Scholarship - The Experiences of Nursing Students for Whom English Is an Additional Language in Preparing for and Taking Examinations

In this episode of Nursing EDge Unscripted Scholarship, Dr. Steven Palazzo interviews Dr. Peter Cooper-Lara, dean of teaching and learning at Chamberlain College of Nursing, about his research on challenges faced by nursing students for whom English is an additional language (EAL). They explore themes from his study, including psychological factors, test item construction, and the perseverance of EAL students. Dr. Cooper-Lara shares practical recommendations for educators to create more equitable testing environments by revising test materials and involving EAL students in improving classroom inclusivity. The conversation highlights the importance of culturally responsive teaching to enhance nursing education outcomes.

Cooper-Lara, Peter PhD, MSN, RN. The Experiences of Nursing Students for Whom English Is an Additional Language in Preparing for and Taking Examinations. Nursing Education Perspectives 45(1):p 25-30, 1/2 2024. | DOI: 10.1097/01.NEP.0000000000001169 

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Transcript

0:37

Welcome to this episode of NLN podcast Nursing EDge Unscripted the scholarship track. I'm  your host, Dr. Steven Palazzo, a member of the editorial board for Nursing Education  Perspectives. Nursing EDge Unscripted in our track entitled Scholarship celebrates the published work  of select nurse educators from the NLN's official journal, Nursing Education Perspectives, and our  nursing blog, Nursing EDge. The conversations embrace the author's unique perspectives  on teaching and learning innovations and the implications for nursing program development and  enhancement. In this episode, we will discuss the difficulty English as additional language students  encounter with test questions, specifically the hindrance students experience when trying to  translate teachers constructed test questions. We will discuss the perspective of my guest today,  Dr. Peter Cooper-Lara, the dean teaching and learning for Chamberlain College of Nursing with  23 campuses around the country. We will discuss his article published in the January-February 2024  issue of Nursing Education Perspectives titled, "The Experiences of Nursing Students for Whom  English is an Additional Language in Preparing for and Taking Examinations." Dr. Cooper-Lara, welcome! Thank you so much, Dr. Palazzo. I want to thank you for having me as a guest today to  discuss what I believe is valuable research for nurse educators in the higher academic  learning environment. The purpose of the study was to gather subjective data by discovering  common themes related to the experiences of preparing for and test taking nursing  examinations, especially from the perspective from those to whom English is an additional language. So the goal was to investigate those factors that might influence the outcomes of this  demographic of test takers who were enrolled in a pre-licensure baccalaureate nursing program.  The interest for this research actually was sparked after a conversation I had with a colleague who  noted that it seemed as though most of the exam failures per semester were students  for whom English was an additional language. So after some review and some informal discussion  with the students the assumption was correct, which led me to conduct this qualitative study. In the study I conducted one to one interviews with 16 participants on college campuses from  three different regions of the United States. Of the 16 participants, they were from seven  different countries speaking seven different original languages before coming to the United  States. Once the data was interpreted and we used a constant comparative approach, there  were three primary themes that we identified or that I identified: those being psychologic factors,  perseverance, and additional factors affecting outcomes. If I may, I want to provide a little  bit of information about the three themes. Sure, please! Participants identified psychological factors related to their experiences surrounding test taking These factors appeared to have the most impact on the participants with a large number of question responses related to this theme, especially in the areas of difficulty focusing, lack of confidence,  and test anxiety, all related to English as an additional language. In addition probably to the normal or expected kind of anxiety and psychological concerns you'd have taking exams. Exactly, which is a point that I'll be talking about a little bit later. A second theme related to English language  struggles was noted with additional factors affecting outcomes such as comprehensibility  and test item construction. This is important as test items with extraneous variables can alter  the meaning of a question. In other words, test items that contain something irrelevant and  extraneous variable that affects the outcomes as those things are irrelevant to the focal  construct of the question. These are variables that interfere with reasonable cognitive process  in a native English speaker, let alone someone who identifies as an English as an additional  language learner. Some of the participants noted that errors in test item construction created  undue reading comprehension requirements of a specific test item, which can affect  the interpretation of the test item as can be seen in those items that have  grammatical errors or that have spelling errors or that even include things like colloquialisms  or idioms and/or even slang terms. I'll give you a good example. When I was a novice educator  in 2011 and I was giving my very first exam and it included a question and included a slang phrase or  an idiom, a flight of stairs, where we were educating a patient on what they couldn't  or shouldn't do and I used the term a flight of stairs and a student raised their hand who was  obviously someone who identified as an English language learner and said Professor Cooper-Lara,  I don't understand this question. And so I read it and I said so tell me what confuses you about this? The response was, I can't understand how stairs can be flying. Oh right. So her literal translation was inconceivable to her and in that sense I provided her with only a 25% of getting  that question right because she was confused by that one response. Right, right. It could have been the correct or the incorrect response. That was an eye opener for me. Oh for sure yeah and you don't think about that sometimes when you're constructing those questions.  Sure, I've seen in reviewing exam questions at times especially like for a leadership  course where the faculty is trying to note that two nurses on the unit or a manager and  a nurse on the unit aren't getting along and the term "rubs me the wrong way" was used in referring to one  of the other people. "I can't with work with her, she rubs me the wrong way." Well, if you think about  the literal interpretation how that could confuse somebody who's trying to translate that back and forth into their language to understand what exactly that means. Oh, great point, great point.  I think we forget about that a lot of times when we're constructing these questions. We do and I counsel faculty all the time. As a dean of teaching and learning, my priority job is to  orient faculty and make them the best faculty that they possibly can and continue with their faculty  development and when I talked to them about being culturally responsive and thinking as an English  language learner student when they're reviewing their lecture content and their PowerPoint slides  and their exams, I have them think about from the perspective of that English language learner. How would they feel if they were faced with that knowing that they only had a 25% chance of getting  that question right? What if they failed that exam by that one question? What if that  exam was their second failure within that course? What if that course they then failed was  their second failure in a nursing program and now they're no longer enrolled in that nursing program? All came down to one question. All came down to one question. Something to really think about and review as a nurse educator. Well, tell me a little bit why you were immersed in this issue  and really doing some deep dive and research into the literature. What did you learn about English  as additional language students that you didn't know previously or that maybe surprised you?  There were a few things actually. The first was the participants were very, very vocal in sharing  their experiences and I found that very refreshing. These students identifying this research as an  opportunity for making a difference in nursing education. Nice. And one where their experiences can be viewed as unique when compared to their native english-speaking peers. So that aside, I was pleased with their candid responses, especially when referencing test item construction and their experiences with lecture. So one participant in particular shared their experience when asking faculty a question that was related to lecture content. The student was having some difficulty stating their question clearly in English and they were taking time in expressing their self  and the faculty cut them off and offered an answer based on an assumption of the intended question  and unfortunately, the faculty response was unrelated to the student's question and the intent  of the student's question and it resulted in the student feeling not only unsupported but it also  led to diminished participation in future lectures. Sure. You felt like you weren't heard. That's right. And at that moment creates the inequity in the learning environment.  The participants discussed a difficulty with comprehension. They highlighted factors that  affect the focus and clarity of questions. For instance, noting that in the construction of  test items one misplaced comma, one period, one quotation in the wrong place and even  word typos for them altered the meaning and challenged their understanding especially  when attempting to translate the question into their native language to help with that comprehension. They noted that the issue wasn't only with them and their  language, but they understood how that could also affect native English speakers. Right. They also noted that the issue wasn't only with English-speaking faculty, but also with  those faculty who generated exams who were themselves English as additional  language persons. And I think the best way to really convey the experiences is  through direct quotes from the participants. In these direct quotes you'll note that they are,  they're not grammatically correct. You'll note the difficulties that these participants have  with the English language. For instance, one of the participants, number 13, stated about  the exam questions themselves. "It was a lot of typos that really threw me off. I get very  anxious and immediately, I mean, I guess because it's typos I'm like, whoa. For me it's very...that  creates a difference in my confidence. It creates a difference in my...like I start doubting myself.  It has to be my grammar is no great, but when I read it if the grammar is wrong it throw me  off, if that makes sense." Sure.

And an additional participant said: 14:33

"A lot of teachers are foreign  as well and when you're foreign and you're gonna teach and you're gonna do a test, you have to  proofread the test, like, you have to submit it to people who knows grammar to read the  test so that way it don't change the meaning. For me it's something else." Those are powerful  words I think, coming straight from those test takers. What an opportunity for them, though, to  feel safe enough in this study and empowering them to provide this type of feedback that will  be beneficial hopefully to others down the road. And see, I just used down the road, right? A great example there. That is and you're exactly right. Like I said earlier, I was so grateful with their candid responses. Yeah. And that they just felt free to offer all of this valuable information to help nurse educators open their eyes and realize what some of these struggles are these students are going through. Well, it's a testament to the safety, the safe environment you created so were able to do that and feel that they could be very forthcoming and honest with you so that's  wonderful. So what strategies would you recommend a college of nursing can implement to increase the  equity of the test administration? So you had some recommendations in your study of course, but what  do you think one or two takeaways would be for someone listening to the podcast that they can consider right now going back and constructing their exam? I think there are two. Probably the most important is peer review of your exams, but not only peer review of your exams, it's peer review and I know, I understand, I realize it takes time, but peer review of lecture materials,  peer review of assignments that are being created, peer review of case studies that are being done in  a classroom where again, in a leadership course you might have a scenario or a situation where  that type of idiom comes up that says "rubs me the wrong way" and not even realizing thinking  that the students, every student in the classroom is going to understand exactly what that means.  I think looking at those resources and really scrutinizing them, making sure that there are no  grammatical errors, that there are no typos, that periods and and commas are exactly where they  need to be. You know, as a native English speaker, we might not realize, oh, well that comma is in  the wrong spot and just keep going and it wouldn't affect us at all, but knowing that somebody who's  trying to translate something that comma is a pause in that sentence and how that pause  might affect that interpretation with somebody who identifies as an English language learner. Secondly,  what's really important too is I think campuses can create their own organization. It's  important for them to have their own committee where they look at from a faculty perspective,  from a campus leadership perspective, what can we do to ensure equity in our classroom between  English language learners and native English speakers? But not only from their perspective.  It's important that they also include those English language learner students to find out  from them the resources they need, what will help them to be successful and feel that they're in  a more equitable learning environment. Bring the stakeholders into the conversation. Exactly. Yeah. That's a great point. Any final points you want to make, anything you want to clarify or expound on? You know, I would just say the one last thing that I found surprising about  these students was their perseverance, which actually was the third theme identified in the  research. These students were not going to fail. Failure was not an option for them and what they  found pride in was having something associated to their name, which I found very interesting. So to have their name - Peter Cooper-Lara, RN was important to them. They wanted that not only for themselves but they wanted it for something for their kids and their family to be proud of as well. They also saw it as something that nobody can take away from them that really led to that - I  accomplished this, this is mine, and I'm proud of what I've done, and nothing is going to get in  my way of failure. I loved that. That's a great way to end it on. I want to thank you so much for joining us for this important conversation. I really appreciate your time Dr. Cooper-Lara and  broadening our understanding of the work and where we can begin to introduce this into our classrooms or courses, take a better look at our examinations, the way we're testing our students,  looking for inclusive language and making sure that our questions  and things are unbiased and really are taking into consideration English an additional language  students when we're doing this. To our listeners if you've not had the opportunity to read the article  please take a look at the work, "The Experiences of Nursing Students for Whom English is an Additional  Language in Preparing for and Taking Examinations." That's in the January February 2024 issue. Again,  I want to thank you for your time Dr. Cooper-Lara. It's been a great conversation and look forward to  hearing more from you about this. Thank you Dr. Palazzo. Have a great rest of your day.