english research article

English dominates scientific research – here’s how we can fix it, and why it matters

Científica del Instituto de Lengua, Literatura y Antropología (ILLA), del Centro de Ciencias Humanas y Sociales (CCHS) del Consejo Superior de Investigaciones Científicas (CSIC), Centro de Ciencias Humanas y Sociales (CCHS - CSIC)

Disclosure statement

Elea Giménez Toledo does not receive a salary, nor does she own shares, nor does she receive funding from any company or organisation that might benefit from this article. She is a commissioner of the SEGIB, which implies only unpaid scientific advice to this institution, as part of the scientific activity carried out at the CSIC.

Consejo Superior de Investigaciones Científicas provides funding as a founding partner of The Conversation ES.

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It is often remarked that Spanish should be more widely spoken or understood in the scientific community given its number of speakers around the world, a figure the Instituto Cervantes places at almost 600 million .

However, millions of speakers do not necessarily grant a language strength in academia. This has to be cultivated on a scientific, political and cultural level, with sustained efforts from many institutions and specialists.

The scientific community should communicate in as many languages as possible

By some estimates, as much as 98% of the world’s scientific research is published in English , while only around 18% of the world’s population speaks it. This makes it essential to publish in other languages if we are to bring scientific research to society at large.

The value of multilingualism in science has been highlighted by numerous high profile organisations, with public declarations and statements on the matter from the European Charter for Researchers , the Helsinki Initiative on Multiligualism , the Unesco Recommendation on Open Science , the OPERAS Multiligualism White Paper , the Latin American Forum on Research Assessment , the COARA Agreement on Reforming Research Assessment , and the Declaration of the 5th Meeting of Minsters and Scientific Authorities of Ibero-American Countries . These organisations all agree on one thing: all languages have value in scientific communication .

As the last of these declarations points out, locally, regionally and nationally relevant research is constantly being published in languages other than English. This research has an economic, social and cultural impact on its surrounding environment, as when scientific knowledge is disseminated it filters through to non-academic professionals, thus creating a broader culture of knowledge sharing.

Greater diversity also enables fluid dialogue among academics who share the same language, or who speak and understand multiple languages. In Ibero-America, for example, Spanish and Portuguese can often be mutually understood by non-native speakers, allowing them to share the scientific stage. The same happens in Spain with the majority of its co-official languages .

Read more: Non-native English speaking scientists work much harder just to keep up, global research reveals

No hierarchies, no categories

Too often, scientific research in any language other than English is automatically seen as second tier, with little consideration for the quality of the work itself.

This harmful prejudice ignores the work of those involved, especially in the humanities and social sciences. It also profoundly undermines the global academic community’s ability to share knowledge with society.

By defending and preserving multilingualism, the scientific community brings research closer to those who need it. Failing to pursue this aim means that academia cannot develop or expand its audience. We have to work carefully, systematically and consistently in every language available to us.

Read more: Prestigious journals make it hard for scientists who don't speak English to get published. And we all lose out

The logistics of strengthening linguistic diversity in science

Making a language stronger in academia is a complex process. It does not happen spontaneously, and requires careful coordination and planning. Efforts have to come from public and private institutions, the media, and other cultural outlets, as well as from politicians, science diplomacy , and researchers themselves.

Many of these elements have to work in harmony, as demonstrated by the Spanish National Research Council’s work in ES CIENCIA , a project which seeks to unite scientific and and political efforts.

Academic publishing and AI models: a new challenge

The global academic environment is changing as a result the digital transition and new models of open access. Research into publishers of scientific content in other languages will be essential to understanding this shift. One thing is clear though: making scientific content produced in a particular language visible and searchable online is crucial to ensuring its strength.

In the case of academic books, the transition to open access has barely begun , especially in the commercial publishing sector, which releases around 80% of scientific books in Spain. As with online publishing, a clear understanding will make it possible to design policies and models that account for the different ways of disseminating scientific research, including those that communicate locally and in other languages. Greater linguistic diversity in book publishing can also allow us to properly recognise the work done by publishers in sharing research among non-English speakers.

Read more: Removing author fees can help open access journals make research available to everyone

Making publications, datasets, and other non-linguistic research results easy to find is another vital element, which requires both scientific and technical support. The same applies to expanding the corpus of scientific literature in Spanish and other languages, especially since this feeds into generative artificial intelligence models.

If linguistically diverse scientific content is not incorporated into AI systems, they will spread information that is incomplete, biased or misleading: a recent Spanish government report on the state of Spanish and co-official languages points out that 90% of the text currently fed into AI is written in English.

Deep study of terminology is essential

Research into terminology is of the utmost importance in preventing the use of improvised, imprecise language or unintelligible jargon. It can also bring huge benefits for the quality of both human and machine translations, specialised language teaching, and the indexing and organisation of large volumes of documents.

Terminology work in Spanish is being carried out today thanks to the processing of large language corpuses by AI and researchers in the TeresIA project, a joint effort coordinated by the Spanish National Research Council. However, 15 years of ups and downs were needed to to get such a project off the ground in Spanish.

The Basque Country, Catalonia and Galicia, on the other hand, have worked intensively and systematically on their respective languages. They have not only tackled terminology as a public language policy issue, but have also been committed to established terminology projects for a long time.

Multiligualism is a global issue

This need for broader diversity also applies to Ibero-America as a whole, where efforts are being coordinated to promote Spanish and Portuguese in academia, notably by the Ibero-American General Secretariat and the Mexican National Council of Humanities, Sciences and Technologies .

While this is sorely needed, we cannot promote the region’s two most widely spoken languages and also ignore its diversity of indigenous and co-official languages. These are also involved in the production of knowledge, and are a vehicle for the transfer of scientific information, as demonstrated by efforts in Spain.

Each country has its own unique role to play in promoting greater linguistic diversity in scientific communication. If this can be achieved, the strength of Iberian languages – and all languages, for that matter – in academia will not be at the mercy of well intentioned but sporadic efforts. It will, instead, be the result of the scientific community’s commitment to a culture of knowledge sharing.

This article was originally published in Spanish

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ORIGINAL RESEARCH article

Investigating the relationship among english language learning strategies, language achievement, and attitude.

• 1 Institute of Education, University of Szeged, Szeged, Hungary
• 2 MTA–SZTE Digital Learning Technologies Research Group, Szeged, Hungary

The main objective of the study was to ascertain whether English as a Foreign Language learners with various levels of English language achievement differ significantly in applying foreign language learning strategies. We also aimed to explore strategy use frequency in connection with attitude toward English language learning. Data were collected from 1,653 lower secondary students in Hungary through a revised version of the previously developed online Self-Regulated Foreign Language Learning Strategy Questionnaire (SRFLLSQ) based on Oxford’s Strategic Self-Regulation (S 2 R) Model. The findings point to statistically significant differences in the frequency of English language strategy use among more and less proficient learners. Quantitative analyses also reported that, in spite of the students stated low or moderate levels of strategy use, it turned out as a statistically significant predictor of foreign language attitude and language achievement. The results draw attention to the relevance of strategy research in foreign language teaching as well as encourages strategy teaching within language instruction.

Introduction

Foreign language learning requires many underlying skills and techniques. Learners have to master a number of complex linguistic, personal, cultural and social skills, and competences and be aware of effective techniques and strategies to help them cope with various challenges during the learning process. The frequent use of learning strategies can help learners to become more competent and effective language users in the classroom and inspire them to achieve higher levels of mastery in the target foreign language ( Wong and Nunan, 2011 ; Oxford, 2016 ). Since the mid-1970s, an immense amount of learning strategy research has attempted to establish the concept and identify strategies that help learners to become more effective language learners ( Oxford, 1990 ; Cohen, 1998 ). It is a widely researched and highly debated area even today ( Thomas and Rose, 2019 ; Thomas et al., 2021 ). The most well-known and widely used taxonomy of language learning strategies (LLS) was developed by Oxford (1990 , 2011 , 2016) . In her recently reconsidered Strategic Self-Regulation (S 2 R) Model based on Vygotsky’s (1978) sociocultural theory of self-regulated learning (SRL) and Zimmerman’s three-phase model ( Zimmerman, 2000 ; Zimmerman and Schunk, 2011 ), she identified four main strategy categories: cognitive, affective, motivational, and social, each of them guided by the master category of “meta-strategies.” These meta-strategies are metacognitive, meta-affective, metamotivational, and metasocial strategies, respectively ( Oxford, 2016 ).

Oxford also developed a measurement tool (Strategy Inventory for Language Learning, SILL) for investigating LLS use, which is employed worldwide; however, it is based on her original conceptualization. Nevertheless, it is essential to relate the latest pedagogical theories to language teaching practice. Self-regulation theory, which was the basis for Oxford’s new taxonomy, has been dominant since the beginning of this century. It is thus crucial to develop state-of-the-art measurement tools which can be used in the classroom by language teachers. In previous research, we have developed and validated a questionnaire based on Oxford’s S 2 R Model (SRFLLSQ; Habók and Magyar, 2018b ). To obtain a more comprehensive view of the role and possible effect of language learning strategies on certain other factors, such as attitude, motivation, and self-efficacy, it is essential to conduct further research. In this study, we aimed to examine LLS in relation to other crucial factors of language learning; we have investigated the relationships among the application of English language learning strategies, language achievement, and attitude toward English among lower secondary students in Hungary.

Literature Review

The concept of language learning strategies.

Language learning strategies have been a research focus since the mid-1970s, as strategic language learning is a key to successfully acquiring a foreign language ( Rubin, 1975 ). A number of definitions of LLS have emerged, with one of the most influential having proved to be that of Rebecca Oxford, who not only established a conceptualization, but also conducted empirical research. In her content-analytic study, Oxford involved 33 distinct definitions and interpretations of the term LLS and thus determine it as follows:

L2 learning strategies are complex, dynamic thoughts, and actions, selected and used by learners with some degree of consciousness in specific contexts in order to regulate multiple aspects of themselves (such as cognitive, emotional, and social) for the purpose of (a) accomplishing language tasks; (b) improving language performance or use; and/or (c) enhancing long-term proficiency. Strategies are mentally guided but may also have physical and therefore observable manifestations. Learners often use strategies flexibly and creatively; combine them in various ways, such as strategy clusters or strategy chains; and orchestrate them to meet learning needs. Strategies are teachable. Learners in their contexts decide which strategies to use. Appropriateness of strategies depends on multiple personal and contextual factors ( Oxford, 2016 , p. 48).

Strategic language learners select their LLS according to their personal preferences, motivational intentions, and situational circumstances. Therefore, it is especially difficult to identify a system for these strategies. This is one of the reasons why an extremely large number of conceptualizations and debates have emerged ( Thomas and Rose, 2019 ; Thomas et al., 2021 ). Thomas et al. (2021) have pointed out that with the emphasis on self-regulation, the field of strategy research has moved away from formal educational settings toward learner autonomy. They argue that this is a hazardous trend because definitions of LLS minimize teachers’ role and classroom contexts that can also be an influencing factor in strategic behavior among students. Thomas and Rose (2019) have therefore suggested a separation of LLS from self-regulation and introduced the Regulated Language Learning Strategies Continuum to make it clear that self-regulation can be conceptually separated in defining LLS. By interpreting LLS as being both other- and self-regulated, Dörnyei and Skehan (2003) argue that strategy use cannot be regarded as either emotional or cognitive or even behavioral, thus opening up another debated area in the field.

The classification of LLS is another key area of argument. Oxford’s original classification of six major fields (memory, cognitive, metacognitive, affective, compensation, and social strategies) was recently reconsidered and restructured on the basis of self-regulation theories. Her Strategic Self-Regulation (S 2 R) Model was developed based on Vygotsky’s (1978) sociocultural theory of self-regulated learning (SRL). In her concept, she identified four main fields—cognitive, affective, motivational, and social strategies—each of them directed by a “master category of meta-strategies.” These meta-strategies are metacognitive, meta-affective, metamotivational, and metasocial strategies ( Oxford, 2016 ). Her taxonomy was again open to a number of debates as some theorists ( Dörnyei, 2005 ; Hajar, 2019 ) argued that success in language learning cannot be assessed through the frequency of strategy use alone.

Research on Language Learning Strategies

Despite the debates, LLS researchers have been devoted to conducting quantitative research on LLS use and its connection with other individual factors, such as gender, learning style, motivation, attitude, and proficiency (e.g., Radwan, 2011 ; Alhaysony, 2017 ; Habók and Magyar, 2018a , 2019 ). The most widespread measurement tool for assessing L2 learners’ strategy use is Oxford’s Strategy Inventory for Language Learning (SILL; Oxford, 1990 ). This questionnaire has been translated into numerous languages and adapted for a vast number of cultures around the world. It is based on her original taxonomy and employs her original six strategy fields. Based on her renewed taxonomy, a number of reconsidered measurement tools have been developed since then, which have approached effective language learning from different perspectives ( Wang et al., 2013 ; Salehi and Jafari, 2015 ; Božinović and Sindik, 2017 ; Köksal and Dündar, 2017 ; Habók and Magyar, 2018b ; An et al., 2021 ).

One major area for researchers has been to find out what set of strategies foreign language learners rely on the most ( Platsidou and Sipitanou, 2015 ; Alhaysony, 2017 ; Charoento, 2017 ; Dawadi, 2017 ; Habók and Magyar, 2018a , b , 2019 , 2020 ; Habók et al., 2021 ). Overall, results have concluded moderate use of LLS among participants. The most frequently used strategies are cognitive, metacognitive, and compensation strategies, while affective and memory strategies are the least preferred. Habók et al. (2021) have pointed out the different strategy preferences in different cultural contexts. Their results reinforced the preferred use of metacognitive strategies in both European and Asian contexts. However, there were statistically significant differences in the affective field with regard to the lower strategy use preference in the European sample.

A great deal of research has investigated strategy use in connection with other aspects ( Platsidou and Kantaridou, 2014 ; Rao, 2016 ; Charoento, 2017 ; Habók and Magyar, 2018a , 2020 ). One of the most often used factors was language achievement, which has been specified and covered in a multitude of ways. Some studies have focused on level of language proficiency or achievement test results ( Raoofi et al., 2017 ; Taheri et al., 2019 ; An et al., 2021 ; Malpartida, 2021 ), others have relied on self-ratings ( Charoento, 2017 ), and still others have involved language course marks ( Habók and Magyar, 2018a ; Sánchez, 2019 ; Bećirović et al., 2021 ). As a result, most research has pointed out that students with higher proficiency use LLS more frequently than those with less ( Rao, 2016 ; Charoento, 2017 ; Raoofi et al., 2017 ; Sánchez, 2019 ). Charoento (2017) highlighted that successful students mainly used metacognitive strategies and less proficient students preferred to use social strategies the most. Sánchez (2019) reported that the application of social, metacognitive, and cognitive strategies was the highest among high achievers. Some research failed to find any significant differences in LLS use between learners with lower and higher English proficiency levels ( Rianto, 2020 ).

A relatively small number of studies have examined how LLS use predicts language proficiency. Some research has pointed out a positive correlation between strategy use and proficiency. Comprehensive work by Taheri et al. (2019) indicated a statistically significant correlation between LLS and second language achievement. Specifically, they confirmed a statistically significant relationship between cognitive, social, and compensation strategies and second language achievement. Platsidou and Kantaridou (2014) also found that language use is predicted by learning strategy use in a statistically significantly way and that it anticipates perceived language performance. Rao (2016) also reinforced that learners’ English proficiency level determines their strategy use and highlighted that students with high proficiency use strategies more frequently than low-level learners. Habók and Magyar (2018a) stated that strategies have a statistically significant effect on proficiency through attitudes. In addition, these effects reflect general school achievement. Bećirović et al. (2021) observed that LLS can influence students’ English as a foreign language (EFL) achievement. Specifically, cognitive strategies have a statistically significant positive effect on EFL achievement, while other strategies showed negative or no significant impact. An et al. (2021) also reported the positive direct effect of SRL strategies on students’ English learning outcomes. Lin et al. (2021) concluded the direct impact of learning strategies on learners’ performance in literal and inferential comprehension.

Another research direction is the investigation of strategy use in relation to other underlying factors, like affective variables, such as motivation, attitude, self-efficacy, and self-concept. Educational research has pointed out that learners’ attitude toward language learning is crucial since it can greatly impact learning results and language learning proficiency ( Platsidou and Kantaridou, 2014 ). Studies have indicated that learners with a positive attitude toward language learning employ LLS more frequently and effectively. Platsidou and Kantaridou (2014) used confirmatory factor analysis to show that attitudes toward language learning predict the use of both direct and indirect learning strategies. Jabbari and Golkar (2014) reported a more frequent use of cognitive, metacognitive, compensation, and social strategies among students with a positive attitude toward language learning. Habók and Magyar (2018a) demonstrated the reverse effect: learners who apply LLS effectively were more likely to have improved learning experiences and positive attitudes toward foreign language learning.

It can be concluded that strategy research is often related to other vital areas of language learning, among which attitude plays an important role. However, only a limited number of researchers have developed measurement tools for investigating self-regulated foreign LLS and measured it in relation to attitude. In addition, most studies have focused on the strategy use of tertiary samples with relatively high levels of proficiency. This study aims to fill this gap and provides an insightful investigation into the connections among strategy use, attitude, and English language achievement among lower secondary students. Based on the relevant literature ( Jabbari and Golkar, 2014 ; Platsidou and Kantaridou, 2014 ; Habók and Magyar, 2018a ), we hypothesized the statistically significant effect of LLS on proficiency through attitude.

Research Questions

The research addresses the following three research questions:

1. Which EFL strategy was the most frequently used by 11-year-old lower secondary students?

2. Were there statistically significant differences among students in their language learning strategy use on the basis of their English language achievement?

3. Which language learning strategy type has a statistically significant impact on learners’ English language achievement and attitude?

Research Methods

Participants.

In Hungary, students start primary school at the age of six. This lasts 4 year. Then, they continue their studies at the lower secondary level. At the age of 14, they move on to upper secondary school. The participants of the present research were 11-year-old lower secondary students in Grade 5 (N total  = 1,653; N boys  = 827, N girls  = 780, N missing  = 46) from 64 schools in Hungary. Hungarian students take EFL in compulsory courses in school, and they usually start learning a foreign language at the age of nine. However, in some schools, they can start at the age of six. Typically, they can choose between English and German, but recently a preference for English has become more common. In upper secondary school, two foreign languages are compulsory, English and German or Italian or Spanish. The second language depends on curricular choice at the school level.

The English proficiency of the participating students was at beginner/elementary level (A1–A2). As for their engagement in learning, there were 17 students in the sample who spent 2 h or less per week on English. Around half of the learners ( N  = 884) devoted 3 h a week to this subject, and few participants dedicated four ( N  = 303) or five ( N  = 357) hours a week to the language. We also found 67 students who dealt with English six or more hours per week. In addition, we did not receive any answers to this question from 25 students.

The revised and improved version of the Self-Regulated Foreign Language Learning Strategy Questionnaire (SRFLLSQ) was employed after our first measurement and validation ( Habók and Magyar, 2018b ). We reviewed the new findings on the theoretical background to foreign LLS research and continued revising the affective field. In addition, based on the relevant literature, we included the field of motivation in the questionnaire. We thus completed the measurement tool with motivational and metamotivational factors based on Oxford’s Strategic S 2 R Model. Finally, the questionnaire covered four strategy areas: metacognitive (eight items), cognitive (six items), meta-affective (eight items), affective (eight items), metasocial (eight items), social (six items), motivational (four items), and metamotivational (four items; see Appendix ). The fifth-grade students provided their responses on a five-point Likert scale, which ranged from 1 (“Never or almost never true of me”) to 5 (“Always or almost always true of me”). The measurement tool was also complemented with a background questionnaire, which asked students about their foreign language school marks, which indicated students’ English language achievement (1 = fail, lowest school mark; 5 = excellent, highest school mark). Students also self-reported their attitudes toward English learning on a five-point Likert scale, which again ranged from 1 to 5.

First, the research was accepted by the IRB at the University of Szeged Doctoral School of Education. It was concluded that the research design follows IRB recommendations. The participating learners’ parents were asked for written informed consent, which was handled by the participating schools. Second, an invitation was sent to schools to register for the measurement. In the call, schools were given information about the purpose of the measurement. Once the schools accepted the invitation, they received further instructions on data collection and a link to log into the Online Diagnostic Assessment System (eDia), which is developed, supervised, and operated by the University of Szeged Centre for Research on Learning and Instruction ( Csapó and Molnár, 2019 ). Students’ participation was voluntary in the research. They logged into the system with an official student assessment code (developed by the Hungarian Educational Authorities), which provided complete anonymity for them. The researchers could not identify the respondents on this basis. The identification code was handled by the school administrators, but the students’ results were not available to them. Thus, complete anonymity was guaranteed. The eDia system is familiar to students because they regularly use it for diagnostic purposes during official school hours. The students had already acquired the necessary ICT skills at primary level, further improved through remote learning. For the present questionnaire, the participants indicated their responses by clicking on radio buttons. The learners were given a school lesson in a personal classroom environment provided by the school. After logging in, the respondents filled in the questionnaire in Hungarian, which is their native language, because they do not yet have the foreign language skills to provide reliable answers in English. This took 20 min to complete the instrument. Teacher assistance was not required while the questionnaire was being completed, but it was available. The students had the option to ask for assistance on any technical problems.

Data Analysis

First, we employed classical test analysis and examined reliability, means, and standard deviations for the questionnaire fields with SPSS Statistics 23.0. In the case of frequency of strategy use, we aimed to find out how strategy use was perceived by our sample. We also compared the students’ strategy use vis-à-vis their English language achievement and attitude using an independent sample t -test. To interpret effect size, we followed Wei et al.’s (2019) and Wei and Hu’s (2019) benchmark: under 0.005 is small, 0.01 is typical or medium, 0.02 is large, and is 0.09 very large. We used R 2 unsquared; thus, the benchmark for the effect size index is 0.07, 0.10, 0.14, and 0.30, which, respectively, represents small, medium, large, and very large cut-off values. We applied path analysis to map the possible relationships and effects of our variables. We studied the goodness-of-fit indices by applying various cut-off values for many fit indices, including the Tucker–Lewis index (TLI), the normed fit index (NFI), the comparative fit index (CFI), the root mean square error of approximation (RMSEA), and Chi-square values ( Kline, 2015 ). TLI, NFI, and CFI were regarded as eligible with a cut-off value of 0.95, and RMSEA values indicated an acceptable fit of 0.8 ( Kline, 2015 ).

Descriptive Analysis

The questionnaire was reliable in all the fields ( Table 1 ). As regards the whole sample, moderate strategy use was observed. The lowest strategy use was noted in the field of metasocial strategies, and the most frequent strategy was found in the affective field. As regards the corresponding factors, the most frequent use was observed in the motivational field (see Table 1 ).

Figure 1 . The path model for EFL strategies on English language achievement through attitude.

Table 1 . Frequency of language learning strategy use in Grade 5.

We also identified the frequency of strategy use among the more and less proficient learners. Students were divided into two categories based on their English language achievement ( Table 2 ). Those with excellent and good school marks were placed in the more proficient learners’ category, while learners with average, fair, or unsatisfactory school marks were grouped into the less proficient learner category. Students ( N  = 810) who received excellent school marks met the requirements of the English language curriculum and performed at a high level. Learners ( N  = 500) with good marks had minor gaps. Those ( N  = 229) with an average school mark had major gaps in their knowledge, and those ( N  = 65) with unsatisfactory school marks had difficulty following the curriculum and varying levels of difficulty in all areas of language learning. Finally, students ( N  = 9) who received an unsatisfactory school mark are at a disadvantage which is difficult to overcome. No data were received from 40 students. Students’ EFL achievement could be regarded as good with a mean of 4.2 (SD = 0.89). As a result, the more proficient learners employed strategies with greater frequency in all of the fields, a statistically significant finding. The affective factor indicated above medium effect size, while the other factors reported small effect sizes.

Table 2 . Frequency of language learning strategy use among less and more proficient learners.

Multivariate Analyses

Finally, we investigated the effect of strategy use on English language achievement and attitudes. As Oxford’s Strategic S 2 R Model considers strategies as being closely directed by their corresponding meta-strategies, we have regarded the strategies and their meta-strategy counterparts as common factors. The correlation coefficient was statistically significant between every strategy factor ( r  = 0.45–0.25, p  < 0.001). Our model showed acceptable fit indices (Chi-square = 35.574, df = 5, p  = 0.000, CFI = 0.995, TLI = 0.977, NFI = 0.994, RMSEA = 0.061). We therefore concluded that English language achievement and attitude are statistically influenced by strategy use ( Figure 1 ).

We found that the meta-affective and affective and metasocial and social categories directly influenced students’ attitude toward English. A direct effect of attitude was observed on English language achievement. In addition, the metacognitive and cognitive categories had a direct effect on English language achievement, while English language achievement was indirectly affected by meta-affective and affective and metasocial and social factors. We could not confirm any significant effect of metamotivational and motivational factors on attitude or English language achievement.

We investigated the strategy use of 11-year-old lower secondary students in Grade 5 in connection with their language achievement and attitude toward the English language. Our first research question asked which LLS was the most frequently used by the sample. We found moderate strategy use with regard to a slightly modest application of the metasocial field, and the most frequent strategy use was observed in the affective field. These aspects of our findings partly correspond with most of the recent research with respect to moderate use of strategies; however, there are profound differences in the strategy preferences of the sample ( Platsidou and Sipitanou, 2015 ; Alhaysony, 2017 ; Charoento, 2017 ; Dawadi, 2017 ; Habók and Magyar, 2018a , b , 2019 , 2020 ; Habók et al., 2021 ). Raoofi et al. (2017) also pointed out the low level of social strategy use in their research. Another important statistically significant finding is that higher proficiency learners used learning strategies with greater frequency than their less proficient peers. This applies to every strategy field in agreement with Charoento’s (2017) results.

Our second research question concerned differences in the use of LLS based on English language achievement. As concerns the sample, we regarded the EFL school mark as an indicator of English language achievement. The mean indicated that a considerable portion of the sample was grouped as more proficient. As a result, these students used LLS with greater frequency in all of the categories, which is a statistically significant finding. These results correspond with other research, which also reinforces this ( Rao, 2016 ; Charoento, 2017 ; Raoofi et al., 2017 ; Sánchez, 2019 ). However, we also found that less proficient learners employed motivational strategies the most frequently, while their more proficient peers most often preferred the affective field, a result which is not reinforced by any previous findings. Apart from this, the strategy uses of both subsamples followed the same order, with social and metasocial strategy use being the least preferred type for both. This may be due to the fact that our sample was mainly at the beginner/elementary level (A1–A2), so they cannot yet initiate conversations with others, even with native speakers. They also cannot understand many words and grammatical structures that are used by more proficient speakers, so social interaction is more difficult for them, even for the more advanced ones.

Our results on the role of LLS in English language achievement and attitude confirmed the statistically significant effect of LLS on background variables. English language achievement was directly influenced by the metacognitive and cognitive fields and attitudes and indirectly affected by the meta-affective and affective fields, as well as the metasocial and social fields. Our model could not confirm any direct or indirect effect of the metamotivational and motivational fields on attitude or English language achievement. This may be because motivational components form distinct factors and their role differs somewhat in predicting language achievement. These results are in line with previous findings ( Platsidou and Kantaridou, 2014 ; Habók and Magyar, 2018a ), which also concluded the outstanding role of attitudes, which is an important predictor of language achievement and reinforces the role of strategy use. In summary, strategy use influences English language achievement through attitude to language learning in a statistically significant way.

The main objective of the study was to find evidence for the role of strategy use in students’ achievement at the beginner/elementary level of English language learning. As a result, the strategy use preferences of the sample differed somewhat from the findings of previous research, as the affective and motivational fields were the ones the students preferred the most. This may be due to the fact that young children are more likely to use strategies that are rather emotional and related to their personality traits than strategies that require deeper understanding, specific learning techniques, and awareness, such as cognitive strategies. The use of social strategies was also quite low, probably owing to the low level of foreign language communication skills in the sample. As regards the different proficiency levels, more frequent strategy use was observed among the more proficient learners, a statistically significant finding. However, the patterns of strategy use were almost the same across the groups. The only difference was that the more proficient learners mostly preferred the affective field, while the less proficient ones mostly employed motivational strategies. This indicates that students at a higher level have more confidence to speak up and show how they feel about learning English. Learners with lower proficiency at this age often try to show that they are motivated, that is, that they are trying and want to achieve good results and present a good image of their own performance. The study also highlighted the importance of attitude; from the results, it can be concluded that, even at the beginner/elementary level, strategy use can affect language achievement and that a student’s attitude is an important predictor and plays an important role as mediator between strategies and language achievement. This can have a positive impact on classroom performance and highlights the importance of teaching students about learning strategies.

Limitations

There are some limitations to consider in the study. First, the questionnaire was administered to fifth-grade students, who were at the beginner/elementary level of their English language learning. Thus, generalizability cannot be confirmed, and more research is needed across higher grades and higher proficiency learners. Second, we had difficulty identifying the affective domain in the first version of the questionnaire. For the fields in the present measurement tool, we have succeeded in identifying the affective and meta-affective domains of LLS. However, they still have to be optimized. Additional research is also called for with regard to the motivational components. Third, other underlying factors should be included in the investigation, such as self-efficacy, self-esteem, and self-concept.

Pedagogical Implications

The study points out that the role of learning strategies is substantial for the students in their language learning. Learning English is a complex process for Hungarian fifth graders. English pronunciation, vocabulary, and grammar are very different from those of Hungarian. For these learners, grammatical rules are often abstract phenomena, and it is difficult for them to associate meaning with the words they say and write. Furthermore, reading and listening comprehension are also influenced by many factors. The results draw attention to the paramount importance of teaching LLS, which can promote greater success among language learners. In addition, it is essential how consciously strategies are employed. Teachers are strongly urged to include strategy training in their courses. Strategy training can be conducted either in the form of an embedded sub-course in any of the subjects or in an independent form as an individual course. Strategy courses integrated into a school subject provide specific help for students learning that specific course material. For example, language learning strategies paid students in learning grammatical formulae or vocabulary in a foreign language, while general strategy courses help students to learn strategies that can be used in other school subjects, such as reading and writing strategies.

Another implication of the study is that motivation and attitude also influence language achievement in a statistically significant way. Creating a learner-friendly and encouraging atmosphere is therefore essential. The findings from our research have provided important insights into these issues for classroom practice.

Data Availability Statement

The datasets presented in this article are not readily available because the datasets are confidential and cannot be shared with third parties. Requests to access the datasets should be directed to AH, [email protected] .

Ethics Statement

The studies involving human participants were reviewed and approved by IRB at the Doctoral School of Education, University of Szeged. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

AH and AM designed the study and implemented the data collection, as well as analyzing the data and participating in completing the manuscript. GM supervised the research and provided support. All the authors contributed to the editing and revision of the study and approved the final version of the manuscript.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

This research was supported by the Research Programme for Public Education Development, Hungarian Academy of Sciences (grant KOZOKT2021-16) and a Hungarian National Research, Development and Innovation Fund grant (under the OTKA K135727 funding scheme).

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Revised Version of the Self-Regulated Foreign Language Learning Strategy Questionnaire (SRFLLSQ).

Keywords: self-regulated foreign language learning, language learning strategies, foreign language attitude, language achievement, lower secondary students

Citation: Habók A, Magyar A and Molnár G (2022) Investigating the Relationship Among English Language Learning Strategies, Language Achievement, and Attitude. Front. Psychol . 13:867714. doi: 10.3389/fpsyg.2022.867714

Received: 01 February 2022; Accepted: 15 April 2022; Published: 13 May 2022.

Reviewed by:

Copyright © 2022 Habók, Magyar and Molnár. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Anita Habók, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Pragmatics in English Language Learning

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Peter Grundy, Pragmatics in English Language Learning, ELT Journal , Volume 77, Issue 4, October 2023, Pages 522–526, https://doi.org/10.1093/elt/ccad032

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It is a truth universally acknowledged that an intelligent reader in possession of an edited collection of papers must have a real treasure chest in hand. However little known the feelings or views of such a reader may be on their first turning the pages of such a volume, this truth is so well fixed in the mind of the writer of the foreword that the reader’s approbation is considered as the rightful property of some or all of the contributors.

Despite the foregoing and despite its title, there’s probably more that’s directly useful in Pragmatics in English Language Learning to researchers in applied pragmatics than to English language teachers, teacher trainers and materials writers. Nevertheless, the contributions in this collection raise many important issues about the relationship of pragmatics and L2 learning and teaching, so pieces of eight for all of us.

The book opens with a brief introduction (well, there’s a foreword that I’ll come back to later) in which the editors define pragmatic competence as ‘making socially appropriate linguistic choices’ (p. 1) and closes with a brief conclusion in which they call for ‘more systematic approaches to pragmatics instruction’ (p. 229). In the first chapter, Naoko Taguchi charts the development of L2 pragmatics from its beginning in the 1980s to the present day. This is followed by four chapters that study the longitudinal development of pragmalinguistic knowledge in educational contexts, grouped together under the title ‘Pragmatics in Action’, and three further chapters under the title ‘Instructed L2 Pragmatics’, which investigate classroom learning in experimental situations.

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Challenges and opportunities of English as the medium of instruction in diploma midwifery programs in Bangladesh: a mixed-methods study

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BMC Medical Education volume  24 , Article number:  523 ( 2024 ) Cite this article

Metrics details

English is generally recognized as the international language of science and most research on evidence-based medicine is produced in English. While Bangla is the dominant language in Bangladesh, public midwifery degree programs use English as the medium of instruction (EMI). This enables faculty and student access to the latest evidence-based midwifery content, which is essential for provision of quality care later. Yet, it also poses a barrier, as limited English mastery among students and faculty limits both teaching and learning.

This mixed-methods study investigates the challenges and opportunities associated with the implementation of EMI in the context of diploma midwifery education in Bangladesh. Surveys were sent to principals at 38 public midwifery education institutions, and 14 English instructors at those schools. Additionally, ten key informant interviews were held with select knowledgeable stakeholders with key themes identified.

Surveys found that English instructors are primarily guest lecturers, trained in general or business English, without a standardized curriculum or functional English language laboratories. Three themes were identified in the key informant interviews. First, in addition to students’ challenges with English, faculty mastery of English presented challenges as well. Second, language labs were poorly maintained, often non-functional, and lacked faculty. Third, an alternative education model, such as the English for Specific Purposes (ESP) curriculum,  has potential to strengthen English competencies within midwifery schools.

Conclusions

ESP, which teaches English for application in a specific discipline, is one option available in Bangladesh for midwifery education. Native language instruction and the middle ground of multilingualism are also useful options. Although a major undertaking, investing in an ESP model and translation of technical midwifery content into relevant mother tongues may provide faster and more complete learning. In addition, a tiered system of requirements for English competencies tied to higher levels of midwifery education could build bridges to students to help them access global evidence-based care resources. Higher levels might emphasize English more heavily, while the diploma level would follow a multilingualism approach, teach using an ESP curriculum, and have complementary emphasis on the mother tongue.

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Introduction

As the international language of science, English holds an important position in the education of healthcare professionals. Globally, most scientific papers are published in English. In many non-native English-speaking countries, English is used as the language of instruction in higher education [ 1 ]. The dominant status held by the English language in the sciences is largely considered to increase global access to scientific information by unifying the scientific community under a single lingua franca [ 2 ].

In Bangladesh, where the mother tongue is Bangla and midwifery diploma programs are taught in English, knowledge of English facilitates student and instructor access to global, continuously updated evidence-based practice guidance. This includes basic and scientific texts, media-based instructional materials (including on life-saving skills), professional journals, and proceedings of medical conferences. Many of these resources are available for free online, which can be particularly useful in healthcare settings that have not integrated evidence-based practice.

In addition to opportunity though, English instruction also creates several challenges. Weak student and faculty English competency may impede midwifery education quality in Bangladesh. Globally, literature has linked limited instructor competency in the language of instruction with reduced depth, nuance, and accuracy in conveying subject matter content [ 3 ]. This can lead to the perpetuation of patterns of care in misalignment with global evidence. In addition, students’ native language proficiency in their topic of study can decline when instruction is in English, limiting native language communication between colleagues on the job later on [ 4 , 5 ].

In this paper, we examine the current status of English language instruction within public diploma midwifery programs in Bangladesh. Midwifery students are not required to demonstrate a certain skill level in English to enter the program. However, they are provided with English classes in the program. Midwifery course materials are in English, while—for ease and practicality—teaching aids and verbal classroom instruction are provided in Bangla. Following graduation, midwifery students must pass a national licensing exam given in English to practice. Upon passing, some new midwives are deployed as public employees and are posted to sub-district health facilities where English is not used by either providers or clients. Others will seek employment as part of non-governmental organization (NGO) projects where English competency can be of value for interacting with global communities, and for participating in NGO-specific on-the-job learning opportunities. The mix of both challenge and opportunity in this context is complex.

Our analysis examines the reasons for the identified English competency gaps within midwifery programs, and potential solutions. We synthesize the findings and discuss solutions in the context of the global literature. Finally, we present a set of viable options for strengthening English competencies among midwifery faculty and students to enable better quality teaching and greater learning comprehension among students.

Study design

We employed a mixed-methods study design [ 6 ] in order to assess the quality of English instruction within education programs, and options for its improvement. Data collection consisted of two surveys of education institutes, a web-search of available English programs in Bangladesh, and key informant interviews. Both surveys followed a structured questionnaire with a combination of open- and closed-ended questions and were designed by the authors. One survey targeted the 38 institute principals and the other targeted 14 of the institutes’ 38 English instructors (those for whom contact information was shared). The web-search focused on generating a list of available English programs in Bangladesh that had viable models that could be tapped into to strengthen English competencies among midwifery faculty and students. Key informant interviews were unstructured and intended to substantiate and deepen understanding of the survey and web-search findings.

No minimum requirements exist for students’ English competencies upon entry into midwifery diploma programs. Students enter directly from higher secondary school (12th standard) and complete the midwifery program over a period of three years. Most students come from modest economic backgrounds having completed their primary and secondary education in Bangla. While English instruction is part of students’ secondary education, skill attainment is low, and assessment standards are not in place to ensure student mastery. To join the program, midwifery students are required to pass a multi-subject entrance exam that includes a component on English competency. However, as no minimum English standard must be met, the exam does not screen out potential midwifery students. Scoring, for instance, is not broken down by subject. This makes it possible to answer zero questions correctly in up to three of the subjects, including English, and pass the exam.

Processes/data collection

Prior to the first survey, principals were contacted by UNFPA with information about the survey and all provided verbal consent to participate. The survey of principals collected general information about the resources available for English instruction at the institutes. It was a nine-item questionnaire with a mix of Yes/No, multiple choice and write-in questions. Specific measures of interest were whether and how many English instructors the institutes had, instructors’ hiring criteria, whether institutes had language labs and if they were in use, and principals’ views on the need for English courses and their ideal mode of delivery (e.g., in-person, online, or a combination). This survey also gathered contact information of institute English instructors. These measures were chosen as they were intended to provide a high-level picture of institutes’ English resources such as faculty availability and qualifications, and use of language labs. To ensure questions were appropriately framed, a pilot test was conducted with two institute principals and small adjustments were subsequently made. Responses were shared via an electronic form sent by email and were used to inform the second survey as well as the key informant interviews. Of the 38 principals, 36 completed the survey.

The second survey, targeting English instructors, gathered information on instructors’ type of employment (e.g., institute faculty or adjunct lecturers); length of employment; student academic focus (e.g., midwifery or nursing); hours of English instruction provided as part of the midwifery diploma program; whether a standard English curriculum was used and if it was tailored toward the healthcare profession; use of digital content in teaching; education and experience in English teaching; and their views on student barriers to learning English. These measures were chosen to provide a basic criterion for assessing quality of English instruction, materials and resources available to students. For instance, instructors’ status as faculty would indicate a stronger degree of integration and belonging to the institute midwifery program than a guest lecturer status which allows for part time instruction with little job security. In addition, use of a standard, professionally developed English curriculum and integration of digital content into classroom learning would be indicative of higher quality than learning materials developed informally by instructors themselves without use of listening content by native speakers in classrooms. The survey was piloted with two English instructors. Based on their feedback, minor adjustments were made to one question, and it was determined that responses were best gathered by phone due to instructors’ limited internet access. Of the 14 instructors contacted, 11 were reached and provided survey responses by phone.

The web-search gathered information on available English language instruction programs for adults in Bangladesh, and the viability of tapping into any of them to improve English competency among midwifery students and faculty. Keywords Bangladesh  +  English courses , English training , English classes , study English and learn English were typed into Google’s search platform. Eleven English language instruction programs were identified. Following this, each program was contacted either by phone or email and further detail about the program’s offerings was collected.

Unstructured key informant interviews were carried out with select knowledgeable individuals to substantiate and enhance the credibility of the survey and web-search findings. Three in-country expert English language instructors and four managers of English language teaching programs were interviewed. In addition, interviews were held with three national-level stakeholders knowledgeable about work to make functional technologically advanced English language laboratories that had been installed at many of the training institutes. Question prompts included queries such as, ‘In your experience, what are the major barriers to Bangla-medium educated students studying in English at the university level?’, ‘What effective methods or curricula are you aware of for improving student English to an appropriate competency level for successful learning in English?’, and, ‘What options do you see for the language lab/s being used, either in their originally intended capacity or otherwise?’

Data analysis

All data were analyzed by the lead researcher. Survey data were entered into a master Excel file and grouped descriptively to highlight trends and outliers, and ultimately enable a clear description of the structure and basic quality attributes (e.g., instructors’ education, hours of English instruction, and curriculum development resources used). Web-search findings were compiled in a second Excel file with columns distinguishing whether they taught general English (often aimed at preparing students for international standard exams), Business English, or English for Specific Purposes (ESP). This enabled separation of standalone English courses taught by individual instructors as part of vocational or academic programs of study in other fields, and programs with an exclusive focus on English language acquisition. Key informant interviews were summarized in a standard notes format using Word. An inductive process of content analysis was carried out, in which content categories were identified and structured to create coherent meaning [ 7 ]. From this, the key overall findings and larger themes that grew from the initial survey and web-search results were drawn out.

The surveys (Tables  1 and 2 ) found that English instructors are primarily long-term male guest lecturers employed at each institute for more than two years. All principal respondents indicated that there is a need for English instruction—18 of the 19 reported that this is best done through a combination of in-person and computer-based instruction. Ten institutes reported that they have an English language lab, but none were used as such. The other institutes did not have language labs. The reported reasons for the labs not being in use were a lack of trained staff to operate them and some components of the technology not being installed or working properly. The findings from the instructors’ survey indicated that English instructors typically develop their own learning materials and teach general English without tailoring content to healthcare contexts. Only two mentioned using a standard textbook to guide their instruction and one described consulting a range of English textbooks to develop learning content. None reported using online or other digital tools for language instruction in their classrooms. Most instructors had an advanced degree (i.e., master’s degree) in English, and seven had received training in teaching English. Interviews with instructors also revealed that they themselves did not have mastery of English, as communication barriers in speaking over the phone appeared consistently across 10 of the 11 instructor respondents.

The web-search and related follow up interviews found that most English instruction programs (10 out of the 11) were designed for teaching general English and/or business English. The majority were offered through private entities aiming to reach individuals intending to study abroad, access employment that required English, or improve their ability to navigate business endeavors in English. One program, developed by the British Council, had flexibility to tailor its structure and some of its content to the needs of midwifery students. However, this was limited in that a significant portion of the content that would be used was developed for global audiences and thus not tailored to a Bangladeshi audience or to any specific discipline. One of the university English programs offered a promising ESP model tailored to midwifery students. It was designed by BRAC University’s Institute of Language for the university’s private midwifery training program.

Three themes emerged from the other key informant interviews (Table  3 ). The first was that, in addition to students’ challenges with English, faculty mastery of English presented challenges as well. Of the 34 faculty members intending to participate in the 2019–2020 cohort for the Dalarna master’s degree, half did not pass the prerequisite English exam. Ultimately, simultaneous English-Bangla translation was necessary for close to half of the faculty to enable their participation in the master’s program. English language limitations also precluded one faculty member from participating in an international PhD program in midwifery.

The second theme highlighted the language labs’ lack of usability. The language labs consisted of computers, an interactive whiteboard, audio-visual equipment, and associated software to allow for individualized direct interactions between teacher and student. However, due to the lack of appropriately trained staff to manage, care for and use the language lab equipment, the investment required to make the labs functional appeared to outweigh the learning advantages doing so would provide. Interviews revealed that work was being done, supported by a donor agency, on just one language lab, to explore whether it could be made functional. The work was described as costly and challenging, and required purchasing a software license from abroad, thus likely being impractical to apply to the other labs and sustain over multiple years.

The third theme was around the ESP curriculum model. The program developers had employed evidence-informed thinking to develop the ESP learning content and consulted student midwives on their learning preferences. Due to the student input, at least 80% of the content was designed to directly relate to the practice of midwifery in Bangladesh, while the remaining 10–20% references globally relevant content. This balance was struck based on students’ expressed interest in having some exposure to English usage outside of Bangladesh for their personal interest. For conversation practice, the modules integrated realistic scenarios of midwives interacting with doctors, nurses and patients. Also built into written activities were exercises where students were prompted to describe relevant health topics they are concurrently studying in their health, science or clinical classes. Given the midwifery students’ educational backgrounds and intended placements in rural parts of Bangladesh, an ESP curriculum model appeared to be the most beneficial existing program to pursue tapping into to strengthen English competencies within midwifery programs. This was because the content would likely be more accessible to students than a general English course by having vocabulary, activities and examples directly relevant to the midwifery profession.

The study findings demonstrate key weaknesses in the current model of English instruction taught in public midwifery programs. Notably, the quantitative findings revealed that some English instructors do not have training in teaching English, and none used standard curricula or online resources to structure and enhance their classroom content. In addition, weak mastery of English among midwifery faculty was identified in the qualitative data, which calls into question faculty’s ability to fully understand and accurately convey content from English learning materials. Global literature indicates that this is not a unique situation. Many healthcare faculty and students in low-resource settings, in fact, are faced with delivering and acquiring knowledge in a language they have not sufficiently mastered [ 8 ]. As a significant barrier to knowledge and skill acquisition for evidence-based care, this requires more attention from global midwifery educators [ 9 ].

Also holding back students’ English development is the finding from both the quantitative and qualitative data that none of the high-tech language labs were being used as intended. This indicates a misalignment with the investment against the reality of the resources at the institutes to use them. While setting up the costly language labs appears to have been a large investment with little to no return, it does demonstrate that strengthening English language instruction in post-secondary public education settings is a priority that the Bangladesh government is willing to invest in. However, scaling up access to an ESP curriculum model tailored to future midwifery practitioners in Bangladesh may be a more worthwhile investment than language labs [ 10 ]. 

The ESP approach teaches English for application in a specific discipline. It does this by using vocabulary, examples, demonstrations, scenarios and practice activities that are directly related to the context and professions those studying English live and work (or are preparing to work) in. One way ESP has been described, attributed to Hutchinson and Waters (1987), is, “ESP should properly be seen not as any particular language product but as an approach to language teaching in which all decisions as to content and method are based on the learner’s reason for learning” [ 11 ]. It is proposed by linguistic education researchers as a viable model for strengthening language mastery and subject matter comprehension in EMI university contexts [ 12 ].

Though it did not arise as a finding, reviewing the literature highlighted that Bangla language instruction may be an additional, potentially viable option. Linguistic research has long shown that students learn more thoroughly and efficiently in their mother tongue [ 12 ]. Another perhaps more desirable option may be multilingualism, which entails recognizing native languages as complementary in EMI classrooms, and using them through verbal instruction and supplemental course materials. Kirkpatrick, a leading scholar of EMI in Asia, suggests that multilingualism be formally integrated into EMI university settings [ 13 ]. This approach is supported by evidence showing that the amount of native language support students need for optimal learning is inversely proportional to their degree of English proficiency [ 14 ].

Ultimately, despite the language related learning limitations identified in this study, and the opportunities presented by native language and multilingualism approaches, there remains a fundamental need for members of the midwifery profession in Bangladesh to use up-to-date guidance on evidence-based midwifery care [ 11 ]. Doing that currently requires English language competence. Perhaps a tiered system of requirements for English competencies that are tied to diploma, Bachelor’s, Master’s and PhD midwifery programs could build bridges for more advanced students to access global resources. Higher academic levels might emphasize English more heavily, while the diploma level could follow a multilingualism approach—teaching using an ESP curriculum and integrating Bangla strategically to support optimal knowledge acquisition for future practice in rural facilities. Ideally, scores on a standard English competency exam would be used to assess students’ language competencies prior to entrance in English-based programs and that this would require more stringent English skill development prior to entering a midwifery program.

Methodological considerations

One of the limitations of this study is that it relied on self-reports and observation, rather than tested language and subject matter competencies. Its strengths though are in the relatively large number of education institutes that participated in the study, and the breadth of knowledge about faculty and student subject matter expertise among study co-authors. It was recognized that the lead researcher might be biased toward pre-determined perceptions of English competencies being a barrier to teaching and learning held by the lead institution (UNFPA). It was also recognized that due to the inherent power imbalance between researcher and participants, the manner of gathering data and engaging with stakeholders may contribute to confirmation bias, with respondents primarily sharing what they anticipated the researcher wished to hear (e.g., that English needed strengthening and the lead agency should take action to support the strengthening). The researcher thus engaged with participants independently of UNFPA and employed reflexivity by designing and carrying out the surveys to remotely collect standard data from institutes, as well as casting a wide net across institutes to increase broad representation. In addition, while institutes were informed that the surveys were gathering information about the English instruction within the institutes, no information was shared about potential new support to institutes. Finally, the researcher validated and gathered further details on the relevant information identified in the surveys through key informant interviews, which were held with stakeholders independent of UNFPA.

Adapting and scaling up the existing ESP modules found in this study, and integrating Bangla where it can enhance subject-matter learning, may be a useful way to help midwifery students and faculty improve their knowledge, skills, and critical thinking related to the field of midwifery. Given the educational backgrounds and likely work locations of most midwives in Bangladesh and many other LMICs, practitioners may want to consider investing in more opportunities for local midwives to teach and learn in their mother tongue. This type of investment would ideally be paired with a tiered system in which more advanced English competencies are required at higher-levels of education to ensure integration of global, evidence-based approaches into local standards of care.

Declarations.

Data availability

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

Bangladesh Rehabilitation Assistance Committee

English medium instruction

English for Specific Purposes

Low- and Middle-Income Countries

Ministry of Health and Family Welfare

United Nations Population Fund

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Acknowledgements

The authors acknowledge Farida Begum, Rabeya Basri, and Pronita Raha for their contributions to data collection for this assessment.

This project under which this study was carried out was funded by funded by the Foreign Commonwealth and Development Office.

Open access funding provided by University of Gothenburg.

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Authors contributions in the development of this paper were as follows: AW- Concept, acquisition, drafting, revision, analysis, interpretation. JRS- Concept, revision. RA- Concept, analysis MB- Revision, analysis, interpretationAll authors read and approved the final manuscript.

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This study was part of a larger project in Bangladesh approved by the Ministry of Health and Family Welfare (MOHFW) with project ID UZJ31. The MOHFW project approval allows data collection of this type, that is carried out as part of routine program monitoring and improvement, including informed verbal consent for surveys and key informant interviews.

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Williams, A., Stevens, J., Anderson, R. et al. Challenges and opportunities of English as the medium of instruction in diploma midwifery programs in Bangladesh: a mixed-methods study. BMC Med Educ 24 , 523 (2024). https://doi.org/10.1186/s12909-024-05499-8

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Received : 31 July 2023

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Published : 10 May 2024

DOI : https://doi.org/10.1186/s12909-024-05499-8

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Rodriguez JA , Khoong EC , Lipsitz SR , Lyles CR , Bates DW , Samal L. Telehealth Experience Among Patients With Limited English Proficiency. JAMA Netw Open. 2024;7(5):e2410691. doi:10.1001/jamanetworkopen.2024.10691

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Telehealth Experience Among Patients With Limited English Proficiency

• 1 Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
• 2 Harvard Medical School, Boston, Massachusetts
• 3 Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco
• 4 Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco
• 5 Center for Healthcare Policy and Research, University of California Davis, Davis
• 6 Department of Public Health Sciences, University of California Davis School of Medicine, Davis

Patients with limited English proficiency (LEP) face disparities in using telehealth. 1 While research has focused on access, attention to patient experience is essential. Patients with LEP have worse experience with in-person care. 2 We examined differences in telehealth access and experience between patients with LEP and patients with English proficiency (EP) in California.

We analyzed the 2021 adult data from California Health Interview Survey (CHIS), which is conducted in 6 languages. 3 The Brigham and Women's Hospital Institutional Review Board deemed this cross-sectional study exempt from review and waived informed consent because publicly available data were used. We followed the STROBE reporting guideline.

Study exposure was LEP, defined as speaking English not well or not at all. Study outcomes were telehealth use and visit experience. For telehealth use, CHIS participants were asked whether they had used video or telephone telehealth in the past 12 months (eAppendix in Supplement 1 ). For visit experience, participants were asked to compare their experience with video or telephone visits to in-person visits. We dichotomized visit experience to better or same vs worse. Outcomes of patients with LEP or EP were assessed and compared. Covariates included factors associated with use of digital tools: age, sex, marital status, insurance status, educational level, poverty level, health status, internet use, and having usual source of care. 1 , 4 Self-reported race and ethnicity and metropolitan area residency were excluded due to collinearity.

We performed bivariable comparisons using weighted χ 2 analysis. We then performed weighted multivariable logistic regression to ascertain odds of worse experience after controlling for covariates. We used survey-supplied replicate weights to produce population estimates, as recommended by CHIS. 3 Weights represent California’s residential population.

Two-sided P  < .05 was considered significant. Analyses were performed using R 3.6.2 (R Core Team).

The study included 24 453 participants (10 735 males [weighted 49%], 13 718 females [weighted 51%]), representing a population of 29 649 837. Patients with LEP accounted for 9% of participants and 7% of telehealth users. Telehealth users with LEP differed significantly from users with EP across most covariates ( Table 1 ). Among telehealth users, patients with LEP accounted for 6.8% of video visit users (387, representing a population of 840 764) and 8.1% telephone visit users (484, representing a population of 1 021 909).

In unadjusted analyses, patients with LEP were less likely to report either video or telephone telehealth use (37% vs 50%; P  < .001). In adjusted analyses, patients with LEP were less likely to report video or telephone telehealth use (odds ratio [OR], 0.63; 95% CI, 0.52-0.77; P  < .001) vs patients with EP ( Table 2 ). For video visits, in unadjusted analyses, patients with LEP reported worse experience (32% vs 26%; P  = .04) vs patients with EP. In adjusted analyses, patients with LEP were more likely to report worse experience with video visits than in-person visits (OR, 1.42; 95% CI, 1.04-1.94; P  = .03). For telephone visits, there was no difference in visit experience between the 2 groups (unadjusted: 29% vs 31%, P  = .60; adjusted: OR, 1.24 [95% CI, 0.91-1.69], P  = .17).

For patients with LEP, we found not only telehealth access disparities but also worse video visit experience. Additionally, characteristics of video and telephone visit users differed by English proficiency. Worse video visit experience may be associated with challenges in integrating interpreters into telehealth visits or perceived effectiveness by both clinicians and patients. 4 Patients, especially those with LEP, prefer in-person care due to anxiety with self-evaluation without a medical professional. 5 Digital barriers (eg, lack of affordable broadband/devices, unavailable translated portals, and limited digital literacy and support) may also play a role. 6

Study limitations include reliance on self-reported telehealth use, focus on California, and inability to control for clinician factors that may affect care experience. Future work may evaluate the potential of digital navigators in improving the video visit experience. These findings highlight access to telephone visits alongside needed improvements to video visits for patients with LEP.

Accepted for Publication: March 9, 2024.

Published: May 9, 2024. doi:10.1001/jamanetworkopen.2024.10691

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Rodriguez JA et al. JAMA Network Open .

Corresponding Author: Jorge A. Rodriguez, MD, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, 1620 Tremont St, Boston, MA 02120 ( [email protected] ).

Author Contributions: Dr Rodriguez had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Rodriguez, Lipsitz, Lyles, Bates.

Acquisition, analysis, or interpretation of data: Rodriguez, Khoong, Lipsitz, Samal.

Drafting of the manuscript: Rodriguez, Lipsitz, Bates.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Rodriguez, Lipsitz.

Obtained funding: Rodriguez.

Administrative, technical, or material support: Rodriguez.

Supervision: Lyles.

Conflict of Interest Disclosures: Dr Rodriguez reported receiving grants from National Institute on Minority Health and Health Disparities (NIMHD) during the conduct of the study. Dr Lyles reported receiving equity from Google Health outside the submitted work. Dr Bates reported receiving personal fees from CDI Negev; equity from ValeraHealth, Clew, MDClone, and FeelBetter; and personal fees and equity from AESOP and Guided Clinical Solutions outside the submitted work as well as holding a patent for PHC-028654 issued Brigham and Women’s Hospital Intraoperative clinical decision support. No other disclosures were reported.

Funding/Support: This study was supported by grant K23MD016439 from the NIMHD (Dr Rodriguez).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the views and policy of the National Institutes of Health.

Data Sharing Statement: See Supplement 2 .

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Submission open for the Vol.12 Issue 2: 2024; April-June Issue

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Research Journal of English Language and Literature (RJELAL) an International Journal open access print and online, indexed, peer reviewed and refereed  journal that provides rapid publication (quarterly) of articles in all areas Related to English Language and Literature, Linguistics of the subject. Philosophy of RJELAL guides it to map new frontiers in emerging and developing areas in research, Teaching, industry and governance as well as to link with centers of excellence worldwide to stimulate young minds for creating knowledge based community

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A Peek Inside the Brains of ‘Super-Agers’

New research explores why some octogenarians have exceptional memories.

By Dana G. Smith

When it comes to aging, we tend to assume that cognition gets worse as we get older. Our thoughts may slow down or become confused, or we may start to forget things, like the name of our high school English teacher or what we meant to buy at the grocery store.

But that’s not the case for everyone.

For a little over a decade, scientists have been studying a subset of people they call “super-agers.” These individuals are age 80 and up, but they have the memory ability of a person 20 to 30 years younger.

Most research on aging and memory focuses on the other side of the equation — people who develop dementia in their later years. But, “if we’re constantly talking about what’s going wrong in aging, it’s not capturing the full spectrum of what’s happening in the older adult population,” said Emily Rogalski, a professor of neurology at the University of Chicago, who published one of the first studies on super-agers in 2012.

A paper published Monday in the Journal of Neuroscience helps shed light on what’s so special about the brains of super-agers. The biggest takeaway, in combination with a companion study that came out last year on the same group of individuals, is that their brains have less atrophy than their peers’ do.

The research was conducted on 119 octogenarians from Spain: 64 super-agers and 55 older adults with normal memory abilities for their age. The participants completed multiple tests assessing their memory, motor and verbal skills; underwent brain scans and blood draws; and answered questions about their lifestyle and behaviors.

The scientists found that the super-agers had more volume in areas of the brain important for memory, most notably the hippocampus and entorhinal cortex. They also had better preserved connectivity between regions in the front of the brain that are involved in cognition. Both the super-agers and the control group showed minimal signs of Alzheimer’s disease in their brains.

“By having two groups that have low levels of Alzheimer’s markers, but striking cognitive differences and striking differences in their brain, then we’re really speaking to a resistance to age-related decline,” said Dr. Bryan Strange, a professor of clinical neuroscience at the Polytechnic University of Madrid, who led the studies.

These findings are backed up by Dr. Rogalski’s research , initially conducted when she was at Northwestern University, which showed that super-agers’ brains looked more like 50- or 60-year-olds’ brains than their 80-year-old peers. When followed over several years, the super-agers’ brains atrophied at a slower rate than average.

No precise numbers exist on how many super-agers there are among us, but Dr. Rogalski said they’re “relatively rare,” noting that “far less than 10 percent” of the people she sees end up meeting the criteria.

But when you meet a super-ager, you know it, Dr. Strange said. “They are really quite energetic people, you can see. Motivated, on the ball, elderly individuals.”

Experts don’t know how someone becomes a super-ager, though there were a few differences in health and lifestyle behaviors between the two groups in the Spanish study. Most notably, the super-agers had slightly better physical health, both in terms of blood pressure and glucose metabolism, and they performed better on a test of mobility . The super-agers didn’t report doing more exercise at their current age than the typical older adults, but they were more active in middle age. They also reported better mental health .

But overall, Dr. Strange said, there were a lot of similarities between the super-agers and the regular agers. “There are a lot of things that are not particularly striking about them,” he said. And, he added, “we see some surprising omissions, things that you would expect to be associated with super-agers that weren’t really there.” For example, there were no differences between the groups in terms of their diets, the amount of sleep they got, their professional backgrounds or their alcohol and tobacco use.

The behaviors of some of the Chicago super-agers were similarly a surprise. Some exercised regularly, but some never had; some stuck to a Mediterranean diet, others subsisted off TV dinners; and a few of them still smoked cigarettes. However, one consistency among the group was that they tended to have strong social relationships , Dr. Rogalski said.

“In an ideal world, you’d find out that, like, all the super-agers, you know, ate six tomatoes every day and that was the key,” said Tessa Harrison, an assistant project scientist at the University of California, Berkeley, who collaborated with Dr. Rogalski on the first Chicago super-ager study.

Instead, Dr. Harrison continued, super-agers probably have “some sort of lucky predisposition or some resistance mechanism in the brain that’s on the molecular level that we don’t understand yet,” possibly related to their genes.

While there isn’t a recipe for becoming a super-ager, scientists do know that, in general , eating healthily, staying physically active, getting enough sleep and maintaining social connections are important for healthy brain aging.

Dana G. Smith is a Times reporter covering personal health, particularly aging and brain health. More about Dana G. Smith

A Guide to Aging Well

Looking to grow old gracefully we can help..

The “car key conversation,” when it’s time for an aging driver to hit the brakes, can be painful for families to navigate . Experts say there are ways to have it with empathy and care.

Calorie restriction and intermittent fasting both increase longevity in animals, aging experts say. Here’s what that means for you .

Researchers are investigating how our biology changes as we grow older — and whether there are ways to stop it .

You need more than strength to age well — you also need power. Here’s how to measure how much power you have  and here’s how to increase yours .

Ignore the hyperbaric chambers and infrared light: These are the evidence-backed secrets to aging well .

Your body’s need for fuel shifts as you get older. Your eating habits should shift , too.

People who think positively about getting older often live longer, healthier lives. These tips can help you reconsider your perspective .

• Get involved

Are we communicating climate change wrong? Here are five ways to improve.

The way we communicate the issue has a different impact on different audiences

May 6, 2024

We typically communicate climate change focusing on rising ocean levels, more intense storms and droughts. But we rarely connect the dots to the social and economic impacts.

Fernando Andrade

Climate Change Technical Specialist, UNDP

During the last decade working on climate change, I’ve witnessed how the way we communicate the issue has a different impact on different audiences. Tailormade messages and differentiated approaches have proven to be the most effective for me. I’m sharing my top tips to help you communicate climate change to your audience.

Take on the role of a climate change translator

To motivate our audience to take action, we need to avoid the “one speech for all”.

If you are working on climate change, and you want to share your message across different audiences, the first thing you need to consider is, who is listening or reading. Make sure you are tailoring your message for the intended audience.

I often see colleagues in our industry communicating in a way that assumes that people understand them. All the technical jargon, the acronyms and technical concepts tend to alienate people. We don’t need to sound smart to be smart, especially when not everybody has the same access to knowledge and awareness of the topic. 

We need to resonate with our audience. We must identify their motivations, their objectives, and their needs. For instance, the interests and experiences of young people will be different than those of government officials. How they speak or what kind of words will impact them will be different too.

When talking to the private sector, I’ve seen that focusing on how their businesses can be affected by climate change, talking about how climate action can help them be more efficient, more competitive, and gain access to new markets can go a long way.

We should make more conscious attempts to better communicate outside of our echo chamber. The same way that an interpreter translates from one language to another so more people can understand, we need to be “climate interpreters” to help bring more people into the conversation. 

If you are afraid of oversimplifying concepts or not being scientifically accurate, don’t forget that there is a big difference between simple and simplistic. We don’t want to be simplistic, but being clear and simple will really help you to get your message across.

Make it human

Climate change is no longer an exclusively scientific issue, it is also a socio-economic development issue. 

Yet, we can go out to the streets and start asking people about climate change, and you’ll be surprised to see how many don’t understand the term, although they do feel the impact. 

I typically see how people communicate about climate change focusing on the physical impacts, such as the rising sea levels, the polar ice caps melting, and extreme weather events, but often don’t connect the dots to the social and economic impacts.

To change this perception, it’s necessary to tell the story differently - using metaphors, analogies, and real life examples. Focus on the human side, explain how climate change can affect different aspects of their current lifestyle, such as purchasing power, the ability to work more efficiently, and make a living for themselves and their families. For example, explaining how droughts can affect the generation of electricity creating blackouts and how this impacts their livelihood, how the cost of food will rise due to floods, how fishing communities will suffer from ocean acidification.

Add a dash of hope

It’s well known that if we feel hopeless about a situation, we won’t take action to make a change. Why would we bother if we’re doomed anyway?

Yes, we need to communicate the need for urgent action, and yes, we need to sound all the alarms, but we also need to communicate hope and let people know that we can reverse the problem. That our actions count, and that collectively we can change the trajectory. The solutions are there, we just need the political will to foster the change.

Let’s inform about the different options and paths to be more prepared for the impacts of climate change. Let’s inform readers and listeners about the alternatives to help us reduce our impact. Highlight the positive and tell people what they can do to take action instead of listing only the terrible things that will happen if they don’t. Focus on sharing successful and inspiring examples or local experiences that they can relate to. 

Co-create the message

If you want your message to be replicated, it needs to be co-created with the relevant audiences. If you want to reach Indigenous Peoples, you need to work with them, create the messages in a way that relates to their lives and their culture. It might need to be in their native language, so it has more impact and reaches more people.

If you are working with the private sector, you need to shape the message with them based on their knowledge of their own industries. This approach often leads to companies becoming champions or advocates who start bringing other companies into the conversation. 

If you want to send the message to young people, you have to share it using their channels of communication. For example, we recently developed the  Youth for Climate Action e-learning course , but we didn’t do it from UNDP only. We worked with youth organizations so that they could shape the course in the way they knew was best for young people. It was designed by youth for youth. 

Get your sources right

If you are a communicator or a journalist, you know that communicating science is no easy task. You’ll need to become a “half-expert” on some topics, so you understand the issue enough to repackage it and communicate it to your audience in a more digestible way. This is especially a challenge when talking about climate change. There are countless acronyms, extensive theories, endless pages of treaties and agreements. It gets even more challenging as climate change misinformation and disinformation are so widespread and are  on the rise . 

But before you panic, there’s no need to become an expert on climate science to communicate it. There are resources that will help you to familiarize with the climate change terminology such as the  Climate Dictionary . You can partner with organizations and institutions that are authorities in the topic who could act as reliable sources of information. You can seek fact-checking websites, such as  Verified , that will help you avoid giving inaccurate or fake information. When communicating, share resources based on evidence and official sources, such as  UN websites , including UNFCCC and UNDP, academic research, and reputable news sources. 

Beware of greenwashing, making sure that you are communicating about real sustainable practices, and think whether you are including the different communities involved in your narrative. 

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