This document discusses obstacles in learning to speak English, specifically for nursing students in Manggarai, Indonesia. It outlines several key factors that affect learners' ability to communicate orally in English as a foreign language. Age/maturational constraints, sociocultural factors, and affective factors like anxiety and motivation can all influence how well students develop their speaking skills. The document also reviews different theories of language learning and strategies students can use, like cognitive, metacognitive and affective strategies, to help facilitate their learning process. However, developing oral proficiency remains a challenge for foreign language learners.