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Re-inventing Health Literacy

“Health Literacy is a crucial need for adult ESOL learners-during the COVID-19 pandemic, now more than ever.”

by Phil Cackley

When teachers at the Arlington Education and Employment Program (REEP) moved English as a Second Language (ESL) classes online last spring, they re-invented health literacy lessons to reach learners connecting via video conference. The COVID-19 lockdown arrived in March 2020 with little warning, sending students and teachers home. Within weeks, the program moved instruction to Zoom and staff set about adapting instruction to a virtual environment.

The basics of what REEP teachers do for health literacy remains relatively unchanged from in-person classes. But the new online delivery mode for instruction has meant web tools are being adapted for use in class—with great success.

REEP’s ESL Curriculum for Adults is the cornerstone of how teachers help learners improve their English that is needed when they or family members navigate the U.S. health care system. Health is one of 12 possible units that can be taught in a 12-week intensive class term. Teachers conduct a needs assessment with each new group of learners so that it is possible to concentrate on four or five subject areas—health almost always makes the cut. 

“We start with a foundation of vocabulary,” explained intermediate-level teacher Ellen Clore-Patron. “Students have previous knowledge and we build on that.” Over top of that foundation, learners work with grammar structures and extended dialogues to practice the oral language needed in situations where they are health consumers, she said. Reading and writing practice are integrated, as well.

At beginning levels, the vocabulary is very basic—learning to recognize terms for body parts, basic illnesses and injuries, and key verbs to create short sentences. Beginning-level teacher Stacy Clark collected numerous images from the Internet that she shares with students in a Zoom class via PowerPoint slide decks. Getting learners to use pantomime to express health problems and then moving to short pair practices keeps the learning interactive and engaging.

“We have labeled flash cards and unlabeled flash cards. We spend a lot of time with have and has,” Clark said.

In addition to covering objectives focused on explaining health problems to a medical provider, teachers cover material related to nutritious food and healthy lifestyle choices; completing medical history forms; understanding medication labels; and identifying healthcare resources in the community.

While Zoom classes make it harder to cover some objectives—Clark said it has been tough understanding medicine labels without actual pill bottles (realia)—in other cases, the virtual environment has offered opportunities to use digital tools.

Quizlet vocabulary reviews can be shared with students via communication apps (such as WhatsApp or Telegram) for out-of-class homework. Google forms can give Angie Greene’s beginning-level learners practice filling out medical history forms. 

The students practice radio buttons, check boxes, and drop down menus as a way to target the health objective and digital literacy,” Greene said. She gives her learners invented patient profiles to work with so that students are not being asked to share their private health history.

Flipgrid, a video sharing web tool, has been a favorite digital choice for Clore-Patron with her intermediate-level classes. She guides her learners to create and post short videos on several different topics, including nutrition, home remedies, and end-of-unit reflections. She sets up user accounts for each student on her class account (“It doesn’t take nearly as long as you’d think.”) and the final products can be viewed by classmates, not by the public. (Several students gave permission, however, to share their work with the public and REEP has posted those to social media.)

“It usually takes a good four days to get through it,” Clore-Patron said. Students write to a prompt one night, to use as a script; do revisions from teacher feedback (on Screencastify, the video screen recorder on Chrome) the next night; followed by instruction and practice sessions on Flipgrid on an easily accessible topic (such as what’s your favorite food); with the final night devoted to producing the video. She tries to have one of her classroom volunteers available to do troubleshooting, one-on-one, with students who may be struggling with the technology.


Some of the learners need more time to complete the assignment, meaning it gets pushed into the weekend and done as homework. The final product helps both the student and teacher—Clore-Patron can assess the writing ability of the students and their level of oral production while learners boost their confidence and get a sense of accomplishment at creating a video in their second language.

“There’s this sense of independence—‘Teacher, I did it!’” Clore-Patron said.

The most recent iteration of the Flipgrid project required students to reflect on what they had learned in the Health unit and how they expected to use the new language. You can view some of the results from REEP student Yury and from Alejandro who was a doctor in his home country.

Health literacy is a crucial need for adult ESL learners—during the COVID-19 pandemic, “now more than ever,” as Yury said—and REEP teachers continue to develop effective ways of delivering instruction to help their students be successful.

Access the REEPworld Health Pages, a free English practice website for adult ESL students and teachers.

Phil CackleyPhil Cackley has taught at REEP, the Arlington Education and Employment Program, part of Arlington Public Schools, since 1991. During that time, he has taught every level from low-beginning to advanced. For the past 15 years, he has also been one of the program’s instructional coordinators, supporting teachers and overseeing one of REEP’s two main sites.

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