Background The cognitive demands of medical education require optimal learning environments. While the influence of background music on cognition has been widely studied, existing research exhibits a significant Eurocentric bias, predominantly focusing on Western classical music like the “Mozart Effect.” This leaves a critical gap in understanding the impact of culturally salient, non-Western musical traditions on learning within their native contexts.

Methods A single-blind, randomized controlled trial was conducted with 147 clinical (4th, 5th and 6th) year medical students stratified by ethnicity at the Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria between March and September 2025. Participants were randomly assigned to one of three background music conditions: Igbo Highlife (instrumental), Western classical (Mozart’s Sonata K.448), or silence (control with pink noise masking). Cognitive performance was assessed through a short-term memory recall test of 20 medical terms and a timed clinical problem-solving task comprising 20 multiple-choice questions. Baseline mood was controlled for using the Positive and Negative Affect Schedule (PANAS). Data were analyzed using ANOVA and post-hoc Tukey HSD tests.

Results Music condition had a highly significant effect on student performance (p < 0.001). The Igbo Highlife group demonstrated superior outcomes, achieving the highest scores in memory recall (mean = 16.7) and problem-solving accuracy (mean = 15.7), alongside the fastest completion time (23.4 seconds/question), significantly outperforming both the classical and silence groups. A significant correlation was found between cultural familiarity with Highlife and enhanced cognitive performance (accuracy: ρ = 0.268, p = 0.001).

Conclusions Incorporating music that holds cultural significance and familiarity to learners, specifically Igbo Highlife, is a highly effective auditory stimulus for enhancing learning efficiency in medical education. Students and educational institutions should consider integrating culturally familiar instrumental music into study environments to optimize cognitive performance and learning outcomes.

Competing Interest Statement The authors have declared no competing interest.

The authors have declared no competing interest.

This study was self-funded

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Nnamdi Azikiwe University Teaching Hospital Health Research Ethics Committee gave ethical approval for this work (NAUTH/CS/66/VOL.18/VER.3/141/2025/48).

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