The survey was conducted between February and May 2026 among undergraduates in medicine, dentistry, nursing and applied medical sciences at five universities in Riyadh. Participants had a mean age of 21.78 ± 3.73 years; 352, or 77.1%, were female and 104, or 22.9%, were male. Medicine was the largest professional group, contributing 280 participants, followed by applied medical sciences with 100, nursing with 53 and dentistry with 23. Recruitment into the university groups was also uneven: University A supplied 201 respondents, University B 90, University C 74, University D 63 and University E 28. The final dataset contained no missing observations, and all 456 students were included in the analyses.

Researchers used a 32-item questionnaire adapted from a previously validated instrument for health workers. A panel of five specialists in oral medicine, oral pathology and dental public health reviewed the questions for relevance, clarity and cultural appropriateness in Saudi Arabia. The panel removed 22 of the original 54 items, including questions about alcohol use, betel-quid or areca-nut chewing and practices not routinely performed by Saudi healthcare students. The adapted questionnaire achieved a scale-level content validity index of 0.94. A pilot study with 40 students, excluded from the main analysis, produced an intraclass correlation coefficient of 0.82, while internal consistency was 0.74 for awareness, 0.72 for attitudes and 0.77 for practice.

Because eight of the 12 knowledge questions allowed multiple answers, the researchers did not construct a conventional total knowledge score. Instead, they used two-step cluster analysis on 27 categorical variables covering risk factors, oral changes, lesion recognition and treatment-related responses. This method separated 195 students into a higher-knowledge cluster and 261 into a lower-knowledge cluster. The higher cluster was much more likely to identify leukoplakia, tobacco use and non-healing ulcers: 82.1% recognized leukoplakia, 94.4% identified tobacco use and 67.2% recognized non-healing ulcers. In the lower cluster, the corresponding proportions were 13.0%, 58.2% and 30.3%.

Dental students had substantially stronger results: 18 of 23, or 78.3%, fell into the higher-knowledge cluster, compared with 143 of 280 medical students, or 51.1%; 21 of 100 applied medical sciences students, or 21.0%; and 13 of 53 nursing students, or 24.5%. In multivariable binary logistic regression, dental students had 12.67 times the odds of belonging to the higher-knowledge cluster than applied medical sciences students, with a 95% confidence interval of 4.17 to 38.40 and p < 0.001. The wide interval signals considerable imprecision, however, and medical students also had higher odds than applied sciences students, at 3.77 with a 95% confidence interval of 2.19 to 6.49 and p < 0.001. Nursing did not differ significantly from applied sciences, and age was not a significant independent predictor.

Awareness also varied by professional stream, with a p-value of 0.006. Fifteen dental students, or 65.2%, were classified as having high awareness, compared with 29.3% of medical students, 32.0% of applied sciences students and 32.1% of nursing students. In regression analysis, however, the dental difference from applied sciences narrowly missed the conventional threshold for statistical significance, producing an odds ratio of 2.68, a 95% confidence interval of 0.99 to 7.23 and p = 0.052. Knowledge was more clearly associated with awareness: students in the higher-knowledge cluster had 2.07 times the odds of high awareness than those in the lower cluster, with a 95% confidence interval of 1.35 to 3.19 and p = 0.001.

Attitudes and reported practices showed parallel variation. Positive attitudes toward oral cancer examination, screening and education were recorded for 52.2% of dental students, 24.5% of nursing students, 17.0% of applied sciences students and 13.6% of medical students; the association with professional stream was significant at p < 0.001. Dental students also had 3.54 times the odds of a positive attitude than applied sciences students, with a 95% confidence interval of 1.23 to 10.17 and p = 0.019. University D had higher odds of a positive attitude than University E, although the study did not model possible within-university correlation fully. The knowledge cluster itself was not independently associated with positive attitude after adjustment, with an odds ratio of 1.66, a 95% confidence interval of 0.96 to 2.87 and p = 0.070.

Good clinical practice was reported by 65.2% of dental students, 26.4% of nursing students, 19.0% of applied sciences students and 16.4% of medical students. High awareness was associated with 3.53 times the odds of good practice, while a positive attitude was associated with 5.10 times the odds; both confidence intervals excluded 1 and both p-values were below 0.001. Dental students also had 4.40 times the odds of good practice compared with applied sciences students, with a 95% confidence interval of 1.44 to 13.43 and p = 0.009. Medical and nursing students did not differ significantly from applied sciences in the adjusted model. Notably, the higher-knowledge cluster itself was not independently associated with good practice, with p = 0.374, indicating that greater factual knowledge alone was not fully aligned with reported clinical behavior.

Knowledge did not differ significantly among the five universities, with p = 0.057. That borderline result should not be read as evidence that the institutions were equivalent, particularly because institutional sample sizes ranged from 28 to 201 and potential clustering within universities was not formally modeled. Differences in curriculum, academic stage, prior training and clinical exposure were also not measured, so the study cannot establish that professional discipline itself caused the observed variations. Its cross-sectional design, voluntary online convenience sampling and self-reported answers further limit causal interpretation and generalizability. Without a complete sampling frame or denominator of eligible students, the researchers could not calculate a reliable response rate or assess nonresponse bias. Selection of students with greater interest in oral health may also have produced more favorable results than those found in the wider Riyadh student population.

The results point toward interdisciplinary education that combines recognition of oral potentially malignant disorders with practical examination, counseling and referral training. Students across medicine, nursing and applied medical sciences may encounter oral lesions during routine care, yet the survey indicates that knowledge alone does not reliably predict favorable attitudes or practices. The authors therefore recommend clinically oriented oral cancer instruction, interprofessional collaboration and opportunities to apply knowledge in realistic settings. They also call for larger, representative multicenter studies using probability-based recruitment, balanced participation across professions and institutions, objective assessments of clinical performance and statistical methods that account for institutional clustering. Until such evidence is available, the dental advantage and the size of the broader educational gaps should be treated as preliminary rather than definitive.

Subject of Research: Knowledge and clinical readiness concerning oral potentially malignant disorders and oral cancer among health professional students in Riyadh

Article Title: Knowledge, awareness, attitudes and practice regarding oral potentially malignant disorders and oral cancer among health professional students in Riyadh, Saudi Arabia: a multicenter cross-sectional study

Article References: Khanagar, S. B., Alofi, A., Alzaaqi, L. A., Alsubaie, J. M., Alayed, D., Abothnin, S. M., Almuammar, A. A., Alfaifi, A., & Iyer, K. (2026). Knowledge, awareness, attitudes and practice regarding oral potentially malignant disorders and oral cancer among health professional students in Riyadh, Saudi Arabia: a multicenter cross-sectional study. Frontiers in Oral Health, 7, Article 1942387. https://doi.org/10.3389/froh.2026.1942387

Image Credits: AI Generated

DOI: 10.3389/froh.2026.1942387

Keywords: oral cancer, oral potentially malignant disorders, health professional education, Riyadh, Saudi Arabia, dental students, medical students, early detection, cross-sectional study, Knowledge, awareness, attitudes

The stakes are far from abstract. Ableist attitudes among future physicians and dentists can shape clinical decisions, communication, and even whether disabled patients feel safe seeking treatment at all. They also influence how learners and professionals with disabilities are treated within the health system itself, affecting who gets admitted, who gets supported, and who quietly leaves the profession. The United Nations Convention on the Rights of Persons with Disabilities obliges signatory states, including Germany, to dismantle such barriers, yet until now there has been no brief, context-sensitive German tool to quantify these subtle attitudes in the very institutions that train the country’s clinicians.

What makes the new study distinctive is its methodology. Conducted between 2022 and 2024, the three-phase instrument-development project placed people with disabilities at the center of the process from the outset. Rather than treating disabled people as subjects to be measured, the researchers involved them directly as experts by experience in interpreting the construct, generating new items, and reviewing content alongside specialists in disability studies and clinical practice. This participatory approach reflects a growing consensus in disability studies that instruments about disabled people should not be built without them, and it likely explains why the final scale captures dimensions of ableism that purely academic item-writing might have missed.

The technical groundwork began with the original English Symbolic Ableism Scale, which the team subjected to forward-backward translation into German. But translation alone was not enough. The researchers complemented the translated items with de novo items generated through the participatory process, then used qualitative content analysis and content validity ratios to refine the pool. Content validity ratios quantify how many experts judge each item as essential, giving the team a numerical handle on which questions genuinely belonged. By the end of Phase 1, a 25-item pool was ready for field testing, blending classic items on denial of rights and interpersonal comfort with new material grounded in lived experience.

Phase 2 put that pool to the test in a general-population pilot sample of 210 participants. Item-level statistics from this pilot guided both conceptual and linguistic redevelopment, trimming and reworking the instrument into a 21-item pre-final version tailored for students. This iterative winnowing is standard practice in scale construction, but the Freiburg team added an unusually rigorous statistical apparatus in the final phase, in which 173 medical and dental students completed the pre-final version. Deciding how many factors underlie a set of questionnaire items is one of the most contested problems in psychometrics, and the researchers attacked it from several directions at once.

Factor retention was guided by parallel analysis, a technique that compares observed eigenvalues against those generated from random data, using both Pearson and polychoric correlations. The team also applied Velicer’s minimum average partial criterion, which identifies the point at which removing further components no longer meaningfully reduces the correlations among remaining items. A primary exploratory factor analysis using maximum-likelihood extraction with oblimin rotation, which allows the resulting factors to correlate, was then supplemented by a sensitivity analysis designed for ordinal data, employing polychoric correlations and minimum residual extraction. The convergence of these methods on the same solution strengthens confidence that the two-factor structure is not a statistical artifact.

The final scale retained just ten items organized into two complementary factors. The first, Denial of Rights and Structural Barriers, comprises six items and showed strong internal consistency, with Cronbach’s alpha of 0.81 and McDonald’s omega of 0.83. The second, Interpersonal Comfort, comprises four items with alpha of 0.70 and omega of 0.74, values acceptable for a brief subscale. The unrotated maximum-likelihood extraction accounted for 44.3 percent of total item variance, and critically, the ordinal-data sensitivity analysis reproduced every primary item-to-factor assignment, suggesting the structure is robust to the choice of statistical treatment. The two dimensions echo a classic insight from prejudice research: someone can endorse abstract principles of equality while still feeling uneasy in personal interactions with members of a stigmatized group.

Exploratory regression analyses offered intriguing, if preliminary, correlates. Lower scores on Denial of Rights and Structural Barriers were associated with female gender, enrollment in medicine rather than dentistry, and friendship with a person with disabilities. Lower Interpersonal Comfort scores were associated with medical study and with such friendship. The friendship finding is particularly interesting, because sustained personal contact has long been identified in social psychology as one of the most reliable reducers of prejudice, and the pattern here is consistent with that literature. The authors are careful, however, to frame these regressions as hypothesis-generating rather than confirmatory, given the modest sample size and single-site design.

Indeed, the team is unusually candid about the limits of the evidence. The findings provide initial exploratory support for the scale’s structure and internal consistency in a single-site student sample, but independent multisite confirmation is required before the SAS-G can be deployed to evaluate interventions or compare groups or countries. Evidence of temporal stability, meaning that scores remain consistent over time in the absence of real change, is still lacking, as are data on responsiveness to change and measurement invariance, the property that a scale measures the same construct across different populations. These are exactly the psychometric milestones that separate a promising research instrument from one suitable for high-stakes program evaluation.

Even so, the arrival of the SAS-G marks a meaningful step for German-speaking health professions education. A ten-item questionnaire that can be completed in minutes gives educators, researchers, and curriculum designers a practical tool to benchmark attitudes, track the effects of disability-awareness training, and open honest conversations about how ableism operates in clinical culture. Its participatory pedigree may prove as important as its statistics: by building the scale with disabled people rather than merely about them, the Freiburg team has modeled the kind of inclusion the instrument is designed to promote. As medical and dental faculties across Germany and beyond grapple with their obligations under the CRPD, the SAS-G offers a way to measure how far there is still to go, and whether the steps being taken are actually working.

Subject of Research: Development and psychometric evaluation of a German-language scale measuring symbolic ableism in health professions education

Article Title: Symbolic ableism in health professions education: development and initial psychometric evaluation of the German symbolic ableism scale

Article References: Hillebrecht, A.-L., Hausdorf, D., Warth, R. V. D., Jeung-Maarse, H., Fabry, G., Linde, P., Auerbacher, M., Spies, B. C., & Reissmann, D. R. (2026). Symbolic ableism in health professions education: development and initial psychometric evaluation of the German symbolic ableism scale. BMC Medical Education. https://doi.org/10.1186/s12909-026-10636-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10636-6

Keywords: symbolic ableism, health professions education, psychometrics, scale development, disability studies, medical students, dental students, exploratory factor analysis, participatory research, prejudice measurement, Germany, questionnaire validation

The study, published in BMC Medical Education, recruited ninety-one first-semester undergraduate students from the dental programme at Karolinska Institutet and the nursing programme at Sophiahemmet University in Stockholm. Participants completed a detailed survey that captured sociodemographic information, their estimated daily screen use broken down by purpose, and a battery of twelve self-report instruments covering everything from anxiety and depression to sleep quality, physical activity, fear of missing out, and jaw pain. Self-perceived academic performance was measured with the Academic Performance Scale and treated as a continuous score rather than a crude pass-fail category, allowing the researchers to detect subtle associations that binary outcomes would have obscured.

The analytical design is where the study becomes genuinely interesting. Rather than simply correlating total screen hours with grades, the team ran a hierarchical linear regression, a statistical technique that adds explanatory variables in successive blocks so that each block’s unique contribution can be isolated. Demographic variables went in first, followed by total screen time, then purpose-specific screen use, and finally a composite measure of psychological symptom burden together with screening status for temporomandibular disorders, a family of conditions affecting the jaw joint and chewing muscles that was assessed with a validated three-question screening tool.

The results upended the conventional narrative. Total screen time was unrelated to academic performance in every analysis the researchers conducted. When purpose-specific use was added to the model, it explained an additional 19.0 percent of the variance in performance beyond total duration, a highly significant contribution. Strikingly, when the order was reversed and total duration was entered after purpose, it added only 2.2 percent of explained variance and failed to reach statistical significance. In other words, once you know what a student is doing on their devices, knowing how long they spend on them tells you almost nothing extra.

Within the full model, which accounted for roughly a third of the variance in self-perceived performance, three factors emerged as significant. Academic screen use, time spent on screens for study purposes, was positively associated with performance, carrying a standardized coefficient of 0.426. Work-related screen use showed the opposite pattern, with a negative association, and psychological symptom burden was also negatively associated with performance. Students carrying heavier loads of depressive, anxious, and stress-related symptoms reported poorer academic performance regardless of how many hours they spent in front of a display.

The health findings added a further layer. Students who rated their academic performance lower also reported poorer health-related quality of life in five of the eight domains measured by the RAND-36, a widely used health survey covering physical functioning, role limitations, energy, emotional wellbeing, social functioning, pain, and general health. The lower-performing group was also more likely to screen positive for temporomandibular disorders, although this jaw-related association did not survive statistical adjustment for oral parafunctional behaviors, habits such as teeth clenching and grinding that the researchers measured with the Oral Behavior Checklist. That statistical nuance suggests the apparent link between jaw problems and academic self-assessment may be mediated by these unconscious oral habits rather than the disorder itself.

Why should purpose matter so much more than duration? The answer likely lies in what different types of screen use actually demand from the brain and body. Academic screen use is, by definition, aligned with the outcome being measured, so a positive association is almost tautological: students who study more, even if that studying happens on a laptop or tablet, tend to feel they are performing better. Work-related screen use, by contrast, may compete directly with study time and recovery time, fragmenting attention and adding fatigue without contributing to academic mastery. And psychological symptom burden is a well-established correlate of academic difficulty, capable of degrading concentration, memory, and motivation independently of any digital behavior.

The study’s methodology deserves attention for its statistical discipline. The researchers used the Holm-Bonferroni procedure to control the family-wise error rate within families of outcomes, a correction that reduces the risk of false positives when many comparisons are made simultaneously. They also reported effect sizes alongside significance tests and compared groups using appropriate non-parametric and parametric tests depending on the distribution of the data. This level of rigor matters in a field, screen-time research, that has been criticized for producing noisy, contradictory findings driven by small effects and uncorrected multiple comparisons. The Swedish team’s willingness to report that total screen time simply did not matter, even after building a model specifically designed to detect such an effect, lends credibility to the positive findings that did emerge.

Several caveats temper the conclusions. The study is cross-sectional, meaning it captures a single moment in time and cannot establish whether screen use patterns cause differences in academic performance or merely accompany them. The sample is modest in size and drawn from two health-science programmes at elite Swedish institutions, so the findings may not generalize to students in other disciplines or countries. And the key outcome is self-perceived performance rather than objective measures such as examination scores, raising the possibility that students’ self-assessments are shaped by the same psychological factors that appear in the model. The authors themselves frame the work as exploratory, a word that signals hypothesis generation rather than definitive proof.

Even with those limitations, the implications are hard to ignore. If the study holds up in larger and longitudinal samples, the widespread practice of setting screen-time limits as a blunt instrument may be misguided, particularly for university students whose academic lives are now inseparable from digital devices. A student spending seven hours a day on screens, most of it reading course material and writing assignments, may be in a far healthier position than one spending three hours scrolling through work-related messages and social feeds while battling anxiety. The message from Stockholm is not that screens are harmless, but that the question we should be asking has changed: not how much, but what for, and at what psychological cost. For students, educators, and the growing industry of digital wellbeing tools, that reframing could reshape how screen habits are assessed and managed in the years ahead.

Subject of Research: The relationship between screen use, health status, and self-perceived academic performance in Swedish dental and nursing students

Article Title: Screen use, health status, and self-perceived academic performance among Swedish dental and nursing students: an exploratory cross-sectional survey study

Article References: Christidis, N., Lärfars, M., Khattar, P., Markus, D., Canales, G. D. L. T., & Christidis, M. (2026). Screen use, health status, and self-perceived academic performance among Swedish dental and nursing students: an exploratory cross-sectional survey study. BMC Medical Education, 26(1), Article 1508. https://doi.org/10.1186/s12909-026-10445-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10445-x

Keywords: screen time, academic performance, dental students, nursing students, mental health, temporomandibular disorders, digital media use, RAND-36, psychological symptoms, Karolinska Institutet, cross-sectional study, medical education

The research team, led by Irem Cosar Tufekci and colleagues in the Department of Endodontics at Marmara University School of Dentistry, together with Fatima Betul Basturk of Istanbul Gelisim University, set out to answer a question that has lingered since 2020: did the pandemic’s patchwork of closures, restrictions, and hybrid teaching leave a measurable scar on endodontic competence? Rather than surveying student confidence or exam scores, the researchers chose a harder, more objective endpoint, the technical quality of the first maxillary molar root canal treatments performed by fifth-year undergraduate students on real patients.

The study design exploited a natural experiment created by the pandemic itself. Four consecutive graduating classes experienced distinctly different patterns of disruption during their preclinical and clinical endodontic training. The Class of 2019, which completed its education entirely before COVID-19 arrived, served as the pre-pandemic control. The Class of 2022 absorbed the heaviest blow, with the greatest interruption of hands-on clinical training during the critical middle years of the curriculum. The Classes of 2023 and 2024 experienced progressively milder disruption, with the Class of 2024 ultimately receiving uninterrupted clinical training throughout its third and fourth years. By comparing these cohorts side by side, the researchers could trace how the timing and duration of lost clinical exposure translated into treatment quality.

Only first molar treatments documented with high-quality periapical radiographs at four critical stages were included in the analysis: diagnosis, working length determination, master cone fit, and obturation. This radiographic gatekeeping mattered. Root canal treatment quality cannot be judged without clear images of the canal anatomy, the instruments’ depth, and the final filling, so the strict imaging criterion protected the comparison from being confounded by poor documentation. In total, 324 maxillary first molars entered the analysis, distributed across the four cohorts: 87 from the Class of 2022, 73 from the Class of 2023, 100 from the Class of 2024, and 64 from the pre-pandemic Class of 2019.

Each treatment was graded against the guidelines of the European Society of Endodontology, the reference standard for endodontic quality assessment in Europe and beyond. Three dimensions determined whether a root canal filling counted as adequate: the length of the obturation, meaning whether the filling material terminated within the correct apical range rather than short of the apex or extruding beyond it; the density of the filling, meaning a homogeneous, void-free seal of the canal space; and the absence of procedural errors such as instrument separation, canal transportation, or perforation. Treatments meeting all criteria were classified as adequate, while any shortfall rendered the case inadequate. Differences between cohorts were tested with chi-square statistics, with significance set at a p value below 0.05.

The results told a striking story. The Class of 2022, the cohort whose clinical training was most severely disrupted, achieved an adequacy rate of just 24.1 percent, meaning roughly three out of every four of their first molar root canal treatments failed to meet the European quality standard. The Class of 2023, whose disruption was somewhat less severe, reached 30.1 percent. The pre-pandemic Class of 2019 control group sat at 32.8 percent, establishing the historical baseline. And the Class of 2024, the first cohort to pass through the third and fourth years of clinical training without pandemic-related interruption, topped the table at 43.0 percent. The difference across cohorts was statistically significant, with p equal to 0.049, just under the conventional threshold.

That the Class of 2024 exceeded the pre-pandemic baseline is perhaps the most intriguing finding. It suggests that uninterrupted clinical continuity in the final two years may do more than simply restore lost ground; it may consolidate skills in a way that even the pre-pandemic curriculum, with its ordinary scheduling gaps and competing demands, did not fully achieve. The authors interpret this pattern as evidence that continuity itself, the steady accumulation of supervised clinical experience without forced pauses, is a decisive ingredient in endodontic competence. Skills that are built and then repeatedly exercised appear to consolidate differently from skills built in fragmented bursts separated by months of clinical inactivity.

The technical dimensions of the assessment help explain why root canal treatment is such a sensitive barometer of clinical training. Obturation length requires the student to accurately determine the working length of each canal, typically with electronic apex locators and radiographs, and then to consistently maintain that reference throughout cleaning, shaping, and filling. Density depends on meticulous canal preparation, appropriate master cone selection, and disciplined compaction technique. Procedural errors, from ledge formation to instrument fracture, tend to cluster in the hands of operators whose psychomotor skills have not been sufficiently rehearsed. Each of these abilities decays or fails to consolidate when supervised practice is interrupted, which is precisely the situation the pandemic imposed on dental schools around the world.

The study’s retrospective design and single-institution setting carry inherent limitations. Radiographic assessment captures technical quality but not biological outcomes such as healing or long-term survival of the treated tooth, and the analysis was restricted to first maxillary molars with complete, high-quality imaging, which may not represent the full spectrum of cases students treated. The authors also note that the study was approved by the Marmara University Ethics Committee and conducted in line with the Declaration of Helsinki, with written informed consent obtained from all participants prior to treatment. The research received no specific funding from any public, commercial, or not-for-profit agency, and the authors declared no competing interests.

Nevertheless, the implications reach well beyond one dental school in Istanbul. As education systems worldwide continue to debate how to recover from pandemic-era learning losses, this study provides a quantitative argument that clinical continuity is not a luxury but a structural requirement for procedural disciplines. For dental educators, the message is that simulation-based and distance learning, however valuable, could not fully substitute for the supervised, patient-centered repetition that endodontics demands. For curriculum designers, the findings suggest that when disruption is unavoidable, protecting the continuity of clinical rotations in the final pre-graduation years may be the single most effective safeguard of graduate competence. And for the students of the Class of 2024, whose treatments outshone every cohort before them, the results stand as quiet proof that steady, uninterrupted practice at the chairside is what turns a dental student into a competent clinician.

Subject of Research: The effect of COVID-19 pandemic disruptions to clinical training on the technical quality of root canal treatments performed by undergraduate dental students.

Article Title: Clinical training continuity during the COVID-19 pandemic improves root canal treatment quality in dental students: a retrospective cohort study

Article References: Cosar Tufekci, I., Basar, U. G., Basturk, F. B., & Turkaydin, D. (2026). Clinical training continuity during the COVID-19 pandemic improves root canal treatment quality in dental students: a retrospective cohort study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10430-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10430-4

Keywords: dental education, endodontics, root canal treatment, COVID-19, clinical training, clinical competence, preclinical education, BMC Medical Education, retrospective cohort study, Marmara University, pandemic disruption, dental students

The research, published in BMC Medical Education by Merve Candan, Melike İdacı, Feyza Topbaşoğlu, and Alper Çamgöz of the university’s Department of Pediatric Dentistry, surveyed 441 dental students at a single faculty. The response rate of 75.3 percent was high enough to give the sample meaningful weight, and the investigators classified participants into three groups according to their level of patient contact: preclinical students who had not yet treated patients, observer students who shadowed clinical work, and clinical students who performed procedures themselves. This stratification is more than administrative convenience. It allowed the team to test a hypothesis that has long circulated in health-professions education, namely that exposure to real patients and real clinical environments is what converts abstract knowledge about infection into concrete habits of protection.

To measure the outcome, the researchers used the Communicable Diseases Risk Awareness and Protection Scale, a questionnaire instrument that captures both cognitive awareness of disease risks and self-reported protective behaviors, alongside demographic items. The statistical machinery applied to the data was correspondingly layered. Group differences were tested with one-way analysis of variance and Bonferroni-corrected post hoc comparisons, with effect sizes reported so that readers could judge not just statistical significance but practical magnitude. Independent-samples t-tests compared male and female respondents. Then came the analytical core: multiple linear regression to identify independent predictors of protective behavior, and an observed-variable path analysis to decompose the association between each predictor and behavior into a direct pathway and an indirect pathway running through risk awareness.

The results paint a clear developmental gradient. Preclinical students scored significantly lower than both observer and clinical students on the behavior dimension and on the total scale score, with p-values below 0.001, while the observer and clinical groups did not differ from each other. In other words, the jump in protective behavior occurs at the threshold of patient contact, not gradually across the later stages of training. Once students begin observing and then performing clinical work, their protective practices appear to consolidate quickly and then plateau. This pattern is consistent with the idea that infection-control behavior is learned less through lectures about hepatitis B or HIV transmission and more through the embodied experience of sitting chairside, where a splash of saliva or a needlestick near-miss carries immediate, visceral meaning.

Gender emerged as the other dominant axis of difference. Female students scored higher than male students on every dimension of the scale, with all comparisons reaching significance at p ≤ 0.01. This finding echoes a broader literature on gender differences in health-protective behavior, in which women across many populations report greater engagement with precautionary practices, from hand hygiene to mask wearing. In the dental training context, the authors’ data indicate that this gap is present across the awareness and behavior dimensions alike, meaning the disparity is not merely a matter of women knowing more about risks; they also act more consistently on that knowledge. The consistency of the gender effect across all scale dimensions strengthens the case that it reflects a genuine behavioral orientation rather than a measurement artifact.

The regression analysis sharpened the picture considerably. When gender and clinical training stage were entered together as predictors of protective behavior, the primary outcome of the study, only these two variables remained significant. Being female predicted higher protective behavior with p < 0.001, and advancing clinical training stage predicted it with p = 0.004. Risk awareness, the variable one might intuitively expect to be the engine of protective action, did not stand up as an independent driver once these factors were accounted for. For educators who have invested heavily in knowledge-based infection-control curricula, this is an uncomfortable result: the knowledge students acquire appears weakly coupled to what they actually do at the chair.

The path analysis pushed this conclusion further. For gender, the model identified both a direct association with protective behavior and an indirect association operating through risk awareness, with the indirect path significant at p = 0.003. This means that part of the female advantage in protective behavior can be statistically attributed to higher awareness, but a substantial direct effect persists even after that mediation is accounted for. For clinical training stage, the story was different in an instructive way: the total association with behavior was significant at p = 0.032, but neither the direct path nor the indirect path through awareness was individually significant. The authors interpret this as evidence that the overall effect of training stage on behavior is real but diffuse, distributed across pathways too small to reach significance on their own, and crucially not channeled through increased risk awareness.

That last point deserves emphasis because it strikes at a foundational assumption of the classic knowledge–attitude–practice framework that has shaped health-education interventions for decades. The framework presumes a causal chain running from knowledge to attitude to behavior, and it underwrites countless training programs that measure success by gains in knowledge scores. The present study found that increased risk awareness was not directly reflected in protective behavior, and that a strong awareness-mediated pathway to behavior was not supported in the data. Awareness rose only weakly with advancing clinical training stage, while behavior rose substantially. The two constructs, in this population, appear to move on largely separate tracks, driven by different forces.

The practical implications follow naturally. If protective behavior improves mainly with hands-on clinical exposure, then infection-control education should be embedded in clinical practice rather than delivered as preclinical theory alone. Simulation-based training, early chairside mentoring, and structured feedback on personal protective equipment use may do more to build durable habits than additional didactic content. If the gender gap is robust, as it appears to be here, then targeted interventions for male students, perhaps emphasizing the personal and professional stakes of consistent protection, could close a disparity that currently leaves one half of the trainee population less protected. And if awareness alone is a weak lever, then measuring awareness as a proxy for safety culture in dental schools may be misleading, giving educators false comfort while actual chairside practices lag behind.

The authors are appropriately cautious about the limits of their design. A cross-sectional study captures a single moment in time, so it can identify associations but cannot establish that clinical exposure causes improved behavior, however plausible that mechanism appears. The sample came from a single institution, which raises fair questions about generalizability to dental faculties with different curricula, patient populations, or infection-control resources. Self-reported protective behavior is also vulnerable to social desirability bias, since students may overstate their compliance with protocols they know they should follow. Yet the study’s methodological rigor, including effect-size reporting, multicollinearity checks via variance inflation factors, and adherence to STROBE reporting guidelines, gives its findings credibility. For a profession whose daily work unfolds at the boundary between clinician and contagion, the message is clear: the safest dental students are not necessarily the best informed, but the most experienced and, in this dataset, the female ones. Building protective instinct, it seems, requires the clinic itself as the classroom.

Subject of Research: Determinants of communicable disease risk awareness and protective behaviors among dental students

Article Title: Determinants of communicable disease risk awareness and protective behaviors among dental students: a path analysis-based cross-sectional study

Article References: Candan, M., İdacı, M., Topbaşoğlu, F., & Çamgöz, A. (2026). Determinants of communicable disease risk awareness and protective behaviors among dental students: a path analysis-based cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10543-w

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10543-w

Keywords: dental education, infection control, communicable diseases, risk awareness, protective behavior, path analysis, cross-sectional study, clinical training, gender differences, health professions education, dental students, public health

The study was led by Aysha Sadaf and colleagues at Shifa College of Dentistry, part of Shifa Tameer-e-Millat University in Islamabad. Rather than collecting new data, the team carried out a retrospective secondary analysis of an existing multicentre cross-sectional survey. This means they went back to data that had already been gathered from students at three dental colleges and re-examined it with a specific question in mind: do gender and a previous COVID-19 infection show measurable associations with mental well-being? The original survey used a census sampling approach, meaning every eligible student was invited to take part, and all consenting respondents were included in the final dataset.

To measure mental well-being, the researchers used the Warwick–Edinburgh Mental Well-Being Scale, commonly abbreviated to WEMWBS. This instrument is widely used in population health research and consists of a series of statements about positive aspects of mental health, such as feeling useful, having energy, feeling close to other people, and being able to make up one’s own mind about things. Respondents rate each statement, and the answers are summed to produce an overall score in which higher values indicate better mental well-being. Unlike scales that focus narrowly on symptoms of depression or anxiety, WEMWBS is designed to capture a broader, more positive picture of psychological functioning, which makes it particularly useful for studying student populations where the goal is to understand flourishing rather than just diagnosing illness.

The headline finding was the average score. Across the 210 students, the mean WEMWBS score was 44.05 with a standard deviation of 10.2. For context, WEMWBS scores in general adult populations typically cluster well above this level, and lower scores are interpreted as indicating poorer mental well-being. A mean in the mid-forties for a cohort of young people in professional training is a signal worth taking seriously, particularly in a field like dentistry, where students face demanding clinical workloads, high-stakes examinations, and, during the pandemic years, disrupted hands-on education and heightened infection concerns.

The statistical core of the study was a multivariable linear regression analysis. This technique allows researchers to estimate the independent association of each factor with the outcome while holding the other variables constant. In this model, female gender was significantly associated with lower WEMWBS scores, with an unstandardized coefficient of −3.85, a standardized beta of −0.24, and a 95 percent confidence interval running from −5.90 to −1.80, corresponding to a p-value of 0.002. In practical terms, after adjusting for the other variables in the model, female students scored, on average, nearly four points lower on the well-being scale than their male peers. The standardized beta of −0.24 indicates a modest but meaningful effect size for a study of this design.

Previous COVID-19 infection told a similar story. Students who reported having been infected with the virus scored lower on mental well-being than those who had not, with a coefficient of −3.74, a standardized beta of −0.19, and a 95 percent confidence interval from −6.20 to −1.30, and a p-value of 0.011. Again, the difference of roughly three to four points is not trivial on a scale of this kind. The finding aligns with a growing international literature documenting that a history of SARS-CoV-2 infection is associated with worse psychological outcomes, whether through the direct biological effects of the illness, the stress of isolation and recovery, or the lingering uncertainty that accompanied infection during the pandemic years.

Not everything the researchers examined turned out to matter. Age and academic year, the other demographic variables included in the model, were not significantly associated with mental well-being scores. This is an interesting negative result. It suggests that the well-being deficit in this cohort was not simply a matter of being a fresh first-year student adjusting to a new environment, or of being a senior student facing imminent clinical examinations. Instead, the associations concentrated around gender and infection history, pointing to factors that cut across the whole trajectory of dental education rather than being tied to a particular stage of it.

The overall model performed respectably for research of this type. The full regression was statistically significant, with an R-squared of 0.175 and an adjusted R-squared of 0.155, and a p-value below 0.001. In plain language, the variables in the model together explained roughly 15 to 17 percent of the variation in well-being scores. That leaves the majority of the variation unexplained, which is typical for studies of complex psychological outcomes, but it confirms that gender and infection history are not statistical noise; they carry genuine signal. The authors suggest that these findings could help dental institutions develop targeted educational and mental well-being support strategies, focusing resources on the groups identified as most at risk.

The study was conducted with attention to ethical safeguards. Approval came from the Institutional Review Board of Shifa College of Dentistry at Shifa Tameer-e-Millat University, granted in February 2022 before data collection began. The work followed the ethical principles of the 2013 revision of the Declaration of Helsinki, and electronic informed consent was obtained from every participant. Participation was voluntary, students could withdraw at any stage without consequence, and personal identifiers were removed to protect anonymity. The authors also disclose that they used an AI language tool to assist with editing and manuscript organization, while stating that the tool played no role in generating, analyzing, or interpreting the data or in formulating the scientific conclusions.

As with any cross-sectional analysis, the study has limits that readers should keep in mind. The data capture a single point in time, so the associations cannot prove that a previous infection caused lower well-being, and the sample comes from three colleges in a single city, which may limit how far the findings generalize to other settings. Self-reported infection status may also be imperfect. Nevertheless, the consistency of the gender gap with findings from other student populations, and the plausible link between infection history and psychological strain, make this a study with practical implications. For dental schools in Pakistan and beyond, the message is that well-being support cannot be one-size-fits-all: female students and those with a history of COVID-19 may need particular attention as the profession continues to recover from the pandemic era.

Subject of Research: Mental well-being among undergraduate dental students in relation to gender and prior COVID-19 infection

Article Title: Associations of gender and previous COVID-19 infection with mental well-being among Pakistani undergraduate dental students: a retrospective secondary analysis of a multicentre cross-sectional survey

Article References: Sadaf, A., Sajid, A., Bint-e-Nadeem, T., & Javed, M. (2026). Associations of gender and previous COVID-19 infection with mental well-being among Pakistani undergraduate dental students: a retrospective secondary analysis of a multicentre cross-sectional survey. BMC Medical Education. https://doi.org/10.1186/s12909-026-10467-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10467-5

Keywords: COVID-19, mental well-being, dental students, WEMWBS, Pakistan, gender differences, dental education, cross-sectional survey, linear regression, medical education, pandemic, student health

The research team, led by Nada Hashim of RAK College of Dental Sciences at RAK Medical & Health Sciences University in the United Arab Emirates, together with colleagues from the University of Khartoum, the University of Illinois Chicago, Nile University, and other institutions, surveyed dental students enrolled in universities affected by the Khartoum conflict. The study, which received ethical approval from the Ethical Committee of the Faculty of Dentistry at the University of Khartoum, was conducted in accordance with the Declaration of Helsinki, with informed consent obtained from every participant and participation kept strictly voluntary.

Methodologically, the study relied on a cross-sectional online survey, a design chosen out of necessity in a setting where physical data collection was impossible. Psychological distress was measured with the Depression, Anxiety and Stress Scale, universally known in psychiatric research as the DASS-21, a validated twenty-one-item instrument that yields separate dimensional scores for depression, anxiety, and stress rather than a single blended index. Resilient coping was assessed with the Brief Resilient Coping Scale, or BRCS, a compact four-item measure that classifies individuals along a spectrum from low, or fragile, coping through moderate coping to high, or transformational, coping.

Beyond the two psychometric instruments, the survey captured a wide array of sociodemographic variables and conflict-related circumstances: whether students had been displaced from their homes, whether their academic progression had been interrupted, and the broader context of insecurity in which they were living. The researchers then applied multivariable logistic regression models to explore how these circumstances were associated with psychological outcomes, an approach that allows multiple predictors to be weighed simultaneously while adjusting for the influence of the others.

The results were sobering. The students reported high levels of depression, anxiety, and stress, a pattern the authors attribute to the combined weight of ongoing insecurity, disruption of education, and forced displacement. Dental students occupy a particularly vulnerable position in any crisis of this kind because their training depends so heavily on structured clinical immersion and uninterrupted academic progression. Unlike some disciplines, where theoretical study can be more readily transferred online or deferred, dental education requires hands-on practice in clinics under supervision, and severing that continuity severs a core thread of professional identity formation.

Resilient coping, by contrast, varied considerably from one participant to another. This heterogeneity is itself informative. It suggests that even within a population exposed to the same broad conflict, individual differences—whether in personal resources, social support networks, prior trauma exposure, or the specific nature of each student’s losses—shape how coping capacity is expressed. The BRCS findings indicate that while some students retained a capacity for adaptive, transformational responses to adversity, others had drifted toward fragile coping, leaving them psychologically exposed at precisely the moment when external support systems had also collapsed.

Among the conflict-related factors examined, displacement and interruption of education stood out as the variables most consistently associated with increased psychological distress. Displacement strips individuals not only of physical safety and material stability but also of the social scaffolding—family proximity, peer networks, familiar routines—that buffers stress in ordinary times. Academic interruption adds a second layer: for students on the cusp of professional qualification, each halted semester represents a receding horizon and an uncertain future, a form of anticipatory stress that compounds the acute stressors of the present.

The authors were careful about what their models can and cannot claim. The regression models demonstrated modest discriminative ability, with area under the curve, or AUC, values ranging from 0.57 to 0.66. In practical terms, an AUC of 0.5 corresponds to chance-level prediction, while 1.0 reflects perfect discrimination; values below roughly 0.7 are considered weak for individual-level prediction. The team therefore frames these models as suitable for identifying group-level associations rather than forecasting which individual student will experience severe distress—a distinction that matters enormously for how the findings should inform policy.

The researchers also ran exploratory moderation and mediation analyses, frameworks designed to test whether displacement and academic interruption might not merely accompany distress but actively transmit or amplify its effects. The results hinted at such roles, but the authors are explicit that these findings were not statistically robust and should be interpreted with caution. In a cross-sectional design, with data collected at a single point in time, it is impossible to establish temporal sequence, and pathway claims about cause and effect must await longitudinal follow-up.

What the study does establish with confidence is that dental students in Khartoum carried a significant psychological burden during the conflict, one shaped by intersecting academic, social, and environmental stressors. The authors argue that this burden demands targeted mental health support and deliberate strategies for preserving educational continuity in conflict-affected settings—interventions that address both the psychological and the academic dimensions of the crisis rather than treating them as separate problems. They also call for future research using longitudinal or pathway-based designs to clarify how conflict-related stressors, coping resources, and academic instability interact over time, so that the tentative signals uncovered in this survey can be tested against the richer evidence only time can provide.

Subject of Research: Psychological distress and resilient coping among dental students during the armed conflict in Khartoum, Sudan

Article Title: Psychological distress and resilient coping among dental students during the Khartoum conflict

Article References: Hashim, N., Ahmed, A., Elsheikh, M., Ahmed, S. F., Babiker, R., Ahmed, A., Mohammed, R., Padmanabhan, V., Islam, M. S., Chaitanya, N. C. S. K., Rahman, M. M., & Gismalla, B. G. (2026). Psychological distress and resilient coping among dental students during the Khartoum conflict. Discover Psychology. https://doi.org/10.1007/s44202-026-00893-3

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00893-3

Keywords: psychological distress, dental students, Khartoum conflict, DASS-21, resilient coping, armed conflict, displacement, academic interruption, mental health, Sudan, Brief Resilient Coping Scale, depression anxiety stress