ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: How Doctors Think (And Students Don't)

เลือกโหมดฝึก

แต่ละโหมดจะเปิดห้องฝึกแบบเต็มจอ

439 ประโยค

หากประโยคสั้นหรือยาวเกินไป กดที่ Edit เพื่อปรับแก้

When I see students learning, I think the biggest mistake they make is they don't realize they're studying to be a doctor.

They're so overwhelmed by their exams, everything is right in front of them and you just see them going,

exam coming up, I've got to pass it.

And it's very hard with these exams and the volume of material not to have real anxiety.

I think the biggest challenge I face teaching students is their deep underlying anxiety.

Because anxiety makes you go to ritual behaviors and one of those ritual behaviors is memorizing.

Why do students struggle when they feel that they're working hard?

Why do students insist on memorizing?

How do doctors think through patient problems?

Why is everything that I teach centered on pathophysiology?

What do we say to medical students who are failing?

Why am I wrecking my personal life to do this?

In today's video we're going to address a number of topics

that keep coming up in the letters that you send us and they're important topics.

I see it every day when I'm teaching my medical students.

Any one of these could be an hour's discussion

but I want you to be aware of these subjects and at least make an introduction to them.

Before we get further into this, a number of you have not subscribed to my channel.

Every week we're posting videos on how to help you learn medicine.

Do yourself a favor, hit that subscribe button.

Why do students struggle when they feel that they're working hard?

Well, there's a general truism that I use.

Performance equals talent times effort times directed effort squared.

So most of the time when students feel they're trying really hard, one of two things is true.

They're kidding themselves that that's what trying hard looks like.

And number two is that they're not studying effectively.

So let's talk about each of those in turn.

Everybody has different rhythms through the day.

I'm an early morning person.

So when I have to learn something,

much better for me to get up and start at eight o 'clock and study for the two hours until 10.

And then I can go on to other activities.

Everybody's different.

You have to learn your own body.

So when you say, when do you learn the best?

Don't confuse learning something new with reviewing something that you already know

when you're learning something new that learning has to be really active

if you don't have a pen and paper

and you're not taking multiple sources

and you're not creating this is how i'm going to think about it

and you write it down

and then you know it proves you're learning it you have to turn

that piece of paper over and see if you can do it yourself

so let me give you a practical example

when i assign you something from my book you'll see my book is mostly figures and tables and algorithms.

And I tell students, there's only one reason I give you a table because you clear the contents into blank spaces.

You fill it in.

That's active learning.

And then the second part is you have to be able to come back and do it again tomorrow.

So when you've studied today, you go, these are my notes.

I can do them at the end of my study period.

When you start the next day, you take out that blank piece of paper and you prove that you've still got it.

In other words, you've got to repeat.

It's really hard when you got active classes.

There's a ton of material.

You have to be absolutely ruthless.

So when I was going through med school, I actually studied in the law library because I didn't know anyone.

And people would come over and be friendly and I'd say,

thanks for the invitation, but I don't want to know you because I can't afford to be social right now.

So I blocked off my learning period.

I got the notes that I knew I had to learn.

And I ruthlessly decided I'll learn this and I won't learn that.

And then I came out of the end of that study period with my notes.

And then I practiced them at the end of the time.

And I started them the next day.

You watch how people are studying.

They're socially interacting.

They've got earbuds on.

You know, the proof that someone's not learning, they highlight.

Nothing proves you're not learning effectively than highlighting.

Because you know what that says?

You know what?

I'll learn that tomorrow.

So you've got to go to class or however you're getting your material presented and you've got to take active notes.

That's a third of your learning.

You're not sitting back with your coffee going, you know, I'll learn this tonight.

There's no time.

So you have to be ruthless.

You go to class, you say, this is what I'm going to learn.

That evening you sit down and you say, these are my final notes.

You finish them and then you say blank piece of paper.

Good.

Prove that you know that.

The second part is the directed part.

I know that medicine is built on pathophys.

So make sure when you're making your notes, you take the book and you say what Dr. T said, all that other stuff is fine,

but you've got to have this core pathophysiology to hang it all on.

So go get your notes, go get other sources, but make sure you can do the pathophys.

Why do students insist on memorizing?

Well, the first thing to understand is students have been trained through their university to study for exams.

So when you say, how are they trained to do that?

Well, memorize for the multiple choice, wink, wink.

The professor will often tell you a couple of questions on the test.

Learn that material, pass that test, move on to the next thing.

It's hard to recognize when you come to medical school, that's just not true anymore.

You're not passing exams to pass exams.

You're actually training to be a doctor.

The problem is they start medical school with PhDs who still believe that you're an undergrad.

It's hard for PhDs to understand you're not teaching biochemistry, you're training doctors.

100

And it's a constant struggle in every medical school because most of the clinicians actually aren't very good at their basic sciences.

101

They never knew much to begin with and they certainly haven't improved since they didn't practice.

102

So the clinicians aren't going to teach you that and the PhDs control the early years.

103

So we have this terrible gap in which we're learning subjects in the old undergrad system of multiple choice questions, check the box, move on.

104

I'll give you a good example.

105

Today I'm doing a course

106

and part of what I'm doing is thromboembolism for the first your students

107

and so i pinged one of my colleagues

108

and said have we reviewed coagulation can i assume they do

109

that when i'm teaching workout triad and she said oh yes we've done

110

that but there's no harm in repeating it

111

and i thought to myself what do you mean

112

there's no harm in repeating it the question is do they know it

113

because i can assume i'm building on it

114

or have they never heard of it

115

and i'm introducing the subject for the first time

116

but it goes to this undergrad mentality and i think the problem is for students, memorizing works for exams.

117

Yeah, and you forget it in a month

118

and you don't have any of it when you come to me

119

and I'm trying to treat hypercoagulable states and you vaguely remember you sort of touched on that last year.

120

No, no, you're learning as foundations because you need them to build on more advanced concepts of patient care.

121

It's a problem in every medical school.

122

How do doctors think through patient problems?

123

Well, you know, if I'm really being honest, it's right brain, left brain.

124

And what I mean by that is when you've got some experience, you know what 80 % of your patients are going to be.

125

You walk in, you go, oh, it's one of those.

126

And frankly, you don't think at all.

127

So I sort of think of this as the 80 -20 rule.

128

I think 80 % of the time doctors aren't thinking.

129

They just walk in and know what it is because they've seen it so many times.

130

And that works actually quite poorly for medical students.

131

And so what I teach medical students is it's actually surprisingly hard to learn from experienced clinicians

132

because they look at something and they know what it is.

133

And they look at you and go, what's wrong with you?

134

This is obvious.

135

Well, doctor, I've never seen it before.

136

Okay, how about that?

137

So what I do very deliberately is I say, find the chief complaint.

138

And you'll notice in the book, I have like the mid fifties.

139

If you can do these 50 plus chief complaints, you kind of got a lot of it in hand.

140

And then I don't say get a shotgun out and hope one of your pellets is a diagnosis.

141

Please don't do that.

142

It just works really badly.

143

What you want to say is with that chief complaint, what organ systems could it be?

144

Okay, it could be heart.

145

Well, which family of heart diseases?

146

Well, left ventricular congestive failure.

147

Excellent. Which subfamilies?

148

Well, ischemia, valves, hypertension.

149

So we really specifically teach the 50 commonest chief complaints so that you learn to do a differential diagnosis.

150

I think it's actually quite unhelpful to go see a really experienced doctor because she just knows because she knows.

151

And if you ask me what I've been learning in my teaching coming out of decades of practice,

152

it's I've worked with students on a personal basis and they've really taught me, don't make assumptions.

153

Go explain everything.

154

And so I think that's the problem.

155

Don't ask how doctors think.

156

Ask how should medical students be taught to think?

157

Why is everything that I teach centered on pathophysiology?

158

And you know, this is the old CPC, which is a legacy term that's died out with the autopsy dying out.

159

But clinical pathologic correlation means what you see in your patient has an underlying explanation in the pathology of the disease.

160

Pathophysiology is mechanism of disease, but it's way more than that.

161

It's how to think about that disease.

162

And the challenge is this, and I'm learning more and more as I'm working with my Nerdistines, is if I have a chief complaint,

163

you get a list, but that list is more than just a list.

164

It's a how do you think about?

165

So if I said to you, chief complaint edema.

166

Have you got a picture of Starling's forces kind of pathophys, right?

167

Once you have your Starling's forces, can you recognize that one of them is cirrhosis?

168

Great.

169

So now you've got a family of diseases, but here's the problem.

170

How are you now going to rule in

171

and rule out cirrhosis as a cause of edema if you don't know how to think about it as a disease?

172

Well, you think about it with its pathophysiology, which breaks into two clusters, portal hypertension and elevated estrogen.

173

So the very act of the most fundamental diagnostic procedure, chief complaint to differential is completely built on pathophys.

174

So when I say to you, patient walks in with edema and I say to you, how do you think about right ventricular heart failure?

175

Have you got the nice picture backing it all the way up so that you know it's foundationally based on JVD?

176

Have you got the picture or did you memorize it?

177

Well, good luck memorizing.

178

As I always say, if you've got the picture, you'll recognize edema and JVD are inferior vena cava to superior vena cava.

179

I really just don't think I can teach you if you don't have pathophys.

180

And what I really emphasize now is when I see a disease and I say, how do you think about?

181

What I mean is, have you got a clear concept of it's pathophys?

182

So I just don't think you can do medicine without it.

183

When I see students learning, I think the biggest mistake they make is they don't realize they're studying to be a doctor

184

because they're so overwhelmed by their exams.

185

Everything is right in front of them.

186

And you just see them going, exam coming up, I've got to pass it.

187

And it's very hard with these exams and the volume of material not to have real anxiety.

188

I think the biggest challenge I face teaching students is their deep underlying anxiety.

189

Because anxiety makes you go to ritual behaviors.

190

And one of those ritual behaviors is memorizing.

191

You know, you might not be learning much and you certainly don't understand it very well, but you feel as though you've tried hard.

192

You can show what you've memorized.

193

And so it deals with your anxiety.

194

It's not getting you to be a better doctor.

195

And so when I say to students, take a breath, let's go to pathophys and patient -centered learning.

196

Their answer is, can't face it.

197

You're asking me to change and people who are anxious don't change.

198

Students have one fundamental error in clinical reasoning.

199

They somehow think if you have the symptom, you can get a shotgun out,

200

shoot a thousand pellets, and one of them is going to hit the diagnosis.

201

That works after 20 years experience, because you know, you're 80, 20 split, you know, 80 % of your patients are 20 % of the diagnoses.

202

And you're so good at pattern recognition.

203

You walk in the room, you can take it all in.

204

You sort of go, well, I bet it's one of these three things.

205

Yeah, not you.

206

That's an experienced clinician.

207

For a medical student to learn diagnoses, they have to learn how to identify a chief complaint,

208

how to identify the possible organ systems, and then for each organ system, which pathophysiologic family does it represent.

209

So yes, you've got to learn your chief complaints, but you notice the differential diagnosis is based on having a pathophysiology in your mind.

210

When you've seen a million patients, you just go straight to pattern recognition, but not you when you're just beginning.

211

What do we say to medical students who are failing?

212

You have to explore, tell me how you're learning.

213

And I do this a lot, right?

214

The people that do the education send lots of students to me if they think I'll be able to help them.

215

And the first thing you've got to get out of the way is whether your personal life's interfering.

216

I've had many students who felt they were the responsible member of their family

217

and when someone gets sick they're the ones

218

that are supposed to take care of it

219

so the first thing i teach those students is this is like you're flying in the airplane remember they say

220

when the oxygen mask falls put it on yourself first not your kid

221

i say well that's the airplane rule for medical students

222

you come first you're just gonna have to tell your family

223

i'm sorry i'm not available i have to prioritize my medical school

224

and if you don't do that well it'll suck you down and you'll fail.

225

This is an all -in experience.

226

Once you're doing the all -in experience, the question then becomes, tell me how you're learning.

227

And almost invariably, you're seeing highlighting and sketchy, socially distracted study periods.

228

Nope.

229

And so what I do is I learn to assign students something to learn.

230

And then I say, you come back and show me your notes

231

and that's very helpful because invariably they're not very good and

232

so then we say let's just sit down

233

and talk about how i would map out these notes

234

and they go away and they're just shocked how hard it is

235

and how tired they are

236

and how your brain turns to porridge i could never study for more than two

237

and a half hours and when i did i could actually flip my head

238

and it felt like my brains are washing back and forth so differentiate in your mind

239

Whether you're learning something new, that's your very precious time.

240

Or whether you're reviewing something that you've already completely written your notes on.

241

Because you can do that when you're a little more tired.

242

And then there's invariable busy work.

243

And so you should do that when you're totally crashed.

244

The second big challenge in learning is that it's quality over quantity.

245

Remember, we've talked about how medical students are always anxious.

246

And so you actually study to treat your anxiety, not to learn the material and part of that is to say, oh, four hours of study.

247

No, you weren't.

248

No one can study that long.

249

It's much better that you spend two high quality hours going through something and say, this is what I'm going to learn.

250

And here's my practice notes.

251

Way better than highlighting for four hours, which you just won't learn anything.

252

Once you recognize it's quality over quantity, then you have ways to come back to that and keep practicing it.

253

And so that's what I do with students.

254

You know, that's why I make you draw pictures

255

and fill in blank tables and fill up algorithms because we all have lazy, cheating brains.

256

All of our brains say, you've got that.

257

Well, okay, go fill in the table.

258

Yeah, your lying, cheating brain didn't have it.

259

It just hurts to learn.

260

And so I have to keep telling students, learning hurts.

261

Knowing is fun.

262

Go put that quality time into learning.

263

Then you can go practice with your friends.

264

So almost invariably, it's get your life in order.

265

And then number two, show me how you're learning.

266

If I could change one thing about medical education, it would be, I would stop exams that give you a percent.

267

You're not studying so that you get an A.

268

You're studying to prove to me that you've mastered that subject.

269

So for example, I'm preparing a little video on thromboembolic disease.

270

My first year is finally starting pathology.

271

But you know, under their normal subjects, they've done coagulation.

272

When I say thromboembolic disease, do you have a clear concept of the difference between fluidics in a vein and fluidics in an artery?

273

If we're doing the slow, low pressure fluidics of a vein, can you do Virchow's triangle?

274

Okay, they've all been passed to me as passing COAG, haven't they?

275

They've all been passed in physiology and anatomy.

276

And I guarantee you, not a single one of my students will be able to discuss

277

that intelligently for me to discuss deep vein thrombosis.

278

So somewhere in here, we've got to stop teaching to percent multiple choice question exams.

279

And we've got to switch over to, well, DBTs are coming up.

280

You're going to need three concepts here.

281

You're going to need the concept of Virchow's triangle.

282

You're going to need the concept of fluidics.

283

And you're going to have to understand the real fundamental difference between veins and arteries as tubes.

284

I'm not holding my breath, but that's what we need.

285

Why did I write a textbook?

286

You know, all over thousand pages of it and 104 chapters.

287

Well, not because I had a burning need to write a book.

288

What happened was I was teaching a lot and I was teaching a pathology review course.

289

And what I found was I kept repeating myself.

290

And when you do it enough, you actually get your standard script that's been tested against teaching.

291

So, you know, this teaches well.

292

Well, when you do that 10 times a year for five years, you realize, you know, I could write this down.

293

And then when a student says, please explain this to me, I could say, why don't you go read this?

294

And when you come back, you'll be prepared.

295

And there is a standard story taught to me.

296

Robbins was a pathologist at University of Toronto.

297

And the standard story taught to me by the old timers

298

when I was a young student was he was a great autopsy pathologist that taught at the U of T medical school.

299

And apparently he just got so tired of repeating himself.

300

He wrote it all down and issued notes and said, read this and then we'll talk.

301

I don't know if that's a true story, but that's how Robbins pathology came to be what it is.

302

And I just thought that always made really good sense.

303

And so when I found myself repeating a lot, I just said, you know, why don't I write it down?

304

And then there's a hard copy.

305

What is wrong with most textbooks is you have to be very clear who your target audience is.

306

The hardest thing coming out of practice is trying to understand what can you fairly expect a first

307

and second year medical student to know.

308

And it's a standard joke amongst medical educators that no matter how little you think that is, it's actually less.

309

So most textbooks, their single biggest problem if they're written by clinicians is they're too advanced for a first and second year medical student.

310

And by advanced, I don't mean that the ideas are hard.

311

I mean that they don't explain everything.

312

It's like learning a language.

313

You can learn five synonyms, but they all have different meanings and they're all used slightly differently,

314

even though they have a core finding this true so that's the challenge for most textbooks is if they're written by doctors

315

They don't explain enough.

316

The other problem is subject -based books because they're all fine books.

317

They don't tell you why would a doctor need to know that.

318

So I think those are the two biggest challenges and I got so frustrated.

319

That's why I went and wrote mine.

320

I mean, I didn't do it for my health.

321

I did it because I just couldn't find an acceptable other source.

322

Why do you need my textbook as opposed to say Robin's pathology?

323

The challenge for most textbooks is who are you writing it for?

324

And I'm writing this for medical students, which means you stop and explain everything like any language.

325

If you grew up in the language, you assume people know what words mean.

326

Well, it's the same in medicine and you've been in it for years.

327

You just assume people know what it means.

328

Well, you can't with people that are just starting out.

329

The second reason is most books don't do it in such a way

330

so that it's easy to remember because none of us were taught this way, right?

331

All of us were given our subject base.

332

We learned anatomy and histology.

333

And then we went to the patient floors where we practice with patients.

334

So we ended up learning because we just repeated it with patient care.

335

Well, that doesn't help you with clinical medicines built on a foundation of basic medical sciences.

336

So this book really is a bridge between patient care and the basic sciences they're built on.

337

I'm not aware of any other source for that, especially at a medical student level.

338

So who should read my textbook?

339

Well, the obvious answer is for sure first and second year medical students should read the textbook.

340

You are being given all of that volume of what's fundamentally subject -based learning.

341

You might be doing it by systems, but let me ask you this.

342

Do you have a biochemist come in to do biochemistry?

343

Do you have a physiologist come in or is it by your professor of cardiology?

344

Yeah.

345

It's all those subject -based people.

346

So you might say, oh, I'm being taught by system.

347

But if you're being taught by a subject -based expert, you're not being taught for patient care.

348

You're somehow supposed to figure out all of the anatomy, histology, physiology, and farm.

349

You're supposed to synthesize all that.

350

Yeah.

351

Well, good luck.

352

When you come into your system, just read through the book.

353

That's how you're going to need it for patient care.

354

It's patient centered learning.

355

And now when you come to all those lectures, they're great for facts.

356

That's not a criticism.

357

They're all wonderful facts.

358

But when you read the ClinPath book, you'll understand some facts are more important than others because they matter more in patient care.

359

Read the book, go to your subject based lectures, and they'll make much better sense to you.

360

Well, great news.

361

We look like we're going to have our version 2 .0 website up and going in a week or two.

362

We've done our beta testing.

363

It's been good.

364

So what are we going to do?

365

Students improve when they use medicine as a language in a conversation.

366

And so you will come and it almost doesn't matter where we start.

367

That's why when people say let's do multiple choice questions, I always quietly say to myself, well, it takes me about an hour to do one.

368

By the time I have to rebuild all the basic sciences you don't have, I can do about a question an hour.

369

A new thing that I've started doing is bringing an important picture.

370

So for example, I was doing a review class at my medical school

371

and I just put a picture up of a hemolytic anemia and I almost blew my two hour budget.

372

That was just supposed to introduce the subject I was doing, but it's such an iconic picture.

373

And the next thing you know, you're talking about, well, if it has polychromasia, can you do red cell maturation?

374

If it has a spherocyte, why would a cystocyte become a spherocyte?

375

Well, wait, why is there even a schistocyte?

376

Well, that just introduced the subject of the mahas, and then you find out no one's got any core pathophys,

377

and the next thing you're discussing endothelial.

378

So what are we going to do in this session?

379

We're going to have conversations in medicine, and you're going to feel that you are going to take notes and go,

380

well I didn't handle that conversation very well I didn't understand

381

that term and you're going to learn how we use basic sciences in patient care

382

and how words don't have meanings meanings have words

383

and what a tutor looks like when they look at you

384

and ask a question they say hmm

385

that was a pretty slow response let's go explore how you see

386

that and so I view these live sessions as a chance for you to come

387

and practice your medicine in a clinical way.

388

And you'll find, because I've done this for years, what I know is that students have done this over months,

389

become different students and they grow in two different ways.

390

First of all, they absolutely grow in their medicine

391

because all of a sudden they're understanding these ideas that are new to them eventually repeat.

392

Well, thank goodness for that.

393

But the other is they learn how to be handled by a clinician.

394

So when they get on the wards or in the offices,

395

they will know exactly what's expected of them and what a good tutoring doctor feels like when when she talks to you.

396

So I can promise you, I mean, obviously we've done thousands of students after you diligently practice this for months, you will just be better.

397

You'll be a better student and you'll be ready for patient care.

398

Why am I wrecking my personal life to do this?

399

One of the things I do when I'm starting a class and we're waiting for the time to begin and,

400

you know, we get into conversations of why we're becoming doctors.

401

And I always tell them, you know, you guys think this is awful.

402

You're drenched in anxiety and you just wish you could get to patient care.

403

And I always say to them, well, you know, let me tell you how it looks from my perspective 50 years later.

404

You're sitting in a nice, comfortable chair with a good cup of coffee and a nice old veteran's going to tell you war stories.

405

Yeah, it never gets better than this.

406

Next, you're going to be on the wards where you're going to have all those hours of patient care, still get to study.

407

So it's worse.

408

And I can remember, I said, when I'm an MD and I'm writing my own orders, oh no, we had internships in those days.

409

I was working 80, 100 hours a week.

410

I was exhausted still had exams coming.

411

I said, you know, when I'm a resident, I'll be able to narrow it down and be more thoughtful.

412

Of course, that isn't remotely true because now you're still studying and you're now doing all the patient care,

413

but you're also responsible for teaching your juniors.

414

So it's more.

415

And you can see everyone's starting to slump in their chairs at this point.

416

And then you say to yourself, you know, but when I'm in practice, it'll be better.

417

Yeah, no, it's much worse because when you're in practice,

418

now you'll have a family and you'll have a business to run in addition to all that patient care.

419

No, it just gets harder.

420

And they all look at me with this.

421

Well, then why are we doing this?

422

And the answer is we don't do medicine to be happy.

423

We do it because it's who we are.

424

When you see a person collapse on the sidewalk, you run towards them, not away.

425

So we don't do medicine to be happy.

426

Please don't expect that.

427

But do understand, it's infinitely satisfying if you have this in you.

428

And so for me, late in light, in my 50s, I just love teaching.

429

It's an addiction.

430

If I go two or three days without teaching, it's like I'm withdrawing from a drug I'm addicted to.

431

And so I don't do it to make me happy.

432

I do it because it's who I am.

433

If you're willing to embrace this philosophy of how to learn medicine, version 2 .0 of our textbook is now available.

434

Click the link in the description.

435

If you're ready to start learning with me, come join our community.

436

I plan to teach live every week and so you can come

437

and participate and learn new ways of thinking about medicine and really test whether you're learning in a clinical way.

438

For more information, visit drphiliptisdell .com.

439

See you next time.

ดาวน์โหลดแอป

ทุกอย่างที่ต้องใช้เพื่อพูดได้คล่อง

AI ให้คะแนนการออกเสียงให้คะแนนทุกประโยค

ฝึก IPAเชี่ยวชาญทุกเสียง

คำศัพท์สร้างคลังคำของคุณ

เกมคำศัพท์เล่นไปเรียนไป

สแกน QR

Download on theApp Store Get it onGoogle Play

📺 ช่องเดียวกัน

Why the CPC Method Changes How You Learn Medicine (And Why Memorization Fails)

Business EnglishUniversity StudentsWorking Adults

✨ วิดีโอแนะนำ

78 ประโยค

Day in the Life as a Doctor

Daily ConversationUniversity StudentsWorking Adults

256 ประโยค

Stop Studying Wrong: How to Actually Learn & Remember | Why Your Current Method Isn’t Working l

Daily ConversationHigh School StudentsUniversity Students

131 ประโยค

The medicine myth | Denis Noble, Nessa Carey, Guy Brown

Daily ConversationUniversity StudentsWorking Adults

249 ประโยค

How to Present a Patient Case: The Signpost Method

Daily ConversationUniversity Students

206 ประโยค

Anxiety, Stress, Loneliness & Depression Cured In 9 Weeks? | Dr. Sahar Yousef | Raj Shamani Clips

Daily ConversationUniversity Students

388 ประโยค

คำศัพท์และข้อสังเกตด้านการพูดสำหรับบทเรียนนี้

บทเรียนฝึกพูดนี้ใช้วิดีโอ “How Doctors Think” เป็นสื่อ คำที่ถูกพูดซ้ำบ่อยที่สุด: student, learning, learn, medical, patient วิดีโอนี้มี 439 ประโยค และ 5145 คำ สำหรับฝึกพูดตาม ช่วงที่มีเสียงพูดยาว 27:42 ผู้พูดพูดเร็ว ประมาณ 186 คำต่อนาที จึงมีการเชื่อมเสียงและลดเสียงค่อนข้างมาก 86% ของคำอยู่ใน 3,000 คำที่ใช้บ่อยที่สุดในภาษาอังกฤษ ส่วนที่เหลือควรดูไว้ก่อนเริ่มฝึก

คำศัพท์สำคัญในวิดีโอนี้

คำที่ควรเรียนรู้ 15 คำจากวิดีโอ พร้อมคำอ่านและความหมาย:

คำศัพท์	คำอ่าน	ความหมาย
anxiety คำนาม	/æŋˈzaɪ.əti/	ความวิตกกังวล
complaint คำนาม	/kəmˈpleɪnt/	ร้องเรียน
textbook คำนาม	/ˈtɛkst.bʊk/	ตำราเรียน, ตำรา
diagnosis คำนาม	/daɪəɡˈnəʊsɪs/	การวินิจฉัย
ritual คำนาม	/ˈɹɪt͡ʃ.u.əl/	พิธี, พิธีกรรม
vein คำนาม	/veɪn/	หลอดเลือดดำ, เส้นเลือด
fundamental คำคุณศัพท์	/ˌfʌn.dəˈmɛn.təl/	พื้นฐาน, เบื้องต้น
organ คำนาม	/ˈɔːɡən/	อวัยวะ, องค์
anatomy คำนาม	/əˈnætəmi/	กายวิภาคศาสตร์
topic คำนาม	/ˈtɑpɪk/	หัวข้อ, กระทู้
harm คำนาม	/hɑːm/	ความเสียหาย
recognition คำนาม	/ˌɹɛkəɡˈnɪʃ(ə)n/	การจำได้
introduce คำกริยา	/ˌɪntɹəˈdus/	แนะนำ
explore คำกริยา	/ɪkˈsploɹ/	สำรวจ
examination คำนาม	/ɪɡˌzæm.ɪˈneɪ.ʃən/	ไต่สวน

กริยาวลีที่คุณจะได้ยิน

คำศัพท์	ความหมาย
come back คำกริยา	กลับมา
sit down คำกริยา	นั่ง
get up คำกริยา	ลุก

ประโยคที่ควรฝึกพูดซ้ำ

ประโยคสั้น ๆ ที่สมบูรณ์จากวิดีโอ ซึ่งนำไปใช้ในบทสนทนาประจำวันได้:

Why is everything that I teach centered on pathophysiology?
What do we say to medical students who are failing?
Because you know what that says?
It's a how do you think about?
Why did I write a textbook?

ไวยากรณ์ในวิดีโอนี้

โครงสร้างที่ผู้พูดใช้บ่อยที่สุด พร้อมคำพูดจริงจากวิดีโอ:

โครงสร้าง	ในวิดีโอ
ประโยคเงื่อนไข if + อนุประโยค, will/would + กริยา — เงื่อนไขและผลลัพธ์	if you've got the picture, you'll recognize · if they think I'll be · if you don't do that well it'll suck
Present perfect have/has + กริยาช่อง 3 — เหตุการณ์ในอดีตที่ยังเกี่ยวข้องกับปัจจุบัน	have not subscribed · you've studied · have been trained
Passive voice be + กริยาช่อง 3 — เน้นสิ่งที่เกิดขึ้น ไม่ใช่ผู้กระทำ	is built · have been trained · be taught
Relative clauses who / which + อนุประโยค — ข้อมูลเพิ่มเติมเกี่ยวกับคนหรือสิ่งของ	students who are · CPC, which is · people who are

การออกเสียงที่ควรระวัง

ผู้พูดใช้รูปย่อและรูปลดเสียง 228 ครั้ง เช่น you're, don't, I'm ให้พูดแบบสั้นตามที่ได้ยิน

เสียง “th”: pathology /pəˈθɒləd͡ʒi/, algorithm /ˈælɡəɹɪðm̩/, ruthless /ˈɹuːθləs/, thoughtful /ˈθɔːtfəl/
เสียง “sh” และ “zh”: differential [dɪfəˈɹənʃəɫ], recognition /ˌɹɛkəɡˈnɪʃ(ə)n/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, anxious /ˈæŋkʃəs/, socially /ˈsoʊʃəli/
คำยาว — ลงเสียงหนักให้ถูกพยางค์: anxiety /æŋˈzaɪ.əti/, pathology /pəˈθɒləd͡ʒi/, fundamental /ˌfʌn.dəˈmɛn.təl/, anatomy /əˈnætəmi/, differential [dɪfəˈɹənʃəɫ]

เสียงที่คนไทยมักออกเสียงยาก:

เสียงท้ายคำ — ออกเสียงให้ครบ ไม่เปลี่ยนเป็นตัวสะกดแบบไทย: diagnosis /daɪəɡˈnəʊsɪs/, ritual /ˈɹɪt͡ʃ.u.əl/, fundamental /ˌfʌn.dəˈmɛn.təl/, differential [dɪfəˈɹənʃəɫ], introduce /ˌɪntɹəˈdus/
/v/ — ไม่ใช่ /w/ ให้ฟันบนแตะริมฝีปากล่าง: vein /veɪn/, invitation /ɪnvɪˈteɪʃən/, valve /ˈvælv/, invariably /ɪnˈvɛɹ.i.ə.bli/, overwhelm /ˌoʊ.vɚˈwɛlm/
/z/ — เสียงก้อง ไม่ใช่ /s/: exam /ɪɡˈzæm/, anxiety /æŋˈzaɪ.əti/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, physiology /ˌfɪziˈɑ.lə.d͡ʒi/, resident /ˈɹɛzɪdənt/

วิธีฝึกกับวิดีโอนี้

ฟังวิดีโอให้จบหนึ่งรอบโดยยังไม่ต้องพูด แล้วจดคำที่ยังไม่รู้จัก
เริ่มที่ความเร็ว 0.75× พูดตามทีละประโยค แล้วกลับไปใช้ความเร็วปกติเมื่อเริ่มคล่อง
อัดเสียงตัวเองแล้วเทียบกับต้นฉบับ โดยสังเกตคำอย่าง anxiety, complaint, textbook เป็นพิเศษ

เทคนิค Shadowing คืออะไร?

Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ

เทคนิค shadowing: อ่านคู่มือฉบับเต็มทีละขั้นตอน →