The research team, led by Ines Heinen and Nina Matthes, who contributed equally to the work, brought together experts from two departments that rarely share a classroom: dermatology and venereology on one side, and medical psychology on the other. Their workshop for medical students combined the hard clinical science of syphilis with the soft skills of stigma-sensitive communication. Thirty-three students participated in the session, and thirty-one of them completed the voluntary surveys that formed the basis of the analysis. The design was a pre-post evaluation, meaning each student rated their own knowledge and confidence immediately before and immediately after the workshop using standardized questionnaires, allowing the researchers to measure change at the level of the individual learner.

On the dermatological side, the curriculum covered the epidemiology of syphilis, its clinical presentation across its stages, diagnostic procedures, and current treatment standards. This technical grounding matters because syphilis is famously called the great imitator: its symptoms can mimic everything from a harmless rash to neurological disease, and a clinician who does not think to ask the right questions may never order the right test. The students also practiced a practical procedural skill that is easy to overlook in lecture-based teaching, namely the administration of an intramuscular injection, which they rehearsed using a model. Because benzathine penicillin, the mainstay of syphilis therapy, is delivered intramuscularly, this hands-on component connected the pharmacology of treatment directly to a skill students will need at the bedside.

The psychological half of the workshop addressed what many educators consider the true bottleneck in STI care: stigma. Students explored how stigmatization affects patients with sexually transmitted infections, engaged in structured self-reflection about their own attitudes and discomforts, and learned the concrete content of a professional sexual history. The centerpiece of this component was a series of role-playing exercises based on fictional patient cases, in which students practiced taking a medical history in a simulated clinical encounter. This format deliberately forced learners to confront the awkwardness of asking intimate questions in a safe environment, where mistakes carry no consequences for real patients but generate immediate feedback and reflection.

The results were striking in their breadth. After the workshop, students reported a significant increase in their self-assessed knowledge of syphilis epidemiology, clinical symptoms, diagnostic procedures, and treatment. Their confidence in administering an intramuscular injection also rose significantly. Just as importantly, the measures targeting communication shifted in the right direction: students reported greater knowledge of what a sexual history should contain, more confidence while actually taking one, and a better understanding of the relevance of stigmatization. These gains were recorded on standardized self-assessment scales, the workhorse of medical education research, which capture a learner’s subjective sense of preparedness, a known predictor of whether a skill will actually be used in practice.

Equally telling were the scores that fell. Students’ self-reported embarrassment while taking a sexual history decreased significantly after the workshop, and so did their concerns that patients might feel stigmatized during such conversations. This dual movement, confidence up and anxiety down, is precisely the pattern educators hope to see, because embarrassment is one of the most commonly cited barriers that keeps young doctors from asking about sexual behavior at all. When a clinician hesitates to ask, the question often goes unasked, the risk factor goes unrecorded, and the infection goes undiagnosed. Reducing that hesitation at the training stage could therefore ripple forward into better case-finding years later.

The study did not rely solely on self-report. After the workshop, students also completed an objective test covering the treatment of syphilis and sexual history taking, providing a check on whether the subjective confidence gains were anchored in actual knowledge. The authors present this combination of subjective and objective measures as a methodological strength, since self-assessed competence can inflate independently of real ability. While the pre-post design without a control group means the researchers cannot rule out effects of simply spending a day in focused study, the consistency of the improvements across knowledge, communication, and attitudinal domains lends credibility to the intervention itself.

Perhaps the most persuasive endorsement came from the participants themselves. Most students stated that the workshop should be integrated into the standard medical curriculum, a notable verdict in a crowded course of study where every additional hour competes with anatomy, pathology, and clinical rotations. The enthusiasm suggests that students perceive the gap the workshop fills, and that they experience the combination of clinical content and communication training as directly relevant to the doctors they are becoming. In an era when curricula are increasingly packed with technical content, a format that students actively want more of is a valuable currency for curriculum reformers.

The broader implications reach beyond syphilis. Sexually transmitted infections remain among the most common infectious diseases worldwide, and public health agencies have documented rising case numbers for years, including congenital syphilis, which can cause severe harm to newborns. Every missed diagnosis begins with a conversation that never happened, and every conversation that never happened often traces back to a clinician who was never trained to have it. The Hamburg team argues that teaching dermatological and psychological content together may prepare students for patient-centered sexual healthcare better than traditional discipline-specific education, in which the biology of infection and the human dynamics of disclosure are taught in separate silos, if the latter is taught at all.

The study, conducted with ethics approval from the local Psychological Ethics Committee at University Medical Center Hamburg-Eppendorf and published open access, is a small one, and the authors are careful about what it can and cannot show. Thirty-one students, one workshop, and self-assessed outcomes do not settle the question of long-term behavior change in clinical practice. But the findings offer a concrete, replicable template: pair the venereology with the psychology, add role-play and procedural practice, and measure what happens. If subsequent studies with larger cohorts and follow-up assessments confirm these results, medical schools may gain a proven answer to a question that has lingered for decades, namely how to turn students who dread asking about sex into clinicians who can do it competently, confidently, and without judgment.

Subject of Research: Medical education interventions for sexually transmitted infection training

Article Title: Enhancing medical students’ self-assessed competence in sexually transmitted infections: outcomes of an interdisciplinary workshop on syphilis, stigmatization and sexual history-taking

Article References: Heinen, I., Matthes, N., Booken, N., Härter, M., Schneider, S. W., & Abeck, F. (2026). Enhancing medical students’ self-assessed competence in sexually transmitted infections: outcomes of an interdisciplinary workshop on syphilis, stigmatization and sexual history-taking. BMC Medical Education. https://doi.org/10.1186/s12909-026-10507-0

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10507-0

Keywords: syphilis, sexually transmitted infections, medical education, medical students, sexual history-taking, stigmatization, dermatology, medical psychology, workshop, communication skills, Hamburg-Eppendorf, curriculum

Hidradenitis suppurativa, often abbreviated HS, is a chronic, recurrent inflammatory skin condition that causes painful nodules, abscesses, and draining tunnels, known as sinus tracts, most commonly in the armpits, groin, and beneath the breasts. It is driven by inflammation of hair follicles and immune dysregulation rather than poor hygiene, yet patients have long battled the misconception that the disease reflects uncleanliness. The condition follows a relapsing course, with flares that can erupt suddenly, progress unpredictably, and produce some of the highest rates of emergency department use in all of dermatology. Previous quantitative work has shown that many patients rely on emergency care rather than outpatient visits, and that pain is a dominant feature of those encounters. What has been missing is a detailed account of the decision-making that unfolds in the hours after a flare begins.

To fill that gap, a team led by researchers at Harvard Medical School and Brigham and Women’s Hospital, including first authors Natalie M. Baker and Karla Santiago-Soltero, conducted semi-structured interviews with adults who had recently sought care for a flare. The study is part of a broader sequential mixed-methods project, meaning an earlier quantitative analysis of patient-specific factors associated with emergency visits directly shaped the interview guide. Participants were recruited from a dermatology specialty clinic at an academic medical center and from surrounding emergency departments within the same geographic catchment area. To be eligible, patients had to speak English, be adults, have established care with an HS specialist, and have recently presented to either an emergency department or a dermatology clinic for a flare. Interviews ran from February 2024 through January 2025.

In total, twenty patients were interviewed: nine who had gone to an emergency department and eleven who had visited a dermatology clinic for their flare. The group’s demographics mirrored the broader HS population, with a mean age of thirty-seven years, eighty-five percent female participants, and a racially diverse composition that included forty-five percent White, thirty percent African American, ten percent mixed heritage, ten percent Asian, and ten percent Hispanic or Latino participants. Transcripts were analyzed using qualitative thematic analysis, a method in which researchers code recurring ideas across interviews and refine them into broader themes, continuing until thematic saturation was reached, the point at which new interviews stop producing new themes. A grounded-theory approach was then used to build a conceptual framework from those themes, letting the explanation emerge from the data rather than testing a predetermined hypothesis.

The analysis surfaced twelve primary themes that shaped whether patients chose the emergency department or the dermatology clinic during a disease exacerbation. On the side of emergency care, the strongest driver was severe pain that failed to respond to at-home management. When over-the-counter measures and prescribed strategies ran out and the pain kept climbing, the emergency room became the only option patients felt they had. Recommendations from providers or family members also pushed patients toward emergency care, as did a specific and understandable worry: concern that the flare might represent an infection rather than a routine HS exacerbation. Distinguishing a painful HS nodule from a bacterial abscess that needs drainage is genuinely difficult, even for clinicians, and patients carry that uncertainty with them.

Yet the same emergency departments that patients turned to in desperation were also described as places to avoid. Negative prior experiences acted as powerful barriers to returning, and two stood out: stigmatization and painful procedures. Patients described feeling judged, a wound that cuts deep in a disease already burdened by misconceptions about hygiene and body weight. They also recalled emergency interventions, such as incision and drainage, that were excruciating. This creates a painful loop: uncontrolled symptoms send patients to the emergency department, the experience there leaves them reluctant to return, and the next flare finds them hesitating until the pain becomes unbearable again. The study’s authors argue that this dynamic is a key reason emergency utilization remains high even among patients who, on paper, should not need it.

Dermatology clinics, by contrast, earned loyalty for reasons that emergency settings struggle to match. Positive relationships with providers were a major facilitator of clinic use, as was the sense of receiving comprehensive care that addressed the disease over time rather than one crisis at a time. Patients who trusted their specialists and felt known by them preferred to wait for clinic availability rather than default to the emergency room. Those therapeutic alliances, the interviews suggest, are not a soft luxury but a functional component of the health system, steering patients toward continuity of care and away from fragmented acute encounters that rarely change the disease’s long-term trajectory.

But the clinic route had its own structural limits, and the study catalogs them precisely. Restricted clinic availability, especially outside standard business hours, was the dominant barrier, since flares do not respect the nine-to-five schedule. Extended wait times for appointments meant that by the time a slot opened, a manageable flare could have escalated into an emergency. Perhaps most insidiously, the unpredictable progression of flares made planning impossible: patients could not know in the morning whether a tender spot would settle down by evening or explode into an abscess overnight. That uncertainty pushes patients toward the setting that is always open, even when they would prefer the setting that knows them best. The timing mismatch between flare behavior and clinic operations is, in effect, a design flaw that the emergency department silently absorbs.

The findings point toward concrete fixes. The researchers suggest that improving after-hours access to urgent dermatologic care could intercept many of the flares that currently land in emergency departments, an idea supported by emerging work on walk-in dermatology appointments for HS and atopic dermatitis. They also call for the development of evidence-based guidelines for at-home treatment strategies, so that patients facing a flare in the middle of the night have a validated playbook instead of guesswork. Written action plans, already tested in randomized trials for HS patient education, and patient support tools such as the HS Foundation’s Papaya app represent steps in that direction. Enhanced education for both patients and providers, particularly around differentiating HS flares from infection, could reduce both unnecessary emergency visits and the stigmatizing encounters that follow them.

What makes the study resonate beyond dermatology is its methodological honesty. By grounding the conceptual framework in patients’ own narratives rather than administrative billing data, the researchers captured the lived arithmetic of a flare: how much pain, how much fear, how much trust, and how many phone calls before a decision is made. The interviews also add texture to earlier population-level findings, including studies documenting low use of dermatology ambulatory encounters among HS patients and analyses of pain management at United States emergency department visits. The research was funded by the HS Foundation’s Danby Research Grant Program and a Dermatology Foundation Clinical Career Development Award. For a disease affecting an estimated one percent or more of the population, often beginning in young adulthood and disproportionately affecting women, the message is clear: reducing emergency utilization will require not just better access, but a system designed around the unpredictable, painful, and deeply personal reality of the flare itself.

Subject of Research: Patient decision-making in flare management and emergency department use in hidradenitis suppurativa

Article Title: Flare management perspectives among patients with hidradenitis suppurativa: a qualitative study

Article References: Baker, N. M., Santiago-Soltero, K., Narayana, A., Oke, O. H., DeWane, M. E., Cohen, S. R., Barbieri, J. S., Noe, M., & Charrow, A. P. (2026). Flare management perspectives among patients with hidradenitis suppurativa: a qualitative study. Archives of Dermatological Research, 318(1), Article 496. https://doi.org/10.1007/s00403-026-04907-x

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04907-x

Keywords: hidradenitis suppurativa, flares, emergency department, dermatology, qualitative research, thematic analysis, pain management, stigmatization, health care utilization, patient experience, access to care, after-hours care

The research, conducted by Fatoş Bulut-Ateş and Idil Eren Kurt of the Department of Psychological Counseling and Guidance at Cukurova University, set out to answer three distinct questions about this phenomenon: who is using social media and search engines for psychological help, how do these users differ from their peers, and what function does this digital help-seeking actually serve in their lives. To capture all three dimensions, the researchers employed an explanatory sequential mixed methods design, a rigorous architecture in which quantitative findings are collected first and then elaborated and deepened by qualitative interviews.

The quantitative phase unfolded between March and June 2024, when 778 university students completed an online survey. The researchers subjected the resulting data to a battery of statistical procedures, including descriptive statistics, Pearson correlations, chi-square tests, independent-samples t tests, and multivariable binary logistic regression, a technique that estimates the independent contribution of each predictor while holding the others constant. The headline number was striking: 62.3 percent of participants reported using social media and search engines as sources of psychological help, with a 95 percent confidence interval spanning 58.9 to 65.7 percent. Female students reported such use at a higher proportion than their male counterparts.

The group comparisons that followed painted a psychologically coherent picture of the digital help-seeker. Compared with non-users, students who turned to social media and search engines reported greater fear of stigmatization, lower perceived social support, and higher levels of psychological distress. In other words, the students drifting toward their screens for comfort were those who felt more alone, felt more judged, and were suffering more. Yet the logistic regression told a more nuanced story when the variables were considered simultaneously. In the adjusted model, gender, fear of stigmatization, and psychological distress remained independently associated with usage status, whereas perceived social support did not. Low support, it seems, may travel together with stigma and distress rather than exerting its own separate pull toward the digital sphere.

To understand what these numbers meant in lived experience, the researchers moved to the qualitative phase, conducting semi-structured interviews with 20 students who reported using social media and search engines for psychological help. The interview data were analyzed using reflexive thematic analysis, an approach that treats themes as actively generated by the researcher rather than passively discovered, and that has become a methodological standard in psychology following the influential work of Braun and Clarke. The analysis deepened the statistical profile considerably, uncovering three interlocking roots of the digital turn.

The first root was relational. Students described the turn toward social media as grounded in the relational cost of opening up to another person. Confiding in a friend, family member, or counselor carries social risks: vulnerability, potential judgment, the awkwardness of being seen in distress. A search engine asks for nothing. A social media platform offers anonymity or at least distance. The second root was a multi-layered stigmatization operating at three distinct levels: internalized, where students had absorbed negative beliefs about mental illness and help-seeking into their own self-concept; interpersonal, where they feared the reactions of peers and family; and structural, where institutional and cultural arrangements made professional help feel inaccessible or shameful. This layered model echoes broader theoretical work distinguishing self-stigma from public and structural stigma, and it suggests that interventions targeting only one layer may leave the others intact.

The third root was epistemic: students needed to make sense of their experiences. They wanted names for what they were feeling, frameworks that could organize confusing emotional states into recognizable categories. Social media, with its vast ecosystem of psychology-themed content, personal testimonials, and peer communities, offered a vocabulary. In this respect, the digital space functioned as what the researchers describe as an accessible and low-visibility compensatory environment, a place where students could explore their inner lives without the exposure that formal help-seeking demands. The process of naming experiences and connecting with others who shared them did reduce feelings of isolation, a finding consistent with long-standing evidence that peer support and shared identity can buffer psychological suffering.

But the study’s most consequential finding concerns what happens next, or rather, what does not. The relief that students obtained from social media was often temporary. More importantly, participants’ accounts more often portrayed social media as a substitute for professional help rather than a bridge toward it. This distinction between substitute and bridge is the conceptual heart of the paper. Digital platforms have frequently been celebrated as gateways that might funnel reluctant help-seekers toward formal services, a stepping-stone narrative that has shaped youth mental health policy in several countries. The Turkish data complicate that optimism: the very features that make social media appealing, its accessibility, its low visibility, its demand for no disclosure, may also make it a comfortable terminus rather than a waypoint.

The researchers’ conclusion reframes the policy problem entirely. The primary challenge, they argue, is not that students use these digital sources at all, but that they are unable to transition to professional care because of barriers such as limited mental health literacy, confidentiality concerns, and difficulties of access. This is a subtle but important shift in emphasis. Rather than pathologizing digital help-seeking or treating it as a symptom of a misinformed generation, the study locates the failure in the systems that should be catching these students. A significant portion of the obstacles, the authors underscore, can be mitigated through the dissemination of accurate information and the development of more accessible professional services. Mental health literacy campaigns, transparent confidentiality policies, and lower-friction entry points to counseling could convert the digital detour into a genuine pathway.

The findings arrive amid a global surge of concern about student mental health. Epidemiological work has repeatedly documented elevated psychological distress among undergraduates compared with community peers, and meta-analytic reviews confirm that help-seeking intentions and behaviors among college students remain persistently low relative to demonstrated need, with stigma among the most consistently reported barriers. Against that backdrop, the Cukurova study suggests that the roughly 62 percent of students consulting social media and search engines for psychological help are not an anomaly but a mainstream population, one whose digital forays represent rational responses to real barriers. The task for universities and mental health systems, the study implies, is not to compete with the search bar but to earn the trust that would make the transition from screen to clinic feel safe, affordable, and worth the relational cost that students so clearly fear.

Subject of Research: Use of social media and search engines as sources of psychological help among university students

Article Title: Social media and search engines as sources of psychological help for university students

Article References: Bulut-Ateş, F., & Kurt, I. E. (2026). Social media and search engines as sources of psychological help for university students. Current Psychology, 45(19), Article 1551. https://doi.org/10.1007/s12144-026-10106-8

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10106-8

Keywords: social media, psychological help-seeking, university students, stigmatization, perceived social support, psychological distress, mixed methods, mental health literacy, search engines, digital help-seeking, reflexive thematic analysis, Türkiye

The research team recruited thirty emergency care practitioners using non-probability sampling strategies and conducted in-depth interviews with each of them. A qualitative lens was chosen deliberately: rather than measuring stress with rating scales, the researchers wanted to capture the texture of lived experience, the stories and emotions that numbers alone cannot convey. The interviews were then subjected to thematic analysis, a systematic method for identifying recurring patterns of meaning across accounts. The approach was ethically rigorous, with approval from the University of Cape Town Human Research Ethics Committee, written informed consent from every participant, and explicit assurances that participation was voluntary and could be withdrawn at any time.

The findings paint a sobering picture. Participants reported significant levels of mental health distress, a burden the authors attribute to their personal fragility within a turbulent health environment. Emergency care practitioners were more likely than many other health workers to experience deep psychological strain, the study concludes, precisely because they worked within the direct milieu of the virus. Every shift carried the risk of exposure, and every patient encounter was a potential transmission event. In a province that became one of South Africa’s early epicentres of the pandemic, the volume and severity of cases left little room for recovery between calls.

Stigmatization emerged as a distinct and painful theme. Emergency care practitioners, who move constantly between communities, homes and health facilities, found themselves viewed with suspicion and fear by the very public they served. Some were perceived as potential carriers of infection, a perception that compounded the stress of their clinical duties. The study also documented burnout, the gradual erosion of emotional and physical reserves that occurs when chronic workplace stress goes unrelieved. Burnout among emergency personnel is a well-recognized occupational hazard, but the pandemic compressed years of cumulative strain into a far shorter period, intensifying exhaustion and detachment.

Perhaps one of the most striking findings concerns the home front. Participants reported a lack of emotional support from family members, an absence that deepened their isolation. This paradox, in which workers risking their lives for the community returned home to distance, silence or misunderstanding, reflects the broader social dynamics of the pandemic. Fear of infection within households, the need to protect loved ones through self-isolation, and the general disruption of social life all conspired to cut practitioners off from the very relationships that ordinarily sustain people through hardship.

The study did not stop at cataloguing harm. It also uncovered the interventions the practitioners used to help bolster their physiological and psychological strength. These self-directed coping strategies, drawn from the participants’ own accounts, represent a form of resilience forged under extreme conditions. The authors’ emphasis on these adaptive responses is significant for practice: understanding what frontline workers actually did to sustain themselves offers concrete guidance for designing support programmes that resonate with the realities of emergency medical work, rather than imposing generic wellness initiatives from above.

The South African context matters for interpreting these results. The Western Cape’s health system, like much of the country’s, entered the pandemic with existing resource constraints, high patient loads and pronounced health inequalities. Emergency care practitioners routinely navigate a demanding pre-hospital environment, and COVID-19 layered an invisible, highly contagious pathogen on top of those pressures. The researchers note that the plight of emergency care practitioners at the frontier of treating COVID-19 patients had remained an under-researched area, and their study is positioned as one of the efforts to bring this workforce out of the shadows of the pandemic literature.

Methodologically, the study’s reliance on in-depth interviews with thirty practitioners gives it depth at the expense of breadth. Qualitative designs of this kind are not intended to produce statistics that generalize to all emergency workers, but they excel at revealing mechanisms, the how and why of psychological distress, stigma and coping. Thematic analysis allowed the researchers to move from individual narratives to shared patterns, and the transparency of the process, from ethical approval to consent procedures, strengthens confidence in the findings. For readers seeking to understand the human cost of pandemic response, such accounts are often more revealing than incidence rates alone.

The implications reach well beyond South Africa. Health systems worldwide depend on emergency medical services as the connective tissue between communities and hospitals, and the pandemic exposed how vulnerable that tissue can become when psychological support is thin. The study’s documentation of mental health distress, stigmatization, burnout and family estrangement provides a checklist of the pressures that any surge-capacity plan should anticipate. Its findings on self-generated coping strategies suggest that peer support, family engagement and accessible mental health services could be integrated into emergency care employment from the outset, rather than improvised during a crisis.

As the world moves past the acute phase of COVID-19, studies like this one serve as a record of what frontline emergency workers endured and a warning about what they may still carry with them. The thirty practitioners interviewed in the Western Cape describe a period of profound personal fragility, but also of resourcefulness and endurance. By documenting both the wounds and the coping strategies, Cermak and Bhagwan have provided health planners, employers and researchers with an evidence base for protecting the people who answer the call when systems are pushed to their limits. The full open-access article is available in Discover Social Science and Health, and the authors declare no competing interests and received no external funding for the work.

Subject of Research: The lived experiences and mental health of emergency care practitioners during the COVID-19 pandemic in the Western Cape, South Africa

Article Title: The experiences of emergency care practitioners working at the forefront of the COVID-19 pandemic in the Western Cape, South Africa

Article References: Cermak, R., & Bhagwan, R. (2026). The experiences of emergency care practitioners working at the forefront of the COVID-19 pandemic in the Western Cape, South Africa. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00467-7

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00467-7

Keywords: emergency care practitioners, COVID-19, mental health, burnout, stigmatization, South Africa, Western Cape, qualitative research, emergency medical services, occupational stress, coping strategies, health workers