Literacy for health workers / English language for health workers

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Northern Territory Department of Health Library Services Historical Collection

English language for Health Workers

( We have ways of making you talk! )

(EXPERIMENTAL MATERIAL)

Developed by: The Institute for Alx>riginal Developnant

Northern Territory Depart:rcEnt of Health ( Southern Region )

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HISTORICAL COLLECTION

ISBN O 7245 1144 X Volume 1 of 8.

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Prepared by Sue Shore

Institute for Aboriginal Development

Northern Territory Department of Health ( Southe~n Re9ion

"LITERACY FOR HEALTH WORKERS"

Contents Tutors' notes: Level one/two . . Workpads: Level one/two.

Reading series: Readers written a 1rying levels.

Activity books/games etc. (See R~source leaflet) English Language for Health Workers.

This material is the result of many years of field testing and development on the part of the I.A.D. Health Worker Literacy Programme, sisters, health workers and doctors working with the Health Department (Southern Region) and members of the Urapuntja and C.A.A.C. Medical Services. The resource people developing this material need the advice and direction of workers in the field to keep them on the right track.

Send your comments and criticisms to: Literacy Teacher

I.A.D. Health Worker Literacy Programme P.O. Box 2531,

ALICE SPRINGS. 5750.

"I often ask a question and then have to change the wording.

You know, ask it in a different way because I haven't used the right words. She hasn't understood what I've said."

"I know they know the answer. I just don't know whether they're too shy or not confident enough to say it. How can I get

them talking? " Rural Heal th Sisters

This material has

been

developed

in

response

to

conments made by Rural Health Sisters teaching

in

the bush.

The

main objectives are:

- to

encourage health w:>rkers

to

be confident English language speakers.

- to

teach the camon language health workers will have to

cope

with in day

^to

day clinic situations.

- to

demonstrate by simple lesson plan approaches,

the

way in which untrained teachers can help health workers gain nore control of

the

English language.

To

develop this material successfully

we

need your carments on

how

appropriate the dialogues are

and

whether the suggested methcxls are appropriate for bush or small

group

situations. We intend

to

evaluate the material in the latter

part

of 1983. Please look carefully at

the

evaluation sheet at

the

back of this book

and

return it with

your

carments

and

criticisms.

Prepared by Sue Shore ( Institute for Aboriginal Developnent )

Photography by Nicky Baruch.

Why am I using this book?

Many health workers use little English on their own settlements. Others use it reluctantly or with little confidence. When they do use it they speak mainly to doctors, nurses or on the radio to other medical staff.

From a job point of view it is important that they know the basic variations of medical talk.

They need to understand questions and be able to respond to them according to varying situations and the many inevitable staff changes.

This book presents a number of situations encountered by health workers. It is by no means complete as far as health worker's language needs go. After using the basic lesson plan with your health workers you will soon be able to adapt them to their more immediate language needs. This can be done by noting areas of language difficulty and making up short dialogues with variations to suit these situations.

These dialogues look at the language needs related to conversations with non-aboriginal people. In cases where health workers deal with patients the conversations will normally take place in language so English practice is not required.

.. . . . . . ' ..

Why is there so much repetition of the dialogue?

A set dialogue encourages confidence.

It allows learners to become familiar with the language and gives them the confidence which is essential to the process of changing and using the language for their own needs. The early drill and dialogue work must be followed by work with substitutions and dialogues to meet individual health worker's needs.

If this is not done the health worker remains dependent on the teacher or interpreter when confronted by new situations. The repetition using different lesson plans also enables health workers to consolidate the new forms of language introduced. Work with substitutions encourages health workers to integrate new language forms into their everyday speech.

)

'

⁾

People learning another language need to learn the language they have to use in every day life. This has immediate use and is of most importance to them. They will have more motivation to learn when what they learn is of value to them.

The different uses of language are often called "functions" - that's teaching jargon!

Some examples of the functions of language are:

- greetings and goodbyes

- personal information about self, family, extended family etc.

- introductions

- identifying people, places or things.

- asking for people, things or directions.

- giving or receiving advice - giving warnings

- clarifying information

- expressing likes/dislikes, wants/needs.

- describing present events.

- describing past events.

Health worker using language.

Health workers need to use language for some of the following reasons. This is by no means a complete list.

Naturally health workers also use English in a number of non-health related situations in their contact with non-aborigines in the general community.

. . ~·

Health related English language functions

Greetings - in person and on the radio

- for doctors, nurses, visitors etc.

Personal information - about sick people - about the community

- about extended families and relationships Introductions - to the general community

- to sick patients - to Council members

Asking for - clinical things in their day to day work - directions re places in town

- medical supplies/stationery on the radio or using order forms Advice - giving advice re personal relationships

- about the signs and symptoms of illness {radio/face to face) - receiving advice on the treatment of a patient

Warnings - about the need to evacuate a patient - about preventing further sickness

- regarding fire/flood/road/airstrip damage Clarifying information - unable to hear on the radio

- unable to understand English language - unable to keep up with the speaker - not enough clinical information And many other functions too numerous to list here.

Objective:

Aim:

Activity:

Aids:

What to do:

To convey information without the use of language.

To show that language learning involves more than just speaking.

Mime

Photographic and an extrovert personality.

If unavailable - mime it!

Show the photograph for the topic.

Use handsigns, facial expressions and movements to ask questions about the topic.

You want to know - what's happening?

- who are the people?

- what are they doing?

- why are they doing it?

- what will happen if they stop?

Where groups are available have one person mime the answers.

Have another person convey the information to a person in the group who has not seen the photograph.

Check the information

Is this what the mimer meant?

Look! back at the photo - has all the information been included?

REMEMBER - NO TALKING

PLAN 1

Objective:

Activity:

Aids:

When to do this:

What to do:

To understand and use words associated with a set clinical topic.

Discussion and story telling.

A thesaurus.

As a regular word study exercise or

as difficult Mords arise in the teaching program.

Say the problem word.

Explain it in simple terms.

Try not to use complex medical terms.

The explanation may be longer than the word but it will be easier to understand.

Give an example of how the word is used. {e.g. Remember when Johnny was bitten by that snake. Well he got really drowsy. You know he wasn't awake and he wasn't asleep. But he looked like he was going to sleep).

Think of other words which have the same meaning.

Don't confuse the issue by suggesting words with very different meanings.

If there are no similar words - say so. That's the way languages are and

trying to give a single word in place of another sometimes just isn't possible.

Complex medical terms often cannot be explained by giving another word or even a set of words. It may be that the health worker can say the word but doesn't understand the medical concept behind it.

P~N2

Objective:

Activity:

Aids:

What to do:

Why do we do this:

Learn the language for a specific task.

Asking and answering questions.

Flashcards with pictures and numbers to help give answers to questions.

Show the picture to set the scene.

Read out a question and ask a health worker to demonstrate the answer by looking at the picture.

All health worker's choose a picture or answer to a problem.

Health worker's walk around asking each other the question. Other health

workers answer according to their picture etc.

Teacher asks health workers the next question.

Health workers walk around asking and answering this question also.

Repeat for all forms of the question.

Health workers learn to understand and answer questions asked in a variety of ways. They are also "forced" to speak English and overcome some of the problems of learning to work in a second language.

PLAN 3

What's wrong with Freddie?

What happened to Freddie?

What's the matter with Freddie?

Objective:

ActivitY:

Aids:

Learn the language for a specific situation.

Role play.

Dialogue from the textbook.

Photograph from the textbook.

PLAN 4

Doctor: What happened to Freddie?

What to do:

Show the picture and set the scene.

Why do we

do this:

Read the dialogue.

Health workers LISTEN. Read again.

Ask how many people are talking in this conversation.

Group in threes. (doctor,health worker,patient).

Say: "What happened to ?"

- - -

All people in the group ask this question in a role play. Substitute real names.

Repeat each part of the conversation in this way. Repeat a number of times.

H.W.:

Doctor:

H .W.:

Doctor:

He fell down the step.

Did he hurt himself?

Yes, his ankle's swollen.

Tell him I want to look at it.

After confidence has been gained with all parts of the dialogue put it together as a

complete conversation, grouping three people together as doctor, patient, and health worker.

If necessary put picture cues on the board to remind them of the parts of the conversation.

Health workers learn the language for a situation and put it into practice.

They are required to listen, understand and respond to English language. This work must be followed up by work with substitutions. (ie. He fell off the chair, over the

log, •• Yes, his arm's sore, his back hurts, ••. ) See following page.

Objective:

A.ct i Vi tY:

Aids:

What to do:

Learn to adapt language to meet a variety of different situations.

Role play - extension of plan 4.

Flashcards with a range of clinical situations.

OR Photographs from this book.

PLAN 5

H.W.: Little Julie¹s sick.

Follow the plan for lesson 4. Doctor: What's wrong with her?

Health workers get experience in changing the dialogue for names and pronouns.

H.W.: She's coughing a lot.

(he/she, him/her) Doctor.: Is she coughing anything up?

In this lesson give each group (doctor, patient and health worker) a picture or word flashcard indicating a medical problem appropriate to the question.

(eg. for first aid - sore leg, ankle, arm.

for chest infection - a bit of rubbish, a lot of rubbish).

H.W.:

Demonstrate how to make substitutions with the basic dialogue.

No OR

OR OR

OR Yes.

Yes, she's coughing up rubbish Just a bit of rubbish.

No, she's got a dry cough.

Health workers repeat the dialogue line by line making the appropriate substitutions and doing only one substitution per turn of the dialogue.

Each person has a turn at each part of the dialogue. That is each health worker role plays the doctor, patient and the part of the health worker.

Repeat the process a number of times to - overcome shyness

- allow time for practise and getting i t right.

* Remember -

Health workers need to hear every line of the dialogue and the changes so they know what to do when i t is their turn.

What's wrong with Freddie?

What happened to Freddie?

What's the matter with Freddie?

Doctor: What happen to Freddie?

H. W.: He fell down the step.

Doctor: Did he hurt himself?

H. W.: Yes, his ankle's swollen.

Doctor: Tell him I want to have a look at it.

Substitutions

happened to wrong with the matter with

fell down the step fell in the creek fell off the chair tripped over the wire

did he Is he hurt?

Is he O.K.?

foot's sore back's hurting wrist is sprained

have a look at. i t examine i t

check i t see i t

How hot is he?

Is he very hot?

What¹s his temperature?

Has he got a temperature?

H. W.: This kid is sick

Doctor: What's the matter with him?

H. W.: He's a stomach ache

and he's real hot.

Doctor: Has he a

H. W.: Yes.

Substitution

the matter wrong

a stomach ache a headache a sore head

pains in his stomach

a

is he hot?

what's his

(Show flashcards with temps.)

How fast is

What's his

What's the

Doctor: What's wrong with Ralph?

H. W.: He doesn't feel well. He's hot

and he's tired.

Doctor: What part of him feels sick?

H.W.: He says he feels sick all over.

Doctor: Lets examine him. You take his

Substitutions

with the matter

feel well feels sick

says he's crook

of him where does he

examine look at check

Have you taken a urine

Did you a urine

Have you the

the specimen H .. W .. : Here• s 's urine for that the sample

sugar sickness ..

Doctor: Thanks You the Neostix and

we'll do the test. on the bench

in the drawer

H .. W .. : Where•s the jar? on the shelf

by the scales Doctor: In the over there.

She's got weak blood.

Her blood¹s a bit weak.

She's got strong blood.

Her blood is good and strong.

Doctor: We'll need to a of blood.

H. W.: O .. K. I' 11 the

the hb machine and

Doctor: Are the batteries O.K.?

H .. W.: Yes, I checked them

We' to

We'll have to

o ..

good

this morning last night

Does the cut look deep?

Is i t a deep cut?

How is the cut?

Is there a lot of blood?

How much blood is there?

Is the cut bleeding a lot?

H. W.: Ralph fell off his bike and cut his leg.

Doctor: Is i t a bad cut?

H.W.: Yes, i t ' s deep and bleeding a lot.

Doctor: What did you do first?

Substitutions

fell off his bike fell down the hill tripped over the wire fell on some glass

Is i t a bad cut?

Is he hurt?

Did he hurt himself badly?

a lot a fair bit heavily

Is she conscious?

·!~~ /

.. ,,.J ~ ! : ~ , . .

,,it ••

· t Is she unconscious?

Is she breathing?

Can you see her breathing?

Is her heart beating?

Can you feel her pulse?

Has she got a pulse?

. ·I!, ... ,h,;:'":: .. -

~.. . . ': "'w

··~ _~ -'

"\

'.~~ · .

.. .,•:-,.

Elsie:

Frank:

Elsie:

Frank:

Hey Louise is unconscious.

You stay with her, I'll go and get help.

O.K. Be quick. She's still breathing.

Remember to turn her over, so she doesn't choke

Substitutions

unconscious knocked out with her here :se·quick hurry

Don't take long

·turn·her over

put her in the coma position.

Has she got a headache?

Is her head aching?

Is she

she

Are there in her

Has she in her groin?

w .. : a

.. w.

wrong with his eye?

in his eye?

H s

a

a small

knee her ankle

shoulder

th 0 like

s i ?

a ?

Doctor: How long ha he been

H W

1

tor s t

s

Doctor: O.k. Let's examine him

g?

i

s

di art

i 1

a

had a tempreature h a feve

so

s s e

s

H W.

Nurse:·

s n

I t sounds like she's t a cold.

Do you know what to do for he?

Schoo Te re 1

t ' driving me er

H. W .. : Let look.

School Teacher: Can you see ing?

H. W. : Yes you've got nits.

I ' l l get some of that medicine for you.

School Teacher: Thanks.

s this for?

What do you use this for?

Whats this medicine ·for?

---

When do I use this medicine?

Doctor:

H. W. :

Doctor:

H W .. :

Doctor:

H. W .. :

What medicine's go in the blue group?

They're the ones we can eat or drink. There's also injections in that box.

What ones go in the green group?

Medicines to on the skin about the yellow group?

Those medicines are for ears, eyes, nose and throat sickness.

i t ' s

I st be a Y sho

bott

OU h bottl

1 l i t bottle.

litre tle

i t in a one litre

s e a one litre

11Ra.dio ^{11 :} Remember to show the mother how to make i t up.

H .. W.: O.K. Should I give her a bottle

for it too.

11 Radio " : Ye s give her a 1 1 i t re p 1 a st i.c bottle and show her how ro

H. W. :

mix the powder.

I ' l l mix i t in the jug first then give her the mixture in the bottle.

"Radio": Yes and tell her to give the child a l i t t l e bit often.

How bad is the diarrhoea?

How long has she had diarrhoea?

s she had ve long?

I diarrhoe ver bad?

Nurse:

H .. W. :

Nurse:

H .. W. :

Nurse:

Here's the diarrhoea medicine.

What will I tell her to do?

Tell her to give i t to him with a spoon.

When should she give i t to him?

Tell her to give him a l i t t l e bit at a time all through the day.

Tell her he should drink all this medicine by tomorrow.

did you do the school drops this week?

done the chool s

?

H you b e to the school this week'?

Old man: My eyes are sore.

Nurse: What happened to them?

Old man: I think some dust blew in them.

Nurse: I ' l l check them s i t down.

I can't see ing in there.

I ' l l some soothing eye drops in them

I need to amine her ears ..

I want to look in her ears.

I ' l l have a look in her ears

an I look he ears?

Mother:

Nurse:

Mother:

Nurse:

Mother:

Nurse:

I want to look at my baby.

What"s the matter with her.

She keeps crying all the time and rubb her ears.

When did she start doin that?

She st ted yesterday afternoon.

O.K. r•11 look at her ears first.

Is the patient detio ating?

Is the patient any worse?

Is the condition worse?

Has there been a change in the patient¹s condition?

Nurse:

H. W .. :

Nurse:

H. W. :

Nurse:

Henry must come to hospital.

Ask his relatives if this is O.K.

Yes. They say that's O.K.

Good. Make sure they sign the papers for Henry to come to hospital.

Can his mother come in with him?

Standby.

hospital.

I ' l l check with the

EVALUATION SHEET Return to:

Explanation of why th.is book is being used:

What was unclear?

Presentation of lesson plans:

Caments on lesson plans:

PLAN 1 PLAN

2

Appropriateness of dialogues/questions.

close to natural situation Suggested changes:

clear unclear

LA .. D.

H .. W. Literacy, P.O ..

Box

2531, Alice Springs ..

5750 ..

simple to follow not enough detail

suited

to

bush situation unsuited to bush situation What

was

difficult?

What worked well?

What changes did you make? Why?

What couldn't you do? Why?

Was it difficult

to

develop resources?

Other resorces required.

PLAN 3 PLAN 4

not what would

PLAN 5

O .. K ..

in parts