Jurnal Ilmu Sosial dan Pendidikan (JISIP) Vol.
9 No.
3 Juli 2025 e-ISSN : 2656-6753, p-ISSN: 2598-9944 DOI: 10.
36312/jisip.
9068/http://ejournal.
org/index.
php/JISIP/index Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali Kadek Maya Cyntia Dewi1.
Ni Wayan Novi Suryati2.
Putu Rusanti3.
I Gusti Agung Galuh Wismadewi4.
I Putu Agus Endra Susanta5 Program Studi D IV Keperawatan Anestesiologi.
Fakultas Kesehatan.
Institut Teknologi dan Kesehatan Bali Article Info Article history:
Received: 25 June 2025 Publish: 3 July 2025 Keywords:
Motivation.
English for Nurse Anesthesiology.
ESP.
Abstract In the globalized healthcare system, nurse anesthesiologists require strong English communication skills to ensure safe and effective patient care (Hidayat, 2.
This study investigates the motivational factors influencing students enrolled in the Advanced English for Nurse Anesthesiology course at ITEKES Bali.
Using a mixed-method design, data were collected from 30 students through questionnaires and semistructured interviews.
The findings reveal that both intrinsic factors .
ersonal growth, confidence, and professional readines.
and extrinsic factors .
areer advancement, institutional expectations, and international opportunitie.
significantly influence students' motivation.
Task-based learning, role-plays, and clinical simulations emerged as highly motivating instructional strategies.
The study highlights the importance of aligning course design with studentsAo motivational drivers to optimize learning outcomes.
The findings suggest that educators should emphasize practical, interactive activities that foster confidence while reducing language anxiety.
This is an open access article under the Lisensi Creative Commons Atribusi-BerbagiSerupa 4.
0 Internasional Corresponding Author:
Kadek Maya Cyntia Dewi Institut Teknologi dan Kesehatan Bali Email: maya.
agapita88@gmail.
INTRODUCTION
In todayAos globalized healthcare environment, the ability to communicate effectively in English has become a crucial skill for nurse anesthesiologists.
The profession of nurse anesthesiology involves not only administering anesthesia and monitoring patients during surgical procedures but also engaging in comprehensive patient care, preoperative and postoperative consultations, and collaboration with diverse healthcare teams (Widodo.
These responsibilities require precise communication to ensure patient safety, coordinate care effectively, and adhere to clinical protocols, many of which are standardized globally and documented in English.
As a specialized field that involves complex procedures and patient interactions, nurse anesthesiology demands not only technical expertise but also clear and precise communication, particularly when dealing with international guidelines, research, and diverse patient populations.
Nurse anesthesiologists often engage in multidisciplinary teams that include international experts, consult global medical literature, and adhere to international safety standards and protocols that are primarily published in English (Santosa, 2.
Miscommunication in such highstakes environments can lead to serious patient safety concerns, highlighting the critical need for proficient English communication skills.
1589 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944 Moreover, the rapid growth of medical tourism and international collaborations further emphasizes the necessity for nurse anesthesiologists to be competent in English.
Bali, being a renowned medical tourism destination, hosts a growing number of international patients who seek healthcare services.
Effective communication in English not only improves the quality of care but also strengthens the institution's global reputation and competitiveness, contributing to the professional growth of healthcare providers and the sustainability of healthcare services.
In addition, advancements in medical technology and the continuous expansion of scientific knowledge necessitate that nurse anesthesiologists stay updated with the latest research and clinical guidelines, most of which are disseminated in Englishlanguage journals, conferences, and online platforms.
Therefore.
English proficiency enables nurse anesthesiologists to engage in lifelong learning, participate in global medical communities, and contribute to evidence-based practice.
Recognizing these multifaceted needs.
ITEKES Bali offers the Advanced English for Nurse Anesthesiology course to equip students with the necessary language proficiency that goes beyond general English and focuses specifically on the linguistic demands of clinical practice, patient care, and professional interactions within the field of anesthesiology (Galuh, 2.
The course covers medical terminology, patient communication, documentation, interdisciplinary teamwork communication, and reading and interpreting research articles.
However, students' motivation plays a pivotal role in the success of language acquisition, especially in a highly specialized and challenging subject such as English for Nurse Anesthesiology.
Motivation determines the level of effort, engagement, persistence, and ultimately, the learning outcomes (Sunaryati et al.
, 2.
Highly motivated students are more likely to practice consistently, seek additional resources, actively participate in class, and overcome language anxiety, all of which contribute to effective language acquisition.
Despite the importance of this course, little research has been conducted to explore what motivates students to learn English in this specific professional context.
Understanding studentsAo motivation can provide valuable insights for educators to design more effective and engaging curricula that not only address linguistic needs but also foster sustained interest and long-term commitment to language learning (Gunawan et al.
, 2.
This study aims to investigate the motivational factors that influence students in learning Advanced English for Nurse Anesthesiology at ITEKES Bali.
The findings are expected to contribute to the development of teaching strategies that better meet the students' needs, optimize their learning experiences, and ultimately prepare them for successful clinical practice in a global healthcare environment.
GardnerAos Socio-Educational Model of Second Language Acquisition .
This model emphasizes that language learning motivation consists of two major orientations: integrative and instrumental.
Integrative motivation refers to the learner's desire to identify with and integrate into the language community and culture, fostering a genuine interest in engaging with the language beyond purely academic purposes (Bayhaqi et al.
, 2.
For students in the Advanced English for Nurse Anesthesiology course, this might include a willingness to communicate effectively with international patients, collaborate with colleagues from diverse cultural backgrounds, and embrace global healthcare practices.
Instrumental motivation, on the other hand, focuses on the practical benefits of language acquisition, such as career advancement, passing certification exams, accessing medical literature, and improving employability.
In specialized fields like nurse anesthesiology, instrumental motivation often plays a significant role because proficiency in English can directly impact professional development, job opportunities, and international recognition.
GardnerAos model highlights that both orientations are not mutually exclusive.
instead, they often coexist and collectively influence the learnerAos 1590 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944 sustained commitment, effort, and success in mastering the language (UJIHANTI et al.
Self-Determination Theory (Deci & Ryan, 2.
This theory distinguishes between intrinsic motivation .
earning for personal satisfactio.
and extrinsic motivation .
earning for external reward.
, both of which are crucial for sustained learning engagement.
Self-Determination Theory posits that individuals have basic psychological needs for autonomy, competence, and relatedness.
When these needs are fulfilled, learners are more likely to experience intrinsic motivation, leading to greater engagement and deeper learning (Kristina, 2.
In the context of Advanced English for Nurse Anesthesiology, students who feel they have control over their learning .
, believe in their ability to master medical English .
, and feel supported by instructors and peers .
are more likely to sustain motivation.
Conversely, if these needs are unmet, learners may rely solely on external rewards such as grades or job prospects, which may result in lower long-term commitment (Aditya et al.
Therefore, fostering a supportive, empowering, and socially engaging learning environment is essential to nurture studentsAo intrinsic motivation and ensure their sustained effort in mastering specialized language skills.
These frameworks are highly applicable in specialized English for Specific Purposes (ESP) courses such as Advanced English for Nurse Anesthesiology (Rahman, 2.
This study is novel in its focus on the motivational factors influencing students learning Advanced English for Nurse Anesthesiology, a highly specialized ESP context that has received little attention in previous research.
By applying GardnerAos Socio-Educational Model and Self-Determination Theory, the study offers a deeper understanding of how both intrinsic and extrinsic motivations impact studentsAo engagement in mastering medical English for complex clinical tasks, patient safety, and international collaboration.
Conducted in Bali a growing medical tourism hub the study provides new insights that can inform more targeted curriculum design to better integrate language proficiency with professional competence in global healthcare settings.
METHOD
Research Design This study adopts a mixed-method approach, combining both quantitative and qualitative data to gain a comprehensive understanding of students' motivation.
Participants The participants are 30 students enrolled in the Advanced English for Nurse Anesthesiology course at ITEKES Bali.
Instruments Questionnaire The quantitative data were collected using a structured questionnaire based on GardnerAos Socio-Educational Model and Self-Determination Theory.
It included intrinsic .
nterest, enjoyment, self-developmen.
and extrinsic .
areer goals, job requirements, external reward.
motivational factors.
Interview Semi-structured interviews were conducted with 10 selected students to explore indepth perceptions, experiences, and specific motivational drivers.
Data Analysis Quantitative data from the questionnaire were analyzed using descriptive statistics to identify dominant motivational factors.
Qualitative data from interviews were thematically analyzed to provide deeper insights and support the quantitative findings.
1591 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944
RESULT
The results of this study revealed that both intrinsic and extrinsic motivations play significant roles in students' engagement with the course.
The findings of this study highlight the complex interplay between motivation, challenges, technology integration, and the need for continuous professional development among students in the Advanced English for Nurse Anesthesiology course at ITEKES Bali.
Students expressed strong intrinsic motivation, driven by intellectual curiosity, personal growth, and a genuine desire to communicate effectively in clinical settings.
They recognized the importance of English proficiency not only for academic achievement but also for professional competence, particularly in patient care, interdisciplinary teamwork, and international collaboration.
Instrumental motivation was also evident, as students saw English mastery as a gateway to career advancement, access to global medical literature, and participation in international medical communities (Jainiyah et al.
, 2.
Despite this motivation, students at ITEKES Bali face several challenges in learning advanced English for anesthesiology.
Many struggles with mastering complex medical terminology, accurate pronunciation, and grammatical precision, especially during spontaneous clinical conversations.
Anxiety and lack of confidence in speaking English, particularly in high-stakes situations with international patients or colleagues, remain significant barriers.
Limited exposure to authentic clinical communication in English further compounds these difficulties, emphasizing the need for interactive, contextualized learning approaches that simulate reallife scenarios (Subagio et al.
, 2.
In this context, the integration of technology into language learning at ITEKES Bali plays a critical role in addressing these challenges.
Digital platforms, simulation technologies, and mobile-assisted language learning (MALL) provide flexible, accessible, and interactive learning environments.
Students can engage in realistic clinical simulations that mirror the complexities of anesthesiology practice, allowing for repeated practice of communication skills in a safe setting.
Mobile platforms offer the flexibility to study beyond class hours, catering to studentsAo demanding academic and clinical schedules.
Additionally.
AI-powered tools such as speech recognition and adaptive learning systems offer personalized feedback, helping students refine their pronunciation, comprehension, and vocabulary acquisition.
These technological innovations not only enhance learning outcomes but also boost student confidence and reduce language anxiety.
Beyond their academic studies.
ITEKES Bali students must recognize the importance of continuous professional development (CPD) in maintaining and advancing their English The rapidly evolving nature of anesthesiology, coupled with BaliAos growing role in medical tourism, requires graduates to remain current with global guidelines, research, and best practices, much of which are disseminated in English.
Participation in international conferences, advanced training, and collaborative research will demand ongoing engagement with the language.
By fostering habits of lifelong learning and emphasizing the role of CPD.
ITEKES Bali prepares its students not only for immediate clinical competence but also for sustained professional growth in a globalized healthcare Intrinsic Motivation Many students expressed a strong desire for personal development, intellectual curiosity, and confidence in using English in clinical settings.
They perceived the course as an opportunity to strengthen their communication skills, especially for patient interactions, international collaboration, and reading scientific literature (Savitri et al.
, 2.
For these students, the course was not only about fulfilling academic requirements but also about achieving a higher level of professional competence that aligns with their future roles as 1592 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944 nurse anesthesiologists.
Being able to confidently interact with patients, communicate effectively with international medical teams, and interpret complex medical studies published in English provides them with a sense of empowerment and professional identity.
The opportunity to engage with authentic clinical scenarios through English learning activities fosters their intellectual curiosity and helps them connect theoretical knowledge with practical applications (Fitriyani et al.
, 2.
Furthermore, acquiring advanced English skills allows them to access cutting-edge medical research, keep up with international developments in anesthesiology, and contribute to evidence-based practices, ultimately enhancing patient care quality.
Extrinsic Motivation Career aspirations were a dominant external factor.
Students recognized that English proficiency could enhance their employability, especially in hospitals with international standards or when participating in global medical conferences.
Some students were also motivated by institutional expectations and future certification requirements (Alfiah et al.
Challenges noted include anxiety about medical terminology, fear of making mistakes, and limited speaking practice opportunities, indicating the need for teaching approaches that balance linguistic accuracy with confidence-building strategies (Lina et al.
The interviews highlighted that task-based learning, role-plays, and simulations of real clinical scenarios were perceived as the most motivating and practical learning These methods helped students visualize the real-world application of the language, making learning more meaningful and enjoyable.
Students Challenges Many students at ITEKES Bali expressed a strong desire for personal development, intellectual curiosity, and confidence in using English in clinical settings.
They perceived the course as an opportunity to strengthen their communication skills, especially for patient interactions, international collaboration, and reading scientific literature.
For these students, the course was not only about fulfilling academic requirements but also about achieving a higher level of professional competence that aligns with their future roles as nurse anesthesiologists.
Being able to confidently interact with patients, communicate effectively with international medical teams, and interpret complex medical studies published in English provides them with a sense of empowerment and professional identity.
The opportunity to engage with authentic clinical scenarios through English learning activities fosters their intellectual curiosity and helps them connect theoretical knowledge with practical applications.
Furthermore, acquiring advanced English skills allows them to access cutting-edge medical research, keep up with international developments in anesthesiology, and contribute to evidence-based practices, ultimately enhancing patient care quality.
However, despite their strong motivation, students at ITEKES Bali also face significant challenges in learning advanced English for nurse anesthesiology.
Many students struggle with mastering complex medical terminology, which often includes Latin or Greek roots unfamiliar to them.
Pronunciation of these technical terms poses additional difficulties, especially when they need to communicate clearly in high-stakes clinical Grammatical accuracy and fluency in spontaneous communication are also common challenges, particularly during patient interviews or professional discussions (Nadialista Kurniawan, 2.
Moreover, some students experience anxiety and lack of confidence when speaking in English, especially when interacting with international peers or instructors.
Limited exposure to real-life clinical communication in English further 1593 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944 contributes to these difficulties, emphasizing the need for more interactive, contextualized, and supportive learning environments that simulate authentic clinical encounters.
Technology Integration in Language Learning At ITEKES Bali, the integration of technology into the Advanced English for Nurse Anesthesiology course offers significant benefits in addressing studentsAo learning needs.
Many students face challenges in mastering complex medical terminology, improving pronunciation, and building confidence in clinical communication.
By utilizing digital platforms and simulation technologies, students can engage in interactive clinical scenarios that closely resemble real-life anesthesiology practice.
These tools provide a safe environment where students can repeatedly practice critical language functions, such as explaining procedures, giving patient instructions, and collaborating with healthcare teams, thus enhancing both their linguistic competence and professional readiness.
Given the busy schedules of nurse anesthesiology students at ITEKES Bali, mobile-assisted language learning (MALL) offers additional flexibility.
Students can access course materials, practice exercises, and clinical dialogues on their smartphones or tablets, allowing them to continue learning outside of formal class hours (Agustina & Kurniawan, 2.
This flexibility supports self-directed learning and enables students to review challenging content at their own pace, which is particularly valuable when preparing for clinical rotations or international collaborations in BaliAos growing medical tourism industry.
Moreover, the incorporation of AI-powered tools and adaptive learning systems into the curriculum provides personalized feedback that caters to individual student needs.
For example, speech recognition technology can help students at ITEKES Bali refine their pronunciation of medical terminology, while interactive quizzes and digital case studies can reinforce specific clinical language skills.
This immediate and tailored feedback helps students monitor their progress, build confidence, and reduce language anxiety, which is often reported as one of their main challenges in learning English for anesthesiology.
integrating technology into language instruction.
ITEKES Bali not only modernizes its educational approach but also better prepares its students for the demands of global The ability to communicate effectively in English, supported by technological tools, empowers students to participate confidently in international medical communities, collaborate with global healthcare professionals, and provide high-quality care to both local and international patients in BaliAos dynamic healthcare environment.
The Need for Continuous Professional Development In the field of nurse anesthesiology, continuous professional development (CPD) is essential to ensure that practitioners remain competent, up-to-date, and capable of delivering safe, effective care in a rapidly evolving healthcare environment.
For students at ITEKES Bali, learning English for Nurse Anesthesiology is not a skill that can be fully mastered during their academic program alone.
Instead, it represents the foundation for a lifelong learning process that must continue throughout their professional careers.
As medical technologies advance, international guidelines are updated, and new research findings emerge, much of the critical information is published in English, requiring ongoing engagement with English-language materials.
For ITEKES Bali students, developing strong English skills during their studies is just the beginning.
Once they enter clinical practice, they will encounter diverse patient populations, multidisciplinary international teams, and complex clinical situations that demand continuous language use and further development.
For example, engaging in international conferences, accessing cutting-edge research, participating in global training programs, or pursuing advanced certifications often requires proficiency in English.
Therefore, students must cultivate not only language skills but also 1594 | Motivation of Students in Learning English for Nurse Anesthesiology at ITEKES Bali (Kadek Maya Cyntia Dew.
Jurnal Ilmu Sosial dan Pendidikan (JISIP) e-ISSN : 2656-6753, p-ISSN: 2598-9944 the habits and motivation for continuous professional development to remain competitive and effective in a globalized healthcare setting.
Moreover.
BaliAos growing role as a medical tourism destination means that nurse anesthesiologists increasingly serve international patients who expect high-quality care and clear communication.
This adds another layer of responsibility for ITEKES Bali graduates to continually refine both their clinical and communication competencies in English to meet international standards.
Continuous professional development empowers them to adapt to these demands, enhances their career opportunities, and strengthens the global reputation of both themselves and their institution.
By instilling the importance of lifelong learning and professional development early in their education.
ITEKES Bali helps prepare its students to thrive in dynamic healthcare environments.
Encouraging students to view English language mastery as an ongoing process ensures that they remain confident, competent, and responsive to the evolving needs of international healthcare practice throughout their CONCLUSION This study underscores the importance of understanding both intrinsic and extrinsic motivational factors in the context of learning Advanced English for Nurse Anesthesiology.
While personal interest and professional goals drive students' motivation, effective instructional strategies such as task-based learning, role-play, and authentic simulations can further enhance engagement and learning outcomes.
Educators at ITEKES Bali are encouraged to continuously adapt their teaching methods to align with students' motivational needs, reduce learning anxiety, and create a supportive, interactive learning environment that reflects real clinical practice.
For educators, it is essential to incorporate task-based learning, role-play, and simulation activities that closely reflect real-world clinical scenarios.
These interactive approaches provide students with opportunities to practice authentic communication in a safe, supportive environment, allowing them to develop the necessary language skills while simultaneously building confidence in handling complex clinical interactions.
Curriculum developers should focus on designing courses that strike a balance between linguistic competence and professional communication skills.
While it is important for students to master grammar, vocabulary, and pronunciation, equal emphasis should be placed on developing their ability to engage in patient-centered communication, collaborate with medical teams, and navigate culturally diverse clinical settings.
A wellrounded curriculum will better prepare nurse anesthesiology students for the demands of international and interdisciplinary healthcare environments.
In addition, future research is encouraged to explore long-term motivational trends among nurse anesthesiology students as they progress through their English language learning journey.
Investigating how motivation evolves over time can provide valuable insights into how to sustain engagement and performance.
Furthermore, studies examining the effectiveness of digital or blended learning platforms in English courses for nurse anesthesiology may offer innovative solutions to overcome existing learning barriers and enhance studentsAo language acquisition in both academic and clinical contexts.
ACKNOWLEDGMENTS
The authors thank all the individuals and institutions that contributed to the success of this study.
REFERENCES