Personalization as a way of stimulation to developing speaking skills Content: Introduction Chapter I: Teaching English Speaking as a Foreign Language

2.1 Materials and Methods

In order to be eligible for participation in the present study, tinnitus patients had to be between 18 and 75 years old, exhibit a tinnitus duration of more than 6 months (chronic tinnitus), and needed to be fluent in German. Further prerequisites were no presence of any serious somatic, neurological, or psychiatric condition (e.g., major depression, substance abuse, or encephalitis) as well as, if applicable, a stable medication with psychoactive drugs. Additional inclusion criteria were no present contraindications regarding TMS (e.g., known epilepsy or past epileptic seizures) and magnetic resonance imaging (MRI) (e.g., claustrophobia or metallic/electrical body implants). Parallel participation in any other tinnitus-related study or treatment was defined as an exclusion criterion.
Participants were fully informed about the objective, proceedings, and methods as well as the potential side effects of study participation and gave written informed consent prior to study onset. An applicable sample of 22 tinnitus patients (5 female) was recruited at the Interdisciplinary Tinnitus Centre Regensburg, Germany, from which N = 20 (5 female) fully participated in the present treatment study. Causes for the two dropouts during the treatment phase were tinnitus loudness increase and non-appearance at the stipulated study appointments. For analyses of test-session responses, these two treatment dropouts were not excluded.
RTMS sessions were executed with an e-field guided TMS machine (NBT System 2; Nexstim Plc. Helsinki, Finland) in combination with co-registered anatomical T1 brain scans allowing for visualization of strength (V/m) and direction of the induced e-field on individual 3D head models. Any stimulation was conducted with the induced e-field oriented perpendicular to the sulcus of the target brain area/gyrus of interest. Moreover, a system-integrated aiming tool allowed for a repetition of the stimulation/coil position for each applied pulse in terms of centering, rotation, and tilting. To avoid hearing damage caused by the loud TMS click noise, each patient was wearing in-ear plugs. Test sessions as well as resting motor threshold (RMT) determination followed the exact same methodological procedure as already outlined in Schoisswohl et al. [30].
Before the start of the first test session, patients’ RMT was determined for the purpose of stimulation intensity specification of test sessions and treatment sessions. Single pulses were administered at different locations over the left primary motor cortex up to the visibility of several motor evoked potentials (MEP) with a peak-to-peak amplitude of >50 µV recorded from three muscles of the right hand (musculus abductor pollicis brevis, musculus of the first dorsal interosseus, musculus abductor digiti minimi). The stimulation position which elicited the highest MEP amplitude was repeated via the system-integrated aiming tool. Next, patients’ RMT was defined by the maximum likelihood threshold hunting algorithm [32] implemented in the used TMS system.
Throughout the test sessions, 200 pulses of 1 Hz, 10 Hz, and 20 Hz rTMS served as verum magnetic stimulations, whereas 20 pulses at 0.1 Hz were deployed as a sham stimulation since this type of protocol is supposed to not provoke neuroplasticity [33,34]. All magnetic stimulation protocols were applied in a randomized order at 110% RMT over the left and right TPJ using an uncooled figure-of-eight coil (no cooling noise). In total, eight different rTMS protocols were applied per test session. Electrode positions CP5 and CP6 (10–20 system) served as a point of reference for TPJ stimulation and were marked on the structural scans via a digitization pen. Additionally, a single pulse at 10% RMT was given in order to ensure an exact replication of the coil position via the aiming tool whilst each test or treatment session.
Over the course of the subsequent treatment period, patients received 10 rTMS sessions á 2000 pulses, either with their personalized protocol or the most common clinically used rTMS protocol for tinnitus—namely left hemispheric 1 Hz (standard treatment). All treatment stimulations were conducted with an air-cooled coil at 110% RMT.

2.4. Questionnaires and Outcome Measures

Demographic and clinical characteristics were assessed via the European School of Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ, [35]) and the Tinnitus Sample Case History Questionnaire (TSCHQ, [36]) during screening visits.
The Tinnitus Functional Index (TFI, [37]) was defined as the primary outcome for the trial (see also ClinicalTrials.gov; NCT03957122) and had to be filled out at screening, baseline, treatment end, and follow-up visits together with the following further questionnaires: the Tinnitus Handicap Inventory (THI, [38,39]), the Mini Tinnitus Questionnaire (Mini-TQ, [40]), the Major Depression Inventory (MDI, [41]), the World Health Organization—Quality of Life instrument (WHOQOL-BREF) covering the four domains physical health, psychological, social relationships, and environment [42]. Beyond that, participants had to rate the loudness of their tinnitus (0—not at all loud; 10—extremely loud), the tinnitus-induced discomfort (0—no discomfort; 10—severe discomfort), annoyance (0—not at all annoying; 10—extremely annoying), unpleasantness (0—not at all unpleasant; 10—extremely unpleasant) as well as the possibility to ignore their tinnitus (0—very easy to ignore; 10—impossible to ignore) on Visual Analog Scales (VAS). At the end of the treatment and follow-up phase, patients had to evaluate their tinnitus complaints via the Clinical Global Impression Scale for Improvement (CGI-I, [43]) compared to before treatment on a 7-point Likert Scale (1 = very much better; 2 = much better; 3 = minimally better; 4 = no change; 5 = minimally worse; 6 = much worse, and 7 = very much worse).
This section explores various interactive techniques employed by teachers to facilitate speaking practice. It examines strategies such as role-plays, debates, discussions, and question-answer sessions, highlighting their effectiveness in promoting fluency, accuracy, and confidence in speaking.
The rapid development of modern society compels a student to learn and understand the material quickly, especially a foreign language. Nowadays, mastering at least one foreign language is becoming integral requirement for the professional competence of a specialist. Therefore, it is necessary to pay attention to the efficiency and quality of the process of learning foreign languages. The most effective methods of learning languages are interactive methods. The aim of the article is to define the main role of interactive methods of teaching English. To achieve the given aim, the following tasks were specified: to describe the main interactive methods and to give some examples of using these techniques. The term "interactive" means that people work together and have an influence on each other. This situation implies a dialogue or a conversation. Therefore, these methods are aimed at the interaction between students and the teacher as well as among students only. It requires an active role of students in the learning process.⁹
The purpose of the interactive learning is to create some special conditions leading to the involvement of all the students into the learning process in which the participants can understand and realize everything that happens, influence each other and make their own contribution having established the friendly and mutually supportive relationship. The most popular methods are role plays, brainstorming, case-study method, presentations and discussions. They develop communicative skills, logical thinking and different types of intellectual activity such as analysis, synthesis, comparison, and generalization. These student-centred methods are highly appropriate, particularly for involving students more actively in acquiring knowledge, skills and strategies. It is commonly known that role plays make the learning process at the university more educational and proficient, improve interdisciplinary relationships, connect the theory with real needs of the professional field, and develop skills that are necessary for the future specialists. The key element is the role playing that gives opportunity to form skills that are difficult to acquire under ordinary learning conditions.
There are two ways a role play can go: scripted and non-scripted. With a scripted role play, the teacher might use an example in a text book. This is a good idea for a warm up exercise, by getting everyone to split up into pairs and allowing them to speak to their partner, taking on different roles. Non-scripted ones are such role plays when students are given some roles and must use whatever knowledge they have in order to speak with partners. There are a couple of ideas for a general English class. This can be adapted to suit a situation. - Telephone Conversation Speaking on the phone is different to a face-to-face conversation because one relies solely on the language to communicate. Get the students who are practicing to sit back to back in order to work properly. There is a whole range of ideas which one can use to act this out. Examples include: phoning to make a complaint, speaking to a friend or inquiring about a job position. - Going to the Shop It is effective for younger learners as it will teach them the basics of interacting with people. Children generally rely on their parents to buy things for them, therefore this will boost their overall general confidence in buying. It can be as simple or as complex as one wishes, depending on the situation. Key phrases are often important here, such as "I would like…" "How much are…" "Good morning…" and so forth.
Another interesting interactive method that allows to form significant qualities and to develop thinking is brainstorming. Brainstorming represents joint search of the ideas necessary for the solution of any problem. The main advantages of this method (under the condition of its correct application) are that students seem to be "liberated" – the language barrier disappears, there is no fear to say something wrong, the restraint goes away, etc. The method of brainstorming develops creative and associative thinking, initiative, the ability to produce a maximum of ideas in a tight time, the ability to express personal opinion. There are some ideas of brainstorming activities: - Multi-purpose Items First, the teacher gives the class any object. Next, give the students a couple of minutes to think of all of the different uses for that item. In about five or six minutes, the teacher asks students to share what they have come up with. For example, you can use forks to eat food, comb your hair, open cans, mix ingredients, and clean pans. Not so bad for a simple fork. Using the "Multi-purpose Items" encourages creativity and it’s fun to hear what the students come up with. - Talking Timebomb First, the teacher comes up with a topic or idea.
Next, the teacher starts the music, and students have to think of as many words as they can for that topic. Someone starts with a ball. When he /she comes up with a word, he /she passes the ball to another student. This process continues but students can’t repeat something that has already been said. When the music stops, whoever is holding the ball loses. And the punishment can be anything. For example, they must speak for one minute about a topic the teacher gives them. An equally interesting interactive method that the teacher can use is the casestudy method. It is a learning technique in which the student is faced a particular problem, the case. The case study facilitates the exploration of a real issue within a defined context, using a variety of data sources. Performing case study gives students the following benefits, it: 1) allows students to learn by doing. Case study permits students to step into the shoes of decision-makers in real organizations, and deal with the issues managers face, with no risk to themselves or the organization involved; 2) improves the students ability to ask the right questions in a given problem situation; 3) exposes students to a wide range of industries, organizations, functions and responsibility levels.
This provides students the flexibility and confidence to deal with a variety of tasks and responsibilities in their careers. It also helps students to make more informed decisions about their career choices; 4) strengthens the student’s grasp of management theory, by providing real-life examples of the underlying theoretical concepts. By providing rich, interesting information about real business situations they breathe life into conceptual discussions; 5) reflects the reality of managerial decision-making in the real world. Here students must make decisions based on insufficient information. Cases reflect the ambiguity and complexity that accompany most management issues; 6) helps to understand and deal with different viewpoints and perspectives of the other members in their team. Unquestionably, this serves to improve students communication and interpersonal skills; 7) provides an integrated view of management. Managerial decision-making involves integration of theories and concepts learnt in different functional areas such as marketing and finance. The case method exposes students to this reality of management. Topic areas that teachers of general English courses may consider include the following:
• planning a weekend in a specific town, reconciling the various interests of group members;
• choosing a restaurant suitable for people with different dietary requirements;
• planning a vacation on a budget for a group or family at a specific destination;
• advising somebody how to reduce plastic waste in daily life;
• advising somebody how to lead a healthier lifestyle;
• planning an intercultural party;
• evaluating a brochure;
• evaluating apartment rental offers. Conclusions: So, after representing the given methods, we can conclude that interactive teaching methods contribute to optimizing the learning process in studying English. They intend to put mechanisms for motivation in place and increase the efficiency of teaching English language communication. The advantages of using interactive methods in the process of students learning include the maximum approximation to the real conditions of professional activity, the broad autonomy of students, decision making in conditions of creative competition and the development of skills for spontaneous speech, promoting the development of organizational skills of students, overcoming the barrier between the study of language and its practical application