What do nursing students need in learning English?

This study aimed at investigating the needs of English-specific purposes materials for nursing students at the Dehasen University of Bengkulu. It focused on the existing materials used by English lecturers, target situation (the purpose of learning English, materials needed, and topics needed), and the activities needed by nursing students from students’ and stakeholders’ perception. This research was a mixed-method that involved forty-nine nursing students and nine stakeholders. The data of this research were collected by using a questionnaire, documentation, and interview. The results of the study revealed that the existing materials used by the English teachers tended to general English materials. In addition, the analysis results of target situation show that; 1) most students learn English for looking for jobs; 2) the most needed language proficiency components were vocabulary mastery, speaking and listening skill; 3) the materials needed in each language skill and knowledge were the materials that were related to nursing activities and job; 4) almost all of the topics were needed by nursing students such as giving information on treatment plans or diagnosis. Moreover, the learning activities needed by nursing students were in terms of the workgroup (small group, large group, and pairs) and discussion. In conclusion, the findings describe that student need the real English learning materials in nursing profession and the appropriate learning activities that can make them interact and work together with their classmates.

graduates graduated from all universities in East Java each year (Handayani, 2015). It happened because nursing graduates are still needed in Indonesia. Nurses are often the only health staff in remote and difficult areas because there are still some public health centers that have not been served by doctors (Anderson et al., 2014). This phenomenon makes nurses become the front line in the Indonesian health system to improve public health outcomes (Efendi et al., 2018).
Moreover, nurse is still needed by many countries in Asia. Handayani (2015) reported that nurse is one of the seven skills workforces needed by ASEAN countries from 2015 until 2030 and it is not included other countries in the world. However, one of the obstacles faced by Indonesian nurses is English language factor that is used in hospitals (Rosanda et al., 2018). It means that they cannot speak English actively as one of the required skills of being a nurse. This case shows the importance of the ESP course for nursing students to improve their English in order for them to communicate well as a nurse.
The Dehasen University of Bengkulu is one of the higher educational institutions that offers the nursing study program in Bengkulu. This study program offers several general courses including English language course. The students take it in the first and third semester. In the first semester, they learn general English with course' name English I, while ESP English material is learned in the third semester with course' name English II. The English II course is hoped to be able to enhance the students' English skills in specific academic and professional communication. Therefore, ESP reflects learners' specific purpose in learning the target language, being a response to students' needs and the acquisition of language relevant to communication outside the classroom, especially in their studies and future careers.
On the other hand, based on the researcher's preliminary study in the nursing department, lecturers' preparation of teaching ESP has not been done systematically based on need analysis principles. They generally made teaching outlines on what they are going to teach without using the syllabus and inappropriate materials based on the ESP course for nursing students. The lecturers tended to give the general English materials to the nursing students than ESP materials. Of course, it is not able to fulfill the nursing students' needs to work as English-capable nurses in their future carrier in the real workplace. Moreover, the limitation of course credit for the English course in this department is one of the factors why the goal of the ESP to prepare the students to be able to use English actively in their work had not been achieved. Therefore, a need analysis is important to do to meet the nursing students' needs in English skills.
Need analysis (NA) basically is the activity of analyzing students' needs. It aims at achieving the goals of the ESP itself in a program taken by the students. Richards (2001) defined NA as a procedure to collect information about learners' needs. It gives a positive impact on the students' English skills after they graduated and worked in the workplace. It shows that NA has a vital role in the process of designing and carrying out any language course, whether it will be ESP or general English course, and its centrality has been acknowledged by ESP experts (Dudley-Evans & St. John, 1998;Hutchinson & Water, 1987).
The results of the NA will be guidelines for the English language teachers, lecturers, and instructors in designing the materials for the students in the ESP course. Likewise, Basturkmen (2010) mentioned that NA could help curriculum designers designing effective ESP courses or programs. It is because NA is the basis of training and development programs to determine the essence and the underlying reasons for an ESP course (Saragih, 2014). It includes the ESP curriculum, syllabus, materials, and teaching methods that will be applied and learned by students in the classroom. However, particular course programmers in particular higher education institutions do not conduct the NA maximally. As a result, the existing materials of the ESP course are not able to make the students have English ability based on their needs. For example, this case happened in the nursing department in Indonesia.
Several studies have been conducted by some scholars on the need analysis of ESP materials for nursing students. Firstly, Chetsadanuwat (2018) investigated the needs of the English skills of Thai nurses who worked at International Hospitals in Bangkok, Thailand. Secondly, Saragih (2014) explored the learning needs of 50 nursing students, and designed ESP materials for nurses at the University of Prima Indonesia. Thirdly, Miyake and Tremarco (2005) explored the needs of the undergraduate, postgraduate, and professional nurses and discussed the implications for EFL teachers in Japan. The last, Susandi and Krishnawati (2016), designed the ESP Syllabus for Indonesian EFL Nursing Students. The results of those studies revealed that English is needed for nursing students. They need the English materials that suitable with the nurses and the practice of ESP instructions and descriptions of ESP for nurses used in their workplace. In addition, the prioritized language skills needed were speaking and listening, while they also need to improve their vocabulary knowledge.
Based on the previous studies above, there is no study discusses the NA that focuses on analyzing the nursing students' needs based on three components of NA in ESP. Therefore, to fill the gap, this study investigated the NA of the ESP materials for nursing students in terms of the present situation (the existing materials), target situation (the purpose of learning English, the materials and topics needed), and learning situation analysis at the Nursing Department of the Faculty of Health Sciences of the Dehasen

Instruments
The data of this study were taken from the questionnaire, documentation and interview. First, the questionnaire was distributed to the nursing students and stakeholders. The questionnaire of this study was built by adapting the questionnaire of Chamnankit (2015), Pongsapan (2015) and Susandi and Krhisnawati (2016).
The questionnaire used was the Likert Scale with five option answers (e.g., very needed, needed, neutral, not needed, and very not needed). The questionnaire contained the target situation and the learning situation analysis. Second, documentation was used to collect the data from the English module and semester lesson plans. It was used to investigate the existing materials used by the English lecturers for nursing students. Third, the interview was used to get in-depth information of the data from the questionnaire. The questions of the interview were adapted from Huh (2006). In addition, two experts' judgments also involved in validating the instruments of this study.

Data Analysis Procedures
The data from the questionnaire were analyzed quantitatively. First, the participants' responses were counted by counting the weighted mean score of each item in the questionnaire. Then, determination of the interval range was done. The interval range was 0.80. The last, the mean score was interpreted with the range category as presented in the table below; The data from the English module and semester lesson plans were analyzed by using observation sheet. The materials in each meeting (semester lesson plans) and unit (English module) were observed. Then, the materials in both documents were put into the table analysis. After that, the conclusion of the analysis was drawn. In addition, the data from the interview were analyzed qualitatively by using the interactive data analysis model of Miles et al. (2014). The procedures of this method were data collection, data reduction, data display, and conclusion drawing.

FINDINGS The Existing Materials used by English Lecturers at the Nursing Department of Dehasen University of Bengkulu
Regarding the first question, the results of the analysis from the documents (English module and semester lesson plans) were summarized in the table below. Formal and informal greetings and responses for greeting (Greetings and introductions) 2 Daily routines and affirmative (Daily activities and affirmative) 3 Talking on the phone and numbers (Where do you live) 4 (Names of sports, and the use of article (a, an, and the) (Favorite sports) 5 Kind of Feelings, moods, and emotion (How do you feel) 6 Names of family and relatives and asking and introducing about family and relatives (Family and relatives) 7 Tell the time, preposition for time, names of the days (Talking about the times) 8 Types of drinks, food and favorite food (Eating and drinking) 9 Type of jobs (Occupations) 10 Giving direction, study the map, and expression of location (in the street) As described in Table 2, there were ten topics used by English lecturers for nursing students at the nursing department of the Dehasen University of Bengkulu. Each of the topic consists of several materials and those materials were presented for each language skill and language knowledge. The materials were not relevant to the nursing students. It tended to general English materials. In addition, the results of the analysis of English materials from the English module and semester lesson plans were relevant to the English lecturer's statement in the interview. It was stated as follows.
(Materials related to English, both in general and specific. Put more emphasis on the ability to translate the language from English to Indonesian or vice versa). (Lecturer, January 8, 2021). Based on the interview above, the English lecturer stated that the English materials were for general English. The materials were mostly not based on nursing students' needs. Moreover, they emphasized their student to master the translation skill than other English skills such as speaking, reading, writing, and listening.

The Target Situation Needed by Nursing Students of The Dehasen University of Bengkulu
Regarding the second question, there were three findings. They were the purpose of the nursing students learning English, the materials needed and the topics needed.

The purpose of the nursing students learning English
This part aimed to know the purpose of the nursing students of the Dehasen University of Bengkulu in learning English. The results are presented in the table 3 below. It shows that most of the nursing students of the Dehasen University of Bengkulu learn English for looking for the job with the percentage of 81.36% or 48 responses. The possible job for them is a nurse, and it is relevant to their disciplines.

The Materials Needed by Nursing Students: The Needs of Language Proficiency
The needs of language proficiency for nursing students included language skills (e.g., listening, speaking, reading, and writing) and language knowledge (e.g., vocabulary, grammar, and pronunciation). The results are summarized in the table below; As presented in Table 4, there were seven components of the English proficiency. For all those seven components, both students and stakeholders chose "very needed" as their responses. Moreover, speaking was on the top position and then followed by vocabulary and listening.
The results of the questionnaire analysis from both students' and stakeholders' responses were in harmony with the interview results. It is stated as follow; "Menurut saya semuanya penting dipelajari untuk tahap awal banyakbanyak berlatih berbicara dan perdalam kosa kata". "In my opinion, all of them are important to be learned, but for the beginning step, they should practice speaking and mastering vocabulary a lot". (Head of Public Relation of Dr. MY Hospital, January 7, 2021).
"Menurut pengalaman saya yang dibutuhkan adalah cara berkomunikasi (berbicara) dan mendengarkan"." Based on my experiences, the way of communication; speaking and listening are needed". (A Nurse at the Evangelisches Krankenhaus Konigin Elisabeth Herzberger, Germany, January 4, 2021) The interviews results above show that the ultimate English skills to be mastered by nursing students are speaking and listening and for language knowledge is vocabulary.

The Sub-Skills of Language Skills and Language Knowledge Needed
This part of the analysis described the needs of English language sub-skills and language knowledge sub-knowledge needed by nursing students. The first skill is reading. The results of the needs of the reading sub-skills are presented in the table below; As presented in Table 5, students responded only one reading sub-skills as a needed (reading emails) category, while stakeholders responded all of the reading sub-skills as a very needed category. Moreover, both students and stakeholders agreed that reading textbook or academic journals was the most needed for reading sub-skills.
The second skill is speaking. The results of the needs of the speaking sub-skills are presented in table 6. As presented in Table 6, both students and stakeholders agreed the sub-skills in terms of giving information on treatment plans or diagnosis was highly very needed.
The third skill was listening. The results of the analysis are presented in table 7 below. The results show that that the most highly needed listening sub-skill based on students' response was listening to general information of daily routines, while stakeholders' response was listening to physician's order and diagnosis. The first language knowledge is grammar. The results of the analysis are presented in table below. As presented in Table 9, almost all of stakeholders responded the grammar sub-knowledge as a very needed category. Only one sub-knowledge was a in needed category (present progressive). Meanwhile, students categorized four sub-knowledge as a needed category (articles, number and unit, time, and present progressive). The second language knowledge was vocabulary. The results are presented in table below. As presented in table 10, both students and stakeholders agreed that the most needed vocabulary was noun in the nursing context. Then, it was followed by technical vocabulary.

The Topics of English Learning Materials Needed by Nursing Students
This part described the topics of English learning needed by nursing students of the Dehasen University of Bengkulu. There were fifteen topics provided in the questionnaire to be rated by nursing students and stakeholders in this research. The results of the analysis are presented in the table below; As presented in Table 11, there were sixteen topics. Among them, there were thirteen topics responded as a very needed category by nursing students and six topics were responded as a needed category. Meanwhile, stakeholders were responded all of the topics as a very needed category. Moreover, both students and stakeholders agreed that the topic about the hospital teams was the most needed for nursing students. It was shown by the mean score of the topic with the highest mean score. Then, it was followed by the topic of parts of the body and illness. The findings were supported by the interview results as follow; "Topik yang dibutuhkan adalah yang berkaitan dengan pekerjaan sebagai orang perawat, nama-nama benda alat kesehatan, istilahistilah dalam terapi pengobatan pasien, nama-nama bagian dalam rumah sakit, nama-nama anggota tubuh dan jenis-jenis penyakit". "The topics needed were related to nurse' jobs, such as medical tools, terms in the patient's medical therapy, the names of the inside of the hospital, parts of the body and types of disease". (An alumnus at RH, January 7, 2021).
The interview results shows that the topics that are in two top high score have the same response with the statement from the stakeholder statement who works at the hospital.

The Activities Needed by Nursing Students of The Dehasen University of Bengkulu in Learning English
Regarding the third question of this study, it describes the situation of English learning activities needed by nursing students of the Dehasen University of Bengkulu. The results of the analysis are presented in the following table. As indicated in Table 12 above, it shows the nursing students' perception toward the activities needed in learning English in the classroom. They responded to four activities categorized as a very needed in learning English, namely small work group with the mean score of 4.41, discussion with the mean score of 4.37, pairs with the mean score of 4.32, and large work group with the mean score of 4.31. Meanwhile, the activities in terms of out of the class work with the mean score of 4.07 and demonstration/debate with the mean score of 4.05 categorized as a needed category. In addition, the stakeholders gave the same response that the four activities categorized as very needed in learning English were small workgroup with the mean score of 4.88, discussion with the mean score of 4.63, pairs with the mean score of 4.63, and large work-group with the mean score of 4.38. Meanwhile, the activities in terms of out of the class-work with the mean score of 3.75 and demonstration/debate with the mean score of 4.13 were categorized as a needed category.
The results of the analysis from the questionnaire were in line with the results of the interview. It is stated as below; "Kalau menurut saya aktivitas yang membuat mahasiswa aktif di kelas dan bisa mempraktekan bahasa Inggris dengan kawan-kawan di dalam kelas. Misalnya prakteknya perpasangan atau dalam kelompok-kelompok. Jadi, mahasiswa terlatih dan ketika sudah bekerja mereka sudah terbiasa berbicara dalam bahasa Inggris". "In my opinion, the activities that can make students active in classroom and can practice English with their classmates in classroom. For example, practicing in pairs or in groups. So, the students are trained when they have got a job, they have used to speaking in English". (Head of the Hospital's Nursing Department, January 7, 2021).
The result of the interview above implies that there is the same response on the needs of activities in learning English. The activities in terms of workgroup and pairs are suggested to be implemented by English lecturers in order for the students to be able to practice their English.

DISCUSSION The Existing Materials Used by English Lecturers at The Nursing Department of Dehasen University of Bengkulu
The results of the analysis show that the existing materials are greetings, daily routines, sports and numbers, feelings, introducing family and relatives, time, preposition, and names of food and drink, type of jobs, and giving directions (map and location). It indicates that the English materials given by lecturers were not suitable for students' needs. In terms of the ESP course, this finding is line with the research findings of Ariana (Ariana, 2020) who found that there were no available specific materials for computer science students at the Muhammadiyah University of Bengkulu. It shows that the English lecturers still do not aware of providing the materials based on their students' needs and wants in teaching English.
In the teaching and learning process, providing suitable instructional materials for the students is important. It aims at achieving the goals of the teaching and learning process of the English subject itself. In learning, topics that will be learned by students in the teaching and learning process are called materials of learning (Yunita et al., 2018). Those topics as materials of learning should match with students' needs in which aims at supporting the students in mastering English either English for general language or English for specific purposes (Veranita et al., 2017). In this case, the English lecturers should prepare the materials that are related to the nursing students in terms of language skills (listening, speaking, reading, and writing) and language knowledge (vocabulary and grammar). Also, providing suitable instructional materials for nursing students will help them in their profession as a nurse when communicating (written and spoken) in the future.

The Target Situation Needed by Nursing Students of The Dehasen University of Bengkulu: The Purpose Of Learning English
The results of the analysis revealed that the aim of nursing students in learning English is to look for a job as a nurse in the future. The result of this finding is line with the study of Pongasapan (2015) who found that looking for job is one of two purposes of the nursing students at the STIKES Toraja in learning English beside for study. In addition, Tomlinson (2013) argued that ESP refers to teaching English for the students who want to learn a language for work or study purpose. It indicates that English skill is needed as a tool of communication with patients, colleagues, people, and others in around and outside of the hospitals, health clinics, or public places.
In nursing work field, nurse is one of the public services so that they have opportunity to meet and contact with other people. Sumaraw (2018) stated that nursing students should have good English skills to give better service to related people in their job and it is also as one of the requirements for nurses when they work in a foreign country. In addition, when a nurse has good English, she or he can communicate well in her/his job and she or he can understand the terms that related to health devices, drugs, instructions, and others. Based on research finding of Hwang and Lin (2010) on the description of the linguistics needs and perceptions of medical students and faculty members in Taiwan, it reported that English knowledge is influential in academic and professional life. It means that English is a bridge for nursing students and it is in the field of medical and health science to understanding the materials for their study and for their future job after graduated.

The Materials Needed by Nursing Students: The Needs of Language Proficiency
Regarding the needs of language proficiency for nursing students of the Dehasen University of Bengkulu includes language skills, language knowledge (e.g., vocabulary and grammar), and pronunciation skill, the results show that the students and stakeholders rated that those are in a very needed category. Also, the findings revealed that speaking, listening, and vocabulary as the most priority to be mastered by them when learning English. The findings of this study is in line with the research findings of Susandi and Krishnawati (2016), and Miyake and Tremarco (2005) that nursing students need all of the language skills and knowledge, while speaking, listening, and vocabulary are the main skills and knowledge to acquired.
The findings of this study from the questionnaire and interview analysis imply that the students need to rich their vocabulary to communicate and understand the terms related to nurse, health, and hospital context. Cameron (2001) points out that vocabulary plays a great role for learners in acquiring a language. Then, with vocabulary, nursing students can communicate well with patients, hospital teams, and others. It is because vocabulary learning is an essential part of foreign language learning and it improves all areas of communication such as listening, speaking, reading, and writing (Alqahtani, 2015). Thus, knowledge of vocabulary is important to be mastered by the nursing students, then it is followed by speaking, listening, reading, and writing.
Besides, grammar and pronunciation are also important to be mastered well by the students. Yunita (2016) emphasized that grammar is the powerhouse of a language in which if it is combined with words in patterns will make particular meaning. In other words, people cannot convey meaning, a message, an idea, or thought without constructing words well. Also, pronunciation skill will influence in understanding the utterances in speaking and listening when pronouncing a word or some words that have been constructed with correct grammar. The learners who are good at English pronunciation will be easy to be understood even though they make errors in other areas, whereas those who are bad at pronunciation will be difficult to understand even though they speak with correct grammar (Gilakjani, 2016). Thus, pronunciation and grammar support each other in learning a language.

The Needs of The Sub-Skills of Language Skills and Language Knowledge Materials Needed
The results of the analysis show that there are some differences in responses between the students and stakeholders. It happened due to there is a different experience on the needs of English skills between the students and stakeholders. The stakeholders have more experiences than students because they have entered the real job as a nurse.
In terms of listening sub-skills, the result show that that the most highly needed listening sub-skill based on students' response was listening to general information of daily routines, while stakeholders' response was listening to physician's order and diagnosis. These results are different from the results of Chetsadanuwat (2018) mentioning that the most needed listening sub-skills was listening to patient's history, symptoms, and requests. Likewise, Chamnankit (2015) reported that the most required skill from this group of participants is listening to conversations on the phone. It implies that there is a different level of needs related to listening sub-skills between Indonesian students and Thai students in ESP course.
In terms of speaking sub-skills, both students and stakeholders agreed the sub-skills in terms of giving information on treatment plans or diagnosis is highly very needed. This finding is accordance to study of Chetsadanuwat (2018) who found that giving information of treatment plans or diagnosis and asking patients about their chief complaints and symptoms are in highest category of speaking sub-skill needed by nursing students in Thailand. This finding implies that the nursing students need to master this speaking subskill due to a nurse should be able to communicate in English fluently when giving information to the patients related to treatments plans and diagnosis results from the doctors.
In terms of reading sub-skills analysis, the students and stakeholders agree that the materials needed are the materials related to nursing activities, job (reading medical charts and drug prescriptions) general publication, and academic journals. The finding of this research is different from the study of Chetsadanuwat (2018) who revealed that the reading sub-skill in terms of reading physician's orders is the most needed by nursing students in Thailand. The findings mean that the nursing students of the Dehasen University of Bengkulu do not only need reading materials related to reading medical charts and drug prescriptions, but also general publication, and academic journals in ESP course. They tended to have more or wide reading skills to improve their knowledge from various materials related to their study.
In terms of writing sub-skills analysis, students and stakeholders agreed that the sub-skill in terms of writing medical histories are highly very needed for nursing students. Meanwhile, students categorized other writing sub-skills as a needed category. The stakeholders categorized three writing sub-skills as needed category (e.g., writing a resume, a memo, an email), while the other writing sub-skills are as a very needed category. The findings of this research are different from study of Chamnankit (2015) who reported that taking telephone message, writing E-mails, writing memos, writing messages for customers were the top ranked. It indicates that the nursing students only need writing skills related to medical history and condition of the patients. This skill is an indicator of students' achievement in learning a foreign language (Jasrial, 2019). The writing skills in terms of writing a resume, a memo, and an email are seldom done by them as a nurse.
In terms of grammar, students agreed that the tenses skills (except present progressive), modal, preposition, and verb form tended to categorize as a very needed category. In contrast, the stakeholders agreed that the nontenses skills (except simple past tense) such as time, articles, modal, and preposition are five the highly very needed (the same mean score) for the nursing students. Both students and stakeholders agreed that the present progressive is the lowest one rate in which categorized as needed category. As stated by Chen (2016), the functions of mastering English grammar in ESP course are to increase the comprehensive input and to monitor the effective output. The comprehensive input means that grammar knowledge is used to face some the difficulties in reading comprehension, while the effective input means the language learners can monitor the spoken or written expression correctly without ambiguity sentences or phrases. Based on the findings, nursing students need to master tenses form, preposition, articles, modal, telling the times correctly since they use it in speaking and writing. Then, present progressive is used to ask and tell of what the patient's feeling and condition.
In terms of vocabulary sub-skills, both students and stakeholders agreed that the most very needed vocabulary sub-skills are a noun in the nursing context. However, based on the analysis results, the nursing students still need general vocabulary. It is because the nursing students need it to communicate in around and outside of their workplace. (Hanifia, 2013) stated that language learners would have difficulties in mastering a language without mastering or understanding a certain number of vocabularies. As affirmed by Nation (2006), language learners need to have 6.000 to 7.000 word-family vocabularies for spoken texts and around 8.000-to-9.000-word family vocabulary for written texts in order to perform the language effectively without using any comprehension tools. In other words, in learning a second language, students or language or nursing students should master any kind of vocabulary with large number including general vocabulary.

The Topics Needed by Nursing Students
The results show that almost all of the topics provided in the questionnaire were rated as very needed category by students and stakeholders. The topics needed are hospital teams and parts of the body and illness. The different perception on the needs of topics between students and stakeholders due to the students focus on the topics they are interested in, while stakeholders have had experiences in the real work situation. The findings imply that the topics that categorized as a very needed and a needed category have been matched with the nursing students' needs and wants when learning English. The results of this study are the same as the research results of Chamnankit (2015), Gultom (2016), Pongsapan (2015 and Susandi and Krishnawati (2016) who found that the nursing students needs the topics that related to the nurses' real job activities such as in the hospitals or health clinics.
The findings of the analysis indicate that teaching English with the topics suitable with students' needs are important. It will help improve students' English skills significantly. Nurhamsih and Syahrial (2018) stated that materials are everything used to support the language learning. Thus, the topics provided in the questionnaire of this research can be used as materials of English learning to support the ESP course at the nursing department of the Dehasen University of Bengkulu.
The English lecturers design and develop the topics to be more authentic. It aims at making the learning process will be more beneficial and interesting for the learners since it directly applies their daily life (Agustina et al., 2018). Also, the goal of ESP course can be achieved maximally and the students will be motivated to learn better in ESP course so that they can learn English easily without having difficulty. As emphasized by Mitsalina (2015), some factors that influence the students' motivation toward teaching materials are enthusiasm for the topic, level of difficulty, importance to existing learning, and impression of helpfulness. Thus, providing appropriate and interesting materials for students and they have high motivation in learning English will get satisfying achievement on ESP course.

The Activities Needed by Nursing Students of The Dehasen University of Bengkulu in Learning English
The results of the analysis revealed that nursing students and stakeholders prefer to study English in a group (small group, large group, and pairs) and in discussions. This finding is line with the study of Pongasapan (2015) who reported that learning English in small group and pairs are more suitable for nursing students of STIKES Toraja, South Sulawesi. Also, this study reported that demonstration or debate, large group work, and discussion are difficult activities performed by the nursing students in learning English. Likewise, Saragih (2014) reported that the most needed activities performed by nursing students in learning ESP for Nursing are group work, pair work and whole class activities. These findings imply that group work activities are the most needed by nursing students.
Learning-based group (small group, large groups, pairs) promotes the students to learn collaboratively. In EFL classrooms, a workgroup is an effective method of teaching for adult students. It will make students to be more independent because they can teach their friends and also learn from their friends (Alfares, 2017)). Several researchers (Brown, 2001;Foster, 1998;Harmer, 1991) have claimed that group work is efficient in language classrooms because the students can have many opportunities to practice English with their group members. They will feel free to speak with their friends without feeling anxious. This activity, automatically, will improve the students' English skills.
The findings of this study have informed the needs of the nursing students in learning English. According to Hariyadi and Yanti (2019), there are three focuses of needs for students' needs in need analysis, namely, learning needs, and future professional needs. The personal needs related to students' age, sex, and cultural background interest. The learning needs related to education background learning styles previous language learning experiences, and the gaps between the target level and the present level of proficiency in various competence areas such as skills. The future professional needs related to learning goals and expectations for course requirements for the future undertakings in terms of knowledge of language and knowledge of language use L2 competencies. Thus, the results of the need analysis in this study have fulfilled and covered the students' needs in learning English in terms of personal needs, learning needs, and future professional needs.
The strengths of this study are; 1) it analyzed the existing materials used by the lecturers from two sources (e.g., English module and Semester Lesson Plan). 2) There are many sub-materials in each language skill and knowledge and the topics provided in the questionnaires so that the students and the stakeholders could have many options to respond which submaterials are relevant to the nursing students. 3) It investigated the purpose of the nursing students in learning English so that the results of the needed materials analysis have strong relationship with the results of the purpose of the nursing students in learning English.
The weaknesses of this study are; 1) the analysis of the learning situation is only limited to learning activities. 2) The purpose of the nursing students learning English are still limited to the students' response. 3) Some items did not include in the questionnaire such as individual work in the learning activities. 4) This study did not involve the ESP experts as the participants of this research. Also, the numbers of the alumni or ex-students who have worked as the nurses in the international hospital in Indonesia and outside of Indonesia are still limited. The strengths and the weakness of this research can be consideration for the further researcher to continue this research.

CONCLUSION
As presented in the results section, it can be concluded that; 1) the purpose of the nursing students learning English is to find a job. 2) they need to master all language skills and language in ESP course. The materials needed in each language skill and each language knowledge is the materials that related to the nursing activity. 3) the most needed learning activity for nursing students is in terms of workgroup.
The results of this research can be useful information for the English lecturers and head of the nursing department of the Dehasen University of Bengkulu. They can evaluate the existing English materials that have been used by them in the teaching English for the nursing students. The materials that they used are not relevant to the nursing students' needs and wants. They can use the materials that have been categorized as very needed category in the findings of this research. They should create the learning activities based on the findings of this study and they should create the suitable materials with the materials given. Also, the curriculum designers can design the English materials for the nursing students based on the findings of this research and create a new textbook for them. It aims to make the nursing students have better English skills and they can use them in their workplace in the future.