[The role of questionnaires in assessing speech perception among foreign medical students studying in Russian]

Background. In Russian medical universities, the proportion of international students from Asian countries, Africa, and the Middle East enrolled in Russian-medium programs is steadily increasing. Even when they have formally achieved a B1-B2 level of Russian language proficiency, many of them still experience difficulties in perceiving spoken Russian in noise and under high cognitive load, which reduces the effectiveness of learning, complicates clinical communication, and increases the risk of errors when interacting with patients.

To determine the relationship between questionnaire scores reflecting difficulties in communicative interaction and perception of spoken Russian and the results of audiological assessment and speech-in-noise tests.

We examined 178 international students (18-30 years) who had been enrolled for at least 1 year in Russian-medium medical programs (Arab countries - 80, English-speaking African countries - 48, Asian countries - 50). The assessment protocol included otorhinolaryngological examination, audiological evaluation, and a structured questionnaire. The questionnaire assessed self-reported difficulties in communication in Russian (communication preferences, use of Russian with peers, understanding speech in the metro and in emotionally charged situations).

Mild hearing impairment (predominantly grade I conductive hearing loss) was detected in 27.5% (n=22) of students in group 1, 25.0% (n=12) in group 2, and 40.0% (n=20) in group 3; early signs of cochlear dysfunction according to distortion product otoacoustic emissions (DPOAE) were significantly more frequent in the Asian group. Approximately one third of students with a normal audiogram and satisfactory speech audiometry nevertheless reported, in the questionnaire, pronounced difficulties in understanding spoken Russian in classrooms and in the metro («I hear but do not understand»), which was associated with lower speech-in-noise audiometry (SIN) scores and signs of cochlear dysfunction.

The combination of speech audiometry in noise and targeted questionnaire-based assessment makes it possible to detect «hidden» deficits in understanding spoken Russian in international medical students that are not captured by standard pure-tone audiometry, which supports the need to include speech intelligibility questionnaires in routine screening of international medical students after completing Russian language courses.