医学生英语写作能力培养研究
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摘要
随着医学教育的全球化及大学英语教学改革的逐步深入，将医学生的外语能力和专业能力相结合，不断提高其跨文化交际能力日益成为众多研究者关注的课题。在这一背景下，医学生英语写作能力的培养具有重要的现实意义。近年来，国内外学者对目前学术界认可的多种写作教学方法，如成果法、过程法、体裁法，以及基于问题的学习方法等，在以英语为第二语言及以英语为外语的教学环境下对大学英语写作能力的提高方面进行了大量的理论及实证研究并取得了丰硕的研究成果。但作者发现，在我国以英语为外语的教学环境中应采取何种教学方法来提高医学生英语写作能力的研究仍是凤毛麟角。因此，探讨有效的写作教学方法以提高医学生的英语写作能力成为本文的研究主题。
本文作者首先在对“全球医学教育最基本要求(GMER)”及“我国本科医学教育标准”中医学生应该具备的核心能力进行分析的基础上，进一步结合了《大学英语课程要求》中对英语写作能力的“较高要求”，认为医学生应具备的英语写作能力应涵盖以下三个方面的内容：基本英语语言能力、批判性思维能力和专业英语写作能力。其次，通过分析目前国内外比较流行的英语写作教学法（成果法、过程法、体裁法、基于问题的学习等方法）的优势与不足，提出我们应该针对医学生的专业特点，根据学生实际需求，在不同的教学阶段结合多种教学法的长处来帮助学生解决英语写作的实际问题，逐步培养医学生的英语写作能力。
作者以河北医科大学临床医学专业的1个教学班的43名学生为研究对象，进行了为期24周的实证研究。本研究遵循行动研究的基本步骤，主要采用对学生写作文本的分析、课堂观察、学生访谈、学生写作反思、问卷调查等方式，在三轮的行动研究过程中，分别采用结果法与过程法相结合、基于问题的学习方法和过程法相结合、体裁法和过程法相结合，旨在探索不同教学法的综合应用在医学生英语写作中的语言能力、批判性思维能力以及专业英语写作能力等不同方面所起的作用。同时，作者针对教学实践中出现的问题不断进行反思，并及时提出改进措施，再回到自己的实践，观察其实施效果，并对出现的问题进行再次研究和实践。
本文拟通过课堂行动研究，回答以下问题：
１．医学生的写作能力如何界定？具体体现在那些方面？
２．应采用何种英语写作教学方法提高医学生基础英语写作语言能力？
３．如何在发展语言能力的同时，进一步提高医学生英语写作的批判性思维能力？
４．如何在发展语言能力、批判性思维能力的基础上，进一步提高医学生的专业英语写作能力？
作者通过对三轮行动研究中所收集的学生作文文本、学生访谈、学生写作反思及问卷调查等数据资料进行多方位、多角度的分析与讨论之后，得出如下研究结论：
首先，过程法和结果法相结合能够有效提高医学生基础英语写作语言能力，尤其体现在文章内容、结构及语言运用方面。与此同时，学生在阐释、分析、评价及说明等方面的批判性思维技能也逐步得到提高。但作者发现，学生在词汇运用方面仍存在很多问题，因此，如何加强词汇输入，进一步提高学生正确、有效运用词汇的能力仍值得进一步探讨；另外，在第一轮行动研究中作者还发现，以考试为导向的命题作文及课堂限时作文限制了学生的思维和创造力，致使学生的作品千篇一律，缺乏个性与多样性。因此，今后的写作教学中应加强非限时作文写作，增加写作任务的趣味性、新颖性和挑战性，激发学生的写作热情。
其次，过程法和基于问题的学习法相结合能激发医学生的写作兴趣，培养其交际能力、协作学习能力、自主学习能力及分析问题、解决问题的能力。因此，这两种教学方法的有机结合，能有效提高医学生的批判性思维能力，尤其是阐释、分析、评价、推理与说明等方面的能力。但作者发现，写作中自我校准能力的缺失仍是医学生中普遍存在的一个严重问题。因此，如何加强医学生元认知知识与策略的指导与培训，如何培养学生自我反思、自我质疑及自我校正的能力仍是值得进一步探讨的课题。
第三，过程法和体裁法相结合能有效提高医学生的专业英语写作能力。通过摘要这一特定体裁的写作训练，医学生的写作目的更加明确，体裁意识和读者意识明显增强，文本结构和语言表述进一步规范，词汇运用的准确性与专业性也有所提高。但作者发现，专业词汇匮乏仍是医学生专业英语写作中所面临的主要问题。因此，应在写作教学中增加医学词汇的输入，同时还要加强专业英语阅读教学，以读促写，不断提高学生专业英语写作能力。
本文在研究方法上采用以定性研究为主，定性与定量分析相结合的方法。作者通过课堂行动研究，以不同的写作教学方法为研究变量，采用课堂观察、文本分析、学生访谈、学生写作反思、问卷调查等方式，对医学生的写作过程、写作态度及写作能力的变化进行了详细的观察与分析，这种自然状态下的写作教学研究更具有实效性、反馈性与灵活性（陈坚林，2004）。
本研究从分析医学生的实际需求出发，结合其自身专业特点，探索了“动态结合”不同写作教学方法对提高医学生英语写作能力的可行性和有效性，同时使各种教学法的优势得到充分发挥。各种教学法在课堂上的综合应用进一步丰富了外语教学法理论的内容，对我国的大学英语写作教学实践具有重要的启示和指导意义，同时也对英语教育与教学工作者及实践者的写作教学研究具有一定的参考价值。
With the globalization of medical education and the reform of College Englishteaching in China, the integration of medical students’ foreign language proficiencywith their professional competence and the promotion of their cross-culturalcommunication competence have attracted great attention from numerous researchersand become sharply focused. Under this social context, fostering the medical students’English writing competence is of great realistic significance. In recent years, scholarshome and abroad have carried out a large quantity of theoretical and empirical studieson the application of a variety of the writing teaching approaches such as the productapproach, the process approach, the genre approach and the problem-based learning(PBL) approach, etc. to the college English teaching of writing in the context ofEnglish as a second language (ESL) and English as a foreign language (EFL).However, there are few studies on the cultivation of the medical students’ writingcompetence. Therefore, exploring effective writing teaching approaches to foster themedical students’ writing competence becomes the major focus of the presentresearch.
The present study aims to have a tentative exploration on the development ofthe medical students’ writing ability through integrating different teaching approaches.Based on the analysis of core competences required by the Global Minimum EssentialRequirements in Medical Education (GMER) and the Criteria of China’s MedicalEducation for Undergraduates (CCMEU) and in combination with the Intermediaterequirements for writing established by the College English Curriculum Requirements(CECR), the author defines the English writing competence of the medical students asinvolving the following three aspects: the English language proficiency, the criticalthinking ability and the medical English academic writing ability. Then throughcommenting on the main teaching approaches popular in China such as the productapproach, the process approach, the genre approach and the problem-based learning(PBL) approach, the author points out that in view of the professional characteristicsof medical students, a combination of the advantages of different writing approaches in different teaching stages is of great value in solving the practical problems andenhancing their writing competence in their writing process.
An action research, conducted by the researcher in Hebei Medical University,lasted for twenty-four weeks, and43students majoring in clinical medicine wereselected as its research subjects. Following the essential steps of action research, withanalysis of the students’ compositions, classroom observations, participants’interviews, and students’ reflective journals and a questionnaire employed as the mainresearch methods, the researcher conducted three rounds of research during which thecombination of the product approach with the process approach, the integration of theproblem-based learning (PBL) approach with the process approach, the combinationof the genre approach with the process approach were respectively adopted to explorethe roles they played in developing the medical students’ English language proficiency,critical thinking ability and medical English academic writing ability. In the course ofthe three-round action research, the researcher kept reflecting on the problemsdiscovered in her own teaching practice, put forward measures for improvement intime and applied new writing approaches to the teaching practice again. Theresearcher then made an observation on the implementation and effectiveness, didsome reforms and continued the research and teaching practice.
The present action research attempts to address the following questions:
1. What is the operational definition of medical students’ writing competence? Inwhat aspects does it manifest itself?
2. What approaches should be adopted to develop the medical students’ Englishlanguage proficiency in writing?
3. What approaches should be adopted to facilitate the medical student’ criticalthinking ability with the development of their English language proficiency?
4. What approaches should be adopted to enhance the medical English academicwriting ability of the medical students while developing their English languageproficiency and facilitating their critical thinking ability?
Through multidimensional analysis and discussion of the students’ compositions,participants’ interviews, students’ reflective journals and the questionnaire collected during the three rounds of action research, and based on the researcher’s reflectionupon the research results, the author arrives at the following conclusions:
First of all, the integration of the product and the process approach contributesgreatly to the development of the medical students’ English language proficiency,especially in such aspects as content, organization, and language use. At the sametime, the combination of the two approaches also helps to improve the medicalstudents’ critical thinking skills such as interpretation, analysis, evaluation andexplanation. However, some problems have arisen. On one hand, in respect of thevocabulary, no remarkable changes have taken place and there exist a number ofproblems about the proper word choice and correct word usage. Therefore, how toenlarge the students’ vocabulary and improve their ability in the appropriate use of thevaried and sophisticated words will still need further study. On the other hand,examination-oriented propositional writing and timed writing in class confined thestudents’ creativity and creative thinking ability, and as a result, the students’ essaysare often stereotyped in organization and sentence structures, lacking personalizationand variety. Therefore, examination-oriented propositional writing is supposed to bereformed, untimed writing practice should be strengthened and the writing tasksshould be interesting, novel and challenging enough to inspire the students’enthusiasm for writing.
Secondly, the integration of the PBL with the process approach can greatlystimulate the students’ enthusiasm for English writing, enhance their communicativeand collaborative competence, improve their self-directed learning skills andproblem-solving ability, and most important of all, it can greatly facilitate thedevelopment of their critical thinking ability, especially in interpretation, analysis,evaluation, explanation, and inference. However, no significant improvements havebeen detected in the critical thinking skill of self-regulation in their compositions.Therefore, how to strengthen the guidance and training of meta-cognitive knowledgeand strategies, and how to enhance the students’ ability in self-reflection,self-questioning and self-validation still need further exploration.
Thirdly, the integration of the genre approach with the process approach contributes greatly to the development of the medical students’ medical Englishacademic writing ability. Through a period of specific training of English abstractwriting, most students’ abstracts demonstrate explicit writing purpose, strong genreawareness and audience awareness, the integrity of the textual structure, the accuracyand specialty of vocabulary, and the standardization of grammatical structures.However, lack of the specialized vocabulary and correct use of grammar rules stillconstitute big challenges for quite a number of students. Therefore, the input ofmedical English words should be enhanced and the teaching of medical Englishreading and writing should be better integrated in the future teaching practice ofmedical English.
Action research, an ideal methodology when an in-depth study is needed, isemployed by the researcher. On the basis of a large quantity of observations, textanalyses, interviews, students’ writing reflections, questionnaires, and the researcher’sown reflective thinking, and with different writing approaches as its variables, theresearcher makes detailed observation and analysis on the medical students’ writingprocess, writing attitude and writing competence. Hence, compared with thetraditional quantitative data analysis, the research findings reached naturally are moreauthentic, valid, flexible and easy to give feedbacks (Chen Jianlin,2004).
In accordance with the medical students’ actual needs and their professionalcharacteristics, the researcher makes a tentative exploration on the feasibility ofmaking a “dynamic” integration of various teaching approaches in their differentlearning stages to develop the medical students’ writing competence. The effectiveintegration brings the advantages of different writing approaches into full play, andfurther enriches college EFL writing pedagogy. Moreover, with the knowledge gainedfrom the study, it is possible for EFL educators, researchers and instructors to gaininsight into how to make effective use of different writing approaches for thedevelopment of the students’ writing skills.
本文作者首先在对“全球医学教育最基本要求(GMER)”及“我国本科医学教育标准”中医学生应该具备的核心能力进行分析的基础上，进一步结合了《大学英语课程要求》中对英语写作能力的“较高要求”，认为医学生应具备的英语写作能力应涵盖以下三个方面的内容：基本英语语言能力、批判性思维能力和专业英语写作能力。其次，通过分析目前国内外比较流行的英语写作教学法（成果法、过程法、体裁法、基于问题的学习等方法）的优势与不足，提出我们应该针对医学生的专业特点，根据学生实际需求，在不同的教学阶段结合多种教学法的长处来帮助学生解决英语写作的实际问题，逐步培养医学生的英语写作能力。
作者以河北医科大学临床医学专业的1个教学班的43名学生为研究对象，进行了为期24周的实证研究。本研究遵循行动研究的基本步骤，主要采用对学生写作文本的分析、课堂观察、学生访谈、学生写作反思、问卷调查等方式，在三轮的行动研究过程中，分别采用结果法与过程法相结合、基于问题的学习方法和过程法相结合、体裁法和过程法相结合，旨在探索不同教学法的综合应用在医学生英语写作中的语言能力、批判性思维能力以及专业英语写作能力等不同方面所起的作用。同时，作者针对教学实践中出现的问题不断进行反思，并及时提出改进措施，再回到自己的实践，观察其实施效果，并对出现的问题进行再次研究和实践。
本文拟通过课堂行动研究，回答以下问题：
１．医学生的写作能力如何界定？具体体现在那些方面？
２．应采用何种英语写作教学方法提高医学生基础英语写作语言能力？
３．如何在发展语言能力的同时，进一步提高医学生英语写作的批判性思维能力？
４．如何在发展语言能力、批判性思维能力的基础上，进一步提高医学生的专业英语写作能力？
作者通过对三轮行动研究中所收集的学生作文文本、学生访谈、学生写作反思及问卷调查等数据资料进行多方位、多角度的分析与讨论之后，得出如下研究结论：
首先，过程法和结果法相结合能够有效提高医学生基础英语写作语言能力，尤其体现在文章内容、结构及语言运用方面。与此同时，学生在阐释、分析、评价及说明等方面的批判性思维技能也逐步得到提高。但作者发现，学生在词汇运用方面仍存在很多问题，因此，如何加强词汇输入，进一步提高学生正确、有效运用词汇的能力仍值得进一步探讨；另外，在第一轮行动研究中作者还发现，以考试为导向的命题作文及课堂限时作文限制了学生的思维和创造力，致使学生的作品千篇一律，缺乏个性与多样性。因此，今后的写作教学中应加强非限时作文写作，增加写作任务的趣味性、新颖性和挑战性，激发学生的写作热情。
其次，过程法和基于问题的学习法相结合能激发医学生的写作兴趣，培养其交际能力、协作学习能力、自主学习能力及分析问题、解决问题的能力。因此，这两种教学方法的有机结合，能有效提高医学生的批判性思维能力，尤其是阐释、分析、评价、推理与说明等方面的能力。但作者发现，写作中自我校准能力的缺失仍是医学生中普遍存在的一个严重问题。因此，如何加强医学生元认知知识与策略的指导与培训，如何培养学生自我反思、自我质疑及自我校正的能力仍是值得进一步探讨的课题。
第三，过程法和体裁法相结合能有效提高医学生的专业英语写作能力。通过摘要这一特定体裁的写作训练，医学生的写作目的更加明确，体裁意识和读者意识明显增强，文本结构和语言表述进一步规范，词汇运用的准确性与专业性也有所提高。但作者发现，专业词汇匮乏仍是医学生专业英语写作中所面临的主要问题。因此，应在写作教学中增加医学词汇的输入，同时还要加强专业英语阅读教学，以读促写，不断提高学生专业英语写作能力。
本文在研究方法上采用以定性研究为主，定性与定量分析相结合的方法。作者通过课堂行动研究，以不同的写作教学方法为研究变量，采用课堂观察、文本分析、学生访谈、学生写作反思、问卷调查等方式，对医学生的写作过程、写作态度及写作能力的变化进行了详细的观察与分析，这种自然状态下的写作教学研究更具有实效性、反馈性与灵活性（陈坚林，2004）。
本研究从分析医学生的实际需求出发，结合其自身专业特点，探索了“动态结合”不同写作教学方法对提高医学生英语写作能力的可行性和有效性，同时使各种教学法的优势得到充分发挥。各种教学法在课堂上的综合应用进一步丰富了外语教学法理论的内容，对我国的大学英语写作教学实践具有重要的启示和指导意义，同时也对英语教育与教学工作者及实践者的写作教学研究具有一定的参考价值。
With the globalization of medical education and the reform of College Englishteaching in China, the integration of medical students’ foreign language proficiencywith their professional competence and the promotion of their cross-culturalcommunication competence have attracted great attention from numerous researchersand become sharply focused. Under this social context, fostering the medical students’English writing competence is of great realistic significance. In recent years, scholarshome and abroad have carried out a large quantity of theoretical and empirical studieson the application of a variety of the writing teaching approaches such as the productapproach, the process approach, the genre approach and the problem-based learning(PBL) approach, etc. to the college English teaching of writing in the context ofEnglish as a second language (ESL) and English as a foreign language (EFL).However, there are few studies on the cultivation of the medical students’ writingcompetence. Therefore, exploring effective writing teaching approaches to foster themedical students’ writing competence becomes the major focus of the presentresearch.
The present study aims to have a tentative exploration on the development ofthe medical students’ writing ability through integrating different teaching approaches.Based on the analysis of core competences required by the Global Minimum EssentialRequirements in Medical Education (GMER) and the Criteria of China’s MedicalEducation for Undergraduates (CCMEU) and in combination with the Intermediaterequirements for writing established by the College English Curriculum Requirements(CECR), the author defines the English writing competence of the medical students asinvolving the following three aspects: the English language proficiency, the criticalthinking ability and the medical English academic writing ability. Then throughcommenting on the main teaching approaches popular in China such as the productapproach, the process approach, the genre approach and the problem-based learning(PBL) approach, the author points out that in view of the professional characteristicsof medical students, a combination of the advantages of different writing approaches in different teaching stages is of great value in solving the practical problems andenhancing their writing competence in their writing process.
An action research, conducted by the researcher in Hebei Medical University,lasted for twenty-four weeks, and43students majoring in clinical medicine wereselected as its research subjects. Following the essential steps of action research, withanalysis of the students’ compositions, classroom observations, participants’interviews, and students’ reflective journals and a questionnaire employed as the mainresearch methods, the researcher conducted three rounds of research during which thecombination of the product approach with the process approach, the integration of theproblem-based learning (PBL) approach with the process approach, the combinationof the genre approach with the process approach were respectively adopted to explorethe roles they played in developing the medical students’ English language proficiency,critical thinking ability and medical English academic writing ability. In the course ofthe three-round action research, the researcher kept reflecting on the problemsdiscovered in her own teaching practice, put forward measures for improvement intime and applied new writing approaches to the teaching practice again. Theresearcher then made an observation on the implementation and effectiveness, didsome reforms and continued the research and teaching practice.
The present action research attempts to address the following questions:
1. What is the operational definition of medical students’ writing competence? Inwhat aspects does it manifest itself?
2. What approaches should be adopted to develop the medical students’ Englishlanguage proficiency in writing?
3. What approaches should be adopted to facilitate the medical student’ criticalthinking ability with the development of their English language proficiency?
4. What approaches should be adopted to enhance the medical English academicwriting ability of the medical students while developing their English languageproficiency and facilitating their critical thinking ability?
Through multidimensional analysis and discussion of the students’ compositions,participants’ interviews, students’ reflective journals and the questionnaire collected during the three rounds of action research, and based on the researcher’s reflectionupon the research results, the author arrives at the following conclusions:
First of all, the integration of the product and the process approach contributesgreatly to the development of the medical students’ English language proficiency,especially in such aspects as content, organization, and language use. At the sametime, the combination of the two approaches also helps to improve the medicalstudents’ critical thinking skills such as interpretation, analysis, evaluation andexplanation. However, some problems have arisen. On one hand, in respect of thevocabulary, no remarkable changes have taken place and there exist a number ofproblems about the proper word choice and correct word usage. Therefore, how toenlarge the students’ vocabulary and improve their ability in the appropriate use of thevaried and sophisticated words will still need further study. On the other hand,examination-oriented propositional writing and timed writing in class confined thestudents’ creativity and creative thinking ability, and as a result, the students’ essaysare often stereotyped in organization and sentence structures, lacking personalizationand variety. Therefore, examination-oriented propositional writing is supposed to bereformed, untimed writing practice should be strengthened and the writing tasksshould be interesting, novel and challenging enough to inspire the students’enthusiasm for writing.
Secondly, the integration of the PBL with the process approach can greatlystimulate the students’ enthusiasm for English writing, enhance their communicativeand collaborative competence, improve their self-directed learning skills andproblem-solving ability, and most important of all, it can greatly facilitate thedevelopment of their critical thinking ability, especially in interpretation, analysis,evaluation, explanation, and inference. However, no significant improvements havebeen detected in the critical thinking skill of self-regulation in their compositions.Therefore, how to strengthen the guidance and training of meta-cognitive knowledgeand strategies, and how to enhance the students’ ability in self-reflection,self-questioning and self-validation still need further exploration.
Thirdly, the integration of the genre approach with the process approach contributes greatly to the development of the medical students’ medical Englishacademic writing ability. Through a period of specific training of English abstractwriting, most students’ abstracts demonstrate explicit writing purpose, strong genreawareness and audience awareness, the integrity of the textual structure, the accuracyand specialty of vocabulary, and the standardization of grammatical structures.However, lack of the specialized vocabulary and correct use of grammar rules stillconstitute big challenges for quite a number of students. Therefore, the input ofmedical English words should be enhanced and the teaching of medical Englishreading and writing should be better integrated in the future teaching practice ofmedical English.
Action research, an ideal methodology when an in-depth study is needed, isemployed by the researcher. On the basis of a large quantity of observations, textanalyses, interviews, students’ writing reflections, questionnaires, and the researcher’sown reflective thinking, and with different writing approaches as its variables, theresearcher makes detailed observation and analysis on the medical students’ writingprocess, writing attitude and writing competence. Hence, compared with thetraditional quantitative data analysis, the research findings reached naturally are moreauthentic, valid, flexible and easy to give feedbacks (Chen Jianlin,2004).
In accordance with the medical students’ actual needs and their professionalcharacteristics, the researcher makes a tentative exploration on the feasibility ofmaking a “dynamic” integration of various teaching approaches in their differentlearning stages to develop the medical students’ writing competence. The effectiveintegration brings the advantages of different writing approaches into full play, andfurther enriches college EFL writing pedagogy. Moreover, with the knowledge gainedfrom the study, it is possible for EFL educators, researchers and instructors to gaininsight into how to make effective use of different writing approaches for thedevelopment of the students’ writing skills.
引文
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