ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Renal Colic History | OSCE Guide | UKMLA | CPSA | PLAB 2
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173 ประโยค
หากประโยคสั้นหรือยาวเกินไป กดที่ Edit เพื่อปรับแก้
1
Hi my name is Grace, I'm one of the medical students in A &E today.
2
Hello.
3
Hi, could I just confirm your name and date of birth?
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Yeah it's Imogen Mann, it's the 13th of August 91.
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Okay nice to meet you Imogen, how can I help you today?
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I've just been having this really severe pain in my lower back.
7
It's like nothing I've ever experienced before. So yeah.
8
Okay.
9
Just before we begin, are you comfortable enough for me to be asking you some questions or do you need some painkillers?
10
No, I've been given something.
11
I'm still uncomfortable if I'm honest, but yeah, I'm happy to chat to you.
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Okay.
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If that changes Imogen's, just let me know because I want you to be comfortable.
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Okay.
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Thank you.
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Okay, Imogen.
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So you mentioned you've been having this pain.
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Do you want to tell me a bit more about your symptoms?
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Yeah, it just came on suddenly this morning in my side of my back.
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Yeah, just a really severe pain that I've never experienced before.
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Okay, and what does that feel like?
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It's like a cramping pain.
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Yeah, it's really awful.
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Okay, and I mean it sounds really uncomfortable.
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If you had to grade it on severity where 10 out of 10 was the worst pain, how would you place it on that scale?
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Definitely a 10 and I've got a pretty high pain threshold generally
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but like I say this is nothing I've ever experienced before.
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Okay and is it that all the time?
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No it sort of comes on in in waves is the best way to describe it but yeah it's awful.
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Yeah it sounds really uncomfortable.
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You mentioned that the pain is on the right hand side, where's that exactly?
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Like kind of my right lower back here.
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Is it going anywhere else?
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Yeah, it goes into the groin area.
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Okay, and have you noticed anything that makes it better or worse?
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No, I did take a couple of painkillers, but that didn't really do anything.
37
And what did you take painkiller -wise?
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Cocodomol and ibuprofen.
39
Okay, and what time was that?
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That was earlier this morning.
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Okay, and with this pain that you're having, have you noticed any other symptoms alongside it?
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It's so bad, it's making me feel sick when the pain comes on.
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Okay and have you been sick?
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I have yeah I've been sick twice this morning.
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Was there any blood when you were vomiting?
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I didn't know I didn't say anything like that no. Okay so it's definitely got you feeling quite unwell.
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Have you noticed any other symptoms?
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Um kind of my main worry is I think there's blood in my urine.
49
Okay can you describe that for me?
50
Um just the last two times I've been to the toilet for a week uh
51
it's been this like reddish color um which is obviously a worry okay
52
so let me find out a bit more about that
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so the color of the urine you said it's reddish is it more in the pink kind of color
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or more like a deep dark red no more more pinkish
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yeah pinkish okay have there been any blood clots in the urine
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so any kind of red dots no okay and
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when you're going for a wee does that feel unusual at all no
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that that all feels fine all normal yeah okay so no burning or stinging
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No. Are you weeing more often than usual?
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No. And when you're peeing the flow of it does that feel okay?
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That's all normal yeah.
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Okay and obviously you're quite worried about the blood in your urine have you had blood in your urine before?
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No never.
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Okay so something new.
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Yeah.
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Have you noticed any other symptoms at all?
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No not that I can think of.
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Okay so you've woken up today
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and as you were getting ready you developed this severe pain that's coming in waves it's got you feeling sick
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and you've been sick a couple of times
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you've also had this probably blood in your urine a bit
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pinkish urine yeah let me just check for any other symptoms
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so specifically have you noticed a fever at all no okay
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and you talked about vomiting can i just check your bowels are there any changes
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there that's all been normal okay
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when did you last open your bowels uh yesterday evening okay have you been unwell recently with anything
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i've been absolutely fine until this came on this morning okay
78
and just to double check any injuries
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you've not fallen onto this side at all no okay um
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have you had anything like this before in terms of the
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pain oh no never had anything like this before okay
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and recently have you been feeling more tired than usual
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or run down no have you lost any weight no
84
and you've not mentioned this
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but just to double check any difficulty breathing any pains in your chest no it's all fine any feeling lightheaded
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or dizzy no
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and have you noticed any bleeding from anywhere else from your
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back passage for example no can i ask do you have periods no i've got the marina coil
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so i don't have periods fine and have you had any unscheduled bleeding with that no so
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what are your thoughts about what's going on um my initial thoughts are
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because where the pain is um possibly something to do with my kidneys my my worry is
92
that you know with the blood in my urine and my first thoughts is cancer really, but I know I'm quite young, so I don't know.
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Yeah and I can understand why you might think cancer because that is sort of a red flag isn't it?
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There's lots of different causes for blood in the urine
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so we'll be doing some tests today but I just want to reassure you
96
that there's lots of other things that could be the cause.
97
Okay yeah thank you.
98
Is there anything else specifically that you're worried about?
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The pain really, I'd say it's such a severe pain and I'm really worried about
100
that coming back on
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and to be honest
102
I really need to get back to work as quickly as I can okay what do you do for work Imogen?
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I'm a police officer right okay
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so I'm guessing you're quite busy on your feet a lot yeah okay um
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you're here in A &E we're here to help you you've had some painkillers in terms of any specific things
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that you wanted us to definitely do in A &E today did you have anything in mind
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that I should know about um I guess just get the relevant tests um
108
and get this sorted so I can get back on my feet
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and back to work as soon as I can yeah I think so especially with you being so uncomfortable.
110
Yeah.
111
Okay.
112
So Imogen, what I'm going to do now is ask you a few more questions about your background
113
because I've not met you before.
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Do you have any other medical conditions?
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Yeah, I've got hypothyroidism.
116
Okay.
117
Anything else?
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No. Have you had any surgeries before?
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No. And have you ever had any scans of your tummy?
120
No. Okay.
121
Do you take medication?
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Yes, levothyroxine.
123
Do you know what dose you take?
124
150, I think it is.
125
Okay.
126
Do you take any other medications? um nothing more prescribed i occasionally take gaviscone
127
but that's it okay and are you allergic to anything no are there any medical conditions
128
that run in the family no and specifically in the family are there any bladder
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or kidney problems no okay
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and you mentioned already
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you're a police officer what's your living situation uh just live
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on my own okay do you smoke at all no do
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you drink alcohol um a couple of glasses of wine in a week okay
134
and do you take any recreational drugs at all no okay
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so I'm just going to summarize back to you Imogen to make sure we've not missed anything
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so you've come to A &E today because you um you wake up
137
and you develop this severe pain on the right hand side going into the groin yeah um
138
it's coming in waves it makes you feel quite sick
139
when it comes on and you've been sick a couple of times
140
and you've also noticed some pinkishness to your urine and you're worried
141
that there's some blood there that's right you're worried
142
this is something to do with your kidneys
143
you were a bit worried about cancer although we know there's lots of different causes for blood in the urine
144
and your main concerns the pain
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and getting back to work absolutely yeah okay is there anything you feel
146
that i've missed there no i think that's everything do you have any questions for me no okay in
147
that case that's all my questions
148
so thanks for your time imogen thank you today
149
i spoke to imogen mann a 32 year old police officer
150
who is presented to the a e department with right -sided
151
lower back pain Imogen describes sudden onset day of episodic right -sided loin to groin pain
152
which has a severity of up to 10 out of 10.
153
This pain is cramping and has been severe enough to cause vomiting.
154
Imogen has also noticed two episodes of pinkish hematuria without clots.
155
She doesn't have dysuria or fever.
156
Imogen has a past medical history of hypothyroidism for which she takes levothyroxine.
157
She has no other medical conditions and takes no other regular medications.
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She has no known drug allergies.
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Imogen lives alone.
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She drinks up to 10 units of alcohol per week.
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She doesn't smoke or take recreational drugs.
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Imogen suspected that this could be a kidney problem.
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She did have concerns that there could be a cancer given the blood in her urine.
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Her other concerns are the level of pain and that she wants to get back to work.
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Her expectations are analgesia and investigations in A &E.
166
Based on the information gathered so far the most likely differential diagnosis here is renal colic due to a ureteric stone.
167
Other possible diagnoses would be a palonephritis.
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To complete my assessment today I would perform an abdominal examination and check vital signs.
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I'd perform bedside tests including urinalysis and and urinary pregnancy test.
170
I will check bloods, including full blood count, user knees and CRP.
171
Based on the likely diagnosis, it would be appropriate to consider further imaging, such as a CTKUB.
172
Check out the GeekyMedics collection of over 1 ,000 OSCE stations.
173
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คำศัพท์และข้อสังเกตด้านการพูดสำหรับบทเรียนนี้
บทเรียนฝึกพูดนี้ใช้วิดีโอ “Renal Colic History” เป็นสื่อ คำที่ถูกพูดซ้ำบ่อยที่สุด: pain, imogen, blood, urine, noticed วิดีโอนี้มี 173 ประโยค และ 1799 คำ สำหรับฝึกพูดตาม ช่วงที่มีเสียงพูดยาว 9:25 ผู้พูดพูดเร็ว ประมาณ 191 คำต่อนาที จึงมีการเชื่อมเสียงและลดเสียงค่อนข้างมาก 84% ของคำอยู่ใน 3,000 คำที่ใช้บ่อยที่สุดในภาษาอังกฤษ ส่วนที่เหลือควรดูไว้ก่อนเริ่มฝึก จากทั้งหมด 173 ประโยค มี 31 ประโยคเป็นคำถาม จึงเหมาะสำหรับฝึกน้ำเสียงประโยคคำถามและการตอบสั้น ๆ
คำศัพท์สำคัญในวิดีโอนี้
คำที่ควรเรียนรู้ 15 คำจากวิดีโอ พร้อมคำอ่านและความหมาย:
| คำศัพท์ | คำอ่าน | ความหมาย |
|---|---|---|
| urine คำนาม | /ˈjʊɹɪn/ | ฉี่, ปัสสาวะ |
| symptom คำนาม | /ˈsɪm(p)təm/ | อาการ |
| uncomfortable คำคุณศัพท์ | /ʌnˈkʌm.fɚ.tə.bl̩/ | ไม่สะดวก |
| kidney คำนาม | /ˈkɪdni/ | ไต, วักกะ |
| diagnosis คำนาม | /daɪəɡˈnəʊsɪs/ | การวินิจฉัย |
| vomit คำกริยา | /ˈvɑmɪt/ | อาเจียน, อ้วก |
| fever คำนาม | /ˈfivɚ/ | ไข้ |
| bleed คำกริยา | /ˈbliːd/ | ตกเลือด |
| bowel คำนาม | /ˈbaʊ.əl/ | ลำไส้ใหญ่ |
| confirm คำกริยา | /kənˈfɝm/ | ยืนยัน |
| sudden คำคุณศัพท์ | /ˈsʌd.ən/ | กะทันหัน |
| knee คำนาม | /ni/ | เข่า, หัวเข่า |
| pregnancy คำนาม | /ˈpɹɛɡnənsi/ | การตั้งครรภ์ |
| breathe คำกริยา | /bɹiːð/ | หายใจ |
| examination คำนาม | /ɪɡˌzæm.ɪˈneɪ.ʃən/ | ไต่สวน |
กริยาวลีที่คุณจะได้ยิน
| คำศัพท์ | คำอ่าน | ความหมาย |
|---|---|---|
| wake up คำกริยา | /ˌweɪk ˈʌp/ | ตื่น, ตื่นนอน |
ประโยคที่ควรฝึกพูดซ้ำ
ประโยคสั้น ๆ ที่สมบูรณ์จากวิดีโอ ซึ่งนำไปใช้ในบทสนทนาประจำวันได้:
- Was there any blood when you were vomiting?
- Have you noticed any other symptoms?
- Are you weeing more often than usual?
- Have you noticed any other symptoms at all?
- Is there anything else specifically that you're worried about?
ไวยากรณ์ในวิดีโอนี้
โครงสร้างที่ผู้พูดใช้บ่อยที่สุด พร้อมคำพูดจริงจากวิดีโอ:
| โครงสร้าง | ในวิดีโอ |
|---|---|
| Present perfect continuous have/has been + -ing — การกระทำที่เริ่มก่อนหน้านี้และยังดำเนินอยู่ | I've just been having · you've been having |
| Present perfect have/has + กริยาช่อง 3 — เหตุการณ์ในอดีตที่ยังเกี่ยวข้องกับปัจจุบัน | I've ever experienced · I've been given · I've never experienced |
| Passive voice be + กริยาช่อง 3 — เน้นสิ่งที่เกิดขึ้น ไม่ใช่ผู้กระทำ | I've been given · is presented |
การออกเสียงที่ควรระวัง
ผู้พูดใช้รูปย่อและรูปลดเสียง 56 ครั้ง เช่น I've, I'm, you're ให้พูดแบบสั้นตามที่ได้ยิน
- เสียง “th”: breathe /bɹiːð/, gather /ˈɡæðɚ/, threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, levothyroxine /ˌli.voʊ.θaɪˈɹɑkˌsin/
- เสียง “sh” และ “zh”: medication /mɛdɪˈkeɪʃən/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, threshold /ˈθɹɛʃ(h)oʊld/
- คำยาว — ลงเสียงหนักให้ถูกพยางค์: uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, medication /mɛdɪˈkeɪʃən/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/
เสียงที่คนไทยมักออกเสียงยาก:
- เสียงท้ายคำ — ออกเสียงให้ครบ ไม่เปลี่ยนเป็นตัวสะกดแบบไทย: diagnosis /daɪəɡˈnəʊsɪs/, awful /ˈɔːfʊl/, bowel /ˈbaʊ.əl/, unusual /ʌnˈjuːʒ(u)əl/, vital /ˈvaɪtəl/
- /v/ — ไม่ใช่ /w/ ให้ฟันบนแตะริมฝีปากล่าง: vomit /ˈvɑmɪt/, fever /ˈfivɚ/, severity /səˈvɛɹ.ə.ti/, vital /ˈvaɪtəl/, virtual /ˈvɜɹt͡ʃuəl/
- /z/ — เสียงก้อง ไม่ใช่ /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, dizzy /ˈdɪzi/, summarize /ˈsʌməˌɹaɪz/
วิธีฝึกกับวิดีโอนี้
- ฟังวิดีโอให้จบหนึ่งรอบโดยยังไม่ต้องพูด แล้วจดคำที่ยังไม่รู้จัก
- เริ่มที่ความเร็ว 0.75× พูดตามทีละประโยค แล้วกลับไปใช้ความเร็วปกติเมื่อเริ่มคล่อง
- อัดเสียงตัวเองแล้วเทียบกับต้นฉบับ โดยสังเกตคำอย่าง urine, symptom, uncomfortable เป็นพิเศษ
เทคนิค Shadowing คืออะไร?
Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ