The influence of language family on academic performance in Year 1 and 2 MBBS students

High- and low-achieving international medical students' perceptions of the factors influencing their academic performance at Chinese universities

China has become an attractive destination for international medical students, particularly those from developing countries in Asia and Africa. These students are known to face difficulties in adapting to Chinese medical universities and they tend to score poorly on subsequent examinations to enter the medical profession in their home or in a third country. To date, limited research concerning the factors that affect the academic performance of this group of students in China has been conducted. In particular, there have been very few comparisons between high and low achievers to identify the factors that high- and low-achieving international medical students in all years of study perceive as affecting their academic performance. A qualitative research approach was implemented at two medical universities. Semi-structured interviews were conducted with 18 high achievers and 22 low achievers in their second, third, fourth, fifth, sixth, and post-graduation years. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.A few key overlapping factors were identified: social support, learning motivation and interest, exam preparation and strategies, time management, and coping. The high achievers manipulated these strategies successfully while the low achievers did not. The high achievers demonstrated efficient learning methods (efficient use of class time, good note-taking habits, preview and review strategies, expanded learning, self-study and group learning, deep learning, choosing an appropriate study location, and focusing on basics and concepts). They also achieved a good balance between studying and leisure. The low achievers mentioned learning challenges, health issues, English language barriers, and problems with online classes. This study allowed us to identify important factors that international medical students at Chinese institutions perceive to influence their performance. The findings contribute to the literature on the topic and provide a solid basis for practice and policy development.

Clinical skills examination as part of the Swedish proficiency test of dentists educated outside of the EU/EEA

INTRODUCTION

The increase in the migration of dentists educated outside the EU/EEA calls for the sharing of information and evaluation of recognition processes within countries in the EU. In 2017, the Swedish National Board of Health and Welfare implemented the Proficiency test, a recognition process for dentists who have completed an education programme outside the EU/EEA. The Proficiency test consists of a theoretical and an integrated clinical skills examination, followed by a 6-month clinical practice. The clinical skills examination is a two-part examination that includes an OSCE and an operative test on a dental manikin. This paper presents data from proficiency tests between 2018 and 2022, and explores factors related to grade fail, that is, demographics, theoretical exam scores and language comprehension.

MATERIALS AND METHODS

In a cohort study, demographics and factors associated with grade fail were explored using test results from theoretical and clinical skills examinations (n = 181) from 2018 to 2022. Pearson correlation coefficient and linear regression analysis were used for studying correlations and associations between exam results. Univariable linear and logistic regression models were used for background variable associations with clinical skills exam outcomes.

RESULTS

Higher age was a significant risk factor for failing the clinical skills examination and the OSCE. Higher scores in the theoretical exam reduced the odds of failing the OSCE but were not associated with results in the operative test or the overall results of the clinical skills examination. Regarding the OSCE there was a statistically significant difference within all professional qualifications explored between participants who passed and participants who failed the OSCE.

CONCLUSIONS

Four years of data collection reveal that age and previous theoretical exam results influence the odds of failing the clinical examination. The study results also highlight the necessity of multiple assessment formats to assess clinical and communication skills of foreign-trained dentists.

The influence of occupational therapy students' preferred language on academic and clinical performance in a Canadian university program

The Occupational Therapy Program at this Canadian university is a French program however, students must be bilingual to function in English or French clinical fieldwork settings. An understanding of the role of language in successful completion of program requirements was needed to effectively support students' education. The study objectives were to identify the role of linguistic factors in students' academic and clinical performance and to provide recommendations for strategies to address areas of learning difficulty. A multimethod approach used 4 data sources: (1) Multiple Mini Interview (MMI) informal language assessment scores, (2) grade point average (GPA), (3) fieldwork evaluation reports, and (4) an online survey of program graduates. The GPA on admission and MMI scores of 140 students predicted respectively only 20% and 2% of the variation in GPA on program completion. The areas of poorest performance in failed clinical fieldwork reports were in clinical reasoning and communication competencies. Among survey respondents (n = 47), 44.5% reported that a clinical placement in their second language with related charting (51.6%) and client communication (40.9%) were the most significant difficulties encountered in the program. Clients with mental health issues (45.4%) were the most challenging population to work with, attributed to communication barriers in the students' second language. Strategies are proposed to support occupational therapy students' academic and clinical language proficiency, including conversational training courses, problem-based learning activities in students' second language, focussed teaching on the clinical reasoning process and reflective skills, and language coaching to address early signs of difficulty in clinical fieldwork.

Language of Medical Instruction in Palestine: A Mixed Method Approach of Students’ Perceptions

This mixed method study explores medical students' perceptions and attitudes regarding the language(s) of medical instruction in two Palestinian universities. The researcher aimed to identify the way medical students look at the language of medical education as well as the merits and drawbacks of the language(s) used in medical instruction. A 25-item descriptive, online questionnaire was built to explore the way university students evaluate and perceive the medium of medical instruction at the Faculty of Medicine. To complement and inform the quantitative findings, fifty-five students from each university were randomly selected, and their responses to an open question about the merits and drawbacks of the language(s) were analyzed using MAXQDA. Of the too many medical students enrolled in the two universities, 604 completed and returned the survey, and 55 students were selected to interpret their open responses qualitatively. The study findings suggest that the students are divided into two camps concerning what the language of medical instruction should be; some prefer Arabic, their mother tongue, while the others showed no reservations about using the medical academic vocabulary in English. Some statistically significant differences were found when some demographic variables, i.e., gender, specific major, and year of study, interact. Finally, study respondents highlighted several issues which the researcher sorted into advantages and disadvantages for each language. There is a considerable discrepancy in the choice of the language of medical instruction at the Faculty of Medicine. Each language has its pros and cons; consequently, a mixture of a mother and a foreign language (e.g., English) could be a suitable compromise in a country like Palestine.

A randomised controlled pilot trial of the influence of non-native English accents on examiners' scores in OSCEs

BACKGROUND

Objective structured clinical examinations (OSCEs) are important aspects of assessment in medical education. There is anecdotal evidence suggesting that students with non-native English accents (NNEA) may be subjected to unconscious bias. It is imperative to minimise the examiners' bias so that the difference in the scores reflects students' clinical competence. Research shows NNEAs can cause stereotyping, often leading to the speaker being negatively judged. However, no medical education study has looked at the influence of NNEAs in assessment.

METHODS

This is a randomized, single-blinded controlled trial. Four videos of one mock OSCE station were produced. A professional actor played a medical student. Two near identical scripts were prepared. Two videos showed the actor speaking with an Indian accent and two videos showed the actor speaking without the accent in either script. Forty-two OSCE examiners in the United Kingdom (UK) were recruited and randomly assigned to two groups. They watched two videos online, each with either script, each with a different script. One video with a NNEA and one video was without. Checklist item scores were analysed with descriptive statistics and non-parametric independent samples median test. Global scores were analysed with descriptive statistics and Mann-Whitney test.

RESULTS

Thirty-two examiners completed the study. The average scores for the checklist items (41.6 points) did not change when the accent variable was changed. Independent samples median test showed no statistically significant relationship between the accent and the scores (p = 0.787). For the global scores received by the videos with the NNEA, there were one less 'Good' grade and one more 'Fail' grade compared to those without the NNEA. Mann-Whitney test on global score showed lower scores for videos with NNEA (p = 0.661).

CONCLUSIONS

Examiners were not biased either positively or negatively towards NNEAs when providing checklist or global scores. Further study is required to validate the findings of this study. More discussion is warranted to consider how the accent should be considered in current medical education assessment.

REGISTRATION

Trial registration completed trial, ID: ISRCTN17360102, Retrospectively registered on 15/04/2020.

An Ensemble Prediction Model for Potential Student Recommendation Using Machine Learning

Student performance prediction has become a hot research topic. Most of the existing prediction models are built by a machine learning method. They are interested in prediction accuracy but pay less attention to interpretability. We propose a stacking ensemble model to predict and analyze student performance in academic competition. In this model, student performance is classified into two symmetrical categorical classes. To improve accuracy, three machine learning algorithms, including support vector machine (SVM), random forest, and AdaBoost are established in the first level and then integrated by logistic regression via stacking. A feature importance analysis was applied to identify important variables. The experimental data were collected from four academic years in Hankou University. According to comparative studies on five evaluation metrics (precision, recall, F1, error, and area   under   the   receiver   operating   characteristic   curve ( AUC ) in this analysis, the proposed model generally performs better than compared models. The important variables identified from the analysis are interpretable, they can be used as guidance to select potential students.

Current status of international medical education in China: A cross-sectional study

Objective: This study aims to understand the current learning state, curriculum evaluation, and career planning of international Bachelor of Medicine, Bachelor of Surgery (MBBS) students in China in order to support educators and policy makers in developing interventions to support international MBBS students.

Methods: A cross-sectional survey was conducted at Fudan University from March 2017 to May 2018. A self-administered questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from international MBBS students ([Formula: see text]) and native Chinese medical students ([Formula: see text]) currently at the school as well as teachers directly involved in teaching activities with these students ([Formula: see text]). Data were analyzed using GraphPad Prism 6, and all results are presented as frequencies (percentages).

Results: Most of the international MBBS students had never studied at a university before (76%). The first and second most common reasons for choosing the MBBS program were an interest in medical science (79%) and relieving patients’ sufferings and realizing self-value (61%). The learning motivation of international MBBS students came mainly from the interests in medicine (90%). A total of 74% of international MBBS students considered the course setting to be appropriate or neutral. The top biggest problem in clinical practice reported by international MBBS students was communication barriers caused by the lack of language proficiency. The first choice of future work after graduation for international MBBS students was studying or working abroad. The top two recommendations among teachers for improving academic achievement were providing textbooks in students’ native languages (64%) and reading more medical books (47%).

Conclusions: International MBBS students generally thought that the course setting was rational, and were mostly satisfied with the international MBBS program. The use of textbooks in the international MBBS students’ native languages was reported to be helpful for improving these students’ academic achievements.

Dental education in the Arabic language vs English language: A survey among Arab dentists

Objective:

The aim of this study was to explore the language difficulties encountered by Arabic dental students and dentists in some aspects of their dental education and to determine their attitude towards the Arabization of the medical curriculum.

Materials and Methods:

A web-based self-administered questionnaire with 14 multiple-choice questions was designed and distributed online via google forms in the Arabic language. The online link was sent randomly to Arabic dental students, dental academic staff, and dental practitioners. The survey questions explored language problems during reading, attending lectures and scientific conferences, preparing scientific researches, taking deferent exams, and the attitudes towards Arabization. Descriptive statistics and Chi-square tests were used to analyze the responses to the questions.

Results:

There were 378 respondents for this study. Nevertheless, paying high attention to the importance of English language as the global language of communication, (70.6%) of the respondents believed that studying in Arabic is a basic requirement for the Arabs. Near percentage agreed that mastering their mother tongue is much easier than to acquire another language, which further facilitates studying and improves understanding. More than (65%) of the subjects preferred a mixture of both languages for attending lectures, conferences, and exams. But (68.3%) said that they use English when they search for any subject related to dentistry.

Conclusion:

There has been a consensus on the need for receiving knowledge in the Arabic language, and the importance of studying the mother tongue for enhancing understanding and memorization. The results demonstrated that the idea of teaching some dental courses in Arabic is not impossible and it might be the key to improve dental study for the Arabs. Consequently, a majority stated that there were obstacles in teaching dentistry in fully Arabic language due to the dominance of English language internationally and the weak possibilities of Arabization and translation in the Arab world.

Same same but different - A qualitative study on the development and maintenance of personal networks among German and international medical students

Introduction: In addition to linguistic and cultural difficulties, problems with social integration are frequently found among international medical students. In contrast, the social interaction among German medical students is considered as non-problematic. Personal networks are considered as positively influencing factors for the learning environment of students as well as their academic performance and personal wellbeing. However, while general findings on the development and maintenance of personal networks among medical students are available, there is insufficient data on students with different nationality or cultural backgrounds. Therefore, we compared the perception of international and German medical students on the development and maintenance of personal networks and examined possible influencing factors. Methodology: Following the principles of theoretical sampling in qualitative research, we recruited 17 international and 10 German preclinical medical students. The survey was conducted with semi-structured interviews, which focused on the participants' experiences with the development and maintenance of personal networks in medical school. The coding and analysis of the interview transcripts was based on the principles of grounded theory. Results: We show that German participants rated the network development in medical school much more positively than the international participants. This difference was influenced by: a different perception of affiliation to the group of medical students, a low academic benefit from contacts with international students, the socio-cultural framework of medical school as well as the individual strategies of international medical students in dealing with integration. Conclusion: Our study extends existing insights into the development and maintenance of the social environment in medical school by understanding the perception of a subgroup of medical students. A better understanding of these social processes enables an effective evaluation of support and teaching for the subgroup of international medical students in Germany.

Welcome, Orientation, Language Training: a project at the Charité for new international medical students

Objective: A comprehensive, integrated support programme for new international students of medicine has been developed, implemented and evaluated at the Charité. The objectives of the programme were improved social integration, orientation on the study program and Charité campus, as well as qualification in medical specialist language. Project outline: The "Charité Orientation Module for International Students" (ChOIS) was designed by a working group with a variety of expertise in the field of international students. The programme has three stages: Recruitment (specific invitation on matriculation); Orientation week before semester start; and Parallel events during the first semester. ChoOIS was piloted in the Winter Semester 2015/16 and, following evaluation, continued in a modified form in the Summer Semester 2016. Key features were: Welcome and social integration by faculty welcome-events and student group activities; Orientation on the study program, on teaching infrastructures at the Charité and on student life in Berlin by senior medical students; and Training in language for medical communication and bedside teaching by professional lecturers. Results: Results of evaluations conducted after the orientation weeks, at the end of the semester and retrospectively in the 3rd semester produced high approval ratings of the individual features of the ChOIS-programme and of the programme as a whole by participating students. Discussion: A comprehensive, integrated support programme for new international students of medicine has been developed and implemented. The ChOIS-programme can serve as a practice model to guide other medical faculties. In future, a programme that goes beyond the start of the course and includes more involvement by senior students would be desirable.

Reducing Stress and Promoting Social Integration of International Medical Students through a Tandem Program: Results of a Prospective-Program Evaluation

Medical students, and especially international medical students (IMS), have been shown to experience more psychological distress than the general student population in Germany. In order to address these issues, a structured Tandem Program (TP) to reduce stress and foster social integration of IMS has been introduced at the Medical Faculty of Tuebingen. The Tandem Program was evaluated prospectively with perceived stress (PSQ-20) as the main outcome. Secondary outcomes were ‘motives to participate’ in the TP, ‘specific stressors’, and ‘experiences made’ during the program. Stress levels of IMS at the beginning of the program (t₀) (M = 48.14, SD = 11.95) were higher than those of German participants (M = 39.33, SD = 8.31) (t (67) = −3.66, p < 0.001). At the end of the TP (t₁), stress levels of international students were significantly lower than at t₀. “Improved ability to work in a team” was seen as one of the most beneficial factors. The results indicate that tandem programs at medical faculties may be a promising curricular intervention towards reducing stress levels, improving integration of international students, and to enhance intercultural and team-oriented competencies in both international and national medical students.

Performance of International Medical Students In psychosocial medicine

BACKGROUND

Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students.

METHODS

All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making.

RESULTS

International medical students scored significantly poorer than their local peers (p < .001; η² = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η² = .053). No differences emerged within the multiple-choice examination (p = .127).

CONCLUSION

International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

Investigating the Performance of Second Language Medical Students on Lengthy Clinical Vignettes

This study evaluated the extent to which medical students with limited English-language experience are differentially impacted by the additional reading load of test items consisting of long clinical vignettes. Participants included 25,012 examinees who completed Step 2 of the U.S. Medical Licensing Examination®. Test items were categorized into five levels based on the number of words per item, and examinee scores at each level were evaluated as a function of English-language experience (English as a second language [ESL] status and scores on a test of English-speaking proficiency). The longest items were more difficult than the shortest items across all examinee groups, and examinees with more English-language experience scored higher than those with less experience across all five levels of word count. The effect of primary interest-the interaction of word count with English-language experience-was statistically significant, indicating that score declines for longer items were larger for examinees with less English-language experience; however, the magnitude of this interaction effect was barely detectable (η² = .0004, p < .001). Additional analyses supported the conclusion that the differential effect for examinees with less English-language experience was small but worthy of continued monitoring.

International medical students' expectations and worries at the beginning of their medical education: a qualitative focus group study

BACKGROUND

The number of international students has increased substantially within the last decade. Due to cultural barriers, this specific group faces diverse challenges. In comparison to German colleagues, international medical students perform significantly lower in clinical examinations and exceed the average duration of study; they suffer from personal distress as well as insufficient support. Within the present study, their individual perspectives, expectations, hopes and fears were examined.

METHODS

Four focus groups with first-year international medical students (N = 16) were conducted in October 2013. Each 60- to 90-min discussion was audiotaped, transcribed and analysed using qualitative methods.

RESULTS

International medical students go abroad in search of good study-conditions. For the choice of place of study, affordability, social ties as well as an educational system following the achievement principle are decisive factors. While contact with German-students and other international students is seen as beneficial, international medical students are most concerned to encounter problems and social exclusion due to language deficits and intercultural differences.

CONCLUSIONS

Facilitating the access to university places, the provision of financial aid and, moreover, social support, nurturing cultural integration, would greatly benefit international medical students. Hereby, the establishment of specific medical language courses as well as programs fostering intercultural-relations could prove to be valuable.

Performance of a core of transversal skills: self-perceptions of undergraduate medical students

BACKGROUND

There is an increasingly growing trend towards integrating scientific research training into undergraduate medical education. Communication, research and organisational/learning skills are core competences acquired by scientific research activity. The aim of this study was to assess the perceived performance of a core of transversal skills, related with scientific research, by Portuguese medical students.

METHODS

A cross-sectional study was conducted in 611 Portuguese students attending the first, fourth and sixth years of the medical course, during the same academic year. A validated questionnaire was applied for this purpose.

RESULTS

Medical students felt confident regarding the majority of the analyzed transversal skills, particularly regarding team work capacity (72.7% perceived their own capacity as good). On the other hand, the perceived ability to manage information technology, time and to search literature was classified only as sufficient by many of them. The progression over the medical course and participation in research activities were associated with an increasing odds of a good perceived performance of skills such as writing skills (research activity: OR = 2.00; 95% CI: 1.34-2.97) and English proficiency (research activity: OR = 1.59; 95% CI: 1.06-2.38/final year medical students: OR = 3.63; 95% CI: 2.42-5.45).

CONCLUSIONS

In this line, the early exposure to research activities along undergraduate medical education is an added value for students and the implementation of an integrated research program on medical curriculum should be considered.

Voluntary peer-led exam preparation course for international first year students: Tutees' perceptions

BACKGROUND

While the number of international students has increased over the last decade, such students face diverse challenges due to language and cultural barriers. International medical students suffer from personal distress and a lack of support. Their performance is significantly lower than non-international peers in clinical examinations. We investigated whether international students benefit from a peer-led exam preparation course.

METHODS

An exam preparation course was designed, and relevant learning objectives were defined. Two evaluations were undertaken: Using a qualitative approach, tutees (N = 10) were asked for their thoughts and comments in a semi-structured interview at the end of the semester. From a quantitative perspective, all participants (N = 22) were asked to complete questionnaires at the end of each course session.

RESULTS

International students reported a range of significant benefits from the course as they prepared for upcoming exams. They benefited from technical and didactic, as well as social learning experiences. They also considered aspects of the tutorial's framework helpful.

CONCLUSION

Social and cognitive congruence seem to be the key factors to success within international medical students' education. If tutors have a migration background, they can operate as authentic role models. Furthermore, because they are still students themselves, they can offer support using relevant and understandable language.

The effect of English proficiency and ethnicity on academic performance and progress

Non-local ethnicity or nationality and lower English proficiency have been linked with poor performance in health professional education. This study sought to compare the relative contributions of ethnicity and English proficiency, and to do so in a context where students had not been selected via interviews or some other proxy for language proficiency. Ethnicity, citizenship, and demographic data, as well as academic performance and progress were obtained for three successive cohorts (entering in 2007, 2008 and 2009) into a three-year pharmacy programme, following a common first-year. Complete data was available for all 297 students entering via this path. By the end of the programme, controlling for grades at entry, students from some non-local ethnic backgrounds (p < .001) underperformed local students, as did males (p < .001) and those who had been identified as having low English proficiency in year 1 (p < .01). Males (p < .01) and one non-local ethnic group (p < .01) were also more likely to have to repeat a year of study. Ethnicity was a stronger predictor than English proficiency or acculturation, but English proficiency was still independently and additively predictive. This suggests that targeted support strategies for students with lower English language proficiency are still important, but that cultural differences should not be underestimated.

International medical students--a survey of perceived challenges and established support services at medical faculties

INTRODUCTION

Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties' perceived problems nor of the offered support exists.

METHOD

All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis.

RESULTS

Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology.

DISCUSSION

Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.

Examination performances of German and international medical students in the preclinical studying-term--a descriptive study

INTRODUCTION

Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries.

METHOD

A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137).

RESULTS

German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all p<.05). The performance of students with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (p<.05). Furthermore, German students completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (<.01).

DISCUSSION

Due to its poorer performance in written and oral examinations and its simultaneously longer duration of study, the group of non-German medical students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations.

Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students

Working memory (WM) is often poorer for a second language (L2). In low noise conditions, people listening to a language other than their first language (L1) may have similar auditory perception skills for that L2 as native listeners, but do worse in high noise conditions, and this has been attributed to the poorer WM for L2. Given that WM is critical for academic success in children and young adults, these speech in noise effects have implications for academic performance where the language of instruction is L2 for a student. We used a well-established Speech-in-Noise task as a verbal WM (vWM) test, and developed a model correlating vWM and measures of English proficiency and/or usage to scholastic outcomes in a multi-faceted assessment medical education program. Significant differences in Speech-Noise Ratio (SNR₅₀) values were observed between medical undergraduates who had learned English before or after five years of age, with the latter group doing worse in the ability to extract whole connected speech in the presence of background multi-talker babble (Student-t tests, p < 0.001). Significant negative correlations were observed between the SNR₅₀ and seven of the nine variables of English usage, learning styles, stress, and musical abilities in a questionnaire administered to the students previously. The remaining two variables, Perceived Stress Scale (PSS) and the Age of Acquisition of English (AoAoE) were significantly positively correlated with the SNR₅₀, showing that those with a poorer capacity to discriminate simple English sentences from noise had learnt English later in life and had higher levels of stress – all characteristics of the international students. Local students exhibited significantly lower SNR₅₀ scores and were significantly younger when they first learnt English. No significant correlation was detected between the SNR₅₀ and the students’ Visual/Verbal Learning Style (r = −0.023). Standard multiple regression was carried out to assess the relationship between language proficiency and verbal working memory (SNR₅₀) using 5 variables of L2 proficiency, with the results showing that the variance in SNR₅₀ was significantly predicted by this model (r² = 0.335). Hierarchical multiple regression was then used to test the ability of three independent variable measures (SNR₅₀, age of acquisition of English and English proficiency) to predict academic performance as the dependent variable in a factor analysis model which predicted significant performance differences in an assessment requiring communications skills (p = 0.008), but not on a companion assessment requiring knowledge of procedural skills, or other assessments requiring factual knowledge. Thus, impaired vWM for an L2 appears to affect specific communications-based assessments in university medical students.

Demographic attributes and knowledge acquisition among graduate-entry medical students

BACKGROUND

Recent changes to undergraduate (basic) medical education in Ireland have linked an expansion of student numbers with wide-ranging reforms. Medical schools have broadened access by admitting more mature students from diverse backgrounds and have increased their international student numbers. This has resulted in major changes to the demographic profile of students at Irish medical schools.

AIM

To determine whether the demographic characteristics of students impact on their academic performance and specifically on their rate of knowledge acquisition.

METHODS

As a formative assessment exercise, we administered a progress test to all students twice each year during a 4 year graduate-entry medical programme. We compared scores over time between students from different age cohorts, of different gender, of different nationalities and from different academic backgrounds.

RESULTS

In the 1143 tests taken by 285 students to date, there were no significant differences in the rate of knowledge acquisition between the various groups. Early in the course, students from a non-biological science background performed less well than others but outperformed their peers by the time of graduation.

CONCLUSION

Neither age, gender, nationality nor academic background impacts on the rate of knowledge acquisition among graduate-entry medical students.