Abstract

Background: Effective communication in patients’ native languages is vital for patient-centered care in aging, multilingual societies such as Taiwan. Although Taiwanese (Holo) is widely spoken among older adults, systematic instruction in “Medical Taiwanese”—the clinical application of Holo—remains limited. Most studies emphasize English language learning, leaving a gap in culturally grounded healthcare language education.

Aim: To evaluate the effectiveness of integrating podcast-based scenario dialogues and shadow play role-plays into nursing courses compared with traditional lectures.

Design: Quasi-experimental pre–post control group design with explanatory qualitative inquiry.

Setting and Participants: Conducted at a university of science and technology in northern Taiwan with 122 third-year nursing students (mean age = 20.6 years; 85% women).

Methods: The flipped-classroom intervention, grounded in multimedia learning and situated learning theories, comprised (1) podcast listening for autonomous preparation, (2) shadow play for contextualized and anxiety-reducing role-play, and (3) structured reflection. Outcomes—vocabulary comprehension, conversational ability, and clinical communication confidence—were assessed via standardized pre- and post-tests. Quantitative analyses used paired- and independent-sample t-tests with effect sizes. Qualitative interviews (n = 18; maximum-variation sampling) underwent thematic analysis to explain underlying mechanisms.

Results: The experimental group showed significant gains (all p < .001) in vocabulary (+13.6, d = 1.64), conversation (+15.3, d = 1.58), and communication confidence (+15.4, d = 1.48). The control group showed minimal change. Between-group comparisons confirmed the hybrid model’s superiority (p < .001). Qualitative data indicated that podcasts fostered repetition and learner autonomy, while shadow play enhanced cultural immersion and transferability to ward communication.

Conclusions: Combining podcasts and shadow play offers an innovative, multimodal, and culturally responsive pedagogy that strengthens linguistic competence, communication confidence, and cultural sensitivity in nursing education. This model provides a scalable framework for promoting culturally competent care.

Notes

Reference list included in separate attached file.

Description

Focus: Academic

Status: Completed Work/Project

This project implemented a hybrid podcasts–shadow play model to enhance nursing students’ Medical Taiwanese communication skills. Using a mixed-methods design with 122 students, the intervention improved vocabulary, conversation, and communication confidence (all p < .001). Podcasts promoted repetition and autonomy, while shadow play fostered empathy and contextual fluency. The model is scalable, low-cost, and aligns with SDGs 3, 4, and 10 for inclusive nursing education.

Author Details

 Hsiao-Ying Wu, PhD; Yu-Huan Chao [no credentials listed]

Sigma Membership

Lambda Beta at-Large

Lead Author Affiliation

Chang Gung University of Science and Technology, Guishan District, Taoyuan City, Taiwan

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Mixed/Multi Method Research

Keywords:

Curriculum Development, Continuing Education, Faculty Development, Podcast, Podcasting, Shadow Play, Nursing Education, Flipped Classroom, Multimodal Learning, Cultural Competence, Culturally Responsive Pedagogy

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-22

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Hybrid Podcasts and Shadow Play Model for Teaching Medical Taiwanese: A Mixed-Methods Study

Toronto, Ontario, Canada

Background: Effective communication in patients’ native languages is vital for patient-centered care in aging, multilingual societies such as Taiwan. Although Taiwanese (Holo) is widely spoken among older adults, systematic instruction in “Medical Taiwanese”—the clinical application of Holo—remains limited. Most studies emphasize English language learning, leaving a gap in culturally grounded healthcare language education.

Aim: To evaluate the effectiveness of integrating podcast-based scenario dialogues and shadow play role-plays into nursing courses compared with traditional lectures.

Design: Quasi-experimental pre–post control group design with explanatory qualitative inquiry.

Setting and Participants: Conducted at a university of science and technology in northern Taiwan with 122 third-year nursing students (mean age = 20.6 years; 85% women).

Methods: The flipped-classroom intervention, grounded in multimedia learning and situated learning theories, comprised (1) podcast listening for autonomous preparation, (2) shadow play for contextualized and anxiety-reducing role-play, and (3) structured reflection. Outcomes—vocabulary comprehension, conversational ability, and clinical communication confidence—were assessed via standardized pre- and post-tests. Quantitative analyses used paired- and independent-sample t-tests with effect sizes. Qualitative interviews (n = 18; maximum-variation sampling) underwent thematic analysis to explain underlying mechanisms.

Results: The experimental group showed significant gains (all p < .001) in vocabulary (+13.6, d = 1.64), conversation (+15.3, d = 1.58), and communication confidence (+15.4, d = 1.48). The control group showed minimal change. Between-group comparisons confirmed the hybrid model’s superiority (p < .001). Qualitative data indicated that podcasts fostered repetition and learner autonomy, while shadow play enhanced cultural immersion and transferability to ward communication.

Conclusions: Combining podcasts and shadow play offers an innovative, multimodal, and culturally responsive pedagogy that strengthens linguistic competence, communication confidence, and cultural sensitivity in nursing education. This model provides a scalable framework for promoting culturally competent care.