Most people who learn medical English are already multilingual. Medical students in Riyadh, Ho Chi Minh City or Tashkent study medicine in English but speak to patients in Arabic, Vietnamese or Uzbek. Internationally educated nurses and doctors preparing for OET often use two or three languages every day at work. Many of their future patients will be multilingual too.
Yet many medical English classes still follow an ‘English only’ rule. OET preparation may emphasise this, because the test itself is entirely in English. Translanguaging challenges this habit. This article looks at what it means, what the recent research says, and how teachers might use it.
The term began in Wales when, in 1994, Cen Williams used the Welsh word trawsieithu to describe bilingual teaching. Later, Ofelia García and Li Wei developed the idea into an international theory. In simple terms, translanguaging means that teachers treat all of a learner’s languages as a resource for learning, seeing them as an asset, not as a problem. Jasone Cenoz and Durk Gorter use the term pedagogical translanguaging for planned use of this kind by teachers.
The debate on whether translanguaging is effective is not new. In 2012, for example, Graham Hall and Guy Cook reviewed the research on ‘own-language use’ in Language Teaching. They argued that the long tradition of English-only teaching had rarely been tested against evidence, and that learners’ own languages can support learning.
In a medical English class, translanguaging might include:
None of these activities replaces English as the goal. The aim is to help learners reach that goal by building on what they already know and widening the resources that teachers can draw on.
Research on translanguaging in medical and healthcare education is still small, but it is growing.
Two patterns are clear. First, most of the benefits reported are for comprehension, confidence and engagement. No study yet measures gains in medical English proficiency or test scores. Second, the Saudi study shows that while learners’ first languages can help them understand medical English, heavy reliance on them may slow the move to using English independently.
Translanguaging also happens in real healthcare. This matters for teachers because it shows the kind of language that learners will meet at work.
In Perspectives on Medical Education, Pilar Ortega and Josh Prada argue that medical communication training should reflect how patients really speak. Spanish-speaking patients in the United States often mix English and Spanish, for example by saying ‘refill’ in a Spanish sentence. A word as simple as ‘straw’ has several different Spanish words, depending on where the patient comes from. The authors suggest including these ‘translanguaging moments’ in simulated patient cases.
In the UK, a doctoral study by Emma Brooks at UCL looked at antenatal appointments in a hospital in south London. When no professional interpreter was present, midwives and patients used every resource they had: words from different languages, gestures and written notes. This helped communication happen. But it could also hide the fact that a patient had not fully understood.
This is an important point for healthcare learners. A clinician’s other languages are a real asset. They are not, however, a replacement for a professional interpreter when clinical safety is at stake.
Graham Seed, a teacher and researcher at Cambridge University Press and Assessment who has studied translanguaging, offers practical advice that applies well to medical English.
OET candidates must perform in English, under time pressure, without any support from other languages. So translanguaging in OET preparation should be a means, not an end. In practice, this suggests:
The evidence does not show that translanguaging necessarily raises medical English proficiency. However, it does suggest that careful, planned use of learners’ languages can support understanding and confidence which will have a positive impact on student motivation and willingness to engage in lessons.
For teachers:
For course designers and institutions:
While research is still to be further developed, it does seem that the question is no longer simply whether other languages belong in the medical English classroom. It is more how teachers can use them effectively.
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