NUR 635 Module 6 Diverse Learners Paper Example

Teaching the Language of Nursing, Not Testing the Language of Idiom: Multilingual Students in a Pharmacology Course

[Student Name]

Southern New Hampshire University

NUR 635: Teaching and Learning for Nurse Educator

Module Six Diverse Learners Paper

[Instructor Name]

[Date]

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Teaching the Language of Nursing, Not Testing the Language of Idiom: Multilingual Students in a Pharmacology Course

Nursing programs increasingly enroll students whose first language is not English, and the health care workforce benefits from their languages and cultural knowledge. Yet these students often progress more slowly and leave programs at higher rates, and faculty sometimes interpret their struggles as weaker ability. This paper looks at the multilingual students in Harborside's pharmacology course and argues that some of their difficulty comes from the real demands of nursing language, which faculty should teach explicitly, and some from unnecessary linguistic complexity in teaching and testing, which faculty can remove without lowering standards.

What Multilingual Students Report

Qualitative research gives these students a voice. In an interpretive study of English language learners in a nursing program, students described academic progress as requiring extra time and effort to learn English, the language of health care and the language of nursing at once, and they described traditional, monocultural teaching practices as obstacles to learning. They made progress despite those practices and despite financial pressures (Mulready-Shick, 2013). An earlier study of English language learners in community college nursing classrooms explored what helped: faculty who were accessible, who clarified expectations and who created classroom conditions in which students felt able to participate (Mulready-Shick & Parker, 2012). Both studies are small and qualitative, so they describe experiences rather than measure effects, but they point to practices faculty control.

The Course Situation

At Harborside, about 18 of the 72 students in the pharmacology course grew up speaking another language, most commonly Spanish, Haitian Creole, Vietnamese or Arabic. Clinical instructors rate several of these students among the strongest in communicating with patients who share their languages. Yet on the first pharmacology exam, the average for students who reported another home language was 9 percentage points lower than for native speakers. When faculty reviewed the items these students most often missed, they found that many were long, used negative wording, relied on idioms such as "red flag" or "on the fence" or placed the key clinical fact in a subordinate clause. The pharmacology being tested was not harder; the English was.

Two Kinds of Language

It helps to separate two kinds of language. The language of nursing, terms such as thrombocytopenia, neuraxial and anticoagulant, and the precise meanings of words such as hold and titrate, is content. Every student must learn it, and multilingual students may need more explicit teaching of it, because they cannot rely on having heard the terms in everyday English. The language of the test, idioms, double negatives, long stems and culturally specific references, is not content. When it makes an item harder for some students without measuring nursing knowledge, it introduces error into the grade. Fair teaching adds support for the first kind and removes the second.

Changes in Classroom Talk and Reading

In the anticoagulant lesson, faculty will introduce key terms explicitly with a glossary distributed a week in advance, giving each term a plain-language definition and a clinical example. When a term is first used in class, the faculty member will write it, say it and define it. Faculty will avoid idioms and sports metaphors in explanations and will slow down when presenting new terms. Prediction questions and case work will be answered in writing before discussion, and groups will record their reasoning on shared forms, so that participation does not depend on speaking quickly in front of the whole class. Readings will be posted early so students can use translation tools or read twice. Office hours will include a drop-in session specifically for questions about terms and phrasing.

Changes in Test Items

The most consequential change concerns exam items. A review of item-writing guidelines for classroom assessment recommends keeping vocabulary simple for the group being tested, avoiding negative wording such as not and except, minimizing the amount of reading, avoiding window dressing that adds words without information and placing the central idea in the stem (Haladyna et al., 2002). Applying these guidelines, an item that read, "A nurse is on the fence about administering a dose of enoxaparin to a patient whose epidural catheter was pulled an hour ago. Which of the following would not be an appropriate action?" becomes, "A patient's epidural catheter was removed one hour ago. An enoxaparin dose is scheduled now. What should the nurse do first?" The revised item tests the same safety knowledge with fewer words, no idiom and no negative. Each item on the anticoagulant exam will be reviewed by a colleague for these features before use.

Recognizing an Asset

Multilingual students also bring strengths the course should recognize. Several Harborside students already interpret informally for family members at medical appointments and understand how anticoagulant instructions can go wrong when translated word for word. In the lesson's patient teaching segment, students will be invited, not required, to draft a short bleeding-precautions explanation in a language they speak and discuss which terms have no simple equivalent, such as the difference between bruising and bleeding under the skin. The exercise reminds the whole class that patients with limited English face the same barriers, and it treats bilingualism as a clinical skill rather than a deficit. Faculty will make clear that professional interpreters remain the standard for clinical teaching, so the activity builds awareness without encouraging students to interpret beyond their role.

Maintaining Standards

These changes do not lower the bar. Students must still know the monitoring tests, the reversal agents and the timing rules, and they must still meet the licensure standard. Clearer items benefit native speakers too, since unnecessary complexity adds error for everyone. What changes is that a student's grade more accurately reflects nursing knowledge. The program will track whether the gap between native and multilingual students narrows on the revised exam while overall item difficulty remains similar, which would suggest that linguistic noise, not standards, has been reduced.

Conclusion

Multilingual students in Harborside's pharmacology course face the real challenge of learning nursing language and the avoidable challenge of decoding idioms and convoluted test items. Teaching the first explicitly and removing the second makes the course fairer and its grades more accurate, while keeping the standard every future nurse must meet.

References

Haladyna, T. M., Downing, S. M., & Rodriguez, M. C. (2002). A review of multiple-choice item-writing guidelines for classroom assessment. Applied Measurement in Education, 15(3), 309-333. https://doi.org/10.1207/S15324818AME1503_5

Mulready-Shick, J. (2013). A critical exploration of how English language learners experience nursing education. Nursing Education Perspectives, 34(2), 82-87. https://doi.org/10.5480/1536-5026-34.2.82

Mulready-Shick, J., & Parker, T. L. (2012). English language community college students in the nursing classroom: Exploring what matters. Community College Journal of Research and Practice, 37(1), 37-53. https://doi.org/10.1080/10668920903299577