title: Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students.
abstract: 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 (r (2) = 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.
authors: Department of Physiology, Faculty of Medicine Nursing and Health Sciences , Monash University , Clayton, VIC , Australia.
authors: Collette
authors: C
authors: Mann
authors: Benedict J
authors: BJ
authors: Canny
authors: David H
authors: DH
authors: Reser
authors: Ramesh
authors: R
authors: Rajan
keywords: Assessment; English as a second language; International students; Medical education; OSCE; Speech in noise; Working memory
references: J Psycholinguist Res. 2004 Jan;33(1):25-49
references: 15002170
references: Neurobiol Learn Mem. 2008 May;89(4):448-61
references: 17884609
references: Int J Lang Commun Disord. 2011 Jul-Aug;46(4):411-22
references: 21771217
references: Med Educ. 2004 Feb;38(2):187-98
references: 14871389
references: Med Educ. 2010 Jan;44(1):85-93
references: 20078759
references: Br J Educ Psychol. 2000 Jun;70 ( Pt 2):177-94
references: 10900777
references: Scand J Psychol. 2003 Feb;44(1):13-21
references: 12602999
references: J Acoust Soc Am. 2007 Jan;121(1):519-26
references: 17297805
references: Memory. 2010 May;18(4):458-72
references: 20397100
references: Med Educ. 1986 May;20(3):162-75
references: 3724571
references: J Acoust Soc Am. 2004 Feb;115(2):813-21
references: 15000192
references: Br J Educ Psychol. 2001 Mar;71(Pt 1):115-32
references: 11307704
references: Speech Commun. 2010 Dec 30;52(11-12):943-953
references: 21179561
references: J Acoust Soc Am. 2001 Mar;109(3):1101-9
references: 11303924
references: Eur J Dent Educ. 2007 Nov;11(4):222-9
references: 17935562
references: J Exp Child Psychol. 2010 May;106(1):20-9
references: 20018296
references: Appl Psycholinguist. 2009 Jan;30(1):79-99
references: 19714256
references: J Acoust Soc Am. 2001 Nov;110(5 Pt 1):2527-38
references: 11757942
references: Med Educ. 2010 Aug;44(8):786-94
references: 20633218
references: J Acoust Soc Am. 2005 Apr;117(4 Pt 1):2181-92
references: 15898659
references: J Acoust Soc Am. 1990 Aug;88(2):663-6
references: 2212289
references: Neuroscience. 2008 Jun 23;154(2):784-95
references: 18485606
references: J Cogn Neurosci. 1992 Summer;4(3):281-8
references: 23964884
references: Br J Audiol. 1979 Aug;13(3):108-12
references: 486816
references: BMJ. 2003 Apr 12;326(7393):800-3
references: 12689978
references: J Acoust Soc Am. 1990 Dec;88(6):2607-10
references: 2283433
references: J Acoust Soc Am. 2005 Nov;118(5):2775-8
references: 16334654
references: Q J Exp Psychol (Hove). 2006 Apr;59(4):745-59
references: 16707360
references: Adv Health Sci Educ Theory Pract. 2008 Dec;13(5):607-16
references: 17487565
references: Q J Exp Psychol A. 1992 Jul;45(1):21-50
references: 1636010
references: Memory. 2005 Apr-May;13(3-4):403-13
references: 15952262
references: J Learn Disabil. 1994 Jan;27(1):34-50
references: 8133185
references: Acad Med. 2003 Oct;78(10 Suppl):S72-4
references: 14557101
references: J Acoust Soc Am. 2007 Jul;122(1):418-35
references: 17614500
references: Dev Psychol. 2004 Mar;40(2):177-90
references: 14979759
references: Hear Res. 2008 Apr;238(1-2):155-64
references: 18024026
references: J Exp Psychol Gen. 2001 Jun;130(2):208-223
references: 11409100
references: J Speech Lang Hear Res. 1997 Jun;40(3):686-93
references: 9210123
references: Cogn Psychol. 1989 Jan;21(1):60-99
references: 2920538
references: J Gen Intern Med. 2007 Aug;22(8):1155-60
references: 17558538
references: J Acoust Soc Am. 2012 Feb;131(2):1449-64
references: 22352516