4 Health and care

Unit Objectives
Grammar: cohesion 1 (linkers); future forms with be
Vocabulary: health collocations; healthcare; the language of emotion
Scenario: justifying opinions; choosing and planning a publicity campaign
Study skills: analysing visual information
Writing skills: describing visual information

4.1 HEALTH AND SPEAKING

HAPPINESS 1 Students work in pairs and discuss the questions.
• Then put pairs together to form groups of four to
discuss the questions further.
IN THIS LESSON • During class feedback, elicit the most popular
Lesson topic and staging activities for physical health, as well as the best
This lesson looks at the connection between and worst things for mental health.
happiness and good health. Students begin by
discussing questions about personal health and READING
fitness. They then read an article on health and 2 Students do the activity as per Coursebook. Make
happiness before answering a quiz and focusing on sure they realise they should not do the quiz yet.
informal language and new vocabulary connected to • Allow two minutes for the reading, then check.
health. They finish the lesson discussing quotations
by famous people on the subject of health. 1 a lifestyle/health magazine/site 2 c 3 There
Meet the expert video is a close relationship between health and
happiness. If we do what we can to be happy,
Watch the video to hear the Director of the Stress
we will be healthier. 4 Students’ own answers.
Management Society talk about stress: how it
impacts individuals and society, how to recognise it 3 Critical thinking: Reporting research. Being able
and how to manage or alleviate it. to determine claims based on research and then
report back on them using supporting evidence
Objectives are important academic skills. In this exercise,
By the end of the lesson, students will have: students find information relating to claims made
• considered the issue of health and happiness and evidence given, noting the language used.
• read to identify the general idea, purpose, gist and • Encourage students to compare answers before
specific information, and report on research doing class feedback. Ask them to underline the
• learnt and practised health vocabulary key language used to introduce the claims made.
• talked about people’s ideas on health. If time, discuss students’ opinions on the claims.
Timings
1 Three claims made. 1 Claim: Happy people
Possible lesson break: after Exercise 6b.
have stronger immune systems. Evidence:
They don’t pick up as many colds or get struck
WARM-UP down as often by a flu virus. 2 Claim: Happy
Ask students to look at the picture on page 36. What people take better care of their health.
do they think is the connection between health and Evidence: They have regular check-ups, do
happiness? Ask them how the picture connects with more exercise, put on sunscreen. 3 Claim:
the title of the lesson. We can all learn to be happy. Evidence: no
Irish proverb: Ask students to read this and elicit particular evidence given
what they understand by it. It suggests you will stay 2 Researchers have discovered that, Studies
healthier if you take things less seriously, laugh more also indicate that, research shows
(to relax, have fun and reduce stress) and rest well. 3 more evidence, referencing

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4a Students first do the quiz individually then SPEAKING
discuss their answers in small groups.
• Do class feedback and check for justification. 7 Before starting the activity, make sure students
For classes in universities and university understand the quotes.
preparation courses, encouraging students to give • Students work through the quotes in groups of
justification is a good habit to establish. Many threes or fours. Remind them that giving reasons
academic and exam tasks require this and it and justifying opinions is a necessary critical
promotes more language use and critical thinking. thinking skill for both academic and exam tasks.
4bGive students two minutes to read the feedback on • Do class feedback and elicit ideas and justification.
page 159 and think about alternative answers.
• Allow them time to change any of their previous MEET THE EXPERT
answers and to discuss their choices in groups. 1 Direct students to the five questions and give them
• Take class feedback. There is no right answer, as five minutes to discuss their ideas in pairs.
long as the students can give a good justification. • Open the discussion to the class and elicit ideas.
5 Give students three minutes to do this task as it 2 Play the video and then give students time to
requires more intensive reading. compare their answers to Exercise 1 in pairs before
With weaker students, allow time for them to doing class feedback. Ask students how Neil uses
compare answers in pairs. body language to add meaning to what he says
• During class feedback check students understand (He uses facial expressions, head movements and
the multi-word verbs and informal words. gestures for emphasis and to order points).

Multi-word verbs: pick up, get struck down 1 The pace of life has got much quicker because
by, bounce back Informal words: jamboree, of new technologies, social media and mobile
clutter, sexy Expressions: the life and soul of electronic devices. We are subjected to an
the party, grinning from ear to ear overwhelming amount of information and
Use of contractions: don’t, you’re, we’re have too much to do with not enough time.
Use of personal pronouns: we, you We’re also expected to deal with many
different things at the same time.
VOCABULARY: health collocations 2 Western countries have traditionally tended
to ignore stress and carry on without
6a Students do the activity as per Coursebook
addressing it (while eastern cultures have
individually and then check in pairs.
traditionally placed importance on dealing
• Finally, do class feedback, making sure students
with stress and promoting well-being.)
have understood the meaning of each phrase.
3 Some studies suggest that stress may
contribute to heart disease, cancer, diabetes,
1 heart surgery 2 maternity ward, tanning stroke and depression. Stress weakens your
salon 3 high salt intake, omega-3 oils immune system and may leave you more
4 infant mortality, maternity ward 5 immune susceptible to illness.
system 6 chest pain, heart attack, premature 4 simple physical activity, such as going for a
ageing 7 flu virus, high salt intake 8 blood walk, riding a bike, going for a swim
pressure, infant mortality, life expectancy 5 The key to managing stress within a
6bStudents scan the text for the words/phrases. If company is to measure the extent of stress
preparing for an exam, give them one minute to employees feel and analyse how this stress is
do this task to encourage faster reading. generated. This can be done through surveys
• Elicit from the class which words/phrases they and staff forums, by analysing absenteeism,
found in the text and where. Encourage them to staff turnover and carrying out exit
read out the whole line so they can see the context. interviews when employees leave the
company. Once the causes of stress have been
identified, action can be taken to address
immune system, flu virus, blood pressure,
these issues.
heart attack, life expectancy

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3a Give students two minutes to complete the notes
Meet the expert video
before they discuss their ideas in pairs. Remind
Neil Shah, Director, Stress Management Society
them to focus on the words around the gaps when
considering the parts of speech needed. My name’s Neil Shah, I’m Director of the Stress
3bPlay the video a second time, this time pausing it Management Society and author of The 10-Step
before each answer is given so as to elicit the Stress Solution.
answer before checking it. Elicit the meaning of
Primarily, my role involves raising awareness on
language such as alleviate and a stiff upper lip.
stress and the impact it has on modern society,
Have/Keep a stiff upper lip means ‘not show your
how it affects us and the deep implication it has to
feelings when upset’.
both health and well-being from a health and
safety perspective, the moral and legal obligations
1 cope 2 multiple demands 3 upper lip, pull,
that organisations have and how we can start,
socks 4 embraced 5 immune system
once we’ve recognised it, how we can start to
6 Physical activity, calmer 7 efficiency
minimise that impact.
8 commercial value
I think do we have to bear in mind that the
4a Give students four or five minutes to consider
modern day experience of stress is somewhat
their answers to the questions individually.
different to how people would have experienced
4b Allow five minutes for students to discuss their
it even twenty or thirty years ago. The, the pace of
answers in small groups. Then do class feedback.
life has quickened ridiculously over the last fifteen
Students write a blog article of 150–200 words on
or twenty years, with the advent of new
one of the 4b questions, in class or for homework.
technologies, social media, Facebook, Twitter,
smart phones in our pockets, tablet computers.
1 Suggested answers:
General: Take up meditation. Talk to someone The amount of information that people are
outside the situation and ask for advice. Spend subjected to on a daily bases has increased
time with family and friends. Go for a long exponentially over the last ten, twelve years and
walk. Take regular exercise. Spend time doing most people are just not coping. Uh, we’re, we’re
a hobby you enjoy. Write in a journal. Eat waking up to a tsunami of information from the
healthily and get enough sleep. moment we open our eyes to the moment we go
Specific: 1 Find somewhere quiet to study, to sleep, and many people are buckling under
such as a library. Go to bed earlier to ensure that extreme pressure.
you get enough sleep and increase daytime
I think if we look at the modern-day experience of
productivity. Find recipes for quick, healthy
stress, the main causes of stress are excess of
meals or suggest taking turns to cook with
demand. Most of us are being subjected to levels
your housemates. Create a revision timetable
of demand that we can’t cope with. It’s too much
and take regular breaks. 2 Allocate specific
information and too much to do and not enough
times to look on social networking sites and
time. And it’s also the fragmented nature of our
email. Turn off your phone and computer/
daily existences – we don’t just do one thing and
tablet for parts of the day. Restrict the number
then move on to something else. We’re expected
of social networking sites you visit. Time and
to be dealing with multiple demands at
limit your internet use, only using it when
the same time.
absolutely necessary. Try to phone your friends
or meet in person rather than texting and We’ve definitely found that there are different
emailing. 3 Arrange meetings with your team approaches to recognising and dealing with stress
to encourage communication and find out in some countries. For example, in a lot of western
what you can do to help. Encourage your team societies that, you know, we’ve got that stiff upper
to support each other and to come to you if they lip attitude – you pull your socks up and get on
feel overwhelmed. Ensure employees have with it. And, you know, the, the, … I think we’ve
clear goals which are achievable. Encourage been slow to recognise the impact of stress, and
employees to take proper lunch breaks and it’s starting to become very clear in more, more
arrange social activities to boost morale. countries, and more, more organisations are
starting to take this very seriously.

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 And it’s not just countries, um, that, that, uh, and There are many, many, many different things that
cultures that I, I would differentiate, it’s also we can do to alleviate stress. What we have to
industries as well. Some industries tend to take bear in mind is our body’s gone into a state of
this very, very seriously. If we look at, for preparation for some kind of physical activity;
example, industries like the oil and gas industry, we’ve gone into the ‘fight or flight stage’ – your
they take this very, very seriously ‘cos they body is expecting to be fighting or running away
recognise it to be a health and safety risk, risk from whatever is the cause of the stress. So simple
hazard. If people are stressed, they make physical activity is all that’s required to take
mistakes, which could lead to accident, injury, yourself out from that state. Even something as
even death. simple as a walk around the block, you know,
taking the dog out, riding your bike, going for a
We found, particularly in a lot of eastern cultures, swim, getting out and getting some fresh air, and
that for many years it’s been acceptable to have movement, exercise, physical activity is enough to
yoga and tai chi in the workplace and massage in burn off the adrenaline and cortisol that your
the workplace and where they do embrace well- body’s produced to put you in a physiological
being, and they understand that actually, an state of stress. But it also produces good mood
investment in well-being results in cultural and substances, like serotonin, endorphins, which will
commercial success. We’ve been slow on the leave you feeling happier and calmer. So there’s
uptake with that in, in, in the UK and in the States much that we can do, very quickly, to change our
and in various other western cultures, but that is state. So anything that changes your physiology,
changing. through physical movement or activity, will also
It is very, very important that we firstly recognise change your psychology, your mental and
stress and secondly take steps to manage it. emotional state, because the two are intricately
There’s a whole range of issues, health issues that linked.
are directly related to stress. If we think of the top Stress is a health and safety risk hazard just like
four killers on the planet today, there’s many any other, and in many countries is recognised as
studies that have connected heart disease to stress. such under law. So the first step is recognition. It’s
In fact, stress is the number one contributing very important that companies conduct some
factor to heart disease. Many forms of cancer have kind of a, a risk assessment and audit, surveying
been associated with stress. Um, diabetes, type their staff, um, getting a sense of what their
two diabetes in particular, has been connected to employee’s experience is at work, gauging moral,
stress. And stroke – there’s significant research gauging, uh, how engaged their employees feel,
suggesting that stress massively contributes to ensuring that they have opportunities for people
stroke. So even if of itself it can’t kill you, but it to feed back things that, uh, are not working or
definitely leads to issues and illnesses that things that are causing them undue stress –
will. Um, it is a very serious illness. whether that be through employee forums, annual
Stress decimates your immune system, leaves you staff conferences … But also reviewing
much more susceptible to illness, um, it can lead management data – that could be absenteeism
to mental issues, uh, mental health problems like records, staff turnover, and if as part of the exit
depression. And what we’ve also got to bear in interview, stress has been cited as a reason.
mind: mental health and physical health problems
So there’s a variety of different metrics and, uh,
aren’t isolated – we are part of one holistic being,
there’s a variety of different management data
and something that impacts your mental health
that we can draw upon to help to build a picture
will have a direct implication to your physical
of a, the, the state of play within the organisation
health.
and how stress is impacting that organisation. We
But as I said, the first step is recognition, not can even look at, as I said, things like employee
waiting until we get to the point where we are morale through engagement surveys, uh,
already suffering, but taking action early, being productivity, efficiency even, uh, output could be
able to recognise when we’re in a state that’s not a, um, a guiding measure to give us an indication
serving us and knowing what we can do to, to of what’s going on within an organisation. Once
take action to do something about it.

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 we’ve then recognised it, that’s when we can take
action to start addressing some of the issue that 4.2 HEALTH OF A
have come up.
NATION
Um, so we’re actually raising awareness on, on
well-being and why it’s important, and making IN THIS LESSON
the connection between well-being and
Lesson topic and staging
commercial success. If you’ve got a happy and
engaged workforce, you get far more out of them. This lesson focuses on different healthcare systems
They put in more effort, more energy, they are and private and state healthcare. Students begin by
more productive, more efficient and they stay, discussing general healthcare issues, then listen to a
they don’t leave. You don’t have the costs of politician speaking to the National Federation of
replacing good people. So there’s a direct Medical Practitioners. They read a newspaper article
commercial value in addressing workplace stress. on US and Cuban healthcare, which then leads onto
vocabulary work and the grammar point, linkers.
Students identify conjunctions and linking devices,
HOMEWORK OPTIONS then practise using them. After learning more
Students do Exercise V1–5 on page 133 in the healthcare-related vocabulary, they discuss their own
Language reference. healthcare systems and end by writing a short essay
evaluating their country’s own healthcare system.
Students do the vocabulary, reading and
pronunciation exercises for this lesson in Objectives
MyEnglishLab. They can also do the MyEnglishLab By the end of the lesson, students will have:
video activities after this point. • discussed different healthcare issues and found
out about healthcare systems in different places
Students create their own sentences using multi- • listened for specific information, taken notes and
word verbs and informal words from Exercise 5. identified the author’s purpose
Encourage them to use a range of structures and to • read for gist, purpose, specific information and
write longer sentences with a wide variety of meaning from context
cohesive devices. • revised linkers and learnt new ones
• learnt and practised new vocabulary on healthcare
• spoken/written about their own healthcare system.

Timings
If short of time, set Exercise 8, 9 or 12 for homework.
Possible lesson break: after Exercise 6a.

SPEAKING
1 Elicit where the countries mentioned are located
(take in a map to refer to if needed) before
students discuss the questions in pairs. In a multi-
cultural class, mix nationalities up.
• During class feedback, elicit and discuss students’
ideas and encourage them to justify their opinions.
For classes preparing for IELTS, give students one
minute to prepare a two-minute talk on one of the
two questions. Remind their partner to time them
and tell them to stop after two minutes, then to ask
a follow-up question before swapping roles.

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LISTENING Remember, that compares with $6,543 in the USA,
forty-sixth in the world. We 7must learn from this.
2a Explain to students who they are going to listen to 7Spending more money, while useful, I’m sure,
and ask them to take notes on the key points.
does not actually bring the best health results.
For classes in universities and university
That’s a fact. So just what is it about these
preparation courses, note taking is a key academic
countries, many of them in South America, and
skill to develop and is particularly important
their approach towards national healthcare? 8How
when attending lectures. Remind students to
do they produce good national health at much
identify the main ideas and make condensed notes
less cost? How should we change our own
on them, not write down everything they hear.
system? Let me give you those answers.
Audio script 4.1 and answer key to Exercises 2b 2b Students compare ideas in pairs and discuss how
and 2c (underlined) to summarise the talk and identify the stages in
We’re always hearing cries for change to our the argument presented.
national healthcare system, and right now 1the For classes preparing for PTE-A, remind them that
opposition are calling for a huge increase in in the exam they have to summarize spoken text
expenditure on healthcare, to be financed through and write a summary of 50–70 words after they
both increased taxation and compulsory personal have listened to a recording of 60–90 seconds.
private insurance. These would be 2huge costs for 2c Students listen to the speech again to check ideas
us to bear – costs which, in these difficult times, and add further information as needed.
no one can afford. They claim that 3 building more • Allow time for summaries to be updated.
hospitals, buying the latest medical equipment • During class feedback, pairs take turns to present
and spending more on medicines will vastly their summaries to the class. Note key points on
improve the health of the nation. Of course, this the board and at the end, tidy up the notes on the
seems to be a strong argument, 4 but the statistics board to make a final accepted set. Remind
demand caution and I say that there’s a better and students to use headings to help with their
actually cheaper way to improve the health of the organisation and add in any points required.
nation. • Elicit the connections made between the points.

The World Health Organisation health reports

See Audio script 4.1 for underlined answers.
reveal that the 5connection between expenditure
Introducing opposing view (1)
on health and key health outcomes is not as direct
Initial counter argument (2)
as the opposition chooses to claim. 5Spending
Returning to opposing view (3)
more does not mean better health for the people.
Main counter argument (4)
When we look at 6the United States, we see a
Arguing against opposing view (5)
country which spends the most per person on
Statistical support (6)
healthcare and which has the most up-to-date
Conclusion (7)
technology and medicine. 6However, comparative
Introducing next section (8)
studies rank the USA at only forty-sixth in the
world for healthcare success, with a spend of 3 Critical thinking: Identifying the author's
$6,543 per citizen. purpose. Students work individually, referring to
6Countries Audio script 4.1 on page 169 to find the extracts.
ranked more highly include South
• Encourage students to compare answers in pairs
Korea, Chile, erm, Venezuela and the UK. These
before discussing them as a class.
countries spend significantly less per person than
the USA. Er, for example, 6Chile, which is ranked
much higher, at thirteenth in the world, spends
$1,075 per person and 6Venezuela spends half this
and is twenty-sixth in the world.

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 Elicit students’ reactions to the text. Are they now
1 Of course, this seems to be a strong
interested in seeing the film? If so, the viewing
argument, but the statistics demand caution.;
could be set up as a future lesson or homework
… as the opposition chooses to claim … ;
activity, with associated tasks.
Spending more money, while useful, I’m
sure, does not …
2 The World Health Organisation health reports 1 This paragraph shows the extensive range of
reveal that …; When we look at the United approaches to healthcare: exercise, local
States, we see …; Countries ranked more doctors and hospitals. We know it is accessible
highly include …; For example, Chile … because the doctors receive many phone calls
3 … a huge increase …; These would be huge and the fact that the office is shabby and the
costs for us to bear, costs which … no one can hospitals are antiquated indicates that it is a
afford; … USA at only forty-sixth …; ropey system in places. 2 Both life expectancy
Remember, that compares with 8,600 in the and infant mortality rates are better in Cuba
USA, forty-sixth in the world; We must than in America. In America 25 times as much
learn from this. money is spent per person on healthcare than
4 They claim that building more hospitals, in Cuba. 3 a focus on prevention, as opposed
buying the latest medical equipment …; to cure, and the early treatment of illnesses,
I say that there is a better and actually supported by regular check-ups; secondly, easy
cheaper way to …; Spending more does not and free access to local doctors, with a good
mean better health for the people; Spending doctor-to-patient ratio 4 They aren’t paid a
more money, while useful, I’m sure, does not lot, so don’t enter the profession for the money.
actually bring the best health results. That’s 5 Students do the activity individually and then
a fact. check in pairs before doing class feedback.
• They could also make example sentences to show
READING understanding or you could do dictionary work to
find out other forms and meanings.
4a Before focusing on the article, write the name
Michael Moore on the board and ask the class who
1 steady stream 2 blend 3 ethos 4 are
he is and what they know about him.
entitled to 5 impoverished 6 on a par with
Michael Moore, an American filmmaker, political
7 geared towards 8 utopia
activist and author, is best known for Fahrenheit
9/11, the highest ever grossing documentary film.
• Give students three minutes to answer questions GRAMMAR: cohesion 1 (linkers)
1–3, then one minute to think about question 4.
6a Students do the activity individually before
• Do this as a class discussion. Make sure students
comparing answers in pairs.
give justifications for all their answers.
• During feedback, check answers and elicit
whether students know the difference between the
1 In spite of its limited means, Cuba achieves different types of linkers (i.e. their purpose).
the same results as much richer countries.
2 to see if Michael Moore’s claims about Cuba
a In addition b Although, yet, However
stand up to investigation
c As a result, because d Meanwhile, before
3 It takes a preventative approach towards
healthcare. It is free at the point of use and 6bThis activity is best done as a class.
open to everyone. • Refer students to the Language reference and extra
4 Probably, as the journalist sees it as a practice on pages 132–133 as needed.
successful system.
1 meanwhile, as a result, in addition, however
4bGive students four minutes to reread the text and
2 although, because
answer the questions. You could suggest students
only focus on questions 1–4 now and discuss 7 Students complete the exercise individually and
question 5 as a class during feedback. then check in pairs before doing class feedback.
• Students check answers in pairs before doing class
feedback. Encourage discussion of question 5.

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 1 a as well as this, moreover, similarly VOCABULARY: healthcare
b even so, even though, in contrast,
10 Students do this activity in pairs or small groups
nevertheless, nonetheless, on the other hand,
before class feedback. Make sure they have
while, whilst c as, consequently, for this
dictionaries on hand. First, ask them to try to
reason, otherwise, therefore d after that, as,
guess or work out the difference and then let them
as soon as, until, while, whilst
check answers in their dictionaries.
2 across sentences: after that, as well as this,
consequently, even so, for this reason, in SPEAKING
contrast, moreover, nevertheless,
nonetheless, on the other hand, similarly, 11 Ask students, in groups of four, to fill in
therefore across clauses: as, as soon as, information under the five headings given. Then
even though, otherwise, until, while, whilst get the groups to present their ideas.
 Not all students may know about their own
8 Read through the rubric and check understanding, healthcare system, therefore it may help if this
before directing students to the Grammar tip box. activity is preceded by some research and prepared
After they read it, ask what a semi-colon is. Elicit for homework. If you have a homogeneous class in
examples of conjunctive adverbs from the word the country of your students, you may like to
box in Exercise 7. prepare some reading texts, recordings or videos to
• Students rewrite the sentences individually before help them.
checking their ideas in pairs.
• Do a whole-class check, writing answers on the WRITING
board and making sure students have followed
the information in the Grammar tip. 12 Students could work in pairs or small groups.
This activity can be done in class straight after
1 The Americans spend the most on healthcare; Exercise 11, or given for homework.
even so, they don’t have the world’s best For classes preparing for IELTS/PTE-A, an opinion
system. 2 The Cubans emphasise prevention essay is one of the three essay types they might
of illness, whereas the Americans emphasise have in the exam. For students preparing for
treatment of illness. 3 Since Cuba is a PTE-A, allow 40 minutes for the planning and
relatively poor country, it makes sense for its writing of the 200–300 word essay. For students
government to focus on prevention as this is preparing for IELTS, allow 40 minutes for them to
cheaper. 4 While I was reading the article, I write their 250–280 word essay. Remind students
realised that even though spending a lot of to check they understand the question, brainstorm
money on healthcare is probably a good idea, it and make an essay plan before writing and on
doesn’t necessarily lead to the best results. completing their essay, to check for errors. Tell
5 If the government doesn’t improve them to use linkers and to provide justification for
healthcare, people will continue to die any opinions expressed.
unnecessarily; furthermore, the current
approach is a waste of money.
HOMEWORK OPTIONS
Students do Exercise V2–6 on page 133 in the
9 Students complete the gaps individually before
Language reference.
comparing ideas in pairs.
• Elicit answers during class feedback and put a Students do the vocabulary, reading, grammar and
range of possible endings on the board. Let listening exercises for this lesson in MyEnglishLab.
students correct them and choose the best ones.
• Students can look at the Language reference on Students create their own sentences (or a short
page 132 and do Exercises G1–1 and G1–2 on paragraph) using as many of the linkers from
page 133 either in class or for homework. Exercise 7 as possible. They should give information
on the healthcare system in their country, using a
variety of tenses and also new language covered in
the first units of the book.

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4.3 CALL OF DUTY LISTENING
2a The main objective of this activity is to allow
IN THIS LESSON students to access language that they already
Lesson topic and staging know on the subject. This would best be done as a
whole-class activity.
This lesson focuses on nurses and begins by students
2bRead the instructions as a class and then discuss
discussing different terms. After listening to a
what a VIP might say at a graduation ceremony.
graduation speech for nurses, they read an article
• Students do questions 1 and 2, then get feedback.
questioning typical views of nurses, focus on
You may need to play the recording twice.
evaluating contrasting arguments and write a reply
• Finally, give students a few minutes to discuss
to the article. They then study the vocabulary of
question 3 in pairs and do a quick class feedback.
emotions and future forms with be, using examples
from the reading and listening texts. Finally, they
1 Be adaptable and flexible. Think on your feet.
hold a group discussion on vocations.
Enjoy the years to come. Don’t lose sight of the
Objectives human dimension. When the going gets tough,
By the end of the lesson, students will have: remember why you entered nursing.
• discussed terms relating to work and vocations 2 How do you intend to maintain a balance
• read for specific information and for gist between your patients’ needs and your own
• evaluated contrasting arguments needs? How are you to avoid burning out?
• written a response to a newspaper article. Who’s going to care for the carers (i.e. you)?
• learnt and practised new language of emotion How are you going to keep alive your idealism?
• learnt about future forms with to be
• held a discussion on vocations. Audio script 4.2
Thank you for inviting me to be with you here this
Timings morning, as you celebrate what is certain to be
Possible lesson break: after Exercise 5. one of the most important days in your lives. First
If short of time, set Exercise 5 for homework. of all, let me say that I’m going to be nice to you,
as I’m very likely to need your services one day.
SPEAKING
You have worked hard to be where you are now
1 To begin the lesson, students work in pairs to and I want to congratulate you on your success.
discuss some key terms relating to vocation. And it’s fantastic to see many male graduates
• Elicit and discuss answers during class feedback. among you today, a huge increase on the numbers
Alternatively, do this activity as a class. of only a few years ago. Now you are on the point
of becoming members of one of the most
1 a a job or profession that you have been demanding of all professions. A profession that
trained for and which you do for a long makes a real difference to people’s lives. You
period of your life b a job that needs a high should treat this as a tremendous opportunity,
level of education and training c a service which not everybody has. You do.
that a government provides; a service
So, you’ll need to be adaptable and flexible, and to
provided to people because it will help them
think on your feet. You are going to learn that
and not for profit d the belief that you
being a nurse is a full-time job – literally. You are
should live your life according to high
nurses whether or not you’re in uniform. Your
standards and principles, even when they are
family, friends and neighbours will call you for
very difficult to achieve e the feeling that
help in a crisis.
the purpose of your life is to do a particular
type of work, especially because it allows you Erm, in the early years of your career, you’ll
to help other people experience uncertainty, anxiety and fatigue. For
2 Possible answers: doctor, teacher, religious all that, these years are sure to be some of the
leader (priest, imam, etc.) most exciting in your life. Relish them.
New technologies are due to revolutionise the
way healthcare is delivered, but you mustn’t lose

New Language Leader Advanced Health and care 9

 higher up in the department have fallen. He
sight of the human dimension.
fears that the problem could have even more
Although you’ll face many challenges, you’re serious consequences if nurses are to be given
especially well placed to deal with them. No more responsibility for diagnosis and
previous generation of nursing professionals has treatment.
had your level of training. You are the first The solution is to decrease the emphasis on
generation of a new kind of nurse, with new academic training and to remind ourselves that
skills, for new roles. caring for patients is, in itself, a highly
respected career.
I’ve offered some advice, but I’d also like to ask
you some questions. Here’s one: you’ll be 4a Give students two minutes to read the article
working with people who are in pain or who are again and answer questions 1–3 individually.
grieving. Some of these people are bound to want • Students then compare answers in pairs and
you to come along with them on their emotional discuss 4 and 5 with their partner.
roller coaster rides. Now, how do you intend to • During class feedback, elicit answers and widen
maintain a balance between their needs and your the discussion for the last two questions.
own? How are you going to avoid burning out?
Who’s going to care for the carers? 1 seeing patients suffer because of nurses’
Here’s another question: the longer we work, the laziness and incompetence 2 those who do
harder it is, sometimes, to keep up our early more than their job description and work long
idealism. If you’re confronted with unsatisfactory hours 3 knowing that nurses might get more
working conditions and bureaucracy, if you don’t responsibilities, such as prescribing medicines,
get the level of respect you think you deserve making diagnoses, operations and discharge
from your co-workers, if the media report that 4/5 Students’ own answers.
you have lost your sense of vocation, how are you 4bCritical thinking: Evaluating contrasting
to keep alive that idealism that prompted you to arguments. Explain that in academic settings, it is
do this work in the first place? important to be able to consider different sides of
When the going gets tough, remember why you an argument. This skill is also useful when writing
entered nursing. You have chosen this profession about other people’s opinions or the advantages
because you wanted to heal the sick and help the and disadvantages of an issue, e.g. for an essay.
suffering. You are dedicated to improving health • Ask students to discuss the question in pairs or
and showing concern for others. You are groups, before widening the discussion to the
committed to public service. These are some of the class. Encourage students to justify their answers.
noblest aims it is possible to have. Alternatively, students could first summarise the
two points of view. This section could then be
The qualification you’re about to receive is richly extended with a debate.
deserved and a passport to a lifetime of fulfilment.
Congratulations and best wishes for the future. WRITING
5 Although the writing itself can be done at home,
READING the introduction should be done in class. Draw
3 Write the phrase Call of duty on the board. Elicit students’ attention to the three readers’ comments
the meaning of duty and ask who this could be after the article in the reading text.
referring to. Elicit nurses. • Get students to read these texts and check they
• Give students one minute to the activity, making have understood. Ask about the tone of the
sure they do not read the three responses to the comments and the way these replies are written.
article at this stage. Then do class feedback. Are they aggressive, polite, clear? Discuss how
they are organised.

The doctor writing says some nurses are lazy

and incompetent, often because the standards

New Language Leader Advanced Health and care 10

• Students then write their own short reply. 7c Students do the activity individually then compare
After writing, students swap reviews in pairs and ideas with a partner.
peer review each other’s work, giving feedback • Check answers with the class.
on the content and any errors spotted. • Students can look at the Language reference on
For homework, students rewrite their reviews, page 132 and do Exercise G2–3 on page 133 either
taking on board the feedback received. in class or for homework.

VOCABULARY: the language of 1 a be about to, be on the point of, be on the

emotion verge of b be bound to, be certain to, be sure
to c be due to d be likely to
6a Before starting this activity, elicit from students as 2 a be about to, be bound to, be certain to, be
many words as they know to describe emotions. sure to, be due to, be likely to
They should already know quite a lot. b be on the point of, be on the verge of
• Students then complete the activity and compare
ideas in pairs before class feedback.
SPEAKING
uncaring, fury, distressing, upsetting, 8 Put students in groups to discuss the questions.
admirable, enthusiastic, worry, passionate, • Round up by bringing the class together to elicit
disheartened, satisfaction ideas. End by finding out if money or enjoyment
near synonyms: distressing/upsetting at work is more important.
6bStudents do the activity as per Coursebook
HOMEWORK OPTIONS
individually and then in pairs.
• During class feedback, check students understand Students do Exercise V3–7 on page 133 in the
the meaning of the words through example Language reference.
sentences, writing definitions or dictionary work.
If your students are preparing for IELTS/PTE-A, Students do the listening, reading, vocabulary and
you may wish to do some pronunciation work grammar exercises for this lesson in MyEnglishLab.
here. Focus first on word stress patterns before
practising the pronunciation of the words.
6c Students work in pairs, taking turns to ask and
answer questions using words from the box.

GRAMMAR: future forms with be

7a Refer students to the examples before asking them
to look at the texts and find examples.
• Allow time for students to compare ideas before
eliciting examples from the class. Encourage
students to underline any they had missed.

Reading text: is bound to provoke, are certain

to have, are to be given, is not to be considered
Listening text: is certain to be, ’m very likely to
need, are on the point of becoming, are sure to
be, are due to revolutionise, are bound to want,
how are you to keep, you’re about to receive

7bThis question would be best discussed as a class.

• Students can check the Language reference on
page 132 if they have problems with this.

to be + infinitive: nurses are to be given, how

are you to keep

New Language Leader Advanced Health and care 11

4.4 SCENARIO: 1 high levels of salt consumption 2 causes
high blood pressure leading to nearly 200,000
CHANGE YOUR deaths annually 3 affects more than half the
WAYS population 4 a simple change in behaviour
has immediate positive effects on health
5 to reduce levels of salt consumption
IN THIS LESSON 6 improve food labelling 7 persuade food
Lesson topic and staging companies to reduce salt content of processed
This lesson provides a scenario to practise the food 8 inform people of the dangers of eating
language of justifying opinions. Students choose and too much salt, to encourage lower levels of salt
prepare a publicity campaign to heighten health consumption 9 TV advertising, poster
awareness. First, they look at posters and discuss campaign, internet site (with blogs and fact
health awareness campaigns. They listen to a sheets) 10 humorous campaign featuring an
proposal for a health campaign and consider the animated slug called Sid 11 ‘We’re all Sid at
strengths and weaknesses of it. The listening heart.’
introduces the language of justifying opinions, which
students analyse and practise. The task is then to Audio script 4.3
take part in a meeting and present the health issue Charlie, Nishi, Peter
they want to campaign for, using the Key language C: Right. Well, my proposal is that we launch a
and Useful phrases provided. In groups, they plan major campaign to reduce people’s currently
their campaign and finally give a presentation on it. high levels of salt consumption.
N: Salt consumption?
Objectives C: That’s right. One reason I favour this
By the end of the lesson, students will have: campaign is that eating too much salt is a
• gathered information from short reading texts significant risk factor in developing high
• listened and taken notes blood pressure, which causes nearly 200,000
• focused on the language for justifying opinions deaths each year.
• participated in a meeting to present information, P: OK, so is this a big problem?
make a choice and plan the next steps C: Oh yes. The second point I want to make is
• given a presentation. that almost half of the population eat more
than the daily recommended amount of salt,
Timings which is six grams a day. So you can see that
Possible lesson break: after Exercise 5. this affects a large number of people, can’t
If short of time, set Exercise 8 for homework. you? Thirdly, changing salt consumption
habits has a quick and tangible effect. By this
SITUATION I mean that within just four weeks of
Before students open their books, ask what a reducing your salt consumption, your blood
publicity campaign is and elicit examples. Ask what pressure will be lower. That’s exactly the kind
forms of media can be used in a publicity campaign of thing that people want to see – an
and what it aims to do. After students read the immediate result of their actions. Basically, a
situation, check they have understood it. simple and slight change to lifestyle can have
a dramatic effect.
1 Students look at the posters and discuss the N: Fair enough, and quite convincing. Have you
questions in groups before class feedback. had any thoughts about the shape that the
2a Students do the activity as per Coursebook campaign could take?
individually, then check with a partner. Play the C: Yes, I have. So obviously, the main aim of the
recording twice. While they listen, put the campaign is to get people to reduce their salt
headings up on the board. intake. Firstly, we need to make sure that
• For class feedback, ask students to come up and people can find out how much salt they’re
write their notes under the appropriate headings. consuming; and I think this means that we
Discuss any differences in opinion and check have to lobby the food industry for improved
spelling and grammar. labelling on food packaging and, secondly,

New Language Leader Advanced Health and care 12

 we also need to press the food companies to KEY LANGUAGE: justifying
reduce the salt content of processed foods –
opinions
you know the kind of thing: microwave
meals, crisps, etc. If we do these two things, 3 Students try and complete as many of the
people will inevitably be eating less salt and sentences as they can individually.
also they’ll be able to monitor their salt • Play the recording so they can check their answers
intake. Thirdly, we, of course, have to run a and complete any gaps they may have.
major publicity campaign to inform the • Allow students time to compare ideas in pairs
public about the effects of salt. In this case, before eliciting the answers from the class.
the fact that the problem’s so widespread
means a TV advertising campaign’s fully 1 reason I favour, is that 2 can’t you
justified. While I accept that it’d be expensive, 3 this I mean that 4 exactly 5 If, will
it’d be the most direct way to reach such a inevitably be eating 6 fact, means
large target audience. A key part of the 7 I accept 8 ask why a slug, answer
strategy here would be to have a humorous
approach to make the message memorable. 4 Students match the techniques to the sentences
P: OK, and I guess you’d have a poster individually then check answers in pairs.
campaign as well, and an internet presence of • Do class feedback.
some sort, wouldn’t you?
C: Absolutely. And on the internet we’ll provide a 4, 5 b 1, 3, 5, 6 c 2, 8 d1 e3 f 7, 8
fact sheets and have some blogs written by
5 This activity is best done as a class discussion.
people who are reducing their salt intake.
Ask students to practise using these phrases.
You know the kind of thing: weekly updates
Monitor them, checking their intonation and
about the changes in their diet, how their
stress patterns.
health is improving, etc. Finally, the whole
campaign would be tied together by our main
campaign tool – Sid the Slug!
TASK: choosing and planning a
N: Sid the Slug? Do you mean an animated slug? publicity campaign
C: Exactly. You may well ask why a slug, and
6 Read through the instructions with the class, then
the answer is that salt kills slugs. And so Sid label students as A, B and C. Where it is not
the Slug will highlight that direct link possible to have groups of threes, ask two students
between eating too much salt and the to work together for role A. Tell students to go to
increased risk of fatal heart attacks. And also, the relevant pages and read the information about
this gives us the all-important humour that I the issue they favour.
talked about. We can have Sid being tempted • Once they have read the information, put them
by all those things which are high in salt, only into groups of three with one A, B and C in each
to see him fall ill as a consequence. Or we group. Explain that their aim is to persuade their
could have him turning his back on that kind group that their issue is the most important one.
of food, telling us why he always goes for • Give students five minutes to prepare. Remind
lettuce over a packet of crisps. Of course, them to use as many phrases they learnt in
we’ll need a slogan – perhaps: ‘We’re all Sid Exercises 3, 4 and 5 as possible.
at heart.’ I like that because it makes the 7 At the end of five minutes, tell them they can start
connection with blood pressure. Oh, and on the meeting and encourage them to use the
the website, Sid’ll host the site and answer language in the Useful phrases box.
user enquiries and so on. So what do you Go through the phrases given to check students
think? understand them. Give examples of use if needed.
2bStudents consider the proposal in groups. • Tell students they have ten minutes to decide
• Elicit ideas during class feedback and ask students which issue they will support as a group.
for suggestions on how to improve the campaign. • After ten minutes point the students to question 2
and give them an extra ten minutes (or more if
you have more time) to prepare their campaign.
Score the groups during the meeting for correct
use of the Key language. A group gets two points

New Language Leader Advanced Health and care 13

 for using Key language correctly and one point
for using Useful phrases correctly.
4.5 STUDY AND
8 If time permits, groups can prepare visuals, e.g.
posters, brochures, etc. to support their campaign.
WRITING SKILLS
If time is short, this aspect of the task can either be IN THIS LESSON
omitted or students can prepare their visuals for
homework instead and do their presentation in the Lesson topic and staging
next class. This lesson is in two parts. In the first part, students
9 Allow students six minutes to present their learn to analyse visual information, taking an
campaign. example from the World Health Organisation
• At the end of the presentations, ask the class to (WHO). They study a chart based on WHO’s
choose the best campaign and to justify why they activities and consider how the chart could be
think it is the best one. Discuss its strengths and if improved. In the second part, students practise
they were convinced by it. writing a text that describes visual information. They
For classes in universities and university consider the writing process involved and analyse a
preparation courses, remind students that they chart description, for instance, how to express
will be expected to take part in group meetings approximation and to use reference words. They
and give presentations (either individually or as conclude by writing their own description of a chart.
part of a group) when studying in an academic
setting and that collaboration is a key element of Objectives
higher/further education. By the end of the lesson, students will have:
• learnt about the World Health Organisation
HOMEWORK OPTIONS • thought about sources of charts
• analysed a chart and its findings, especially trends
Students do Exercise KL–4 on page 133 in the
• considered how to improve a chart
Language reference.
• analysed the process of writing a description of a
Students do the reading, listening and Key language chart, for instance expressing approximation and
exercises for this lesson in MyEnglishLab. using reference words
• written a description of a chart.
Students write a reflective piece (180–200 words),
individually or as a group, analysing the strengths Timings
and weakness of their group’s presentation. In a If short of time, set Exercise 8 and/or 16 for
subsequent lesson, students discuss (in mixed groups homework.
or as a class) what they did well and what they will Possible lesson break: after Exercise 10.
do differently in future presentations. Suggest they
make notes for future reference. STUDY SKILLS: analysing visual
information
1 Students discuss the questions in small groups.
Give them five minutes to discuss the questions.
• Do class feedback and ask if WHO is an acronym
or an abbreviation. (See notes in 3.2 for more
information about WHO.)

2 Communicable diseases can be transmitted,

typically from one person to another or from
animals/insects to humans. Non-communicable
diseases cannot be transmitted in this way.

2 Do the activity as a whole class. This is a good

place to discuss what to consider when checking
the reliability of information on the internet.

New Language Leader Advanced Health and care 14

 1 The World Health Report, 2008 1 F (Diarrhoeal diseases will be the least
2 Yes, because the WHO is a trusted significant cause.) 2 T 3 T 4 T 5 F (They
international organisation. will show a slow decline.) 6 F (probably not
until 2030)
3 Students match the explanations to the terms.
• Allow time for them to compare answers in pairs 9 Do this activity as a whole class.
before doing class feedback. Check whether 10 Divide the students back into groups of three or
students remember what an X (horizontal) axis four. Give them three or four minutes to come up
and a Y (vertical) axis are. with a few possible improvements for the chart.
• Discuss ideas during class feedback.
1F 2B 3E 4C 5G To give students extra practice in interpreting
charts, bring in another example (health-related if
4 Do this as a class. If students are not comfortable possible) and elicit or provide examples of key
working with numbers, reassure them that these information or changes over time. Ask students
exercises look at language and they won’t need to (or show them) how this information is
do any maths. demonstrated in the chart.

1 F, G, H, I, J 2 B, C, D, E WRITING SKILLS: describing

5 Students work in pairs. During class feedback,
visual information
elicit answers and discuss options for question 3. Note: If this is the beginning of a new lesson, you
might want to recap what was done in the last lesson
1 No, this is a selection. 2 No, from 2016 it before continuing, as it is so closely connected.
only gives information for every other year.
11 Ask students to read the instructions for the
6 Students do the activity individually, then compare writing task quickly and check for understanding.
ideas in pairs before doing class feedback. • Students work in pairs. Then do class feedback.
For classes preparing for IELTS, remind students For classes preparing for IELTS, remind students
that in Task 1 of the Writing test they may have to of the importance of planning before writing and
describe the key features of a graph. When doing leaving time to check work for accuracy. Explain
this type of task, they need to find a way to that their accurate use of grammar and
introduce the key features of the chart without vocabulary, as well as organisation of ideas, is as
copying the rubric word for word. relevant as answering the question asked.

This chart shows causes and predicted causes 1d 2f 3b 4e 5g 6a 7c

of death worldwide between 2004 and 2030.
12 Give students three minutes to do the activity
7 Give students one minute to decide what the main individually before doing class feedback.
trend is. Allow time for students to compare ideas
in pairs before doing class feedback. 1 Para 1: mortality rate worldwide between
2004 and 2030
The main trend is that communicable diseases Para 2: shift away from communicable diseases
(caused by viruses and bacteria that can be as causes of death
transmitted to humans) account for a Para 3: rise in non-communicable diseases and
decreasing number of deaths, whereas non- accidents as causes of death
communicable diseases and road accidents Para 4: summary
account for an increasing number of deaths. 2 The first sentence is an introduction/
description of the chart, giving the context. The
8 Students do the activity individually. With a last sentence is an overview, summarising the
weaker class, students could work in pairs. main information emerging from the chart.
When going through the answers with the class, it
might be useful to project the chart on the board
to demonstrate where the information exists and
why the false answers are just that.

New Language Leader Advanced Health and care 15

13 Give students two minutes to underline all the In the next lesson, students could peer review each
approximations they can find. other’s reports and check for the following:
• Students compare answers in pairs. • a clear introduction
• Do a class check, asking students to think of their • key information selected and supported using
own examples using these approximations. data
• approximations used when data is not exact
just over thirty-five million, approximately • the writing is coherent and cohesive
thirty-nine million, about ten million, close to • the correct tense or tenses are used
thirty percent, around five million, less than • the writing is grammatically accurate
fifteen percent, nearly double, roughly one • the data is accurate
million, somewhere in the region of 2.5 million • the report has a clear overview and summarises
the main trends
14 Students have done basic referencing before, so it • the report is between 150–180 words long (if
is worth checking this first. Put on the board a doing as IELTS preparation practice).
simple sentence like: I’ve just bought a new car. Students find their own chart or graph on the
_____ is the most expensive thing I have ever bought. internet and write a report on it for the next class.
Elicit the word that goes in the blank (It) and then Separate the diagrams from the descriptions and
other reference forms used to refer back to what ask the class to then decide which description
has been previously said. Also elicit what they matches which diagram.
refer to (things, people, actions, etc.).
• Students then do the activity as per Coursebook in HOMEWORK OPTIONS
pairs before doing class feedback.
Students do the study skills, writing and academic
Para 2: This = ten million deaths; these = collocations exercises for this lesson in
communicable MyEnglishLab. This is also a good time to do the
Para 3: These = cancer deaths; The latter = MyEnglishLab video activities.
fatalities that are the result of road accidents

15 This activity can be done in pairs before the

answers are discussed as a class.
• Elicit any other tips students might have for
describing visual information.

1 F (You should change the language a little.)

2 F (It’s important to be selective and pick out
the main points.)
3 T (This will help you to keep on track.)
4T
5 T (You should show that you can manipulate
a range of simple and complex structures.)
6 T (Generally true – this would be the normal
way, but it is possible to have the overview at
the beginning.)
7 F (It can be a little longer, but ideally not
more than 20 words longer. It must not be
shorter, however.)

16 Refer students to the chart on page 160 and ask

them to work through the task and write a report
on it. This could be done in class or for homework.
If you have students preparing for IELTS, give a
time limit of 20 minutes and remind them of the
word limit of 150–180 words.

New Language Leader Advanced Health and care 16