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Partial EMI Nursing Program: Insights From Students and Teachers in Thailand

— The adoption of English as a medium of instruction (EMI) in Thailand is not without difficulties. In this study, the needs and challenges of nursing students and teachers were explored qualitatively in a program where courses are allowed to be taught fully in English, fully in Thai or both in Thai and English. Focus group interviews for students were conducted, while semi-structured interviews were employed for teachers to gain in-depth knowledge about the topic at hand. Insights from students revealed the importance of English toward their career goals, their needs and challenges related to EMI (i.e., bilingual support system, clarification of technical terms, code-switching instruction), and their coping strategies when the lesson is challenging to comprehend. On the other hand, teachers confirmed the students’ language proficiency problems. In addition, they also reflected on their challenges in teaching the content subject in English, for example, the lack of time to prepare teaching materials in English. Teaching techniques were also elicited to respond to the learning challenges experienced by the students. Finally, practical implications were discussed to support students and teachers of EMI programs.

alternative sources of income, builds international strategic alliances, promotes international cooperation in research and knowledge, and meets international academic requirements (Knight, 2004).
The internationalization of higher education has contributed to the rise to EMI programs. In Thailand alone, Xu and Chuaychoowong (2017) reported 884 EMI taught programs in Thailand, including 215 doctoral degrees, 350 master's degrees, and 296 bachelor's degrees. The implementation of EMI, however, varies. Some institutions offer international programs entirely taught in English, and other programs are taught bilingual -both in Thai and English. Other institutions allow programs to offer courses taught fully in English while other courses are taught fully in Thai. In some cases, a course is taught by a few lecturers, where one teaches fifty percent of the course fully in Thai while the other teaches the half part in English.
Despite the varying structures of EMI, it is gaining popularity as an educational paradigm in universities, secondary schools, and even primary schools throughout the world. However, the implications of this academic phenomenon are still largely unknown. Tang (2020) investigated the lecturers' perspectives on the difficulties of teaching EMI in Thailand. The findings indicated four types of difficulties -linguistic, cultural, structural, and identity-related (institutional) challenges. Nonetheless, it is unknown what challenges teachers face as the study focused on students' language proficiency and subject matter learning. Accordingly, four key characteristics of EMI implementation were revealed: relevance for language improvement, subject matter learning, career possibilities, and internationalization strategy (Tang, 2020).
Among students, some challenges reported are inadequate linguistic skills (Chen et (Hengsadeekul et al., 2014), lack of speaking ability (Alavi, 2020), and foreign language anxiety (Paleleo & Srikajang, 2018). In a cross-cultural communication program between Indonesian and Thai students, the former reported linguistic challenges due to the Thais' mispronunciation of English words, incorrect word clues, and grammatical errors (Anggoro, 2020). Despite the challenges, the Thais could use coping strategies, including asking for assistance, miming, and repetitions.
In nursing, some programs offered by Thai universities attract students by offering international programs that provide intensive English language training for effective communication and collaboration with multinational patients, taught by qualified and competent faculty members, produce qualified graduates under international professional standards, and ready to serve in the country or abroad. Needless to say, nursing education in the country is not without challenges. For instance, a review of the nursing program in Thailand was conducted and noted some challenges, including education mobility and education technology (Liu et al., 2015).
There is a scarcity of research studies about EMI nursing programs in Thailand. One study closest to our interest was conducted in 2017 by a team of researchers in an esteemed university in Thailand (see Kongkar et al., 2021). A survey questionnaire was distributed to students enrolled in a Thai program and bilingual group (Thai and English) to know and compare the learning outcomes between the two groups of students. Findings indicated no difference concerning the learning outcomes; however, those students in the bilingual group had a higher English proficiency test score. They also had a higher chance of joining student exchange programs, attending extra English language classes for free, and studying in small groups. However, those in the bilingual group had to study harder to understand the lessons.
Among engineering and nursing students in a university in Thailand, Wilang and Nupong (2022) reported several factors affecting their EMI attitudes. Such factors include (1) difficulties of the English language, (2) availability of resources and opportunities, (3) personal goals in life, (4) limitations of time when studying EMI courses, (5) providing activities to improve English proficiency, (6) enhancement of career goals, (7) supports needed, and (8) motivation and intercultural ability. They suggested differentiated language programs to support students with varying levels of English language proficiency.
Since EMI is dubbed as an 'unstoppable train' and a few studies were conducted to know the perceptions of nursing students and teachers, it is vital to investigate their needs and challenges to ensure that adequate support is provided for a successful EMI implementation and to gain international recognition. Therefore, this paper attempts to answer the research question: What needs and challenges did students and teachers face in a partial EMI nursing program?

A. Research Context
The study was conducted in a reputable science and technology university in Thailand. It offers international and Thai undergraduate and graduate programs in science, engineering, agricultural technology, information technology, management technology, public health, medicine, nursing, and English language studies. The nursing program was selected because it practices partial EMI in teaching content courses, an interesting case in the EMI context. For example, a content course is taught 50-50 by two lecturers. It means that 50 percent of the course is taught in English, and the other half is taught in Thai.

B. Student-Participants
Thirty-seven nursing students voluntarily participated to take part in the survey questionnaire, an EMI-based questionnaire available online. It covers topics such as perceived benefits of nursing, perceived difficulties of EMI, perceived personal challenges, perceived supports needed, perceived activities to develop English skills, and attitudes toward learning content in English. Results of the survey questionnaire were published elsewhere. Among the 37 students, only 16 were purposely chosen to join the focus group interviews, which is primarily based on their CEFR level. Four groups were created accordingly (see Table 1). All participants consented to take part in the study.

C. Teacher-Participants
Through snowball sampling, three teacher-participants agreed to be interviewed and consented to use the data for this study. All received their doctoral degrees and were assigned to teach the EMI parts of the content courses.

D. Data Collection
The study adopted a case-study design combining different methods to illuminate students' and teachers' challenges and coping strategies in a partial EMI nursing program in a Thai university context. The instruments used were a survey questionnaire, focus group interviews for students, and individual semi-structured interviews for teacher-participants.

E. Survey Questionnaire
The online survey questionnaire consists of seven items, including background variables such as year level and CEFR level; perceived benefits of their chosen program, personal challenges, difficulties of EMI, activities needed to improve their English proficiency, and other supports needed; and attitude toward learning content courses in English. The validity and reliability of the survey questionnaire were not established, so it was adapted to suit the context of the study. For example, some items were deleted and added, and some were reworded, rephrased, or rewritten. Then, it was submitted to six lecturers for content validity. Afterward, it was piloted, and the reliability was calculated using Cronbach alpha at 0.81, high reliability. The results were not presented in this paper as it was used only to select the student-participants for the focus group interviews.

F. Focus Group Interview for Student-Participants
As mentioned earlier, four focus groups of student-participants were created. They were selected based on their English proficiency level based on CEFR levelsbeginner (A1 and A2), intermediate (B1 and B2), and advanced (C1 and C2). Students with lower proficiency in English most likely struggle in learning EMI content courses, while those

THEORY AND PRACTICE IN LANGUAGE STUDIES
with a better command of English experience lesser challenges. The questions were elicited from a survey questionnaire mentioned previously. For example, they were asked to elaborate on the difficulties they have experienced studying content in English, the common problems they have faced when studying in partial EMI courses, etcetera. The focus group interviews were conducted in Thai, the students L1 to ensure comprehensibility of questions and answers and elicit deeper insights on the topic.

G. Semi-Structured Individual Interview for Teacher-Participants
The semi-structured interview was used to collect the teachers' views concerning the use of EMI in teaching nursing courses. Some questions were formulated based on the students' responses from the focus group interviews. Sample questions are -Could you tell us your thoughts concerning teaching nursing courses in English? How do you feel? What challenges have you and your students experienced or observed when using EMI? The interviews were conducted in both Thai and English.

H. Data Analysis
All data were transcribed and translated into English accordingly. Then thematic analysis was used to analyze the data. The researchers' followed Braun and Clarke's (2006) framework, which includes researchers' familiarization of data, creating initial codes, looking up for themes, reviewing the themes generated, naming and defining the themes, and publicizing the themes in this paper.

III. FINDINGS
This section presents the data elicited from the students and teachers. Three themes were deduced from students' insights, and another three were derived from teachers' insights.

A. Insights from Students
The data analysis has illustrated that the student-participants consider themselves to be beginning and intermediate English language learners. They claimed that their English skills were insufficient (for example, read Ant's remarks below). The students would also want to enhance their speaking and listening abilities.

"I believe my English proficiency is B1 because my speaking and listening abilities are very poor." (Ant)
In addition, three themes were elicited from students' focus group interviews. These themes are career goals, needs and challenges related to EMI, and coping strategies (see tables [3][4][5]. Career goals (see Table 3) All groups agreed about the significance of English, as shown by the data in table 3. The data analysis has revealed that the students realized the importance of English in their nursing careers. All have mentioned better job opportunities if they have a high degree of English proficiency because many areas in their nursing career require English to perform their tasks effectively. For example, doctor's orders are written in English, and technical terminology such as 'ward vocabulary' and 'medical and nursing technical words' are also in English (see Nancy). They also said that a 'good' TOEIC score is required for the job and could increase their salary. Also, the university requires students must pass a certain level of English proficiency scores before graduation. Furthermore, communicating with foreign patients is essential, and they would want to be able to talk with patients using simple and basic sentences. Being good at English offers a broad channel of work that is not restricted to Thailand, but they may also work abroad, which provides better opportunities.
"For the working part, all of the doctors' orders are always written in English, and the vocabulary used in the ward is technical terms."(Nancy)  Table 4) When examining the needs and challenges of the students, these two components cannot be separated as the participants' needs were determined due to their challenges in the EMI classroom. All groups raised a wide range of concerns regarding problems they encountered while learning the content in English. Data elicited indicated that the language used in the class contributed significantly to content incomprehension. Six subthemes were coded and explained below.

Bilingual Support System
The participants appeared to be unaware of the EMI platform as they were all informed about it before the registration period. They were convinced that they had become familiar with English, and it might be beneficial for them in their nursing career. However, there are some difficulties during their learning due to a lack of translation into their mother tongue; for example, the PPT and teaching videos were presented in English. Most of them are worried about the comprehension of the content, and they do not want to lose the critical part. Therefore, all participants required the bilingual support system (Thai-English) by having supplemental materials, lessons, texts, and educational videos with Thai subtitles. Even though their levels of comprehension varied, all did not want to miss all the topics and details. This is the primary reason why they have asked for bilingual supplementary resources. They were anxious about their performance outcome if they could not understand the lesson. Although Nancy (in group 4) is good in English, she still needs a summary in Thai to ensure that all of the critical information is covered and that she can review the content independently.
"I am fine with using English in the classroom, but I need a supplementary document or summary in Thai because I don't want to lose all the crucial aspects." (Nancy)

Clarification of Technical Terms
Comprehension has been limited because some terminologies are specific and new. There was no translation of words into Thai in the EMI class during the class. However, they agreed that defining technical words in English is a significant issue due to its complex nature. Students stated that it is impossible to connect main ideas if they do not understand nursing terminologies. Although definitions in English were provided, they mentioned that they could not grasp the whole meaning of those words due to their specific connotations. Therefore, they plead for explanations of technical words into their L1. In addition, the results revealed that despite the differences in English proficiency among the students, all needed clarification of nursing terminologies in Thai. Poom said that she prefers the meaning of technical terms in Thai because if she understands the meaning of those words, she can 'catch up' with the details quickly.
"I need the explanation of technical terms in Thai because I will research more information during learning to catch up with what the teachers are talking about." (Poom)

Code-Switching Instruction
A consequence of EMI implemented in the class is content incomprehension. For example, when EMI is used in class, some lecturers focus on content delivery in English without extending or clarifying the content. In addition, because of the students' poor listening abilities, they thought some teachers spoke quickly, leaving them unable to keep up with the lecture (See Natty). Therefore, they occasionally asked the teacher to lecture in their mother tongue.
"When studying, I can't keep up with what the teacher teaches. So, I feel worried. I have to try to read by myself later." (Natty) Most students who cannot comprehend the topic have experienced anxiety and suffering. Participants stated that they could not 'keep up' with the lessons taught in English, so they could get lost if the instruction was entirely in English. As a result, in the final section of their class, they require a summary of the topic in their native language. As Cake remarked, she needed the translation into Thai, particularly when the instructors talked about complicated examples or cases since they were concerned about missing important information.
"For me, some parts should be explained in Thai because the content is difficult to understand in English." (Cake)

THEORY AND PRACTICE IN LANGUAGE STUDIES
Surprisingly, it has been coded that students who are exceptionally proficient in English rarely need the translation into their native language. They explained that they could review more from the provided texts and related research articles. They want to push themselves to learn English, and they would be less enthusiastic about studying if they knew there would be a Thai translation in the final part. Accordingly, using both Thai and English causes confusion. The high proficient student (see Pure) would prefer the teacher to utilize only one language rather than combine the two. When a teacher mixes or switches languages while teaching or using Thai to explain the English handouts, it creates much confusion. Another issue concerns confidence because linguistic politeness and formality cause difficulty for the students to put inquiries in Thai.
"I want the teacher to use only one language because I cannot switch myself right away when the two languages are combined. I think it's difficult for me to use Thai because I need to make it very polite when I talk to the teacher." (Pure)

Production-Based Instruction
This need is emphasized by those who are good at English because students want their subject teachers to schedule more discussions and presentations in EMI classes than they usually did to practice their English. They also require collaborative activities among students in different sections to increase motivation and inspiration for learning English. However, it is not surprising that the students with basic language competency hardly like interactive classroom activities due to their lack of confidence and language skills. For example, Bam believes that teachers should give students more opportunities to communicate and express their opinions in English. It may also contribute as a motivator for students in the classroom.
"I think teachers should design more activities to motivate students speaking English with friends in the classroom." (Bam)

Self-Development of Listening, Speaking, Reading, and Writing Skills
In terms of English language skills, the participants emphasized self-improvement. All groups pointed out that this program (EMI) is pretty good, but the biggest problem is their language competency. They want to raise their language proficiency so that they can understand more. They may lose their confidence if they join discussion or writing tasks. Thus, they believed that practicing four skills would improve their understanding of content. They emphasized language learning tactics such as self-discipline and self-motivation. Moreover, they need support from the school and university, such as online language learning programs, free tutorial courses, or textbooks in the library (see Pure). She said that students should take English foundation courses to improve their English before participating in the EMI program.
"I believe that a foundation course is required to establish the fundamental notion of English learning before getting into teaching content in English." (Pure)

Lecturers' English Proficiency
This difficulty was only suggested by the group of highly language-skilled participants in group 4. As we can see from table 4, the participants mentioned teachers' proficiency. In particular, the speaking skill was a big issue because some of them could not comprehend the topic due to the lecturers' accents and pronunciation. Some students are used to American and British accents, but they are unfamiliar with a strong Thai accented speech. Furthermore, when teaching topics in English, some teachers lack naturalness and interpretation skills. Students are concerned that they overlook specific essential details; thus, they need lecturers with strong English skills who can effectively and comprehensively communicate the messages. Bam said that she could not understand the content because of the accent and sentences presented by the lecturers. Her response was completely different from the other participants in terms of comprehension.
"I am not familiar with the Thai accent. And I cannot understand some parts when the content is explained in English." (Bam) Coping strategies (see Table 5)

THEORY AND PRACTICE IN LANGUAGE STUDIES 1391
According to the data given by the participants about EMI, they seemed to be struggling with the English language. Therefore, the students' strategy in the EMI classroom relies on preparing themselves before the actual class by translating the phrases or vocabulary words shown in learning materials (except for group 4). The following example shows Cake's preparation before class.
"Sometimes we needed to translate the PowerPoint slides before class by ourselves." (Cake) If students cannot comprehend the lectures, they would use Line to chat with their friends. Furthermore, they would ask the teacher to clarify or repeat the content in the class. They also asked the teacher the names of the diseases or symptoms in the Thai language or the references of the research articles the teacher used to search for more information online.

B. Teachers' Insights
Concerning teachers, three themes were deduced including challenges in teaching the content subject in English, teaching techniques, and support needed (see tables 6-8). Challenges in teaching the content subject in teaching (see Table 6) Because students' English skill levels differ, teaching students in English is a challenging endeavor. Students struggled to express their ideas and think in English, making it challenging to converse when doing classroom activities. Another problematic aspect of teaching in English is the lack of time to prepare classroom activities because the primary focus is on content delivery. On the other hand, teachers were also afraid to teach in English because they did not receive their education overseas. These participants (P 2 and P3) believed they were not as excellent as others who have received degrees from other countries. Furthermore, because they were scared of using incorrect language, these individuals devoted more time to preparing the subject to be presented rather than extra activities for the students. In addition, it may also be required to convert instructional scripts into English before teaching such as how to motivate students or how to start and continue teaching processes. Some participants were sometimes afraid and hesitant to approach their coworkers for help in checking their work like the scripts because their colleagues had much work to do, and the participant did not want to bother or interrupt their friends' breaks. Another challenge is that some information must be translated into Thai for students to comprehend it in class.
In terms of teaching, activities, and assessment, instructors employed various methods of instruction and support. Teachers can assess students' comprehension by asking for translations of the words they are talking about. The teachers would watch the clips online and create their videos because their content is varied in settings and the availability of the resources. Most of the videos that the professors make are in Thai. In addition, one teacher usually makes several short videos around 5-10 minutes for each topic to be easier for students to understand. In class, P3 would choose only essential topics for teaching in English, such as the introduction part, not all. In addition, following the session, the content will be summarized in Thai to ensure that the students comprehend what they have learned in lieu of codeswitching.
Another thing teachers often do is to help explain one more time when students ask or ask for further explanation after class. Alternatively, there may repeat teaching using the Thai language in teaching directly. Students are also taught and encouraged to utilize Google to pronounce words correctly. Moreover, teachers do one interesting thingintegrating culture in lessons, i.e., people's beliefs from different nations or religions. In terms of assessment, Thai multiple-choice questions are utilized in the evaluation instead of English because it may impact students who are not good at English, and the teacher would like to check the comprehension and knowledge of students, not the language proficiency. As we can see from the examples, the lecturers are quite concerned about the students' understanding, and as a result, they prefer to use code-switching strategies in the classroom if possible. Teachers Nat and Chen agreed that the content should be summarized in Thai.
"I have to ask in Thai; otherwise, those who hate English will sleep."(Teacher Nat) "It is impossible for them to fully understand the content which is taught in English without any Thai supportive materials." (Teacher Chen) This program did not involve complete courses taught entirely in English; therefore, not all lectures and slides will be in English. However, teachers Nat and Chen informed us that instructors who graduated overseas from adult nursing present their slides in English. So, the internationalization policy does not relate to current staff. In the classroom or in the process of learning, students need to apply English when they search for information, and the articles or some supplementary provided to students are in English. The slides can help students improve their reading abilities, and the instructors can help them improve their listening skills. Nonetheless, they will avoid speaking or communicating English with teachers or classmates. When it comes to writing, they write some parts in English based on the pattern given. For example, the health check-up lab report is written in English. Although some parts of the course were taught in English, the test was given in Thai. There are some English parts, but the overall number of questions is just about 10-15. In some instances, the information gathered on teaching nursing courses via English is contradictory; for example, some participants said there is a policy, while others said there is none. However, one critical piece of information emerges: most classes will be taught in English, as the university expects, to enhance internationalization. The following is a summary of what the participants offered: (1) Every department is required to teach 55 percent of its courses in English; however, students are notified of this requirement in class, (2) The PowerPoint Presentation is in English -there is no translation; as a result, students are taught about EMI entirely per the Institute's English Policy, and (3) In some courses, such as adult nursing tools and nursing informatics, 30 percent of the sessions are entirely provided in English. Furthermore, in a 36-hour course, three to four professors collaborate in teaching the students.
The challenges in the institute involve both lecturers' needs and students' proficiency. To provide an example, the university's policy is that lecturers should employ English in the classroom, and the institute then attempts to encourage lecturers to do so. As clearly seen from Teacher Palm's quotation, she said that it is not easy to find lecturers teaching in English. Some lecturers are not familiar with speaking and teaching English, so there is a lack of lecturers who can speak English fluently. In their mindset, they prefer to teach in Thai because it can deliver the messages naturally. And they do not have to worry about language use and can clearly explain more cases and examples regarding their courses. In the same way, the English proficiency of some students is not good enough to learn the content in English. For instance, Teacher Chen mentioned that one factor that affects the students' comprehension is their proficiency. Moreover, there are double anxieties because the content and instruction are 100 percent English, so the students cannot comprehend English. The students want the teachers to teach in Thai regarding the review part. The students understand that it is the policy to study in English. Then, teaching in Thai and English is good, but not all agree on this point. The subjects also mentioned that evaluation from students might affect the application of the academic position, so the lecturers will avoid complaining and then explain the conclusion in Thai.
"I have to follow the policy and it is my responsibility. However, it is not easy to find nursing lecturers who can teach in English fluently." (Teacher Palm) "The students will be divided into three groups based on their proficiency during the interview. I could say that the low competence group may not be that good at English. " (Teacher Chen) the end of each class and giving them quizzes and assignments. They also encouraged students to use technology in the classroom for translation, research for additional information, and so on. Moreover, based on the internationalization policy, the institute will apply only 25% of the content taught in English, and they will always choose simple topics that are easy and not complicated. As Teacher Palm mentioned, the institute would like to meet the goal of nationalization, and they are also concerned about the students' knowledge. So, easy topics would be reasonable and appropriate for the students.
"We only use English in our classes 25% of the time because we want to achieve the goal of 'nationalization', so we try to balance them" (Teacher Palm) Support needed (see Table 8) In terms of development, they need support both for lecturers and students. The institute or university should provide funding for better teaching training in English or English camp for students. Training to teach in English is required for the lecturer since they will gain more techniques and build their confidence in teaching in English. In addition, the institute should create an international environment such as an English corner, lecturer Meet-Up in English, or cooperation with other institutes or some outside international organizations. In the same way, students should have a good foundation of English before joining the EMI program. If the students are trained in their English 1 course, it may help and reduce their fear of English. It would be better if only the basic subject courses were taught in English. Even though some extracurricular activities, such as online exchange programs, are not enough to enhance students' proficiency. For example, Teacher Nat emphasized the importance of support for both students and lecturers. She said that she knows the content, but she is unsure how to translate it into English in the simplest way. In addition, Teacher Chen suggested that there should be some specific English courses for students related to the nursing context.
"Not only the classroom, but the institute and the university should join forces" (Teacher Palm) "I need more training before teaching nursing content in English, I think I will learn some techniques and how to develop my teaching while using English in the classroom" (Teacher Nat) "If there is reinforcement or basic courses to help them, they will be better. The teachers from general education are so smart." (Teacher Chen)

IV. DISCUSSION AND IMPLICATIONS
Several distinct findings emerged regarding the challenges students and teachers face in partial EMI nursing courses. One is the lack of confidence due to English language proficiency (Chen et al., 2020; Choomtong, 2014; Galloway et al., 2017;Macaro et al., 2018). Perhaps institutions may need to re-evaluate how EMI nursing programs are implemented. For example, at the instructional level, code-switching may be normalized. When teachers have difficulty explaining the content in English, they may do so without fear of retribution from the administration. And for the students, they can always use L1 and ask their teachers to speak in L1 during classes if the goal is comprehension. In fact, L1 could be a scaffolding strategy for both teachers and students who lack confidence in speaking English. Teachers may choose the lessons to teach fully or partially in English, while students could be encouraged to use English when answering questions and sharing their ideas. For 'difficult' lessons, students may be given advanced annotated readings and key vocabularies, and teachers may code-switch at any time during the lesson. PowerPoints may also contain bilingual slides.
Not only students feel the need to improve their language skills but also the teachers. In this case, it is highly recommended that institutional help is needed. The institute may compile a bilingual glossary of technical terms in each nursing course to help students comprehend the technical terms and lessons. Activities to help students gain confidence in speaking English should be prioritized rather than teaching speaking skills. Lessons should use scaffolding techniques, such as teaching basic concepts entirely in English and more challenging lessons in Thai and English. For teachers, the institute may promote professional development programs focusing on language development and EMI. For both teachers and students, the institute may drive the internationalization of the environment to provide opportunities for the stakeholders to use English in their everyday academic life.
Further results have shown that student-centered learning is fostered due to the challenges of EMI nursing courses. For instance, teachers are fully aware of the difficulties students experience in their classes. The study found that teachers provide lesson summaries in L1, reteach in L1, allow students to use translation applications, and distribute short videos. This is interesting as student-centered learning is promoted, away from teacher-centered traditional classes. When students are allowed to use help from available resources to help their comprehension, they are more 1394 THEORY AND PRACTICE IN LANGUAGE STUDIES likely to become autonomous learners. In addition, when they are allowed to use their L1, they may become appreciative of the teacher and increase their motivation. Providing help for students to aid their comprehension, however, can lead to questions of the effectiveness of EMI itself -'Does it help drive internationalization?', 'Does it improve students' English proficiency?', among others. To what extent do teachers provide such instructional help without 'spoon feeding' the students? Another novel finding is the concern of teachers who need to balance content delivery (to be able to cover all lessons within the timeframe), use of English in teaching (slower when English is used), and students' comprehension of the lesson (more time needed for students to process the content). In fact, students have asked for more time to learn difficult lessons. Herein, teachers could possibly use various methods to deliver the lessons. For example, teachers may have to use random checks on students' comprehension and decide how to move forward with their lessons accordingly. After each lesson, they may also keep reflective diaries to note their difficulties and students' challenges. Such data would be helpful in lesson planning.
In light of the findings, future studies may explore EMI in various fields of disciplines and programs in the EFL context to help design the most suitable typepartial or full, and consider the needs and challenges of both students and teachers in terms of language and content.