Are you ready to encounter foreign patients with infectious diseases? – Developing nursing students’ language skills through educational co-creation

An educational co-creation project can provide valuable information about the current needs in working life and engage students in a meaningful way thus promoting their learning outcomes significantly. The nursing students at Laurea University of Applied Sciences were involved in an educational co-creation project whose aim was to increase their knowledge of infectious diseases and to develop the contents of their language course “English for Health Care”. The project was carried out through innovative methods: a learning café and online educational material for professionals in the field. This collaboration involved the infectious diseases ward of Aurora Hospital, nursing students and lecturers at Coventry University as well as an infection prevention and control practitioner at University Hospitals Coventry and Warwickshire.

Julkaistu: 16. toukokuuta 2019 | Kirjoittanut: Sari Myréen

What is educational co-creation?

Co-creation plays a very important role in today’s innovations as companies are eagerly developing their products and services with their clients to fulfil their needs. Educational co-creation processes are also becoming more and more common. How could foreign language courses be designed through educational co-creation methods? The aims of foreign language courses are usually defined from the viewpoint of language learning objectives, and language courses are not always designed to meet the foreign language skill requirements in different work environments. The requirements might also differ a lot, and language teachers are not always fully aware of them.

At some workplaces, such as on infectious diseases wards, professionals will encounter English-speaking clients and they should be able to provide nursing care not just in their native language, but also in English. The knowledge of varied foreign language skill requirements at different workplaces can be acquired through co-creating with e.g. superiors. They can often perceive that their employees’ English language skills are inadequate in a certain field, but that it is difficult to impose time-consuming language courses on them.

Increasing student motivation through educational co-creation

Educational co-creation is also very interesting from students’ viewpoint, because they will equally benefit from an engagement in this type of co-creation process. According to Wardley, Bélanger and Nadeau (2017, 998) “there could be a different strategy to increasing student commitment through internal motivation created by developing tasks and course contents that inspire students to become more engaged in their university studies. Motivation is linked to engagement because internal drive triggers a reaction or action.” Higher education students should therefore be regarded as involved co-creators of their language courses, and not just from the more traditional client service perspective as consumers of education.

Language teachers are usually engaged with students from many different fields, and it is therefore impossible for them to specialise in each one of them. Developing the language course “English for Health Care” with students provided valuable information for the language teacher about the current infectious diseases and how this knowledge can be adapted into spoken language exercises, such as dialogues on the ward.

The impact of student engagement

The outcome of this project corresponds to the findings in previous research papers; there was a significant improvement in student engagement in the four aspects introduced by Kahu (2013). According to Kahu (2013) student engagement can be described from four different perspectives: the behavioural perspective, which focuses on effective teaching practice; the psychological perspective, which views engagement as an internal individual process; the socio-cultural perspective, which considers the critical role of socio-cultural context; and finally a holistic perspective, which strives to draw these strands together. Kahu (2013) maintains that our understanding of student engagement and the influences on it help us to meet the needs of students, enhance their experience and improve the educational outcomes. The feedback from the students and the observations made by the teacher revealed that the course was practical and useful, and helped the students build the confidence they will need to use their English skills at work.

Wardley, Bélanger and Nadeau (2017) exhibit a new model for management of education called the conceptual Student Engagement Work Design Model (SEWDM) where the elements of engagement in the co-creation process are identity, significance, variety, feedback, autonomy and customer service. Their model highlights the supposition that university students’ work can be improved through motivational (engagement) approach that is focused on increasing meaningful mental tasks over another work design approach. Motivation played a major role in this project, and the use of various digital platforms further improved motivation and helped the students to become active learners and to engage in meaningful practical tasks. Celuch, Bačić, Chen, Maier-Lytle and Smothers (2018) discuss the impacts of student engagement on learning and service outcomes through current theories and a student co-creation pilot project.

Facilitating in-class activities through a learning café

There are already more than half million immigrants in Finland, and English has become often the only common language between the nurse and the patient. Thus, Finnish nurses encounter increasingly more foreign patients, and English language as well intercultural communication skills have become important tools in nurses’ daily activities. The topics of English language courses at universities of applied sciences are usually integrated with professional studies, and global health issues and infectious diseases are discussed among other topics as part of the language syllabus.

In this co-creation project, learning café activities were created around these topics to facilitate the students’ learning process. During these activities the student groups could present simulated dialogues on the ward to other peer groups, which provided also an opportunity to discuss these issues more in detail together in small groups. The students’ dialogues around infectious diseases included besides professional terminology, information about the disease.

Learning café is one of many facilitation methods applied in different types of workshops. This method enables efficient interaction between approximately 6-8 people around a round table. The table facilitator teams presented in this case their dialogues to another student team, a table team, and both teams were involved in a feedback discussion after the dialogue. After each dialogue the students had learned at least how many people were diagnosed with the disease in Finland and globally, what kind of symptoms the disease caused, how the disease was treated, what the typical features of the disease were and what isolation precautions were required in the treatment of the disease. The table facilitator teams ensured this by asking open questions about the dialogue from the table teams who rotated in the classroom, whereas the table facilitator teams stayed at the same place.

Practising the dialogues improved the nursing students’ spoken language skills, and thus prepared them for real work life situations. The best way to practise communication situations on the ward is through problem-based learning with case studies in healthcare settings. In order to motivate language learners and promote their learning outcomes, it is crucial to create inspiring and authentic learning environments and give learners possibilities to learn from each other through peer-to-peer learning. This type of learning is easily facilitated through learning café activities, and the future simulation hospital on the campus will further promote this type of exercises when the students can practise their dialogues in a simulated hospital setting.

From in-class activities to an educational co-creation project with working life

The students perceived learning café activities as a very rewarding way to learn new things and improve one’s language skills, and we wanted create similar activities to improve the spoken language skills among professionals working on infectious diseases wards. Thus, these learning assignments could be regarded meaningful also from the socio-cultural perspective, and not just from the behavioural and psychological perspective as discussed in previous studies.

For the pilot project we chose three infectious diseases as topics for the e-learning material that could be later provided for all nurses in Finland. The basis of the e-learning material were hundreds of written dialogues created by the students which were then edited by a student who had worked on hospital wards both in England and Finland so that they would correspond to the requirements on a Finnish ward. The editing phase was very time-consuming and demanding although there were already hundreds of similar dialogues available, because the reliability of every detail had to be confirmed by experts. The dialogues were finally ready for proofreading in England, where an infection prevention and control practitioner added some elements to the texts.

Eliademy is a platform that is accessible for any user also globally thus enabling the participation of co-creation partners abroad, so the choice where to present the pilot material was easy to make. The link to the Eliademy workspace was then published on the Finnish Nurses Association’s website with the aim of the pilot project to reach as many Finnish nurses as possible in order to increase their professional vocabularies as well as their abilities to encounter English-speaking patients on the ward. 

The pilot project becomes an intercultural learning project

Finally, this educational co-creation process also involved students and lecturers from an English university when a group of English students recorded the edited dialogues during their field trip to Finland. The audios were uploaded on the Eliademy website in addition to the dialogues, and the collaboration between the students of Laurea and Coventry University will continue through another online intercultural learning (OIL) project built around the themes in the near future. The educational co-creation process will also continue with professionals on infectious wards, and will hopefully in the future result in an educational product that can be offered to Finnish nurses as continuous professional development training. Finnish nurses and nursing students will play key roles in this educational co-creation process thus adding value to the educational product development and ensuring its relevance to the target group.


Sari Myréen, M.A. works as a senior lecturer in English and French at Laurea University of Applied Sciences.



Celuch, K., Bačić, D., Chen, M.W., Maier-Lytle, J. & Smothers, J. 2018. The Potential of Student Co-Creation in Extracurricula Experiences. Marketing Education Review Vol. 28 Issue 3:230-243. DOI: 10.1080/10528008.2017.1419432

Kahu, Ella R. 2013. Framing student engagement in higher education. Studies in Higher Education, 38:5, 758-773, DOI: 10.1080/03075079.2011.598505

Wardley, L.J., Bélanger, C.H. & Nadeau, J. 2017. A co-creation shift in learning management: work design for institutional commitment and personal growth. High Educ 74:997–1013, DOI: 10.1007/s10734-016-0090-0