Verbal and nonverbal disagreement in an ELF academic discussion task.

Recent English as a Lingua Franca (ELF) studies have examined the linguistic features of disagreements during interactive academic tasks and casual conversations. Fewer studies, however, have explored nonverbal cues of disagreement, and even less is known about how interlocutors perceive disagreements. Therefore, using data from a corpus of ELF interaction, this study examined the verbal features and visual cues used by ELF university students to disagree during an academic discussion task. The disagreement episodes were selected through a content analysis of stimulated recall protocols in which a speaker stated that a disagreement had occurred. Transcripts were analyzed to classify the speaker's verbal strategies as being mitigated or unmitigated. Video recordings were examined for facial expressions, body movements, and hand gestures. Findings revealed that ELF students used mitigated linguistic strategies, such as hedges, during disagreement while gaze aversion, smiling, and head nods were the most frequent nonverbal cues. The stimulated recall data showed that disagreements were perceived as an opportunity to listen, think, and share different opinions. Implications are discussed in terms of how to interpret features of disagreement in language classrooms.

The Impact of Shortened Clinical Clerkships on Medical Student Performance and Clerkship Assessment.

INTRO: Medical schools sometimes need to adjust the length of third-year clinical clerkships. The literature surrounding the effects of shortened clerkships on student experience and performance is mixed. METHODS: Our medical school shortened the third year by an average of 20% per clerkship to accommodate a curricular re-design in 2018-2019. We examined test scores and measures of clinical performance as well as student experience in order to understand the impact of this change. RESULTS: Two hundred and eight students were included in the analysis, 104 in each cohort. No statistically significant differences were noted between cohorts on NBME subject examination results. There were no significant differences on Step 2 CK scores between the traditional curriculum cohort (M = 249.4, SD = 13.7) and shortened curriculum cohort (M = 248.7, SD = 15.8). Student performance on OSCE cases was similar. Similar percentages of students rated each clerkship either "good" or "excellent" in the traditional (77%) and shortened (78%) curriculum. CONCLUSION: There was no significant impact on student test scores after shortening the curriculum. Measures of student satisfaction and experience also remained stable, likely related to emphasis on retaining patient care experiences and streamlining of didactics. Curricular shortening during the third year of medical school was feasible and safe from the student perspective in our experience.

Exploring Japanese EFL Learners' Attitudes Toward English Pronunciation and its Relationship to Perceived Accentedness.

This study investigates what individual differences may play a role in second language (L2) learners' pronunciation, exploring whether English as a Foreign Language (EFL) learners' attitudes toward English is linked to their perceived accentedness. Japanese EFL secondary school students (N = 62) carried out a 69-word read-aloud task and their speech samples were evaluated by 16 raters for accentedness. A ten-item questionnaire examined the attitudes toward L2 pronunciation of Japanese EFL learners. From the questionnaire, an exploratory factor analysis revealed three dimensions: pronunciation significance, interest in English sounds, and confidence in pronunciation. However, only confidence in pronunciation was significantly correlated with accentedness scores. Results are discussed in terms of the relationship between affective factors and L2 pronunciation attainment.

Data of the interaction mindset questionnaire: An initial exploration.

The survey data derives from a newly-developed questionnaire of interaction mindset. Interaction mindset pertains to second language (L2) learners' disposition towards the task and/or an interlocutor prior to and/or during task-based interaction [1]. The theoretical model is consisted of five factors: (a) peer interaction; (b) collaboration; (c) form-orientation; (d) provision of peer feedback; and (e) reception of peer feedback. In the larger study ("Predicting L2 learners' noticing of L2 errors: Proficiency, language analytical ability, and interaction mindset" [2]), the questionnaire results were used as predictor variables of L2 learners' attention to language form. The current dataset contains responses from 102 L2 learners in university-level English classes. In addition to the descriptive statistics of the questionnaire, the current article reports on the results from structural equation modeling explaining the unique contributions of the five factors to the construct of interaction mindset. The model is visually depicted with a figure using AMOS. The model shows the questionnaire's potential in examining L2 learners' affective variables that may influence the learners' cognitive and behavioural engagement patterns. The entire dataset is included in an Excel file (.xlsx) and the original questionnaire is included as a supplementary file.

The differential diagnosis of dyspnea in a woman with metastatic breast cancer--consideration beyond pulmonary embolism.

Metastatic breast cancer can have protean manifestations. Here we present a case of a woman with recurrent breast cancer who presented with acute dyspnea and evidence of right heart strain. Diagnoses of myocardial ischemia and of pulmonary embolus were ruled out and the patient ultimately succumbed to respiratory failure. At pathology she was found to have tumor emboli clogging capillaries and arterioles, consistent with the diagnosis of embolic carcinomatosis. While a rare diagnosis, clinicians must be aware of this phenomenon in patients with breast cancer who present with rapidly deteriorating pulmonary function.