Critical Discourse Analysis in a Medical English Course: Examining Learner Agency through Student Written Reflections (original) (raw)

Theorizing and Analyzing Agency in Second Language Learning

This paper examines and describes students’ written critical reflections during a medical ESP course, analyzing how they respond to issues raised during the course, asserting their agency and constructing their “future selves” (Markus & Nurius, 1986, p. 957) as medical doctors. The course is intended to bridge the “what” with the “how” (Watson Todd, 2003, p. 148) of ESP course content, introducing selected issues identified through critical discourse analysis from the medical literature and asking students to reflect on the doctor-patient discourse models derived from such research, including topics such as lifeworld versus medical “voice” (Barry, Stevenson, Britten, Barber, and Bradley, 2001, p. 495). The intention of the course is to promote student agency in understanding and evaluating the doctor-patient discourse literature by first introducing key concepts and then asking students to react and respond to those concepts in writing. The purpose of this chapter is to examine students’ reflective essays for evidence of developing agency and construction of their identities as future medical doctors. Analysis of their writing describes how they build an image of themselves as future medical professionals, demonstrate agency in describing the kind of doctors they hope to become, explain the kind of doctor-patient relationships they hope to have, and react and respond to the conclusions of the medical discourse literature. Their reflections demonstrate that they do not simply accept the assertions of the literature, but instead interpret and evaluate the conclusions of the literature based on their life experiences and understanding, coming to their own conclusions regarding how doctors should approach patient communication and the unequal power relationship inherent between doctor and patient. This paper will use student texts to describe their journey of developing an understanding of what critical discourse analysis is and how it can be applied to interactions in health care provider situations. The focus will be on examining the critical understanding students demonstrate through their writing and how they project, predict, and describe their future selves as medical professionals. Conclusions will highlight implications for encouraging student agency in an ESP context and how this might inform language teaching and learning more generally. References Barry, C. A., Stevenson, F. A., Britten, N., Barber, N., & Bradley, C. P. (2001). Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor-patient communication in general practice. Social Science & Medicine, 53, 487-505. Markus, H., & Nurius, P. (1986). Possible selves. American Psychologist, 41 (9), 954-969. Watson Todd, R. (2003). EAP or TEAP? Journal of English for Academic Purposes, 2, 147-156.