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Practising difficult conversations with an AI patient
Back to Menu ↩ Good doctors do not simply tell patients what to do. They explain the options, listen to the patient’s values and concerns,
September 28, 2026
Metaphors can tell us a lot about how people think. A new study, published in Acta Psychologica, uses metaphors to explore how medical students see their English for Medical Purposes (EMP) teachers.
The researchers worked with 144 medical students at a university of medical sciences in Iran. Each student completed the sentence: “The English for Medical Purposes teacher is like a/an …, because …”. Students could answer in Farsi, their first language, so they could express complex ideas and feelings freely. The students produced 152 metaphors.
The researchers grouped the metaphors using Cameron and Low’s (1999) metaphor analysis framework with four “philosophies” of teaching. The largest group saw the teacher as a conduit, a channel that passes on knowledge. Examples included a coach, a driver, a signpost and a ship’s captain. Almost as many saw the teacher as a nurturer: a mother, a cook, a gardener or a physician. Others saw the teacher as a scaffolder (someone who gives temporary support while learners build their skills), with images such as a key, a map or a lighthouse.
Some images were less positive. A small group of metaphors showed the teacher as an authority figure, such as a traffic police officer. Two students described the teacher as an “executioner” and as an “uninvited guest”. One student explained that being questioned in front of classmates felt humiliating, and that this made them stop taking part in class.
Perhaps the most interesting finding is what was missing. No student described the teacher as a learning partner or as someone who works collaboratively with students to change things. The authors suggest that students see Medical English mainly as a practical tool for their careers and exams.
The authors describe a tension in the students’ beliefs. Students wanted emotional support from a caring teacher. But they also expected a teacher with clear authority. The authors link this to the high-stakes, exam-focused nature of medical education.
What does this mean for teachers? The authors warn that simply introducing learner-centred methods may clash with students’ expectations of structure and authority. Instead, teachers should balance the two: keep the role of a knowledgeable guide, while giving emotional and practical support. They also suggest that metaphor-based reflection could be a useful part of teacher training.
The study took place in one university in one country, so we should be careful about generalising. But it offers a simple idea that any teacher can try. Ask your own students to complete the sentence. Their answers may surprise you, and they may help you understand what your learners expect from you.
Back to Menu ↩ Good doctors do not simply tell patients what to do. They explain the options, listen to the patient’s values and concerns,
Back to Menu ↩ In many countries, a large part of the healthcare workforce has trained overseas. In the UK for example, international medical graduates
Back to Menu ↩ Every day, healthcare workers meet patients who do not share their language or their cultural background. Language is only part of