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Sentences and Speech: Don’t equate the two!


“An unhealthy dose of social awkwardness”


I’ve written previously about how the propensity to teach and practice fully grammatical sentences can lead to increased difficulties in producing speech for non-native English speakers, as well imbuing that speech with an unhealthy dose of social awkwardness. Moreover, when we reward fully grammatical speech forms with higher grades or mark them as somehow more ‘correct’, it is natural for learners to assume that these represent superior, preferred, or prestige language skills when in fact this is not the case at all. This has an ongoing negative effect upon Japanese students’ practical English skills.


Now, I understand that most readers do not work at universities or teach medical students, but, yes, bad habits ingrained from conversation schools or public school English linger even here. Let me give you an example.


“…problems arising from sentence-making fetishism”


Due to remote teaching, I’ve had to give my nursing and medical students online assignments to complement in-class, print, and textbook learning. One such assignment has been to construct a Doctor-Patient medical history taking in English (after the students have learned and practiced several models in class). Again, I know that almost none of you are teaching such a skill but this does serve as an apt illustration of the problems arising from sentence-making fetishism. Anyway, a large number of students turned in something like the following (*a reconstructed section from the middle section of some dubious medical history taking).  See if you can find the problems:


*D: How long have you had these stomach aches?

P: I have had them for three weeks.

D: What did you eat yesterday?

P: I had salmon for dinner yesterday.

D: Do you have any medications?

P: I take insulin because I have diabetes.

D: Can you remember when it first came on?

P: It first appeared three weeks ago.

D: Do you have a cough or runny nose?

P: No, I don’t have them.


First, you’ll note that there are no grammatical errors in the above dialogue. Moreover, all the utterances are fully-formed sentences (which is also why it seems so horribly stilted). There are, however, much bigger issues. To wit:


  1. If the patient has had the symptoms for 3 weeks, what sense does it make for the doctor to ask about yesterday’s meal? What exactly does he/she want to know? A recipe?
  2. Do you have any medications?’ does not equal the more pertinent, ‘Are you taking any…?’ I have lots of meds clustered around my bathroom cabinet. Doesn’t mean I’m taking them.
  3. Nothing further is mentioned regarding the significant fact that the patient has diabetes. Like, who cares??
  4. The onset question (‘Can you remember…’) is answered by merely repeating the duration (from the first question). The consultation does not advance at all and yet the doctor seems unconcerned. Hey, after all, at least sentences were formed!
  5. Why ask about ENT symptoms (cough, runny nose) before more stomach ache-associated gastro-intestinal or central nervous issues such as vomiting, diarrhea, nausea, or dizziness? Priorities please!
  6. There is absolutely NO human element in this dialogue – it’s a bit like talking to Pepper the Robot.


  “We will now have a conversation”


“(They) were simply content with constructing a series of grammatically ‘full and correct’ sentences”


It’s not hard to see that those students who composed sloppy history takings (like in the example above) were simply content with constructing a series of grammatically ‘full and correct’ sentences – as if that alone were sufficient for producing effective or meaningful English communication. Relevance, clarification/vagueness, content priority, coherence/cohesion, and clinical logic/order were not considered at all. On the other hand, the students who did apply these qualities to their work – i.e., rather than merely making ‘correct’ sentences, they have also considered relevance and cohesion — the hallmarks of most meaningful interaction — were duly rewarded grade-wise.


Now, this may look like higher order academic stuff to those of you teaching children or high schoolers but I think we can agree on this: it doesn’t take a brain surgeon to understand that a focus on relevant responses and interactions is pretty damn important once our young charges enter something like the medical profession. In fact, sensitivity to managing content is a central feature of any successful communication.


“Let’s compose sentences until we come up with a diagnosis”


“In Japanese, a failure to produce full-forms (may be) seen as glib, rude, or flippant”


In the above example, the insistent, pounding S-V-O structures, particularly in the responses, serve to negate the flow, the humanity, of the dialogue. Normally, people would put the most most relevant items at the head of the response and dispense with any unwieldy grammatical baggage. But there is also a cultural reason why Japanese students might avoid using truncated English forms. Let’s use the most basic example:

“What’s your name?”

“My name is Taro Watanabe.”


In Japanese, a failure to produce full-forms when dealing with someone of ‘higher status’ is often seen as glib, rude, or flippant.


This is, of course, rarely the case in English. In terms of communicative need and intent, there is no reason that a subject and verb are warranted in Taro’s response (and in fact it can be annoying waiting to get the key information while the speaker indulgently feels compelled to construct some ‘grammar’). For example, if the Pope asked you, ‘What time is Mass today?’ you could, without fear of indiscretion, respond with a mere, “10 o’clock” (while wondering, of course, how in God’s name the Pope wouldn’t know the time of Mass).


Any Japanese student at an entrance exam interview, however, would answer a similar inquiry in Japanese with something like, “The time of Mass is 10 o’clock” (and wondering just why the hell the Pope is present at their Juken interview anyway).


But do we teach this about English? Or do we end up reinforcing just the opposite?



“For including that auxiliary verb you will be rewarded in heaven”


“The ability to produce a full, grammatical sentence has only a peripheral relationship with meaningful or effective communication”


In reality, people speak in chunks and clusters of words. Many utterances are sentence fragments, while others are multi-clausal meanderings that would make Thomas Pynchon proud, often starting mid-thought and then following in an impressionistic haze with grammatical form disappearing into the ether, only occasionally approximating what we might think of as a ‘sentence’ (particularly of the subject-verb-object variety). In short, the ability to produce a full, grammatical sentence has only a peripheral relationship with meaningful or effective communication.


The bottom line is that purpose, meaning, and relevance are what determine effective spoken communication, not formally ‘correct’ sentence construction. And this is not a truth relevant only to ‘advanced’ learners but is applicable to even the most basic of interactions.


There is, of course, a place for emphasizing formal sentence construction skills (specifically, in much of written English) but to prioritize ‘correct’ sentence-making when evaluating speaking skills is to effectively handicap your students for the future.


Mike Guest

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