[An Inconvenient Fact: Impact of EMI on Nursing Education].

With the internationalization of higher education, English as a Medium of Instruction (EMI) has become one of the most significant global educational trends in the 21st century (Aizawa et al., 2023). Medium of instruction refers to the language used when teaching non-language academic/content subjects such as science (Lo & Lo, 2014). The aims of EMI include developing students' English professional expertise, expanding their knowledge of different academic disciplines, and preparing them to participate in the international community. EMI is used in many countries, including Taiwan, as an internationalization strategy in higher education (HE). In 2018, Taiwan's National Development Council proposed a blueprint for developing Taiwan into a bilingual nation by 2030, with related policies promoting the widespread use of English in HE. In 2021, Taiwan's Ministry of Education announced a new program on bilingual education for students to promote EMI courses in HE. However, in addition to English language proficiency, internationalization is essential to nursing education. Thus, it is also necessary to actively strengthen the international outlook and global village citizenship of Taiwan's nursing students. In both university and vocational nursing education, English education focuses mostly on English for Specific Purpose (ESP)-oriented English courses designed to help learners do well in their academic and professional preparations for their future careers (Saragih, 2014), while English for Academic Purposes (EAP) focuses on enabling learners to use English in their study and research activities (Flowerdew & Peacock, 2001; Hyland & Hamp-Lyons, 2002). EAP is concerned with using English in academic domains (Walkinshaw et al., 2017). In contrast to ESP and EAP, EMI, although also using English as a teaching tool and conveying academic knowledge in English, does not include improving English proficiency and abilities as a primary goal (Dearden & Macaro, 2016). The current global explosion of EMI in higher education is unprecedented (Aizawa et al., 2023), leading to EMI being described as an 'unstoppable train' from which EMI educators must safely ensure their students alight at their destination (Macaro, 2018). To reduce the challenges students face on their EMI journeys, educators must first understand the common challenges experienced by students. In this EMI educational scenario, educators experience how the change in the language of instruction impacts their teaching and their students' learning effect. From a pedagogical perspective, studies have confirmed that, in addition to teacher training support (Lauridsen, 2017; Sánchez-Pérez, 2020), HE should focus on providing more solid and diverse training courses that teach strategies for pronunciation and discourse, accommodate diversity in the classroom, and teach multicultural competencies (Orduna-Nocito & Sánchez-García, 2022). Therefore, for this column, we have invited authors with backgrounds in different disciplines to share their ESP and EMI teaching experiences, suggest the next steps beyond EMI, and offer insights into how to apply multimodal design in nursing education. After reading this column, we hope readers will be able to employ different levels of thinking to help the development of nursing education in Taiwan keep pace with the times and internationalization trends, prepare for EMI training, successfully face the challenges of EMI, and take EMI beyond the first step.難以忽視的事實—英語授課對護理教育之衝擊.隨著高等教育（higher education）的國際化，英語授課（English as a medium of instruction, EMI）已成為二十一世紀最大的全球教育現象之一（Aizawa et al., 2023）。授課或教學媒介（medium）是指用於教授「非語言學術或內容科目」的語言，例如科學（Lo & Lo, 2014）。EMI的目標是培養學生的英語專業知識，擴展他們對不同學科的知識，並為他們參與國際社會做好準備。因此，在許多國家EMI被用作高等教育的國際化戰略。台灣也不例外，國家發展委員會（2018）發布「2030年台灣雙語國家發展藍圖」，旨在提升英語溝通能力，提升台灣在全球的競爭力。教育部（2021）針對學生的雙語教育新計畫，以在高等教育中推廣EMI課程。而國際化對護理教育至關重要，更應積極加強學生具備國際觀與地球村公民的素養。英語教育在大學或技職護理教育領域中，大多運用在以特定為目的英語課程（English for Specific Purpose, ESP），幫助學習者做好在學術（不同領域的學生）、專業（不同職業的人員，例如醫生、護理師和工程師）或工作場所（例如技術人員）環境中使用英語的準備（Saragih, 2014）；學術英語（English for Academic Purpose, EAP）是專注於專門教授英語，以促進學習者透過英語媒介進行學習或研究（Flowerdew & Peacock, 2001; Hyland & Hamp-Lyons, 2002），亦即關注英語在學術領域的運作方式（Walkinshaw et al., 2017）。然EMI相較前述ESP與EAP二種英語教學，它亦使用英語作為教學工具，是透過英語傳播學術知識，但不以增進英文程度或能力為首要目標（Dearden & Macaro, 2016）。 現今全球高等教育EMI爆炸式增長是前所未有的現象（Aizawa et al., 2023）。因此，EMI被描述為「一列不可阻擋的火車（an unstoppable train）」，EMI教育者必須確保學生安全抵達目的地（Macaro, 2018），在這種EMI教育場景中，教師們能清楚地感受到教學語言的變化影響他們的教學和學生的學習成效。從教育學的角度（pedagogical perspective）來看，研究證實高等教育除了對教師的培訓支持外（Lauridsen, 2017; Sánchez-Pérez, 2020），應更加紮實和多樣化措施的培訓課程，包括發音、言說策略（discourse strategies）以及如何在課堂上容納多樣性和融合多元文化能力等（Orduna-Nocito & Sánchez-García, 2022）。因此，本期專欄嘗試邀請不同學科背景的作者來分享ESP和EMI教學經驗，開啟我們對EMI的理解，並嘗試如何跨出EMI的第一步，以及如何運用多模態設計在護理教學的應用，以供讀者們參酌。期盼讀者們在閱讀完本期專欄後，能開展各位不同層面的思考，使護理教育的發展與時俱進並邁向國際化的趨勢，做好EMI培訓準備，面對EMI的挑戰，並跨出EMI的第一步。.