Beyond Words: The Psychological and Physiological Impacts of English Language Anxiety in Medical Education
Novelty in Biomedicine,
Vol. 14 No. 2 (2026),
6 June 2026
,
Page 70-75
https://doi.org/10.22037/nbm.v14i2.50820
Abstract
Background: English has become the primary medium of instruction in medical education, creating linguistic and psychological challenges for non-native speakers. English language learning anxiety may affect both mental health and sleep quality, yet its impact in medical students remains underexplored. This study examined the relationships among English learning anxiety, generalized anxiety, and sleep quality.
Materials and Methods: A cross-sectional survey was conducted with 286 medical students enrolled in English-medium programs. Participants completed the Medical English Language Anxiety Scale (MELAS), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, correlations, and multiple regression analyses.
Results: Moderate-to-high English learning anxiety was reported by 72.4% of students, and 61.5% experienced poor sleep quality. English learning anxiety correlated positively with generalized anxiety (r = 0.48, p < 0.001) and sleep disturbance (r = 0.42, p < 0.001). Regression analyses indicated that language anxiety independently predicted poorer sleep quality, and generalized anxiety partially mediated this relationship.
Conclusion: English language learning anxiety is a significant psychological burden for medical students, affecting both anxiety levels and sleep quality. Integrating language anxiety management and psychological support into medical English curricula may improve students’ well-being and academic performance.
- English language learning anxiety
- Medical students
- Generalized anxiety
- Sleep quality
- English for medical purposes
How to Cite
References
1. Salimi Chegenie M, Khomeijani Farahani AA, Nemati M. A socio-cultural development of Iranian EFL high school teachers through reflection on critical incidents. J Manag Plann Educ Syst. 2024;17(1):315–35. doi:10.48308/mpes.2024.231904.1335
2. Horwitz EK, Horwitz MB, Cope J. Foreign language classroom anxiety. Mod Lang J. 1986;70(2):125–32.
3. Deng J, Zhou F, Al-Shaibani M. Development and validation of the Medical English Language Anxiety Scale among Chinese medical students. Front Psychol. 2022;13:895117.
4. Binjabr AA, Alshehri HA, Alamri AA, Alotaibi AM, Alzahrani RA. The prevalence of poor sleep quality among medical students: a systematic review and meta-analysis. J Clin Med. 2023;14(7):2274.
5. Rao WW, Li W, Qi H, Hong L, Chen C, Li CY, et al. Sleep quality in medical students: a comprehensive meta-analysis of observational studies. Sleep Breath. 2020;24(4):1151–65.
6. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.
7. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.
8. Sedgwick P. Cross sectional studies: advantages and disadvantages. BMJ. 2014;348:g2276.
9. Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care. 2008;46(3):266–74.
10. Horwitz EK. On the misreading of Horwitz, Horwitz, and Cope (1986) and the need to balance anxiety research and the experiences of anxious language learners. Mod Lang J. 2017;101(3):700–2.
11. Teimouri Y, Goetze J, Plonsky L. Second language anxiety and achievement: a meta-analysis. Stud Second Lang Acquis. 2019;41(2):363–87.
12. Lemma S, Gelaye B, Berhane Y, Worku A, Williams MA. Sleep quality and its psychological correlates among university students in Ethiopia: a cross-sectional study. BMC Psychiatry. 2012;12:237.
13. Pagnin D, de Queiroz V, de Oliveira Filho MA, Gonzalez NV, Salgado AET, Cordeiro EC, et al. Burnout and sleep quality in medical students: a cross-sectional study. Clin Pract Epidemiol Ment Health. 2014;10:235–42.
14. Pekrun R. The control-value theory of achievement emotions: assumptions, corollaries, and implications for educational research and practice. Educ Psychol Rev. 2006;18(4):315–41.
15. O’Driscoll M, Byrne S, McGillicuddy A, Lambert S, Sahm LJ. The effects of mindfulness-based interventions for health and social care undergraduate students: a systematic review of randomized and non-randomized controlled trials. Explore (NY). 2017;13(1):26–35.
16. Yang Y, Li W, Zhang Q, Zhang L, Cheung T. Effects of mindfulness-based interventions on anxiety, depression, and sleep in university students: a systematic review and meta-analysis. Front Psychol. 2022;13:882443.
17. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving hum.
- Abstract Viewed: 26 times
- pdf Downloaded: 27 times