Category Archives: Medical

For Deaf Children: The Sound of Hope

“My mother practically cried when I heard a cricket chirping in the house,” says a woman who got a cochlear implant at age 11. Jane R. Madell, a pediatric audiology consultant …in Brooklyn, N.Y., wants every parent with a child who is born hearing-impaired to know that it is now possible for nearly all children with severe hearing loss to learn to listen and speak as if their hearing were completely normal.” J. Brody, The New York Times

ESL Voices Lesson Plan for this post  With Answer Key

Photo- tcpreschool.org

Excerpt: “Unlocking The world of Sound for Deaf Children” By Jane E. Brody, The New York Times

‘Children identified with hearing loss at birth and fitted with technology in the first weeks of life blend in so well with everyone else that people don’t realize there are so many deaf children,’ she told me.

With the appropriate hearing device and auditory training for children and their caregivers during the preschool years, even those born deaf ‘will have the ability to learn with their peers when they start school,’ Dr. Madell said. ‘Eighty-five percent of such children are successfully mainstreamed. Parents need to know that listening and spoken language is a possibility for their children.’

Central Institute for the Deaf

Determined to get this message out to all who learn their children lack normal hearing, Dr. Madell and Irene Taylor Brodsky produced a documentary,“The Listening Project, to demonstrate the enormous help available through modern hearing assists and auditory training…

Ms. [Amy] Pollick, a psychologist, 43 and deaf since birth, lives in Washington, D.C., with her husband and two young children, all with normal hearing. Her deaf parents, determined that she learn to speak, got her a hearing aid at 6 months along with years of auditory therapy…She told me, ‘The earlier you get the implant, the more successful it is because the more auditory input the brain gets at an early age, the better the auditory skills you will develop.’

Central Institute for the Deafjpeg

A cochlear implant bypasses the nonfunctioning hair cells of the auditory system and transmits sound directly to the auditory nerve so that the brain can process it. Implants can be inserted in babies before they can walk.

According to the National Institute on Deafness and Other Communication Disorders, children with profound hearing loss who receive implants before 18 months of age ‘develop language skills at a rate comparable to children with normal hearing… But, as Dr. Madell points out, only 0.1 percent of the population knows sign language, and 95 percent of deaf children are born to hearing parents, who then have to spend a long time learning to sign, during a period when children are normally learning to speak.

‘Deafness today is not what it was 20 years ago,’ she said. Every baby born in the United States is supposed to be screened at birth for hearing loss. One baby in 1,000 of those screened will turn out to have moderate, severe or profound hearing loss that, if not promptly and properly treated, can delay their ability to learn to speak and understand speech. Today’s auditory technology makes it possible for these babies to be fitted with a device that enables them to hear and, with auditory training, develop language skills as good as those of their normal-hearing peers.”

 

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  deaf people.  Next, have students look at the pictures in the text and generate ideas or words that may be connected to the article.  Regroup as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

Brainstorming Map by rentonschools.us

 

For additional charts Visit ESL Voices List of Charts  http://esl-voices.com/teachers/charts-and-organizers/

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Children fitted with technology in the first weeks of life blend in well with everyone else.
  2. Children need the appropriate hearing device and auditory training during the preschool years.
  3. Eighty-five percent will be  successfully mainstreamed.
  4. Still, many deaf people resist the current technology.
  5. They reject the idea that deafness needs to be corrected.
  6. Every child with hearing loss will be able to hear with  hearing aids and cochlear implants.
  7. One baby in 1,000 of those screened will turn out to have moderate, severe or profound hearing loss.
  8. Jane R. Madell, a pediatric audiology consultant.
  9. Many children will have the ability to learn with their peers when they start school.
  10. I heard a cricket chirping in the house for the first time.

Reading Comprehension

Fill-ins

Directions: Place students in groups and after they have read the entire article, have them complete the following sentencestaken from the article. They can use the words and terms from the list provided, or provide their own terms. They are to find the meanings of any new vocabulary.

All started out with___that helped them learn to ___and ___spoken language. But now all have___implants that, as Ms. Lippert put it, “really revolutionized my world” when, at age 11, she became the first___to get a cochlear implant at New York University Medical Center. “Suddenly when I was playing___I could hear what my ___were saying,” Ms. Lippert, now 33, recalled.

WORD LIST:speak, cochlear, teammates preteen, soccer, hearing aids, understand,

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

My mother practically/practical cried/cry when I hear/heard a cricket chirping in/on the house. I couldn’t talk on/in the phone before. Now in my/mine job at the Veteran’s Affairs Hospital in Manhattan, I’d/I’m on the phone all days/day long. The implant have/has been a/an wonderful gift.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: In groups, have students discuss the following questions taken from the blog: Myths and Misconceptions about Deaf People  After, have them check their answers and share them as a class.

  1. All deaf and hard of hearing persons benefit from hearing devices. Why or why not?
  2. For some deaf people, English is a second language. Why do you think this is so?
  3. Most deaf people communicate in sign language. Do you think that this is true? Explain why or why not.
  4. Do you think that a deaf person can drive a car? Explain why or why not.
  5. Do you believe that most deaf people are able to read lips?
  6. Many believe that deaf people can’t talk. Is this true or false? Why?
  7. If you shout at a person with a hearing loss they will hear you better. Does this work? How do you know?

1-Minute Free Writing Exercise

Directions: Allow students 1 minute to write down one new idea they’ve learned from the reading. Ask them to write down one thing they did not understand in the reading.  Review the responses as a class. Note: For the lower levels allow more time for this writing activity.

ANSWER KEY

Category: Medical, People | Tags:

The Trouble With Advance Directives: Doctors Often Miss Them

“This is not how it was supposed to happen…First there was a cancer diagnosis, too far gone for cure, then surgery…The elderly man had been found there earlier that evening, pale, feverish and too confused to communicate. There’s no family around. We’re probably going to have to intubate, the emergency room doctor told me… one of the doctors in training tapped me on the shoulder and pointed urgently at the computer screen. There was something important there at the very end of a progress note from the patient’s outpatient oncologist…Facing a prognosis on the order of months, the elderly man had requested that when things got worse, there would be no breathing tubes or chest compressions. Only comfort and quiet.” Dr. D. Lamas, The New York Times

ESL Voices Lesson Plan for this post with Answer Key

Image- Stuart Bradford

Excerpt: You’ve Detailed Your Last Wishes, but Doctors May Not See Them-By Daniella Lamas, M.D., The New York Times

“But now he was unable to speak for himself. Too busy with X-rays and ultrasounds and medications, the emergency team hadn’t seen the note. I sent a page off to the attending taking care of the patient to alert him to the patient’s wishes, and my resident gathered his papers to run down to the emergency room.

This patient had done everything we could have asked. He’d been brave enough to talk with his doctors about his cancer and acknowledge that time was short. He had designated a health care proxy. But there he was, surrounded by strangers, the intubation he never would have wanted looming and the record of that conversation buried in his electronic record.

Something had gone wrong. And though it would be easy to blame the oncologist for not sending the patient home with a legally binding directive documenting his end-of-life wishes, or the emergency doctors for not searching harder in the chart, it’s not that simple. As it usually is with a surgery performed on the wrong side of the patient’s body or a medication that’s prescribed despite a known allergy, the problem here is not about individuals, but instead about a system that doesn’t sufficiently protect patients from getting care they do not want.

 Increasingly, doctors like me are trained to have frank, hard conversations with our patients about prognosis and care goals. Outside the hospital, people with serious illnesses are encouraged to discuss these issues with their friends and family.

But what happens after? As a doctor working in the I.C.U., I knew firsthand the frustrations of searching the electronic record for notes and scanned documents. But I had no idea how common this problem was…Through my interviews, I heard stories of patients who had been transferred to nursing facilities without their advance directives and returned to the hospital intubated when that was explicitly not what they wanted. Others told me about patients of theirs who’d grown ill on vacation only to end up in a hospital they’d never been to, with an entirely different electronic medical record, where no one was able to access any prior documentation… In the absence of nationwide standards, there’s significant variability among hospitals and among electronic records. Some have worked to make end-of-life documentation more easily accessible.

At my hospital, for example, clicking on an ‘Advance Care Planning’ tab will bring you to a record of all advance care planning notes, health care proxy forms, scanned directives and code status orders.

This is a start, but it wasn’t enough for that elderly man in the emergency room. Habits are hard to break, and without a clear set of incentives, training and ongoing education, doctors (myself included) continue to record information about end-of-life conversations in progress notes, where they are not readily available, particularly when they are urgently needed.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the pictures in the text and generate ideas or words that may be connected to the article.  Regroup as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

 

Brainstorming chart by UIE

 

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Many patients do not have advance directives.
  2. I was working  in the intensive care unit.
  3. The patient finally had  a discharge to go home.
  4. There was a note from the patient’s oncologist.
  5. Doctors gave him ultrasounds and medications.
  6. There was the intubation he never would have wanted looming.
  7. Increasingly, doctors are trained to have frank conversations with patients about prognosis and care goals.
  8. Some have worked to make end-of-life documentation more easily accessible.
  9. Doctors and health care workers need a clear set of incentives and training.
  10. Just imagine, your E.D. doctor is fumbling to find your information in your chart.

Word Chart By Education Oasis

 

Reading Comprehension

Sentence Match

Directions: Students  are to complete the sentences from the article by selecting the correct words or phrases.

  1. This ___ had done everything we could have asked.
  2. It’s tempting to assume that if you tell one ___ what you want at the end of your life, that’s enough.
  3. For the past year, I delved into the unexpectedly interesting world of advance ___planning.
  4. Recently, a ___ of start-ups have stepped in, trying to offer a solution.
  5. There’s software and ___patient apps that work outside the electronic record.
  6. Just imagine, your doctor is fumbling to find your ___in your chart, but you have an advance directive that was safely uploaded onto your smartphone.
  7. This most likely could have helped my ___ that day.
  8. At least, all related advance care planning documentation should be in one place in the ___.
  9. Beyond that, maybe all ___could require identification of a health care proxy for all patients.
  10. Yet as it is, we’re___.

WORDS/PHRASES: a-care, b-playing catch-up, c-clever, d-patient,  e-medical record,  f-handful,  g-information,  h-health systems,  i-patient,  j-doctor

 

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

When the resident/reside arrived outside my patient’s room, he was relieved/relive to see that the elderly/elder man was still breathe/breathing on his own. The E.D. attending had held off. The patient’s family was on the way. Up in the I.C.U., we treated/trotted him gentle/gently with fluids and antibiotics and oxygen. He never did get strong/strength enough to make it back home, but I think he was quite/quiet and comfortable in the end, as he had wanted.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: Place students in groups  and  have each group read the following statements from Dr. Lamas. Then see if each group can think of solutions to this problem. Share ideas as a class.

“As a doctor working in the I.C.U., I knew firsthand the frustrations of searching the electronic record for notes and scanned documents. But I had no idea how common this problem was… Through my interviews, I heard stories of patients who had been transferred to nursing facilities without their advance directives and returned to the hospital intubated when that was explicitly not what they wanted. Others told me about patients of theirs who’d grown ill on vacation only to end up in a hospital they’d never been to, with an entirely different electronic medical record, where no one was able to access any prior documentation.”

1-Minute Free Writing Exercise

Directions: Allow students 1 minute to write down one new idea they’ve learned from the reading. Ask them to write down one thing they did not understand in the reading.  Review the responses as a class. Note: For the lower levels allow more time for this writing activity.

ANSWER KEY

Category: Medical | Tags:

The Doctor’s Dilemma: Helping Patients to Die…Or Not

“I was leafing through a patient’s chart last year when a colleague tapped me on the shoulder. ‘I have a patient who is asking about the End of Life Option Act,’ he said in a low voice. ‘Can we even do that here?’ I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. Now, five months after the law took effect here in California, I was facing my first request for assistance to shorten the life of a patient. I could see my own discomfort mirrored in his face. ‘Can you help us with it?’ he asked me. ‘Of course,’ I said. Then I felt my stomach lurch.”  J. N. Zitter, The New York Times

ESL Voices Lesson Plan for this post with Answer Key

Excerpt: Should I Help My Patients Die? By Jessica N. Zitter, The New York Times

“California’s law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this.

But that is where the law leaves off. The details of patient selection and protocol, even the composition of the lethal compound, are left to the individual doctor or hospital policy.

Our hospital, like many others at that time, was still in the early stages of creating a policy and procedure. To me and many of my colleagues in California, it felt as if the law had passed so quickly that we weren’t fully prepared to deal with it.

This first patient of mine was not a simple case. When I walked into his room, he glared at me.  ‘Are you here to help me with this aid-in-dying thing?’ he asked. He was in his early 60s, thin and tired, but in no obvious distress.  From my read of his chart, he met all criteria to qualify. Terminal illness, decision-making capacity, ability to self-administer the medications. And he had made the requisite first request for the drugs two weeks earlier, as procedure dictates.

When I asked why he wanted to end his life early, he shrugged. ‘I’m just sick of living.’ I asked about any symptoms that might lie behind his request: unrelenting pain, nausea, shortness of breath. He denied them all. In palliative care, we are taught that suffering can take many forms besides the physical.

At our second meeting, with more trust established, he issued a sob, almost a keening. He felt terrified and powerless, he said. He didn’t want to live this way anymore. I understood. I could imagine my own distress in his condition — being shuttled like a bag of bones between the nursing home and the hospital. It was his legal right to request this intervention from me. But given how uncomfortable I was feeling, was it my right to say no? …I’ll admit it: I want this option available to me and my family.

I realized it was past time to sort out my thinking and turned to the de facto specialist in our area on this issue for counsel. Dr. Lonny Shavelson, an emergency medicine and primary care physician in Northern California, has been grappling with the subject for many years. Given his interest in the topic, Dr. Shavelson felt a personal obligation to ensure that this new practice would be carried out responsibly after the law was passed. He founded Bay Area End of Life Options, a consulting group that educates physicians, advocates on patients’ behalf and prescribes the lethal concoction for some patients who meet the criteria for participation. Since starting his practice, he has been approached by 398 patients. He has accepted 79 of those into his program and overseen ingestion and death for 48. When I asked Dr. Shavelson how he might have proceeded with my patient, he said he would have tried everything to relieve his distress without using the lethal medication. But if in the end the patient still wanted to proceed, he would have obliged, presuming his depression was not so severe as to impair his judgment.

Photo- The Atlantic

The American Society of Clinical Oncology recommends that patients with advanced cancer receive concurrent palliative care beginning early in the course of disease. In my experience, far too few of these patients actually get it…We must continue to shape our policies and protocols to account for the nuanced social, legal and ethical questions that will continue to arise. We must identify the clinicians who are best qualified and most willing to do this work and then train them appropriately, not ad hoc. And we must remember that this is just one tool in the toolbox of caring for the dying — a tool of last resort.”  

NOTICE: UPDATE: 

Obama’s tweet after Charlottesville one of most popular tweets ever

former U.S. President Barack Obama

“In subsequent tweets, Obama continued the quote, which read: “People must learn to hate, and if they can learn to hate, they can be taught to love … For love comes more naturally to the human heart than its opposite.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the picture(s) in the text and generate ideas or words that may be connected to the article. Debrief as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

G. Cluster Brainstorming-workshopexercises

 

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Doctors are taught that in palliative care suffering can take many forms.
  2. Oregon was the pioneer 20 years ago.
  3. The law allows physicians  prescribe a lethal cocktail.
  4. The idea of hastening death is uncomfortable.
  5. Many oppose this practice for ethical reasons.
  6. The doctor probed further to find out the truth.
  7. Some terminally ill patients want to die sooner.
  8. Many feel abandoned by their family.
  9. Doctors feel a personal obligation to this new practice.
  10. Dr. Shavelson strives to mitigate all symptoms.

ELLteaching 2.0 vocabualry chart

 

Reading Comprehension

True /False/NA-Statements

Directions: Review the following statements from the reading.  If  a statement is true they mark it T. If the statement is  not applicable, they mark it NA. If the statement is false they  mark  it F and provide the correct answer. 

  1. In June 2016, California became the  seventh in the nation to allow medical aid in dying.
  2. The details of patient selection and protocol, even the composition of the lethal compound, are left to the patients.
  3. The author felt that  she wasn’t fully prepared to deal with the new law.
  4. The American Medical Association, the nation’s largest association of doctors, has been formally opposed to the practice for 23 years.
  5. The  author’s first patient died in a nursing home, of natural causes, the following year.
  6. Dr. Lonny Shavelson is  an emergency medicine and primary care physician in New York City.
  7. Catholic health systems do not participate in the program.
  8. Dr. Shavelson offers  the medications to most of the patients who request them.
  9. One problem is payment, because many insurers won’t cover it.
  10. Doctors worry that public hospital patients like mine will not be able to afford this degree of care.

 Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I

  1. His patient intake procedures is time-consuming.
  2. Providers can bill for an office visit.
  3. Many insurers won’t cover  treatment.

II

  1. He counts this cases among his greatest successes.
  2. The patient had carefully thought through the decision.
  3. The vast majority of cases here have gone smoothly.

III

  1. Most communities won’t have doctors that offer discounts.
  2. These  is inequities we must address.
  3. We must continue to shape our policies.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: Place students in groups and have them  discuss the following statements. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

“But still. I didn’t feel comfortable with the idea of helping to shorten the life of a patient because of depression and resentment. In truth, I’m not sure I am comfortable with helping to intentionally hasten anyone’s death for any reason. Does that make me a hypocrite?”

“There is another question I feel compelled to raise. Is medical aid in dying a reductive response to a highly complex problem? The over-mechanization of dying in America has created a public health crisis. People feel out of control around death. A life-ending concoction at the bedside can lend a sense of autonomy at a tremendously vulnerable time.”

Extra: Web Search

Directions: In groups/partners have students “Google” the topic and see what additional information they can find. Students can either have further discussions or write an essay about the subject.

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading,  two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

Category: Culture, Medical | Tags:

Name Your Fear… A New Drug Can Cure It…Maybe

“Who among us hasn’t wanted to let go of anxiety or forget about fear? Phobias, panic attacks and disorders like post-traumatic stress are extremely common… Sitting at the heart of much anxiety and fear is emotional memory — all the associations that you have between various stimuli and experiences and your emotional response to them…. New research suggests that it may be possible not just to change certain types of emotional memories, but even to erase them.” R. Friedman, New York Times

ESL Voices Lesson Plan for this post with Answer Key

Image-

Excerpt: A Drug to Cure Fear by Richard A. Friedman, NYT

“Whether it’s the fear of being embarrassed while talking to strangers (typical of social phobia) or the dread of being attacked while walking down a dark street after you’ve been assaulted (a symptom of PTSD), you have learned that a previously harmless situation predicts something dangerous. 

Photo- telegraph.co.uk

Photo- telegraph.co.uk

It has been an article of faith in neuroscience and psychiatry that, once formed, emotional memories are permanent. Afraid of heights or spiders? The best we could do was to get you to tolerate them, but we could never really rid you of your initial fear. Or so the thinking has gone.

Photo-senselessscrutiny.com

Photo-senselessscrutiny.com

The current standard of treatment for such phobias revolves around exposure therapy. This involves repeatedly presenting the feared object or frightening memory in a safe setting, so that the patient acquires a new safe memory that resides in his brain alongside the bad memory. But if he is re-traumatized or re-exposed with sufficient intensity to the original experience, his old fear will awaken with a vengeance.

This is one of the limitations of exposure therapy, along with the fact that it generally works in only about half of the PTSD patients who try it…Several studies of rats done in 2000 showed that a drug called anisomycin, which blocks the synthesis of proteins in the brain, could reduce fear associations.

In one, researchers taught rats to fear a sound by pairing it with a shock. After the animals were fear-conditioned, they were presented with the sound and then immediately given the drug. When the animals were exposed to the sound again, they no longer appeared afraid; they had forgotten their original fear.

Curiously, there is a very narrow time window after retrieving a fear memory when you can disrupt that memory — hours, in the animal studies — before it closes and the drug has no effect.

Some may view any attempt to tamper with human memory as disturbing because it seems at odds with what we ought to do as a culture with the darker aspects of our history… Some may also argue that it’s a mistake to tinker with our fear responses because they’re natural — they evolved this way for a reason.

People who suffer panic attacks hyperventilate and have an intense desire to flee in situations where there is rarely actual danger. It turns out that panic disorder is associated with an increased sensitivity to carbon dioxide in the brain. If you lived in a cave with a clan of hominid fire-dwellers, you’d have been one of the first to get out when the oxygen supply was dwindling.

Evolutionary design has left us a few million years out of date; we are hard-wired for a Paleolithic world, but have to live in a modern one. The irrational fear of anxiety disorders was once probably useful and lifesaving. No longer.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

L2 Student Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the pictures  in the article  and generate ideas or words that may be connected to the article. Debrief as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

Colorful Brainstorming chart from Live It Magazine.

Colorful Brainstorming chart from Live It Magazine.

II. While Reading Tasks

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Fear of being attacked while walking down a dark street after you’ve been assaulted is a symptom of PTSD.
  2. A harmless situation can suddenly predict something dangerous.
  3. The best doctors could do was to get you to tolerate them.
  4. They could never really rid you of your initial fear.
  5. The current standard of treatment for such phobias are exposure therapy.
  6. The patient acquires a new safe memory that resides in his brain.
  7. But if he is re-traumatized his old fear will awaken with a vengeance.
  8. This might be a cure for people with arachnophobia.
  9. Exposure to your fear at the right moment, could free you of that fear forever.
  10. We should think twice about casually prescribing stimulants for young people.Word Map Education Oasis

Reading Comprehension

Fill-ins

Directions: Place students in groups and after they have read the entire article, have them complete the following paragraphs taken from the article. They can use the words and terms from the list provided, or provide their own terms. They are to find the meanings for  any new vocabulary.

Anxiety enhances___memory. We all know that — it’s why you can easily ___where you put your___, but will never forget being___.

Indeed, a ___that will be published next month found that the escalating use of ___by the ___in active duty___, including those serving in Iraq and Afghanistan, was strongly correlated with an ___in the rates of___, even when___ for other factors, like the rate of attention deficit ___disorder.

The study___ the use of prescription stimulants, like Ritalin and Adderall, and the rates of PTSD in nearly 26,000 military service members between 2001 and 2008, and found that the ___of PTSD ___along with the prescriptions.

Word List: controlling, increase, forget, emotional, military, stimulants,

examined, increased, incidence, study, hyperactivity, attacked,

wallet, soldiers, PTSD,

 Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I.

  1. It has been a article of faith in neuroscience.
  2. This is one of the limitations of exposure therapy.
  3. Their fear did not return even at the end of one year.

II.

  1. Arachnophobes has an emotional memory.
  2. The basic idea is that they are no longer afraid of spiders.
  3. When the animals were exposed to the sound again, they no longer appeared afraid.

III.

  1. There’s a flip side to this story.
  2. Evolutionary design has left us a few million years out of date.
  3. Some may also argue that it’s an mistake to tinker with our fear responses.

III. Post Reading Tasks

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion/Writing Exercise

Directions: Place students in groups and have them restate the following three statements in their own words. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the following discussion topics.

  1. “So it is possible that taking stimulants could increase one’s risk of developing PTSD when exposed to trauma… a study that will be published next month found that the escalating use of stimulants by the military in active duty soldiers, including those serving in Iraq and Afghanistan, was strongly correlated with an increase in the rates of PTSD, even when controlling for other factors, like the rate of attention deficit hyperactivity disorder.”

  2. “Some may view any attempt to tamper with human memory as disturbing because it seems at odds with what we ought to do as a culture with the darker aspects of our history: Never alter the facts, even if we have divergent interpretations of them.”

  3. “Some may also argue that it’s a mistake to tinker with our fear responses because they’re natural — they evolved this way for a reason. Like most other animals, we come hard-wired with a flight or fight response along with its associated anxiety and fear. Without this warning system to protect us from predators and other dangers, we’d have been dinner long ago on the savanna.”

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading,  two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

Category: Medical

Telemedicine: Online Alternatives to Hospital Visits

“One night, when her face turned puffy and painful from what she thought was a sinus infection, Jessica DeVisser briefly considered going to an urgent care clinic, but decided to try something kind of sci-fi. She went online and requested a virtual consultation. She typed in her symptoms and credit card number, and within half an hour, a doctor appeared on her screen via Skype. He looked her over, asked some questions and agreed she had sinusitis. In minutes, Ms. DeVisser, a stay-at-home mother, had an antibiotics prescription called in to her pharmacy.” A. Goodnough- New York Times

ESL Voices Lesson Plan for this post with Answer Key

Ask a medical question and receive medical advice from our online doctors.Credit- Medicalium.com

Ask a medical question and receive medical advice from our online doctors.Credit- Medicalium.com

Excerpt: Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis by Abby Goodnough New York Times

“The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care. Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike. And more people like Ms. DeVisser, fluent in Skype and FaceTime and eager for cheaper, more convenient medical care, are trying them out.

Dr. Ben Green, a physician who helped develop the telemedicine program at Carena, a company that offers virtual visits. Credit Evan McGlinn The New York Times

Dr. Ben Green, a physician who helped develop the telemedicine program at Carena, a company that offers virtual visits. Credit Evan McGlinn The New York Times

But telemedicine is facing pushback from some more traditional corners of the medical world. Medicare, which often sets the precedent for other insurers, strictly limits reimbursement for telemedicine services out of concern that expanding coverage would increase, not reduce, costs. Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnoses via video is great.

Legislatures and medical boards in some states are listening carefully to such criticisms, and a few, led by Texas, are trying to slow the rapid growth of virtual medicine. But many more states are embracing the new world of virtual house calls, largely by updating rules to allow doctor-patient relationships to be established and medications to be prescribed via video.

Advocates say virtual visits for basic care could reduce costs over the long term…Even as virtual visits multiply, researchers say it is not clear whether they really save money or provide better outcomes… Ms. DeVisser turned out to be one of those cases. While happy with her virtual visit last summer, she ended up going to her primary care doctor a few weeks later because the antibiotics had not fully cleared up her sinus problems. At least it mitigated the problem, she said of her video consultation.”

ESL Voices Lesson Plan for this post

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

 KWL Chart

The K-W-L chart is used to activate students’ background knowledge of a topic in order to enhance their comprehension skills.

Directions: Have students use the KWL chart to list the information they already know about doctors making diagnosis over the web. Later in the Post- Reading segment of the lesson, students can fill in what they’ve learned about the topic.Students can use this colorful chart by Creately.com

KWL Chart from Creately.com

KWL Chart from Creately.com

II. While Reading Tasks

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart by Freeology for assistance.

  1. Instant messaging and video calls are part of daily life for many Americans.
  2. Health systems are rushing to offer video consultations for routine ailments.
  3. Telemedicine is facing pushback from some more traditional medical doctors.
  4. Medicare, often sets the precedent for other insurers.
  5. There are strict limits for reimbursement concerning telemedicine services.
  6. Some doctors assert that hands-on exams are more effective.
  7. Advocates say virtual visits for basic care could reduce costs.
  8. It’s plausible, that people who do a virtual visit would otherwise have stayed home.
  9. Even as virtual visits multiply, researchers say it is not clear whether they really save money.
  10. Carena, a private company in Seattle employs 17 physicians to do virtual consultations.
Freeology Chart

Freeology Chart

Reading Comprehension : Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

While/will telemedicine consult/consultations have been/being around for decades, they have mostly connected/connect specialists/special with patients in remote/remove areas, who almost always had to visitation/visit a clinic or hospital for the videoconference. The difference know/now is that patients can be wherever they want/wish and use their own smartphones or table/tablets for the visits, which are trending toward more basic care.

 Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I

  1. More people are fluent in Skype and FaceTime.
  2. More states is embracing the new world of virtual house calls.
  3. Health systems are facing stiff competition.

II

  1. Telemedicine consultations have been around on decades.
  2. Patients can use their own smartphones or tablets for the visits.
  3. Mount Sinai in New York is starting to offer video visits for primary care patients.

III

  1. Some large insurers is starting to pay, too.
  2. Virtual urgent care visits are undoubtedly less expensive.
  3. Users are prescribed medication about 40 percent of the time.

III. Post Reading Tasks

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion/Writing Exercise

Directions: Place students in groups and have them answer the following questions. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the following discussion topics.

1. The following two statements were taken from the article. Rephrase each statement in your own words, then discuss the meaning with the members of your group.

“Advocates say virtual visits for basic care could reduce costs over the long term. It is cheaper to operate telemedicine services than brick-and-mortar offices, allowing companies to charge as little as $40 or $50 for consultations — less than for visits to emergency rooms, urgent care centers and doctors’ offices.”

“They also say that by letting people talk to a doctor whenever they need to, from home or work, virtual visits make for more satisfied and potentially healthier patients than traditional appointments that are available only at certain times.”

2. In your opinion do you think virtual doctor visits are helpful? Explain why or why not?

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading,  two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

Category: Medical, Technology | Tags: