Writing:writingtheillnessreportsandkeepingdailyworkingjournalsaretheroutineworkforclinicaldoctors.Thiskindoflanguageskillshavebeenpracticedalotincollegesanduniversities,sotheneedstoimprovewritingdonotseemtobemorenecessarythantheotherthreeskills.

　　2.2Communicativeneedsandcross-culturalbackgroundknowledge

　　Communicativeneeds:AmajorityoftheexchangedclinicaldoctorsareincapableofcommunicatingfluentlyinEnglisheventhoughtheyhavehadagoodcommandofvocabularyandreadingskills.Inaddition,theymightnotbefamiliarwiththecultureofthecountrytheyworkinaswellasthecultureofthemedicalprofession.Asaresult,thelanguageprogramshouldprovidecourseswhichhelptobuildEnglishcommunicativecompetenceofthoseclinicaldoctorsintheirparticularcontextinordertoensureprofessionalsuccess.AsHwangandLin(2010:49)pointoutthatadoctor'sabilitytocommunicatesuccessfullywiththeirpatientsconsiderablydetermineswhetherapatientacceptsthedoctor'srecommendedtreatmentandtheeffectsofthetreatmentresults.

　　Cross-culturalbackgroundknowledge:Apartfromthecommunicativeneeds,therearealsoimperativeneedstoadapttoadifferentculture.Intermsofthedifferentcultureintheworkingplace,twoaspectsareillustrated:firstly,thedifferentmedicalsystem.Fortheexchangedclinicaldoctors,theyhavetoadjusttothedifferencesinthemedicalsysteminwesterncountries.Forexample,medicalsystemsinwesterncountriesmaydiffercompletelyintheirorganization,sotheexchangedclinicaldoctorsmustbecomefamiliarwiththeproceduresofthenewworkingsystem.Inaddition,themedicalapproachesthatthewesterndoctorsutilizemightalsodifferfromthoseinChinawherethemedicalqualityoftreatmentislessadvanced.Forexample,inNorthAmerica,themedicaltreatmentemphasizesonevidence-basedpracticeandtheapplicationoftechnology,whilethesedoctorsmaycomefromaculturewhichpreferstoemphasizetraditionalmedicine.

　　Secondly,thedoctor-patientrelationshipvariesfromculturetoculture.Chinesecultureseemstotraditionallygivethedoctorsanunquestionableauthorityandahighersocialrespectbecauseoftheirlife-savingprofession.However,westerncultureseemstogoinanotherway,itconcernsmorewiththepatientsthantheChineseculturedoes.Inwesternculture,patients'voicescanbebetterheardbythedoctorsratherthandirectlytakingthedoctor'ssuggestions.Thisdoesnotmeandisrespectforthedoctor,butratheraneedforthepatienttofeelrespectedandvaluedasanindividual.Asaresult,itwillbecrucialfortheAsianclinicaldoctorstounderstandthedoctor-patientrelationshipwithinthecontextofthenewculture.

　　3.CorseDesign

　　3.1Theaimofthecourses

　　Accordingtotheneedsoftheclinicalstaff,theaimofthecoursesistobothimprovetheirlinguisticaswellascommunicativecompetency.Intermsofthelanguageskills,speakingandlisteningareemphasized.

　　3.2Thecontentoflanguageandcommunicativeskills

　　Asmentionedintheneedsanalysissection,theemphasizedskillsarelistening,speaking,communicativeandcross-culturalknowledge,inthissection,thecontentwillbedesignedinaccordancewiththoseneeds.

　　Oralskills:pronunciationispracticedduringthespeakingcourseanditisusuallypracticedafterlisteningbecauseithelpsthelearnerstopronouncethewordsinthewaythatnativespeakersdo.Thepronunciationaspectsincludewordandsentencestress,intonationandrhythmbecausetheseaspectsfrequentlyinfluenceone'sfluency.Ifanyoneoftheseaspectsisincorrectlypronounced,somemisunderstandingswillbegenerated.Inaddition,somespeakingskillsarealsoincluded,suchastheconversationbetweendoctorsandpatients,collaboratinganddiscussingwithcolleaguesandsuperiors,presentationskillsinmedicalconferenceandseminarsandsomedailycommunicationskills.

　　Listeningskills:apartfromlisteningforsomecluesinrealconversationswhichmayoccurintheworkplace,learnersarealsosupposedtogetfamiliarwiththeidiomsandtherulesoflistening,suchaswhentointerrupt,howtointerrupt,whenshouldtaketheturnoftalkingandhowtoencourageapatienttoopenupaconversation.

　　Cross-culturalknowledge:theappropriatenessincommunicatingeitherwiththepatientsandforeigncolleagues,abriefunderstandingoftheculturalvaluesinwesternsociety.

　　3.3Activities,materialsandassessment

　　Allthelanguageandcommunicationskillsaretaughtincontextsothatlearnersareabletogetfamiliarwithactualtaskswhichmightoccurintheirrealworkplace.Intermsoftheactivitiesduringthecourses,problem-basedactivitiesaredesignedastohelplearnerstodevelopcriticalthinkingandtheabilityofreasoning,activelycollaboratewithotherstudentsinagroupandfosteraself-studylearninghabit.ThisisbecauseAsianlearnersusuallygetaccustomedtoexpecttheteacherstotellthemexactlywhattoreadandassignclearlydefinedtasks.However,thisovertlyteacher-dependentlearningstylemightinhibitthelearners'communicativecompetence.Therefore,theimplementationofproblem-basedlearningactivitiesshouldcarefullypreparedaccordingtothelearners'interestsandpreviousworkingandlearningexperienceinordertoavoidtheirresistancetothiskindofnewlearningmethod.Apartfromproblem-basedactivities,somecommunicativeactivitiesarealsodesigned,suchasrole-plays,simulations,presentationsandinterviews.

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