Medlex Context - Isolated vs Contextualised Lexical Processing in Medical English Listening

This study extends the MedLex Context framework to auditory processing, examining the effects of isolated versus contextualised lexical presentation on receptive vocabulary access in Medical English listening within an English for Specific Purposes (ESP) context. Using a counterbalanced within-item design, 40 second-year medical students completed controlled listening tasks based on a corpus-derived set of 30 lexical items, presented either in isolation or embedded in sentence context. Results indicate a small but statistically significant overall advantage for contextualised listening, alongside substantial item-level variability, including both facilitative and inhibitory effects. These findings suggest that contextualisation does not uniformly support lexical access, but instead redistributes cognitive load across concurrent processing demands characteristic of auditory input. In comparison with reading-based findings within the MedLex paradigm, listening demonstrates a more balanced yet highly variable interaction between context and lexical accessibility, highlighting the importance of modality-specific constraints. The study contributes to a modality-sensitive account of vocabulary processing in ESP, emphasising the conditional nature of contextual effects and their dependence on lexical properties, input structure, and cognitive load. It further supports a staged pedagogical approach integrating isolated and contextualised listening tasks. Note: This is a pre-print version of the paper. The record will be updated following formal publication in conference proceedings.