Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

English Education for Medical and Dental Students Language Skills Necessary
for Rapport
Yukiko Ideno1 and Yoko Sakamoto2
1

Division of Curriculum Development, Kanagawa Dental University,
Division of Languages and Humanities, Dokkyo Medical University
ideno@kdu.ac.jp, y-saka@dokkyomed.ac.jp

2

Abstract
Advances in information technology and biotechnology - technologies that will support the healthcare sector
in the fourth industrial revolution - have made it possible to aggregate and utilize data related to people andmedical care. In recent years, the use of AI and robots will further advance the sophistication and remotenessof medical care, and physicians will be required to play a role in connecting medical care and patients.
Therefore, we will report and discuss the practice of English education that fosters the formation of rapport
with patients at Dokkyo Medical University and Kanagawa Dental University, and discuss the curriculum forthe basic year (1st and 2nd year).

Keywords
globalization, rapport, curriculum, medical English, humanity

1

Introduction

The development of communication skills is an essential element for medical students, and the formation of
rapport with patients is now considered to be a part of treatment. Dokkyo Medical University, based in Mibumachi, Tochigi Prefecture, is surrounded by Utsunomiya City, Oyama City, and Tochigi City, where 25,000
foreign workers (about half of the foreign population of Tochigi Prefecture) live. On the other hand, Kanagawa
Dental University is located in Yokosuka City, which is an international city with about 6,000 foreign residents
in Yokosuka alone. Even in this cosmopolitan city, the university and the general hospital are located next to a
US military base. Since both universities are located in a cosmopolitan area, rapport in English with patients
is essential for hospital training. In this article, we will discuss the practice of English education for students
who aim to practice medicine in such a region, focusing on the curriculum of the first and second year.

2

Objectives (The following are the skills required for the objectives)

Philosophy of Kanagawa Dental University Hospital(http://www.kdu.ac.jp/hospital/hospital_guide/patient_right/)(1) We provide safe, gentle, and high-quality medical care to patients.
→Cultivate communication skills → Thorough medical ethics(2) We contribute to the improvement of health and hygiene in the local community
by placing importance on cooperation between doctors and patients.
→Fostering English skills(3) We promote research and development of advanced medical care.
→To develop competent medical personnel with rich humanity.
→Cultivate communication skills.
(4) We nurture competent medical professionals with a rich sense of humanity.
→To develop competent medical personnel with rich humanity.
→Cultivate communication skills.
Philosophy of Dokkyo Medical University Hospital(https://www.dokkyomed.ac.jp/hosp-m/hospital/overview/philosophy.html)
9Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics(1) Respect the dignity and rights of life, and do our utmost to serve the sick with high ethical standards.
→Thorough medical ethics(2) In order to provide medical care that seeks the highest potential in the ever-advancing medical field, we
strive to improve ourselves tirelessly and provide a high level of knowledge and skills for the benefit of all.
→Cultivate English language skills.
(3) To contribute to society by eradicating disease and seeking the truth for the sake of people's peace and wellbeing, and to work diligently as a research institution on the path to advanced medical treatment.
→Development of English language skills(4) To provide highly advanced medical care as a hospital with special functions, and to take pride in being a
medical center at the core of the local community, and to build good relationships with other medical
institutions in the community.
→Cultivate communication skills.
(5) As an educational institution, the university hospital fosters its students and faculty members to become
high-quality medical professionals who can carry out team medicine to confront illnesses with a common
understanding and grow to become members of high-quality, safe medical practices.
→Cultivation of communication skills and English skills
Takahashi et al. (2020) states, "It is clear that students who will become medical professionals are required tohave English skills that enable them to communicate with non-Japanese speakers in multidisciplinary medicalcare.” As mentioned above, communication skills and English skills are related to each of the objectives
required by hospitals, so it is necessary to lay the foundation for these in the basic grades.
2.1
Methodology - Syllabus
2.1.1 Kanagawa Dental University
Instead of the conventional two-semester system, we have introduced a five-stage system with one stage
lasting seven weeks. The syllabus allows students to study a small number of subjects intensively and complete
them steadily. Each subject is planned to be completed in about 7 weeks, and the 7th week includes a subject(module) examination and supplementary education to increase the educational effect by stepping up the
support to prevent students from developing weak skills.
First Year Foreign Language I
One to four stages (module examinations in the seventh week)stage

1 stagelisteningspeaking

6 weekwriting

2 stage

3 stage

4 stage

2 week2 week2 week2 week2 week2 week2 week2 week2 weekSecond Year Foreign Language II
One to three stages (module examinations in the seventh week)stage
1 stage
2 stage
3 stagelistening speaking

2 week2 week2 weekwriting

2 week2 week2 week

medical English

2 week2 week2 weekAbout 100 students are divided into three classes, and three teachers are in charge of each stage twice a year.
In the first year, a teacher changes every two weeks, and in the second year, a teacher changes every week for
two rotations.
10Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

2.1.2 Dokkyo Medical University
Dokkyo Medical University has a three-semester system. The three-semester system allows students to study
many subjects intensively. English is important for both research and clinical practice for medical students,and many students aim to study abroad. Therefore, in the first and second years, students study medical English
and General English comprehensively, with the aim of laying the foundation for medical English in the thirdand fourth years and overseas training in the fifth and sixth years.

11Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

First Year
1st semester Medical English I (9 classes) General English A (14 classes)
General English B (9 classes)
2nd semester Medical English I (9 classes) General English A (14 classes)
3rd semester General English A (14 classes)
Electives: Speech Clinic, Intercultural Communication, TOEFL Writing, etc.
Second Year
1st semester English IIL (7 classes) English IIR (6 classes)
2nd semester Medical English II (5 classes) English IIL (4 classes) English IIR (5 classes)
3rd semester Medical English II (5 classes), English IIL (8 classes), English IIR (5 classes)
Third Year
1st semester Medical English III (10 classes)
Electives: Overseas Training Program (Philippines)
Fourth Year
1st semester Medical English IV (6 classes)
Electives: English Special Study (5 classes)
Overseas Training Program (Philippines)
Fifth Year
Electives: Overseas Training Program (Germany, USA)
Sixth Year
Electives: Advanced Overseas Training Program (Germany, USA)

12

Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics(https://www.dokkyomed.ac.jp/dmucn/schoollife/campus-map.html)
In addition, an English Community Lounge has been set up for all grades throughout the year, where native
English speaking teachers are stationed to help students and faculty of the School of Medicine and Nursing
learn English.
In Dokkyo Medical University, flipped classroom teaching, active learning, and quizzes have been introduced
to all classes since this year, and students are required to watch a 15-minute video as a pre-class assignmentand study for the quiz. As a result, the class time is still in a state of trial and error to enable active learning
activities to take place.
In Medical English I, the class is divided into two classes of about 120 students, and two teachers take turns
teaching the class, one for nine classes in the first semester and the other for nine classes in the second semester,
one to practice speaking medical English using consecutive interpretation and to discuss English newspaper
articles. The other is teaching listening, reading, and vocabulary using ALC Net Academy Next's medical
English course. In Medical English I, the class focuses on output, and the students learn the basics tocommunicate smoothly in English with other medical professionals, patients and their families as future
doctors. In these classes, students practice not only English, but also posture, voice, eye contact, and othercommunication skills that will lead to rapport building.
In General English A, three native English teachers (two from the UK and one from Canada) are in chargeof the class, which is divided into three classes of about 40 students. All classes are designed to develop
communication skills in English.
In General English B, three Japanese English teachers are in charge of reading and listening classes. The
purpose of this course is to deepen students' understanding of environmental issues, racial diversity, and othertopics that are difficult to discuss in English.
In addition, students can take elective courses such as Speech Clinic, Intercultural Communication, and
TOEFL Writing, and they can choose courses according to their interests and motivations. In this way, thecurriculum for the first and second years is designed to comprehensively cultivate the English communication
skills for rapport building.
2.2
Goals of Basic Education
The objectives of this course are to develop communication skills to become humanistic and competent
medical professionals, and to improve English skills to contribute to the improvement of health and hygienein the community.
2.3
Evaluation
Evaluation will be based on a combination of three measures: activities, unit examinations, and module
examinations. The activity is the history of activities in the class of the day, the unit examination is theassignment of the class day, and the module examination is the assignment at the end of the stage. It will benecessary in university education to evaluate the three elements of academic ability required by the Common
Test for University Entrance - "knowledge and skills," "ability to think, judge, and express," and "attitude
toward independent learning. In particular, "multifaceted and comprehensive evaluation" for evaluating
independence corresponds to "activities," and this standard must be further clarified.
13

Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

3. Achievement Goals (at graduation)
1)Kanagawa Dental University
Curriculum Policy
In order to comprehensively acquire the knowledge, skills, and attitudes listed in the Diploma Policy, theuniversity systematically organizes all liberal arts, basic, and clinical subjects into four courses: "Dental
Occlusal Medicine," "Life Science and Oral Pathology," "Society and Dental Medicine," and "Kanagawa
Dental College Specific Subjects," each of which offers an appropriate combination of lectures, exercises, andpractical training.
→There is a need to promote language learning as inherent in this curriculum policy.
Knowledge
The curriculum is designed to provide students with a progressive curriculum throughout the school year, frombasic medical knowledge to specialized knowledge, and to enable them to acquire independent learning.
Skills
The curriculum is designed to enable students to acquire the comprehensive skills necessary for dentistry byorganizing education in communication skills and medical techniques in stages.
Attitude
The curriculum is designed to provide progressive education in ethics and professionalism, and to enable
students to practice medicine in a sincere manner with patients.
Diploma Policy (Degree Awarding Policy)
1) To have the knowledge, education, and integrity necessary to be a member of society, and to have the ability
to respond to an increasingly diverse age.
①To have the ability to conduct independent study in order to gain a wide range of knowledge and education.
(Knowledge)②Communication skills for smooth human relations. (Skills)③Possess a sense of ethics and integrity as a member of society. (Attitude)2) Possess a spirit of love (with reverence for life) and the ability to find and solve problems as a medical
professional.
①Possess the knowledge necessary for a dentist regarding basic medicine and adjacent medicine.
(Knowledge)
Possessthe communication skills necessary for good information sharing with patients and medical staff.
②(Skills)③Have an attitude of respect for others (patients and staff) and the ability to gather and analyze information
to understand social needs for medical care. (Attitude)3) Have a systematic understanding of clinical dentistry necessary for a dentist and the ability to develop ahigh level of professional knowledge.
①Possess the specialized knowledge necessary for dental health care. (Knowledge)② Possess the skills necessary for dental health care based on scientific evidence. (Skills)③ Professionalism to respond appropriately to the situation. (Attitude)
In order to open the door to students from a wide range of fields, the Kanagawa Dental College requires only
two subjects for the General Admission Examination. For this reason, there are a considerable number ofhumanities students who have not taken science courses among the new students. In the first year of education,
14

Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

students learn basic knowledge at the high school level. However, there is a big difference in academic ability
between students who have taken science courses before entering the university and those who have not.
Therefore, from this year on, it will be necessary to set up an English curriculum with an emphasis on science
subjects for students who have taken humanities courses, unlike the conventional education.
2) Dokkyo Medical University
By graduation, the students of our university must have the necessary abilities in each of the following:
Things to understand as basic knowledge

●
●
●
●

Normal development and structure of the human mind and body, its functions and abnormalities.
Knowledge of the pathogenesis, pathology, and diagnosis of as well as the treatments for majordiseases.
Knowledge of the social aspects medical care, as well as disease prevention, rehabilitation, and thepatient's QOL (Quality of Life).
From an international viewpoint, a wide range of information on the study of medicine and medical
information.

Basic attitudes that must be possessed

●
●
●
●
●

Ability to enlighten oneself throughout life based on an active leaning attitude.
Work on the study of medicine, medical care, and healthcare encompassing humanism.
Develop a habit of building a good physician-patient relationship to solve patients’ problems.
Be aware of the social responsibilities as a doctor while recognizing the limits of one’s abilities, andhaving the attitude to humbly accept an expert’s advice.
Attach importance to cooperation as a member of the medical team, and at the same time be preparedmentally to take a leadership attitude.

Fundamental skills that should be acquired

●
●
●
●
●

Ability to acquire basic treatment skills and to be able to differentiate between normal and abnormal.
Ability to comprehensively identify the problems and assess the solutions.
Ability to acquire information through the medical interview and the examination, then grasp an
accurate diagnosis and disease condition, and fully explain it to the patient and family.
Ability to diagnose a critical condition and implement emergency treatment.
Basic Skills necessary for medical research.

At Dokkyo Medical University, the general entrance examination consists of four subjects: English, mathematics,
and two subjects selected from physics, chemistry, and biology. After entering the university, students are required
to take elective courses in physics, chemistry, and biology that they have not taken in high school. In the first year
English class, students can learn not only medical English, but also general English, including ethics, science, andcommunication.

3) Summary of Achievement Goals
The Ministry of Education, Culture, Sports, Science and Technology (MEXT) has the following to say about
the state of university hospitals. “The progress of internationalization has reached university hospitals as well,and it is necessary to take into consideration how to deal with foreign patients and participate in international
medical cooperation in terms of medical treatment, and how to educate foreign students in terms of education.”
In order to respond to these demands, foreign language education in medical universities must take a further
leap forward from the conventional language education, and the curriculum must be structured from theperspective of improving humanity toward the internationalization of medical and dental professionals.
15

Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

Medical and Dental universities have the characteristic of being a place for medical and dental treatment aswell as a place for education of medical and dental personnel, and it is necessary to obtain the cooperation ofpatients in some aspects. For this reason, it is necessary for medical and dental universities to perform thefunctions of education and research as they are indispensable for the development of future medical and dental
professionals and the progress of medicine and medical and dental treatment in Japan. In addition to fully
explaining this to individual patients, it is necessary to conduct a variety of public relations activities, including
the use of information technologies, so that the public can gain a broader understanding.

4. Challenges and Prospects
The Kanagawa Dental University has introduced a five-stage system of learning for first through fourth year
students, dividing the year into five stages, prior to the practical training at the affiliated hospital for fifth year
students who will engage in treatment as student doctors. The five-stage system consists of a unique curriculumthat allows students to steadily acquire credits by studying a small number of subjects every two months. In
addition, all classes are recorded and students can freely repeat the lessons as many times as they want. We
were one of the first universities to respond to the Ministry of Education, Culture, Sports, Science andTechnology's "University Reform Action Plan" and are implementing a completely new educational program
to train new dentists who will be the engine of a super-aging society. For English, three faculty members taketurns teaching classes at the same stage, focusing on the skills that each faculty member specializes in. By
receiving instruction in listening and speaking from teachers at Yokosuka Air Base, students are able to acquire
the attitudes and postures necessary for communication, and by receiving instruction in writing from a former
teacher at a nearby international high school, students are able to compose English essays using the grammar
they learned in high school. They will be able to write English essays using the grammar they learned in highschool. It is expected that these skills will not be concentrated in any one stage, but will be well-balanced anduseful for hospital practice in the upper grades. As for challenges, as Mituhiro Morita (2020) points out, there
is a criticism that "the quarter system tends to reduce the content of the classes than the semester system," andthis criticism will also apply to the five-stage system. In order to maintain the same amount of content as thesemester system, it will be important to improve the syllabus and hand it over to the next year.
Dokkyo Medical University has introduced a one-year hospital training program for fifth-year students asstudent doctors, which provides opportunities to come into contact with patients from abroad. So our university
aims to foster medical professionals with an international perspective, and many patients who communicate inEnglish visit the university hospital. Therefore, the Medical University aims to train doctors who can conduct
medical interviews in English, present at conferences, and write papers. In the first and second years, students
learn basic general English and the rudiments of medical English, and English classes are provided until the
fourth year. In the fifth and sixth years, students can choose to participate in overseas training programs. In
this way, the curriculum is designed so that students can learn English at all grade levels. One of the challenges
is to cultivate and nurture the students' ability to continue to learn, as class time alone is not sufficient to mastergeneral English and medical English. So students are expected to take advantage of opportunities for self study,
such as the English Community Lounge, and develop an active learning attitude that will lead to the acquisitionof communicative English to build rapport with patients and their families.

5. Conclusion
Both Kanagawa Dental College and Dokkyo Medical University, as hospitals accepting patients from abroad,require students to acquire sufficient English skills and communication skills to form rapports. In a medical
school with a vast number of learning items, English education is required to teach English effectively and toencourage students to study autonomously. We would like to continue to improve the curriculum and course
content to foster medical professionals with an international perspective.

16

Selected Papers of the 25th Conference of Pan-Pacific Association of Applied Linguistics

Note
Complementary education means that all classes are videotaped, and if a student is absent, he or she must makeup the class using the video and report it to the instructor. If you miss a class, you have to make up the classby video and report it to the teacher in charge. Also, you can check the part of the class that was unclear in thelive class by video. 2.
After the remote class, there are activities such as using the chat function to respond to the questions asked by
the teacher in Zoom by writing an English essay immediately.
References
Takahashi, R.., Takahashi, H., Ohno, M., Ogura, H., & Yoshikawa, Y. (2020). On Medical English Education
in a Medical University: Focusing on Vocabulary Education for First-Year Students. Journal of the
Showa Academy, 80, 508-516.
Morita, M. (2020). The Impact on English Education of Adopting the Quarter System at Hiroshima University.
Hiroshima Studies in Language and Language Education, 23, 121-136.

17