Examining the linguistic needs of internationally educated nurses: A corpus-based study of lexico-grammatical features in nurse–patient interactions

• A corpus of nurse–patient interactions was examined for lexico-grammatical features.
• The discourse of internationally educated nurses and U.S. nurses was compared.
• U.S. nurses used more stance features and past tense.
• Differences were related to patient rapport and patient-centeredness.

Within English for Medical Purposes (EMP), one area of concern is to develop programs for international medical graduates (IMGs) working in the U.S. (Hoekje & Tipton, 2011). Along with IMGs, internationally educated nurses (IENs) are an increasingly important part of the U.S. workforce (Davis & Nichols, 2002). While communication difficulties for IENs are well documented (Davis & Nichols, 2002; Xu, 2007), few previous studies have investigated the discourse of IENs' interactions with patients. In order to inform IEN training programs, it is important to determine linguistic characteristics that distinguish IEN speech from that of U.S. nurses (USNs), native English speaking nurses born and trained in the U.S. To investigate differences between the two groups, a corpus of 102 nurse–patient interactions (52 IENs and 50 USNs) was collected and analyzed for lexico-grammatical features. Results show that USNs used particular lexico-grammatical features more frequently, including past tense and various stance features (e.g., certainty adverbs such as maybe and kind of), all of which play an important role in creating rapport with patients and providing more patient-centered interactions. The findings have implications for IEN training programs, as well as EMP courses for nursing students and other medical professionals.