DOI: 10.14457/tu.the.2017.782
title: The inclusion of Asian English accents in the listening proficiency test for healthcare personnel working in the Thai context

description: As Thailand has become a medical hub of Asia and experienced the growth of medical tourism, having the ability to listen and understand English accents of international patients and medical laborers from Asian countries has become crucially important to healthcare personnel working in the Thai context. However, due to the practice of limiting test input to the native English accents in listening assessment, this ability cannot be assessed in the listening proficiency tests for healthcare professions. The inclusion of Asian accents in the English proficiency test is proposed under the rationale of more accurate representation of the test construct, validity of score inference, test authenticity, beneficial washback on test users and relevance to test takers’ communicative needs.Previous studies (Major et al. 2002; 2005, Harding, 2011a; Oh, 2011; Abeywickrama, 2013) that incorporated non-native English accents in listening tests mainly focused on examining the effects of NNES accents on listening comprehension and test performance and the shared-L1 effect. However, the tests developed in their research and the choice of accents were not based on the needs analysis of stakeholders and limited to academic listening tests and general English proficiency tests. Thus, the present study has its niche in developing a specific listening proficiency test for healthcare professions with Asian English accents based on the stakeholders’ needs.This mixed methods study investigates the test construct of listening proficiency of healthcare professionals focusing on the stakeholders’ needs and attitudes towards the use of NNES accents as test input and assessing the ability to understand the speech of Asian English speakers in the listening test. The study also investigates the types of TLU tasks in which healthcare personnel perform and interact with NNESs and the varieties of accents to be included in the test. Further, it examines the validity of the listening test that includes Asian English accents.The data were collected from job description analysis, worksite observation, domain expert consultation, two sets of questionnaires, interviews, speech evaluation tasks, content validation and test taker evaluation. In Phase 1 Needs analysis, a total of 120 healthcare personnel from different healthcare positions and 12 staff supervisors from three international hospitals in Bangkok participated in the questionnaire. Nine supervisors joined the consultation session and fifteen healthcare staff were chosen for the in-depth interview. In Phase 2 Test production and an initial validation, a total of 62 healthcare staff participated as test takers and completed the evaluation form. Nine speakers for the test from seven L1 backgrounds were recruited and five experts from academic and professional areas were chosen for test validation. In the phase of needs analysis, job description analysis, consultation with domain experts, questionnaires and interviews were carried out to obtain information regarding needs of healthcare personnel, their target language use situations, types of tasks, varieties of accents and their perceptions towards the use of Asian accents and the test construct. The information was used as a basis for developing the listening test (the HELP Test). In the phase of constructing and validating the test, the test items and audio recordings were developed based on the test specification. After that, the test was reviewed and validated by experts using a content validation form. After the test revision, the test was trialed with five healthcare personnel. Then the test was administered to the test takers and the evaluation forms were completed.The results indicate that the inclusion of Asian accents in the English proficiency test and assessing the ability to understand Asian English speakers as a part of the test construct has been accepted by stakeholders as a useful way to bring many beneficial consequences. Healthcare personnel can gain familiarity with Asian accents and achieve mutual understanding with their interlocutors and this can contribute to more effective communication, patient safety, better quality of healthcare services as well as more patient satisfaction. Implications for pedagogical practice and research, limitations of the study and recommendations for further research are presented based on the findings.