Based case based learning and flipped classroom as a means to improve international students' active learning and critical thinking ability.

BACKGROUND: International student education has become an important part of higher education and an important symbol to measure the level of higher education. To change the traditional teaching model, here we introduced a combination of Case-Based Learning (CBL)and Flipped Classroom (FC) into the pathophysiology course for international students. This study aimed to explore whether the active learning ability and critical thinking ability of international students can be improved, based on this new teaching model, improving the innovation ability of teachers' team and students' attitude to the reform. METHODS: The two chapters of Cardiac Insufficiency and Apoptosis in Pathophysiology are designed as a CBL + FC teaching method. Distribute the Self-assessment Scale on Active Learning and Critical Thinking (SSACT) and satisfaction questionnaire to international students to evaluate teaching reform based on CBL + FC. RESULTS: Compared with the traditional classroom, the online flipped classroom based on CBL has significantly improved the learning enthusiasm, as these students are required to independently complete literature review, actively participate in classroom teaching, learn to use multiple learning strategies, and collaborate with other students to complete PowerPoint (PPT)production. At the same time, the students' ability to raise problems and solve problems has been greatly improved by analyzing clinical cases; By consulting the literature, the theoretical knowledge learned can be better applied to clinical analysis. The results of the satisfaction survey also show that international students are more likely to accept the flipped classroom teaching mode. CONCLUSIONS: This teaching mode will stimulate the learning motivation of international students, enhance teaching attraction and increase teaching interaction; At the same time, the CBL + FC teaching method can strengthen the evaluation of international students' in and out of class and online learning, enhance students' active learning ability and critical thinking ability, promote the development of personalized learning, and integrate with international medical education.

Assessing institutional image's influence on student satisfaction and loyalty in Singapore's higher education: A study on higher learning institution students.

This research project expands on previous studies to analyze the institutional image from the perspective of higher education students in Singapore. The work builds on extensive prior research and examines the impact of the recent pandemic and lockdowns in Asia, which have increased Singapore's popularity as a study destination for Asian students, particularly from China. Known as the Garden City and one of Asia's wealthiest cities, Singapore has grown significantly due to foreign direct investment and its strategic location near Malaysia and Indonesia. This study aims to identify institutional and city image dimensions in higher education, focusing on three of Singapore's six publicly funded universities. The critical factors examined include Institutional Image, Economic Image, Social Image, Environmental Image, Perceived Educational Quality, and Satisfaction and Loyalty. These factors are crucial for Singapore's goal to become an innovation and talent powerhouse by 2030, aligning with national scientific and technological advancement plans. The research also explores how Singapore competes with traditional study destinations like the USA, Britain, and Australia.

The relationship between acculturative stress and psychological outcomes in international students: a systematic review and meta-analysis.

Introduction: The current systematic review aimed to examine the relationship between acculturative stress (AS) and psychological outcomes in international students to determine the role AS may play in predicting the mental health of international students. Methods: The studies included in the current systematic review and meta-analysis had considered AS and its impact on psychological outcomes among international students studying abroad. After checking the studies found in our primary search through the scientific databases in terms of our eligibility criteria, 29 studies were included, of which 26 were eligible for a meta-analysis (total N = 7,247). Results: Meta-analysis indicated a moderate mean correlation of AS with psychological outcomes like depression, life satisfaction, quality of life, vocational outcome expectations, drinking behaviors, resilience, health promotion behavior, psychological adjustment, psychological distress, negative affect, and mental health symptoms (r = 0.39) and depression (r = 0.41), respectively. Discussion: The review of studies revealed a robust relationship between AS and increased negative psychological outcomes such as depression, psychological distress, and general stress, as well as decreased positive psychological outcomes such as psychological adjustment, mental health, life satisfaction, and quality of life.

Understanding International Students' Perspective of Health Service Quality: A Cross-Sectional Study in a Hungarian University.

Purpose: Understanding patient's preferences is important to delivering good quality services. Patients' feedback provides healthcare providers with valuable information about the services provided. The increasing number of international students enrolling in Hungarian Universities raises the need to ensure the quality of services meets international students' requirements, which includes healthcare. This study aimed to assess service quality in the University Health Center (UHC) from the international student's point of view to be used to improve the quality of services. Methods: This cross-sectional study was conducted at the university health center. We used a mixed methods approach to collect both quantitative and qualitative data. We used the importance-performance analysis (IPA) for quantitative analysis to understand expectations and perceptions in service research. The qualitative analysis was conducted from responses to reflection questions. The qualitative data were then analyzed using thematic analysis. Results: 437 international students participated in the study, but only 402 (91.99%) were analysed. The gaps between the importance and performance of service quality were negative in all dimensions (P-value < 0.001). This suggests that there is an unmet need for student expectations and university health center performance. From the Importance factor, the highest and lowest were related to safety (4.54 ± 0.56) and efficiency (4.31 ± 0.66) dimensions. The Performance factor's highest and lowest mean scores were also related to safety (4.22 ± 0.72) and efficiency (3.91 ± 0.87), respectively. From qualitative analysis, there are two major themes several secondary themes from the thematic analysis of free-text responses were identified. Conclusion: The importance and performance analysis could provide useful information to university policymakers about university health center service quality. There is a need for improvement and obviating the importance-performance gaps, especially in the efficiency dimension. Decision-makers can use the IPA analysis results to allocate limited resources more effectively, giving special attention to possible organizational weaknesses for further direction.

The darkness of reacculturation: examining factors influencing depression among Chinese international student returnees in the post-COVID-19 era.

Introduction: In the aftermath of the COVID-19 pandemic, the reintegration of Chinese international student returnees intersects with China's critical effort to combat a significant brain drain of highly skilled talents, highlighting an unprecedented psychological battleground. This convergence underscores the urgent need for nuanced research to navigate the uncharted territory of their mental health. Methods: Employing Bayesian analysis supported by Markov Chain Monte Carlo (MCMC) algorithms, this study examined depression prevalence and associated factors among 1,014 Chinese returnees. The sample comprised 44.87% male participants (455), 51.58% female participants (523), and 3.55% identifying as "Others" (36), with an age distribution of 61.74% aged 18-30 (626), 28.80% aged 31-40 (292), and 9.47% aged 41-50 (96). The mean age of participants was 29.6 years, ranging from 18 to 50 years. PHQ-9 diagnoses revealed alarming levels of depression, with 47.9% exhibiting a moderately severe degree of depressive disorder. Results: Our findings highlight the intricate interplay between identity clusters- "homestayers" (those leaning towards a Chinese cultural identity), "navigators" (those with a bicultural identity), and "wayfarers" (those leaning towards a foreign cultural identity)-and the likelihood of depression. Specifically, homestayers showed a clear and strong negative association, navigators demonstrated a positive association, and wayfarers had a positive yet unclear correlation with depression levels. Furthermore, acculturation, age, and gender showed no significant effects, whereas education mildly mitigated depression. Discussion: Based on these findings, we suggest the implementation of better-tailored mental health support and policies to facilitate smoother reintegration.

A Case Study Investigating the Relational Well-Being of International Students at Hohai University Nanjing, Jiangsu Province of China.

This study acknowledges the growing importance of international student mobility and examines the relational well-being of international students at Hohai University in Nanjing, China. Understanding the complexities of interactions among international students is essential for their well-being and the university's overall success, since this tendency continues to increase. By examining the distinct possibilities and problems faced by international students at Hohai University and considering elements including cultural distinctiveness, the campus environment, interpersonal dynamics, and support networks, the study fills a research void. For this purpose, 150 international students at Hohai University participated in semi-structured interviews and 10 participants participated in unstructured interviews as part of the mixed-methods approach to obtain in-depth information. Hence, the descriptive data were analyzed using SPSS and qualitative analyses were performed using NVIVO. According to preliminary findings derived from quantitative data, important results emphasize the significant impact of homesickness (0.143, T value: 5.931) and the positive correlation of relational well-being (0.146), highlighting their significance. The effect of the language barrier is also significant (0.125, T value: 4.378), whereas loneliness has little bearing (0.011, T value: 0.847). Additionally, the highest concern of the international students (M = 8.35; SD = 1.43) was making connections with local students. Additionally, (M = 8.21; SD = 1.15) international students favored Hohai University, which provided a welcoming atmosphere for intercultural dialogue. The Foreign Student Office, social events, cultural exchange programs, counseling services, and peer support networks are just a few examples of the support structures and networks crucial to international students' general well-being. At the same time, the cultural hurdles, including the language barrier and loneliness, seemed to be the challenge. The study concludes by shedding light on the relational well-being of international students at Hohai University and highlighting the importance of community-building and supporting actions. The results provide insightful information that will help the institution better respond to the particular difficulties that international students encounter, creating a more welcoming and stimulating atmosphere. This study establishes the foundation for further research in comparable contexts and advances our understanding of relational well-being in the context of experiences for overseas students.

Deciphering dynamic interactions among multidimensional psychological motivations, academic performance, and sociocultural adjustment: The critical influence of excessive WeChat use.

As the preeminent mobile social media platform in Mainland China, WeChat's meteoric expansion has revolutionized the dynamics of interpersonal communication and the modalities of mutual interaction among individuals. Despite the escalating significance of mobile social media in the cross-cultural adaptation of international students, existing scholarly works have largely neglected the underlying relationship between psychological motivations, excessive WeChat use, academic performance, and sociocultural adaptation of these students. Anchored in uses and gratifications theory and cross-cultural adaptation paradigm, the primary objectives of this study are to devise a theoretical model and to scrutinize differential psychological motivations propelling international students' WeChat usage, its association with excessive WeChat use, and impacts on academic performance and sociocultural adjustment. The proposed model undergoes meticulous evaluation through data amassed online from 598 Chinese international students studying in Germany. Sequential analytical techniques, especially Confirmatory Factor Analysis and Structural Equation Modeling, were employed to elucidate the dynamic interplay among key variables. The final results validate the path effect suggesting that both hedonic and social motivations are positive predictors of excessive WeChat use. Moreover, excessive WeChat use is negatively correlated with academic performance and sociocultural adjustment. However, utilitarian motivation is not significantly related to excessive WeChat use. By demystifying the driving factors and consequences of excessive WeChat use, these findings not only accentuate the pivotal role of mobile social media in the cross-cultural adaptation of international students but also enrich the theoretical landscape and enhance the strategic approaches for educators and academic institutions.

Hungry, Stressed, and Away From "Home": Predictors of Food Security and Perceived Stress Among International Students.

PURPOSE: Examine the predictors of food security and perceived stress among international students. DESIGN: Cross-sectional Design. SETTINGS: A public university in the Southwest United States. SUBJECTS: Sample size of Seventy-three participants (≥18 years). MEASURES: Self-report measures of food insecurity and perceived stress. The U.S. Department of Agriculture (USDA) Adult Food Security Survey Module (AFSSM) to assess food security status, and the Perceived Stress Scale (PSS-10) questionnaire to evaluate stress levels. ANALYSIS: Logistic regression was performed to identify predictors of food security and perceived stress. RESULTS: Duration of stay in the U.S. was a predictor of food security status, while gender was a predictor of perceived stress. International students in the U.S. for less than a year had a lower chance of being food secure [OR (95% CI) = 0.22 (0.05 - 0.74)]. Female international students had a lower chance of experiencing low perceived stress [OR (95% CI) = 0.07 (0.00 - 0.51)]. CONCLUSION: In supporting international students, targeted nutrition and stress management interventions should be emphasized, particularly for females and those who recently moved to the U.S.

The impact of mindfulness training on alleviating COVID-19 fear among international students in China: A quasi-experimental study.

This study investigated the effects of mindfulness training on alleviating fear of the COVID-19 epidemic among international students in China during the academic year 2020. The training group participants (N = 41) and the control group participants (N = 44) were surveyed pre-and post-training with the two English questionnaires: The Five-Facet Mindfulness Questionnaire (FFMQ) and the fear of the COVID-19 scale (FCV-19S). The results showed that, regarding the relationship between the two main variables in the study, mindfulness is related negatively to the COVID-19 epidemic. Moreover, compared to the control group, results showed that individuals in the training group demonstrated significant improvements in mindfulness levels and decreased Fear of COVID-19. Thus, findings suggest that a short online mindfulness meditation training may reduce fear of the COVID-19 epidemic.

Analysing the influencing factors of on-line studying engagement of preparatory international students: A case study of the science and technology Chinese course.

With the rapid development of network technology, cross-regional on-line higher education is becoming one of the mainstream directions of distance education development. The effectiveness of on-line studying is significantly influenced by the level of learning engagement, and research on this topic can help learners by providing them with process-oriented learning support and targeted teaching interventions. Using the example of on-line Science and Technology Chinese Course for preparatory international students at four universities in China, this study collected self-reported data from 463 students using a survey method. The questionnaire was divided into two parts: the on-line studying engagement scale and the factors influencing on-line studying engagement. Descriptive statistical analysis and differential testing were conducted on the data using SPSS software, and the structural validity of the questionnaire was tested using AMOS software. With the assistance of Smart PLS, a model of the influencing factors of on-line studying engagement was constructed to explore the relationship between on-line studying engagement and its influencing factors. The study found that: The overall level of engagement in on line studying for preparatory international students is above average. In demographic factors, apart from gender, all other variables have a significant impact on on-line studying. Student-level factors will have a more significant positive impact on the degree of on-line studying engagement of preparatory international students. Among them, academic self-efficacy, basic psychological needs satisfaction, the difficulty of the on-line course, and completion of the assignment have a significant positive effect. The influence of teacher-level factors on behavioral engagement and emotional engagement is stronger than that of student-level factors. However, the emotional support of teacher-level factors, the on-line environment of environmental-level factors, and the perceived usefulness of technology of teacher-level factors have a certain negative impact on engagement in online studying. According to the research results, this paper puts forward the optimization strategies of accelerating the update frequency of Chinese learning materials, strengthening the input of on-line emotional support, and holding language learning activities with cultural characteristics. This study makes an in-depth analysis of the influencing factors of preparatory international students' on-line Chinese studying engagement, and puts forward the optimization strategies to improve the quality of on-line studying, to provide theoretical and practical reference for the development of cross-regional on-line higher education.

Mental health help-seeking intentions & coping strategies of Chinese international students in the United States.

BACKGROUND: Chinese international students (CIS) in the United States may face unique mental health challenges that are often overlooked in discussions about mainstream college student needs. OBJECTIVE: This study aims to investigate the predictors of mental health (MH) professional help-seeking intentions among CIS at a large public Midwestern university, as well as the obstacles that hinder their use of professional MH services. METHODS: The study used quantitative and qualitative approaches to gather data on CIS' help-seeking attitudes. Quantitative analysis focused on the association between specific factors and help-seeking intentions. Qualitative coding of open-ended questions provided additional insights into obstacles and suggestions for improving mental health support. RESULTS: The study identified several factors influencing the mental health help-seeking intentions of Chinese international students. Two primary negative predictors were a preference for emotional self-control and concerns about the questionable quality of treatment. Conversely, having previous experience with professional mental health services, both in China and the United States, was found to be a positive predictor of help-seeking intentions. Additionally, qualitative analysis of open-ended responses revealed further obstacles to seeking help and provided useful suggestions for enhancing mental health support for Chinese international students in college settings. CONCLUSIONS: The study identifies key factors that influence CIS' attitudes toward seeking professional mental health services. Understanding these factors can help in developing strategies to better support the mental health of CIS in college settings. LIMITATIONS: Several limitations must be acknowledged in this study. The cross-sectional design limits the ability to draw causal inferences from the data. Additionally, the sample may not be fully representative of the broader population of Chinese international students, which may affect the generalizability of the findings. Self-reported data may also introduce response biases. Future research should consider longitudinal approaches and a more diverse sample to validate and expand on these findings.

Acculturation and adjustment among international college students: The moderating role of perceived second language proficiency.

Objectives: This study was aimed at examining the relationship between acculturation strategies and both psychological and socio-cultural adjustment, while concurrently assessing the moderating role of perceived second language proficiency. The premise was that proficiency in the host country's language could potentially facilitate successful acculturative outcomes. Method: We used self-report measures to collect data on a sample of 237 international students in Los Angeles. A General Linear Model was applied for data analyses. Results: Overall, integration emerged as the most adaptive acculturation strategy, whereas marginalization was identified as the least adaptive. Noteworthy, moderating effects were observed in the relationships between marginalization and life satisfaction, integration and socio-cultural adjustment, assimilation and psychological problems, as well as socio-cultural adjustment. Conclusions: Our findings lend support to the Integration Hypothesis, highlighting that adopting integration is associated with superior adaptive outcomes, also pointing out that the pattern of associations between acculturation strategies and both psychological and socio-cultural adjustment could fluctuate depending on the level of perceived second language proficiency.

Examining Communicative, Critical Health Literacy and eHealth Literacy among International University Students Residing in Japan.

(1) Background: International students with sufficient health literacy are better equipped to respond to public health emergencies and reduce any unintentional harm that may occur during such events. This study aims to assess the current status of health literacy among international students and investigate the factors that influence health literacy. (2) Methods: A cross-sectional study was conducted in Tokyo on international university students using a questionnaire consisting of the Communicative and Critical Health Literacy and eHealth Literacy Scales. The study analyzed 205 valid responses. Descriptive statistics were utilized to assess the level of health literacy, and linear regression was used to identify the association of socio-demographic characteristics and disease status with health and e-health literacy. (3) Results: Health literacy and e-health literacy were low in 48.29% and 47.29% of international students, respectively. The mean scores of CCHL items ranged from 3.13 to 3.26, while the mean scores of eHEALS items ranged from 3.33 to 3.49. Both health literacy and e-health literacy were better with unmarried status (p = 0.015), and e-health literacy was worse with higher age (p = 0.007). (4) Conclusions: Overall, international students' health literacy and e-health literacy were at intermediate levels, with considerable room for improvement, and affected by certain student attributes.

Comparison of Depressive Symptoms between International and Domestic Students in a Japanese University: Pre- and Post-COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic led to significant lifestyle changes and uncertainties, triggering a secondary wave of mental health issues in society. University students are especially susceptible to mental disorders. International students are considered more vulnerable due to limited emotional and financial support from their families and difficulties accessing community support. Hence, we conducted a longitudinal analysis to compare depressive symptoms among international students before and during the pandemic. METHODS: Data from depression screenings conducted at the University of Tsukuba in 2019 and 2020 were utilized. We included all students enrolled in 2019 who underwent health check-ups in both 2019 and 2020. Participants completed the Patient Health Questionnaire-9 (PHQ-9), enabling a comparison of item scores between domestic and international students. Psychopathological network analysis was employed to examine relationships among the items. RESULTS: Prior to the pandemic, international students generally exhibited relatively good mental health compared with domestic students. During the 2020 pandemic, no significant difference was observed, but international students tended to demonstrate better mental health. However, network analysis revealed intergroup variations in the relationships among PHQ-9 items, with concentration problems and suicidal thoughts being more prominent among international students. CONCLUSION: This study's findings suggest that young people studying abroad experience mental health crises similar to their domestic counterparts. Nevertheless, the patterns of these crises may differ between the two groups.

Bystander intervention for problematic alcohol use among graduate and international students: opportunities and challenges.

OBJECTIVES: Bystander intervention (BI) is a prevention approach commonly used for interpersonal violence, but is less studied for problematic alcohol use (PAU). Domestic graduate and international students' life experiences bring a unique context for the potential application of BI to PAU. METHODS AND MEASURES: We conducted a mixed methods study that consisted of a needs assessment and focus groups at a southeastern university in the U.S. The aims of this study were to understand (1) differences in PAU BI opportunities for domestic graduate versus international students, (2) reasons for differences in PAU BI use, and (3) barriers/facilitators in use of PAU BI. RESULTS: Overall, participants had few opportunities to use BI. Domestic graduate students had slightly more opportunities compared to international students. Most prominent reasons for lack of opportunities included not wanting to drive, the cost of drinking, and holding a graduate student identity (e.g. not interested in heavy drinking). Trusting others to be responsible for themselves was a common barrier noted for not using BI for PAU. CONCLUSION: PAU BI programs should contextualize experiences of domestic graduate and international students to provide appropriate skill development that considers unique barriers and facilitators to intervention use.

"A different country, a different language, a different culture " Educational experiences of international nursing students studying in Turkey: A qualitative study.

AIM: This study was aimed at investigating the educational experiences of international nursing students in Turkey. BACKGROUND: Nursing education has now gained an international dimension, which creates an environment where students from different cultures come together. In Turkey, nursing education is expanding internationally due to the increasing number of international students. DESIGN: A descriptive- phenomenological qualitative study. METHODS: The study data were collected from nursing students who came to Turkey from 17 different countries between April 2023 and July 2023 to study at a nursing faculty in Turkey using a semi-structured interview form. Of these students, 27 constituted the study sample. The data collected were analyzed using the content analysis. The COREQ checklist was used in reporting the study. RESULTS: Four themes emerged: a) challenges, b) gains, c) support needs and d) recommendations. Among challenges reported by the participating students were language barriers, cultural adjustment issues and lack of social support. As for the gains of being a foreign student, they stated that they experienced intercultural interaction and improved their language skills, independence and self-confidence. In the study, the need for language support, provision of psychological assistance and cultural adaptation support for these students and the importance of practical recommendations such as mentoring programs and orientation trainings to improve their educational experience were emphasized. CONCLUSION: In conclusion, in this study, the importance of targeted strategies in nursing education in areas such as language support, psychological assistance and cultural adaptation was emphasized, which helps international students to have a successful educational experience. It was also concluded that mentoring programs and orientation trainings could enrich the educational processes of students by facilitating their adaptation to their new environment. This study is notable in the literature in that students from 17 diverse countries share the same program and the same prerequisites.

International graduate entry nursing students: A qualitative study on engagement.

AIM: This study aims to elicit graduate entry nursing students' views on factors that enable and constrain their learning engagement. BACKGROUND: Learning engagement has been associated with student retention/attrition and the achievement of learning confidence and success. While all students are subject to challenges that affect their learning engagement, those experienced by international students who are learning in a foreign and unfamiliar context are of particular concern to academics. An understanding of international graduate entry nursing students' perspectives on factors that enable and constrain their engagement can inform development of learning and teaching strategies that are more responsive to the needs of this group of students and can support their learning achievement. DESIGN: A qualitative descriptive design conducted in one Australian multi campus university School of Nursing. Participants included first and second-year international students enrolled in a graduate entry Master of Nursing course. METHODS: Data, including demographic information, was collected via a theoretically informed online survey consisting of a Likert scale and open- ended questions. This study reports participant responses to open ended questions included in the survey. A thematic analysis was used to interpret findings. FINDINGS: Analysis identified participants' perspectives on factors that influenced their learning engagement in four theme areas: 1) Availability of study support resources, 2) Opportunities for social interaction, 3) Opportunities to build a sense of belonging, and 4) Constraints on development of a sense of engagement. Opportunities for social engagement emerged as a dominant finding across all themes. CONCLUSION: This research, which focused on international students' perspectives on learning engagement, contributed to existing knowledge on student engagement in higher education graduate entry nursing courses. Opportunities for social interaction within and beyond formal course learning experiences were valued by students and identified as key to their learning engagement. These findings have implications for academics and student support services who together, can influence the context of students learning to better meet their engagement needs.

Help-Seeking After Intimate Partner or Sexual Violence: Exploring the Experiences of International Student Women in Australia.

Research suggests that many international students experience intimate partner violence (IPV) or sexual violence (SV) whilst attending tertiary institutions. Yet, little is known about how they engage in help-seeking and what types of support they need following IPV/SV. In this paper, we present findings from a qualitative analysis of 30 in-depth interviews with international student women who experienced SV/IPV while studying in Australia. The findings highlight how isolation and structural factors can create significant barriers to help-seeking for international student women. Yet, the findings also highlight the agency and resourcefulness of international student women in overcoming challenges. The provision of culturally and linguistically appropriate and tailored support for international students is crucial in order to help reduce the harms of SV/IPV.

Social support and psychotherapy outcomes for international students in university/college counseling centers.

Objective: To explore the relationship between international students' social support at intake and international student distress at end of treatment. Participants: Data was collected from participants (n = 40,085) from 90 United States universities using the Center for Collegiate Mental Health (CCMH) database. Methods: Participants completed measures of psychological distress and perceived social support. Using multilevel modeling, we predicted participants' distress at end of treatment by international student status, social support, race, and length of therapy. Results: We found that international students who reported lower social support at intake ended treatment with higher levels of psychological distress when distress at intake was controlled compared to United States peers. Conclusions: Understanding the significance of social support for international students can help to inform mental healthcare professionals' approach to psychotherapy.

Sociocultural adjustment and social support as predictors for international medical sciences students' anxiety during COVID-19.

BACKGROUND: The prevalence of anxiety is high among international medical sciences students and it increased even more during the COVID-19 pandemic due to different restrictions and social isolation. Successful sociocultural adjustment and social support could be important factors in overcoming those challenges, however, there is a lack of studies which would investigate the role of those factors among inter- national medical students. This study aimed to assess the role of sociocultural adjustment and social support as predictors for international medical students' anxiety during COVID-19. METHODS: Two measurements were conducted via self-reported questionnaires which consisted of three scales - SCAS, MSPSS and GAD-7. In total, 82 international medical students participated in both measurements in this longitudinal study. RESULTS: The findings indicated that 37% of international students had symptoms of moderate or severe anxiety during their first year of studies at university. In the second year, during the COVID-19 pandemic and an official lockdown, 35% of international students had symptoms of moderate or severe anxiety. In addition, this study showed that gender and sociocultural adjustment did not play a role as predictors of students' anxiety during the second year of studies. However, this study revealed that social support provided by family during the first year of studies, as well as having friends or family members who had been ill with COVID-19 predicted higher levels of anxiety at second measurement, while sociocultural adjustment was an even stronger predictor of anxiety in the second year of studies of international medical students. CONCLUSIONS: This knowledge can help to better understand how international medical students felt during the COVID-19 pandemic and what role the above- mentioned factors played in the students' anxiety. As the anxiety level is quite high among international medical students, universities and mental health service providers should take it into consideration and help them to overcome those challenges.