The research, published in BMC Medical Education, was led by Zixin Wang and Aiping He, co-first authors based in the Department of Health Services Management at Anhui Medical University in Hefei, China, with a team spanning the university’s Institute of Medical Education, a Hefei hospital, and the Johns Hopkins Bloomberg School of Public Health. The investigators set out to answer a deceptively simple question: how much vaccine science do undergraduate health professions students actually encounter in their formal coursework, and what do they think about it?

To find out, the team used a two-phase explanatory sequential mixed-methods design with triangulation. In the first phase, conducted between March and May 2025, they collected 708 curriculum guidelines from the medical university in Anhui province. After screening and systematic content extraction, they descriptively analyzed the distribution, proportion, and topical coverage of vaccine-related material across the documented curriculum. In the second phase, from June to July 2025, they conducted semi-structured interviews with 23 senior students who had completed their undergraduate coursework and had either finished or were finishing their required graduation internships under those same guidelines.

The quantitative findings are stark. Across the 30 guidelines that did mention vaccines, the median length of the teaching-related sections was 7,894 Chinese characters, with an interquartile range of 5,505 to 10,989 and a full range of 1,482 to 24,080 characters. The median length of vaccine-related content within those sections, by contrast, was just 49 Chinese characters — an interquartile range of 17 to 89 and a range of 10 to 146. In other words, where a course guideline devoted nearly 8,000 characters to teaching, the portion addressing vaccines amounted to a sentence or two.

The proportions tell the same story from a different angle. The median proportion of vaccine-related content across the 30 guidelines was 0.7 percent, with an interquartile range of 0.2 to 0.9 percent and a range stretching from 0.1 to 10.0 percent. In 24 of the 30 guidelines — 80.0 percent — vaccine-related content accounted for less than 1 percent of the teaching-related character count. The study site’s formal curriculum, as documented, explicitly recorded limited vaccine-related material and relatively narrow teaching approaches.

The interview phase added texture that character counts alone cannot capture. From the 23 conversations with senior students, the researchers identified four themes: vaccine cognition and risk perception; assessment of vaccine education; professional role identity and learning expectations; and acquisition and identification of vaccine information. The themes suggest that students were not indifferent to the subject — they were navigating confusion about vaccines, forming views on how the topic had been taught, weighing their future professional responsibilities, and figuring out where to get and how to judge vaccine information on their own.

Interview data further indicated that some students perceived gaps in practical preparation and vaccine-related learning support. This matters because the study’s premise rests on a well-established observation: healthcare professionals’ recommendations can influence public vaccination decisions, yet insufficient vaccine-related literacy and hesitancy among healthcare professionals themselves remain persistent challenges. If the professionals of tomorrow are left to assemble their vaccine knowledge from fragments, the risk is not merely academic — it is that hesitant or under-informed clinicians may pass that uncertainty along to patients.

The timing is significant. Vaccine hesitancy has been flagged by global health authorities as a threat to hard-won immunization gains, and the COVID-19 pandemic demonstrated both the power of vaccines and the fragility of public trust. China’s research in this specific field — examining how vaccine education is embedded in undergraduate health-related curricula — remains limited, which is precisely the gap the Anhui team sought to address. Their study is among the first to combine a systematic audit of curriculum guidelines with student perspectives at a Chinese medical university.

The methodological choices deserve attention. The explanatory sequential design means the quantitative audit came first and shaped the qualitative follow-up, allowing the interviews to probe and explain what the document analysis revealed. Triangulation — comparing the documented curriculum against student experiences — strengthens the conclusions, because a gap that appears in both the official guidelines and the students’ own accounts is harder to dismiss. The study received ethical approval from the Biomedical Ethics Committee of Anhui Medical University, and oral informed consent was obtained from all interview participants before recording began.

The authors’ conclusions point toward concrete remedies. Educational institutions, they suggest, could consider strengthening vaccine education by making learning objectives and core content more explicit in curriculum guidelines, broadening vaccine-related topics, diversifying teaching approaches, and enhancing practical competency development. The findings help clarify potential directions for further optimizing the documented curriculum. Whether other Chinese medical universities — and programs elsewhere — show similar patterns is an open question, but the study offers a template for finding out: audit the guidelines, count the characters, and then ask the students what they were never taught.

Subject of Research: Vaccine education in undergraduate health-related curricula at a Chinese medical university

Article Title: Vaccine education in undergraduate health-related curricula: a mixed-methods study based on curriculum guidelines and student perspectives from a Chinese medical university

Article References: Wang, Z., He, A., Yang, Y., Zhang, X., Yao, L., Wang, Y., Zhou, R., Wang, L., Chen, R., & Zhang, X. (2026). Vaccine education in undergraduate health-related curricula: a mixed-methods study based on curriculum guidelines and student perspectives from a Chinese medical university. BMC Medical Education. https://doi.org/10.1186/s12909-026-10642-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10642-8

Keywords: vaccine education, medical curriculum, vaccine hesitancy, health professions students, mixed-methods study, medical education, Vaccine, education, undergraduate, health-related, curricula, mixed-methods

The Student Health Service, known in France as the Service Sanitaire, occupies a unique position in the landscape of health professional education. Introduced as a compulsory component of French health curricula, it requires students from six distinct disciplines to work side by side on prevention projects aimed at communities, schools, and other beneficiary populations. According to the study’s authors, it is the only mandatory and universal interprofessional training experience embedded in French health education. That universality makes it an unusually powerful natural laboratory: unlike voluntary electives or single-institution pilots, the program reaches essentially every health student in a given region, allowing researchers to assess skill development across an entire cohort rather than a self-selected sample of enthusiasts.

To quantify the change, the research team turned to a validated instrument called the Interprofessional Collaborative Competency Attainment Survey, or ICCAS. The tool asks respondents to rate their own competence across the domains of interprofessional collaboration, including roles and responsibilities, teamwork, communication, and collaborative patient- or client-centered practice. The French version was used with written permission from Professor Douglas Archibald, with a minor contextual adaptation: references to the patient or family were reworded to refer to the beneficiary of the preventive action, matching the prevention-focused mission of the Student Health Service. The survey uses a seven-point scale, and the study’s primary endpoint was the change in mean score between a retrospective pre-program rating and a post-program rating collected at the same time.

That retrospective pre-post design deserves a technical note, because it is both the study’s methodological strength and a source of interpretive caution. Rather than asking students to rate their skills before the program and then again afterward, the researchers collected both the before and after ratings simultaneously once the program was complete. This approach, widely used in educational research, is thought to reduce response-shift bias, the phenomenon in which participants’ internal standards shift during an intervention, making their earlier self-assessments incomparable with later ones. By anchoring both judgments to a common frame of reference at a single moment, the retrospective design attempts to isolate genuine perceived growth from mere changes in how students understand the rating scale itself.

The scale of the data collection was ambitious. All 1,141 students completing their Student Health Service during the 2024–2025 academic year in the departments of Maine-et-Loire, Mayenne, and Sarthe were eligible. Of these, 943 received the questionnaire, 638 responded, and 553 questionnaires met the predefined completion criterion and entered the final analysis. The results were striking in their consistency. The mean ICCAS score rose from 5.81 before the program to 6.37 afterward, a statistically significant mean improvement of 0.55 points with a p-value below 0.001. In practical terms, students moved from a self-assessment comfortably above the scale’s midpoint to one approaching its upper range, and every one of the ICCAS domains showed significant improvement.

The distribution of individual responses adds texture to the headline numbers. A decisive majority, 86.6 percent of students, reported an improvement in their self-perceived interprofessional skills. A small fraction, 9.9 percent, reported no change, and 3.4 percent actually reported a decrease. The researchers also ran exploratory analyses to see whether the size of the gain varied by field of study, by department, or by the prevention topic students worked on. No significant differences emerged, although the authors caution that some subgroups were small, limiting the statistical power of those comparisons. The apparent uniformity of benefit across professions is itself notable: it suggests the program’s effect is not driven by one discipline’s curriculum or one region’s implementation but appears to operate broadly across the interprofessional mix.

One of the study’s most intriguing findings came from its sensitivity analysis, which compared paper-based questionnaires with digital ones. Students who completed the survey on paper reported a mean improvement of 0.586 points, while those using the digital format reported a mean gain of only 0.251 points, a difference that was itself statistically significant at p below 0.001. The authors do not overinterpret this gap, but it raises genuine methodological questions for anyone designing self-assessment research. Response formats can influence how people recall and evaluate their own past states, and the nearly threefold difference between modalities suggests that survey delivery is not a neutral technical choice. Future evaluations of interprofessional education may need to account for, or standardize, the medium through which self-perception is measured.

Why does a mandatory prevention placement move the needle on collaboration skills at all? The theoretical answer lies in the architecture of interprofessional education itself. Decades of research have argued that health professions students learn in silos, absorbing the norms, vocabularies, and hierarchies of their own discipline while rarely practicing the negotiation of roles that real clinical teamwork demands. The Student Health Service forces that negotiation early. Because prevention projects require students to define who does what, communicate across professional boundaries, and center the needs of a shared beneficiary, they create authentic opportunities to exercise exactly the competencies the ICCAS measures. The study’s findings are consistent with the idea that collaborative competence is not an abstract attitude but a practical skill that develops through structured, repeated, real-world interaction with other professions.

The implications extend beyond France. Health systems globally face workforce shortages, rising chronic disease burdens, and mounting evidence that fragmented care harms patients, all of which have pushed interprofessional education to the top of curricular reform agendas. Yet rigorous evaluations of mandatory, large-scale interprofessional programs remain scarce, partly because few countries have made such training universal. The Angers study, covering six professions across three departments in a single academic year, provides a template for how such evaluations can be conducted: a validated self-assessment instrument, a retrospective pre-post design, and a completion criterion applied before analysis. Its conclusion that the program strengthened interprofessional training in French health curricula gives policymakers empirical support for maintaining and expanding the model.

The authors are careful about the limits of what self-report can show. Self-perceived competence is not the same as objectively measured competence, and students may overestimate or underestimate their actual collaborative abilities. The study’s own recommendation points the way forward: further research should explore the relationship between self-perceived and objectively measured interprofessional competencies, ideally through observational measures, standardized assessments, or longitudinal follow-up into professional practice. There is also the question of durability, whether gains measured immediately after the program persist once students enter clinical rotations and, eventually, the workforce. Still, the core message stands. When a thousand-plus students across medicine, nursing, midwifery, pharmacy, and the therapies were required to collaborate on real prevention work, nearly nine in ten came away believing they had become better team members, and the numbers behind that belief were statistically robust. For a field long criticized for teaching teamwork in lecture halls, that is evidence worth taking seriously.

Subject of Research: Changes in self-perceived interprofessional collaborative skills among health students after a mandatory student health service program

Article Title: Changes in students’ self-perceived interprofessional collaborative skills following participation in the student health service program

Article References: Donat, T., De Roquefeuil, E., Busson, A., Baglin, I., Poiroux, L., Ramond-Roquin, A., Ammi, M., & Levaillant, M. (2026). Changes in students’ self-perceived interprofessional collaborative skills following participation in the student health service program. BMC Medical Education. https://doi.org/10.1186/s12909-026-10479-1

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10479-1

Keywords: interprofessional education, interprofessional collaboration, Student Health Service, ICCAS, self-assessment, health professions students, medical education, teamwork, preventive care, France, BMC Medical Education, curriculum evaluation