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<p><a href="http://dx.doi.org/10.19183/how.21.1.17" target="_blank">http://dx.doi.org/10.19183/how.21.1.17</a></p>
<p><font size="4" color="#666"><b>Language-Building Activities and Interaction
Variations With Mixed-Ability ESL University Learners
in a Content-Based Course</b></font></p>
<p><font size="3">Actividades de construcci&oacute;n de lengua y patrones de interacci&oacute;n
en estudiantes universitarios de ingl&eacute;s como segunda lengua con
habilidades desiguales dentro de un curso basado en contenidos</font></p>
<p align="right"><b>H&eacute;ctor Manuel Serna Dimas</b><br><a href="mailto:hmserna@correo.ean.edu.co">hmserna@correo.ean.edu.co</a><br>Universidad EAN, Colombia</p>
<p align="right"><b>Erika Ru&iacute;z Castellanos</b><br><a href="mailto:eruiz@fcf.com.co">eruiz@fcf.com.co</a><br>Universidad del Rosario, Colombia</p>
<p>Received: January 16, 2014. Accepted: March 9, 2014.</p>
<p>How to cite this article (APA 6th ed.):<br>Serna Dimas, H. M., & Castellanos Ru&iacute;z, E. (2014). Language-building activities and interaction
variations with mixed-ability ESL university learners
in a content-based course. <i>HOW, 21</i>(1), 103-121. <a href="http://dx.doi.org/10.19183/how.21.1.17" target="_blank">http://dx.doi.org/10.19183/how.21.1.17</a>.</p>
<p>This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. License Deed can be consulted at <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/" target="_blank">http://creativecommons.org/licenses/by-nc-nd/4.0/</a>.</p>
<hr> 
<p>The preparation of both language-building activities and a variety of teacher/student interaction
patterns increase both oral language participation and content learning in a course of manual therapy
with mixed-language ability students. In this article, the researchers describe their collaboration in a
content-based course in English with English as a second language learners. The data gathered through
lesson plans, sociograms, and student feedback cards showed an increase of students&rsquo; involvement in
class activities since their concern was to be able to diagnose and treat their future patients&rsquo; physical
condition through a structured interview for which both careful language elaboration and
therapist/patient interaction were essential.</p>
<p><b><i>Key words:</i></b> Classroom interaction patterns, language-building activities, mixed-ability language
students.</p>
<hr>
<p>La preparaci&oacute;n de actividades de construcci&oacute;n de lengua y una variedad de patrones de interacci&oacute;n
entre el profesor y los estudiantes incrementa tanto la participaci&oacute;n oral como el aprendizaje de contenidos
en un curso de terapia manual con estudiantes con habilidades ling&uuml;&iacute;sticas desiguales. En este art&iacute;culo
los investigadores describen su colaboraci&oacute;n en un curso de contenidos en ingl&eacute;s con estudiantes de
ingl&eacute;s como segunda lengua. Los datos recolectados en planeaciones de clase, sociogramas y fichas de retroalimentaci&oacute;n mostraron un incremento en los niveles de participaci&oacute;n de los estudiantes en las actividades
de clase debido a su preocupaci&oacute;n por estar en capacidad de diagnosticar y tratar la condici&oacute;n f&iacute;sica
de sus pacientes a trav&eacute;s de entrevistas estructuradas para las cuales era esencial tanto la elaboraci&oacute;n
de las preguntas como la interacci&oacute;n con los pacientes.</p>
<p><b><i>Palabras clave:</i></b> actividades de construcci&oacute;n de lengua, estudiantes con habilidades ling&uuml;&iacute;sticas desiguales,
patrones de interacci&oacute;n en clase.</p>
<hr>
<p><font size="3" color="#666"><b>Introduction</b></font></p>
<p>Universidad del Rosario is one of the oldest institutions of higher education in Colombia.
The university has undergraduate and graduate programs in areas such as Medicine and
Health Sciences, Law, Economics, International Business Management, Business
Administration, Political Science, International Relations, Urban Development, Sociology,
Anthropology, Journalism, History, Liberal Arts, Philosophy, Mathematics, and Biology.</p>
<p>The university has determined that one of the most important areas for its growth is
internationalization, which is understood as the process of promoting university work in areas
such as teaching, research, and community outreach in the international milieu. Thus, it is
compulsory for the university programs in all schools and departments to offer content-based
courses in English. That is, courses that belong to the universities&rsquo; programs&rsquo; curricula.
However, professors in charge of these courses are often confronted with a series of
challenges, such as having students with diverse linguistic abilities. This situation also poses
issues for professors regarding the demands that both the content and the language will
require of students in terms of their participation, classwork learning, and evaluation.</p>
<p>Two university professors in the areas of manual therapy and English language teaching
decided to team up on an action-research study with students from the Physical Therapy
program in the School of Medicine and Health Sciences. The researchers decided to combine
their expertise so that they both could see how the manual therapy professor was engaging
her students in content-based learning in English, and how the language professor was
looking at the flow of language based upon both the manual therapy professor&rsquo;s input and the
students&rsquo; participation either individually or in groups.</p>
<p>The main concern that triggered this research project was the fact that the professor in
manual therapy was not pleased with the idea of teaching again a course on manual therapy
with English as a second language (ESL) learners who had demonstrated very little
participation and interaction among themselves due to the barriers in their second language
oral proficiency.</p>
<p>The purpose of this study is to describe how both the deliberate work in
language-building activities and a variety of teacher/student interaction patterns such as individual, pair, and group work increase students&rsquo; class participation and content learning in
a manual therapy course with students of diverse language abilities in the Physical Therapy
Program at Universidad del Rosario in Bogot&aacute;, Colombia.</p>
<p>We consider that there is a need to research content-based instruction in higher education
because there is a growing interest among Colombian universities to work towards their
internationalization. This process of internationalization has to do with having content
courses taught in English and with promoting academic mobility. Many universities are
running dual degree programs for which students need to find courses taught in English.
Students who choose a dual degree program are not always fluent in the native language of the
university that hosts the program. In fact, English works as an international language to help
them make the corresponding matches in their curricula.</p>
<p>For the purpose of this research, we define language-building activities as the language
considerations regarding vocabulary, grammar, and pragmatic elements required for students
to engage in appropriate discourse interactions to match the course proceedings. Bean and
Peterson (1998) established some classroom events that involved participation; some of these
linguistic behaviors can be summarized as follows: discussion moments, short exchanges
between professor and students, student comments made in class, students who take risks
and make mistakes, students who ask questions for clarification, and students who ask
questions in private or in small groups.</p>
<p>This article begins with a description of the specific context of this research followed by a
theoretical framework which reviews some studies related to the teaching of students in
tertiary education, particularly in the health sciences. In fact, some of the studies were
conducted with ESL students in English speaking universities. The reviewed studies address
both cognitive and language related aspects that are considered important in the education of
professionals in the health sciences, particularly in the rehabilitation areas. This section also
discusses some theoretical tenets from second language acquisition, cooperative learning, and
differentiated learning. Then the study describes the research design, the data sources,
instruments of data collection, and the researchers&rsquo; intervention. The study ends with a
discussion of the results, the limitations, and the conclusions.</p>
<p><font size="3" color="#666"><b>Context</b></font></p>
<p><font size="3"><b><i>Physical Therapy Program at Universidad del Rosario</i></b></font></p>
<p>The Physical Therapy program is part of the rehabilitation sciences field in the School of
Medicine and Health Sciences at Universidad del Rosario. The program, according to the
Colombian legal framework (law 528, 1999), determines that its object of study is the human
body movement as a central driving force of human development. The university program recognizes the human being as a subject that moves about in the world through social and
cultural interrelations. From this perspective, not only does it delve into the structural,
physical, and physiological domains of human movement but it also advances towards the
understanding of the complexity of their relations in the contexts in which physical therapy
operates (Universidad del Rosario, 2011).</p>
<p><font size="3"><b><i>Manual Therapy</i></b></font></p>
<p>Manual therapy is a specialized field in the basic formation for Physical Therapists, and it
promotes the necessary knowledge of evaluation and intervention processes as concerns the
purpose of therapeutic treatment options. This course gives students the basic elements
necessary for the therapeutic approach to neuromusculoskeletal dysfunction from the
perspective of manual therapy, and the opportunity to explore and develop second language
skills. This specialized field also brings together a set of procedures that both promotes and
improves hands perception and sensibility as a tool for handling body structures that are
directly related to individuals with body movement limitations.</p>
<p><font size="3" color="#666"><b>Theoretical Framework</b></font></p>
<p>There are not very many English for specific purposes (ESP) studies that address both the
linguistic and cognitive needs of prospective professionals in rehabilitation programs such as
occupational therapy, physical therapy, or speech pathology. In fact, there is scant research in
the preparation of these professionals in either second or foreign language settings.
Nevertheless, the research that was reviewed pays special attention to both the language and
cognitive abilities that are required and, more importantly, expected from these professionals.
Thus, studies on how both complex cognitive thinking and their related language abilities are
relevant for areas such as the health sciences, language learning, and content-based
instruction with ESL students.</p>
<p>Liu, Chang, Yang, and Sun (2001) developed a study with a group of university students
that intended to determine a detailed examination of the group&rsquo;s needs in courses of English
for either general (EGP), specific (ESP), or academic purposes (EAP). The researchers set out
to &ldquo;examine how much students&rsquo; perceived needs conflicted with their <i>wants</i> and <i>lacks</i>
regarding their enrollment in English courses&rdquo; (p. 273). They developed a questionnaire to
determine students&rsquo; needs in EGP, ESP, or EAP courses, and the reasons for enrollment in
either of these courses. The results indicated that students do not see that the language
abilities taught in the courses had equal value. The results also indicated a mismatch between
students&rsquo; perceived needs and their course taking action.</p>
<p>The above study illustrates a common scenario with ESL learners, which is the fact that
one of the main sources of conflict between instructors and students is the expectations about the language abilities of the latter. This mismatch usually has almost immediate side effects on
the course&rsquo;s aims, objectives, contents, and evaluation.</p>
<p>Another aspect that requires special consideration in using English as the medium of
instruction at university level is the quintessential question for the accountability of
educational processes. University professors often express their concerns about students&rsquo;
achievement in courses taught in a language that is not their native language, especially if they
are working in complex areas that deal with the treatment of patients and their physical health.</p>
<p>A study researching the faculty perspectives on the English language competence of
nonnative English speakers was developed by Andrade (2010). She describes the population
of international students recruited by a university in an English-speaking country. She also
gives a detailed account of the university English requirements for these students in terms of
their levels of proficiency through different tests such as the Test of English as a Foreign
Language, TOEFL&reg;.</p>
<p>The purpose of her study was to obtain data from the university faculty in some areas of
inquiry that the researcher established as:</p>
<blockquote>(a) Estimation of students&rsquo; language abilities, (b) impact of having L2 students in their classes, (c)
faculty efforts to help students improve, (d) future possibilities for faculty support, (e)
institutional efforts to help L2 students improve, and (f) future institutional possibilities.
(Andrade, 2010, p. 225)</blockquote>
<p>The study&rsquo;s findings indicated that professors viewed students&rsquo; language abilities as
adequate although they could be improved. Professors acknowledged the presence and
efforts of their nonnative students without compromising their views on their achievement
compared with that of native speakers. The findings regarding faculty efforts to support
students indicated that the professors were more focused on maintaining the demands of
their courses; they felt that other people in the university should provide this help directly to
the students. Regarding institutional efforts, the faculty saw it was necessary for other
university bodies to work with these students&rsquo; particular needs. They also pointed out that
these other possibilities should be offered as additional help in terms of mandatory work for
these students.</p>
<p>The following study is not related to the education of ESL physical therapists, yet it
provides relevant evidence on the development of clinical reasoning skills in the education of
physical therapists. Moreover, the maturity of such skills is largely built around cognitive
operations that are manifested mainly through language. Hendrick, Bond, Duncan, and Hale
(2009) conducted an empirical study that intended to provide evidence regarding the
conceptualizations of physical therapy students in the clinical reasoning that they
demonstrated in musculoskeletal practice.</p>
<p>The study was motivated by the musculoskeletal clinical professor&rsquo;s concerns about the
variation of physical therapy students&rsquo; clinical reasoning skills across the curriculum and
throughout their education (Hendrick et al., 2009). The researchers defined clinical reasoning
as &ldquo;the thinking and decision making process used by practitioners&rdquo; (p. 431). A sample of the
student population from various years (only those enrolled in the physical therapy program)
was selected to participate in a semi-structured, in-depth interview in the middle of the
academic year while students were fully involved in their studies. Students were asked about
their understanding of their practice and were encouraged to provide examples to illustrate
their reasoning of particular clinical situations. Finally, they were also asked if they could
elaborate on how they achieved such understandings. The data the researchers obtained
suggested categories of students&rsquo; conceptualizations in terms of:</p>
<blockquote>Category A&mdash;applying knowledge and experience to the problem, patient, or situation; category
B&mdash;analyzing and reanalyzing to deduce the problem and treatment; category C&mdash;rationalizing or
justifying what and why; category D&mdash;combining knowledge to reach a conclusion; and category
E&mdash;problem solving and pattern building. (Hendrick et al., 2009, p. 434)</blockquote>
<p>The results showed the influence of different theories towards the practice of physical
therapy among the students as they progressed in their learning from year one to year four.
There was also a developmental continuum that allowed students to build up a framework
which included different approaches to their practice.</p>
<p>The study by Hendrick et al. (2009) describes the complexity of skills that physical
therapists need to develop for their professional work. First of all, there has to be
congruence between course programs and the abilities professors intend to elicit or teach
to students. Second, there have to be constant moments of feedback among professors
and students in order to assess students&rsquo; clinical reasoning skills in their field of
knowledge. Third, it seems that scenarios where students need to interact with either their
professors or their peers are advantageous, as these reasoning skills grow as a result of the
constant exchanges of more expert views such as those of the professor&rsquo;s or their
classmates&rsquo; ideas.</p>
<p>The common thread that runs through many of the studies on the teaching of EAP to
university students seems to suggest that there has to be congruence between the program
goals and objectives and the students&rsquo; needs, particularly students&rsquo; language needs that are for
the most part oriented towards interacting with colleagues at the expert level and with
patients at both the professional and personal level. Besides that, there is a clear need to
design courses that tap into both the complexity of cognitive abilities and the language
requirements to perform them. Furthermore, it is important to take into consideration the
fact that students do not always have the same levels of language proficiency that are required
for content-based courses; therefore, professors need to have in mind the language demands the course contents place on the students and act on them by building teaching sequences
that involve all the students regardless of their language abilities.</p>
<p>The above conclusions point to the direction of some theoretical tenets that include ideas
from second language acquisition, cooperative learning, and differentiated instruction. Each
one of these elements provides the bases to stage the teaching of both content and language
with ESL students of diverse linguistic abilities.</p>
<p>Kagan (1995) discusses the relationship between input, output, and context in second
language acquisition through the framework of cooperative learning. He brings together
Krashen&rsquo;s (1982) input hypotheses, Swain&rsquo;s (1985) insights about language output, and his
own views concerning context in cooperative learning.</p>
<p>Kagan (1995) states that second language acquisition is fostered as long as input is
&ldquo;comprehensible, developmentally appropriate, redundant, and accurate&rdquo; (p. 1). Students
working in groups need to adjust language input according to the circumstances and their
peers&rsquo; levels of proficiency. In cooperative learning, the teacher is not always the source of
input; many times students will be the source, so the moments of negotiation around
language input allow students to advance in their levels of proficiency. When students
experience a variety of activities in which they are exposed to input, this input will be
redundant as part of communication exchanges that are meaningful for the circumstances of
the cooperative work instead of a myriad of language drills that are intended to make the
language redundant yet useless. However, teachers need to be cautious about the levels of
accuracy in the cooperative learning mode since the source of input stems from many group
members with various levels of language proficiency regarding aspects such as grammar,
pronunciation, and intonation patterns. In order for teachers to resolve these possible
problems, their cooperative work may to some extent compensate for the variety of language
quality which may always be addressed by some explicit teaching or general feedback on
particular language issues.</p>
<p>According to Kagan (1995), second language acquisition will also happen when there is
output from individuals that is &ldquo;functional or communicative, frequent, redundant, and
identity congruent&rdquo; (p. 2). Speech samples are functional or communicative if they are
representative of what people use in their settings of occurrence. For this reason, the speech
in cooperative learning is related to and relevant for the particular situations the groups are
discussing. A variety of group configurations is very advantageous in order for learners to take
part in class activities; for example, learners may work in pairs or groups of different sizes so
that the chances for the group to hear what students have to say are greater. Students will
benefit greatly in practicing and producing language that is akin to their identity. Conversely,
students may experience feelings of alienation when they are asked to work on language
activities that are extraneous to who they are or what they actually need the language for.</p>
<p>Kagan (1995) points out several contextual considerations for the acquisition of a second
language. He asserts that this will happen as long as the context is &ldquo;supportive/motivating,
communicative/referential, developmentally appropriate, and feedback rich&rdquo; (p. 3).
Cooperative work is usually about the <i>here</i> and <i>now</i>, so group members are constantly
reminded of the purpose and the results of their efforts. In other words, the cooperative
learning work is about &ldquo;delivering the goods.&rdquo; Students tend to have a much safer
environment for their participation as part of small groups rather than with the whole class.</p>
<p>Besides Kagan&rsquo;s (1995) discussion of theories of second language acquisition and
cooperative learning, it is worth looking at the perspectives on teaching learners with diverse
abilities. Differentiation is the deliberate effort of teachers to tailor their teaching according to
their students&rsquo; needs. Thus, differentiated instruction conceptualizes learners as they are and
offers them possibilities to work their way forward (Gregory & Chapman, 2007).</p>
<p>Gregory and Chapman (2007) state that differentiation instruction happens &ldquo;at the
level of content, assessment tools, performance tasks, and instructional strategies&rdquo; (p. 3).
There are several aspects regarding the differentiation of content which can occur by
leveling materials, by providing a variety of these materials, and by providing students
with choices. The differentiation of assessment tools has to do with the continuous
assessment of students&rsquo; progress that may even begin with the establishment of students&rsquo;
prior knowledge of the content intended to be studied. Regarding performance tasks,
differentiation includes a variety of activities students may use to evidence their learning.
Finally, differentiating instructional strategies aim to include students&rsquo; learning styles and
interests; sometimes an inventory of these styles may occur prior to or early in the
beginning of a particular course.</p>
<p>One of the most important insights from differentiated instruction at the level of
instructional strategies is the purposeful use of cooperative learning. Gregory and Chapman
(2007) argue that differentiated instruction &ldquo;accommodates academic diversity and
heterogeneous grouping&rdquo; (p. 87), which means that students with diverse abilities can be
productive when they are part of flexible group dynamics in the classroom.</p>
<p><font size="3" color="#666"><b>Research Design</b></font></p>
<p>This is an action-research study whose main purpose is to plan and implement changes in
a particular teaching/learning context to improve practice and provide understanding for its
stakeholders. The researchers decided to develop their classroom intervention with the
following research questions in mind:</p>
<ul>
<li>How do language-building activities influence students&rsquo; class participation in a
Manual Therapy class for ESL learners?</li>
<li>To what extent do changes in teacher/student interaction (individual, pair, and group
work) patterns promote class participation in an ESL course in Manual Therapy?</li>
</ul>
<p>The researchers determined that their sources for data collection were the manual therapy
professor&rsquo;s actions in terms of her lesson plans (Freeman, 1998). The professor&rsquo;s thoughts
also played an important part as a source of data since she was always in touch with the
students not only throughout class encounters but also through periodical teacher-student
extra class tutoring sessions. The specific instrument to account for the professor&rsquo;s thoughts
was her anecdotal records.</p>
<p>The research design also considered students&rsquo; actions as they engaged in various class
activities geared towards their class participation and content learning. The researchers used
sociograms to record changes in students&rsquo; participation based upon three specific class
moments of interaction, namely, individual, pair, and group work. Finally, students provided
the researchers with their own feedback on their class participation through some feedback
cards they filled out and gave to the manual therapy professor at the end of each session.</p>
<p><font size="3"><b><i>Research Participants and Class Format</i></b></font></p>
<p>The Manual Therapy Introductory Course is an eight-class seminar (16 hours total) with a
group of 24 students, 22 women and two men. This group had a different range of abilities and
interests which were manifested when they took an initial language inventory survey. Students
were asked about their preferences regarding their own learning as well as their perception on
their language abilities in English. The purpose of the survey was to get an idea of the learners&rsquo;
strengths and weaknesses as well as their learning styles. The information gathered through this
questionnaire supported the class design per session and the general lesson plan for the entire
course; a variety of activities were introduced in different lessons according to what students
had responded their preferences were regarding their ways to learn.</p>
<p>A number of students (10) reported they preferred kinesthetic learning strategies (role
play, simple skit, or dramatization) or auditory strategies (6) such as interviews, audiotapes,
speeches, debates, and group discussions. Very few reported their preference for either visual
(3) or written type of learning (2), and the remaining students (3) reported no preference at all
by showing very mixed results.</p>
<p>In regard to class work, 18 students reported that they liked working either individually, or
in pairs or groups; only two reported that they preferred working in groups, and four reported
their preference for individual work. Another result observed from this survey was their
perception towards their performance in English: They felt they were good but they were shy
or feared their peers&rsquo; reaction if a mistake was made, or they had some trouble while speaking
or limited capacity to respond to challenges due to their lack of vocabulary.</p>
<p>This Manual Therapy Introductory Course takes into account one introductory lesson,
five main lesson topics, one case study built-up and feedback class, and one final written
evaluation session. The class sessions lasted two hours and were divided into two halves. In
the first half of each session, students developed some language-building activities so that
they had exposure to the language input required to learn the content. They also needed to
experience this language input in communicative contexts that resembled actual professional
practices; some of this input included language functions such as asking and writing
questions, giving instructions, or following directions. In the second half, students worked on
a variety of group configurations so that this language input was both redundant and
recyclable throughout the lesson.</p>
<p><a href="#tab1">Table 1</a> illustrates the lesson plan designed by the professor in manual therapy for each
one of the five sessions of the course. It includes the topics, the content, and the
language-building activity. The choice of activities was based on the students&rsquo; learning styles
and preferences as they stated in the survey. For example, some claimed to prefer auditory
rather than visual activities; others felt that they learned best by doing something instead of
being told how to do it.</p>
<p align="center"><a name="tab1"><img src="img/revistas/how/v21n1/v21n1a06t01.jpg"></a></p>
<p>An external observation of each class was conducted by the English professor whose role
during the course sessions was to watch students&rsquo; language interaction patterns in terms of
individual, pair, and group work. These observations and the dynamics that resulted in the
patterns of students&rsquo; interactions were illustrated through some class sociograms.
Additionally, the manual therapy professor had an anecdotal record that she considered
important for the purposes of the research questions in the study. For example, she wrote
about students&rsquo; attempts to communicate despite their language proficiency; she also wrote
about students&rsquo; personal class notes or students&rsquo; responses whenever she felt they were not
prepared for the class or the activities. The manual therapy professor asked students to fill out
a feedback card at the end of each session. Students had to register three aspects of the class
contents: First, they had to write what they had learned in the session. Next, they had to write
three key words for the day. Finally, they had to give themselves a grade on their participation
in three class moments namely individual, pair, and group work.</p>
<p><font size="3" color="#666"><b>Results</b></font></p>
<p>The above description of the research activities that intended to explore the levels of
student participation in a course of Manual Therapy (with ESL mixed ability students at
Universidad del Rosario in Colombia) provided us with some evidence to articulate some
findings which we want to discuss keeping in mind the three research questions of the study.</p>
<p><font size="3"><b><i>How Do Language-Building Activities Influence Students&rsquo; Class Participation in
a Manual Therapy Class for ESL Learners?</i></b></font></p>
<p>In the first two lessons we found that students established the existence of some
vocabulary and language patterns on technical aspects of Manual Therapy that helped them
produce oral language in order to participate in the class activities. In the first session, students became aware of general language patterns to describe both concepts and models in
Manual Therapy. For example, students were encouraged to describe these models by saying:
&ldquo;The ____ model ___ talks about____,&rdquo; or &ldquo;The key aspects of the ____ model are and they
can be related to ____.&rdquo; Similarly, in the second session, the language-building activities were
carried out around the formulation of questions when interviewing a patient. The manual
therapy professor made sure students structured their questions properly by insisting on their
avoiding translations. Two of these questions were: &ldquo;What is the reason for your
consultation? &ldquo;How many years do you have?&rdquo; Instead, they were guided to produce more
appropriate questions such as: &ldquo;How may I help you today?&rdquo; &ldquo;How old are you?&rdquo;</p>
<p>In the third session, students performed role-plays of therapist/patient interviews which
resembled the real exchanges of therapists in their practice. Thus, the communication
situation matched the content of the professional service sought by patients on a daily basis. It
is worth mentioning that at this point, students were concerned about how to ask proper
questions that helped them gather valuable data to establish the patients&rsquo; health conditions.</p>
<p>In the next session, students continued with the role-plays of the therapist/patient
interaction. This time, however, the language use was aimed at getting students to display
their reasoning skills by identifying a sequence of movements and questions to establish the
physical manual therapy diagnosis. Once again, we can say that the language use was far
beyond the manipulation of linguistic forms since what really mattered for students was to
complete the task at hand; in the first place, it was to conduct an interview and in the second,
to establish the physical condition of a patient based on the use of commands and
instructions.</p>
<p>The last session helped students correlate the patient&rsquo;s evaluation outcome to a simple
muscle chain analysis by using language patterns and new technical vocabulary.
Consequently, the use of English was naturally promoted in contexts where these language
patterns and vocabulary were relevant. Thus, we argue that language learning is the outcome
of its own practice in communicative contexts.</p>
<p>When introducing this action research plan and differentiated students strategies to class,
it is evident that working on a previous language-building activity improves the level of
participation of students. On the completion of the feedback cards, we can observe how
students grade their work better as each session goes by. We can also observe a better use of
English structure to communicate their ideas either to the professor or to classmates.</p>
<p>One interesting case that the manual therapy professor considers worth pointing out in
order to show how this language-building activity influenced participation is the following:</p>
<blockquote>At the beginning of my very first session, one student approached me with a great concern of her
future work in class because in her mind she considered herself very poorly suited for the language
abilities required to perform in class. Her concern was not related to class contents but how to communicate her ideas and show that she could develop the skills for the successful completion of
the course. She actually stated, in a quiet energetic way I must say, that she would not talk in class or
write in English and if so she would only do it in a private moment to myself. Her first session
turned out to be not as traumatic as she first thought according to my interview at the end of the
class. (Anecdotal Record 1)</blockquote>
<p>Two samples of this specific student&rsquo;s work are presented below. Her comments on the
feedback card were written in Spanish. However, by the end of the second session and for the
rest of the course, she participated with some written ideas in English which accounted for
her learning. <a href="#fig1">Figure 1</a> shows the student&rsquo;s attempt to work in both Spanish and English as she
wrote down some of the key concepts they worked in the class session. In this card, the
student seems to feel more at ease with key concepts in English.</p>
<p align="center"><a name="fig1"><img src="img/revistas/how/v21n1/v21n1a06f01.jpg"></a></p>
<p><a href="#fig2">Figure 2</a> is a display of the student&rsquo;s attempt to pin down some key concepts, but this time
she formulated her ideas entirely in English. This activity gained in complexity since students
were integrating new concepts as the course progressed. As a result, they ended up writing
complex sentences.</p>
<p align="center"><a name="fig2"><img src="img/revistas/how/v21n1/v21n1a06f02.jpg"></a></p>
<p><font size="3"><b><i>To What Extent Do Changes in Teacher/Student Interaction (individual, pair,
and group work) Patterns Promote Class Participation in an ESL Course in Manual
Therapy?</i></b></font></p>
<p>The answer to this question is based on the visual depictions and the researchers&rsquo;
reflections on the sociograms activity flow which were drawn in three moments of class, namely, individual, pair, and group work. Due to the scope of the present article, we provide
evidence only for the students&rsquo; individual and pair work activities.</p>
<p><a href="#fig3">Figure 3</a> shows that in Session 1 of the course students still felt they were part of the
traditional teacher/student individual interaction around questions and answers from
previously assigned class readings. <a href="#fig3">Figure 3</a> also shows that in these initial stages students
were more reliant on Spanish except for those who could express their ideas in English.
Nevertheless, the professor encouraged students to contribute by reading their ideas in
English despite problems in either grammar or pronunciation.</p>
<p align="center"><a name="fig3"><img src="img/revistas/how/v21n1/v21n1a06f03.jpg"></a></p>
<p>As the course developed, the sociograms began to display how students made the
transition from the traditional roles they had had in class to a more participatory environment
where they had to be concerned about their interactions with their peers (patients) in terms of
activities they would normally carry out in their practice.</p>
<p>The individual work in Session 4 displayed, for instance, that there were more
students participating only in English. We consider that this participation had to do with
the fact that students were already familiar with the questions they had to ask their
patients and because they had already reviewed their formulation in English.
Furthermore, students were particularly interested in the relevance of their questions
since they needed to respond to categories such as personal information, general data,
regional vertebral, and obligatory information. This particular aspect is worth considering
since the course aimed at developing both language and reasoning skills related to the
therapists&rsquo; professional practice.</p>
<p>A more uniform pattern of interaction appeared in Session 4. However, this time there
was a more consistent use of English which did not depend exclusively on the professor&rsquo;s
input. We can also notice that some students helped the professor keep the flow of English in
class despite the fact that some students still interacted in Spanish. Nevertheless, students
remained on task for the most part of the session. In fact, they all demonstrated their interest
in figuring out the most appropriate ways to formulate their ideas about manual therapy
models in terms of both content and language. <a href="#fig4">Figure 4</a> shows the variations in pair work
interaction in Session 1 and later in the course in Session 4.</p>
<p align="center"><a name="fig4"><img src="img/revistas/how/v21n1/v21n1a06f04.jpg"></a></p>
<p>Finally, Session 4 showed that the patterns of interaction were bilingual. Some students
brought some materials such as dictionaries and English textbooks so that they could prepare
their role-plays based on different tests on manual therapy. We consider that students
brought resources since the task at hand demanded from them to be able to ask specific
questions that would give relevant information of both the patients&rsquo; personal and physical
state. We also noticed that students kept working in both languages since they still needed to
fully grasp some of the technical vocabulary for the assignment.</p>
<p>We think it is very important to emphasize that students started to assume that English
was natural to what they were doing in class. Even though some of them were still concerned
about some language issues such as question formulation, they were more concerned about
collecting the necessary information regarding their patients&rsquo; health condition.</p>
<p>With regard to the class patterns of interaction, namely, individual, pair, and group work,
the sociograms showed how the level of teacher/student interaction and student/student
interaction in English gradually increased. We think the fact that students were constantly
exposed to the language input helped them assume both the class dynamics and the linguistic
exchanges around interviews.</p>
<p>From most of the feedback cards gathered in this particular 24-student course, we can
see that they graded the partner and group work better, and as professors we believe this
trend is related to an increased self-confidence developed after five sessions and because
students realized the role they needed to play in the class in order to build up their
knowledge and participation. Also, they realized they could promote their language skills
when sharing their ideas and work with peers who had the same concerns with their second
language skills.</p>
<p><font size="3" color="#666"><b>Limitations</b></font></p>
<p>Even though the action research study was for the most part oriented towards working
with mixed-ability ESL learners, the university needs to consider some language courses that
address the specific language needs of the students in the therapy programs in the early stages
of their formation. This will allow them to be more prepared to face the demands of more
advance courses later in their curriculum.</p>
<p>It is very difficult to help students advance in their learning both linguistically and
academically in courses whose durations are too short. This limitation echoed some of the
concerns of faculty in similar contexts as we pointed out earlier in the literature review. We
feel that students require longer courses so that they can receive a greater exposure to the
language and content of the courses.</p>
<p><font size="3" color="#666"><b>Conclusions</b></font></p>
<p>This action research project with a mixed-ability group of ESL learners in the Therapy
Program at Universidad del Rosario shows that it is possible to have a course with students of
different language abilities and still cater to both their linguistic and cognitive needs regarding
their area of studies. However, university professors involved in such a project must pay
special attention to the language needs students have in order to cope with the demands of a
course. Moreover, professors who are interested in using English as a medium of instruction
need to redefine and/or adjust their teaching styles so that students meet their demands both
cognitively and linguistically. It is important for these professors to acknowledge the fact that
students working in a second/foreign language have challenges that they would not normally
face when studying in their first language.</p>
<p>The critical event that motivated this study had to do with the manual therapy professor&rsquo;s
concerns regarding her students&rsquo; class participation and interaction in previous manual
therapy courses taught in English. In this regard, the study shows that class participation and
interaction can be built up if professors plan their courses, taking into consideration the
language demands that their content poses on students and deliberately developing activities
to meet such demands in terms of both content and language.</p>
<p>Professors working with mixed-ability language students also need to pay special
attention to their class dynamics since it is fundamental to guarantee some fair level of
participation for all the parties involved&mdash;namely, the range of students&rsquo; language abilities
from basic to advance. Besides that, giving students different opportunities to work with the
language input in a variety of class configurations from individual to pair and group work
increases the level of class participation.</p>
<p>It is also the professor&rsquo;s responsibility to make the match between the language and
content activities so that students feel that they have to master the language component that is
required in order to understand and learn the class contents. It could be a matter of isolating
the language functions and forms students would certainly need to communicate successfully
in particular contexts.</p>
<p>It is worth highlighting that this research process helped students to realize that they did
not need to have advanced oral abilities in English to be able to participate in the course;
however, they needed to understand that there were specific language functions and forms
required to conduct professional interviews and patients&rsquo; evaluations. This is perhaps one of
the most interesting findings of the present study; the content professor matched both the
language and content required for students to advance in their clinical reasoning skills that
were fundamental for their professional performance.</p>
<p>This research also demonstrated that the concept of class participation may take a variety
of forms which gave the class members opportunities to participate flexibly, that is, students
could answer the professor&rsquo;s questions, make comments, and even reflect on their own
language mistakes. All of these communicative exchanges do reflect class participation.</p>
<p>Students&rsquo; class participation and learning were increased by providing them languagebuilding
activities and varieties of formats for classroom interaction that ranged from
individual, pair, and group work.</p>
<hr>
<p><font size="3" color="#666"><b>References</b></font></p>
<p>Andrade, M. S. (2010). Increasing accountability: Faculty perspectives on the English language
competence of nonnative English speakers. <i>Journal of Studies in International Education, 14</i>(3),
221-239. <a href="http://dx.doi.org/10.1177/1028315308331295" target="_blank">http://dx.doi.org/10.1177/1028315308331295</a>.</p>
<p>Bean, J. C., & Peterson, D. (1998). Grading classroom participation. <i>New Directions for Teaching and
Learning, 74</i>(1), 33-40. <a href="http://dx.doi.org/10.1002/tl.7403" target="_blank">http://dx.doi.org/10.1002/tl.7403</a>.</p>
<p>Freeman, D. (1998). <i>Doing teacher research: From inquiry to understanding</i>. New York, NY: Heinle &
Heinle Publishers.</p>
<p>Gregory, G. H., & Chapman, C. M. (2007). <i>Differentiated instructional strategies: One size doesn&rsquo;t fit all</i>.
Thousand Oaks, CA: Corwin Press.</p>
<p>Hendrick, P., Bond, C., Duncan, E., & Hale, L. (2009). Clinical reasoning in musculoskeletal
practice: Students&rsquo; conceptualizations. <i>Physical Therapy, 89</i>(5), 430-442. <a href="http://dx.doi.org/10.2522/ptj.20080150" target="_blank">http://dx.doi.org/10.2522/ptj.20080150</a>.</p>
<p>Kagan, S. (1995). We can talk: Cooperative learning in the elementary ESL classroom. <i>CAL Digest</i>.
Retrieved from <a href="http://www.cal.org/resources/digest/kagan001.html" target="_blank">http://www.cal.org/resources/digest/kagan001.html</a>.</p>
<p>Krashen, S. D. (1982). <i>Principles and practices in second language acquisition</i>. Oxford, UK: Pergamon.</p>
<p>Liu, J. Y., Chang, Y. J., Yang, F. Y., & Sun, Y. C. (2011). Is what I need what I want?
Reconceptualising college students&rsquo; needs in English courses for general and
specific/academic purposes. <i>Journal of English for Academic Purposes, 10</i>(4), 271-280. <a href="http://dx.doi.org/10.1016/j.jeap.2011.09.002" target="_blank">http://dx.doi.org/10.1016/j.jeap.2011.09.002</a>.</p>
<p>Swain, M. (1985). Communicative competence: Some roles of comprehensible input in its
development. In S. M. Gass & C. G. Madden (Eds.), <i>Input in second language acquisition</i> (pp.
235-253). Rowley, MA: Newbury House.</p>
<p>Universidad del Rosario, School of Medicine and Health Sciences. (2011). <i>Working papers on academic
mobility</i>. Bogot&aacute;, CO: Author.</p>
<hr>
<p><font size="3" color="#666"><b>The Authors</b></font></p>
<p><b>H&eacute;ctor Manuel Serna Dimas</b>, PhD, is the research group director in Linguistics,
Translation, and Organizational Communication in the School of Humanities and
Social Sciences at Universidad EAN, Colombia.</p>
<p><b>Erika Ru&iacute;z Castellanos</b>, P.T., is a faculty member in the Rehabilitation Programs in
the School of Medicine and Health Sciences at Universidad del Rosario, Colombia.</p>
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