Effect of choice of instruction language on anatomy learning outcomes

The choice of instructional language in medical education continues to be debated across non-English-speaking nations. In Saudi Arabia, medical schools use English as the medium of instruction, which may challenge students who previously studied in Arabic-medium schools. This study investigated the effect of the medium of instruction on anatomy learning outcomes among medical students. An experimental post-test-only control group design was implemented among 184 third-year medical students (first preclinical year) at King Saud bin Abdulaziz University for Health Sciences. Students were randomly assigned to attend three anatomy lectures, delivered either in English or in mixed English-Arabic. Learning outcomes were assessed through standardized multiple-choice post-tests. Data were analyzed using independent t-tests with a significance level of 0.05. Overall, students taught in English-only and mixed English-Arabic performed comparably across all lectures (p > 0.05). Gender-stratified analysis revealed a slight difference: female students scored significantly higher in English-only instruction for the first lecture, while male students achieved better scores in the mixed approach in the second lecture. Interestingly, more students in the mixed group reported minor comprehension challenges, though not statistically significant. Instructional language did not significantly affect anatomy learning outcomes among third-year medical students. These findings suggest that once adequate English proficiency is achieved, English-medium instruction does not hinder academic performance. However, a flexible approach that integrates Arabic, when necessary, especially in early preclinical years, may improve cognitive load and conceptual understanding. These findings contribute to the ongoing global dialogue on how language policy intersects with learning efficacy in medical education.