Coping strategies for learning medicine through English Medium Instruction: A mixed‑methods study of Saudi medical...

The global expansion of English Medium Instruction (EMI) in medical education has intensified demands on students who must simultaneously acquire disciplinary knowledge and operate in a non-native language. This study investigates the coping strategies employed by Arabic-speaking medical students across three Saudi public universities, contributing empirical evidence on how learners adapt to linguistically complex EMI medical contexts.

A convergent mixed-methods design combined semi-structured interviews (n = 50 female students), questionnaires (n = 289), and non-participant observations (n = 9) across classrooms, study groups, and laboratories. Qualitative data underwent thematic analysis using NVivo; quantitative data were analysed using descriptive statistics (frequencies and percentages) in SPSS version 27. Triangulation enhanced validity, with trustworthiness ensured via member checking and reflexivity.

Students deployed a dynamic repertoire of strategies: multimodal resource use (e.g. 60% commonly watched Arabic YouTube videos, 25% English), translanguaging and translation (68% translated terms), memorisation via flashcards, and collaborative practices (e.g., group translation of slides). Observations confirmed these as central mechanisms for accessing, processing, and consolidating medical knowledge, evolving with proficiency.

These practices are essential for disciplinary learning in EMI medical education and can also be understood as preparing students for participation in multilingual medical settings where English functions as a shared professional resource. Findings offer insights for policy, curriculum design (e.g., legitimising translanguaging, embedding multimodality), and pedagogical and language support, particularly where content is taught through a foreign language. They underscore the need for bilingual approaches to enhance clinical readiness and equity in EMI medical contexts.