Experiential Learning in Refugee Health: A Convergent Parallel Mixed-Methods Study of Medical Student Challenges and...

Refugees face compounding health burdens and access barriers that require culturally responsive, linguistically adapted clinical care. Student-run refugee health clinics offer high-value training environments but are rarely studied as sites of structured experiential learning. Grounded in Kolb's Experiential Learning Theory (ELT), this study examined where the learning cycle breaks down for medical students in a community refugee clinic, with a focus on language barriers, cultural challenges, and resource limitations as the primary disruptions to effective learning and care.

A cross-sectional, convergent parallel mixed-methods survey was administered to medical students (n = 22) who completed at least one clinical session at a biweekly refugee health clinic in the Dallas-Fort Worth (DFW) metroplex over the preceding 12 months, with quantitative and qualitative data collected concurrently and integrated during interpretation. The 22-item instrument used Likert-scale, multiple-choice, and open-ended items organized around three domains derived from Kolb's ELT. Quantitative data were analyzed using descriptive statistics, Mann-Whitney U tests, and Spearman correlations. Open-ended responses underwent directed content analysis by two independent coders using a deductive framework derived from Kolb's ELT stages.

Language discordance was ubiquitous; 90.9% (20/22) of participants reported language barriers often or always, yet 72.7% (16/22) reported inadequate formal training in interpreter use. Cultural challenges were frequent (95.5% (21/22) often or sometimes) and were associated with uncertainty navigating religious norms and gender sensitivities. Perceived faculty and peer support showed a negative correlation with reported resource limitations (rho = -0.425, p = 0.049); given the small sample size, this finding should be interpreted cautiously and viewed as hypothesis-generating rather than confirmatory. Directed content analysis identified four themes: interpreter inaccessibility, cultural and gender-concordant care gaps, inadequate pre-clinic preparation, and structural workflow deficits.

Medical students encounter substantial structured learning disruptions in refugee clinic settings that are amenable to intervention. Applying Kolb's ELT as an analytic framework suggests that deficits may occur more at the reflective and conceptual phases than at the level of direct experience, though this interpretation is drawn from survey and thematic data rather than direct measurement of each stage. These findings suggest that structured interpreter training, simulation-based cultural communication curricula, and intentional faculty mentorship may inform future educational interventions aimed at improving both student learning and equitable refugee care delivery.