Study Abroad at Home: The Impact of a Multilingual and Multicultural Classroom Experience on Non-Native Medical Students’ English Language Skills Development

Abstract

Study Abroad programs yield substantial linguistic advantages in addition to fostering academic and intercultural enrichment. Nevertheless, some students miss these programs due to financial constraints, academic commitments, or insufficient language skills. This paper reports the findings of a qualitative action research study that seeks to evaluate the impact of a multilingual and multicultural class, designed as a quasi-Study Abroad experience, on Hungarian medical students’ perceived English linguistic development by the end of the semester. Semi-structured focus group interviews were carried out with 42 Hungarian medical students at the end of the spring and autumn semesters of the 2021–2022 and the 2022–2023 academic years. The outcomes of the focus-group interviews indicated that the students had a positive experience studying in a multilingual and multicultural environment; their willingness to engage in English communication, along with an increase in self-confidence, was apparent, ultimately showcasing improved perceived proficiency in English communication skills by the end of the term. Creating an educational setting abundant in linguistic and cultural diversity and integrating multicultural project-based learning activities within the curriculum to simulate a quasi-Study Abroad experience represent methodological frameworks that could serve as pivotal models for shaping similar courses in the future.

1. Introduction

Language and communication play a crucial role in healthcare. English, especially, serves as the universal language in the field of medicine and healthcare, underscoring the importance of enhancing the English language skills of non-native speaker medical and healthcare students [1,2]. Numerous studies have investigated the correlation between language, culture, healthcare perspectives, and treatments [3,4,5,6,7,8]. Ineffective communication poses a significant barrier to optimal healthcare delivery and diminishes confidence in the quality of medical services. The absence of a shared language between patients and healthcare providers can result in misdiagnoses and inappropriate treatment [9,10,11,12].

English is also crucial for facilitating effective communication and collaboration among healthcare professionals, as it promotes an exchange of medical and healthcare knowledge and guarantees that healthcare practitioners, regardless of their native language, can both access and contribute to the latest advancements in research and medical literature on a global scale [13,14,15,16,17].

This is especially important as the World Health Organization [18] predicts that by 2030, there will be a shortage of approximately 10 million healthcare professionals, primarily in nations with lower incomes; though, countries of diverse economic statuses also encounter challenges related to the education, hiring, and retention of their healthcare workforce to varying extents. This anticipated dearth of healthcare staff globally poses substantial challenges, including significant language barriers, which emerge when healthcare professionals migrate to countries facing shortages without local language proficiency.

As English is the lingua franca in medicine, English language proficiency becomes essential to bridge these gaps, ensuring seamless communication between healthcare staff and patients, ultimately sustaining patient care and safety. Proficiency in English facilitates not only the exchange of information between healthcare providers and patients but also understanding and respecting each other’s cultural norms, values, and communication styles, fostering teamwork, and enhancing patient care [19,20]. Moreover, the training and education of healthcare professionals from abroad also necessitate effective communication, with English serving as a common medium. This ensures their smooth adaptation to local practices and standards, addressing the workforce shortage without compromising the quality of care.

Nevertheless, even local healthcare staff may present challenges for migrants and ethnic minorities in accessing adequate healthcare due to language and cultural barriers. Communication problems and misunderstandings of cultural norms can contribute to patient non-compliance and distrust, ultimately leading to inferior health results [21,22,23,24,25]. Overcoming the challenges posed by language and cultural differences is critical to ensuring the highest quality of care. Therefore, developing the English language proficiency of medical and healthcare students is essential to achieve these aims in the future, enabling them to effectively communicate, collaborate, and excel in an increasingly globalized healthcare landscape [2,26,27].

To equip students with essential skills in today’s world, Zaafour and Salaberri-Ramiro [28] claim that Project-Based Learning (PBL) and Cooperative Learning (CL) are top teaching methods to achieve this goal, especially when these methods are merged, each supporting the other, with a primary aim of engaging students in collaborative efforts during project integration. The advantages of cooperative projects in English education are vast, particularly in enhancing students’ communication and collaboration skills, as well as fostering creativity and critical thinking, which are all essential parts of 21st-century skills.

Furthermore, the research findings of Imbaquingo and Cárdenas [29] shed light on the positive impact of PBL on students’ English language skills. Such empirical evidence advocates for the widespread incorporation of PBL methodologies within English language learning contexts. These insights collectively underscore the pedagogical value of innovative instructional approaches in optimizing language acquisition and skill development within diverse educational landscapes.

In recent times, several studies have focused on language and intercultural learning outside the traditional classroom. Research findings on Study Abroad (SA) programs indicate that SA provides substantial academic, linguistic, and intercultural benefits to the students [30,31,32]. However, as not all the students are mobile due to various reasons, including academic difficulties, financial problems, lack of foreign language knowledge, or family support [33,34], Internationalization at Home and the internationalization of the curriculum are essential elements in the field of Higher Education (HE) currently. There are numerous means and methods for the internationalization of the curriculum; however, for the purposes of this article, we intend to highlight merely the role international students play in these processes within Hungarian medical HE and how the authors believe they can facilitate a quasi-Study Abroad experience for local students. This involves English language immersion, activities, coursework, as well as projects designed to expose students to international perspectives and cultural diversity without the need for physical travel.

International Students in Higher Education—An Opportunity for Language Teachers

The number of international students in tertiary education programs has increased significantly in the past couple of decades, from 4.1 million in 2012 to over 6.4 million in 2021 worldwide [35,36]. According to OECD [37], students become more mobile as they reach more advanced levels of education. International students account for only 3% of total enrolment in short-cycle tertiary programs, whereas they represent 24% of enrolment in doctoral programs.

The same tendency can be identified in Hungarian HE. The number of international students in the country has been increasing steadily, from 11,783 in 2001 to 38,422 in 2019 [38]. The growth is due to several factors, including the Bologna Process and numerous national policies and initiatives, which all resulted in Hungary becoming a major study destination in Europe among international students. The four medical universities in the country are particularly popular choices among students from other countries [38]. According to the website of one of the universities in Hungary [39], in 2020, more than 4500 international students had an active student status. Of these, 1986 were continuing their studies at the medical school of the same university. The statistics also suggest that close to 60% of the medical students were international, whereas the proportion of Hungarian medical students was around 40%.

Academic scholars, including language educators, recognize the diverse student population within educational settings as offering significant avenues for pedagogical advancement. In their research, Perry and Vlachopoulos [40] focus on the vibrant blend of students in international schools, where both native and non-native English speaker students study together. In alignment with this perspective, the authors of this study posit that such an educational environment presents valuable opportunities for enhancing the English language proficiency of Hungarian medical students. Consequently, to further investigate this phenomenon within instructional contexts, the authors of the present paper opted to conduct an action research study of their classes.

2. Materials and Methods

According to Dörnyei [41], the importance of qualitative research in applied linguistics has been on the rise, and this is because qualitative methods are well-suited for uncovering insights into the social, cultural, and situational factors that significantly influence or shape every aspect of language acquisition and usage.

Action research has become a major tool among educators in the past three decades, as it helps them in assessing their own classes and their effectiveness and can contribute to developing in-depth perspectives about the process of teaching and learning. McNiff claims [42] that action research encourages teachers to be self-reflective in order to enhance the quality of education for themselves and their students, and it can be used effectively for curriculum or professional development purposes. It aims to bring about change and improvement in practice. Action research typically focuses on questions that emerge from a teacher’s or a group of teachers’ immediate classroom situation [43], and therefore it is often defined and directed by them. In the view of Burns [44], action research is contextual, small-scale, localized, evaluative, and reflective. It is also participatory, as it provides for collaborative investigation by teams of colleagues. She also claims that changes in practice are based on the collected data, which provide the stimulus for change. With this in mind, the authors decided on selecting this method of research, which was guided by the following research questions:

• Can a multicultural and multilingual class, as a quasi-Study Abroad at Home environment, contribute to enhancing Hungarian medical students’ perceived English language proficiency by the end of the semester?
• How does participation in a multicultural and multilingual class influence Hungarian medical students’ confidence in using English?
• How do Hungarian medical students’ attitudes towards multiculturalism and multilingualism evolve throughout the course, and how does this impact their English language learning?
• What challenges do Hungarian medical students face in a multicultural and multilingual classroom environment, and how do they overcome these challenges?
• What specific teaching strategies are most effective in fostering English language development in a multicultural and multilingual class?
• What are the perceptions of Hungarian medical students regarding the importance of English language proficiency in their future medical careers?

2.1. Context and the Participants

There are four medical schools in Hungary, and to attract international students and thus higher revenues, they all run their medical education programs in three languages: Hungarian, English, and German. As a result, the number of international students has increased significantly at all four medical schools over the past few decades. Currently, the ratio of international students is close to or even above 50% in each medical school. The students of the German program are mostly from Germany and Austria, whereas the students in the English program are multicultural, as they originate from countries all over the world.

The present action research was conducted at the language department of one of the medical schools in Hungary, at the end of the spring and autumn semesters of the 2021–2022 and the 2022–2023 academic years, as a result of which a total of four interviews took place.

Following thorough needs analyses conducted among educators, medical professionals, and students of the medical school, it has been identified that there exists a compelling necessity for the development of a new course. This arises from the predominant circumstance, wherein a significant portion of Hungarian students lack the opportunity to pursue studies abroad, consequently impeding the enhancement of their academic knowledge, intercultural competences, and proficiency in the English language. Such competences are indispensable for their prospective roles as medical practitioners [2,7,8,27].

Therefore, the elective course, entitled Intercultural Competence in Doctor-Patient Communication was launched with the aim to increase medical students’ awareness of sociocultural influences on health beliefs, attitudes, and behaviors as well as providing skills to understand and manage these factors during medical care with patients from diverse cultural backgrounds.

As a new initiative within the medical school, it was also of primary importance for the educators and medical professionals engaged in the development of this new subject, to extend access to this course beyond Hungarian students, ensuring inclusion for participants in both English and German language medical programs. The conviction underlying this decision rested on the firm belief that cultivating a multicultural and multilingual learning environment would significantly contribute to the enrichment of Hungarian students’ intercultural proficiency and mastery of the English language, thus aligning with the overarching objectives of the curriculum.

English is the medium of instruction in the classes, to facilitate interactive sessions aimed at fostering a seamless exchange of specific and compelling information. The course methodology is grounded in Project-Based Learning (PBL), which entails a semester-long project requirement for students [28]. Collaborating with a partner from a different cultural background, students are tasked with creating a presentation that juxtaposes their respective cultures through a medical lens. Emphasizing crucial aspects that demand a doctor’s awareness in cross-cultural medical contexts, topics encompass various dimensions, such as the pivotal role of English in medical communication, literacy rates, distinctive traditions, customs impacting healthcare, non-verbal communication cues, religious or superstitious beliefs, the influence of traditional healers, emotional expression, pain perception, and trust dynamics with male/female physicians. Additionally, students are required to conduct interviews with healthcare professionals who have encountered medically complex cases involving patients from diverse cultural backgrounds.

Furthermore, through dynamic methods such as debates, group collaborations, and active participation in discussions and inquiries, students remain consistently engaged. These approaches cultivate a vibrant discourse among the multicultural and multilingual student cohorts, sustaining meaningful conversations and reflections beyond the confines of the classroom.

The classes span 90 min and are conducted over a 12-week duration each semester, featuring contributions from native-speaker lecturers and medical professionals. A total of 92 students enrolled for the course during the 2021–2022 and the 2022–2023 academic years. The cohort comprised second- to fifth-year medical students, 35% males and 65% females, aged between 18 and 30. They represented 18 different countries and cultures, including Canada, China, Germany, Hungary, India, Iran, Israel, Japan, Jordan, Kenya, Korea, Mauritius, Nigeria, Norway, Pakistan, Spain, the UK, and the USA. Out of them, 58 (63%) students were Hungarian.

While acknowledging the presence of a significant population of native and non-native English speakers of different nationalities within the class, this study exclusively focuses on the Hungarian medical students. This decision was made to ensure a homogenous sample, given that all other non-native English speakers are pursuing their medical education in English. Consequently, their English proficiency development cannot be directly compared with that of the Hungarian cohort under investigation.

Out of the 58 Hungarian students, 42 students, (31 female and 11 male, average age 21.3) volunteered to take part in the focus group interviews. All participants were Hungarian native speakers studying medicine between year two and five. Their English proficiency was evaluated at a minimum of level B2, according to the Common European Framework of Reference for Languages (CEFR), a requirement for studying medicine in Hungary. To meet this prerequisite, they had passed accredited B2 or C1 level language exams during their secondary school years.

2.2. Data Collection

At the end of each academic semester between 2021 autumn and 2023 spring, after the last classes, semi-structured, focus group interviews were conducted with the Hungarian students in Hungarian and on a voluntary basis (see Appendix A). The interviews aimed to find out the Hungarian medical students’ views and perceptions on whether the multicultural and multilingual class environment could enhance their perceived English language gains and confidence by the end of the specific semester.

The questions had been piloted with a group of Hungarian students during the spring academic semester of 2021. Based on the feedback we received, three questions needed to be reworded to improve their clarity.

Each focus group interview session convened 8–12 participants, lasting between 50 and 60 min, and was facilitated by the educators. Students’ anonymity was assured through anonymization of the dataset. The interviews were recorded, transferred into electronic scripts, and translated into English by the authors.

The dataset was analyzed for themes and topics that came up repeatedly [45,46]. Thematic analysis was used to analyze the data. Braun and Clarke’s thematic analysis method [47] is a systematic approach for identifying, analyzing, and reporting patterns or themes within qualitative data. It involves familiarizing oneself with the data, generating initial codes, and systematically searching for themes that capture important aspects of the data. In this method, the interview questions guide the data collection process by shaping the content of the interviews, while the identified themes provide a structured framework for analyzing and interpreting the collected data.

Quotations from the interviews were extracted (printed in italics in the text) to provide an in-depth understanding of the participants’ views and to support the findings.

3. Results

After analyzing the interviews, the majority of student comments fell into one of seven theme categories, which are as follows;

• Study Abroad at Home experience;
• English language proficiency improvement;
• Increase in self-confidence when speaking in English;
• Building cultural awareness and developing an open mindset;
• Challenges and reservations;
• Effective teaching strategies;
• Importance of the English language proficiency in medical careers.

In the following section, we examine each theme through notable student comments from interviews, presented in italics, capturing common viewpoints discussed throughout the interviews.

• Study Abroad at Home experience:

The majority of students (92%) said that they would recommend the course to their peers as they believed that the multicultural and multilingual environment offered a unique and valuable opportunity to improve English language skills and gain insights from diverse perspectives, similar to Study Abroad programs. A high number of students (83%) emphasized that they enjoyed studying in this multicultural student environment with the international students as it made them feel as if they had been studying abroad, and therefore would love to see more courses in the future where this was possible.

What I liked the most about studying in this class was that it was like being abroad, which, unfortunately I cannot afford, but after this class, I can tell my friends I was studying in another country for a semester.

I never had classes with non-Hungarian students before, so it was a special experience for me to speak English all the time during the classes. I felt like I was abroad.

Because of these classes, I am not afraid of international students anymore and now I decided I want to study abroad with Erasmus or something. Before I never talked to them. I always thought they would laugh at me ‘coz of my English.

2.

English language proficiency improvement:

The majority of students (88%) highlighted their perceived improvement in their English language proficiency throughout the semester. They mentioned feeling more confident in expressing themselves and understanding others. Many Hungarian students (56%) claimed the international students were supportive and empathetic and taught or explained them some new words and phrases, including medical terminology in English:

Sometimes I did not understand a word the teacher said, but Philip [pseudo name] explained it to me.

When I was working with Kim [pseudo name] I could not switch to Hungarian. When I did not know something in English, I had to explain it in English. I was forced to use English. And she understood me.

I got way more knowledge and experience, while talking to international students. They taught me some new words and medical term and slang also.

Participating in these classes has positively influenced my ability to communicate in English. For example, our discussions on medical case studies helped me become more proficient in discussing topics in English.

Interestingly, four students also commented that they had picked up some new words and phrases from the international students in languages other than English, in German and Spanish. These were languages the Hungarian students had studied earlier as L3 in secondary school and grabbed the opportunity to ask certain phrases from their native speaker peers.

I really liked to do the presentation project with an international student. Ulrike [pseudo name] was very nice, it was great to work with her, I also learnt a lot about her culture, and she taught me some words in German.

3.

Increase in self-confidence when speaking in English:

Many students noted an increase in their confidence level regarding using English compared to the beginning of the semester. Engaging in discussions, presentations, and group activities helped them become more comfortable expressing themselves in English. The majority of the students (87%) mentioned that one of the advantages of studying in a multicultural, multilingual environment was that they had to speak English all the time, and this increased their level of self-confidence:

What I enjoyed most was that I realized every class that I can actually speak English. And what’s more, they [international students] can understand me.

I became more confident speaking English by the end of the semester.

I have noticed an increase in my confidence level speaking in English, the discussions and presentations in class have helped me become more comfortable expressing myself in English.

4.

Building cultural awareness and developing an open-mindset:

Students emphasized the positive impact of participating in a multicultural and multilingual class not only on their language skills development but also on building cultural awareness and developing an open mindset by being exposed to diverse perspectives, attitudes, and communication styles. According to several Hungarian students (42%), in this friendly, multicultural environment it was easier to collaborate with international students and learn about their culture. At the same time, this also helped them build awareness of their own culture and cultural value sets:

I often take certain things for granted, maybe even have prejudices. But this class has made me reflect a lot about these issues.

I really liked getting to know and interacting with international students and learning new things about all of our cultures.

I feel my knowledge in general about different cultures has been boosted because of this class.

Regarding the development of their open-mindedness towards other cultures, a high percentage of students (78%) considered this class a revelation:

The classes made me want to know more about other cultures.

Being open-minded and keeping your prejudices and stereotyping to yourself and working on them is essential.

Gaining knowledge about the diversity in the world and better understanding the nationalities of my fellow students at the university is crucial to me. I believe this course has played a significant role in making me more open-minded

5.

Challenges and reservations:

Some students (27%) initially had reservations or faced challenges such as language barriers and differing communication styles. However, they also mentioned overcoming these challenges through active engagement and adaptation. Three students mentioned that presenting together with an international student was not easy for them, mostly for the different perceptions of time and deadlines:

It was difficult sometimes to meet with Fatima [pseudo name], she was always late and never prepared.

Challenges such as language barriers were present, but I tackled them by engaging in group activities and seeking clarification when needed.

Initially, I had some reservations about studying in such a diverse environment, mainly ‘coz of my English. However, as the semester progressed, I realized that my English is OK and I can speak almost fluently.

6.

Effective Teaching Strategies:

Several students (43%) highlighted the interactive, engaging classes and the Project-Based-Learning as teaching methods they considered most effective for enhancing their English language proficiency. Group discussions, collaborative projects, and interactions with classmates from diverse backgrounds were commonly mentioned as effective teaching strategies used in class. The students cited specific instances or activities from the classes that contributed to their English language development.

What I liked the most was that the classes were interactive and we had loads of group work. Participating in group discussions and collaborative projects not only improved my English skills but also broadened my understanding of different cultures.

Working closely with classmates from diverse backgrounds was instrumental in improving my language proficiency.

Through working on projects with peers from various cultural backgrounds, I was able to enhance my language skills while gaining valuable insights into different perspectives.

7.

Importance of the English language proficiency in medical careers:

Many students (63%) claimed that the experiences gained in the classes had shaped their perceptions and career aspirations, including the importance of English language proficiency in their future medical careers.

I believe that these classes will have a positive impact on my future job as a doctor, as effective communication in English is crucial in the medical field, especially in multicultural environments.

I learned a lot about other cultures and it was very cool hearing personal stories from international students. I feel like it’s going to help me understand foreigners’ perspectives in the future too.

I expected this course to provide me with exposure to different cultures and languages, which would enrich my learning experience and broaden my perspective, which I think is very important for my future life as a doctor, mostly if I work in another country …. which is one of my plans.

Three students indicated that they were scared of presenting as part of the project work. Presenting is a skill almost all doctors need in their professional lives. Certainly, doing a presentation is not easy, mostly not in English for a non-native speaker, as it requires knowledge and deep understanding of the topic presented, self-confidence, English proficiency, and most of all, extensive practice.

Presenting was quite frightening for me.

I felt a bit scared speaking in front of everyone and worried about making mistakes.

I was really nervous when I was presenting. English is not my native language, so I was afraid nobody would understand me.

However, pair work and pair presentation made it easier, and it proved to be a success for the majority of the students. The students benefited and learned immensely not only from their own but also from each other’s presentations, and preparing to present in pairs was thus more effective for them.

Overall, the Hungarian students discovered that being part of a multilingual and multicultural class was exceptionally enriching, providing significant benefits that extended beyond improving their English language proficiency. This included heightened cultural awareness and the development of refined intercultural communication skills, emphasizing the comprehensive value of their educational experience.

Every week it was the class I was waiting for. I liked the vibes and the atmosphere present in the classes.

The classes opened new way of thinking and more things to actually think about.

I would definitely recommend these classes to my peers because they offer a unique opportunity to improve English language skills while also gaining valuable insights from diverse perspectives.

I believe that multicultural and multilingual classes have great potential to enhance English language learning for Hungarian medical students.

4. Discussion

The research questions in our action research study centered around investigating the impact of a multicultural and multilingual course experience on developing Hungarian medical students’ English language skills by the end of the semester.

The development of this course stemmed from a comprehensive needs analysis, engaging educators, medical professionals, and university students. Through this process, it became clear that there was a specific demand for the introduction of a new course. Many Hungarian students face limitations in pursuing studies abroad, hindering the development of their academic knowledge, intercultural competences, and English language proficiency, which are essential for their prospective roles as medical practitioners [2,48,49]. While developing this course, the doctors’, teachers’, and students’ ideas and suggestions were taken into account as much as possible. First and foremost, this meant using varied and interactive pedagogical methods rooted in PBL and CL [28,29], providing opportunities for group work, discussions, and debates, and including some project work where the Hungarian students were paired up with their international peers.

Therefore, our course has challenged traditional teaching by turning the classes into an interactive, multilingual, and multicultural platform. The sessions provided several opportunities for the Hungarian students to better understand and use English through the development of projects, through which they had to interact with international students, which contributed to the increase in their perceived English language skills, similar to the study conducted by Perry and Dimitrios Vlachopoulos [40]. This was confirmed by the outcome of the focus group interviews indicating that this method contributes to developing the English proficiency of the Hungarian students, which is as much attributable to the methodology applied in class by the teachers as to the international students, who guaranteed a positive and supportive learning environment to their Hungarian peers. As a result, the Hungarian students became more confident in talking, discussing, and presenting in English.

Collaborating closely with international students served as a revelation for the Hungarian students, shedding light on various cultural issues. This experience contributed to enhancing their awareness of their own and other cultures, as well as their value sets. The students gained insights into how these cultural factors may influence medical care in their future professional lives. As some of them commented, these discussions and socialization continued even after the classes were over. In our understanding, teaching this course in a multicultural, and multilingual setting provides great motivation for Hungarian students to join the classes, as otherwise, there are not many opportunities for them to meet, study, and socialize with their international peers. Our study’s outcomes are in concordance with similar findings of Perry and Vlachopoulos that highlight the benefits of such diverse educational environments [40].

According to the findings from the focus group interviews, it is evident that Hungarian students perceived an improvement in their English language proficiency by the conclusion of the semester. According to Burns [50], in action research projects, the main aim is to identify pedagogical innovations drawn from the results. Our research demonstrated that providing an interactive, multilingual and multicultural student environment and incorporating intercultural project work, thus creating a quasi-Study Abroad at Home experience, are innovative pedagogical methods that could be used as future reference in developing new courses.

5. Conclusions

English is the lingua franca in medicine; therefore, developing the English language proficiency of non-native speaker medical students is essential for effective communication and collaboration among healthcare professionals. Medical education has to prepare future doctors to understand how culture and language influence a patient’s perception of diseases and how these perceptions affect treatment and, ultimately, the quality of care. As noted, previous studies have explored that Study Abroad programs provide substantial academic, linguistic, and intercultural benefits to students. However, since not all the Hungarian medical students are mobile, they miss this opportunity for educational and personal skill development.

The present paper reported the results of qualitative action research aimed at assessing whether a multicultural and multilingual class, as a quasi-Study Abroad at Home experience, is conducive to developing Hungarian medical students’ perceived English language proficiency by the end of the semester. The outcomes of the focus-group interviews confirmed that the Hungarian students had positive experience studying in a multilingual and multicultural environment, demonstrated changed worldviews, and enhanced English communication skills by the end of the semester. The presence of the international students created a motivating atmosphere in the classroom.

One of the aims of multilingual and multicultural education should be to assist students in reaching their full potential, talent, and competences. The authors believe that by developing this class, they have made the first steps to accomplish this goal. In our pursuit of developing proficiency in both cultural understanding and language skills, our objective is to support future doctors in building their global competence. This can only be achieved by acquiring the ability to engage effectively beyond the confines of their native language and cultural boundaries.

6. Limitations and Future Implications

The results of this action research study cannot be generalized due to the small number of participants and because it was conducted at a single institution, which tempers the generalizability of the findings. To enhance the robustness of future studies, it is suggested that the perceived language proficiency of students be evaluated at the beginning of the semester, facilitating a more comprehensive understanding of its evolution over time. This consideration will be duly integrated into the design of forthcoming qualitative and quantitative research projects, aiming to afford a more precise assessment of students’ English language skill development. The action research study gave us some insights into the improvement of Hungarian medical students’ linguistic enhancement in class and thus helped to generate new ideas for the development of our classes and future research.