First Advisor

Kimberley Brown

Term of Graduation

Spring 1995

Date of Publication


Document Type


Degree Name

Master of Arts (M.A.) in Teaching English to Speakers of Other Languages


Applied Linguistics




Physicians -- Rating of, English language -- Pronunciation by foreign speakers, Communication in medicine, Nurse and physician



Physical Description

1 online resource (ix, 189 pages)


Although many researchers have studied language attitudes in the last three decades, none of the studies have been conducted in the hospital setting, where there are more serious consequences for those working with patients being labeled linguistically "incompetent," as charges of incompetence in language are apt to lead to charges of incompetence in other areas of mastery as well (e.g., Ryan, 1983). This study examines the attitudes of a sample of nurses from three Portland-area hospitals towards nonnative English speaking physicians. The subjects, 156 medical-surgical nurses, listened to three anonymous audiotaped physicians who were from three different ethnic backgrounds: American, Japanese and Persian. The physicians were first all recorded reading a short patient history and giving a verbal order directed toward a nurse. This was the formal context. For the informal context, the physicians gave an impromptu response to a question regarding their future plans. The nurses rated each physician twice, once for each context, using the Speech Evaluation Instrument (SEI), a semantic differential scale using bipolar adjectives developed by Zahn and Hopper (1985). Results indicated that there was a significant positive relationship between a physician's pronunciation and a nurse's perceptions of his medical competency, as measured by the SEI, with the native English speaking physician receiving a higher rating than the two nonnative English speaking physicians. The native Japanese speaking physician, who had the strongest accent, received the lowest ratings on the SEI. There was also a significant positive relationship between the context the physician was speaking in and the ratings he received on the SEI, with the informal context receiving a higher rating for all three physicians than the formal context. If a physician's pronunciation or speech style causes nurses, not to mention patients, to evaluate him/her negatively, then one implication of this study is for the need for more pronunciation work and accent reduction exercises not only in the English as a second/foreign language classroom, but also as a continued offering for nonnative English speaking hospital personnel in teaching hospitals. Another implication relates to the need for better preparing nurses to work and communicate successfully with nonnative English speaking physicians, other hospital personnel, and patients by offering transcultural nursing classes in nursing school and making it a mandatory part of every nurse's education.


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