Research-Based Design of a Medical Vocabulary Videogame

Article excerpt

Abstract: This article discusses the research-based design choices and general rationale underpinning the creation of a video game called Medicina. This game is designed to broadly foster better language skills among international nursing students with English as a second language (ESL) and more specifically to teach confusable medication names while also improving reaction time to verbal orders. Research shows that the learning of vocabulary is important to language learning. Without adequate vocabulary knowledge, it is difficult for an international student to interact in professional and university settings. This situation is compounded by the expectation that students will learn key vocabulary incidentally through academic pre-readings, despite the research demonstrating this to be an inefficient and inadequate method of learning. Moreover, medication names are low-frequency vocabulary. Thus, the international student who seeks to enter the health profession encounters the task of learning a large subset of language but without the amount of exposure theorised as being necessary to it. The article will outline how the language-learning video game is designed to encourage rapid discrimination of word form and give multiple exposures to both written and spoken medication names. It concludes with a summary of the preliminary testing of the game and a brief summary of the findings.

Keywords: automaticity, low-frequency vocabulary, medication names, international nursing students, English as a second language

The problem

International nursing students with English as a second language (ESL) sometimes find they are unable to fully engage in their university studies and clinical placements as a result of communication difficulties (for example, see Chiang & Crickmore, 2009; Donnelly, McKiel, & Hwang, 2009; Guhde, 2003; Gunn-Lewis & Smith, 1999; Shakya & Horsfall, 2000; Starr, 2009). The factors contributing to their communication problems include: The range of language registers (from colloquial to specialist language), the physical environment (usually a noisy clinical placement or group-based tutorial/laboratory space), and communicative pressure (quickly, accurately, and under pressure; Müller, 2011). Communication problems can have serious consequences in a medical context. An example of this is mishearing a medication order given verbally over the phone and subsequently administering the wrong medication to a patient.

Vocabulary is a major underlying contributor to the problem

It has been noticed that a major issue contributing to communication problems is a lack of medical vocabulary knowledge (Seibold, Rolls, & Campbell, 2007; Shakya & Horsfall, 2000), but also an inability to rapidly relate spoken to written forms (Blackman & Hall, 2009; Donnelly et al., 2009). It is common to find that international nursing students have difficulty with lowfrequency vocabulary in both speech and writing. As a result, they may not be able to easily recognise a spoken word, repeat it correctly, nor match it to the written form. Moreover, students tend to display a general lack of familiarity with medical vocabulary (understandably, since it is lowfrequency specialist language), difficulty with the phonological requirements of medical terms, and a frequent inability to identify affixes and roots in medical words. This lack of familiarity with medical vocabulary may have negative consequences for students' further study. Research indicates that, for reading activities, English language learners need to be familiar with 98% of the words used in order to have full comprehension (Schmitt, 2008, pp. 329 and 330). In real terms, that means if 1 in 50 words is unknown, comprehension is hindered. Furthermore, in order to have good comprehension in speech, a similarly low threshold of 95% vocabulary knowledge is needed (Schmitt, 2008, pp. 331 and 332). In a medical context, low-frequency words are most likely to be unknown and yet crucial to comprehension. …