Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3036 https://internationalpubls.com Exploring Expectation, Students’ Needs, and Workplace Reality in English for Nurses Syllabus Design: A Needs Analysis in Politeknik Sandi Karsa Yuriatson1*, Abidin Pammu2,, M Amir Pattu3, Nasmilah4 1234 English Department, Faculty of Cultural Sciences, Hasanuddin University, 90245, South Sulawesi, Indonesia jubhariyuriatson@gmail.com, abidinpammu60@gmail.com, amirpattu@unhas.ac.id, imla68@yahoo.com.au Article History: Received: 12-01-2025 Revised: 15-02-2025 Accepted: 01-03-2025 Abstract: This study aims to explore the needs of a comprehensive target situation of nursing students to suggest a comprehensive, relevant, and natural English syllabus for English courses for Nurses. By involving nursing students, nursing lecturers, English lecturers, and a nursing graduate working abroad, this study uses a mixed-method design to descriptively analyze student needs from quantitative data. The study proposes a task- based syllabus, identifying target situational needs: topics related to nursing tasks and knowledge, specific technical skills, communication skills with various parties, factors influencing communication, English language skills, and English language knowledge. This study suggests future research to identify the learning needs of acquiring English proficiency in the nursing context.. Keywords: English for Nurses, Needs analysis, Task-based syllabus, Introduction The English language skills of nursing students have received increasing attention over time. One of The reasons is that English is a language used internationally by academics from various educational backgrounds; thus, English proficiency is mandatory for nursing students (Ching et al., 2020; Giada Goracci, 2013; Ibrahim, 2020). The fact that more resources such as medical books, articles, and seminars are available in English provides more chances for nurses to update their insight and engage with the medical community, ultimately improving their ability to provide quality care (Lu, 2018; Ribes & Ros, 2006). Furthermore, the rise of medical tourism significantly impacts nursing students' English language skills. This is evident in Indonesia, where the Joint Commission International (JCI) accredited 25 hospitals last year, including Wahidin and Siloam Hospitals in Makassar, the author's region. This focus highlights the importance of English for nurses who care for international patients in Indonesia. Additionally, English language proficiency is linked to more career options abroad. The World Bank Group approximated in 2016 that 15 million nurses would be required widely by 2023. According to BNP2TKI, approximately 16,000 nurses are required annually in East Asian and Middle Eastern countries. For example, Saudi mailto:jubhariyuriatson@gmail.com mailto:abidinpammu60@gmail.com mailto:amirpattu@unhas.ac.id Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3037 https://internationalpubls.com Arabia requires 2,000 nurses, but only a few have registered and even fewer have passed (Hardiany, 2018), and, just 65 Indonesian nurses are working in the UAE. However, with the new Memorandum of Understanding (MoU), the goal is to increase the number of Indonesian nurses in the UAE to 1,000 over the next two years (Kemenlu, 2020). Moreover, due to Indonesian nurses' limited English ability, only approximately 5 out of 200 nurses who apply for 500 employment vacancies in Qatar each year are accepted, despite having better nursing skills. Therefore, teaching English to nursing students in their home countries is in high demand and challenging. English for Specific Purposes (ESP) is believed to be the solution, contrasting with General English (GE), which has traditionally been taught to nursing students in most Indonesian nursing academies nowadays. As a part of ESP, which focuses on English for Occupational Purposes (EOP) to prepare nursing students conversant in the language, English for Nurses has been around for a long time. English lecturers are well aware of its main objectives. However, some drift towards GE without considering the course name. Others have managed to deliver ESP courses to learners; however, according to thorough previous studies, they do not fully meet the needs (Mazdayasna & Tahririan, 2008; Nurakhir & Palupi, 2018; Jubhari et al., 2022). The lack of adequate and comprehensive needs analysis, a key characteristic of ESP, appears to be a fundamental problem in this case. A similar situation exists at Politeknik Sandi Karsa. While ESP courses are offered, it does not meet their needs. The course syllabus, including topics and activities, aligns more with GE than ESP or EOP, rendering it unsuitable. Furthermore, the syllabus is not designed through a needs analysis, but only based on the lecturers’ perception. Therefore, to address this and improve English language teaching and learning in the nursing education setting, a syllabus based on a comprehensive needs analysis is essential. This needs analysis or needs assessment is crucial for building focused and effective ESP courses (Dudley-Evans & John, 1998). It involves understanding learners' backgrounds and language skills, maximizing learning for their group, and considering the learning environment to obtain information that can be interpreted appropriately. Hutchinson & Waters further break down needs into target needs (what the learner needs to learn) and learning needs (all things learners need to do to learn). Target needs include necessities (essential skills such as reading medical journals, writing reports and emails, and communicating with patients (Niemiec, 2017), lacks (skills learners haven't mastered), and wants (subjective needs of learners). There are three steps in doing the needs analysis process, i.e., making basic decisions about needs analysis, gathering information, and using the information (Brown, 1995). Numerous empirical studies on syllabus design through needs analysis have been increasing. Many of these studies have identified essential language skills (Dedi, 2017; Gass, 2012; Muntasir & Nurviani, 2020; Pongsapan, 2015; Riza & Ratmanida, 2023; Sofyan & Wati, 2022a) and knowledge to master (Afsaneh & Javad, 2012; Pongsapan, 2015; Sofyan & Wati, 2022b; Wibowo, 2021) along with topics and materials (Dedi, 2017; Hakim, 2017; Muntasir & Nurviani, 2020; Pongsapan, 2015), the goals of learning English (Pongsapan, 2015; Wibowo, 2021), learning difficulties, motivation, perception, and expectations (Pongsapan, 2015; Sofyan & Wati, 2022a), preferred learning activities (Hakim, 2017; Pongsapan, 2015); as well Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3038 https://internationalpubls.com as type of syllabus (Dedi, 2017; Kordja et al., 2022). While these insights are valuable, these studies have significant limitations. Despite these insights being valuable, these studies have significant limitations. First, they only focus on specific aspects, such as language skills, topics, and materials, without providing comprehensive information about all the target situations that students need to learn about. Second, the needs analysis in these studies lacks integration of real-world expectations, needs, and relevance. Although lecturers are involved in aligning student expectations with government guidelines, graduates who are already employed are often overlooked. Student- centered learning must align not only with expectations but also with real-world contexts to ensure its relevance. The current study aims to conduct a comprehensive needs analysis encompassing the entire range of target situations that nursing students need to learn, which is then utilized to design a prototype syllabus that is comprehensive, relevant, and authentic. Those insights are acquired from all stakeholders who are important in suggesting the syllabus, including nursing students, nursing lecturers, English lecturers, and nursing graduates working abroad. There was no prior determination regarding the type of syllabus in this study. The type of syllabus is determined solely based on the needs analysis result to validly represent students’ needs. 1. Literature review 2.1 English for Specific Purpose English for Specific Purpose (ESP) is a language teaching approach for learners with a level of certain English proficiency that aims to use the language in a certain situation. ESP has been one of the most popular areas in the teaching of EFL since the early 1960s because it provides instructional aims, materials, and methods that focus on learners' needs and future interests. Scholars have offered numerous definitions of ESP. They define it in different ways. Some define it as teaching English for specific goals, while others describe it as English language teaching in academic studies, vocational or professional, or for non-native speakers of English learning English on Specific Some view it as an instructional approach where the subject and methods are entirely based on the learning reason of the learners (Agustina, 2014; Hutchison, Tom; Waters, 1987; Susilowati, 2014) while others regard it as a course structured around the specific needs of particular learner groups (Çelik, 2018; Richards & Schmidt, 2010; Stognieva, 2019). ESP learners typically enroll in these courses to fulfill specific roles, such as flight attendant (Kim & Jin, 2017); doctor (Lodhi et al., 2018; Stan, 2013); technician (Guerra & Lima, 2019), or nurse (Finch, 2013; Vuong, 2022). A major focus of ESP instruction is fulfilling students' specific language needs, with all activities and materials carefully selected to suit their needs and preferences. This, of course, poses a challenge for ESP instructors. Conducting a thorough needs analysis among the learners, as emphasized by the ESP instructor (Alsamadani, 2017; Chambers, 1980; Flowerdew, 2011; Mandasari & Wulandari, 2021), is therefore crucial. This analysis is a critical starting point for developing a syllabus and selecting instructional materials, teaching methods, and learning activities. Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3039 https://internationalpubls.com 2.2 Needs analysis Since the ESP teaching aims to enable learners to use the language in a situation where they will use the language, the ESP course should be firstly designed by determining the target situation, and a meticulous analysis of the linguistic features of the situation should be further conducted. This analysis, called "needs assessment Dudley-Evans & John (1998), is crucial for building focused and effective ESP courses. Dudley-Evans & John argue that needs analysis as understanding learners (background, language skills), maximizing learning for their group, and considering the learning environment to obtain information that can be interpreted appropriately. They emphasize gathering information on learners' professions, personal interests, language skills relevant to the target situation, existing knowledge gaps, and course expectations. This procedure entails gathering and analyzing data to design a syllabus tailored to meet the specific needs of students, as well as addressing the findings from the needs analysis, encompassing three steps i.e., making basic decisions about needs analysis, gathering information, and using the information (Brown, 2016) Needs analysis gathers information about the target situation and learner attitudes (Hutchison, Tom; Waterrs, 1987); this can be acquired from learners, academic institutions, and employees through a questionnaire (Jordan, 1997). Hutchinson & Waters further break down needs into target needs (what the learner needs to learn) and learning needs (all things learners need to do to learn). Target needs include necessities (essential skills e.g. reading medical journals, writing reports and emails, and communicating with patients (Niemiec, 2017), lacks (skills learners haven't mastered), and wants (subjective needs of learners). The rise of English for Specific Purposes (ESP) courses created a need for a new approach to language teaching. Needs analysis emerged as a way to tailor courses to learners' specific goals, not just general English skills. This analysis helps design all aspects of an ESP course, from curriculum, and syllabus to learning materials. While there might be different perspectives on how to conduct a needs analysis, they all contribute to a more comprehensive understanding of how to meet learners' unique needs. 2. Methods This study utilizes a mixed-method design, incorporating both quantitative and qualitative approaches. The use of the method design was necessitated by the nature of the data in this study, requiring the collection and analysis of both quantitative and qualitative data to address the research questions (Greene, 2006). Such a combination was employed, as it allows a more accurate and comprehensive interpretation of the research data that enables a better understanding of the phenomena being studied (Albright et al., 2013). This research was conducted at Politeknik Sandi Karsa in Makassar, South Sulawesi, Indonesia. 2.1.Participants The participants of this research was nursing students in the accepting class of 2020 at Politeknik Sandi Karsa in Makassar, South Sulawesi, Indonesia. The population is 27 students, consisting of one class. Since there is only one class available, the researcher selected the entire class as the sample using cluster sampling. Three students out of a total of 27 were selected as pilot responses. Besides, out of the 27 students, one student no longer attended college. Thus, the sample of this research was 23 students. In addition, this study included the participation Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3040 https://internationalpubls.com of two lecturers, specifically a nursing and an English lecturer, along with a nurse graduate working in Saudi Arabia 2.2.Data Collection The questionnaire and interview are the research instruments used in this study. The interview for this research was conducted prior to the questionnaire design to determine what information should be included in the questionnaire. It involved three parties: a nursing lecturer, an English lecturer, and a nurse graduate. Both lecturers were lecturers at Politeknik Sandi Karsa, while the graduate has been working in a clinical setting in Saudi Arabia. The interview with the nursing lecturer aimed to identify the subject knowledge that fourth- semester nursing students had learned, ensuring that the English for Nurses I course aligned with their nursing subject knowledge. The interview with the English lecturers sought to understand their perceptions of the necessary English skills and specific knowledge of students. It also aimed to identify any communicative skills essential for using English. While the lecturers provided insights into the expected mastery of nursing and English, the graduate was interviewed to assess the relevance of English teaching in nursing academies to real workplace situations. The questionnaire used in this research focuses on doing a needs analysis. The questionnaire items were generated and developed by analyzing the interviews conducted with the nursing lecturer, English lecturer, and graduates, along with the consideration of the related literature and previous study review. This process also took into account relevant literature and prior studies. 2.3.Data analysis The questionnaire consisted of seven statements regarding target situational analysis. All items were positive statements and were presented on a Likert scale with five response options: consisting of not important, less important, important, and very important. The questionnaire was formatted using Google Forms and distributed online. It was first piloted to three pilot respondents and later distributed to the actual 23 participants following the pilot feedback review. 2.4.Data collection The perceived importance of each item in the questionnaire: not important, less important, important, and very important, was quantified in terms of its percentage. Items with either very important or important equal or more than 50 percent were determined as the necessities, while those with less very important or important perceptions were determined as the wants. In a case where there is an item whose perceived importance of important and very important equal, then the item with the highest very important perception was prioritized as the necessity than the item with a less very important perception. 3. Results and discussion 3.1.Topics The students’ perceived importance level for each topic is presented in Figure 1. Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3041 https://internationalpubls.com Figure 1. The Perceived Importance of Topic Figure 1 illustrates that the topics with the highest perceived importance level of all are topics related to nursing skills. Those topics consist of four topics: patient admission, patient assessment, nursing care plan development, and patient treatment. This may be due to the fact that those four topics are indeed topics practically related to nursing skills which is the center of the duties and responsibilities as a nurse. They seem to realize that in order to a quality nurse, they have to be competent in all of the skill areas required. So compared to other topics, those topics scored the highest on the perceived importance level. This phenomenon can be attributed to two reasons. The first reason, as discussed by (Ilin et al., 2007), pertains to the nature of the task. Learning tasks perceived to have a strong correlation with students' learning objectives and the outcomes of why students need to learn are generally considered highly important. In this context, acquiring skills closely aligned with students' objectives and outcomes is particularly emphasized. The second reason could be related to learners' changing focus on learning, where their focus may have shifted to meaning (Ilin et al., 2007; Kumaravadivelu, 2006). The remaining topics emphasize form rather than meaning, focusing on the content of the knowledge such as the types of medical conditions, medical supplies, and equipment used in the hospital. To grasp this information, they may heavily rely on memorization, needing to memorize the names or terms associated with the medical condition or the equipment which they may find less enjoyable, particularly since many terms originate from Latin and Greek (Sykes, 1896), making them challenging to memorize. The lack of enjoyment of this rigorous task may contribute to the phenomenon of shifting focus (Li, 2021; Teng, 2018). This suggests that topics such as patient admission, patient assessment, nursing care plan development, and patient treatment are essential for these learners, indicating that all learners must acquire proficiency in performing them. Conversely, the remaining topics mentioned are considered less important in the target situation for nursing students at Politeknik Sandi Karsa. However, since knowledge and content are an important part of the conduction of skills competently, these less crucial topics may be learned through the integration of the 0 10 20 30 40 50 60 70 80 90 Patient admission Human body parts and functions Medical supplies and equipment In and around the hospital Patient assessment Personal Hygiene Nursing care plan development Medical conditions Patient treatment Hospital professions The Perceived Importance of Topic Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3042 https://internationalpubls.com skills. A significant implication for syllabus design is that learners need to learn the specific terminology associated with these four topics and should be provided opportunities to apply this knowledge in practical settings. Therefore, syllabus components, particularly the content for English for Nurses, should focus on mastering these skills. This entails emphasizing vocabulary, common phrases, and expressions relevant to these skills, drawn from relevant corpora, as well as employing methods that facilitate practical application. 3.2.Specific technical skill The students’ perceived importance of the specific technical skills in each of the nursing duties and responsibilities is presented in Figure 2. Figure 2.1 The Perceived Importance of Nursing Skill in Patient Admission Figure 2.1 illustrates that all participants perceived the importance of almost all of the specific skills, which encompass specialized knowledge and expertise needed to execute particular tasks using specific tools and programs essential in real-world situations (Nasir et al., 2011). These skills were important and very important by all respondents, ranging from greeting patients during patient admission to communicating with physicians during patient treatment. This perception may arise from two factors: self-identity and self-role. Figure 2.2 The Perceived Importance of Nursing Skill in Assessing Patients Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3043 https://internationalpubls.com Self-identity refers to the concept of recognition that an individual gives to oneself (Pilegge & Holtz, 1997), related to a set of traits or distinctive qualities that distinguishes an individual from other individuals (Reissner, 2010). In this study, students identify themselves as nurses or future nurses, professionals engaged in nursing practices primarily focused on disease prevention and health promotion within society. Therefore, as suggested by (Wheeler & Bechler, 2021), a relationship between an object and self-identity occurs. Learners view nursing tasks as significant objects that contribute to their sense of self-identity. Figure 2.3 The Perceived Importance of Nursing Skill in Planning Nursing Care Development Such self-identification then induces self-role, which is a component of the self-identity concept (Britt, 2005). In self-role, individuals assign themselves a role that defines their specific function or purpose in a situation, organization, or relationship (Currie & Carr-Hill, 2013). Each role subsequently leads to a series of more detailed, specific tasks organized in a chronological order with specific time requirements. Consequently, all students perceive the specific nursing tasks as highly important due to the self-identity and self-role they envision for themselves as future nurses. Figure 2.4 The Perceived Importance of Nursing Skill in Patient Treatment 0 10 20 30 40 50 60 70 80 90 Administering treatment Employing counseling skill Writing progress note Giving and receiving nursing handover The Perceived Importance of Nursing Skill in Patient Treatment 4. Patient Treatment Not Important Less Important Important Very Important 0 10 20 30 40 50 60 70 80 90 100 Sharing patient’s health information with physicians Identifying current and future care needs Reading literature to develop an appropriate nursing… Getting involved with the discussion of the nursing… Writing nursing care plan Educating patient and family on their nursing care plan The Perceived Importance of Nursing Skill in Planning Nursing Care 3. Planning nursing care Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3044 https://internationalpubls.com The implication is that mastering a comprehensive set of skills is essential for students to meet their target objectives, whereas other skills are considered want. This further implies the importance of integrating language proficiency specific to the necessary skills into the lecturer's primary responsibilities. Similarly, in syllabus design, each component must align with the knowledge and skills required for those previously identified nursing skills. Additionally, commonly used phrases and expressions from COCA that pertain to these skills should be a focal point of attention. 3.3.Communication with different parties The students’ perceived importance of a range of communication is presented in Figure 3. Figure 3 The importance of a range of communication Figure 3 illustrates that all participants perceived the importance of communication with healthcare professionals and patients. Furthermore, the majority of participants emphasized the significance of communicating with patients' families, while less than half of them perceived the importance of communicating with non-healthcare personnel. The types of communication perceived as crucial for fulfilling their duties included interactions between nurses and healthcare professionals, as well as between nurses and patients. However, students viewed communication with non-medical personnel as less important. This perception may stem from the influence of self-identity (Pilegge & Holtz, 1997) and self-role (Britt, 2005), which are reflected in the perceived importance of specific technical skills. Additionally, this perception could be influenced by the critical nature of these communications, which are essential for healthcare quality and patient health outcomes. Effective communication with healthcare providers is recognized as a key driver of healthcare system success (Tushi et al., 2018). Therefore, it is understandable that communication with non-medical personnel is perceived as less important. Communication with doctors was perceived as having the highest level of importance. This is because doctor is the most important link in the health care system (Chantler, 1999). Among their specific roles are assessing patients, providing diagnosis and prescription, and treating patients (Robin DiMatteo, 1998). Therefore, clear, accurate, and effective communication between doctors and nurses is crucial for patient health. Poor communication can lead to adverse medical events, including complaints and clinical 0 10 20 30 40 50 60 70 80 90 Communication with healthcare team (physicians and nurses) Communication with patients Communication with patients’ family Communication with non-healthcare personnel The Perceived Importance of Range of communication Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3045 https://internationalpubls.com negligence, which compromise patient health due to medical errors that may even result in death (Jemal et al., 2021; Mohammed & allah, 2018). It suggests that communication with healthcare professionals and patients is essential for learners in their target situation, which means that they need to learn a specific language concerning those communications. In contrast, communication with patients' families and non- medical personnel will be the wants. Consequently, the key components of the syllabus design for English for Nurses, such as foundational competencies, learning objectives, materials, and methods, must prioritize the development of language skills pertinent to both types of communication. Additionally, commonly used phrases and expressions searched from corpora and integrated into the syllabus should primarily focus on those used in interactions between healthcare professionals and patients. 3.4.Factors influencing communication The students’ perceived importance of factors influencing communication is presented in Figure 4. Figure 4. The importance of factors influencing communication Figure 4 indicates that all participants perceived the importance of the choice of words/verbal communication, nursing personality traits, cultural background, and power distance/role identity. Furthermore, the majority of participants perceived patient development as a factor that can influence effective communication. Students at Politeknik Sandi Karsa perceived factors influencing communication as very important, likely due to their recognition of these factors' crucial role in effective communication. For instance, poor word choices can lead to misinformation and misunderstandings, which can ultimately endanger patient health. Avoiding the use of figurative language and selecting appropriate diction are essential when conveying sensitive information (Dvir et al., 2023). Nonverbal communication plays a significant role as it can complement, regulate, and substitute verbal communication (Phutela, 2016). It serves to express our identity, indicate relational standing, convey specific emotions, and communicate aspects of status, power, and role identity (Keutchafo & Kerr, 2020). Misinterpretation of nonverbal communication can lead to issues ranging from patient dissatisfaction to adverse medical events. 0 10 20 30 40 50 60 70 80 90 Choice of words/verbal expression Patient development Power distance and role identity The Perceived Importance of factor influencing communication Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3046 https://internationalpubls.com 4.4.English Skill The students’ perceived importance of English skills is presented in Figure 5. Figure 5. The importance of English skills Figure 5 indicates that participants perceived listening, reading, speaking as important, and writing skills as very important, as they form the foundation of nursing communication. Proficiency in English listening and speaking is crucial for conveying information between nurses and doctors (Lee et al., 2019) and enhancing patient-nurse understanding to truly understand the patient’s symptoms, feelings, and concerns (Tweedie & Johnson, 2018). Lack of this skill may lead to the compromise of the patient’s health. Skills in reading and writing were also perceived as highly important for performing nursing tasks effectively. The ability to read allows nurses to gather and comprehend necessary information, such as charts, reports, and instruction labels (Chang et al., 2013). Similarly, writing skills are essential for tasks like maintaining patient’s medical records, vital sign records, progress notes, discharge summaries, and instructions (Newton & Moore, 2010). In their broader professional context, both reading and writing skills significantly contribute to enhancing the quality of nurses' work and supporting lifelong learning. Nurses need to do intensive and extensive reading as well as writing the publication of their work (Newton & Moore, 2010; Padagas & Hajan, 2020). It implies that skill in listening, reading, writing, and speaking is essential for students in their targeted situation. Therefore, these skills need to be learned, and teaching and learning approaches to these four skills need to be addressed with considerable emphasis. Methods and classroom activities should be designed to facilitate mastery of all English skills, ensuring every student has ample opportunities to enhance their abilities through exposure to rich and engaging materials and tasks. 4.5.English knowledge The students’ perceived importance of English knowledge is presented in Figure 6. 0 10 20 30 40 50 60 70 80 90 Listening Speaking Reading Writing The Perceived Importance of English Skill Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3047 https://internationalpubls.com Figure 6. The importance of English knowledge Figure 6 indicates that all participants perceived the importance of the importance of vocabulary both technical and general vocabulary, pronunciation, commonly used phrase and sentences. Additionally, the majority of participants emphasized the significance of spelling and grammar. Students perceived the importance of English knowledge at varied levels. They perceived vocabulary both technical and general vocabulary, pronunciation, commonly used phrase and expression to be important. This emphasis may have much to do with the role of vocabulary as the most important factor in language learning. As noted by Blachowicz & Fisher (Blachowicz & Fisher, 2004) who highlight words as fundamental to internal language structures. The wide size of general vocabulary enhances proficiency in all communication areas—listening, speaking, reading, and writing—while specialized technical and semi- technical vocabularies improve understanding and effectiveness in specific field communications (Alqahtani, 2015; Susanto, 2017). Meanwhile, the student's perception of the importance of grammar is less important. This could be attributed to several factors, but it is plausible to assume that their interest plays a significant role (Upadhayaya et al., 2021). These students may not find learning grammar as interesting compared to other aspects of language learning. Certain discouraging or demotivating feelings they have encountered in the past with grammar learning may also contribute to their diminished perception (Athanasopoulos et al., 2015; Dauda et al., 2016). Such feelings further assumed may result from the complexity of grammar rules, along with numerous variations and exceptions associated with them. This implies that all of these areas are necessities for Politeknik Sandi Karsa nursing students in their nursing work environment, except for grammar. Consequently, in syllabus design, these knowledge areas must be addressed by the lecturer through the materials presented in class and the methods used to facilitate student learning of these aspects, with less emphasis on grammar. Grammar learning should be integrated into the necessary knowledge areas that students need to master. 5. CONCLUSION The situational needs of nursing students emphasize practical tasks essential for developing their professional competencies, such as patient admission, assessment, care planning, and patient care. Students prioritize these topics due to their direct relevance to 0 10 20 30 40 50 60 70 Technical vocabulary General vocabulary Pronunciation Commonly used sentence The Perceived Importance of English Knowledge Not Important Less Important Important Very Important Communications on Applied Nonlinear Analysis ISSN: 1074-133X Vol 32 No. 9s (2025) 3048 https://internationalpubls.com practical nursing skills, which are central to their future responsibilities. Additionally, nursing students highlight the importance of communication between nurses and healthcare team members, focusing on linguistic aspects such as technical and general vocabulary, pronunciation, and common phrases. 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