{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:34:44Z","timestamp":1788752084135,"version":"build-2803163510"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>English is generally recognized as the international language of science and most research on evidence-based medicine is produced in English. While Bangla is the dominant language in Bangladesh, public midwifery degree programs use English as the medium of instruction (EMI). This enables faculty and student access to the latest evidence-based midwifery content, which is essential for provision of quality care later. Yet, it also poses a barrier, as limited English mastery among students and faculty limits both teaching and learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This mixed-methods study investigates the challenges and opportunities associated with the implementation of EMI in the context of diploma midwifery education in Bangladesh. Surveys were sent to principals at 38 public midwifery education institutions, and 14 English instructors at those schools. Additionally, ten key informant interviews were held with select knowledgeable stakeholders with key themes identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Surveys found that English instructors are primarily guest lecturers, trained in general or business English, without a standardized curriculum or functional English language laboratories. Three themes were identified in the key informant interviews. First, in addition to students\u2019 challenges with English, faculty mastery of English presented challenges as well. Second, language labs were poorly maintained, often non-functional, and lacked faculty. Third, an alternative education model, such as the English for Specific Purposes (ESP) curriculum,  \u00a0has potential to strengthen English competencies within midwifery schools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ESP, which teaches English for application in a specific discipline, is one option available in Bangladesh for midwifery education. Native language instruction and the middle ground of multilingualism are also useful options. Although a major undertaking, investing in an ESP model and translation of technical midwifery content into relevant mother tongues may provide faster and more complete learning. In addition, a tiered system of requirements for English competencies tied to higher levels of midwifery education could build bridges to students to help them access global evidence-based care resources. Higher levels might emphasize English more heavily, while the diploma level would follow a multilingualism approach, teach using an ESP curriculum, and have complementary emphasis on the mother tongue.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-024-05499-8","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T14:02:18Z","timestamp":1715349738000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Challenges and opportunities of English as the medium of instruction in diploma midwifery programs in Bangladesh: a mixed-methods study"],"prefix":"10.1186","volume":"24","author":[{"given":"Anna","family":"Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rondi","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Bogren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"issue":"2","key":"5499_CR1","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1017\/S0261444816000380","volume":"52","author":"E Macaro","year":"2019","unstructured":"Macaro E. English medium instruction: global views and countries in focus. Lang Teach. 2019;52(2):231\u201348.","journal-title":"Lang Teach"},{"key":"5499_CR2","doi-asserted-by":"crossref","unstructured":"Montgomery S. Does science need a global language? English and the future of research. University of Chicago Press; 2013.","DOI":"10.7208\/chicago\/9780226010045.001.0001"},{"key":"5499_CR3","first-page":"151","volume":"38","author":"A Doiz","year":"2019","unstructured":"Doiz A, Lasagabaster D, Pav\u00f3n V. The integration of language and content in English-medium instruction courses: lecturers\u2019 beliefs and practices. Ib\u00e9rica. 2019;38:151\u201376.","journal-title":"Ib\u00e9rica"},{"key":"5499_CR4","doi-asserted-by":"crossref","unstructured":"Gallo F, Bermudez-Margareto B, et al. First language attrition: what it is, what it isn\u2019t, and what it can be. National Research University Higher School of Economics; 2019.","DOI":"10.2139\/ssrn.3508640"},{"key":"5499_CR5","unstructured":"Yilmaz G, Schmidt M. First language attrition and bilingualism, adult speakers. Bilingual cognition and language, the state of the science across its sub-fields (Ch. 11). John Benjamin\u2019s Publishing Company."},{"key":"5499_CR6","unstructured":"Polit DF, Beck CT. (2021). Nursing research: generating and assessing evidence for nursing practice. Eleventh edition. Philadelphia, Wolters Kluwer."},{"key":"5499_CR7","doi-asserted-by":"crossref","unstructured":"Scheufele, B. (2008). Content Analysis, Qualitative. The international encyclopedia of communication John Wiley & Sons.","DOI":"10.1002\/9781405186407.wbiecc134"},{"issue":"13","key":"5499_CR8","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.3390\/healthcare11131932","volume":"11","author":"PHS Pelicioni","year":"2023","unstructured":"Pelicioni PHS, Michell A, Rocha dos Santos PC, Schulz JS. Facilitating Access to Current, evidence-based Health Information for Non-english speakers. Healthcare. 2023;11(13):1932.","journal-title":"Healthcare"},{"key":"5499_CR9","unstructured":"Pakenham-Walsh N. Improving the availability of health research in languages other than English. Lancet. 2018;8. http:\/\/dx.doi.org\/10.1016\/ S2214-109X(18)30384-X."},{"key":"5499_CR10","unstructured":"Islam M. The differences and similarities between English for Specific purposes(ESP) and English for General purposes(EGP) teachers. Journal of Research in Humanities; 2015."},{"key":"5499_CR11","unstructured":"Lamri C, Dr et al. (2016-2017). English for Specific Purposes (1st Semester) Third Year \u2018License\u2019 Level. Department of English Language, Faculty of Arts and Language, University of Tlemcen"},{"key":"5499_CR12","doi-asserted-by":"crossref","unstructured":"Jiang L, Zhang LJ, May S. (2016). Implementing English-medium instruction (EMI) in China: teachers\u2019 practices and perceptions, and students\u2019 learning motivation and needs. Int J Bilingual Educ Bilinguaism 22(2).","DOI":"10.1080\/13670050.2016.1231166"},{"issue":"2","key":"5499_CR13","first-page":"231","volume":"52","author":"A Kirkpatrick","year":"2015","unstructured":"Kirkpatrick A. The rise of EMI: challenges for Asia. In, English medium instruction: global views and countries in focus. Lang Teach. 2015;52(2):231\u201348.","journal-title":"Lang Teach"},{"issue":"22","key":"5499_CR14","first-page":"8","volume":"1","author":"G Kavaliauskiene","year":"2009","unstructured":"Kavaliauskiene G. Role of the mother tongue in learning English for specific purposes. ESP World. 2009;1(22):8.","journal-title":"ESP World"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-024-05499-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-024-05499-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-024-05499-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T14:03:26Z","timestamp":1715349806000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-024-05499-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,10]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["5499"],"URL":"https:\/\/doi.org\/10.1186\/s12909-024-05499-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3222188\/v1","asserted-by":"object"}]},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,10]]},"assertion":[{"value":"31 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was part of a larger project in Bangladesh approved by the Ministry of Health and Family Welfare (MOHFW) with project ID UZJ31. The MOHFW project approval allows data collection of this type, that is carried out as part of routine program monitoring and improvement, including informed verbal consent for surveys and key informant interviews.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors of this study have no competing interests and no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"523"}}