpeople. However, everyone potentially wants to be listened to and recognized.
Podcasting provides a valuable opportunity to express and share our thoughts
and feelings comfortably. As we usually record with only a couple of friends,
it feels safe for students. For instance, I have a friend who is so shy that she
hardly ever raises her hand and speaks out in class, even though she is smart
and has a strong sense of self-worth. However, she tells us her ideas andthoughts in the podcast class, which I could not have known in other classes.
In that sense, I can say that podcasts have a magical power to invigorate
Japanese students. Furthermore, another aspect of podcasting that draws

12Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

students' attention is that they do not have to expose their faces, only their
voices. Most students are not comfortable showing their faces to unfamiliar
people. However, once the privacy issue has been removed, it is surprising
how naturally students begin to talk about their opinions and circumstances.
In conclusion, from a student’s perspective, podcasting is a lot of fun, but it
is not just fun; it is an excellent way to practice and acquire authentic English
skills.
Finally, a significant benefit students can enjoy through podcasting without
being aware of it is gaining recognition as an English speaker. Over the pastfew decades, the number of non-native speakers has skyrocketed, reachingalmost four times as large as that of native speakers. However, only somestudents perceive themselves as English speakers, and many do not. The lackof identity as an English speaker is a hidden and unconscious burden thatprevents many Japanese students from making real progress using English as
a communication tool (Goharimehr, 2018). Finally, podcasting can graduallycultivate awareness of being an English speaker through authentic andnatural communication.

By the Numbers

The Podcasts and Podcasting class commenced in the autumn of 2020.
Hoping to recruit students to try this experimental class, I advertised
through our campus email network. Initially, two students signed up forthe introduction class. Only one student eventually decided to join. It was a
blessing in disguise as it allowed the two of us (teacher and student) to work

The power of podcasting: creating opportunities for medical students to
speak with creativity and confidence

13

together through trial and error to formulate the class and, more importantly,
launch the podcast itself. Within a couple of weeks, we decided on our show's
name and concept. The name of the podcast is Medical Student Life in Japan.
We cover topics centered on being a student at a medical college in Japan andtopics highlighting Japanese culture (Blodgett, 2020-present). Over time, wehave developed our podcasting skills and upgraded our equipment to create
a better product for our listening audience. This includes investing in a highquality microphone and using audio editing software like Apple's Garageband.
By the end of that first semester, we already had several published episodes
under our belts and a small but growing audience of listeners worldwide.
To date, the Podcasts and Podcasting class has continued for four years. In
those four years, we have had over 30 students join the class as regularly
attending students or as visiting speakers and interviewees. It includes
students spanning all six years of our medical college. Although many of thestudents possess an advanced level of English communication skills, there
have also been several beginners join the class and thrive. We have eveninvited guests on the show including Nara Medical University graduates,
medical students from Taiwan, and a medical student studying in Cuba.
We have created 85 episodes covering various topics, including classes,
extracurriculars, the school festival, medical treatments, Japanese food, andmany more. These 85 episodes equate to over 1500 minutes of content,
equalling more than one whole day. Most interestingly, for the students, wehave had listeners from 68 countries worldwide.

14

Michael Blodgett, Satoshi Suzuki,& Francesco Bolstad

Conclusion

Storytelling is the glue that connects the students’ experience with my original
intention of facilitating a type of speaking practice that would translate to an
ability to operate in real-world situations. These future doctors may now beable to communicate with their counterparts worldwide and do so confidently.
The realization that the students were seeking to express themselves, inessence, a desire to share their own stories, now makes a lot of sense.
Sometimes, in the structured classroom, that is what is missing. Students are
instructed to practice, but as previously stated, it feels like nothing more thanthat, and their investment in the activity is minimal. In contrast, by creating
a podcast, these students learned how to develop their speaking ability andhow to communicate their stories effectively, and with that, their confidence
has grown. The high level of energy and emotion they feel while recording
their stories is striking. It is the same reason I felt listening to podcasts was
so worthwhile when I first became acquainted with them several years ago.
Humans are inclined to enjoy stories, both listening to them and sharing theirown.
This paper takes a preliminary look at the benefits of podcasting withstudents to provide additional speaking practice that is authentic. Although
it is a small sample size, the results are exceedingly positive. Undoubtedly, it
may be more than challenging to apply the concepts laid out here to a large
number of students, which is often the case in the typical university class.
Nonetheless, this class type has excellent potential as a supplemental classor activity for students eager to polish their speaking skills and unleash thepower of sharing their stories in English.

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