Objective This study was aimed at investigating the best way to seek clarification when failing to correctly understand the meaning of an English utterance.

Materials and Methods We administered a survey to Japanese freshmen majoring in medicine to determine the main reasons for their failure to hear utterances and how they seek clarification when facing different situations of mishearing. The same survey was distributed to four teachers who are native English speakers.

Results Generally, the students obtained a low percentage of correct answers to multiple-choice questions. The use of a particular test-taking strategy depended primarily on an individual, but the students evaluated all the choices when answering multiple-choice questions.

Conclusions The current study revealed that the most common causes of mishearing among the participants were a lack of vocabulary and speech speed. The most popular strategy for seeking clarification was asking for it directly. Finally, the native speakers and highly proficient students tended to attempt to understand utterances indirectly.