Developing academic writing skills through a genre-based...

Pontificia Universidad Católica de Valparaíso

Facultad de Filosofía y Educación

Instituto de Literatura y Ciencias del Lenguaje

Developing academic writing skills through a genre-based approach in a blended

learning environment: an elective course for medical students.

TRABAJO DE TITULACIÓN

para optar al título de Profesor de Inglés

y al grado de Licenciado en Educación.

Tesis enmarcada en el proyecto FONDECYT 11130469

Alumna: Romina Jara Marambio

Profesor Guía: Mónica S. Cárdenas-Claros

Co-Director: Walter Koza

Segundo Semestre

2015

2

Acknowledgments

To my teacher for his patience and guidance,

and to my family for supporting me in every challenge I have taken.

Despite the role that academic writing plays in learners' fu

in science disciplines, it is a subject poorly addressed in Chilean higher education. Students

in medical school do not receive enough instruction that would allow them to produce

effective text in their fields of study.

students' academic writing skills in producing a medical case report. In order to achieve this

aim, it is proposed an elective course organized under a genre

students will collaboratively write

Key words: academic writing, genre

writing, blended learning.

Abstract

Despite the role that academic writing plays in learners' future professional life, especially


do not receive enough instruction that would allow them to produce

effective text in their fields of study. This graduation project seeks to develop medical


an elective course organized under a genre-based approach in which

write using a blended learning methodology.

Key words: academic writing, genre-based approach, medical case report, collaborative

3

ture professional life, especially


do not receive enough instruction that would allow them to produce

graduation project seeks to develop medical


based approach in which

medical case report, collaborative

4

Tabla de contenido

Abstract ................................................................................................................................... 3

Tabla de contenido.................................................................................................................. 4

Introduction ............................................................................................................................ 5

Literature Review ................................................................................................................... 7

1. Writing in a second language .......................................................................................... 7

1.1. Academic writing ..................................................................................................... 7

1. 2. Genre-based approach to writing ........................................................................... 8

1.2.1. Genre-based instruction ....................................................................................9

1.2.1.1. Medical Case Report........................................................................ 10

1.3. Collaborative writing.............................................................................................. 11

2. Blended learning .......................................................................................................... 12

2.1. Tools used in blended learning............................................................................... 13

2.1.1. Moodle.............................................................................................................13

2.1.2. Google Docs....................................................................................................14

3. Task-based language learning ....................................................................................... 14

Pedagogical Proposal ............................................................................................................ 16

Syllabus design ................................................................................................................. 16

Course description ............................................................................................................ 16

Course organization .......................................................................................................... 17

General Objective ............................................................................................................. 19

Course Syllabus ................................................................................................................ 19

Assessment ........................................................................................................................ 19

Sample lessons ...................................................................................................................... 20

References ............................................................................................................................ 35

Appendix A: Survey ............................................................................................................. 39

Appendix B: Needs Analysis ................................................................................................ 42

Appendix C: Rubrics ............................................................................................................ 48

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Introduction

English is the international language of research and scholarship and the medium to spread

scientific results (Tardy, 2004). Besides, as Ferguson, Perez-Llantada, and Plo (2011)

claim, it seems likely that English will remain as the dominant international language of

science in the future. The major advantage of English as a lingua franca is that it "is seen as

a tool through which communication can occur in a maximally efficient and effective

manner between people who do not share a common first language. Thus, English courses

must include genres that “the learner has to produce and/or understand” (Dudley-Evans,

2001, p.134) to enter his/her academic or professional community and to share field-

specific “cultural assumptions and practices” (Hyland, 2009).

Ferguson, Perez-Llantada, and Plo claim universities can play an important part in

alleviating linguistic disadvantage by offering contextualized academic writing courses.

However, after a thorough and systematic review of the curriculum descriptions of eleven

institutions that offer medicine programs in our country, the results show that Chilean

educational institutions do not seem to prepare their students well enough to write text in

their specific fields. Most Chilean students in medical school are taught two English

courses that are either common to all programs offered by the institution or focus only on

technical vocabulary and/or reading skills. Some institution additionally offer elective

courses of English but none of them focuses on academic writing. Particularly, Universidad

Católica de Chile, apart from English elective courses, offers courses to pass ALTE

(Association of Language Testers in Europe) tests.

Consequently, the courses available do not meet the needs of a modern medical student that

is inserted in a globalized world and that is actively participating in his or her academic

community. In fact, Chilean students in medical school seem to be interested in publishing

in their field of study, but they just do it in their mother tongue which reduce their

possibilities of spreading their work. The Asociación Nacional Científica de Estudiantes de

Medicina de Chile (ANACEM), an organisation that includes mayor academic institutions

offering medicine in Chile, publishes a three-times-a-year indexed journal where students

share original articles and reports on medical topics. Besides, there are four other

independent indexed journals from individual universities.

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Based on the evidence, an appropriate approach to tackle English as a second language in

this academic context is a genre-based approach because it sees "writing as purposeful,

socially situated responses to particular contexts and communities" (Hyland, 2003b, p.17).

The genre-based approach has been widely implemented and favourable results have been

obtained and, for the same reason, there are a variety of international studies that provide

evidence of its success. For instance, a study based on an English for engineering course

that used a genre-based approached revealed that "the writing ability of students improved

after the experiment. As for student's attitudes, the findings showed that the students were

satisfied with the teaching method, activities, and exercises. More importantly, they felt

more confident in writing" (Piyatida, 2013, p.735). Nonetheless, there is little evidence on

the use of a based-genre approach to teach medical genres such as the Medical Case Report

that is one of the most published texts in scientific journals worldwide.

Consequently, this graduation project aligns with a genre-based approach and seeks to

develop medical students' academic writing skills in producing a medical case report

through an elective course centred on a blended learning methodology and a syllabus

designed based on tasked-based language learning. Blended learning methodologies have

been integrated as a response to time constrains as well as to facilitate different types of

interactions and personalized feedback. It would be observable at the lesson level in

activities that will involve class work and subsequent online work and at the syllabus level

in units that will required different degrees of face-to-face or online interaction depending

on level of independency required. The project is addressed to a group of 20 students with

an intermediate level of English.

The project is organized into two main sections: the theoretical framework and the

pedagogical proposal. The first section reviews the concept of writing in English as a

Second Language as well as Academic Writing. It also introduces the notions of

collaborative writing and the approach in which writing will be taught. In addition, it

briefly describes blended learning and tasked- based language learning. The second section

puts into practice all the theory obtained for the development of the project. The

pedagogical proposal contains the syllabus design and some sample lessons. It also offers

suggestions for evaluating the course.

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Literature Review

This literary review presents an overview of the three elements that will be used in the

development of the pedagogical proposal. The first part reviews the concept of writing in

English as a Second Language (ESL) as well as Academic Writing. It also introduces the

notions of collaborative writing and the approach in which writing will be taught. The

second part focuses on blended learning. Finally, the last part describes task-based language

learning.

1. Writing in a second language

According to Hammer to Harmer (2001) writing is a form of communication to deliver

through written form. Writing involves series of activities going on and involve several

phases. Writing is considered a very demanding activity, with many skills and sub-skills

behind it (Mazandarani, 2010). To develop those skills, the learner will need time to think,

reflect, prepare, make mistakes, evaluate and find solutions (Kotlyarova, 2013). Thus, it is

time consuming and it is usually the last skill acquired by the learner because it implies

complex mental processes (Ferguson, 2007).

Moreover, according to Hyland (2003a) writing in a second language goes beyond learning

a set of rules, acquiring some cognitive abilities or having the chance to compose and

revise. It also implies a clear understanding that "every act of writing is in a sense both

personal and individual, it is also interactional and social, expressing a culturally

recognized purpose, reflecting a particular kind of relationship, and acknowledging and

engagement in a given community" (p. 27).

1.1. Academic writing

According to Strongman (2013), while writing is about communicating with words,

academic writing is about choosing words carefully to communicate complex ideas to a

variety of readers and audiences. Academic writing requires learners to develop "the ability

to integrate a wide range of different types of knowledge in order to create extended written

discourse that is both linguistically accurate and socially appropriate" (Bruce, 2008, p.5).

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Particularly, academic writing is essential for publications worldwide because it focuses on

objective evidence and follows a logical structure, consequently, it is highly valuable in

scientific contexts (Lillis, T., & Curry, M., 2010). Furthermore, along with the great

expansion of the international use of English, there has been an exponential growth in

Academic Writing instruction. Second Language learners from different academic

disciplines are taught to write specific texts with clear purposes and well defined target

audiences (Flowerdew, 2014).

1. 2. Genre-based approach to writing

The Genre-based approach (GBA) starts as a response to a framework that highlights a

process of planning-writing-reviewing. This framework focuses on strategies for writing

rather than on the linguistic resources that learners need to express themselves effectively

in a foreign language (Hyland, 2003b).

According to Hyland (2007), this approach emphasises that:

Genres are specific to particular cultures, reminding us that our students may not

share this knowledge with us and urging us to go beyond syntactic structures,

vocabulary and composing to incorporate into our teaching the ways language is

used in specific contexts. It assists students to exploit the expressive potential of

society's discourse structures instead of merely being manipulated by them. (p.150)

The genre-based approach has been widely implemented and promising results have been

obtained. There are a variety of international studies that provide evidence of its success.

One study involving three writing initiatives carried out at King’s College London UK

showed that a GBA "is the best starting point for teaching and learning of academic

writing, and that students will be more willing to take a critical perspective when they are

able to understand and control disciplinary discourses" (Wingate, 2012, p.26).

A second study, based on a course focused on teaching to write a summary, showed that

the approach "was effective in improving students’ overall summarization performance of a

narrative source text and that the students benefited to a greater extent in content and

organization" (Chen & Su, 2012, p.184).

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Hyland (2007) summarizes the main advantage of GBA as follows:

Explicit - Makes clear what is to be learnt to facilitate the acquisition of writing skills;

Systematic - Provides a coherent framework for focusing on both language and contexts;

Needs-based - Ensures that course objectives and content are derived from students' needs;

Supportive - Gives teachers a central role in scaffolding students' learning and creativity;

Empowering - Provides access to the patterns and possibilities of variation in valued texts;

Critical - Provides the resources for students to understand and challenge valued

discourses;

Consciousness-raising - Increases teachers' awareness of texts to confidently advise

students on writing. (p.150).

1.2.1. Genre-based instruction

Genre-based instruction is based on four key principles that should be reflected in syllabus

goals and teaching methodologies. Those principles are: (i) writing and learning to write is

a social activity, (ii) learning to write is needs-oriented, (iii) learning to write requires

explicit outcomes and expectations, and (iv) learning to write involves learning to use

language (Hyland, 2003b).

According to Hyland (2007), genre-based instruction sequencing does not have a fix

structure to be followed. Many possibilities are proposed and can be adapted according to

the necessities of the learner. Among these possibilities the most important ones are: to

determine the most critical skills or functions relevant to students' immediate needs; to

follow the sequence of a genre set in a real world series of interactions; and to grade genres

by perceiving increasing levels of difficulty.

Furthermore, genre-based instruction gives importance to peer interaction or collaboration

and teacher-supported learning or scaffolding. Scaffolding is supposed to follow a sequence

based on a methodological model represented by the teaching-learning cycle.

The teaching learning cycle consist of five stages: 1. Building the context: study of genre

purpose and the settings where is usually found; 2. Modelling and deconstructing the text:

analysis of representative samples to identify key features and variations; 3. Join

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construction of the text: guided practice through tasks that focus on particular stages or

functions of the text; 4. Independent construction of the text: autonomous writing

monitored by the teacher; and 5. Linking related texts: connection between what has been

learnt to other genres and contexts to understand how genres are designed to achieve

particular social purposes (Feez as cited in Hyland 2007).

The cycle stages described above will be the basis for the syllabus' organization in the

pedagogical proposal. Units will be structured following a logical sequence that will

emphasis different stages depending on writing progress. However, it is important to

acknowledge that the cycle is intended to be used flexibly in order to allow students to enter

at any stage depending on their existing knowledge of the genre and to enable teachers to

return to earlier stages of the cycle for revision purposes (Hyland, 2007).

1.2.1.1. Medical Case Report

Genres in medicine are extremely important. They allow effective communication among

medical communities. The most important ones are the Research Article and the Clinical

Case Report. Particularly, Medical Case Reports represent a relevant, timely, and important

study design in advancing medical scientific knowledge (Vihla, 1999).

In medicine, the Medical Case Report (MCR) is a scientific genre used by doctors or

medical practitioners to describe unusual cases worth reporting for being atypical. More

specifically, the MCR deals with a clinical condition and its care (Aitken & Marshall,

2007).

The Medical Case Reports are valuable for students and doctors. Mostly, they can serve as

early warning signals of adverse effects in therapies (Kidd & Hubbard, 2007); they can

provide “detailed accounts” of “what can go wrong” (Mason, 2001) in medical practice or

they can offer a description of pioneering experimental techniques.

Medical Case Reports have an educational and communicative purpose. Generally, they do

not exceed 1500 to 2000 words. They can contain a few figures, including; radiographs,

ultrasound scans or photographs; and some charts. Besides, they are usually written by four

o more authors (Aitken & Marshall, 2007).

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The Medical Case Report format resembles the research article (see Swales 2004) as it

consists of the following sections: abstract, introduction, case description, discussion and

conclusion. According to Aitken and Marshall (2007) the main characteristics of a Medical

Case Report can be summarize as it is shown in the following chart:

There are a few research articles on linguistics that analyzed the genre but there is not much

evidence of studies that show the use of a based-genre approach to teach Medical Case

Report in academic writing.

1.3. Collaborative writing

Collaborative writing could be considered a text written by more than one individual, but

collaboration implies more; frequently, the writer builds his work in response to feedback

that can come from peers or from the teacher in a school setting. They can learn from each

other through the editing process until they get the final product. Thus, collaborative

writing is about communal work and shared responsibilities (Speck, 1999).

According to Smith and MacGregor (2009) learning is shifting from "passive reception" to

"active creation". Students tend to be more responsible of their contributions and to think

ABSTRACT Brief overview: why the case is important, case details, clinical

impact on literature. It should stand alone and attract perspective

readers’ attention.

INTRODUCTION Setting the scene: general overview of the condition (disorders,

relevant clinical signs to introduce the case), brief review of

literature to contextualize the case.

CASE

PRESENTATION

Description: relevant background info (health history, family

history, current problems, disorders, clinical signs relevant to

contextualize the case, care details: tests, drugs).

DISCUSSION &

CONCLUSION

Commentary: put the case in context to explain results and medical

decisions, recommend future care based on present results, state the

educational message.

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critically about related issues when they work as a team. The collaboration process

enhances students’ learning and develops their social skills like decision-making, conflict

management, and communication.

Collaborative writing brings in a new dimension of social interaction. "Not only do

collaborating writers have differing strategies for writing that need to be reconciled, but

they also form a social group, with its own personality and dynamic" (Sharples, 2012,

p.28). In addition, the outcome of a collective writing activity is not only "the jointly

produced text, it is also collective cognition, emerging when two or more people reach

insights that neither could have reached alone" (Stahl as cited in Storch, 2013, p.2).

Pruitt (2012) suggest six steps to success in collaborative writing: (i) identify the unique

pieces of the project, (ii) Identify everyone’s strengths and specialties and take advantage of

them, (iii) agree on a project schedule and benchmarks for completion along the way, (iv)

assign a project coordinator, (v) assign a final editor, and (vi) disseminate the final draft to

all involved for review and feedback.

2. Blended learning

"Blended learning (BL) is the thoughtful integration of classroom face-to-face learning

experiences with online learning experiences" (Garrison & Kanuka, 2004, p.96). BL

implies blended courses and programs in which online and face-to-face modalities are not

easily distinguishable (Picciano, Dziuban, & Conclusion is not present, 2014).

It is claimed by Bonk and Graham (2012) that BL promotes "improvements in the rate of

learning, as well as the efficiency of training, maximizing corporate investments in reusable

training materials, and, of course attempts to save on training time" (p.16). Furthermore, it

facilitates different types of interaction; learner-instructor, learner-content, learner-learner,

where the student can be independent of space and time but still connected with class

members and where the teacher can provide personalized and extended feedback (Garrison

& Kanuka, 2004).

Based on Garrison and Vaughan (2008) a key element for Blended Learning to work

successfully is group cohesion. Sustained discourse and collaborative activities are

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excellent tools to build it and maintain it. Moreover, distribution of tasks and activities is

particularly important. For instance, "Face-to-face classroom environment may be good

context to introduce a topic and focus interest. However, students must have extended

opportunities to construct meaning and confirm understanding; this is often best done

online" (Garrison and Vaughan, 2008, p.93).

2.1. Tools used in blended learning

Nowadays, there are many online tools that can be used with pedagogical purposes.

"Online programs offer flexibility to students and to professors, increasing opportunities for

learners to experience classroom observations and practice teaching" (Williamson, Mears,

& Bustos, 2015, p.138). Furthermore, "when tasks are asked for interaction with partners,

language production is increased in asynchronous environments" (Thomas, 2010, p.31)

2.1.1 Moodle

Cole (2005) defines Moodle as an open source course system that universities, community

colleges, businesses, and even individual instructors use to add web technology to their

courses. More than 30,000 educational organizations around the world currently use

Moodle to deliver online courses and to support traditional face-to-face courses. Moodle is

available for free on the Web so anyone can download and install it. At the most basic it

give educators tools to create a course web site and provide access control so only enrolled

student can view it. Also, Cole (2005) states that Moodle provides different academic tools,

such as: "an easy way to upload material and share material, hold online discussions and

chats, give quizzes and surveys, gather and review assignments, and record grades" (p.1).

A study based on an online academic writing course showed that Moodle encourages

teamwork and helps developing the skills to write scientific articles (Sánchez et al, 2012).

Another study revealed that "by implementing Moodle’s technologies into an L2

composition course, participants benefit in the areas of organization, implementation,

distribution, communication and assessment" (Robertson, 2008 p.58).

2.1.2 Google Docs

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Google Docs is an application that allows access from any computer and eases the ability to

collaborate by sharing a document with others as viewers or collaborators, or by publishing

it on the web (Conner, 2008). Google Docs supports synchronous editing and comment

writing, and saves versions of the document, options that afford real-time collaborative

learning. "Similar to Wikis, Google Docs enables collaboration by editing a document

written by other students, and by suggesting modifications through comment writing,

without editing the document itself " (Blau & Caspi, 2009, p. 49).

A study based on collaborative writing, suggests that Google Docs is an excellent platform

for collaboration on document creation. "The interface is usable, effective, and efficient. In

addition, setting up collaboration with colleagues proved to be exceedingly simple"

(Dekeyser & Watson (2006). Another study on collaborative writing suggests Google Docs

is "well-suited as a tool for out-of-class collaborative assignments" (Zhou, Simpson, &

Domizi, 2012, p.366). The same study showed enriched learning experiences compared to

the assignment without Google Docs. Also, students reported to be interested in using

Google Docs for future assignments (Zhou, Simpson, & Domizi, 2012).

3. Task-based language learning

Task-based language learning centers around task completion. A task is a plan for learner

activity. The plan takes form of teaching materials or activities and has a clearly define

communicative outcome. It focuses on meaning and engages cognitive processes (Ellis,

2003). "The aim of the task is to create a real purpose for language use and provide a

natural context for language study" (Willis, 1996, p. 10)

In a TBLL context, target language exposure should be presented in a naturally occurring

context. Material are selected and adapted from authentic sources, they are not prepared

especially for the lesson. Therefore, task-based learning requires that learners

independently interpret and analyse language, and that they experiment with their prior

knowledge in order to fully exploit the different activities they face (Willis and Willis,

2009).

According to Robinson (2011), tasks provide opportunities for obtaining feedback by a

partner or a teacher, and for noticing the gap between a participant’s production and input

15

provided, as well as, for metalinguistic reflection on the form of output. Also, Robinson

(2011) states that "task demands can focus attention on specific concepts required for

expression in the second language (L2) and prompt effort to grammaticize them in ways

that the L2 formally encodes them, with consequences for improvements in accuracy of

production" (p.2).

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Pedagogical Proposal

Name of the course: Writing to be read worldwide

Type: Elective course

Target: Medical students (20 participants)

English Level: Intermediate

Duration: 40 hours (45') [Online time required: 20 hours (45')]

Teacher: Romina Jara Marambio

Email address: [email protected]

Syllabus design

This elective course follows a genre-based approach since it is expected that the students

write specific texts needed in their target contexts outside the ESL classroom. The course is

centred in a blended learning methodology that is implemented through a task-based

language learning syllabus design.

The syllabus of the course is based on the results of the needs analysis (appendix A)

conducted to senior students in medical school at Universidad Católica de Chile. The

results of the analysis (appendix B) showed three main aspects to be considered in the

syllabus:

1. Time constrains.

2. Recognition of the structure and conventions of specific texts.

3. Collaborative work and feedback.

Course description

This is an elective workshop designed for senior students in medical school with an

intermediate level of English. This workshop exposes students to authentic material

regarding medical report cases and includes topics that are relevant for participants.

17

The students are required to work collaboratively in the process of writing, mimicking real

life interactions inside the classroom and through two online platforms: Moodle and

Google Docs. Students will have to virtual interact in the process of writing itself by

editing, commenting and composing. Also, they will have to virtually interact through

forums, by building common glossaries, by sharing material and experiences and by giving

feedback.

Course organization

The course is structured in 5 units following the stages proposed by the genre-based

approach (building the context; modelling and deconstructing the text: join construction of

the text; independent construction of the text and linking related texts).

Unit 1 works as an introduction, presenting different medical texts and describing

specifically a medical case report. Students get familiar with the structure and

characteristics of the genre covered during the course. [It implies building the context and

deconstructing the text.].

Unit 2 tackles each section of the medical case report more specifically. Students are

divided into groups and assigned a case to work with. They start to write some paragraphs

and to plan their texts together based on the examples given. [It implies deconstructing the

text and join construction of the text.]

Unit 3 promotes collaborative work. Students work hand-in-hand sketching and writing two

different sections of the medical case report. [It implies join construction of the text.]

Unit 4 gives the students the chance to check their progress. Students work applying

knowledge acquired during previous units in the construction of the text. Individual and

group work is required. Most part of the unit will be covered online. [It implies join

construction of the text and independent construction of the text.]

Unit 5 provides the chance to evaluate and assemble the final product as well as to assess

appropriateness according to a given context. Student reflect on their learning process. [It

implies linking related texts.]

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During Unit 1 and Unit 2, online interaction would be mostly reduced to simple follow-up

tasks based on in-class activities as a way to get familiar with the platforms and the

different tools available. More demanding tasks and activities will be increasingly added.

Virtual participation will be strongly guided. Face-to-face meetings will be scheduled twice

a week.

During Unit 3 and Unit 5, online and face-to-face interaction would be evenly distributed.

There will be simple and complex tasks to be completed online. Participation will be both

guided and free. Face-to-face sessions will be scheduled once a week.

Most of Unit 4 will be held online. Interaction in the platforms will be free. However,

active participation is expected (and will be formally assessed). Teacher will constantly

provide personalized and extended feedback through the platforms. Only two face-to-face

lessons will be schedule, one at the beginning and another at the end of the Unit.

19

General Objective

By the end of this course students will be able to collaboratively write a medical case report

through face-to-face and online interaction.

Course Syllabus

Assessment

Final grades will be based on the following percentages:

Self assessment (10%) Each student will assess his/her performance during the course.

Peer assessment (10%) Each student will assess the performance of the members of his/her group during the course.

Group interaction (20%) Online interaction will be weekly supervised (5%). Work Distribution and participation will be assessed in Unit 4 (15%).

Progress reports (20%) Students will have to present two progress reports. The first one at the end of unit 3 and the second one at the end of unit 4.

Final report (40%) Each group will hand over their final work (appendix C).

UNITS OBJECTIVES Unit 1: Exploring a Medical Case Report

• Define main medical academic genres. • Describe the medical case report. • Identify the structure of a medical case report and its general

characteristics. Unit 2: Getting to know an unusual occurrence

• Recognize the specific purpose, structure, grammar and vocabulary of each section involved in a medical case report.

• Write short paragraphs describing signs and symptoms and other medical aspects.

• Relate the case facts assigned with the medical case report sections analyzed

Unit 3: Taking Shape

• Plan the different sections of a medical case report. • Assign roles and independent work among the group. • Compose some sections of a medical case report: case

presentation, discussion and conclusions. Unit 4: Becoming a professional writer

• Revise the progress. • Apply skills used to write previous sections to work on the

introduction, and abstract. Unit 5: Checked and done

• Assemble the medical case report. • Asses audience adaptation. • Compare and evaluate classmates' work.

SYMBOLS

Pl_n[ry

In^ivi^u[l Work P[ir Work

Stu^y /R_m_m\_r

The following sample lessons belong to either the first or the second lesson of the units (Lesson 2 ohttps://demo.moodle.net/user/profile.php?id=3d=23&section=1)The ideal classroom consists of 20 students with an intermediate

level of English.

Group Work P[ir Work

Stu^y /R_m_m\_r

Onlin_ Work

[@t Hom_]

R_fl_]tion

Sample lessons

The following sample lessons belong to either the first or the nd lesson of the units 1, 2, 3 and 5 from the students' book.

of Unit 4 is available online ahttps://demo.moodle.net/user/profile.php?id=3/course/view.php?i

) The ideal classroom consists of 20 students with an intermediate

Onlin_ Work

[In Cl[ ss]

20

Onlin_ Work

[@t Hom_]

The following sample lessons belong to either the first or the book.

at course/view.php?i

The ideal classroom consists of 20 students with an intermediate

Onlin_ Work

[In Cl[ ss]

II. Compare your though

classmate and write the things you

have in common.

_________________________________________

_________________________________________

_________________________________________

_________________________________________

GET READY

I. Answer the following questions:

1. Have you ever written a medical case report? What about a scientific research article?

___________________________________________________________________________

______________________________________________

2. Have you ever had problems distinguishing both of them?

___________________________________________________________________________

___________________________________________

H@NDS ON

IV. Read the text assigned online (Figure 1) and complete the following chart.

Similarities Medical Case Report

Scientific research article

UNIT 1: Exploring [ M_^i][ l C[ s_ R_port

Lesson 2

II. Compare your thoughts with a

classmate and write the things you

have in common.

_________________________________________

_________________________________________

_________________________________________

_________________________________________

I. Answer the following questions:


___________________________________________________________________________

___________________________________________________________________________

2. Have you ever had problems distinguishing both of them?

___________________________________________________________________________

__________________________________________________________________________

IV. Read the text assigned online (Figure 1) and complete the following chart.

Differences

Exploring [ M_^i][ l C[ s_ R_port

III. Share with the

rest of the class

Figure 1

Objectives:

-Describe the

-Identify the structure of a Medical

Case Report

21


___________________________________________________________________________

_____________________________

___________________________________________________________________________

_______________________________

III. Share with the

rest of the class

Figure 1

Describe the Medical Case Report.

Identify the structure of a Medical

V. Come up with a definition of a Medical Case Report

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

_______________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

____ ABSTRACT ____ INTRODUCTION

____ CASE PRESENTATION ____ DISCUSSION AND CONCLUSIONS

TASK 1: a. Choose one mem

[Medical Case Report definition

b. Individually, vote for the best definition. Explain why. (Figure 2)

a.

recomm


b.

It should stand alone and attract perspective readers’ attention.

c.

to introduce the case), brief review of literature to contextualize the

case.

d.

problems, disorders, clinical signs relevant to contextualize the case,

ca

Figure 2

V. Come up with a definition of a Medical Case Report

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

VI. Guess and match each section with its most important

components and/ or characteristics.

____ ABSTRACT ____ INTRODUCTION


Remember!

A definexplanation of the meaning of a

Three Steps to an effective

definition:

1. Tell readers what concept is being defined.

2. Present clear and basic information.

3. Use facts or examples that readers will understand.

TASK 1: a. Choose one member of the group to upload your definition to the corresponding forum

Medical Case Report definition].

b. Individually, vote for the best definition. Explain why. (Figure 2)

a. put the case in context to explain results and medical decisions,

recommend future care based on present results, state the


b. why the case is important, case details, clinical impact on literature.


c. general overview of the condition (disorders, relevant clinical signs


case.

d. relevant background info (health history, family history, current


care details: tests, drugs).

22

atch each section with its most important


Remember!

A definition is an explanation of the meaning of a concept.

Three Steps to an effective

Tell readers what concept is being defined.

Present clear and basic information.

Use facts or examples that readers will understand.

ber of the group to upload your definition to the corresponding forum

put the case in context to explain results and medical decisions,

end future care based on present results, state the

why the case is important, case details, clinical impact on literature.


isorders, relevant clinical signs


relevant background info (health history, family history, current


VII. Identify the components and characteristics des

given. Assign a different colour or symbol to each one. Then highlight or marked your text

accordingly.

Example Context

Explanation of results and medical decisions

Recommendations on future care

Educational message

THINK ABOUT IT

• Tick the box if you...

thoroughly read and compare different medical genres

wrote a definition trying to include as much as y

actively participated in class discussion

• What would I do different

_________________________________________________________________________

TASK 2: Do your own research. Go to Journal of Medical Case Reports

(http://www.jmedicalcasereports.com/). Then, find a Medical Case Report that clearly portraits all

the components and characteristics covered durin

Activity VII and upload the file (Figure 3).

VII. Identify the components and characteristics described above in the Medical Case Report


blue

Explanation of results and medical decisions green

Recommendations on future care purple

Educational message orange

thoroughly read and compare different medical genres

wrote a definition trying to include as much as you have learned so far

actively participated in class discussion

What would I do differently next time?

_________________________________________________________________



the components and characteristics covered during the lesson. Highlight the text, as you did in

Activity VII and upload the file (Figure 3).

23

cribed above in the Medical Case Report


@

#

<<

*

ou have learned so far

_________________________________________________________________



g the lesson. Highlight the text, as you did in

Figure 3

GET RE@DY

I. 1. Read the following ext

rivaroxaban in an elderly patient with intermediate

pulmonary embolism: a case report

- INTRODUCTION -

a._____________ In summary, this is the first case report showing that initial intensive

treatment with rivaroxaban in an elderly patient resulted in a rapid clinical

improvement and normalization of PE

b. _____________ An 80

department (DEA) presenting with dyspnea; this symptom appeared 2 weeks before

and worsened a few days prior to hospital admission.

c. _____________ Anticoagulant; C

embolism; Rivaroxaban

d. _____________ The main clinical characteristics of patients with suspected PE are

dyspnea, chest pain, fever, hemoptysis, syncope and signs of DVT.

2. Think of your answers. Was there any clue that helped you? Why did you take those decisions?

(Give 2 reasons).

________________________________________________________________________________

________________________________________________________________________________

H@NDS ON

II . Read the following paragraph and highlight the formulaic expressions.

UNIT 2: G_tting to know [ n unusu[ l

o]]urr_n]_

Lesson 1

Formulaic expressions may consist of a single word or of

several words acting as a meaningful or understandable unit.

For example:

I. 1. Read the following extracts from a Medical Case Report called "

rivaroxaban in an elderly patient with intermediate-low early mortality risk due to

pulmonary embolism: a case report" and guess to which section it belongs to. [ABSTRACT

CASE PRESENTATION - DISCUSSION AND CONCLUSION]



improvement and normalization of PE-related early mortality risk parameters.

b. _____________ An 80-year-old white man was admitted to our emergency


and worsened a few days prior to hospital admission.

c. _____________ Anticoagulant; Case report; Elderly; Mortality risk; Pulmonary

embolism; Rivaroxaban

_____________ The main clinical characteristics of patients with suspected PE are

dyspnea, chest pain, fever, hemoptysis, syncope and signs of DVT.

ere any clue that helped you? Why did you take those decisions?

________________________________________________________________________________

________________________________________________________________________________

II . Read the following paragraph and highlight the formulaic expressions.

G_tting to know [ n unusu[ l



For example: By focusing on... / The writer points out that

Objectives:

-Recognize the specific purpose, structure, grammar

and vocabulary of each section involved in a

medical case report.

-Write short paragraphs describing signs and

symptoms and other medical aspects

24

racts from a Medical Case Report called "Use of

low early mortality risk due to

" and guess to which section it belongs to. [ABSTRACT

DISCUSSION AND CONCLUSION]



risk parameters.

old white man was admitted to our emergency


ase report; Elderly; Mortality risk; Pulmonary

_____________ The main clinical characteristics of patients with suspected PE are

ere any clue that helped you? Why did you take those decisions?

________________________________________________________________________________

________________________________________________________________________________



By focusing on... / The writer points out that...

Recognize the specific purpose, structure, grammar

and vocabulary of each section involved in a

hs describing signs and

symptoms and other medical aspects.

In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated

cathepsin K was confirmed in several biopsies, and promoting a gene signature c

MAPK and c-MET signal pathways. It is known that TFEB, the master regulator of lysosome

biogenesis, controls transcription of target genes closely related to lysosomal structure and

function, including hydrolases. Our findings in the DNA motif

genes previously reported to be induced in cells where TFEB was overexpressed. The same

signature overlapped with the CLEAR motif in RNA samples. Tsuda

mTORC1 is a key upstream kinase that directly p

In addition, nuclear TFEB translocation may re

activity in cancer cells normally seen in periods of starvation conducted by the autophagy

program. Again, the gene signature showed increased expression of autophagy

supporting our assumption.

III. Now, go back to activity I and highlight all formulaic expressions you find.

Formulaic expressions list

IV. Read the Medical Case Report assigned online an

(Figure 1)

Figure 1


cathepsin K was confirmed in several biopsies, and promoting a gene signature connected to

MAPK and c-MET signal pathways. It is known that TFEB, the master regulator of lysosome


function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of gene

previously reported to be induced in cells where TFEB was overexpressed. The same signature

overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that mTORC1 is

a key upstream kinase that directly phosphorylates TFEB and inhibits i

nuclear TFEB translocation may re

cells normally seen in periods of starvation conducted by the autophagy program. Again, the

gene signature showed increased expression o

assumption.


cathepsin K was confirmed in several biopsies, and promoting a gene signature c

MET signal pathways. It is known that TFEB, the master regulator of lysosome


function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of


signature overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that

mTORC1 is a key upstream kinase that directly phosphorylates TFEB and inhibits its activity.

In addition, nuclear TFEB translocation may re-establish autophagy, enforcing metabolic


ure showed increased expression of autophagy-related genes,


IV. Read the Medical Case Report assigned online and complete the following chart.

Read the MCR and take notes on the main formulaic expressions you can find in the different sections [examples are given]: ABSTRACT The aim... is...

INTRODUCTION This condition is...

DISCUSSION AND CONCLUSION

Results show...



pathways. It is known that TFEB, the master regulator of lysosome


function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of gene



a key upstream kinase that directly phosphorylates TFEB and inhibits its activity. In addition,

nuclear TFEB translocation may re-establish autophagy, enforcing metabolic activity in cancer


gene signature showed increased expression of autophagy-related genes, supporting our

25



MET signal pathways. It is known that TFEB, the master regulator of lysosome


demonstrated upregulation of


. showed recently that

hosphorylates TFEB and inhibits its activity.

establish autophagy, enforcing metabolic


related genes,


d complete the following chart.

Read the MCR and take notes on the main formulaic expressions you can find in the different sections [some



pathways. It is known that TFEB, the master regulator of lysosome


function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of genes



ts activity. In addition,

establish autophagy, enforcing metabolic activity in cancer


related genes, supporting our

V. Choose one of the MCR assigned among your group members and complete the

following chart.

VI. 1. In no more than 100

chosen including the information in the chart. Remember to incorporate new formulaic

expressions recently learned.

r

Read the MCR and take notes on:Number of subjects involved Medical signs Familiarity / Medical history Routine tests Treatment Drugs Positive Results Negative

TASK 1: Upload your formulaic expressions to the corresponding glossary [

ABTRACT, Formulaic expressions INTRODUCTION, Formulaic expressions CASE PRESENTATION,

Formulaic expressions DISCUSSION AND CONCLUSION

*Remember to check the glossary before typing in your entry in order to avoid repetition (Figure 2)

Remember A summary is a shortened version of aprimary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or interpretations"

Check list

___The main idea is clearly identify.

___ All important ideas are present.

___ All unnecessary details were left aside .

___ Author meaning is kept the same.


VI. 1. In no more than 100-110 words write a summary of the Medical Case Report

information in the chart. Remember to incorporate new formulaic

expressions recently learned.

Read the MCR and take notes on:

TASK 1: Upload your formulaic expressions to the corresponding glossary [Formulaic expressions


expressions DISCUSSION AND CONCLUSION]


A summary is a shortened version of a text that highlights its key points. The primary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or

Figure

s clearly identify. ___I used my own words.

___ I used citations to refer author's ideas.

___ All unnecessary details were left aside . ___ Sentences are built upon the ones before.

___ Author meaning is kept the same.

26


110 words write a summary of the Medical Case Report

information in the chart. Remember to incorporate new formulaic

Formulaic expressions



that highlights its key points. The primary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or

Figure 2

___ I used citations to refer author's ideas.

lt upon the ones before.

Be prepared to:

• Project and read your summary in front of the class.

• Take notes and give feedback on the check list.

2. Make corrections based on yo

THINK ABOUT IT


paid attention to expressions and vocabulary used while reading each section of

the Medical Case Report.

wrote a summary trying

actively participated in group discussions.

gave feedback when needed.

• What would I do different next time?

_________________________________________________

TASK 2: a. Choose one member of the group to upload your summary to the corresponding

forum [Medical Case Report Summary

b. Individually, make at least one comment about other group's

Project and read your summary in front of the class.

Take notes and give feedback on the check list.

2. Make corrections based on your classmates advice.


the Medical Case Report.

wrote a summary trying to include as much as you have learned so far.

actively participated in group discussions.

gave feedback when needed.

What would I do different next time?

__________________________________________________________________


Medical Case Report Summary].

b. Individually, make at least one comment about other group's work. (figure 3)

Figure

27


to include as much as you have learned so far.

_________________________


work. (figure 3)

Figure 2

GET RE@DY

I. 1. Look at the following images, What section do they belong to?

___________________________________________________

2. Describe what you remember about this section

____________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

3. Share with a classmate. Wha

_____________________________________________________________

____________________________________________________________

UNIT 3: T[ king Sh[ p_

Lesson 1

I. 1. Look at the following images, What section do they belong to?

___________________________________________________

2. Describe what you remember about this section

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

3. Share with a classmate. What can you add?

_____________________________________________________________

____________________________________________________________

Objective:

-Assign roles among the group

-Compose a section of a Medical Case

Report

28

_________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

____________________________________________________________

ection of a Medical Case

H@NDS ON

II. Match the following pictures with the corresponding description

III. 1. Read the following information, go to Google Drive and start writing the first paragraph of a case presentation. Use the figures above to complement your writing.

a

b

c

e

Sex: Male Age: 48 years Body temperature: 37 °C. Heart rate: 70 beats per minute. Respiration Rate: 19 breaths per minute. Blood Pressure: 100/70 mmHg.Smoking: one pack of cigarettes daily aAlcohol: occasionally consumed alcohol. Weight: it had decreased by 10 kg during the last 6 weeks before his admission.Reason for admission:More info: self-limited diarrhea, and the stools did not contain mucus or blood. Evolution: diarrhea became persistent accompanied by black, tarry, malodorous feces.Other symptoms: dull abdominal pain, predradiated to the lumbar region. History: no family history of colon cancer, history of peptic ulcer disease, inflammatory bowel disease, trauma or abdominal surgery

II. Match the following pictures with the corresponding description


_____ Fig. 1. a Coronal compimage showing a gastrocolic fistula secondary to a tumor of the splenic flexure of the colon infiltrating the greater curvature of the stomach and diaphragm. b Computed tomography image of the abdomen showing passage of contrast material through a fistulous connection between the stomach and the splenic flexure of the colon _____ Fig. 2. a Gastroscopy image showing an ulcerated mass at the body of the stomach and theopening of a fistula above the mass.splenic flexure of the colon _____ Fig. 3. Thoracoabdominal positron emission tomography image showing a splenic flexure tumorwith enhancement of the greater curvature of the stomach and diaphragm _____ Fig. 4. Surgical specimen showing the fistula between the stomach and the transverse colon _____ Fig. 5. A colon adenocarcinoma infiltrating the gastric wall

d

Patient's fact sheet

37 °C. 70 beats per minute.

19 breaths per minute. 100/70 mmHg.

one pack of cigarettes daily a occasionally consumed alcohol.

it had decreased by 10 kg during the last 6 weeks before his admission.Reason for admission: 3-month history of intermittent watery diarrhea.

limited diarrhea, and the stools did not contain mucus or blood. diarrhea became persistent accompanied by black, tarry, malodorous feces.

dull abdominal pain, predominantly in the left upper quadrant, which radiated to the lumbar region.

no family history of colon cancer, history of peptic ulcer disease, inflammatory bowel disease, trauma or abdominal surgery

29


Coronal computed tomography image showing a gastrocolic fistula secondary to a tumor of the splenic flexure of the colon infiltrating the greater curvature of the stomach and

Computed tomography image of the abdomen showing passage of contrast material

rough a fistulous connection between the stomach and the splenic flexure of the colon

Gastroscopy image showing an ulcerated mass at the body of the stomach and the opening of a fistula above the mass. b A mass at the

Thoracoabdominal positron emission tomography image showing a splenic flexure tumor with enhancement of the greater curvature of the

Surgical specimen showing the fistula between the stomach and the transverse colon

A colon adenocarcinoma infiltrating

it had decreased by 10 kg during the last 6 weeks before his admission. month history of intermittent watery diarrhea.

limited diarrhea, and the stools did not contain mucus or blood. diarrhea became persistent accompanied by black, tarry, malodorous feces.

ominantly in the left upper quadrant, which

no family history of colon cancer, history of peptic ulcer disease, inflammatory

2. Upload your case presentation paragraph to

Moodle. (Figure 1)

3. In group, decide which one of the case

presentations uploaded (do not consider yours) is

the best. Copy and paste it on Google Docs. Then,

make all the editing you consider necessary.

4. Upload it again to receive feedback.

IV. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!

2. Exchange your patient's fact sheet with other group.3. Now is time to assign roles. Choose one role randomly.

Sex: Age: Body temperature: Heart rate: Respiration Rate: Blood Pressure: Smoking:

Alcohol:

Weight:

Reason for admission: More info: Evolution: Other symptoms: History:

Drafter 1 – This person does the primary writing.

Drafter 2person does the primary writing

2. Upload your case presentation paragraph to

3. In group, decide which one of the case

presentations uploaded (do not consider yours) is

the best. Copy and paste it on Google Docs. Then,

make all the editing you consider necessary.

4. Upload it again to receive feedback.

. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!

2. Exchange your patient's fact sheet with other group. 3. Now is time to assign roles. Choose one role randomly.

Patient's fact sheet

Drafter 2 – This does the

primary writing.

Reviewer – This person will read what the others have written to identify and examine paragraph focus, idea arrangement, and development. He/she will choose the one to work with.

30

. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!

Editor – This person will do grammar check, formatting, and review source integration.

Figure 1

THINK ABOUT IT


wrote a case presentation trying to include as much as you have learned so far

actively participated in group work assignments

• What would I do differently next time?

_________________________________________________________________________

TASK 1: a. Drafters: go to Google drive and start writing. intervene when is your turn. b. You have got 3 days to complete your task. When you are ready upload your paragraMoodle to receive feedback. (Figure 2)

TASK 2: a. Once you received feedback, go and checked the information assigned to start writing your medical case report (Case presentation only). b. Start organizing the information c. Assign roles, this time think on each group member skills.


actively participated in group work assignments

do differently next time?

_________________________________________________________________

go to Google drive and start writing. Reviewer and Editor:intervene when is your turn. b. You have got 3 days to complete your task. When you are ready upload your paragraMoodle to receive feedback. (Figure 2)

TASK 2: a. Once you received feedback, go and checked the information assigned to start writing your medical case report (Case presentation only). (Figure 2) b. Start organizing the information

s, this time think on each group member skills.

Figure 2

31


_________________________________________________________________

Reviewer and Editor: be prepare and

b. You have got 3 days to complete your task. When you are ready upload your paragraph on

TASK 2: a. Once you received feedback, go and checked the information assigned to start writing

G_t R_[ ^yG_t R_[ ^yG_t R_[ ^yG_t R_[ ^y

I. 1. Read the following Introduction.

2. What is wrong with it? Take notes on everything

that need to be changed.

______________________________________________

______________________________________________

UNIT 5: Ch_]k_^ [ n^ Don_

Lesson 1

Introduction

Schistocyte rate was 6%. Coombs test was negative. A

Plasmapheresis with fresh frozen plasma was initiated immediately after this test. Bone

marrow examination was performed as he was unresponsive to 5 courses of plasmapheresis

with 1:1 volume. Bone marrow aspiration revealed signs

nonhematopoetic cell infiltration. Pathologic evaluation of trephine biopsy revealed

myelonecrosis and carcinoma metastasis (

was seen on computerized tomography of the abdomen. The patient was referred to the

medical oncology department.

A 67-year old man living in a nursing hom

complaints of fatigue, severe back pain and extensive bruises at his left hip and thigh. At

physical examination, he was pale, he had difficulty in breathing and there were ecchymoses

around his left hip and thigh. At laboratory examination, he was anemic (7.5 gr/dl) and

platelet count was 13.000/µl. Creatinine level was normal but lactate dehidrogenase level

was high (1827 U/l). Schistocytes, polichromasia, fragmantated and nucleated red blood

cells and severe thrombocytopenia were observed on the blood film and he was hospitalized

with a provisional diagnosis of TTP. TTP has a well

diagnosis: thrombocytopenia, microangiopathic hemolytic anemia, neurologic and renal

abnormalities, and fever [5]. In rece

for diagnosis of TTP. Combination of some clinical symptoms and laboratory findings leads to

diagnosis as there are no specific biological markers or symptoms. Our patient had

thrombocytopenia, signs of microangiopathic hemolytic anemia on blood film, he had severe

back pain but he had no signs of renal failure.

I. 1. Read the following Introduction.

2. What is wrong with it? Take notes on everything

______________________________________________

______________________________________________

Ch_]k_^ [ n^ Don_

Schistocyte rate was 6%. Coombs test was negative. ADAMTS-13 activity was 3%.



with 1:1 volume. Bone marrow aspiration revealed signs of myelonecrosis and monoclonal


myelonecrosis and carcinoma metastasis (Figure 5 and Figure 2). A tumor of small intestine


medical oncology department.

year old man living in a nursing home applied to our Hematology outpatient unit with



thigh. At laboratory examination, he was anemic (7.5 gr/dl) and



re thrombocytopenia were observed on the blood film and he was hospitalized

with a provisional diagnosis of TTP. TTP has a well-known pentad of clinical features for


. In recent clinical practice, the whole pentad is not prerequisite



ns of microangiopathic hemolytic anemia on blood film, he had severe

back pain but he had no signs of renal failure.

III. Share with the

rest of the class

Objectives:

-Assemble the Medical Case Report

-Compare and evaluate classmates

work

32

13 activity was 3%.



of myelonecrosis and monoclonal


). A tumor of small intestine


e applied to our Hematology outpatient unit with



thigh. At laboratory examination, he was anemic (7.5 gr/dl) and



re thrombocytopenia were observed on the blood film and he was hospitalized

known pentad of clinical features for


nt clinical practice, the whole pentad is not prerequisite



ns of microangiopathic hemolytic anemia on blood film, he had severe

III. Share with the

rest of the class

Assemble the Medical Case Report

Compare and evaluate classmates

33

H@NDS ON

II. 1. Go to Google Docs an put all the sections you wrote together.

2. Then, discuss on the following checked list based on international standards for

Medical Case Reports publication.

Section Item Checklist item description Reported on page

Title 1 The words “case report” and the area of focus should appear in the title (such as diabetes, a therapeutic approach, an outcome)

Key Words 2 2 to 5 key words that identify areas covered in this case report

Abstract 3a Introduction—What is unique about this case? What does it add to the medical literature? Why is this important?

3b The patient's main concerns and important clinical findings

3c The main diagnoses, therapeutics interventions, and outcomes

3d Conclusion—What are the “take-away” lessons from this case?

Introduction 4 One or two paragraphs summarizing why this case is unique with reference to the relevant medical literature

Patient Information

5a De-identified demographic and other patient specific information

5b Main concerns and symptoms of the patient

5c Medical, family, and psychosocial history including relevant genetic information (this should also appear in the timeline)

5d Relevant past interventions and their outcomes

Clinical Findings 6 Describe the relevant physical examination (PE) and other significant clinical findings

Timeline 7 Relevant data from the patient's history organized as a timeline

Diagnostic Assessment

8a Diagnostic methods (PE, laboratory testing, imaging, surveys)

8b Diagnostic challenges (access, financial, cultural)

8c Diagnostic reasoning including other diagnoses considered

8d Prognostic characteristics when applicable (staging)

Therapeutic Intervention

9a Types of intervention (pharmacologic, surgical, preventive)

9b Administration of intervention (dosage, strength, duration)

9c Any changes in the interventions (with rationale)

Follow-up and Outcomes

10a Clinician and patient-assessed outcomes (when appropriate)

10b Important follow-up diagnostic and other test results

10c Intervention adherence and tolerability (how was this assessed)

10d Adverse and unanticipated events

Discussion 11a Strengths and limitations in your approach to this case

11b Discussion of the relevant medical literature

11c The rationale for your conclusions (a causality assessment)

11d The primary “take-away” lessons from this case report

Informed Consent 12 Did the patient give informed consent? Please provide if requested

34

What do we need to change? What are we keeping the same?

3. Work editing your Medical Case Report Accordingly.

III. 1. Once you're ready, give access to your work to the class. Then, revise other's group work

using check list. [Work a suggesting mode (figure 1)].

2. You can also give the other group a summary of your feedback.

What you should change? What you should keep the same

THINK ABOUT IT


thoroughly read and cautiously edited my Medical Case Report

I gave honest and serious feedback.

What would I do differently next time?

__________________________________________________________________________

Figure 1

35

References

Aitken, L. M. & Marshall, A. P. (2007). Writing a case study: Ensuring a meaningful

contribution to the literature. Australian Critical Care, 20(4),132-136.

Blau, I. & Caspi, A. (2009). What type of collaboration helps? Psychological ownership,

perceived learning and outcome quality of collaboration using Google Docs. In Chais

Research Center for the Integration of Technology in Education (48-55)

Bonk, C. J., & Graham, C. R. (2012). The handbook of blended learning : global perspectives,

local designs. San Francisco : Pfeiffer, c2012.

Bruce, I. (2008). Academic writing and genre : a systematic analysis. London : Continuum,

c2008.

Chen, Y., & Su, S. (2012). A genre-based approach to teaching EFL summary writing. ELT

Journal: English Language Teaching Journal, 66(2), 184-192.

Cole, J. R. (2005). Using Moodle : teaching with the popular open source course management

system. Sebastopol, CA : O'Reilly Community Press, 2005.

Conner, N. (2008). Google Apps: The missing manual. O'Reilly Media.

Dekeyser, S., & Watson, R. (2006). Extending google docs to collaborate on research

papers. University of Southern Queensland, Australia, 23, 2008.

Dudley-Evans, T. (2001). English for specific Purposes. In M. Carter and D. Nunan (Eds.). The

Cambridge Guide to teaching English to Speakers of other Languages (131-36).

Cambridge: Cambridge University Press. E. Cianflone / Scripta Manent 6(1-2) 2-8 8 ©

2011 Scripta Manent. Published by SDUTSJ. All rights reserved.

Ellis, R. (2003). Task-based language learning and teaching. Oxford, U.K.: Oxford

University Press.

Ferguson, G. (2007). Teaching writing in a second language: an overview of principles and

practice. In R. Plo Asastrué (Ed.) I. Andrés Monte (Coord.), Ministerio de Educación y

Ciencia, Secretaría General de Educación, Instituto Superior de Formación del Profesorado,

36

Secretaría General Técnica, Subdirección General de Información y Publicaciones. El

desarrollo de competencias en lenguas extranjeras: textos y otras estrategias (pp. 31-63).

Madrid: Ediciones Gráficas Arial.

Ferguson, G., Perez-Llantada, C., & Plo, R. (2011). English as an International Language of

Scientific Publication: A Study of Attitudes. World Englishes, 30(1), 41-59.

Flowerdew, J. (2014). Academic discourse. Harlow, England: Longman.

Garrison, D. R., & Kanuka, H. (2004). Blended learning: Uncovering its transformative

potential in higher education. The Internet And Higher Education, 795-105.

doi:10.1016/j.iheduc.2004.02.001

Garrison, D. R., & Vaughan, N. D. (2008). Blended learning in higher education : framework,

principles, and guidelines. San Francisco : Jossey-Bass, c2008.

Harmer, J. (2007). The practice of English language teaching (4th ed.). Harlow, England:

Pearson Longman.

Hyland, K. (2003a) Second language writing. Cambridge: Cambridge University Press

Hyland, K. (2003b). Genre-based pedagogies: A social response to process. Journal Of Second

Language Writing, 12(L2 Writing in the Post-Process Era), 17-29.

Hyland, K. (2007). Genre pedagogy: Language, literacy and L2 writing instruction. Journal Of

Second Language Writing, 16(Writing Scholars as Teacher Educators: Exploring Writing

Teacher Education), 148-164.

Hyland, K. (2009). Academic discourse. London: Continuum

Kidd, M. & Hubbard C. (2007). Introducing the Journal of medical Case Reports. Journal of

medical Case Reports, 1(1), 1.

Kotlyrarova, O. (2013). Modern Tendencies in Teaching Writing to ESL students. The Journal

of Teaching English for Specific and Academic Purposes, 12 (1), 159-164.

37

Lillis, T., & Curry, M. (2010). Academic writing in a global context: The politics and practices

of publishing in English. Milton Park, Abingdon: Routledge.

Mason, R. A. (2001). The case report- An endangered species? Anaesthesia, 56(2), 99-102.

Mazandarani O (2010). Teacher’s Effectiveness in EFLers’ Writing Tasks: Utilizing Corrective

Feedback. Annual Staff Student Research Conference (8 Mayo 2010), University of Exeter,

Graduate School of Education.

Picciano, A., Dziuban, C., & Graham, C. (2014). Blended learning: Research perspectives,

volume 2. New York: Routledge.

Piyatida, C. (2013). The Effects of the Genre-Based Approach on Engineering Students' Writing

Ability. Pertanika Journal Of Social Sciences & Humanities, 21(2), 735-756.

Pruitt, D. (2012). Group alchemy: The six elements of highly successful collaboration.

Emeryville, CA: Group Alchemy Pub.

Robertson, C. (2008). Integration of Moodle Course Management System (CMS) into an EFL

writing class. The JALT CALL Journal, 4(1), 53-59.

Robinson, P. (2011). Task-Based Language Learning: A Review of Issues. Language

Learning, 611-36. doi:10.1111/j.1467-9922.2011.00641.x

Sánchez, G. A., Pellicer, Y. S., Valera, Y. R., Sánchez, W. R., Mercado Ollarzábal, Á. L., &

Alés, M. F. (2012). Curso virtual de redacción científica e infotecnología sobre la

plataforma Moodle: resultados y experiencias. Pixel-Bit, Revista De Medios Y Educacion,

(41), 173-183.

Sharples, M. (2012). A framework for the study of computer supported collaborative writing.

Brighton [East Sussex: University of Sussex, School of Cognitive and Computing Sciences.

Smith, B. L., & MacGregor, J. T. (2009). What is collaborative learning? National Center on

Postsecondary Teaching, Learning and Assessment at Pennsylvania State University.

Retrieved November 27, 2015, from http://learningcommons.evergreen.edu/pdf/collab.pdf

38

Speck, B. W. (1999). Collaborative writing : an annotated bibliography. Westport, Conn. :

Greenwood Press.

Storch, N. (2013). Collaborative writing in L2 classrooms. Bristol: Multilingual Matters.

Strongman, L. (2013). Academic writing. Newcastle upon Tyne : Cambridge Scholars.

Swales, J. M. (2004). Research Genres. Explorations and Applications. Cambridge: Cambridge

University Press.

Tardy, C. (2004). The role of English in scientific communication: lingua franca or

Tyrannosaurus rex?. Journal of English for Academic Purposes, 3(3): 247-269.

Thomas, M. (2010). Task-based language learning and teaching with technology. London:

Continuum.

Vihla, M. (1999). Medical writing: Modality in focus. Amsterdam: Rodopi.

Williamson, A. M., Mears, A., & Bustos, C. (2015). Reflection Tools in Teacher Education

Classes: An Analysis of Implementation in Online, Hybrid, and Traditional

Environments. Turkish Online Journal Of Educational Technology - TOJET, 14(2), 138-

143.

Willis, D., & Willis, J. (2009). Six propositions in search of a methodology: Applying

linguistics to task-based language teaching. In S., Hunston & D. Oakey (Eds.), Introducing

Applied Linguistics: Concepts and Skills. London and New York: Routledge, 60-67.

Willis, J. (1996). A framework for task-based learning. Harlow, Essex: Longman.

Wingate, U. (2012). Using Academic Literacies and genre-based models for academic writing

instruction: A ‘literacy’ journey.Journal Of English For Academic Purposes, 11(English

for Academic Purposes: contributions from Systemic Functional Linguistics and Academic

Literacies), 26-37. doi:10.1016/j.jeap.2011.11.006

Zhou, W., Simpson, E., & Domizi, D. P. (2012). Google Docs in an Out-of-Class Collaborative

Writing Activity. International Journal of Teaching and Learning in Higher

Education, 24(3), 359-375.

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Appendix A: Survey

Survey Sample

Objective: The purpose of this questionnaire is to identify medical students' previous experience with

English and with academic writing as well as to gather information about their attitudes, abilities and

interests on writing in English in specific contexts and with specific purposes.

1. How long have you been studying English?

____________________________________________________________________________________

______________________________________________________________

2. Read the following statements about the strategies used when writing in English and choose the

alternative that best represents your learning experience.

Never Rarely Sometimes Always

a) Before writing, I read and

analyze texts that are similar to the

one I am going to write.

b) Before writing, I have got a clear

idea of the structure and

conventions of the type of text I

will write.

c) Before writing, I brainstorm my

ideas.

d) I write drafts before the final

version of my text.

e) I proof read what I write.

f) I ask my classmate to read what I

write.

g)I ask my teacher for advice and

guidance.

h) I consult a dictionary.

i) I consult online translators.

40

3. Indicate your level of familiarity of the following online platforms on a scale of 1-5 (1 being "poor"

and 5 being "Excellent")

1 2 3 4 5

a) Google docs

b) Moodle

4. Read the following statements and choose the alternative that best represents your level of agreement.

I completely

disagree

I disagree I agree I completely

agree

a) I think English is important for my

future career.

b) The English courses available in my

faculty are enough for my future

career

c) The English courses available do

satisfy my specific professional needs.

d) I have time to attend to English

classes regularly.

5. Read the following statements about writing in English and choose the alternative that best represents

your level of agreement.

I completely

disagree

I disagree I agree I completely

agree

a) I feel confident writing in

English.

b) I like receiving feedback

from my classmates about my

writing

c) I like to be read in English

d) I would like to improve my

writing skills in Academic

41

English

e) I would like to work

collaboratively with classmates

in writing assignments

6. Considering your field of interest, choose the alternative that best describes your current situation

when writing in English.

Not well at all Not so well Somewhat

well

Very well

a) I can write short descriptive

texts in English.

b) I can write papers in English

for class assignments.

c) I can write medical case

reports.

d) I can write articles for local

journals in English.

e) I can write articles for

international journals in

English.

7. Select the topics you would like to address in your English classes. (Select all the topics you want)

i) Cancer___ ii) Aging-associated diseases___ iii) Neuroscience and mental health___

iv) Degenerative diseases___ v) Infections___ vi) Other___ Which one?__________

8. Would you be interested in taking an elective workshop on how to write Medical Case Reports in

English?

Yes__ No ___

42

Appendix B: Needs Analysis

Needs Analysis

Participants

This needs analysis was conducted with 10 senior students in medical school from Universidad

Católica de Chile. These students have had at least two general courses of English and, as a

graduation requirement, they need to certify their English abilities at an intermediate level based on

ALTE (Association of Language Testers in Europe) standards (the institution offers free courses of

English for those learners that need additional instruction).

The Survey

The survey conducted for this needs analysis was designed according to Dudley-Evans and St.

John's (1998) proposal. This survey sought to gather information about students' previous

experience with English and with academic writing as well as to gather information about their

attitudes, abilities and interests on writing in English for Specific Purposes. The survey was divided

into four sections:

The first section (I) includes 3 subsections (1-2-3). The aim is to gather information about students'

previous experience with English and with academic writing. It consists of one open question about

time exposure to English instruction, a set of questions about students' writing learning experience

and a some other questions about the level of familiarity with two online platforms that can be used

for collaborative writing.

The second section (II) comprises 2 subsections (4-5). The objective is to collect data about

student´s attitudes to writing in English for Specific Purposes. It incorporates questions about

students' attitudes towards English and English courses available and about learner's attitudes about

ESL writing.

The third section (III) includes 1 subsection (6). The purpose is to obtain information about

student´s abilities on writing in English for Specific Purposes. It consist of set of questions about

some specific ESL writing abilities based on learners' own perceptions.

The fourth section (IV) incorporate 2 subsections (7-8). The aim is to gather information about

student´s interests on writing in English for Specific Purposes. It includes a question in which

43

students can choose some topics that they would like to include in the lessons and a question based

on their willingness to take an elective course on medical case report writing.

Results

Results are presented following the four sections described above. A deeper analysis of each

questions is described and illustrated with the corresponding figure.

Section I

Figure 1

From Figure 1, it can be inferred that most students were taught English from secondary school

and all of them have been exposed to the second language for more than 5 years. These results,

in addition to the university requirements lead them to certify an intermediate level, demonstrate

that students have the abilities needed to take an EAP course.

Figure 2a

0123456

Before writing, I

read and

analyze texts

that are similar

to the one I am

going to write.

Before writing, I

have got a clear

idea of the

structure and

conventions of

the type of text I

will write.

Before writing, I

brainstorm my

ideas.

I write drafts

before the final

version of my

text.

I proof read

what I write.

Read the following statements about the strategies used when writing in

English and choose the alternative that best represents your learning

experience.

Never

Rarely

Sometimes

Always

0%

25%

50%

25%

How long have you been studying

English?

4 years or less

5-8 years

9-12 years

13 years or more

44

Figure 2b

Figures 2a and 2b show that learners know and implement strategies to write; such as drafting,

brainstorming, asking for guidance, or consulting dictionaries. However, they apparently do

not have a clear idea of the type of text they are working with. Therefore, it is important to

teach the students to recognize structures and characteristics that will help them to write more

efficiently and accurately, not only inside the classroom, but in academic settings.

Figure 3

Figure 3 shows that most students are closely familiar with Google docs, but very few know

how to interact with Moodle. Tutorials will be necessary to guide the students during the process

of integrating new online tools.

0

2

4

6

8

10

12

I ask my classmate

to read what I write.

I ask my teacher for

advice and guidance.

I consult a

dictionary.

I consult online

translators.

Read the following statements about the strategies used when

writing in English and choose the alternative that best represents

your learning experience.

Never

Rarely

Sometimes

Always

0

2

4

6

Google docs Moodle

Indicate your level of familiarity of the

following online platforms on a scale of 1-5 (1

being "poor" and 5 being "Excellent")

1

2

3

4

45

Section II

Figure 4

The information presented in Figure 4 indicates that most students believe English is important

for their future. However, the courses available do not satisfy their specific needs. Therefore,

there is a need to create courses that allow learners to acquire tools to participate in their

particular field of interest.

Furthermore, many participants claim that they do not have enough time to attend regular

classes. Thus, it is necessary to build a syllabus that complements face to face interaction with

online work.

Figure 5

0123456

I think English is

important for my

future career.

The English

courses available

in my faculty are

enough for my

future career

The English

courses available

do satisfy my

specific

professional

needs.

I have time to

attend to English

classes regularly.

Read the following statements and choose the alternative that

best represents your level of agreement.

I completely disagree

I disagree

I agree

I completely agree

0123456789

10

a) I feel

confident

writing in

English.

b) I like

receiving

feedback from

my classmates

about my

writing

c) I like to be

read in English

d) I would like

to improve my

writing skills in

Academic

English

e) I would like

to work

collaboratively

with

classmates in

writing

assignments

Read the following statements about writing in English and choose the

alternative that best represents your level of agreement.

I completely disagree

I disagree

I agree

I completely agree

46

Figure 5 shows that students do not feel confident about their writing. Nonetheless, they seem

open to work with others and to improve their performance. Taking this into account, instruction

should use collaborative work as a way to boost confidence in the process of learning to write

and in writing itself.

Section III

Figure 6

Figure 6 shows that learners know to write in English but they are not capable of writing

specific texts. A pertinent course must prepare students not only to write basic text but also

contextualized text that can be useful in their particular field of interest.

Section IV

Figure 7

0123456789

10

I can write

short

descriptive

texts in

English.

I can write

papers in

English for

class

assignments.

I can write

medical case

reports.

I can write

articles for

local journals

in English.

e) I can write

articles for

international

journals in

English.

Considering your field of interest, choose the alternative that best

describes your current situation when writing in English.

Not well at all

Not so well

Somewhat well

Very well

22%15%

17%

15% 20%

5%

3%3%

11%

Select the topics you would like to address in your English classes.

(Select all the topics you want) Cancer

Aging-associated diseases

Neuroscience and mental

healthDegenerative diseases

Infections

Diabetes

47

Figure 7 illustrates that the students' interests towards different topics are quite heterogeneous.

All topics should be included.

Figure 8

Figure 8 reveals participants' high interest in taking a workshop on Medical Case Reports

writing.

Conclusions

Based on the results analysed, it is possible to conclude that students lack skills to work with

specific texts. However, they seem interested in taking a course based on a particular genre.

In addition, they seem open to work with others and to improve their performance. Moreover, they

have limited time to attend regular classes. Thus it is necessary to implement a methodology that

not only uses time effectively but that also enhances collaborative interaction.

100%

0%

Would you be interested in taking an

elective workshop on how to write

Medical Case Reports in English?

Yes

No

48

Appendix C: Rubrics

Final Report Rubric

Name: ________________________________________ Score: ____ /____ Grade: ______

Dimension Accomplished Average Developing Beginning

Content All the contents

asked are covered

Most of the contents are

covered

Some of the contents are

covered

The some of the

contents are poorly

addressed.

Vocabulary and

formulaic

expressions

Uses a great variety

of expressions and

vocabulary

A lot of expressions are

used but some of them

are not well used.

Uses some expressions

are and poor vocabulary

development.

Poor vacbulary and

almost none formulaic

expression.

Grammar and

Mechanics

Excellent grammar,

spelling, syntax and

punctuation.

A few errors in

grammar, spelling,

syntax and punctuation,

but not many.

Shows a pattern of

errors in spelling,

grammar, syntax and/or

punctuation. Could also

be a sign of lack of

proof-reading.

Continuous errors

Abstract Writes a clear well-

structured abstract

The text written has

some flaws regarding

the structure.

Doesn't follow the

structure.

Abstract is not present

Introduction Writes a clear well-

structured

introduction



the structure.

Doesn't follow the

structure.

Introduction is not

present or not clear at

all.

Presentation Writes a clear well-

structured case

presentation



the structure.

Doesn't follow the

structure.

Presentation is not

clear at all.

Conclusions Writes a clear well-

structured discussion

and conclusions



the structure.

Doesn't follow the

structure.

Conclusion is not

present or not clear at

all.

Case report Writes a clear well-

structured medical

case report

Writes a clear medical

case report with some

flaws in the structure.

Medical case report is

clear but does not

follow the structure.

Medical case report is

not clear and does not

follow the given

structure.

Sources and

citations

Demonstrate use of

a range of

appropriate sources

and incorporate

them into the text

effectively.

Some citations

integrated into the text

and most of the sources

are incorporated.

Citations inserted into

the text sometimes at

appropriate points.

Citations given at the

ends of some

paragraphs.

No citations in the

text.

No references at the

end

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