

































English Language Teaching Educational Journal   ISSN 2621-6485 

Vol. 7, No. 2, August 2024, pp. 109-123  

        https://doi.org/10.12928/eltej.v7i2.11570        http://journal2.uad.ac.id/index.php/eltej/index         eltej@pbi.uad.ac.id  

The impact of blended-ESP instructional model on fostering 

English proficiency among students majoring in traditional 

Chinese medicine 

Ruirui Yu a,1,*, Wilawan Champakaew b,2 

a, b School of Liberal Arts, Mae Fah Luang University, 333 Moo 1 Thasud, Muang, Chiang Rai, 57100, Thailand 
1 454293766@qq.com *; 2 wilawan.cha@mfu.ac.th   

* corresponding author 

  

A R T I C L E  I N F O 

 

A B ST R ACT   

 

 

Article history 

Received 16 June 2024 

Revised 12 August 2024 

Accepted 15 August 2024 

 English proficiency is essential for Traditional Chinese Medicine 
(TCM) majors to maintain strong connections with the international 
academic community and promote global academic interaction. 
However, the English instruction effect was not optimal due to large 
class sizes, limited class time and learning resources, less interaction, 
or outdated teaching and evaluation methods (Wang, 2016; Ren, 2017; 
Chen & Liang, 2020; Liu, 2022). This study aimed to investigate the 
impact of the blended-ESP instructional model (BEIM) on fostering 
students’ English proficiency as well as explore their attitudes and 
perspectives on the implementation of BEIM. The participants were 73 
second-year TCM majors enrolled in the TCM English course at a 
TCM university in China. The instruments were pre- and post-tests, a 
questionnaire, and an interview. The data was analyzed using mean, 
standard deviation, paired t-test, segmented analysis, and thematic 
analysis. The results demonstrated the effectiveness of BEIM on 
fostering students’ English proficiency for the significant differences 
between the scores before and after implementing BEIM at 0.000 (P = 
0.000). The results of the questionnaire and interview also revealed 
students’ positive attitudes and perspectives on BEIM. Students’ self-
disciplinary, English proficiency, and national culture awareness and 
confidence should be highlighted when conducting blended-ESP 
instruction.  

 

 

This is an open access article under the CC–BY-SA license. 

    

 

 
Keywords 

Blended Instruction 

English for Specific Purposes 

Traditional Chinese Medicine English 

English Proficiency 

TCM Culture Confidence 

 

 

 

How to Cite: Yu, R., & Champakaew, W. (2024). The impact of blended-ESP instructional model on fostering 
English proficiency among students majoring in traditional Chinese medicine. English Language Teaching 
Educational Journal, 7(2), 109-123. https://doi.org/10.12928/eltej.v7i2.11570  

1. Introduction  

Traditional Chinese Medicine (TCM), as an original medical science of the Chinese nation, is a 
summary of the health and wellness concepts and medical practice of the Chinese nation for thousands 
of years (Chan, 2016; Liu et al., 2021). It is gradually known for its efficacy in disease treatment, 
health maintenance, and its concept of health prevention as it enters the global stage. Traditional 
Chinese medical culture also has been a prominent element of Chinese culture and its national soft 
power (Zhang & Zhang, 2018; Kadetz & Stanley-Baker, 2021). English proficiency plays a crucial 
role in facilitating worldwide academic interaction (Lin & Lei, 2021; Soruç et al., 2021), and it is 
equally necessary for students majoring in TCM to establish and maintain strong connections with the 
international academic community. Many research achievements in the field of TCM also call for 
publishing in English-language international publications or academic exchange and collaboration 

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110 English Language Teaching Educational Journal   ISSN 2621-6485 

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with international scholars. As a result, attaining a certain level of English proficiency is crucial for 
TCM students and practitioners so that they are able to read and understand English literature, research 
reports, and translate professional TCM knowledge into English for sharing and dissemination with 
international peers. Furthermore, as research on Chinese medicine occupies a prominent global 
position, international academic exchanges and cooperation play a crucial role in enhancing the 
international influence and advancement of traditional Chinese medicine. Proficiency in English is 
quite essential for TCM students and practitioners to actively engage in academic exchanges with 
overseas peers, fully participate in international conferences, and effectively collaborate on research 
projects. In short, TCM students and practitioners need to have adequate English proficiency to meet 
their professional needs. 

Colleges and universities have long recognized the importance of foreign language capacity, 
particularly English language proficiency, in order to cultivate globally competitive professionals 
(Cai, 2004; Shen, 2010; Shen, 2015; Shen, 2019). English proficiency is necessary for medical 
students to consult the latest medical literature, publish international papers, attend international 
medical conferences, and exchange ideas with international peers (Zhang et al., 2020). Medical 
students lacking the capacity to comprehend and acquire knowledge from English literature and 
academic publications could be unable to track international progress and update their knowledge at 
any time. The majority of medical students would pursue clinical or scientific research work after 
graduation, which suggests that apart from their demanding job, they also need to consistently stay 
updated with the latest developments in the medical domain both domestically and internationally to 
enhance their professional expertise.  

Research on TCM English is also important for fostering the internationalization of TCM as well 
as inheriting and promoting its culture. In recent years, research on TCM English has achieved fruitful 
results, including the creation of new words, standardization of terminology, and text interpretation; 
promoting the standardized development of TCM internationally; providing better technical support 
for the global dissemination of TCM; emphasizing the transmission of the unique value and concept 
of TCM; fostering the exchange of Chinese and western medicine; and promoting the diversity of 
global medical culture (Pan et al., 2021). TCM English learning facilitates students’ English 
proficiency in some TCM fundamental concepts, including but not limited to Yin-yang theory, five 
elements theory, meridian theory, and TCM therapeutic principles.  

However, the conventional TCM English instruction paradigm consists of teachers, textbooks, 
simple multimedia, and students. The teacher’s explanations in the class, together with the students’ 
attentive listening and memorization, establish the basis of the classroom setting. Teachers pass 
knowledge on to students by utilizing various instructional tools such as chalk, writing on blackboards, 
PowerPoint presentations, and a variety of simple multimedia resources. Mostly, students passively 
receive and internalize the knowledge passed on by their lecturers; they lack interest or motivation in 
learning (Wu, 2015; Liu, 2022). Since the teaching content is based on the university’s compulsory 
unified textbooks, TCM vocabulary explanations, language points, and content analysis are the main 
components of conventional teaching contents. The final exam incorporates content from the textbook 
and closely aligns with the lessons learned in class. There is limited time for teachers to expand on 
further language points or organize group discussions in the classroom due to the necessity of 
completing instructional tasks and test preparation. The absence of substantive classroom discussions 
impedes students’ capacity to develop their problem-solving and creative thinking abilities. The study 
findings of Wang (2016), Ren (2017), and Chen & Liang (2020) support this claim. Furthermore, 
some teachers, influenced by their years of teaching experience, continue to use the outdated teaching 
concepts and approaches. The implementation of the internet to assist teaching seems superficial. 
Finally, conventional TCM course evaluations mostly concentrate on exam scores and classroom 
performance, which means that online instruction receives little attention and “smart classroom” 
equipment becomes a decoration rather than a useful instruction tool. This teaching mode creates a 
dull classroom environment, has low teaching effectiveness, and maintains less active interaction 
between teachers and students. As ESP in China enters its third stage of development, characterized 
by deep integration with modern educational technology (Hu, 2019), TCM English instruction using 
basic multimedia tools is no longer sufficient to meet the diverse and mobile characteristics of today’s 
young students on digital campuses. As the number of “smart classrooms” increases on campuses, 
instructors need to update their teaching methods and effectively utilize information technology to 



ISSN 2621-6485 English Language Teaching Educational Journal 111 
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implement blended instruction models. They should also encourage students to utilize their mobile 
phones to enhance their learning (Liu, 2022).  

Previous studies on TCM English mostly concentrated on the curriculum design of TCM English 
(Ren, 2017; Zhang et al., 2020), the compilation of international TCM English textbooks (Li & Zhang, 
2013), the international dissemination of TCM culture (Hou & Lyv, 2021), the development of TCM 
cultural soft power (Zhang & Zhang, 2018; Kadetz & Stanley-Baker, 2021), the construction of TCM 
translating theory systems (Si, 2019), the training of TCM translators or interpreters (Chan, 2016), 
and the cultivation of TCM English teacher teams (Wu, 2015). However, there was relatively limited 
research on the TCM English instructional models, particularly regarding the correlation between the 
blended TCM English instructional model and the enhancement of students’ English proficiency. To 
cultivate more competitive international professionals in TCM and foster international exchanges in 
its practice and culture, further research is required in the domain of blended TCM English 
instructional models to improve students’ English proficiency in the TCM field. Therefore, the 
objective of this study was to examine the impact of a blended-ESP instructional model on fostering 
English proficiency among students majoring in TCM as well as explore their attitudes and 
perspectives on the implementation of BEIM. This study consisted of two research questions. 

1. Can the blended-ESP instructional model (BEIM) foster university students’ English language 
proficiency?  

2. What are students’ attitudes and perspectives on the implementation of the blended-ESP 
instructional model (BEIM)?  

2. Method 

The current study aimed to examine the impact of BEIM on fostering English proficiency among 
students majoring in TCM as well as explore their attitudes and perspectives on the implementation 
of BEIM. The study was carried out from February 2024 to May 2024 after being approved by the 
Mae Fah Luang University Ethics Committee on Human Research (No. EC24017-10). This study 
employed a mixed-methods experimental design, utilizing a pre-test, a post-test, and an attitude 
questionnaire for quantitative data collection, alongside a semi-structured interview to obtain 
qualitative data.  

2.1. Participants 

Purposive sampling was utilized to recruit the participants. The study population was second-year 
undergraduate students majoring in TCM at Guizhou University of Traditional Chinese Medicine, 
China. The participants were 73 second-year undergraduate TCM majors who enrolled in the 
“Traditional Chinese Medicine English” course in the second semester of the academic year 2023. All 
73 students were selected as participants because they had completed the “College English 1” and 
“College English 2” courses during their first year’s study, while they had never enrolled in the TCM 
English courses. All of them exhibited the same levels of English proficiency in the field of TCM, and 
voluntarily participated in the study. 

2.2. Research Framework 

The blended-ESP instructional model (BEIM) adopted in this study was based on three previous 
instructional models: the production-oriented approach (POA) (Wen, 2015), ESP teaching mode 

construction based on the POA (Zhang, 2019), and the“four-dimension”online teaching of English 

for TCM in the COVID-19 pandemic (Chen & Liang, 2020). The BEIM consisted of eight main 
components: instruction concept, instruction hypothesis, instruction technology, instruction 
procedure, face-to-face instruction mode, online learning mode, self-regulated learning mode, and 
multi-dimensional evaluation. It included three instructional steps: (1) pre-instruction, (2) while-
instruction, and (3) post-instruction. 

 



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Fig. 1. The blended-ESP instructional model (BEIM) in the study 

1) Pre-instruction 

In terms of the instruction concept, BEIM adopted the learning-centered, needs-based, and 
language and content integrated concepts. The “learning-centered” concept, derived from the 
production-oriented approach (POA) (Wen, 2015), advocated that all classroom teaching activities 
should serve the occurrence of effective learning. The “needs-based” and “language and content 
integrated” concepts were based on the prominent characteristics of ESP courses. The “needs-based” 
concept emphasized that the TCM English course should be based on students’ professional learning 
needs and future employment needs. The difference between the TCM English course and the general 
English course was that the former needed to consider both the English language proficiency and 
TCM content expression at the same time, which corresponded to the concept of “language and 
content integrated”. 

There were two instruction hypotheses in BEIM. The first one was that effective learning can 
happen synchronously and asynchronously by combining the benefits of physical classroom 
instruction and online instruction (Hu & Yang, 2018); the second one was that information and 
communications technology (ICT) can facilitate instruction by removing the barriers of space and 
time. The TCM English course was delivered using the Superstar Learning platform, which could 
integrate mobile teaching, mobile learning, mobile reading, and mobile social networking. The 
efficacy of the Superstar Learning platform has been substantiated by several researchers in promoting 
its teaching effects, especially in promoting comprehensive understanding of medical English and 
TCM English (Chen & Liang, 2020; Su et al., 2021). The Juku Correction website (www.pigai.org) 
was selected as the main technology application in the pre- and post-tests. It was an intelligent online 
grading platform for correcting English writings that built an English writing database and was 
launched in 2010 in China. The grading website, a cloud-based online service, has demonstrated 

http://www.pigai.org/


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accuracy and effectiveness in automatically grading English essays. The TCM English course, by 
implementing BEIM, mainly consisted of three instructional procedures. First of all, students were 
required to preview lessons before class online. Secondly, students were encouraged to actively 
engage in the interaction in the classroom and online simultaneously. Thirdly, students were 
encouraged to review lessons and finish assignments after class online. 

2) While-instruction 

The instruction modes included face-to-face instruction mode, online learning mode, and self-
regulated learning mode. Face-to-face classroom instruction constituted 60%, online learning 
comprised 30%, and self-regulated learning represented 10%. The face-to-face instruction mode 
pertained to face-to-face instruction in the physical classroom setting. The online learning mode 
primarily utilized the Superstar Learning system as the platform and the Juku Correction website as 
the supplementary technological application. The self-regulated learning mode encompassed students’ 
online self-monitoring and self-management of their learning processes. 

3) Post-instruction 

The multi-dimensional evaluation, consisting of language outcome, skill outcome, and emotional 
outcome, was used to assess the effectiveness of BEIM. The language outcome referred to the 
students’ English language proficiency in TCM, the skill outcome pertained to the students’ self-
regulated learning ability, and the emotional outcome was to investigate the students’ TCM cultural 
confidence. 

2.3. Research Instruments 

The instruments employed in this study comprised a writing pre-test, a writing post-test, an attitude 
questionnaire, and a semi-structured interview. The two tests were employed to evaluate the students’ 
writing proficiency in describing or introducing traditional Chinese medicine in English. The pre-test 
and post-test consisted of 4 writing tasks, each worth 25 points, resulting in a total of 100 points. The 
students’ writing tasks should consist of a minimum of 120 words and a maximum of 180 words, 
adhering to the writing rubrics of the College English Test Band 4 (CET 4) in China.  

The attitude questionnaire utilized the five-point Likert scale, with 5 representing “strongly agree”, 
4 representing “agree”, 3 representing “neither agree nor disagree”, 2 representing “disagree” and 1 
representing “strongly disagree” to assess students’ attitudes towards implementing BEIM. The 
questionnaire consisted of two sections: the first section gathered the participants’ personal 
information, while the second section focused on the participants’ perspectives regarding the 
implementation of BEIM. The semi-structured interview aimed to gather students’ in-depth 
perspectives on BEIM. The interview consisted of eight questions and was conducted face-to-face. 

2.4. Data Collection Procedures 

The BEIM was implemented into the TCM English course for a duration of ten weeks. Lessons 
delivered in the face-to-face classroom setting made up 60% (2 hours), while online learning 
comprised 30% (1 hour), and learning through self-regulation made up 10% (20 minutes). On the first 
day of the course, the instructor introduced the course, the BEIM, learning content, instruction process, 
proportion of each mode, course requirements, and evaluation system to the students. After the 
introduction, the students completed the writing pre-test. The students’ pre-test scores were initially 
assessed automatically by the Juku Correction website. Subsequently, three English teachers 
meticulously reviewed the scores based on the grading rubrics that encompassed criteria covering 
content, vocabulary, grammar, organization, and mechanics.  

For the face-to-face classroom instruction, the instructor used the “Traditional Chinese Medicine 
English” textbook edited by Zhaoguo Li and Qingrong Zhang (Li & Zhang, 2013), published by 
Shanghai Science and Technology Press. There were a total of eight learning lessons, and one unit 
was covered for one week. The eight units were: 

Lesson 1 Traditional Chinese Medicine: History and Development 

Lesson 2 The Basic Characteristics of TCM Theoretical System 

Lesson 3 The Theory of Yin and Yang  

Lesson 4 The Theory of Five Elements 

Lesson 5 The Five Zang-Organs and Six Fu-Organs 



114 English Language Teaching Educational Journal   ISSN 2621-6485 

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Lesson 6 Qi, Blood, and Body Fluid 

Lesson 7 The Four Diagnostic Methods  

Lesson 8 Acupuncture and Moxibustion 

In terms of online learning, the course “An Introduction to Chinese Medicine” from Guangzhou 
University of Chinese Medicine was chosen as supplemental online learning resources. This course 
focused on using the fundamental theories of TCM to teach the English expressions related to its core 
concepts, knowledge, and cultural ideas. There was a total of eight learning units, each of which 
covered knowledge about TCM and various aspects of TCM culture. The students accessed the 
learning link on the Superstar Learning platform issued by the instructor, and they accomplished 
assignments after learning by utilizing their mobile phones or laptops. As for self-regulated learning, 
students were required to complete assignments such as preview and review lessons, finish learning 
tasks, activities, and discussions, and propose questions after class on the Superstar Learning platform. 
The platform kept records of students’ learning, and the instructor also checked their learning progress 
frequently. 

In the last class of the ten weeks’ instruction, students were required to participate in the writing 
post-test to assess their English proficiency after implementing BEIM. The students’ post-test scores 
were evaluated and verified as the same as the pre-test. Subsequently, the questionnaire was conducted 
on the Questionnaire Star platform (www.wjx.cn) to examine the students’ perspectives on the 
implementation of BEIM. Finally, the semi-structured interview was carried out to collect students’ 
in-depth views. The interview was conducted in a person-to-person manner.  

2.5. Data Analysis 

The descriptive statistics were utilized to analyze the collected quantitative data, and the thematic 
analysis approach was employed to analyze the gathered qualitative data in this study. The students’ 
pre- and post-tests scores were analyzed by using mean, standard deviation, paired t-test, and 
segmented analysis. If the mean value of the post-test was higher than that of the pretest, it signified 
that BEIM had the potential to enhance students’ English proficiency. When the mean value of the 
post-test was roughly equal to that of the pre-test, no significant improvement was observed. A lower 
mean post-test value than the pre-test suggested that BEIM did not improve students’ English 
proficiency. The data obtained from the questionnaire was analyzed using the statistical measures of 
mean and standard deviation. The data collected from the participants’ interview responses was 
analyzed by thematic analysis. Five themes emerged from the interview regarding students’ 
perspectives on the preference model, strengths and weaknesses of the BEIM, perceived improvement, 
application of technology, and TCM cultural confidence, based on the percentage derived from the 
frequencies of the tokens in the interviewees’ responses.  

3. Findings and Discussion 

3.1. The Effectiveness of BEIM on Fostering Students’ English Proficiency 

Table 1.  Comparison between students’ pre-test and post-test scores 

 

Paired Differences 

t df 
Sig.  

(2-tailed) Mean 
Std. 

Deviation 

Std. Error 

Mean 

95% Confidence 

Interval of the 

Difference 

Lower Upper 

Pair 1 pre-score - 

post-score 

-23.7808 12.8087 1.4991 -26.7693 -20.7923 -15.863 72 .000 

Note: p< 0.05 

According to the data in Table 1, the paired sample t-test indicated that the P-value for the 
significance of the variable pre-score paired post-score was 0.000 (p = 0.000). Therefore, there was a 
significant difference between the score before the test and the score after the test, clearly 
demonstrating the important influence of BEIM on improving students’ English proficiency. Based 
on the writing tasks on the Juku Correction website, it was found that the majority of students struggled 
to use the correct vocabulary to express TCM knowledge, and only a small number of students were 



ISSN 2621-6485 English Language Teaching Educational Journal 115 
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 Yu, R., & Champakaew, W. (The impact of blended-ESP instructional model…..) 

able to score above 80 points in the pre-test, primarily because they relied on advanced common 
vocabulary, complex sentence structures, and accurate English grammar instead of using accurate and 
appropriate TCM terms. However, the students’ writings in the post-test demonstrated that the 
majority of them were able to effectively utilize TCM terminology in their writing tasks.  

Table 2.  Segmented analysis for students’ pre-test and post-test scores 

 Pre-test Post-test 

 
Frequency           

(Number of students) 

Cumulative 

Percent 

Frequency 

(Number of 

students) 

Cumulative 

Percent 

Valid 
0-60 

(unqualified) 
34 46.6   

 60-80 (average) 37 50.7 12 16.4 

 
80-100 

(excellent) 
2 2.7 61 83.6 

 Total 73    

Note: N=73 

The segmented analysis was utilized to classify students’ scores into three distinct categories: 
unqualified for scores between 0 and 60, average for scores between 60 and 80, and excellent for 
scores between 80 and 100. According to Table 2, the pre-test results showed that 46.6% of the 
students received scores that were either unqualified or below average. Only 2.7% of the students 
achieved scores that were classified as excellent. Nevertheless, in the post-test, a significant proportion 
of students, specifically 83.6%, achieved a level of excellence, while no students fell into the 
unqualified or below average category.  

The segmented analysis revealed that the implementation of BEIM had positive impacts on 
enhancing students’ English proficiency. This conclusion was supported by the fact that most 
students’ scores in the pre-test were either unqualified or below average, whereas the majority of 
students achieved excellent scores after the implementation of BEIM. This finding aligned with 
previous research indicating that ESP instructors could employ appropriate online platforms to 
mitigate the challenges posed by substantial workloads in both language and content instruction, 
thereby ensuring students’ learning outcomes through the utilization of these platforms (Alvarez, 
2020; Zou et al., 2021; Yi & Bin Baki, 2022).  

3.2. Students’ Attitudes towards BEIM 

The attitude questionnaire included two sections. The first section examined students’ final 
examination scores for the TCM English course. The second section consisted of 10 questions on 
students’ perceptions of BEIM implemented in the course.  

 

Fig. 2. Results of students’ final exam for the TCM English course 



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According to the data obtained from the first section of the questionnaire (Fig. 2), most of the 
students achieved a score of 80+ points (61.64%), followed by a score of 90+ points (24.66%) in their 
final exams. Only a small proportion of the students (9.59%) obtained 70+ points, while 4.11% 
selected 60+ points for their final exam scores. No one chose to obtain a score below 60+ points. In 
conclusion, the majority of students in this course achieved satisfactory final exam grades, with a total 
score concentrated between 80 and 90 points, which was the largest proportion.  

Table 3.  Results of students’ attitude questionnaire (second section) 

Questions Mean 
Std. 

Deviation 
Interpretation 

① You are satisfied with the blended-ESP instructional model in 

terms of improving your TCM English learning. 

 

4.21 

 

.706 

 

positive 

② The blended-ESP instructional model can foster your English 

language proficiency. 

 

3.93 

 

.733 

 

positive 

③ The blended-ESP instructional model can enhance your 

motivation to learn TCM English. 

 

4.10 

 

.767 

 

positive 

④ The blended-ESP instructional model can increase 

communication between the teacher and students both online and 

in face-to-face classroom. 

 

 

4.01 

 

 

.736 

 

 

positive 

⑤ The lesson plans, relevant contents, learning activities and 

assignments are appropriate. 

 

4.11 

 

.737 

 

positive 

⑥ The usage of technology by the instructor is acceptable and 

efficient. 

 

4.10 

 

.748 

 

positive 

⑦ The proportion between face-to-face classroom instruction and 

online learning designed by the instructor is appropriate. 

 

4.00 

 

.764 

 

positive 

⑧ Blended learning provides you more opportunities to review 

TCM English learning materials. 

 

4.19 

 

.720 

 

positive 

⑨ Your self-regulated learning can be stimulated through 

practicing the blended-ESP instructional model for TCM English 

course. 

 

4.03 

 

.687 

 

positive 

⑩ Your cultural confidence towards TCM can be boosted through 

practicing the blended-ESP instructional model for TCM English 

course. 

 

 

4.16 

 

 

.707 

 

 

positive 

 

The five-point Likert scale (5 = “strongly agree”, 4 = “agree”, 3 = “neither agree nor disagree”, 2 
= “disagree”, and 1 = “strongly disagree”) was employed for the 10 questions to measure students’ 
perceptions towards the BEIM implemented in the course. The Likert scale mean score was interpreted 
as follows: 1.0-2.4 = negative attitude, 2.5-3.4 = neutral attitude, and 3.5-5.0 = positive attitude. Table 
3 indicated that the 73 students showed positive perceptions towards the 10 questions, with mean 
values of 4.21, 3.93, 4.10, 4.01, 4.11, 4.10, 4.00, 4.19, 4.03, and 4.16, respectively. Among the 10 
questions, the mean value for question 1 was 4.21, ranking the highest, revealing that students hold 
positive and satisfied attitudes toward implementing BEIM to improve their TCM English learning. 
This finding was consistent with previous studies, which suggested that blended instructional models, 
which combined the strengths of both offline and online instruction, could benefit students more in 
their English learning than traditional classroom teaching or solely online instruction. (Yang et al., 
2017; Cai, 2019; Asaad Hamza Sheerah, 2020; Jiang et al., 2021; Wu, 2023). 

3.3. Students’ Perspectives on the Implementation of BEIM 

Fifteen students were invited to participate in the semi-structured interview based on their 
voluntary participation. The eight interview questions were designed to explore the students’ in-depth 
perspectives on the BEIM implemented for the TCM English course. The overall findings from the 
semi-structured interviews indicated that students held positive views regarding the implementation 
of BEIM for the TCM English course. The findings were categorized into 5 themes that arose from 
the interviews on the students’ perspectives on the preference model, strengths and weaknesses of 
BEIM, perceived improvement, application of technology, and TCM cultural confidence. Table 4 
presented a comprehensive overview of the students’ overall perspectives regarding the 
implementation of BEIM.  

 



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Table 4.  Students’ overall perspectives on the implementation of BEIM 

No. Theme Students’ perspectives 

① Preference model The blended-ESP instructional model 

 

 

 

② 

 

Strengths and weaknesses of 

BEIM 

Strengths: rich online resources; strong flexibility; personalized learning; 

interesting learning experiences; convenient online preview and review 

Weaknesses: Students with poor self-discipline might not complete learning 

assignments on time. 

③ Perceived improvement 
TCM English terms and expressions; TCM English proficiency; TCM cultural 

confidence; self-regulated learning ability 

④ Application of technology 
Students embraced the application of the Superstar Learning platform and Juku 

correction website in their TCM English learning. 

⑤ TCM cultural confidence Students’ cultural confidence towards TCM was greatly enhanced. 

 

1) Students’ perspectives on the preference model 

The fifteen participants unanimously endorsed BEIM, expressing a strong preference for it. They 
stated that this model significantly enhanced their TCM English learning by integrating the advantages 
of both offline and online teaching and learning. Some of the students’ responses were listed below to 
shed light on their statements.  

“I prefer blended learning. Firstly, it can make learning more efficient and save time. Some 
assignments and tasks can be completed after class without taking up classroom time, allowing 
time to be fully used. Secondly, a single learning mode can easily lead me into a dull and routine 
learning state.” (Student ID:42) 

“I think the blended instruction is very good. The classic works of TCM and the English TCM 
materials available online have expanded my knowledge, enhanced my vocabulary, and aligned 
my studies more closely with my major. The second is the combination of online and offline modes, 
which not only improves face-to-face communication, but also makes it convenient to collect and 
sort out extensive information on the Internet.” (Student ID: 51) 

“I prefer the blended model. The combination of online and offline can complement each other. If 
I cannot keep up with the teacher, I can still take the time to review the knowledge learned online. 
And online learning can be done anytime, anywhere.” (Student ID: 63) 

Based on the students’ responses, they expressed a preference for BEIM over the solely physical 
classroom model or online model. This finding was in line with the findings of the attitude 
questionnaire, indicating that students held positive attitudes towards BEIM. The benefits of a blended 
model were stated to encompass diversity in learning styles, efficient and interesting learning 
experiences, saving classroom time, optimal utilization of online learning resources, and convenient 
online preview and review (Wang, 2023). Blended instruction offered a significant advancement in 
terms of increasing the availability of teaching and learning time and space, when compared to 
traditional face-to-face classroom teaching (Cai, 2019; Yang et al., 2017). 

2) Students’ perspectives on the strengths and weaknesses of BEIM 

In terms of the strengths of BEIM, many students reported that the blended instruction helped them 
utilize online resources to enhance their learning. It also offered outstanding flexibility, allowing them 
to arrange their learning content based on their own learning pace and needs. The flexibility in space 
and time and diversity in learning styles helped develop their self-directed learning ability, which was 
significant for lifelong learning. This research finding was in line with Chen and San’s study, which 
indicated that students could develop their self-directed learning through a highly contemporary, 
personalized, and sustainable self-directed learning habit by utilizing the benefits of online learning 
platforms (Chen & Shan, 2021). 

“The advantage is that BEIM can better meet our learning needs. It can help us not only learn new 
knowledge but also save more time.” (Student ID:10) 



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“I think the strengths of BEIM are flexibility and diversity, which can 
make full use of online resources to enrich the learning content.” (Student ID: 38) 

“The BEIM has increased the happy learning atmosphere in the classroom, and happy learning 
can better improve our learning effectiveness, better understand the learning content, and improve 
learning efficiency.” (Student ID: 51) 

“The BEIM allows me to engage in self-directed learning by watching online learning videos and 
completing preview tasks before class, while classroom time is used for discussion, deepening 
understanding, and applying knowledge. Blended learning has strong flexibility, and we can 
arrange learning according to our own situation.” (Student ID: 60) 

However, students also reported the weaknesses of BEIM from their own perspectives. The most 
prominent feedback from the students was that they occasionally struggled with self-discipline while 
conducting online learning or self-regulated learning, resulting in incomplete or superficial 
completion of learning assignments, and limited English improvement. For example, student ID 10 
stated that “For me, the drawbacks outweigh the benefits of using online learning activities to improve 
my English proficiency. Online learning means I have to resist the temptation of mobile entertainment 
information, but my self-control ability is relatively limited. So, the online learning activities are not 
very attractive for me, and my English promotion is very limited.”  

They also reported that sometimes the TCM vocabulary was challenging, they could not hold their 
concentration. Occasionally, the instructor could not timely monitor whether they were indeed 
studying seriously online.  

“The weaknesses are that it requires high self-discipline. Sometimes I am not so self-disciplined, 
then I am unable to finish online tasks on time.” (Student ID: 38) 

“The teacher cannot timely supervise whether we are really studying seriously online. Some of the 
TCM vocabulary is so difficult that I sometimes lose concentration.” (Student ID: 51) 

This study found that students’ online learning or self-regulated learning required them to be highly 
self-disciplined; otherwise, they might be unable to achieve the instructor’s expected goals. According 
to students’ responses, if they had poor self-discipline or the instructor did not make online learning 
tasks as compulsory assignments, they might feel that doing online assignments was a waste of time 
and were not motivated to complete them. Then, the instructor’s intended teaching and learning 
objectives might not be met. This finding was confirmed by some previous studies, which claimed 
that students’ ability to monitor, manage, and regulate their own learning was highlighted by 
educational psychology (Cleary & Platten, 2013; Shekhar & Devi, 2012). Considering this, instructors 
who conduct blended instruction should care about students’ performance online, set regulations for 
students to be self-disciplined, and require them to finish tasks on time, no delays or plagiarism. 

3) Students’ perspectives on the perceived improvements 

Regarding the perceived improvements, students’ feedback indicated that they acquired a number 
of TCM terms and expressions in English, enhanced their English proficiency to articulate TCM 
knowledge and culture, and developed a deeper comprehension of the philosophical Chinese medical 
system through their participation in this course.  

“I used to understand TCM knowledge in Chinese, but now I can use English to introduce it. This 
course introduced much TCM knowledge and culture; vocabulary in the medical field has also 
been added. After learning TCM English, I can better tell the stories of TCM to foreigners.” 
(Student ID: 63) 

“This course helped me master many TCM terms and expressions in English. It may help me to 
expand my international perspective as a healthcare professional in the future and enhance my 
cross-cultural communication skills.” (Student ID: 58) 

Some of the students mentioned that TCM English learning would be very helpful for them to 
improve their scientific research ability and pursue a postgraduate study. This discovery was 
consistent with Zhang’s research, which asserted that learning English for specific purposes was 
essential for the development of students’ scientific research abilities, and academic English was a 
core component of their postgraduate studies (Zhang et al., 2020).  



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“By studying this course, I improved my English proficiency to express TCM knowledge, gained a 
deeper understanding of the rich philosophical Chinese medical system. I think it will be very 
helpful for me to develop my scientific research ability and continue a postgraduate education.” 
(Student ID: 60) 

Online learning materials provided on the Superstar Learning platform could enhance students’ 
interest in learning TCM English and provide a more flexible and diverse learning experience. 
Additionally, students could effectively utilize their fragmented time to learn via some online 
platforms, such as the Superstar Learning platform and the Juku Correction website.  

“It can improve my interest in learning English and through online learning resources, making 
learning more flexible and diverse. And this can also help me better use fragmented time to improve 
my TCM English proficiency.” (Student ID: 38) 

Besides, students’ self-regulated learning ability has been improved by implementing BEIM. 
Utilizing contemporary information technology to enable English teaching and learning to progress 
toward individualized and self-directed learning without being constrained by time or place, has been 
one of the teaching objectives clearly stated in the “College English Curriculum Teaching 
Requirements” in China. Facilitating students to acquire knowledge through self-regulated or self-
directed learning was essential for fostering their interest and motivation in learning, which was one 
of the indispensable conditions for fulfilling academic achievements (El-Adl & Alkharusi, 2020). 

“The learning materials, activities, or tasks on the Superstar Learning platform improved my self-
regulated learning. I can choose the learning materials, pace, and difficulty level to suit my own 
needs and interests, and my English for TCM improved a lot.” (Student ID: 42) 

4) Students’ perspectives on the application of technology 

Based on the students’ responses, it could be seen that they embraced the application of the 
Superstar Learning platform and Juku correction website in their TCM English learning. With the 
assistance of these educational technology tools, students’ learning resources were expanded, 
personalized learning was guaranteed, students’ interest in learning and classroom participation were 
improved, and the interaction between the instructor and students was enhanced.  

“I think the Superstar Learning platform and the Juku Correction website changed the traditional 
teaching method, expanded our learning resources, improved our learning participation and 
effectiveness, and strengthened the interaction and flexibility.” (Student ID:10) 

“We can access richer learning resources from Superstar Learning provided by our teacher. I 
think technology made our classroom presentations more vivid, increased our enthusiasm for 
participating in classroom discussions, and enhanced interaction between the teacher and us after 
class.” (Student ID: 3) 

“The Superstar Learning platform provided abundant resources; we can learn according to our 
own pace and also communicate learning problems with our classmates or teachers at any time.” 
(Student ID: 39) 

By leveraging the benefits of modern network technology, a variety of online learning systems and 
platforms offered students increased access to learning resources. Students could break through the 
limitations of English learning in class time and classroom space; they could choose learning resources 
that fit their own needs for learning and select learning content depending on their interests, needs, 
goals, and task requirements. This discovery was in line with Wu’s study, which indicated that smart 
platforms were crucial for improving college students’ cognitive engagement in self-directed learning 
and their learning outcomes (Wu, 2023). 

“I can revise my writing according to the comments and suggestions provided by the Juku 
correction website after class. At the same time, it also helps to cultivate my ability to independently 
solve problems.” (Student ID: 63) 

5) Students’ perspectives on TCM culture confidence 

This study indicated that the study of TCM English had typically increased students’ confidence 
in Chinese medicine culture. According to students’ responses, acquiring English proficiency through 
this course helped them express TCM knowledge and culture in English more accurately and 
confidently. This was very helpful for their future postgraduate studies, participation in international 



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medical conferences, or career development as physicians. This finding was consistent with Zhang’s 
research, which believed that learning English in a specific field was not only essential for enhancing 
students’ scientific research capacity but also a key component in their postgraduate education, even 
career development (Zhang et al., 2020). 

“Learning this course helps me better express TCM knowledge and concepts in English, allowing 
me to introduce TCM culture more accurately and confidently. If more people can express TCM 
culture in English, it will enable foreigners to experience its charm. By taking this course, I can 
confidently demonstrate the unique value of TCM culture in communication with international 
peers. It also improves my confidence in TCM culture.” (Student ID: 3) 

“Studying TCM English enhanced my English interpretation of TCM knowledge; it is helpful in 
promoting my further study and career development. It also boosted my confidence and pride in 
TCM culture.” (Student ID: 58)  

Since TCM is an ancient medical science that encompasses the health and wellness principles and 
medical practices developed by the Chinese nation over thousands of years, TCM culture has been a 
significant element of China’s rich traditional culture (Hou & Lyu, 2021). An essential element of 
cultivating excellent international professionals in the TCM field is to enhance students’ confidence 
in TCM culture.  

“By studying the TCM English course, I can learn to express basic TCM knowledge in English. 
Our country now widely advocates and encourages the study and application of TCM. In foreign 
countries, TCM has received increasing attention too, and my cultural confidence in TCM has 
naturally developed.” (Student ID: 38) 

As a result, English instructors should understand that language education can facilitate the 
integration of both language and culture. When teaching a foreign language, instructors should help 
students build their own national cultural awareness and cultivate their confidence in their national 
culture as well. 

4. Conclusion 

In conclusion, the findings of this study confirmed some previous studies, indicating that students 
generally possessed positive attitudes towards the blended-ESP instructional model, which effectively 
enhanced their English proficiency due to its advantages, including strong flexibility, abundant 
resources, personalized learning, convenient online review and preview, and effective teacher-student 
interactions. On modern campuses, English instructors are expected to leverage digital technology to 
develop innovative instructional models to enhance their pedagogy. Meanwhile, blended instructional 
models also require students to possess a high level of self-discipline; otherwise, it may result in 
delays, plagiarism, or any other negative consequences. Furthermore, the results suggested that 
students’ cultural confidence toward TCM was enhanced when they learned TCM English. Therefore, 
students’ self-disciplinary, English proficiency, and national culture awareness and confidence should 
be highlighted when conducting a blended-ESP instruction.  

However, there is still space for further and more research in this field. The primary focus of this 
study was to examine the impact of BEIM on fostering TCM students’ English proficiency by 
adopting writing pre- and post-tests, with a research duration of 10 weeks. English proficiency 
comprises not only writing skills but also numerous components such as reading, listening, speaking, 
and even translation skills. Future studies can explore the impact of this model on students’ overall 
English proficiency from multiple perspectives. In addition, this study mainly utilized the Superstar 
Learning system as the main online platform for implementing the blended instruction, and the Juku 
Correction website as the solely intelligent correction system for grading the students’ English writing 
tests. For future study, the mixed use of multiple online platforms (such as Unipus, Rain Classroom, 
DingTalk, Tencent Meeting, etc.) can be explored. Meanwhile, more specialized intelligent writing 
correction platforms like iTEST or iWRITE could be used to assess the precision in evaluating 
students’ written works in comparison to the Juku Correction website. 

 

 



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Acknowledgment  

The researchers would like to express sincere gratitude to all the participants, whose efforts and 
enthusiasm played a crucial role in this study.  

 

Declarations  

Author contribution : Ruirui Yu conducted the research, designed the instruments, gathered 
and analyzed the data, and wrote the manuscript. Wilawan 
Champakaew guided the research, examined and approved the 
manuscript.  

Funding statement : The research is funded by the Office of Postgraduate Studies, Mae 
Fah Luang University, Chiang Rai, Thailand 

Conflict of interest : The authors declare no conflict of interest. 

Additional information : No additional information is available for this paper. 

 

 

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https://doi.org/10.1371/journal.pone.0258137

	1. Introduction
	2. Method
	2.1. Participants
	2.2. Research Framework
	1) Pre-instruction
	2) While-instruction
	3) Post-instruction

	2.3. Research Instruments
	2.4. Data Collection Procedures
	2.5. Data Analysis

	3. Findings and Discussion
	3.1. The Effectiveness of BEIM on Fostering Students’ English Proficiency
	3.2. Students’ Attitudes towards BEIM
	3.3. Students’ Perspectives on the Implementation of BEIM
	1) Students’ perspectives on the preference model
	2) Students’ perspectives on the strengths and weaknesses of BEIM
	3) Students’ perspectives on the perceived improvements
	4) Students’ perspectives on the application of technology
	5) Students’ perspectives on TCM culture confidence


	4. Conclusion
	Acknowledgment
	Declarations


