Questionnaire

Name……………………………

1. Medium of instruction at school………………………………….………….

2. Medium of instruction at Intermediate……………………………………..

3. Father’s Educational background…………………………………………..

1. below 10th ( ) 2.Intermediate ( ) 3.Graduation ( ) 4.Post -graduation ( )

4. I am interested to learn English. Yes ( ) No ( )

5. Rank the below options in the order of importance from one to ten where 1 is the most
important and 10 is the least important in your opinion.

Learning English helps me

1. to gain good marks in optional subjects. ( )

2. to gain employment ( )
3. to gain seat in higher studies ( )
4. to gain social status ( )
5. to gain self-confidence ( )
6. to use computer ( )
7. to communicate nationally and internationally ( )
8. to receive and send messages through email ( )
9. to be successful in the profession ( )
10. to use SMS ( )

6. Rate your level of proficiency in the following Speaking Skills.

Very good=5 Good=4 Average=3 Poor =2 Very poor=1

Counseling
TelephonicSkills

Participating
in Group
Discussions
Asking Questions
and
Enquiring

Making Oral
Presentations

Giving
Instructionsand
Directions

Being Tactful and

Diplomatic
7. Rate your level of proficiency in the following Writing Skills.

Very good=5 Good=4 Average=3 Poor =2 Very poor=1

Note-taking

Essays
Note-making

Letters and Emails

Nurses notes

Anecdotal records

Shift handovers

8. Rank them according to your level of difficulty in the following abilities.

1. Good pronunciation ( )
2. More vocabulary ( )
3. Proper grammatical knowledge ( )
4. Proper punctuation knowledge ( )
5. Spellings ( )
6. Organizing the ideas and sentences ( )

9. English is taught by drilling method in the classroom. Yes ( ) No ( )

10. Tick the appropriate - Things you do usually to improve your English outside the classroom.

1. Talk with my friends in English ( )

2. Watch English programs in TV ( )
3. Listen to others when they are speaking ( )
4. Solve Crossword puzzle ( )
5. Use Dictionary and learn new words ( )
6. Read English Newspapers ( )
7. None of these ( )
11. Tick the appropriate - I want my English teacher to be able to

1. Use Audio Visual aids ( )

2. Tolerate students mistakes ( )
3. Encourage to speak English in the class ( )
4. Insist to use Dictionary in the class ( )

12. I need to develop the following components in Writing Skills for my future work place.

1. Nursing care plans ( )

2. Diary Writing ( )
3. Resume Writing ( )
4. Summarizing Texts ( )
5. Anecdotal Records ( )

13. I need to develop the following components in Speaking Skills for my future work place.

1. Group Discussions ( )
2. Oral Presentations ( )
3. Public Speaking Skills ( )
4. Role-Plays ( )

14. I need to develop the following components in Reading Skills for my future work place.

1. Reading for Information ( )

2. Reading for Specific Information ( )
3. Medical Terminology ( )

15. I need to develop the following components in Listening Skills for my future work place.

1. Listening for General Information ( )

2. Listening for Specific Information ( )
3. Listening to Doctors voice through Audio tapes ( )

16. How you feel when you are taught in English without a prescribed textbook?
Dissatisfied Satisfied

1 2 3 4 5

17. How do you feel when your teachers insist you to speak English in the class?

Tensed Relaxed

1 2 3 4 5
18. How do you feel while writing clinical assignments?

Doubtful Confident

1 2 3 4 5

19. How do you feel when you are asked to read aloud in the class?

Nervous Untroubled
1 2 3 4 5
20. Tick the appropriate answers.

I have the following activities in my English class

Reading for Information Yes No

Reading for Specific Information Yes No

Summarizing the Texts Yes No

Writing Compositions Yes No

Writing Nurses Notes Yes No

Listening for General Information Yes No

Watching Videos Yes No

21. Activities performed by the Nurses in the Clinical settings

Nurses often converse with doctors. Yes No

Reading doctors’ prescription and case sheet is a daily activity Yes No
for a nurse.
Enquiring patients’ problems and clearing their doubts is Yes No
often done by a nurse.
Writing Shift handovers and understanding them is important Yes No
fora nurse.
Nurse has to converse with doctors, patients, colleagues, lab Yes No
technicians,attenders and administrators very often on phones.
Writing Nursing care plans Yes No
Using computer for various purposes is very common Yes No
Explaining the treatment plan to the patients Yes No
Use of Medical terminology in writing, reading and Yes No
speaking is very common
Discussions Yes No
Debates Yes No
Role-plays Yes No
Making Presentations Yes No
Filling the Exercises Yes No

Taking Tests Yes No

Listening to Audio Tapes Yes No