Language-related factors affecting the academic performance of international medical students

Concerns regarding the poorer scholastic performance of international students in western tertiary institutions have generated studies to determine which factors affect academic success. A significant factor appears to be proficiency in the classroom language, generally a second language (L2) for the international students. There is also growing evidence that some sociological attributes and neuropsychological skills, such as cultural dissimilarities and working memory (WM), impact on academic attainment in L2 learners. The present study was conducted to examine the role of language-related factors that may affect academic differences between local and international Bachelor of Medicine/Bachelor of Surgery (MBBS) students in an Australian university. Data were obtained from two separate cohorts of medical students for both their 1st and 2nd years of study. Altogether, academic data from a total of 13 years were used and analyzed for this thesis. Studies 1 and 2 examined the same cohort of students who commenced their studies in 2002-2006 (i.e. 1st year 2002-2006 and 2nd year 2003-2007; data from the 2004 cohort (i.e. 1st year 2004 & 2nd year 2005) was incomplete and, therefore, not useable). This data was from a pool of previously collected information obtained by the Faculty of Medicine, Nursing and Health Sciences for census and other academic purposes. For Study 3, data were obtained from students who commenced their 1st year studies in 2008-2010 and 2nd year studies for only the 2008 and 2009 students (i.e. 1st year 2008-2010 and 2nd year 2009-2010; due to time constraints 2nd year information for the 2010 students was not collected) and data were obtained specifically for the present doctorate studies. For all three studies, information on social demographics, first language (L1) and/or L2 usage and various psychometric scales were obtained via questionnaire and academic assessment outcomes were gathered from official university records. Additionally, 103 students in Study 3 undertook a well-established Speech-in-Noise (SiN) measure of verbal working memory. In Study 1, overall End of Year academic totals were compared between 872 local and international students categorized by the Language Family (LF) of their L1. In Study 2, the individual assessments that made up the End of Year Totals were examined for 707 students from the same cohort of Study 1. Assessment instruments varied, but included Examinations, Coursework and Objective Structured Clinical Examinations (OSCEs). In Study 3, the SiN task was used to develop a model correlating verbal WM and various measures of English usage to the 103 students’ academic outcomes of overall End of Year Totals and individual Assessment instruments. In Study 1, the local students, generally, outperformed their international counterparts academically and this depended not only on Origin (i.e. Local versus International) but also on Language Family of their first language. Given that language proficiency is somewhat controlled for, this indicated that the differences may be due to acculturative stressors rather than English language skills. This was elaborated in Study 2, which examined the details of performance differences in the varying assessment types making up the course assessment each year of Years 1 and 2. There were year-specific differences between local and international students, suggesting that varying factors occurred. In the 1st year, international students showed poorer performance only in communications-based tasks, but in the 2nd year, international students performed worse than the locals in all assessments. After establishing that English proficiency did not appear to be the main influencing factor in academic achievement by international students in the Monash MBBS course, the final study 3 in this thesis examined one major neurophysiological factor that has been suggested to impact on learning, i.e. working memory, and specifically verbal working memory in the language of instruction in the Monash MBBS course (a language that is L2 for a significant number of the international students in the course). In this study, a model was developed to significantly predict the performance difference in a communications-based assessment, but not in other assessments requiring mainly factual knowledge. Overall, evidence from all three studies suggests that international students show poorer performance in academic attainment compared to their local peers as a probable result of impaired verbal WM for the L2 in specific communications-based assessments. Possible greater demands on English language skills and acculturative stress in the 1st year may also be contributing factors. Therefore, support for international students to do well will differ as a function of their progression and language background through the different years of the course