EFFECTIVENESS OF A CULTURALLY RELEVANT MOBILE-ASSISTED ENGLISH LANGUAGE TEACHING MODULE ON ORAL COMMUNICATION COMPETENCE, LANGUAGE ANXIETY, AND SELF-EFFICACY AMONG PAKISTANI UNDERGRADUATE HEALTHCARE STUDENTS: A QUASI-EXPERIMENTAL STUDY

Abstract

It is argued in the present study that a culturally embedded, AI-assisted Mobile-Assisted English Language Teaching (MAELT) module produces very large and statistically significant improvements in oral professional communication competence, language anxiety, and self-efficacy among Pakistani undergraduate healthcare students. A quasi-experimental pretest-posttest design with a matched control group (N=200; experimental n=100, control n=100) was employed across four PMDC-recognised medical institutions in Lahore. The primary ANCOVA yielded a highly significant main effect of group on post-test Oral Communication Rubric (OCR) scores (F(1,197)=142.6, p<.001, partial η²=0.420, d=1.72), with the experimental group outperforming the control group by an adjusted mean difference of 27.8 points (95% CI [23.2, 32.4]). Secondary outcomes indicate that language anxiety decreased significantly in the experimental group, with the post-test MFLCAS mean (M=48.6/120) falling below the clinical significance threshold of 60/120 (F(1,197)=78.4, p<.001, d=1.14), while self-efficacy for professional communication increased substantially (F(1,197)=98.3, p<.001, d=1.37). Furthermore, multiple regression analysis indicates that time on task (β=0.42, p<.001) and AI practice session frequency (β=0.38, p<.001) are the two strongest predictors of oral communication gains, providing new large-scale empirical support for Swain's (1985) Output Hypothesis in a mobile-assisted context. Focus group data confirm that private, iterative, low-stakes practice constitutes the primary mechanism through which anxiety reduction and competence development are jointly produced. In a nut shell, the effect size of d=1.72 substantially exceeds the global MALL meta-analytic average of d approximately 0.89, suggesting that cultural embedding and output orientation amplify effectiveness beyond what generic MALL design achieves.