English 190, which builds on the language skills learned in English 180, is designed to provide nursing students with intermediate (B1-B2) level skills in reading /vocabulary, listening, speaking and writing. The course reviews paragraph organization by means of writing summaries, and further develops composition skills by writing different types of essays. Students are required to demonstrate their writing skills in classification, cause-and- effect, and compare-and-contrast essays on related medical topics. In addition, students will learn how to take note while listening and use their notes to respond to listening comprehension questions. Students will also learn how to use their notes to engage in meaningful and productive class discussion. Therefore, the language skills such as reading and listening for main ideas and specific details are integral parts of the course as well as orally expressing ideas in English succinctly and logically. With a focus on the development of academic English vocabulary and medical terminology through reading and listening, the course also strives to review the fundamental rules of English grammar for students at the intermediate level, including composing different sentence types and identifying types of sentence error.