Foreign language anxiety and nursing clinical communication competence in Indonesian pre-elementary nursing students: A mixed methods study
DOI:
https://doi.org/10.58881/jlps.v4i1.69Keywords:
Anxiety, academic performance, , English for Specific Purposes, Nursing education, Foreign Language Classroom Anxiety ScaleAbstract
English communication competence is essential for nursing professionals in global healthcare settings. However, language anxiety can hinder the acquisition of these skills, particularly among nursing students learning English for Specific Purposes (ESP). Limited research exists on language anxiety in ESP learning for nursing, especially in Asian contexts like Indonesia. This study aimed to examine the relationship between language anxiety and specific nursing communication performance among pre-elementary level nursing students in Indonesia, focusing on a vital-signs checking task. An explanatory sequential mixed methods design was employed. Sixteen pre-elementary level nursing students from Harapan Bangsa University, Indonesia, completed the Foreign Language Classroom Anxiety Scale (FLCAS) questionnaire and participated in a vital-signs checking role-play task. Performance was evaluated using an adapted assessment rubric. Quantitative data were analyzed using descriptive statistics and Pearson correlation coefficients. Participants demonstrated moderate levels of language anxiety (M = 3.00, SD = 1.00), with higher anxiety related to communication apprehension and fear of negative evaluation. A significant negative correlation was found between language anxiety and overall communication performance (r = -0.58, p < 0.05). Stronger negative correlations were observed between anxiety and language accuracy (r = -0.62), fluency (r = -0.54), and pronunciation (r = -0.57), while no significant correlations were found with content accuracy or nonverbal communication. This study provides empirical evidence for the detrimental impact of language anxiety on nursing students' communication performance in clinically relevant tasks. The findings underscore the need for targeted interventions to address language anxiety in ESP learning for nursing, considering individual learner profiles and the specific challenges of communication in healthcare contexts.
References
Aebersold, M. (2018). Simulation-based learning: No longer a novelty in undergraduate education. Online Journal of Issues in Nursing, 23(2), 1-1.
Aida, Y. (1994). Examination of Horwitz, Horwitz, and Cope's construct of foreign language anxiety: The case of students of Japanese. The Modern Language Journal, 78(2), 155-168. https://doi.org/10.1111/j.1540-4781.1994.tb02026.x
Bactol, C. J., Acabado, A., Canales, A., Taborada, A., Nacionales, J., & Claridad, N. (2023). Investigating anxiety in oral recitation among freshmen BS accountancy students in a Philippine higher education institution. Journal of Language and Pragmatics Studies, 2(2), 58–70. https://doi.org/10.58881/jlps.v2i2.18
Bactol, C. J., Acabado, A., Canales, A., Taborada, A., Nacionales, J., & Claridad, N. (2023). Investigating anxiety in oral recitation among freshmen BS accountancy students in a Philippine higher education institution. Journal of Language and Pragmatics Studies, 2(2), 58–70. https://doi.org/10.58881/jlps.v2i2.18.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry & research design: Choosing among five approaches (4th ed.). SAGE Publications.
Dewaele, J.-M., & MacIntyre, P. D. (2014). The two faces of Janus? Anxiety and enjoyment in the foreign language classroom. Studies in Second Language Learning and Teaching, 4(2), 237-274. https://doi.org/10.14746/ssllt.2014.4.2.5
Docena, V. T., Buenaventura, K. H., Lobingco, W., Manlimos, S., Joseph Nacionales, J., & Claridad, N. (2023). Investigating oral presentation anxiety of freshmen English major students in a Philippine higher educational institution. Journal of Language and Pragmatics Studies, 2(3), 173– 189. https://doi.org/10.58881/jlps.v2i3.27
Docena, V. T., Buenaventura, K. H., Lobingco, W., Manlimos, S., Joseph Nacionales, J., & Claridad, N. (2023). Investigating oral presentation anxiety of freshmen English major students in a Philippine higher educational institution. Journal of Language and Pragmatics Studies, 2(3), 173–189. https://doi.org/10.58881/jlps.v2i3.27
Eysenck, M. W. (1979). Anxiety, learning, and memory: A reconceptualization. Journal of Research in Personality, 13(4), 363-385. https://doi.org/10.1016/0092-6566(79)90001-1
Gaffas, Z. M. (2019). Students' perceptions of the impact of EGP and ESP courses on their English language development: Voices from Saudi Arabia. Journal of English for Academic Purposes, 42, 100797. https://doi.org/10.1016/j.jeap.2019.100797
Garone, A., & Van de Craen, P. (2017). The role of language skills and internationalization in nursing degree programmes: A literature review. Nurse Education Today, 49, 140-144. https://doi.org/10.1016/j.nedt.2016.11.012
Gravetter, F. J., Wallnau, L. B., Forzano, L.-A. B., & Witnauer, J. E. (2020). Essentials of statistics for the behavioral sciences (10th ed.). Cengage Learning.
Horwitz, E. K. (2001). Language anxiety and achievement. Annual Review of Applied Linguistics, 21, 112-126. https://doi.org/10.1017/S0267190501000071
Horwitz, E. K., Horwitz, M. B., & Cope, J. (1986). Foreign language classroom anxiety. The Modern Language Journal, 70(2), 125-132. https://doi.org/10.2307/327317
Jin, Y. X., & Dewaele, J.-M. (2018). The effect of positive orientation and perceived social support on foreign language classroom anxiety. System, 74, 149-157. https://doi.org/10.1016/j.system.2018.01.002
Kameg, K. M., Szpak, J. L., Cline, T. W., & Mcdermott, D. S. (2014). Utilization of standardized patients to decrease nursing student anxiety. Clinical Simulation in Nursing, 10(11), 567- 573. https://doi.org/10.1016/j.ecns.2014.05.006
Khan, S. D., Mohammed, L. A., & Mustafa, M. (2024). How enjoyment affects English acquisition and anxiety for university students: An analytical study. Journal of Language and Pragmatics Studies, 3(1), 43–52. https://doi.org/10.58881/jlps.v3i1.41
Khan, S. D., Mohammed, L. A., & Mustafa, M. (2024). How enjoyment affects English acquisition and anxiety for university students: An analytical study. Journal of Language and Pragmatics Studies, 3(1), 43– 52. https://doi.org/10.58881/jlps.v3i1.41.
Krashen, S. D. (1982). Principles and practice in second language acquisition. Pergamon Press.
MacLean, S., Kelly, M., Geddes, F., & Della, P. (2017). Use of simulated patients to develop communication skills in nursing education: An integrative review. Nurse Education Today, 48, 90-98. https://doi.org/10.1016/j.nedt.2016.09.018.
Martiron, J. M. (2017). Language anxiety among Indonesian undergraduate EFL students. Journal of Foreign Language Teaching and Learning, 2(2), 1-10. https://doi.org/10.18196/ftl.2220
Muhtar, S. N., Sutarsyah, C., & Sukirlan, M. (2020). Foreign language anxiety of Indonesian undergraduate nursing students and its effects on their speaking performance. International Journal of Social Sciences and Humanities, 4(3), 91-102. https://doi.org/10.29332/ijssh.v4n3.460
Müller, A. (2011). Addressing the English language needs of international nursing students. Journal of Academic Language and Learning, 5(2), A14-A22.
Park, G. P., & French, B. F. (2013). Gender differences in the foreign language classroom anxiety scale. System, 41(2), 462-471. https://doi.org/10.1016/j.system.2013.04.001
Peddle, M., Bearman, M., Radomski, N., Mckenna, L., & Nestel, D. (2018). What non-technical skills competencies are addressed by Australian standards documents for health professionals who work in secondary and tertiary clinical settings? A qualitative comparative analysis. BMJ Open, 8(8), e020799. https://doi.org/10.1136/bmjopen- 2017-020799
Poupore, G. (2021). Measuring foreign language anxiety at the tertiary level: Developing and validating the Foreign Language Anxiety in Academic Settings scale. Language Testing, 38(2), 201-228. https://doi.org/10.1177/0265532220951635
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763-1768. https://doi.org/10.1213/ANE.0000000000002864
Schroeder, L. D., Sjoquist, D. L., & Stephan, P. E. (2017). Understanding regression analysis: An introductory guide (2nd ed.). SAGE Publications.
Shi, W., & Liu, D. (2020). A systematic review of research on foreign language anxiety in nurse education. Nurse Education Today, 93, 104532. https://doi.org/10.1016/j.nedt.2020.104532.
Silma, N., et al. (2024). Unveiling the Dynamics of Language in Action: A Critical Examination of Classroom Discourse Practices in Language Education. Loquen: English Studies Journal, 17(2), July– December. https://ftk.uinbanten.ac.id/journals/index.php/loquen/article/view/10597
Smith, T., & Rushton, K. (2018). Vital signs in clinical practice. British Journal of Nursing, 27(20), 1164- 1168. https://doi.org/10.12968/bjon.2018.27.20.1164.
Stalnaker, T. A., & Chuo, V. (2019). Language anxiety among nursing students in the clinical setting. Nurse Educator, 44(4), 196-200. https://doi.org/10.1097/NNE.0000000000000604
Teimouri, Y., Goetze, J., & Plonsky, L. (2019). Second language anxiety and achievement: A meta- analysis. Studies in Second Language Acquisition, 41(2), 363-387. https://doi.org/10.1017/S0272263118000311.
Wajdi, M. (2018). Classroom Discourse: A Model of Language Classroom Research. Surabaya: CV. Jakad Publishing.
Woodrow, L. (2006). Anxiety and speaking English as a second language. RELC Journal, 37(3), 308-328. https://doi.org/10.1177/0033688206071315.
Yasuda, T., & Nabei, L. (2018). Effects of coping strategies on language anxiety of Japanese EFL learners: Investigating willingness to communicate. Journal of Language Teaching and Research, 9(5), 905-915. https://doi.org/10.17507/jltr.0905.02
Zhang, X. (2019). Foreign language anxiety and foreign language performance: A meta‐analysis. The Modern Language Journal, 103(4), 763-781. https://doi.org/10.1111/modl.12590.
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