Another 50 students followed the four-year graduate-entry clinical track and served as a contemporaneous comparison group. The researchers examined individual SCI publication counts, cumulative impact factor, clinical examination scores, delayed graduation rates and self-reported weekly time logs. For the eight-year pathway, the new requirement called for graduation with original papers in journals ranked in the first or second quartile of the Journal Citation Reports, with the student listed as first or co-first author.

The four-year clinical track did not have an equivalent SCI publication requirement. The researchers used Mann–Whitney U tests for quantitative comparisons between two groups and Kruskal–Wallis H tests for multigroup contrasts, followed by Bonferroni-adjusted Dunn post-hoc tests. Interview records were assessed through thematic framework coding to explore how trainees allocated time between research and clinical training.

After the policy change, the median number of SCI publications among eight-year-track graduates doubled from 0.5 to 1.0. Their cumulative impact factor rose from 2.8 to 6.5. Both differences were statistically significant at P < 0.001.

Their reported weekly research time also increased from 8 hours to 18 hours. In contrast, graduates in the four-year clinical track recorded zero original SCI papers across all six cohorts. Measured clinical examination performance did not differ meaningfully between the pre-policy and post-policy eight-year cohorts.

Average scores were 85.7 and 86.4, respectively, with P = 0.34. The authors did not identify a statistically significant score difference. Based on weekly time logs and interview accounts, however, they said the additional 10 hours devoted to research likely displaced time that could otherwise have been spent on bedside clinical training.

The study did not directly measure every clinical activity, so this was an interpretation of the reported schedules and experiences rather than a comprehensive time-motion assessment. Interviews showed that protected research blocks were important to completing full research projects. The researchers reported that only trainees with multi-year protected research time were able to complete them.

Four-year-track interviewees described their clinical rotation schedules as fully saturated, leaving no capacity for original scholarship, and their weekly logs were consistent with those accounts. Because the four-year pathway had no corresponding SCI graduation mandate, the results do not show that the same publication rule reduced its scholarly output; instead, they describe how its trainees’ existing clinical workload differed from that of eight-year trainees able to undertake protected research. Among eight-year trainees, higher publication counts and impact factor accompanied a marked increase in weekly research time after the requirement took effect, but average clinical examination scores remained similar.

The study was conducted at a single teaching hospital in Shanghai and used a nonrandomized comparison across two educational pathways and different policy periods. It therefore supports an association between the policy and reported training patterns, rather than proving that the mandate alone caused publication growth or that changes in clinical study time affected patient care. Overall, the study suggests that uniform publication requirements may distribute educational burdens unevenly when training pathways provide different amounts of protected research time.

The researchers proposed tiered criteria that match scholarly expectations to the research time available in each pathway, while noting that this approach requires further investigation. The evidence does not establish that such standards would improve clinical outcomes, reduce delayed graduation or produce better patient care. It does show that measurable research gains after an SCI mandate occurred among eight-year trainees with protected time, whereas clinically saturated four-year trainees had neither that opportunity nor a comparable graduation requirement.

Subject of Research: Effects of SCI publication mandates on research output and clinical training time in Chinese medical education.

Article Title: Uniform SCI Publication mandates are associated with unequal clinical training burdens: a quasi-experiment comparing two medical training pathways in China

Article References: Peng, Y., Zhao, W.-L., Gong, Z.-Y., Xu, E., & Gu, Q. (2026). Uniform SCI Publication mandates are associated with unequal clinical training burdens: a quasi-experiment comparing two medical training pathways in China. BMC Medical Education. https://doi.org/10.1186/s12909-026-10276-w

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10276-w

Keywords: SCI publications, medical education, clinical training, research time, medical students, China, quasi-experiment, education equity, publication output, Uniform, Publication, mandates

The anonymous online survey was conducted from 1 April to 1 May 2026 at Bolu Abant Izzet Baysal University Faculty of Medicine. All 1,275 active students across the six-year medical program were invited, and 249 consenting participants completed the questionnaire, representing 19.5% of the eligible population. Their mean age was 21.49 years, with a range of 18 to 34; 69.1% were women, 30.5% were men, and one participant preferred not to report sex. Previous psychiatric treatment was reported by 24.9% of respondents and current treatment by 11.6%. The authors noted that the voluntary sample may have been enriched for students with greater mental-health concerns, so the results cannot be interpreted as population prevalence.

Students used AI for a mixture of academic and personal purposes. Among the 238 participants who had used AI, 84.5% selected course study or review, 71.8% selected examination preparation, 65.1% selected medical terminology or concept learning, and 62.6% selected research or literature searching. The same proportion, 71.8%, reported personal or non-educational use, while 38.2% used AI for clinical cases or reasoning practice. ChatGPT was the most commonly selected tool, followed by Google Gemini. Among users, 58.4% had been using AI for more than one year, indicating that the survey captured sustained engagement as well as possible recent adoption.

Psychological symptoms were measured with the validated Turkish 21-item Depression Anxiety Stress Scales, or DASS-21, covering the previous week. The primary outcome was a general-distress composite formed by summing all 21 items and doubling the result to match the DASS-42 metric, producing a possible range of 0 to 126. The mean was 56.97 with a standard deviation of 31.55. Internal consistency for the composite was high, with Cronbach’s alpha and McDonald’s omega both 0.951. A one-factor model fit moderately rather than strongly, while a proposed three-factor model for depression, anxiety and stress fitted better but also fell short of conventional absolute-fit benchmarks. The total was therefore treated as a shared symptom burden, not as proof that the three dimensions were identical. DASS severity categories were treated as screening descriptors, not psychiatric diagnoses or estimates of prevalence in the eligible student population.

The central regression used three blocks and ordinary least squares with HC3 robust standard errors. The first block included training year, sex and previous psychiatric treatment and explained 10.6% of the variance in general distress. Adding three categories of AI-use frequency increased explained variance by only 0.016, a change that was not statistically significant: the conventional test gave p = 0.111 and the robust global test p = 0.088. Adding the study’s three exploratory Artificial Intelligence Attitude Scale factors increased explained variance by another 0.052, producing an overall R-squared of 0.175 and an adjusted R-squared of 0.133. Thus, frequency did not improve the adjusted model as a block, whereas attitudes added exploratory explanatory information. Because the analytic models were specified after data collection and were not preregistered, all inferential results were hypothesis-generating rather than confirmatory.

Per one-standard-deviation increase in an attitude factor, Benefit was associated with a 4.90-point lower general-distress score, with a 95% confidence interval from −9.14 to −0.65 and a false-discovery-rate-adjusted q value of 0.036. Risk was associated with a 4.98-point higher score, with a confidence interval of 0.87 to 9.09 and q = 0.036. Use was associated with a 4.69-point higher score, with a confidence interval of 0.26 to 9.12 and q = 0.038. The apparently conflicting Benefit and Use relationships complicate any simple “helpful versus harmful” interpretation. A student might value AI’s educational benefits while also using it more frequently and perceiving greater risks; alternatively, distress and academic pressure could influence both attitudes and willingness to engage.

The findings were directionally similar across the depression, anxiety and stress subscales: Benefit had a negative coefficient and Risk and Use had positive coefficients in each model. Statistical support was much weaker, however, after correction for the 15 additional focal tests. Only the inverse relationship between Benefit and Anxiety survived that correction, with a coefficient of −2.39 points, a 95% confidence interval of −3.91 to −0.87, a nominal p value of 0.002 and an adjusted q value of 0.032. AI-use frequency remained nonsignificant at the block level for all three outcomes. These subscales came from the same participants and do not constitute independent replications, while the strong correlations among depression, anxiety and stress also limit the interpretation of separate domain-specific effects.

Measurement uncertainty was substantial. The 13-item attitude scale had three proposed domains—Benefit, Risk and Use—and was originally developed for Turkish pre-service teachers rather than medical students. Its three-factor structure performed much better than a one-factor alternative, with standardized loadings from 0.520 to 0.938. Internal consistency ranged from 0.775 to 0.931 for Cronbach’s alpha and from 0.774 to 0.933 for McDonald’s omega. Yet its absolute fit was mixed, with a comparative fit index of 0.898, Tucker–Lewis index of 0.872, root mean square error of approximation of 0.107 and standardized root mean square residual of 0.070. The wording was translated by one investigator from the English version rather than formally adapted for cross-cultural use. Nine of the 13 administered items differed lexically or in phrasing from the published Turkish form, and one difference may have broadened the item’s content. The authors therefore treated the factor scores as exploratory and conditional on the structural evaluation.

Several design features also limit what can be inferred. The study was cross-sectional, single-center, voluntary and based entirely on self-report. AI frequency did not capture session duration, task complexity, learning quality, verification of outputs or degree of reliance, and nearly four-fifths of respondents used AI at least a few times a week, leaving limited contrast at the lower end of exposure. Students with distress or strong views about AI may also have been more likely to participate. Training-year differences cannot demonstrate improvement over time because each cohort was assessed once; the survey overlapped a first-year midterm period, and individual workload and assessment timing were not recorded. The results also do not demonstrate that any single AI tool is responsible for the observed patterns. Prior research cited by the study found that mental-health problems predicted later AI dependence among adolescents, making reverse causation a plausible explanation for the positive Use association, but the current data cannot test that pathway.

The results point to a need for longitudinal, multicenter research rather than a simple verdict on AI in medical education. Future studies would need formally adapted attitude instruments, validated well-being measures, objective or diary-based records of AI engagement, and information about assessment timing and specific educational tasks. Qualitative work could help explain how students combine perceived benefits, risks and active engagement. Until stronger evidence is available, the survey’s most defensible conclusion is that AI use was widespread among these students, but its frequency alone did not provide stable evidence of an overall relationship with distress. The exploratory attitude associations require replication and cannot be interpreted as causal effects, psychological diagnoses or evidence that greater AI exposure is inherently advantageous or harmful.

Subject of Research: A cross-sectional survey of AI use patterns, attitudes and psychological distress among 249 medical students at one Turkish university.

Article Title: Artificial intelligence use patterns, attitudes, and psychological distress among medical students: a cross-sectional survey

Article References: Sari, M., İmrek, Y., & Tufan, A. E. (2026). Artificial intelligence use patterns, attitudes, and psychological distress among medical students: a cross-sectional survey. Frontiers in Medicine, 13, Article 1965749. https://doi.org/10.3389/fmed.2026.1965749

Image Credits: AI Generated

DOI: 10.3389/fmed.2026.1965749

Keywords: artificial intelligence, medical students, psychological distress, AI attitudes, medical education, DASS-21, cross-sectional survey, mental health, digital learning, survey research, Artificial, intelligence

Researchers recruited students during classroom sessions between February and March 2025 and analyzed those who provided complete questionnaire data, leaving a sample with a mean age of 20.0 years. Sixty-nine point four percent were women and 97.9% were single. Participants completed self-administered assessments of childhood maltreatment, depressive symptoms, anxiety symptoms, perceived academic stress and suicide risk under the supervision of trained research staff. The final group represented about 30% of the approximately 2,215 eligible second-year students, and the single-school, single-stage sample limits how broadly the results can be generalized.

Childhood adversity was measured retrospectively with the 28-item Childhood Trauma Questionnaire–Short Form, which assesses emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect for experiences before age 18. The main statistical models combined emotional abuse and emotional neglect into an emotional-maltreatment score, and physical abuse and physical neglect into a physical-maltreatment score. Sexual abuse was reported descriptively but excluded from the mediation models because the researchers regarded it as conceptually distinct. Depressive symptoms were measured with the nine-item Patient Health Questionnaire-9, anxiety with the seven-item Generalized Anxiety Disorder-7, academic stress with the SISCO Academic Stress Inventory and suicide risk with the 15-item Plutchik Suicide Risk Scale.

The instruments were internally consistent in this cohort, with Cronbach’s alpha values of 0.90 for the total Childhood Trauma Questionnaire–Short Form, 0.87 for the PHQ-9, 0.90 for the GAD-7, 0.80 for SISCO and 0.78 for the Plutchik scale. Using a Plutchik score of at least 6, investigators classified 174 students as being at high risk and 496 as being at low risk. The average total score was 4.4, with a standard deviation of 3.0 and a range of 0 to 14. Because the mediation analyses treated suicide risk as a continuous variable, the models did not depend only on the binary high-versus-low classification.

Students classified as being at high risk reported substantially more psychological distress than their low-risk peers. Mean PHQ-9 scores were 15.2 versus 7.7, a difference with a large effect size of Cohen’s d = 1.5, and 84.5% of the high-risk group met the study’s threshold for moderate or severe depressive symptoms, compared with 33.1% of the low-risk group. Mean GAD-7 scores were 11.6 versus 6.3, with d = 1.1, while 65.5% of high-risk students had moderate or severe anxiety symptoms compared with 22.6% of low-risk students. Academic stress was also higher among high-risk students, whose mean SISCO score was 3.7 rather than 2.9, a difference with d = 0.6.

Childhood maltreatment likewise differed between the suicide-risk groups. Mean emotional-maltreatment scores were 24.3 in the high-risk group and 16.6 in the low-risk group, with d = 1.0. Moderate or severe emotional maltreatment was reported by 56.9% of high-risk students, compared with 16.1% of low-risk students. Physical-maltreatment scores averaged 15.5 and 12.7, respectively, with d = 0.7, and moderate or severe physical maltreatment was reported by 42.0% of high-risk students versus 14.3% of low-risk students. Sexual abuse, although not entered into the mediation models, was also more common at the moderate or severe level among high-risk students: 28.2% compared with 9.1%.

The researchers tested two separate parallel multiple-mediation models using PROCESS Model 4 in SPSS. Emotional or physical maltreatment was the predictor, continuous suicide risk was the outcome, and depressive symptoms, anxiety symptoms and academic stress were entered simultaneously as mediators. Indirect effects were estimated with 5,000 bias-corrected bootstrap resamples and considered significant when their 95% percentile confidence interval excluded zero. The emotional-maltreatment model explained 53.6% of the variance in suicide risk, while the physical-maltreatment model explained 50.1%. All three specific indirect pathways were significant in both models, but their magnitudes differed.

Depressive symptoms produced the largest specific indirect effect in each model. For emotional maltreatment, the effect was B = 0.08 with a 95% bootstrap confidence interval of 0.06 to 0.10; for physical maltreatment, it was B = 0.12 with a 95% interval of 0.08 to 0.16. The indirect effects through academic stress and anxiety were each B = 0.005 and B = 0.01, respectively, in both models, and their confidence intervals also excluded zero. Maltreatment retained significant direct associations with suicide risk after the mediators were included: the standardized direct effect was β = 0.26 for emotional maltreatment and β = 0.14 for physical maltreatment. The researchers therefore interpreted the results as partial rather than complete mediation.

That pattern separates an early developmental vulnerability from more proximal psychological conditions. In statistical mediation, a significant indirect effect means that the association between exposure and outcome is attenuated when the proposed mediator is included; it does not by itself establish a causal sequence. Because all measures were collected at one point and childhood experiences were recalled retrospectively, the study cannot determine whether maltreatment preceded distress, whether distress contributed to later risk or whether other processes produced all three. Self-report may also introduce recall bias and underreporting, while the classroom recruitment, incomplete participation and restriction to one Mexican medical school may have introduced selection bias. The authors also did not formally test whether the two maltreatment models differed from one another, making direct comparisons of their overall indirect magnitudes uncertain.

The findings nevertheless offer a technically specific account of how developmental history and medical-training conditions can appear together in students’ mental-health profiles. Depressive symptoms had the strongest specific mediating association with suicide risk, academic stress was the mediator most directly associated with the outcome, and anxiety supplied another statistically significant pathway. These overlapping processes may reinforce one another: academic strain can accompany depression and anxiety, anxiety can intensify the perception of demands, and depression can erode coping resources. The analysis was not designed to estimate that feedback cycle, however. Its clearest result is that depression, anxiety and perceived academic stress account for part, but not all, of the statistical association linking early emotional and physical maltreatment to elevated suicide risk in this group of second-year medical students.

Subject of Research: Mediation of childhood maltreatment and suicide risk by psychological distress in Mexican medical students

Article Title: Early wounds, minds in training: childhood adversity and the mediating effect of psychological distress in suicidal risk among medical students

Article References: Martínez-Levy, G. A., Fresán-Orellana, A., Briones-Velasco, M., Romero-Silva, P. G., & Guizar-Sánchez, D. P. (2026). Early wounds, minds in training: childhood adversity and the mediating effect of psychological distress in suicidal risk among medical students. Frontiers in Psychology, 17, Article 1970728. https://doi.org/10.3389/fpsyg.2026.1970728

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1970728

Keywords: medical students, suicide risk, childhood maltreatment, depressive symptoms, anxiety symptoms, academic stress, mediation analysis, Mexico, Early, wounds, minds, training

The sample included 2,507 medical students. Depression-related symptoms were measured with the Patient Health Questionnaire-9, and social isolation was assessed with the Revised UCLA Loneliness Scale-6, allowing the investigators to compare chatbot experiences with two validated measures of psychological distress. Students reported using conversational AI for several purposes.

Academic perceived support was the primary driver of engagement, cited by 88.8% of participants. Smaller proportions reported using chatbots for companionship, at 22.2%, or to cope with stress and loneliness, at 23.1%. Daily use was reported by 41.9% of respondents, indicating especially frequent engagement among a substantial minority of the surveyed students.

The survey found a high prevalence of mental-health and social-well-being difficulties among participants. Mild-to-severe depressive symptoms were present in 70.6% of students according to the PHQ-9, while 65.0% met the survey’s threshold for moderate-to-high loneliness according to the Revised UCLA Loneliness Scale-6. The research therefore characterized chatbot use in a population already carrying a substantial burden of depressive symptoms and social isolation.

Students exhibiting higher levels of psychological distress were significantly more likely to report emotional connectivity, perceived companionship and subjective well-being benefits from their chatbot interactions. However, the authors noted that these correlations remained statistically weak. Because the study was cross-sectional, the measurements represent a snapshot rather than a sequence of events.

The findings nevertheless reveal that these systems occupied both educational and relational roles in the lives of the respondents. Academic support was the dominant reported function, but companionship and coping with stress or loneliness were meaningful uses for subsets of students. The authors described conversational AI as a scalable, low-barrier support mechanism in a conflict-affected setting where access to formal mental health services is severely restricted.

That accessibility does not make the observed benefits equivalent to treatment or establish the long-term safety of chatbot-based support. The study directly measured use, symptoms, loneliness and perceived benefits, but it did not demonstrate that chatbots prevented social isolation, reduced depressive symptoms or worsened either outcome. The authors called for responsible integration and longitudinal research to determine the long-term effects of AI-mediated support on student well-being.

Overall, the survey identifies broad chatbot engagement and substantial psychological distress among Sudanese medical students while highlighting the need for closer examination of how AI tools are used. Its clearest finding is not that chatbots provide a proven mental-health intervention, but that many students already consult them for academic help and some use them in emotionally oriented ways. The weak correlations and cross-sectional design leave the direction and consequences of those relationships unresolved.

Subject of Research: Associations between conversational AI use, depressive symptoms and loneliness among Sudanese medical students

Article Title: Conversational AI chatbots: a double-edged sword for mental health and social well-being among medical students

Article References: Ahmed, A., Mohamed, M. A. E., Ali, W. B. A., Eldouma, M. Y. M., Abdalla MohammedAli, R. M., Barakat, H. O. M., Alapoud, M. M., Ali, A. S. H., Alngar, Y. A. A., Ahmed, S. A. M., Osman, M. M. A., Gassemalseed, T. F. A., Gadallah, A. A., & Eljack, M. M. F. (2026). Conversational AI chatbots: a double-edged sword for mental health and social well-being among medical students. BMC Medical Education. https://doi.org/10.1186/s12909-026-10326-3

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10326-3

Keywords: conversational AI, medical students, Sudan, depressive symptoms, loneliness, cross-sectional survey, digital well-being, academic support, Conversational, chatbots, double-edged, sword

The researchers followed PRISMA guidelines and searched MEDLINE, Scopus, ERIC and ProQuest Central through October 2024. From 1,866 references identified, they included 43 peer-reviewed original studies evaluating Visual Thinking Strategies as learning activities with medical learners and reporting qualitative or quantitative outcomes. The population spanned premedical students, medical students, residents, fellows, faculty and interprofessional learners. Studies limited to non-medical health professions or lacking evaluation were excluded. The reviewers extracted study characteristics, participant demographics, intervention design, outcomes and methodological rigor, while quantitative studies were assessed with the Medical Education Research Study Quality Instrument, or MERSQI.

Medical students were the largest learner group, appearing in 33% of the included studies, followed by residents at 28% and interprofessional students at 19%. Most studies were published between 2020 and 2024, accounting for 60% of the total, and 74% were conducted in the United States. The evidence base was dominated by single-institution, non-controlled interventional studies. MERSQI scores ranged from 7 to 15, which the review described as indicating moderate methodological quality. This combination of results supports interest in the approach while limiting confidence in broad conclusions about its effectiveness across medical-education settings.

Outcomes were primarily assessed at Kirkpatrick Level 1 in 47% of studies and Level 2 in 51%, with one study reaching Level 3. Quantitative research most frequently used Budner’s Tolerance of Ambiguity Scale and the Communication Skills and Attitudes Scale, together with other validated tools, while qualitative studies analyzed reflective narratives. Reported outcomes included enhanced observation, communication, empathy, tolerance of ambiguity and diagnostic reasoning. The review did not establish sustained effects on clinical practice or patient outcomes, because the prevailing study designs and limited higher-level assessment could not answer those questions. The authors therefore call for multi-site, longitudinal and higher-rigor research to determine whether the educational benefits persist and extend to clinical practice.

Subject of Research: Systematic review of Visual Thinking Strategies across medical education

Article Title: A systematic review of visual thinking strategies in medical education

Article References: Robertson, M. L., Kelly-Hedrick, M., Ike, J. D., Cohn, J., White, J., Moniz, T., Chisolm, M. S., & Walsh, A. L. (2026). A systematic review of visual thinking strategies in medical education. BMC Medical Education. https://doi.org/10.1186/s12909-026-10175-0

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10175-0

Keywords: medical education, visual thinking strategies, arts-based learning, medical students, clinical reasoning, communication skills, empathy, tolerance of ambiguity, systematic review, medical humanities, systematic, review

Seven of the 11 universities offered optional transgender-health teaching, while four had no identifiable transgender-related content in either compulsory or optional courses. Optional provision was generally limited: six universities offered only one elective course. The researchers therefore found marked variation among institutions and concluded that transgender health was not systematically embedded in the undergraduate medical curricula examined. The results describe documented provision rather than what students learned during classes, clinical placements or informal teaching.

Most of the transgender-related teaching identified by the review was placed in departments of psychology, psychiatry, sexology, ethics and the medical humanities. There was little evidence of integration into biomedical or clinical disciplines. The study classified courses by their relevance to transgender and intersex health, whether they were compulsory or optional, and their disciplinary placement. It did not directly assess students’ knowledge, teaching quality, course depth, duration, assessment or the influence of the content on graduates’ subsequent clinical practice.

No explicit intersex-related content was identified in any of the available compulsory or optional course syllabuses reviewed. This absence applies to the curricula that could be identified through the systematic documentary search; it does not prove that every classroom session, clinical placement or teaching activity omitted intersex health. Content without an explicit transgender or intersex label, teaching delivered outside formal syllabuses or material that differed between catalogue versions could also have escaped identification. The analysis therefore establishes gaps in visible, formal curriculum documentation, not a complete inventory of all teaching that may have occurred.

Because the research was a cross-sectional review of written curricula, it assessed whether these programmes formally exposed students to transgender and intersex health rather than testing the effectiveness of an educational intervention. The authors concluded that more systematic incorporation of transgender and intersex health into compulsory undergraduate medical education could help ensure that future physicians acquire a common minimum level of competence for respectful, multidisciplinary care. That conclusion is a proposed curricular direction, not evidence that adding compulsory content would necessarily change clinical behavior or health outcomes. Even with broad national coverage, the study cannot show that all Polish graduates lacked relevant competencies; it shows that documented provision remained limited, uneven and dependent largely on optional courses and local institutional initiatives across the 11 programmes reviewed.

Subject of Research: Documentation of transgender and intersex health content in Polish undergraduate medical curricula

Article Title: Transgender and intersex health in undergraduate medical education: a curriculum analysis of medical degree programmes in Poland

Article References: Doda-Nowak, E., den Heijer, M., Ruchała, M., & Ziemnicka, K. (2026). Transgender and intersex health in undergraduate medical education: a curriculum analysis of medical degree programmes in Poland. BMC Medical Education. https://doi.org/10.1186/s12909-026-10600-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10600-4

Keywords: transgender health, intersex health, medical education, curriculum analysis, medical students, Poland, medical schools, health competencies, cross-sectional review, undergraduate curricula, Transgender, intersex

Students use Health Systems Science concepts to address actual system-level problems and submit project-based deliverables and other assignments. The study describes the design as an authentic-learning approach, with the reported aim of preparing physicians to contribute to and lead efforts aimed at transforming complex health systems. Its focus is therefore on physician preparation through practical engagement with health-system problems, not on measuring changes in clinical outcomes.

Researchers evaluated the selectives using evidence routinely collected by the school: end-of-course surveys, transcripts from curricular feedback sessions, project-based deliverables and other student assignments. They generated descriptive statistics from survey ratings and thematically analyzed feedback transcripts, using authentic learning theory as a sensitizing concept for the analysis. Among survey respondents, 93.6% agreed that teaching supported their learning and 88.6% agreed that instructional materials did so.

The results are based on students’ evaluations and their submitted work at a single medical school, rather than on a controlled comparison with another curriculum or measurements of improvements in patient care, institutional performance or population health. Students particularly valued opportunities to apply Health Systems Science concepts to real-world issues that had seemed vague or abstract in didactic or classroom-based learning. The analysis identified four elements that students described as influential: the authenticity of the health-system context, the authenticity of the problem-solving activities, access to system experts, and exposure to different system roles and perspectives.

These observations show that students associated the learning experience with genuine problems, expert involvement and multiple viewpoints. The reported findings do not separately quantify the contribution of each element or establish that one feature was more important than the others. The authors conclude that authentic, system-foregrounded experiential curricula can foster system-thinking skills and promote roles for physicians as contributors to and leaders of system transformation.

The evidence supports that conclusion as the program authors’ interpretation of the students’ experiences and assessments, while the study’s design does not determine the size of any effect or establish long-term changes in professional behavior. The curriculum offers a tested model for exposing future physicians to complex systems and engaging them in system-change efforts, and the authors suggest that other medical schools may develop comparable learning experiences.

Subject of Research: Evaluation of an experiential Health Systems Science curriculum for medical students at one school

Article Title: Cultivating physician change agents by foregrounding systems: experiential learning in health systems science

Article References: Solomon, L. S., Kanter, M. H., Chung, P. J., Robbins, C. W., Schmittdiel, J. A., Chen, I. L., Ryan, G. W., Perlman, S. M., & Chen, H. C. (2026). Cultivating physician change agents by foregrounding systems: experiential learning in health systems science. BMC Medical Education. https://doi.org/10.1186/s12909-026-10457-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10457-7

Keywords: medical education, Health Systems Science, experiential learning, medical students, authentic learning, system thinking, physician leadership, curriculum evaluation, health systems, Cultivating, physician, change

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

Researchers conducted in-depth, semi-structured interviews with the students, who were interns, and analysed the data through inductive thematic analysis. Two researchers iteratively coded the material and developed themes. The researchers reported steps intended to support trustworthiness, including detailed description, participant validation, reflexive analysis and an external audit through regular review by a thesis monitoring committee. Because the supplied evidence is limited to the study abstract, the interview guide, detailed sampling procedures and fuller results cannot be assessed here.

Students also described behaviours that they consciously rejected, including neglect of patient needs, avoidance of responsibility, discriminatory actions, inappropriate communication, internal team conflict and hierarchical mistreatment. The analysis identified a role-model spectrum containing positive, negative and anti-role-model features. Students’ responses included imitation, selective conformity and rejection, indicating that professional identity formation was associated with how they interpreted observed conduct rather than with passive imitation alone.

The abstract further reports that some students imitated paternalistic practices they considered pragmatically effective in managing clinical complexity, even when those practices did not fully align with expected professional standards. The authors conclude that professional identity formation can operate as a lived and interpretive process shaped by clinical conditions and students’ efforts to navigate demanding environments. They also argue that role models should be aware of their influence on learners because interactions that are not explicitly examined may remain implicit in clinical training. These conclusions arise from the reported experiences of 17 interns at one Turkish medical faculty, and the abstract does not establish how widely the findings apply to other students, institutions or clinical settings.

Subject of Research: Medical students’ experiences of clinical role modelling and professional identity formation

Article Title: Exploring medical students’ experiences of role modelling in clinical training: a phenomenological study of professional identity formation

Article References: Mergen, M., Akpınar, A., & Kavas, M. V. (2026). Exploring medical students’ experiences of role modelling in clinical training: a phenomenological study of professional identity formation. BMC Medical Education. https://doi.org/10.1186/s12909-026-10483-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10483-5

Keywords: medical education, role modelling, professional identity, clinical training, medical students, phenomenology, qualitative interviews, Türkiye, Exploring, medical, students, experiences

Medical students took part in observations, lectures, preparation and teaching sessions under an experienced oncologist. Researchers assessed teaching self-efficacy with the Physician Teaching Self-Efficacy Questionnaire and assessed cancer knowledge and literacy with the Japanese Cancer Intelligence Quotient. Medical students’ mean cancer-knowledge score rose from 39.9 before the program to 42.9 afterward, while their mean cancer-literacy score increased from 28.2 to 37.2. Both changes were statistically significant at p < 0.01. These are pre/post associations within the participating student group, rather than evidence from a randomized comparison.

The evaluation also included 1,210 pupils, whose cancer literacy was measured before and after instruction. Pupils showed improved cancer-related literacy, but the analysis found no statistically significant difference between physician-led and medical-student-led programs. Adjusted scores were 33.4 for physician-led and 33.1 for student-led classes, and the analysis of covariance did not detect a between-group difference (F(1, 1207) = 1.85, p = 0.17, partial η² < 0.01). The result therefore does not establish that the two lecturer types were equivalent, nor does the abstract report a significant pre/post increase separately for each pupil group.

Based on the abstract, participation in school-based cancer education was associated with short-term improvements in medical students’ teaching self-efficacy, cancer knowledge and cancer literacy, while pupils also improved in cancer literacy overall. The evidence does not establish long-term retention, effects in other institutions or populations, or superiority of either physician-led or student-led instruction. The authors noted that further research is needed to evaluate long-term outcomes and broader implementation.

Subject of Research: Pre/post evaluation of medical-student service-learning in school cancer education

Article Title: Evaluating a service-learning program: benefits of integrating medical students into school cancer education on teaching skills and cancer knowledge

Article References: Minamitani, M., Katano, A., Ohira, S., Mizumoto, J., & Nakagawa, K. (2026). Evaluating a service-learning program: benefits of integrating medical students into school cancer education on teaching skills and cancer knowledge. BMC Medical Education. https://doi.org/10.1186/s12909-026-10473-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10473-7

Keywords: medical education, service-learning, school cancer education, teaching self-efficacy, cancer literacy, medical students, school pupils, pre/post evaluation, Evaluating, program, benefits, integrating