Lesson 1: Doctor’s Appointments and the Present Perfect Progressive

Lesson Duration: 60 minutes

Assumptions:
Students have learned the present simple, present perfect, and present progressive tenses. They
have also been taught health vocabulary, including symptoms, illnesses, and body parts. The
students have learned frequency words.

Anticipated Problems:
Problem #1: For the “Healthy Survey,” some of the questions may be inappropriate for the class.
Some of the habits and occurrences may be culturally inappropriate and insensitive to ask.

Solution #1: The teacher should carefully research the culture and backgrounds of their students.
They should adapt the “Health Survey” to be culturally sensitive and appropriate for their class.

Problem #2: Based on the exact level and background of the students, some of the vocabulary
may be more troublesome and problematic. Students may not be as familiar with some of the
symptom or frequency words.

Solution #2: The teacher may need to devote more time to pre-teaching vocabulary before the
listening. The teacher can show pictures of the symptom and illness words and inductively teach
them beforehand. They can also take time before or after the listening to explain and review
some frequency words. The “Match the Symptoms” worksheet should also help the teacher to
review the necessary vocabulary words.

Aims/Objectives:
By the end of the lesson, students will be able to (SWBAT):
 Describe on-going activities and symptoms using the present perfect progressive tense
 Recognize the present perfect progressive tense in writing and speech
 Speak about the frequency with which activities and symptoms occur
 Discuss the severity and causes of on-going activities and symptoms
 Formulate questions using the present perfect progressive tense

Materials:
 12 copies of the “Health Survey” worksheet
 Pencils or pens
 “Doctor’s Visit” Photograph
 Whiteboard or chalkboard
 Dry erase markers or chalk
 Audio recording of “Maria’s Doctor’s Appointment Transcript”
 12 copies of “Maria’s Symptoms”
 12 copies of “Match the Symptoms”
 12 copies of “Health and the Present Perfect Progressive”
 12 copies of “Doctor’s Visit Roleplay”

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  Loose-leaf paper

Warm-Up (5 minutes)
The teacher distributes a copy of the “Health Survey” worksheet to each student. The teacher
explains the directions by informing students that they should check the box that best describes
the frequency of each occurrence. Before the students begin, the teacher leads the students
through the first question. The teacher asks the class how often they go to the doctor. They call
on a few students before sharing their own answer and allowing the student to work. As students
work independently to complete the survey, the teacher silently observes and answers any
questions.

The teacher then asks students to discuss their answers with a partner. While students discuss,
the teacher monitors the class and answers questions.

Introduction (5 minutes)
The teacher directs the student’s attention back to the front of the classroom. They present the
“Doctor’s Visit” picture to the class and ask students to describe the picture with their partner.
On the board, the teacher can write the following questions to stimulate thinking.

Questions:
1. Who is in the picture?
2. Where are the people in the picture?
3. What is happening in the picture?

In pairs, the students should discuss the picture while the teacher observes. The teacher then calls
on a few pairs to share their answers to the question, particularly the last one. By the end of the
discussion, the teacher will want to have emphasized the fact that the patient seems to be
describing her symptoms or medical history to the doctor. The teacher should then tell the class
that the patient should use the present perfect progressive tense to describe her symptoms and
medical history. Today the class is going to be learning how to use this tense to describe their
own symptoms.

Presentation (15 minutes)

The teacher then tells students that they are going to be listening in on Maria’s doctor’s
appointment. As the recording of the “Maria’s Doctor’s Appointment Transcript” plays for the
first time, students should focus solely on listening to it. They should not worry about taking
notes.

After the recording plays once through, the teacher distributes a copy of the “Maria’s
Symptoms” worksheet to each student. Before beginning the listening a second time, the teacher
instructs students to read over the questions on the worksheet. Once everyone has read over the
questions and has an idea of what to listen for, the teacher should play the recording. As the
recording plays, the students can begin answering the questions. The teacher can then let the
students decide whether they need to hear the recording one more time or not. Regardless of
whether the recording is played a third time, the teacher should allow students two minute to
finish answering the questions after the listening has finished.

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The teacher then instructs students to discuss their answers with a partner. The students should
discuss their answers while the teacher walks around and observes. The students should ask each
other for the meanings of words before they consult the teacher.

Once the students have discussed the answers, the teacher should go through each question with
the students. The teacher calls on pairs of students and has them share their answers and the
reasons why they chose those answers. While answering the questions, the teacher can review
some of the vocabulary, like “cramps,” “severe,” and “sporadically.” The teacher asks students if
they can describe what these words mean before confirming their definitions and helping to clear
up any confusion over the answers to the questions.

The teacher should write the following three sentences from the recording on the board.
1. I have been throwing up since yesterday morning.
2. Have you been having headaches?
3. No, I haven’t been coughing either.
The teacher asks students if they notice any similarities between the three sentences. The teacher
is looking for the students to point out the use of the present perfect continuous. They would do
so by mentioning that each sentence has “has/have,” “been,” and the -ing form of a verb. As the
students point out these similarities, the teacher should underline these portions of the sentences.

The teacher tells students that this tense is called the present perfect continuous or the present
perfect progressive. The teacher writes these names on the board before writing the form for the
tense next to the name. The form should be written as follows.
Positive Form: has/have + been + -ing form of a verb
Negative Form: has/have + not + been + -ing form of a verb
The teacher should read these forms aloud as they write them.
Once the teacher writes the forms, they should ask students what the tense is used for. The
teacher can pick one of the example sentences and ask students what it means to say about
Maria’s symptoms. The teacher asks the following questions: When did the symptom begin?
How long has the symptom been happening? Is the symptom still happening? Once students
have more or less articulated the meaning and use of the present perfect continuous, the teacher
should reinforce that it is used to describe an action or activity that started in the past and has
continued through the present moment.

Practice #1 (4 minutes)
The teacher distributes a copy of the “Match the Symptoms” worksheet to each student.
Individually, the students should match the pictures with the appropriate sentences. As the
students are working, the teacher can observe and answer any questions. Once the students are
done, the teacher should ask for the class to call out the answers. The teacher can write the
answers on the board as follows.
1. B
2. F
3. C
4. A
5. D

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 6. E
Once the answers have been shared, the teacher can ask if there are any questions.

Practice #2 (6 minutes)
The teacher distributes a copy of the “Health and the Present Perfect Progressive” worksheet to
each student. Students should then get into groups of three to complete the worksheet. Before
beginning, the teacher can complete the first sentence as a class. The teacher should remind
students of the form of the present perfect progressive, which should still be written on the board.
The class should then complete the first sentence with the word “eating.” In their groups of three,
the students should complete the worksheet while the teacher observes and answers questions.
The teacher can also take notes on any mistakes and points of confusion that they overhear. Once
the students are done, the teacher can call on groups to come write their answers on the board.
Each group should write their answers to two of the sentences. They should write the full
sentence next to the appropriate number on the board. Once everyone has written their answers,
the teacher should review them as a class, ask if everyone agrees with each one, and clear up any
mistakes or points of confusion.

Production (20 minutes)

The teacher instructs students to find a partner to work with for the next activity. Once all of the
students have found a partner, the teacher distributes a copy of the “Doctor’s Visit Roleplay”
graphic organizer to each student. The teacher should describe an example before the students
begin. The teacher could write an example for the second chart on the board. It could resemble
the following chart.

Symptom Descriptors (Severity, Frequency, Cause, etc.)

Dizziness I have been feeling dizzy since last night.
The dizziness worsens when I stand up.

The teacher should explain the example chart to help clarify the graphic organizer. The students
should use the present perfect progressive during their presentation when they ask about and
describe the symptoms. When they complete the graphic organizer, they do not have to write in
complete sentences to describe the symptoms, but they can choose to do so if it will help. At the
bottom of the worksheet, the students should also write the diagnosis that the doctor will give the
patient at the end of the conversation. The students should not use the graphic organizer to write
a complete transcript of their roleplay conversation.

Once the teacher has finished explaining the graphic organizer, they should allow the students at
least 5 minutes to complete it with their partners. As the students work, the teacher should walk
around and observe. They should also answer student questions.

After students have completed the graphic organizer, the teacher calls on pairs to present their
roleplay doctor’s appointments. As the pairs present their roleplay conversations, the other
students should take brief notes on a spare sheet of paper. They should listen for the symptoms
and diagnosis that each pair mentions. As each pair presents, the teacher should take notes on

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any mistakes and points of confusion that they notice. The teacher also notes some questions that
they can ask the class about the symptoms and diagnoses that each pair presents.

Review (3 minutes)
Once all of the pairs have presented, the teacher should ask the class some questions about the
presentations. These questions should address the symptoms and diagnoses and be phrased using
the present perfect progressive. When students answer, the teacher should ensure that they use
the present perfect continuous.

Homework (2 minutes)
The teacher writes the following directions on the board before explaining them aloud.

Homework: Write three sentences about activities that you have been routinely doing this week.

Once the homework is written and briefly explained, the teacher can give an example. One
example sentence would be, “I have been reading every day this week.”

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