Research Methodology

Study Design

The research on improving writing skills among the Saudi junior doctors was analyzed using a descriptive research approach. A descriptive research is one that is designed to depict the participants in a research more accurately. It involves the individuals who are taking part in a study. The findings of this study satisfied the research objectives while at the same time enhancing some of the research objectives in that a clear understanding of the strategies of improvement of the writing skills among the Saudi junior doctors in the research sources that were analyzed by the researcher. In this study, the researcher used the case studies in the analysis as well as understanding some of the critical elements of the research.

Case studies help in the determination of some of the crucial research elements as well as establish a closer view of the research variables. Designing a research of this magnitude requires the incorporation of effective research strategies and techniques in enhancing as well as improving the quality of the research that is produced (Hamdan, 2015). Case studies were used in this research where medical reports and progress notes by the junior doctors were used as the case studies for this study.

A research design could be defined as a detailed plan which is used in conducting a research study and obtaining answers to the respective research questions. This research study utilized the descriptive research design. Descriptive research is a study that is designed to depict those participating in a study accurately. It involves describing the people who are to take part in a study. The purpose of this research paper was to look into the strategies for improvement of writing skills among the Saudi junior doctors who just graduated. Through the use of English for Specific Purpose (ESP) it will be possible to design a course that helps these junior doctors to enhance their skills and develop a more responsive framework in managing the information at hospitals. This research study shall use a qualitative research technique. There exist three distinct ways through which a researcher can undertake a descriptive research project. They include; Observational which involves a researcher viewing and recording the participants in a study.

Participants

The study will target junior doctors especially in Saudi who have just graduated. Considering that these doctors are not trained using the English language, their writing could be illegible such that understanding the reports will be much of a challenge. Accurately depicting participants in a study often requires a closer analysis of the salient features of the participants to establish a closer view of the research variables. The medical notes and progress notes that are written in English by the junior Saudi doctors were sampled and comparison done (Dudley-Evans, 2018). An interview of 10 junior doctors and 5 experienced doctors were interviewed in this study. These participants in the study were selected through a pre-selected criteria. Before the inclusion of the participants in the study, the researcher analyzed the qualifications of the doctors so as to determine their suitability to the study. This was to ensure that the people who are interviewed are junior doctors and the experienced doctors. Pre-screening of the questionnaires helped in ensuring that the questions that are addressed to the professionals are accurate.

Data Collection

Data was collected by the use of questionnaires that helped in establishing the challenges that are faced by the junior Saudi doctors in writing of English and at the same time developing a prototype which would help in ensuring that their writing skills have been improved. Collecting relevant data and samples from the research is key as this helped in analyzing the performance of the doctors and developing their writing skills. Progress notes and medical reports that have been done by the Saudi junior doctors are also data that was critical in this research study.

Scope

The target of the study was mainly Saudi junior doctors who from various case studies are not well-conversant with the English language. These doctors were interviewed using a set of pre-prepared questions that they were expected to answer and at the same time a comparative analysis between the junior doctors and experienced senior doctors. The study was centered on Saudi junior doctors who are not well-versed with the English language. Situation analysis was used in the ESP course. Case topics were selected based on the frequent problems that are noticed in typical situations common with junior doctors (Hamdan, 2015). The present situation analysis was designed to help junior doctors get to understand perspective issues in question and design an appropriate framework for dealing with the problem. Language tests were among some of the ESP protocols.

Procedure

The research reviewed progress notes and the medical reports that are in the electronic medical health information system. In this review of progress notes and reports were marked against a checklist to ensure that there is the completeness of the research process. This analysis, therefore, ensured that the evaluations are consistent and accurate among those reviewing. Data that was of particular interest to the researcher was the progress notes and the medical reports that were provided by the junior doctors and the experienced doctors (Kırkgöz & Dikilitaş, 2018). The data was analyzed using patterns and trends that are within the secondary sources. Tentative research analysis was done based on the existing literature that was presented across the board by the various research tools.

Instrumentation

Ithe n collection of da,ta a systematic approach will be used by the researcher. Semi-structured questionnaires were employed ithe n collection of relevant data that helps the researcher in drawing inference on various aspects of research as well as obtaining sufficient data that will help back up the research study that is being conducted by the researcher. Semi-structured interview questions were central to determining the trajectory of the study.

Research Approach

This research shall adopt the use of secondary sources in documenting the research provisions and requirement. An exploratory research design shall be employed by the researcher in approaching the variables in the research. An exploratory design as the name suggests is aimed at exploring the research question. However, it is not intended at providing a conclusive solution to the problems that are in existence (Kırkgöz & Dikilitaş, 2018). The exploratory research design is usually conducted to analyze and study an issue or a problem which is not yet clearly definExploratorytory research is usually conducted for the purpose of determining the nature of a problem which therefore makes the audieto understand a problem (Dudley-Evans, 2018) better018).

In gathering of the secondary data, a qualitative technique will be used. The sources of the secondary data shall include the use of arti; peerpeer reviewed journals as well as course books that will help in analyzing the improvement of writing skills by the junior Saudi doctors. A deductive approach shall be used by the researcher for the development of the hypothesis of the study. assumptionesis that has been developed will then be subjected to testing through the use of the data that have been retrieved from secondary sources which will be retrieved through the use of qualitative techniques.

Interview Questions

The interview questions were designed such that there are specific questions that were directed at the junior doctors and some to the experienced doctors. These questions are spread across an array of issues involving issues of writing which are experienced by junior Saudi doctors. The interview questions were cross-checked for accuracy so as to determine the effectiveness of the research and at the same time to understand the mechanics that could be used in enhancing the writing skills of the junior Saudi doctors.

The interview questions presented below helped in analysis of the data as well as in developing a closer analysis into the issue of improvement of writing skills among the Saudi junior doctors. An eight-week training plan will be used in addressing the understan ofding the English language by the junior doctors. An assessment of the training post the eight-week plan will be done so as to determine the responsiveness of these doctors to the training that they have undergone. Therefore a post-training interview will be conducted so as to determine whether the Saudi junior doctors have understood the art of writing accurate and legible medical reports.

Five Interview Questions to the Junior Doctors

1. For how long have you been a practicing doctor?
2. Do you believe that you have difficulties in legible writing medical reports and progress notes in English? Explain.

• Is your handwriting deliberately intended to look illegible or it is your natural handwriting? Explain

1. What do you think are the implications of writing illegible medical reports and notes on the patients’ safety?
2. Which measures have you taken to improve your English writing skills so that you can start writing legible medical reports and progress notes?

Five Questions to the Experienced Doctors

1. For how long have you been a practicing doctor?
2. Have you ever experience complains in relation to the illegibility of your English writing skills especially when writing medical reports and progress notes?

• Which measures did you take to improve your English writing skills?

1. Do you find the junior doctors’ English written reports and notes illegible and annoying?
2. What strategies do you think they should adopt to improve their English writing skills?

Data Analysis, Results and Discussions

The descriptive analyrevealsveal that most of the Saudi junior doctors are not well-conversant with the basic writing skills of the English language. It is for this reason that reading their handwritings is often quite a challenge especially to the patients as the legibility of handwritingings is quite a challenge (Dudley-Evans, 2018). From the data collected, there was a positive relationship between understanding and writingthe  of English language and the environments where these junior Saudi doctors are trained. English for Medical Purposes (EMP) isessentialtant factor in helping these junior doctors to appropriately comprehend ways they can manage patient information as well as develop progress reports (Hamdan, 2015). The progress notes and medical reports that have been compiled by the junior Saudi doctors were additionally analyzed and subjected to various tests. It revealed the illegibility of the writing by a majority of the junior doctors (Armerding, 2013).

Out of tene 10 junior doctors who were sampled for the study, 9 of them had progress notes with handwritings that were not clear and legible. Key metrics used in understanding the medical language were analyzed and determinations made regarding the criticalitythe  of English language to the junior doctors. Performing medical procedures such as analysis of strequireires the junior doctor to come up with a progress report which requires proper understandingthe  of English language. Since most of the classes undertaken by these doctors are usually in their language, it is critical to incorporate EMP into the medical syllabus (Dudley-Evans, 2018). English for Medical Purposes is likely to help doctors and other physicians as they will not have an additional problem of learning the basics of writing English (Hamdan, 2015).

The other junior Saudi doctor had writings on progress notes and medical reports that are legible. However, the English used in presenting the progress notes and the report was not accurate as there were significant grammar errors and punctuation issues. Needs assessment was also seen as central in determining whether these junior doctors needed to be engaged in the ESP (Jolly et al., 2018). The research established that needs assessment is central as different medical conditions are usually unique and as such comes with own unique challenges (Kırkgöz & Dikilitaş, 2018). Therefore a central idea in determining the needs of the junior doctors is a closer collaboration witexperienced seniorienced doctors. Experienced doctors need to advise the junior doctors on some of the key measures and approaches that they need to take in devising an appropriate language for the writing skills.  Writing of progress notes and medical rearerts is critical in the medical field as this provides a factuaand a more perspective analysiso the patient safety (Armerding, 2013). This means that the understanding of English as a languay the junior Saudi doctorssignificant major challenge (Kırkgöz & Dikilitaş, 2018). It is critical to introduce programs such as the EMP in the medical training so as to help these medical students and doctors to understand the Basic English language which shall help them in presenting medical reports and the progress notes effectively (Jolly et al., 2018). Progress notes retrieved from more experienced doctors with over ten years’ expin practicepractice reveal that this is a challenge that at one point in they also faced (Hamdan, 2015). One of the senior doctors that I interviewed observed that the issue of patient safety is usually among the threats that doctors face especially when writing medical reports and coming up with the progress notes (Dudley-Evans, 2018).

On the other hand, out of the 5 experienced doctors who were sampled, all the doctors had the basic knowlthe edge of English language and at the same time were well-conversant with the writing of the language. From the progress notes and medical reports by the experienced doctors, it is evident that they have mred the English art and even incorporated the effective use of English in their medical reporting system. In fact, on looking at the reports by the experienced doctors, the researcher established that it is through the specific needs assessment and reporting system that helped them build their knowledge and use of the language (Hamdan, 2015)

Needs analysis often described as needs assessment is critical in the design as well as carrying out any course program in the English for Specific Purposes (ESP). Needs analysis should not only be implemented at the pre-stage process in assessing the ability of the students but should be a continuous process that helps in the design as well as improving and corting of a deficiency. Needs assessment is done after a careful review of the language needs of these junior and experienced doctors (Armerding, 2013).

On analysis of the work experience by the junior Saudi doctors, 4 of the 10 had worked for less than a year, 3 had worked in their various stations for between 2-3years while a similar number has worked for over 5years at their workstations.

Respondents work experience (Junior Doctors)

This data on the junior Saudi doctors who were sampled for the study has been represented graphically as below:

Respondents work experience (Experienced Doctors)

The data on the experienced Saudi doctors with the masthe tery of English language has been represented graphically as shown below;

Data collected showed that experienced doctors have a proper understanding of both written and spoken English which helped them in better delivery of their work. Their relationship with the patients was also observed to be cordial given that they relate well with their patients and additionally have an appropriate understanding of the basic writing skills. With the experience that they have over the years, these docto have a proficiency in, writing and their medical reports and progress notes are accurate and can be read easily (Cottle & Laha, 2013). ,

therefore,herefore privy to these experienced doctors to ensure that they advise and help junior doctors through their learning process so as to provide the support that is required. Alongside the ESP and EMP designed explicitlydesigned for understanding specific applications of English within the medical field. The deficiencies in the physical examination notes by the junior doctors were more pronounced. Englishprimaryhe basic language the used in majority of clinical procedures (Crusan, 2002). Saudi junior doctors need to be exposed to practical English tests as this will expose them to an understanding of the medical systems as well as processes that evestrengthenengthenknowledgestanding of key medical procedures. From the data collected from junior Saudi doctors, 9 of the interviewed students believe that they have difficulties in legible writing of the medical reports and progress notes in English. This was verified by the notes and reports collected from these junior doctors. A majority of their reports had a pitfall as they were not legible and even understanding. This is alluded to the fact that most medical students from Saudi are never taught in English (Crusan, 2002). Designing an ESP course for these medical students will be key in ensuring that they understand the language and at the same time improve their writing skills within their medical profession.

Among the junior Saudi doctors, 8 doctors agreed strongly that the handwriting that they have is not deliberately intended to look illegible but rather their own natural handwriting. They argue that writing the reportusing a different handwriting is a challenge to them and as such posing a challenge to the patients as well in understanding the medical history of patients (Cottle & Laha, 2013). From an analysis of the implications of writing illegible medical reports and progress notes on the safety of the patients, it was observed by 10 of the junior doctors interviewed that there are substantial effects on the part of the patients (Crusan, 2002). Writing of illegible reports could affect the safety of patients in a number of ways as they will not be in a position of clearly understanding what has been written in the reports that are documented by the doctors (Jolly et al., 2018). From the research on improving writing skills among Saudi junior doctors, the research established that senior experienced doctors are well-versed with writing medical reports and progress notes (Armerding, 2013). A closer analysis into some of the case notes and medical reports sampled from the experienced doctors reveal a more comprereviewanalysis of medical data and the diagnostic history of the patients. The reports are more comprehensivelye manner as compared to the reports and progress notes obtained previously from the junior doctors.

From the data that was c,ollected it could be recommended that doctors that write medical reports and progress notes should be rewarded through recognition, promotions, or scholarships to further their medical studies. The provision of scholarships to junior doctors is one of the most effective methods of encouraging improvement in their writing skills (Antic, 2017). The majority of junior doctors that join the medical profession have the ambition of climbing up the career ladder (Kırkgöz & Dikilitaş, 2018). This can only be achieved by going back to college for master’s degrees and other medical related courses that allow doctors to specialize (Armerding, 2013). Therefore, promising the junior doctors that they will be given scholarships once they improve their writing skills will encourage them to strive towards learning and practicing how to write medical reports and progress notes effectively. This will likely ensure that these students improve their skills and at the same time strive to be excellent in their basic skills (Antic, 2017).

Consistent training on handwriting is among other training packages that the research observed as being key to junior doctors (Jolly et al., 2018). Writing reports that are legible will help the patient a great deal as they will understand the diagnostic history and at the same time be in a position of getting to determine the history of a medical condition that they are suffering from (Cottle & Laha, 2013).

There are several measures that have been taken by the junior doctors in Saudi to improve their writing skills and start writing medical reports and progress notes that are legible. ESP course which takes eight weeks is among measures developto improve the writing skills of the Saudi junior doctors which helps in enhancing patient safety (Hamdan, 2015). Presenting reports and progress notes in illegible writing could mislead the patients and as such affecting their safety (Crusan, 2002). Therefore junior doctors should ensure that they provide the necessary support systems supported by the experienced doctors. Senior doctorfulfill to fulfil their roles as role models to the junior doctors and interns through showing commitmenttheir own practice and encouraging the juniors and intern doctors to be consistent in their diagnosis as well as care and treatment (Kırkgöz & Dikilitaş, 2018). They can ensure this is achieved through devising an appropriate strategy for communication and presenting the reports and progress notes (Cottle & Laha, 2013). Senior and experienced doctors observe tha at there need for an enhanced supervision n aas well as assessment of skills of junior doctors in ensuring that they improve the clinical skills and reporting of clinical processes and procedures. One of the methods that can be used in overcoming lack of knowledge could be tostandardized criteriazed criteria for writing progress notes and medical reports by clinicians (Crusan, 2002).

A comparative analysis between junior doctexperienced senior experienced doctors shows a huge difference especially in comprehension and understanding of the English language.highe is a great possibility that this is mainly because of the vast experience that they have in managing patient issues as well as an underthe standing of criteria used in compiling medical reports and the progress notes. ESP attempts to identify what the learners like during the start of the course (Antic, 2017). Hospitals need to help junior doctors with their journey to understanding the English language which helps in reporting and compiling of progress notes for the patients.

Conclusion

The research has established that junior Saudi doctors have an issue with English especially presenting medical reports and the progress notes in proper English. The writing is illegible and as such posing a threat to patient safety. On thexperienced senior experienced doctors are well-versed with the methodology of incorporating English into the reports and progress notes that they present. This has been evidenced by the case studies that were collected from both the experienced and junior doctors (Tomlinson, 2005). ESP is among the chelps that helps these junior doctors in enhancing and improving their writing skills so that they can present legible and accurate medical reports and progress notes.

References

Antic, Z. (2017). Forward in Teaching English for Medical Purposes. FACTA UNIVERSITATIS Series: Medicine and Biology, 14(3), 141-147. Retrieved from http://facta.junis.ni.ac.rs/mab/mab200703/mab200703-08.pdf

Armerding, P. L. (2013). Doctors for the kingdom: The work of the American mission hospitals in the Kingdom of Saudi Arabia ; 1913-1955. Grand Rapids, Mich: Eerdmans.

Crusan, D. (2002). An assessment of ESL writing placement assessment. Assessing Writing, 8(1), 17-30.

Cottle, D., & Laha, S. (2013). Anaesthetics for junior doctors and allied professionals: The essential guide.

Dudley-Evans, T. (2018). Developments in English for Specific Purposes: A multi-disciplinary approach. Cambridge: Cambridge University Press.

Ewles, L. (2005). Key topics in public health: Essential briefings on prevention and health promotion. Edinburgh [u.a.: Elsevier, Churchill Livingstone.

Hamdan, A. (2015). Teaching and learning in Saudi Arabia: Perspectives from higher education.

Jolly, B., Kelly, M., Nestel, D., & Watson, M. (2018). Healthcare simulation education: Evidence, theory and practice.

Kırkgöz, Y., & Dikilitaş, K. (2018). Key issues in English for specific purposes in higher education.

Tomlinson, B. (2005). Developing materials for language teaching. London: Continuum.