Xorijiy lingvistika va lingvodidaktika
–
Зарубежная
лингвистика
и
лингводидактика
–
Foreign
Linguistics and Linguodidactics
Journal home page:
https://inscience.uz/index.php/foreign-linguistics
Phonological interference in the ESP context: an analysis
of Uzbek medical students’ pronunciation challenges
Shosura KHUSENOVA
1
Karshi State University
ARTICLE INFO
ABSTRACT
Article history:
Received April 2025
Received in revised form
10 April 2025
Accepted 2 May 2025
Available online
25 June 2025
This article investigates the phonological challenges faced by
Uzbek medical students in learning English, with a focus on
pronunciation, stress, and intonation. Taking classroom
observations, the study identifies common errors, such as
mispronunciations of medical terminology and common general
words, confusion over vowel and diphthong sounds, incorrect
stress placement, and difficulty with intonation and connected
speech. These issues often come from L1 (Uzbek) interference
and a lack of systematic phonological training. The study
highlights the importance of integrating explicit pronunciation
instruction into English for Specific Purposes (ESP), particularly
in medical contexts, where clear and accurate communication is
critical. The research also reviews prior studies and teaching
strategies to propose effective approaches for improving
medical students’ phonological competence. The findings
emphasize the need for targeted, context-sensitive phonological
training to foster more confident and accurate English use
among medical professionals.
2181-3701
/©
2025 in Science LLC.
https://doi.org/10.47689/2181-3701-vol3-iss6
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Keywords:
phonology,
pronunciation,
stress,
medical English,
medical students,
mispronunciation,
silent letters,
intonation.
ESP kontekstida fonologik interferensiya: o‘zbek tibbiyot
talabalarining talaffuz muammolari tahlili
ANNOTATSIYA
Kalit so‘zlar
:
fonologiya,
talaffuz,
urg‘u,
tibbiy ingliz tili,
tibbiyot talabalari,
noto‘g‘ri talaffuz,
Ushbu maqolada ingliz tilini o‘rganish jarayonida o‘zbek
tibbiyot talabalari duch kelayotgan fonologik qiyinchiliklar
–
talaffuz, urg‘u va intonatsiya masalalari tahlil qilinadi. O‘quv
jarayonini kuzatish asosida tibbiy terminlar va umumiy
so‘zlarning noto‘g‘ri talaffuzi, unli tovushlar va diftonglarning
1
Master’s degree student, Karshi State University
. E-mail: shosurakhusenova@gmail.com
Xorijiy lingvistika va lingvodidaktika
–
Зарубежная лингвистика
и лингводидактика
–
Foreign Linguistics and Linguodidactics
Special Issue
–
6 (2025) / ISSN 2181-3701
203
aytilmas tovushlar,
intonatsiya.
aralashib ketishi, urg‘uning noto‘g‘ri qo‘yilishi, shuningdek,
intonatsiya va so’zlashuvdagi nutq bilan bog‘liq muammolar
aniqlangan. Ushbu xatoliklar, odatda, ona tilining (o‘zbek
tilining) ta’siri hamda fonologik jihatdan tizimli ta’limning
yetishmasligi bilan izohlanadi. Tadqiqot natijalari ingliz tilini
kasbiy maqsadlarda o‘qitish (ESP) kurslariga aniq yo‘naltirilgan
talaffuz mashg‘ulotlarini kiritish zarurligini ko‘rsatadi, ayniqsa,
tibbiy sohada aniq va tushunarli muloqot muhim ahamiyatga
ega. Ilgari olib borilgan ilmiy ishlar va o‘qitish metodlari tahlil
qilinib, tibbiyot talabalari fonologik kompetensiyasini
rivojlantirishga xizmat qiluvchi samarali yondashuvlar taklif
etilgan. Tadqiqot xulosalari shu
ni ko‘rsatadiki, kontekstga
moslashtirilgan va aniq mo‘ljallangan fonologik ta’lim tibbiyot
sohasi vakillarining ingliz tilida ishonchli va aniq so‘zlashuv
malakasini oshirishda muhim omildir.
Фонологическая интерференция в контексте ESP:
анализ проблем произношения у узбекских студентов
-
медиков
АННОТАЦИЯ
Ключевые слова:
фонология,
произношение,
ударение,
медицинский английский,
студенты
-
медики,
неправильное
произношение,
немые буквы,
интонация
.
В статье рассматриваются фонологические трудности,
с которыми сталкиваются узбекские студенты‑медики при
изучении
английского
языка,
–
делается
акцент
на произношение,
ударение
и интонацию.
На основе
наблюдений за учебным процессом выявлены типичные
ошибки:
неправильное
произношение
медицинских
терминов и общеупотребительных слов, смешение гласных
и дифтонгов, некорректная расстановка ударений, а также
затруднения с интонацией и связной речью. Эти проблемы,
как правило, обусловлены влиянием родного (узбекского)
языка и отсутствием систематического фонологического
обучения. В исследовании подчёркивается необходимость
включения целенаправленного обучения произношению
в курсы английского языка для специальных целей (ESP),
особенно в медицинской сфере, где точность и ясность речи
играют решающую роль. Проанализированы предыдущие
исследования и методики преподавания, чтобы предложить
эффективные
подходы
к развитию
фонологической
компетенции
студентов.
Полученные
результаты
подчёркивают важность контекстуализированного обучения,
направленного на повышение уверенности и точности
в использовании
английского
языка
будущими
медицинскими специалистами.
Xorijiy lingvistika va lingvodidaktika
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Зарубежная лингвистика
и лингводидактика
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Foreign Linguistics and Linguodidactics
Special Issue
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6 (2025) / ISSN 2181-3701
204
INTRODUCTION
This observational research was designed to investigate the phonological
challenges that Uzbek medical students face in learning English, with a particular focus
on pronunciation, word stress, and intonation. The study emerged from the growing
recognition that accurate pronunciation in medical English is essential, not only for
academic success but also for ensuring effective communication in clinical settings.
To explore this issue in depth, the research was guided by the following key questions:
•
What is the overall performance of students in learning English?
•
What common phonological challenges do students face while learning English?
•
What are the differences between medical students and general EFL students
regarding pronunciation?
•
How can the pronunciation skills of medical students be improved effectively?
These questions were examined through real-time classroom observations of
second-year students in a medical college in Uzbekistan. The observations provided
direct insights into learners' performance and helped identify recurring patterns of
phonological interference, particularly those influenced by the students’ native language
(Uzbek). The study’s aim is to propose practical, research
-informed solutions to address
the phonological needs of future healthcare professionals.
LITERATURE
REVIEW
One of the important aspects that should be investigated to facilitate the learning
process is teaching medical foreign words and pronouncing them correctly. However,
mastering correct pronunciation is often considered less significant. At times, the process
can seem both boring and difficult.
To ensure effective communication, accurate and appropriate pronunciation of
each word is essential. Mispronouncing sounds can lead to misinterpreting messages.
Therefore, pronunciation instruction must be integrated into the classroom alongside
other language components and skills to support successful language learning [1]. Over
the past few decades, significant research has been conducted on teaching pronunciation,
especially regarding textbook content, teachers’ pe
dagogical understanding, and
classroom practices, such as Derwing et al., 2012; Foote et al., 2016; Couper, 2017; and
Nguyen and Newton, 2020. Instructor-researchers like Jabbour-Lagocki, J., who focus on
improving medical English learning processes and teaching methods, note that some
stress rules in medical terminology are similar to those in multisyllabic general English
words. Specifically, stress often falls on either the penultimate (next-to-last) syllable or
the antepenultimate (third-from-last) syllable. She classified English medical terms into
five groups based on stress locations and syllable patterns to aid stress placement [2].
Other researchers in Spain, Cerezo, R., Calderón, V., & Romero, C., suggested using mobile
applications to help students acquire correct pronunciation of medical terms. Arturito
(a mobile app) was selected for their studies and offers four main functions: not only
assisting with pronunciation but also helping to review vocabulary [3]. The study by
Baeyens (2018) examined how phonological instruction and 'noticing' techniques impact
Spanish students learning English for medical purposes. In this empirical research,
intermediate-level Spanish students recorded themselves pronouncing a text before and
after a pronunciation practice session. Initially, the students read the text aloud without
interruption, then participated in a session where explanations were provided, and
targeted pronunciation exercises were performed. The analysis of the recordings showed
significant differences between the initial and later readings, demonstrating notable
Xorijiy lingvistika va lingvodidaktika
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Зарубежная лингвистика
и лингводидактика
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Foreign Linguistics and Linguodidactics
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progress in the students’ pronunciation [4]. Studies on speech perception training have
shown that adult second language learners can learn to distinguish non-native consonant
contrasts through laboratory training. However, research on perception training for non-
native vowels remains limited, with previous vowel studies not training more than five
vowels. In a study in Japan, the effect of training set sizes was examined by training
native Japanese listeners to identify American English (AE) vowels. Twelve Japanese
learners of English were trained for nine days either on the full set of nine AE
monophthongs or on the three most difficult vowels. Five listeners served as controls and
received no training. Performance was assessed before, immediately after, and three
months after training. Results showed that (a) training on all nine vowels improved
average identification by 25%, (b) both training groups generalized improvements to
untrained words and speakers, and (c) both groups maintained progress after three
months. However, the subset group never improved on untrained vowels. We can
conclude that training for learning non-native vowels should involve the full set and not
focus solely on the more difficult vowels [5].
RESEARCH METHODOLOGY
The limited research on pronunciation instruction in the context of local Medical
English has prompted the author to explore effective approaches and practices by
reviewing previous studies and examining relevant materials. This section outlines the
research design and methodology employed in this study.
The study is based on a qualitative analysis of classroom observations conducted
over the course of one week. During this period, seven English lessons were observed
across five groups of second-year medical college students. The college, named after
Abu Ali Ibn Sina, is located in the Kashkadarya region. The observed students were
mostly at beginner to intermediate proficiency levels. Throughout the lessons
, students’
pronunciation performance was carefully monitored, and common phonological errors
were systematically recorded for analysis.
RESULT
This section presents the key findings from classroom observations focused on
phonological performance among second-year medical college students learning English.
The analysis concentrated on identifying recurring pronunciation errors and common
patterns of phonological interference. Several categories of difficulties emerged,
particularly infl
uenced by learners’ first language (Uzbek) and the absence of structured
pronunciation instruction. The most frequent and frequent pronunciation issues are
outlined below.
1. Mispronunciation of Medical Terms: o
ne of the recurring speech issues is
inappropriate pronunciation of medical terms, in particular.
/hɪpər…/ or /haɪpər…/?
For example, the majority of students repeatedly pronounced the term
"
hypertension
" as /ˌhɪ
p
əˈ
ten
ʃən/ instead of the correct /ˌhaɪ
p
ərˈtenʃə
n/, "
hypertony
" as
/ˈhɪ
p
ərˌtɒ
ni/
instead of /ˈhaɪ
p
ərˌtɒni/, and “
hypotony
” as /ˈhɪ
p
ə
t
əni/ not /ˈhaɪ
.p
ə
.t
ə
.ni/.
The mispronunciation of these words comes from L1 sound interference, as these words
are pronounced exactly the same in Uzbek, like
gipentoniya and gipotoniya.
This mistake
during the initial stages of learning a foreign language may appear to be not so serious,
but it can quickly lead to fossilization if ignored, meaning it will be much more difficult to
correct as time goes on. Mispronunciation of terms in clinical communication, where
accurate pronunciation is important, can cause confusion and misunderstandings.
Xorijiy lingvistika va lingvodidaktika
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Double oo as always /u/?
Another common mispronunciation involved words containing the double “oo”
which learners often articulate inaccurately due to fossilized errors formed during their
early schooling. To clarify further, this is primarily because, in most public schools,
students were taught to always pronounce the double "oo" /u/ sound like in words like
"
good
," "
afternoon
," and "
goodbye
" without considering exceptions.
"blood"
/blʌd/ → pronounced as /bluːd/
"door"
/
dɔːr
/
→ pronounced as /duːr/.
Difficulty with vowels
the /æ/ sound:
The English short vowel /æ/ (as in "cat") does not exist in Uzbek, leading students
to pronounce it as /e/ or /a/, resulting in mispronunciations like "ket" instead of "cat."
Here are some examples in our notes that were mispronounced while observing the
lesson.
Observed mispronunciation examples
table 1
Word
Mispronunciation observed
IPA
Hand
hend
/hænd/
Vaccine
veksin
/ˈvæksiːn/
Cancer
kensr
/ˈkænsə
r/
Scalp
skelp
/skælp/
Rash
resh
/ræʃ
/
Fracture
frekchr
/ˈfræktʃə
r/
Transplant
transplant
/ˈtrænsplænt/
Challenges with the /ɪə/ diphthong:
The diphthong /ɪə/ (as in "ear") does not exist in
Uzbek, leading to
mispronunciations where students use a single vowel sound instead.
phobia
/ˈfoʊbja/, not /ˈfəʊb
iə
/ or /ˈfəʊb
ɪə
/
media
/ˈmiːdja/, not /ˈmiːd
iə
/
criteria
/kraɪˈtɪra/, not /kraɪˈt
ɪə
r
iə
/
superior
/suːˈpɪrə/, not /suːˈp
ɪə
r
iə
/
posterior
/pɒˈstɪrə/, not /pɒˈst
ɪə
r
iə
/
Influence of L1
These words in our notes were observed to be pronounced in a way that closely
resembles their written form and pronunciation in Uzbek.
diagnosis
–
pronounced as /ˌdɪaɡˈnoʊsɪs/, not /ˌdaɪəɡˈnoʊsɪs/.
patient
–
pronounced as /ˈpatient/, not /ˈpeɪʃənt/.
antibiotic
–
pronounced as /antɪbɪˈotɪk/, not /ˌæntɪbaɪˈɒtɪk/.
virus
–
pronounced as /virus/, not
/ˈvaɪrəs/.
Silent
Letters
Many students were recorded pronouncing words like "
psychology
" as
/psikologi/ not /saɪˈkɒlədʒi/ and "
pneumonia
" as /pneumonia/ not /njuːˈməʊnɪə/ with
a pronounced "p." This mispronunciation also can be attributed to L1 sound interference.
Since these words are also existent in Uzbek and are commonly heard and used with the
Xorijiy lingvistika va lingvodidaktika
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Зарубежная лингвистика
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"p" sound, students initially tend to pronounce them according to the Uzbek version,
transferring the familiar pattern into their English pronunciation. It was the same case
with “
psychiatry
”, being pronounced /sɪˈkɪatri/, not /saɪˈkaɪətri/.
"th" sounds
Challenge: The "th" sounds (/
θ
/ as in "
think
" and /ð/ as in "
this
") pose a significant
challenge for Uzbek speakers, as these sounds do not exist in the Uzbek language. As a
result, students often pronounced these terms starting with a "t."
/
tɛˈrɒmɪtə/
.
Additionally, students might think it is pronounced the same in Uzbek: “
termometor
.”
Also, students kept saying
/trɒmˈbəʊsɪs/,
substituting /
θ
/ with /t/. The case was similar
to the word "
therapy
", being pronounced /terapi/, not /ˈθɛrəpi/.
Schwa
The schwa sound /
ə
/ posed a challenge for many medical students learning
English. Since the schwa is a reduced vowel occurring in unstressed syllables, Uzbek
learners with more regular stress patterns, often found it difficult to recognize and
produce correctly. Here are some example words which students had challenges with
correct pronunciation.
As this sound doesn't exist in Uzbek, learners tend to replace it with other vowel
sounds, such as /
ɛ
/, /
ʊ
/, /o/, /a/ or /
ɪ
/, or over-pronounce it.
Mispronunciation of schwa area
table 2
Word IPA Mispronunciation of schwa area
doctor
/ˈdɒ
kt
ər/ /ˈ
d
ɒ
ktor/
symptom
/ˈsɪ
mpt
əm/ /ˈsɪ
mptom/
bacteria
/bækˈtɪə
ri
ə/ /bekˈtɪ
ra/
clinical
/ˈklɪ
n
ɪ
k
əl/ /ˈklɪ
n
ɪ
kel/
anatomy
/
əˈnætəmi/ /eˈnetomi
/
condition
/k
ənˈdɪʃə
n/ /kend
ɪʃɛŋ
/
nervous
/ˈnɜːvəs/ /ˈnerːves/
radiology
/ˌreɪ
d
ɪˈɒ
l
ə
d
ʒi/ /ˌreɪ
d
ɪˈ
oli
ʒ
i/
Problem with understanding and applying connected speech
Reduction of Function Words
In English, function words (e.g., "and", "to", "for") are often reduced in casual
speech. As expected, like Uzbek general English learners, medical students pronounced
these words fully, sounding a more formal and less natural speech pattern.
2. Challenge with stress placement:
How was the Intonation?
The majority of the beginner-level students had the same monotone intonation,
speaking all types of sentences with a flat tone. This may affect the clarity of a speech and
the emotions of a patient when communicating. For example, when the teachers told
them to have a short role play, a student, in the role of a doctor, sounded very
unconfident,
"You are going to be fine,"
indifferent, or robotic, rather than reassuring.
DISCUSSION AND SUGGESTIONS
The phonological difficulties observed among Uzbek medical students highlight the
substantial impact of first language (L1) interference and the absence of systematic
pronunciation instruction in the ESP curriculum. Most notably, learners demonstrated
Xorijiy lingvistika va lingvodidaktika
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challenges with English vowel and diphthong distinctions, stress placement in
polysyllabic words, and the natural use of intonation and connected speech. These
findings are consistent with prior studies (e.g., Jabbour-Lagocki, 1992; Baeyens, 2018),
which emphasize the complexity of pronunciation acquisition, particularly in specialized
registers such as medical English.
One of the critical interpretations from our classroom data is that students often
rely on Uzbek phonological rules to pronounce English words, especially those that are
medically technical but resemble their Uzbek equivalents. This leads to transfer errors,
fossilization of inaccurate patterns, and potential miscommunication in professional
contexts. To address these issues, we suggest the following pedagogical interventions:
Explicit phonological instruction should be integrated into ESP syllabi, focusing not
only on general English sounds but also on medical terminology-specific patterns. This
can include targeted practice with medical words that have silent letters, schwa sounds,
and stress rules. Furthermore, Contrastive analysis activities can help students become
aware of the differences between English and Uzbek pronunciation systems. For instance,
side-by-side comparison of similar-sounding words in both languages can promote
phonological awareness. Moreover, the Use of pronunciation technology (e.g., mobile
apps like Arturito, pronunciation software, IPA transcription tools) should be encouraged
for self-practice, especially for recognizing minimal pairs and stress patterns.
Pronunciation drills and role-playing in simulated clinical interactions can
reinforce correct stress, rhythm, and intonation in context. For example, mock doctor-
patient dialogues help students practice both medical vocabulary and the pragmatic
aspects of speech. Training in connected speech and intonation patterns, such as
reductions, linking, and sentence stress, should be provided to enhance students’ fluency
and listener comprehensibility. From a broader perspective, these findings underscore
the need to reconsider how pronunciation is treated within ESP courses. It is often
overlooked, yet in fields like medicine, pronunciation is crucial for safety, accuracy, and
patient trust. For instance, mispronouncing terms such as “hypertony” or “hypotony”
could lead to serious misunderstandings in real clinical situations.
Limitations of the Study:
This study was conducted over a short duration with a limited sample size in one
college, and thus, the findings may not fully represent all medical students in Uzbekistan.
Moreover, we focused solely on classroom observations without pre-/post-test data or
student interviews, which could have added richer insights.
Suggestions for Future Research:
Future studies might explore the effectiveness of specific pronunciation teaching
interventions in ESP contexts through experimental designs. In addition, longitudinal
studies could examine how early pronunciation training impacts medical students’
communicative competence over time.
By implementing these recommendations and developing a pronunciation-focused
component in ESP curricula, especially for future healthcare professionals, educators can
help bridge the gap between linguistic theory and communicative practice, ultimately
fostering more confident, intelligible, and patient-oriented medical professionals.
CONCLUSION
This study highlights the need for explicit phonological instruction in ESP courses
for medical students. Common issues
–
such as mispronunciation, misplaced stress, and
flat intonation
–
often stem from native language interference and insufficient
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pronunciation training. In medical settings, where clarity is vital, such errors can hinder
effective communication. Integrating focused, context-aware phonological practice into
ESP curricula can significa
ntly enhance students’ confidence, accuracy, and
communicative competence in professional environments.
REFERENCES:
1.
Thongsongsee, J., & Watanapokakul, S. (2023). An Analysis of Medical Students'
Performance on the Word Stress Patterns in English Polysyllabic Medical Terms.
RefLections, 30(1), 12-37
2.
Jabbour-Lagocki, J. (1992). Medical Terminology: A Phonological Analysis for
Teaching English Pronunciation. English for Specific Purposes, 11(1), 71-79
3.
Cerezo, R., Calderón, V., & Romero, C. (2019). A holographic mobile
-based
application for practicing pronunciation of basic English vocabulary for Spanish-speaking
children. International Journal of Human-Computer Studies, 124, 13-25
4.
Baeyens, Lucas. (2018). Improving the pronunciation of problematic English
phonological features for Spanish learners through ‘noticing’. 10.13140/RG.2.2.29057.16484.
5.
Nishi, K., & Kewley-Port, D. (2007). Training Japanese listeners to perceive
American English vowels: Influence of training sets.
Training
.
