Exploring the Relationship Between Self-efficacy Beliefs, Autonomy, and TOEFL Reading Comprehension Ability Among Medical Students: A Mixed-Methods Study

Background: The purpose of this study was to examine whether a significant relationship exists among medical students' autonomy, self-efficacy, and performance in the reading comprehension section of the TOEFL. Methods: A total of 60 male and female medical students were randomly selected from those attending TOEFL preparatory courses at the Urmia Medical University Language Center, Urmia, Iran. All participants completed the 25-item self-efficacy Scale (Smith & Betz, 2000) and the Learner Autonomy Questionnaire (Zhang & Li, 2004). Additionally, their scores on the TOEFL reading section were collected and analyzed using correlation and regression tests. Simple linear regression and multiple regression analyses were employed to examine the relationships and predictive effects of the independent variables (autonomy and self-efficacy) on the dependent variable (TOEFL reading comprehension scores). Results: The mean age of the participants was 22.6 ± 2.05 years, with the majority being female (68.3%). The mean scores for self-efficacy, autonomy, and the TOEFL reading section were 96.1 ± 9.96, 70 ± 16.07, and 22.01 ± 1.64, respectively. The findings revealed that students’ self-efficacy levels could predict their TOEFL reading scores by up to 64%, as indicated by a Pearson correlation value of 0.797 with a significance value of 0.000 (P-value < 0.05). However, no significant relationship was found between medical students’ autonomy and their TOEFL reading comprehension performance (Pearson correlation = 0.311, significance value = 0.691, P-value > 0.05). Qualitative data gathered from 10 medical students during semi-structured interview sessions corroborated the quantitative findings. Conclusions: Medical students' autonomy did not show a significant correlation with their performance on TOEFL reading texts. However, self-efficacy significantly correlated with and predicted their performance on reading comprehension texts. Therefore, syllabus designers should consider learners' individual differences, particularly their self-efficacy, when developing English courses.