Humanizing the Foreign Language Coursebook for Medical Students

A foreign language coursebook can be seen as a flexible basis for teacher and student activity, creativity and self-realization. This is possible when the coursebook is humanized by the teacher. The purpose of the study is to reveal the ways to humanize the foreign language coursebook for medical students as means to increase students' motivation and engagement, provide conditions for their personal development and help them achieve high learning results. It is stated that the foreign language coursebook for medical students needs to be humanized to meet high demands for the quality of medical education. The ways to humanize the coursebook have been developed on the basis of person-oriented, action-oriented, value-oriented, multi-dimensional, and humanistic approaches. These ways include providing a positive emotional environment, making the learning process personal, bringing human values to the classroom, provoking students' creativity, using pieces of art in language teaching, involving different senses in language learning, engaging all the students in the education process. Numerous examples of the implementation of the ways in the foreign language teaching to medical students are provided. It is concluded that the foreign language coursebook humanization brings great benefits to students and teachers in the long term


Introduction
An integral element of foreign language teaching is the coursebook. It offers numerous advantages for both teachers and students (Hutchinson & Torres, 1994;O'Neill, 1982;Sheldon, 1988). Not only does the coursebook present the material to be learned, but it also brings logic and coherence to the classroom, becomes a source for teacher-student communication, and a way to encourage students' activity.
The coursebook can be regarded as a flexible basis for teacher and student activity, creativity and selfrealization. T. Hutchinson and E. Torres consider the coursebook to be an agent of change (Hutchinson & Torres, 1994). Any coursebook needs to be adapted in accordance with the education goals, teaching conditions, students' cultural and personal characteristics, and teacher's professional style. As D. I. Banegas says, adapting the coursebook the teacher brings it to life (Banegas, 2018).
One of the ways to adapt the coursebook is to humanize it. The coursebook is humanized if it is based on positive values and oriented on students' personal development, encourages and involves them personally, helps them achieve their fullest potential.
I believe that humanizing is what the foreign language coursebook for medical students needs most. The analyses of the coursebooks that are generally used to teach a foreign language to medical students in Russia have revealed the lack of the content that would encourage students' activity, connect with their personal interests and enthusiasms, life experience, attitudes and feelings. These coursebooks mostly consist of the texts that describe the work of human body systems, symptoms and treatments of different diseases, formal instructions for the doctors or examples of standard dialogues between doctors and patients.
Such content makes language learning rather an impersonal information-oriented process. This problem is vividly presented by B. Tomilson: "All the coursebooks I have used in my 45 years of teaching have needed humanizing but those which have needed humanizing most have been those designed to teach English for Specific Purposes. Such books typically take the position that their students need to learn a lot of language very quickly, that they are intelligent adults and that the most efficient way of helping them is to teach and exemplify language features and then get the students to practice. What these materials often lack is appeal to the personal needs and wants of the human beings who are using them." (Tomilson, 2013).
When it comes to teaching medical students, it is necessary to consider not only the efficiency of the foreign language teaching but also the impact of the education process on the students' moral and ethical development. Medical education is supposed to provide students with the necessary knowledge and skills, as well as to develop students' professional values, empathy and sympathy, communication skills. In this context humanizing the coursebook is one of the ways to meeting high demands to the quality of medical education.

Purpose and objectives of the study
The purpose of the study is to reveal the ways to humanize the foreign language coursebook for medical students as means to increase students' motivation and engagement, provide conditions for their personal development and help them achieve higher learning results.
It is attempted to justify the need for the coursebook's humanization, define the characteristics of a humanized foreign language coursebook, determine teaching approaches that can be applied, develop and implement in the educational process ways to humanize the foreign language coursebook.

Literature review
The foreign language coursebook has rightfully been the focus of attention of many researchers. A number of attempts were made to define the ways to evaluate and select foreign language coursebooks (Andarab, 2019;Banegas, 2018;Dos Santos, 2020;Chambers, 1997). The researchers defined evaluation criteria, possible advantages and disadvantages of the coursebook, steps of the foreign language coursebook selection. F. Chamber names a great number of factors to be considered for the coursebook selection, including suitability for the age group, cultural appropriateness, methodology, level quality, ways of reaching decisions, number and type of exercises, skills, variety, pace, personal involvement, problemsolving (Chambers, 1997).
After the coursebook has been evaluated and selected, it is supposed to be adapted for the certain learning conditions and in accordance with the demands to the quality of education. Modern tendencies of the foreign language coursebook adaptation are its computerization and humanization.
The leading tendency today is obviously computerization. Researchers from all over the world dedicate their studies to bringing language teaching to a new level via implementing computer technologies into the learning process. They study opportunities that digital learning brings (Carrier, 2017), develop framework and strategies for learning with digital coursebooks and mobile devices (Bikowski & Casal, 2018), design and apply language learning digital games (Alyaz & Genc, 2016), explore and incorporate 3D virtual reality into language learning (Christoforou, Xerou, & Papadima-Sophocleous, 2019), etc.
In comparison with computerization, humanization of the foreign language coursebook seems to be a less developed problem.
There are rather few studies devoted to the foreign language coursebooks humanization and even less to the foreign language for specific purposes coursebook humanization.
In this context, B. Tomlinson's research is of particular interest to this study (Tomlinson, 2008;Tomlinson, 2013;Tomlinson, 2016). He emphasizes the necessity to humanize any coursebook so that it would appeal to the students' personalities: their interests, their needs, their experience of life, their views, their feelings, and their capacity to make meaningful connections in their minds. The researcher states that the coursebook should help to create a positive emotional environment where students would be able to "feel at ease, develop self-confidence and self-esteem, develop positive attitudes towards the learning experience and be involved intellectually, aesthetically and emotionally" (Tomlinson, 2013). B. Tomlinson argues that the coursebook humanization involves the engagement of human being's potential to multidimensional processing. The humanized coursebook makes use of student's ability to learn through doing things physically, feeling emotions, and experiencing things.
Thus, according to B. Tomlinson, humanizing the foreign language coursebook means: to make the coursebook appeal to students' personality and help them acquire a foreign language through meaningful experience; to help students build connections between the coursebook's content and their minds; to create a positive emotional environment which encourages students' activity; to help students exploit their full capacity for language learning.
Based on B. Tomilson's idea of the coursebook humanization, I. Timmis suggests that the foreign language coursebook can be humanized through some relatively minor adaptations to dialogues based on processes such as: extending the dialogue, changing the cast of characters, the register, the mood or the 'plot', and unscripting' the dialogue (Timmis, 2016).
Practical suggestions for the coursebook humanization are presented in the book "Humanising Your Coursebook. Activities to bring your classroom to life" by M. Rinvolucri (Rinvolucri, 2002). The book introduces a number of practical activities that the teacher can implement while teaching a coursebook unit.
The author sees humanization in applying multi-sensory activities, changing the teacher's role from the "controller" to the "participant", letting students make mistakes and get positive feedback.
H. Rahmanpanah and A. Mohseni's research examines the results of the coursebook humanization (Rahmanpanah & Mohseni, 2017). They study its impact on developing engagement and motivation among students. To measure the motivational regulations, the researchers administered the adapted version of Behavioral Regulation Questionnaire developed by Markland and Tobin. The results of this study provided evidence on the fact that modifying the coursebook to be more humanistic can expand students' motivation, behavioral, emotional, cognitive engagement subscales. Polina. Yu. Petrusevich / Proceedings TSNI-2021 690 The ways to humanize the foreign language coursebook for medical students were developed on the basis of the following teaching approaches:
The developed ways of humanizing the coursebook were applied in teaching English for specific purposes to the first-year students of Izhevsk State Medical Academy in 2018-2020. According to the educational program, English is studied during one academic year. Students learn general English the first half of the academic year and medical English the second part of the year. The medical topics to cover are "Human Body", "Systems of the Human Body", "Diseases", "Vitamins and Minerals", "Patient diagnostics".
As a rule, medical students have a low level of the foreign language proficiency (A1 or A2). They do not consider English to be their priority and at the same time associate foreign language lessons mostly with difficulties, fears, mistakes, and failures. In such conditions, humanizing the coursebook is a necessity. It ensures the increase of students' motivation and engagement, the efficiency of the learning results, and a positive impact on students' personal development. build value-based relationships with groupmates and the teacher.
At the end of the course students are asked to answer a number of survey questions, including: -Are you satisfied with the results you achieved in language learning?
-What helped you to improve your language proficiency?
-What stood in the way of bigger progress?
-Did your expectations from the English language classes meet the reality? Why? Why not?
-What activities and topics would you like to add to the course?
-What (non-linguistic things) have you learned thanks to the course?

Results
The purpose of the study was to reveal the ways to humanize the foreign language coursebook for medical students. Based on the theoretical study and practical experience, seven ways were found and used in the foreign language classroom. The ways intersect and complement each other. They cannot be used in full isolation from each other as they represent unity. The ways and examples of their realization are presented below.

1.
Providing positive emotional environment -Students are involved in the discussion about the role of mistakes in language learning. The main ideas they are brought to are: 1. It is impossible to learn any language without making mistakes. There is no person in the world who has never made a linguistic mistake. 2. A mistake is a sign that you are trying to do more than you can do now so it is a sign of your development. 3. It is much worse if you do nothing than if you do something and make a mistake. 4. Mistakes need to be corrected; otherwise, the same mistake becomes constant for you. So, mistakes are corrected not to humiliate a student but to help him or her.
-Emotionally positive content is added to the coursebook. For instance, students are encouraged to sing funny songs about human organs such as "I am your heart" and "A wonderful respiratory system".
Students are supposed to sing songs, do several vocabulary exercises based on them, and a creative task (prepare a singing and dancing performance, draw illustrations to the song, and comment on them).

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The teacher gets involved in the teaching activities. The teacher can temporarily become a speaking partner for one of the students or a participant in one of the groups. The teacher can also share his or her personal experience to arouse students' interest in the activity. For example, when I ask students to discuss their choice of profession and talk about their first medical work experience (medical practice), I tell them my story. I tell them how I started teaching English when I was 17 years old and my first student was my neighbours' 6 years old child. We played all the time and had no table and no coursebook but many toys, cards, and drawings. My salary was paid in form of cookies and pastry as my student's mum was an amazing baker.
-Some of the holidays are celebrated in the foreign language classroom. For example, students celebrate Christmas, International Students' Day, or International Day of the Doctor. The lesson is prepared partly by the teacher and partly by the students, and it includes games, drama, songs, classroom decoration, and discussions of the holiday traditions in different countries.

2.
Making the learning process personal -Students are given a choice and asked for an opinion. They can vote for the topic to discuss, the game to play or the creative task to carry out. They can also be given an individual choice when each student decides the form to present his or her ideas or the level of difficulty of the activity or the topic to write about. They are asked to be initiative and produce ideas for further language learning. Students may also be involved in conducting a lesson when they prepare an activity and hold it for their group mates.
-Students are encouraged to express their thoughts and feelings, share their experiences, discuss their likings and preferences. For example, if the students listen to a dialogue between a doctor and a patient when the patient is a small child. Students are asked If they have got experience of working interaction with children, if they find it easy or difficult to communicate with children, and If they would like to work with children as doctors. When students learn the vocabulary connected with the anatomy of the human body, they can be asked to share with each other their experience of studying anatomy as a medical subject, tell what they did to memorize a great amount of information, and what they find the most interesting about the anatomy of the human body.
-Students are encouraged to make up stories and dialogues where they are the main characters or rewrite the text from the coursebook so that it would be about them. For instance, students read the text "My first day as a doctor" and rewrite it as they think their first day as doctors could be.
-Students are asked to individualize their foreign language notebooks. They can divide into some logical parts, use colours to highlight important information, draw illustrations, glue pictures and photos, decorate the notebook the way they like.

3.
Bringing human values to the classroom -Value-oriented texts are added to the coursebook's content. For instance, students are given to read the letter that is written by a medical student to the future himself when he becomes a doctor. The student reminds to the future himself never to stop being companionate and caring about the patients, never to stop expanding the knowledge, to be ready to stand up for what you believe in, to be always kind to nurses, medical students, and colleagues, etc. Students discuss the values that are presented in the letter and why some people lose their value orientations. After that, students are asked to write a letter to future themselves (in 6 years) and give pieces of advice on how to be a great doctor.
-Students are asked to create their personal code of ethics. Students are told that any specialist has his code of ethics. He or she might not completely realize it but he or she surely acts according to this code.
Students are divided into small groups to discuss what codes people of different professions (teachers, pilots, engineers, lawyers) could have. Then students are given a task to develop their personal code of ethics and present it in the way they like (poster, mini-book, audio, or video). - The relationships that are built in the classroom are value-oriented. The teacher sets an example of value-oriented communication and expects students to do the same. The signs of non-humanistic behaviour towards others are suspended by the teacher and used as a cause for a talk with students. The teacher regularly uses activities that help to build trusting relationships among students. For instance, students can be asked to write letters to each other. It can be "I would like to know you better", "Thank you" or "What I admire in you" letters.

Provoking students' creativity
-Students are asked to act out a dialogue between a doctor and the happiest patient in the world / an alien / a very suspicious patient / a character from their favourite film or book.
-Students are asked to read the text "Respiratory system" and rewrite it so that it would become a comedy / drama/ detective / musical.
-Students are asked to think up how the human body would look like in ten thousand years and write a mini-book "Anatomy of the future".
-Invite to hold a part of the lesson. Students are asked to develop and hold a table game, adventure game, or computer game "Minerals and Vitamins" for their groupmates.
-An art teacher is invited to the lesson. Students learn body parts in English with the English language teacher and then learn how to draw a human body with help of the art teacher. During their studies, students are often asked to draw different human body parts and organs, so this type of combination appears to be not only exciting but also quite useful.
-Students are asked to write a poem devoted to the human heart and its role in the human body.

5.
Using pieces of art in the language teaching -The content of the coursebook is extended by literature texts: short stories, poems, fragments of the literature work. For example, we read with students fragments of the books "When Breath Becomes Air" by Paul Kalanithi and "Do No Harm" by H. Marsh.

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The discussion of the doctor's work is organized through paintings that reflect the world of medicine, including such paintings as "A French underground hospital at Verdun" by U. Matania, "Children Playing at Doctors" by F. D. Hardy, "Portrait of a Nurse from the Red Cross" by G. E. E. Nicolet.
-Students are encouraged to watch and discuss films and series that reflect different aspects of patients and doctors' lives. My students found impressive the films "A walk to remember", "Five feet apart" and the series "The Good Doctor".

Involving different senses in language learning
-Kinaesthetic activities are used in the classroom. Students show parts of the body, mime words and stories, touch things to learn, play games, create posters. For example, students bring to the classroom things connected with doctor's work such as cotton, thermometer, or syringe. All these things are put in a bag. Students take one thing from the bag, guess what it is without looking at it and explain what it serves for.
-Visual materials such as pictures, photos, paintings, posters, charts, mind-maps, visual dictionaries are used in the classroom. Students are not only given visual aids but are asked to draw their own illustrations, create their own mind-maps, develop their own visual dictionaries. One of the possible ways to do it is to ask students to prepare a set of cards. On the one side of the card, students write the word that they want to learn and on the other side they draw a picture. This picture does not necessarily show the meaning of the world, it can also reflect student's associations with this word. It is important that students are not given a certain list of words but choose the words from the coursebook on their own. Then, students pair up. They show their drawings and try to guess the word. They can also give a definition to the guessed word, make up a sentence with it or use it to ask a question to the partner.
-Audio materials such as coursebook audios, podcasts, songs, short videos, films, and series are used in the classroom. Sometimes I ask my students to watch a film or an episode of the series. In the classroom, students are given a task to listen to a part of the film without seeing it. Based on the characters' speech, music, and other sounds they try to understand what is happening at that moment in the film. Some students find this task extremely emotional as it stimulates their imagination.
-Smells traditionally are not used in foreign language teaching. However, there are ways to involve this sense in language learning too. For example, students (if they have no allergy) can be given essential oils and asked to associate the smell with one of the words they have learned, one of the fragments from the film they have watched or the book they have read, one of the stories that have happened to them.

7.
Engaging all the students in the education process -Students' homework assignment is to prepare a presentation "My ideal medical university". In the classroom, students are divided into groups of four. Each group gets a laptop which is used to show the presentation. One of the students in the group becomes a speaker, others are listeners. The speaker gets a certain period of time to present his or her ideal university so that the listeners would get interested in entering such a university. After that, listeners get time to ask questions about the university. When the presentation and desiccation are over, listeners go to another speaker and the speaker gets new listeners.
This way each student gets a chance to present his or her ideal university numerous times to different listeners and to listen to many speakers. The final step of the activity is voting. Students chose the university they would like to enter and vote for it.
-Students are asked to pair up. One person describes a disease in 5 sentences and another person tries to guess the disease. The task of the students is to manage to discuss as many diseases as possible for a limited period of time.
-Students are asked to prepare a number of questions that could be used to check the comprehension of the text "First aid". Then, they talk with many of their fellow groupmates in turn, asking their questions. They try to find those students who can answer all of their questions correctly.
-Students are asked to form groups of four. Each group gets 10 minutes to write new words that they had met in the unit on the pieces of paper (cards). Their cards with new words are put in the bag.
Then, one student takes a card from the bag and describes the written word. Other students try to guess the word. The first person, who guesses the word, gets the card and makes up the sentence with the word.

Discussion
The observation of the education process has shown that the coursebook humanization reveals its full benefits in the long term. In the short term, it may even seem less efficient than the traditional teaching with the coursebook. It takes much time and effort to build value-based relationships in the classroom, encourage students' activity and creativity, develop their motivation and enhance their self-reliance. In the early stages humanizing the coursebook might not lead to the expected results, especially if the students are not used to such ways of learning. Some of them find it difficult to carry out creative tasks; others experience problems with working in pairs and mini-groups, etc. However, students ultimately achieve high learning results as they get personally involved in language learning, take an active part in the education process, collaborate efficiently with each other, and exploit their full capacity for language learning.
The analyses of the results of the survey that students took at the end of the course showed students' positive attitude to language learning based on the coursebook humanization. The most valuables aspects of the course for students appeared to be the variety of activities, positive emotional environment, gripping and unusual learning materials, creative and project tasks. Most students noted that they had made great progress in language learning and some of them mentioned that they did not expect language learning to be rather exciting.

Conclusion
In order to meet high demands for the quality of medical education, the foreign language coursebook needs to be humanized. Humanizing the coursebook means making it appeal to students' personality, encourage their activity and creativity, help them achieve their fullest potential, and provide conditions for their personal development.
The key ways to the humanization of the foreign language coursebook for medical students are: -providing positive emotional environment, -making the learning process personal, -bringing human values to the classroom, -provoking students' creativity, -using pieces of art in the language teaching, -involving different senses in language learning, -engaging all the students in the education process.
The ways intersect and complement each other, representing unity. Their specific is that their full benefits can be seen in the long term as they are supposed to affect not only students' knowledge and skills but also various spheres of their personality. Their implementation help to increase students' motivation and engagement, provide conditions for their personal development and lead to higher learning results.