Trial reportBMC medical education2026
The translation paradox: how full translation increases cognitive load and impairs medical vocabulary retention.
Trial report in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundReading English biomedical literature is a core competency for medical students, yet many rely heavily on full-text translation tools. Although translation appears to reduce language barriers, its impact on cognitive load and durable learning remains unclear. This study compared three reading modalities to evaluate their effects on cognitive load, immediate comprehension, and delayed vocabulary retention in medical students.
methodsIn this three-arm randomized controlled trial, 160 Chinese medical students were randomized to one of three reading conditions: Original Text Group (OTG), AI-assisted Bilingual Group (ABG), or Full Translation Group (FTG). Immediate post-reading outcomes included intrinsic, extraneous, and germane cognitive load, as well as comprehension performance. One-week delayed productive vocabulary retention was assessed using a prespecified scoring rubric. Group differences were analyzed using analysis of covariance (ANCOVA) adjusted for academic year and CET-6 level.
resultsA total of 148 participants completed the immediate post-reading assessment, and 148 completed the one-week follow-up according to the available dataset. Compared with the OTG and ABG, the FTG showed significantly higher extraneous cognitive load (both p < 0.001). Immediate comprehension scores were high across groups and did not differ significantly (p = 0.157). Delayed productive vocabulary retention differed significantly among groups, with the highest mean score in the OTG (6.38 ± 2.13), followed by the ABG (5.58 ± 1.89) and FTG (4.90 ± 2.00) (overall p < 0.001). Post-hoc analyses showed that the OTG outperformed both the ABG (p = 0.011) and FTG (p < 0.001).
conclusionsAmong Chinese medical students reading an English biomedical article, full translation was associated with higher perceived extraneous cognitive load and weaker one-week retention of methodological English vocabulary than direct reading of the original English text. A bilingual parallel-text format showed intermediate performance. These findings suggest that translation may be more appropriately used as a selective scaffold rather than a default substitute when the educational goal includes durable acquisition of English medical terminology.
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