This paper reports the development of an English course for medical student
s approaching the junior clerkship, the first part of their clinical traini
ng. Based on the transcripts of video and audio tapes of six 1-hour session
s of ward teaching, the authors first investigated the cognitive demands pl
aced on students as they participated in making diagnostic hypotheses with
experienced doctors. They then identified the linguistic skills students ne
eded in order to achieve various cognitive learning objectives. These inclu
ded the skills of using appropriate everyday and technical terms to transla
te information from doctor-patient to doctor-doctor discourse, using verb t
enses correctly to establish chronology in case reports, and describing loc
ation and procedure accurately in reporting physical examinations. In the c
ourse which was developed, Video sequences were used along with carefully d
esigned teaching tasks, firstly to raise students' awareness of some of the
cognitive and linguistic features of the discourse, and secondly to improv
e students' performance through practice. The study illustrates how authent
ic data from student performance can be exploited to construct a tightly fo
cused curriculum addressing students' needs. (C) 2001 The American Universi
ty. Published by Elsevier Science Ltd. All rights reserved.