The study employed a qualitative descriptive design, a methodology suited to capturing the lived experience of professionals navigating the transition from student to practitioner. Thirteen occupational therapists participated in semi-structured interviews, a sample size consistent with the norms of qualitative inquiry, where depth of insight matters more than statistical generalizability. The interviews were audio-recorded and transcribed verbatim, then analysed using Braun and Clarke’s reflexive thematic analysis, a widely used approach that involves systematic coding of transcript data and the iterative development of themes that capture patterns of meaning across participant accounts. The researchers used NVivo 15, a dedicated qualitative data analysis software package, to manage and organize the coding process.

Trustworthiness, the qualitative equivalent of validity, was addressed through several established techniques. The authors describe the use of reflexivity, in which researchers critically examine how their own backgrounds and assumptions might shape the interpretation of data. Peer debriefing allowed colleagues to challenge and refine emerging interpretations, while triangulation helped ensure that findings were anchored in multiple perspectives within the dataset. The maintenance of an audit trail, a documented record of analytical decisions from raw transcript to final theme, further strengthens confidence in the study’s conclusions. Ethical clearance was granted by the University of the Witwatersrand Human Research Ethics Committee under clearance number H24/03/29, and all participants provided written informed consent before data collection began.

From the analysis, three major themes emerged. The first concerns the genuine strengths of the mental health curriculum as currently taught in South African occupational therapy programmes. Participants identified expert teaching as a foundation of their learning, praising the knowledge and clinical experience of academic staff who delivered the mental health content. They also highlighted meaningful undergraduate clinical supervision, describing placements in which experienced clinicians guided their developing skills in real-world settings. Multidisciplinary learning experiences, in which students trained alongside future doctors, nurses, psychologists and social workers, were credited with building an understanding of how mental health care functions as a team endeavour. Taken together, these elements gave many participants a sense that their education had, in important respects, prepared them for the demands of mental health practice.

The second theme, however, reveals significant gaps between what the curriculum delivers and what the realities of practice demand. Participants reported limited preparation for culturally responsive practice, a shortfall with particular weight in South Africa, where therapists routinely serve clients whose languages, belief systems and cultural frameworks around mental illness differ markedly from their own. Without explicit training in how to adapt assessment and intervention to diverse cultural contexts, graduates described uncertainty about whether their therapeutic approaches were appropriate or effective for the communities they served. This gap is not merely academic; in mental health care, where trust and communication are central to outcomes, cultural misalignment can undermine treatment adherence and therapeutic relationships.

Participants also described feeling underprepared for complex mental health presentations. Undergraduate training, they indicated, did not always expose them to the severity, acuity or diagnostic diversity of the cases they encountered once qualified. Clients with co-occurring psychiatric and physical conditions, acute crises, or severe and persistent mental illness presented challenges that exceeded the scenarios they had practised as students. Related to this was a third shortcoming: limited confidence in applying occupational therapy interventions specifically within mental health contexts. Occupational therapy in psychiatry involves distinct techniques, from activity-based rehabilitation to vocational and social skills training, and participants suggested that the translation of general occupational therapy principles into mental health settings had not been sufficiently rehearsed during their studies.

The third theme captures the participants’ own recommendations for reform, and these form perhaps the most actionable part of the study. Graduates called for expanded community-based mental health training, arguing that learning within the communities where clients actually live would build the contextual competence that hospital-based placements cannot fully provide. Community-based education has gained traction globally as a strategy for aligning health professional training with population needs, and the participants’ experiences suggest that South African occupational therapy programmes could benefit from deepening this component. They further recommended integrating physical and mental health teaching throughout the curriculum, rather than treating them as separate streams, reflecting the growing recognition that the two domains are inseparable in real clinical populations.

The recommendations also extended to the structure and consistency of training itself. Participants urged improved supervision and feedback during clinical placements, emphasizing that the quality of guidance received as a student shapes confidence as a practitioner. Inconsistent experiences across undergraduate mental health curricula emerged as another concern, with graduates from different training pathways describing markedly different levels of exposure to mental health content. Greater standardization, or at minimum greater alignment, across programmes could help ensure that all newly qualified occupational therapists enter the workforce with a comparable baseline of mental health competence. The authors conclude that undergraduate occupational therapy education in South Africa provides an important foundation for mental health practice, but that it could be strengthened through greater cultural responsiveness, expanded community-based learning, improved supervision and feedback, and greater curricular consistency.

The significance of these findings extends beyond occupational therapy. In resource-constrained health systems, newly qualified professionals are frequently the backbone of service delivery, and South Africa’s persistent shortages of mental health specialists mean that occupational therapists often fill roles that would, in better-resourced settings, be staffed by more experienced clinicians. The transition from student to practitioner is a well-documented period of vulnerability, marked by reality shock, reduced confidence and, in some cases, early attrition from the profession. When that transition occurs with limited supervision, as the study’s background notes, the stakes for both clinician wellbeing and patient safety rise considerably. Understanding precisely where educational preparation falls short is therefore a prerequisite for designing interventions that protect the workforce and the populations it serves.

The study, published on 6 October 2026 as an open access article, was supported in part by the Female Academic Leadership Fellowship, which allowed the first author to dedicate time to the conception, data collection and writing of the research. The authors declare no competing interests. While the qualitative design means the findings describe the experiences of thirteen therapists rather than measuring preparedness across the entire profession, the consistency of the themes and the methodological safeguards employed lend weight to the conclusions. For educators, the message is clear: the foundations are sound, but the gaps in cultural training, exposure to complexity and community-based practice are real and fixable. For the graduates themselves, the study offers validation that their struggles reflect systemic curriculum limitations rather than personal inadequacy, and a roadmap for the reforms that could make the next generation of South African mental health practitioners better equipped for the work awaiting them.

Subject of Research: Preparedness of newly qualified occupational therapists for mental health practice in South Africa

Article Title: Perceptions of preparedness for mental health practice among newly qualified occupational therapists in South Africa

Article References: Tsatsi, I., & Silaule, O. (2026). Perceptions of preparedness for mental health practice among newly qualified occupational therapists in South Africa. BMC Medical Education. https://doi.org/10.1186/s12909-026-10387-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10387-4

Keywords: occupational therapy, mental health, health professional education, South Africa, undergraduate curriculum, qualitative research, thematic analysis, clinical supervision, community-based training, culturally responsive practice, workforce preparedness, BMC Medical Education

The study, conducted by Laureen Fröhlich and Andreas H. Mahnken at Marburg University, distributed an anonymous 47-item online questionnaire to 300 fifth-year medical students taking regular radiology courses across two academic terms, between winter 2023 and summer 2024. Eighty-five students completed the survey, a response rate of 28.3 percent, with 67 percent female participants and a mean age of 24.9 years. The questionnaire, based on previously published survey instruments, covered demographic data, students’ knowledge of interventional radiology compared with other disciplines, their familiarity with specific procedures including oncologic, vascular and non-vascular interventions, and their understanding of the specialty’s clinical role. Students completed the survey without any prior teaching intervention, providing a genuine baseline of what five years of medical school had taught them. The study was approved by the institutional ethics committee.

The headline finding is a paradox of awareness without understanding. Every single participant, 100 percent, knew that interventional radiology exists alongside diagnostic radiology. But only 36.5 percent had any prior exposure to the field during their studies, and 67.1 percent rated their own knowledge of it as poor. Not a single student rated their knowledge as excellent, and only 4.7 percent considered it good. The gap between perceived and actual understanding was particularly revealing: 63.5 percent of students claimed to know which diseases interventional radiology could treat, and 58.8 percent said they were aware of the available procedures, yet when tested objectively on specific interventions, their performance collapsed. Only about a third, 35.7 percent, felt they knew when a patient should even be referred to the specialty.

The procedural knowledge test laid bare the blind spot. Students were presented with twelve exemplary interventional radiology procedures and correctly assigned only seven of them to the field. Vascular interventions fared well: 96.5 percent correctly identified arterial revascularization as an interventional radiology procedure, followed by percutaneous angioplasty at 92.9 percent, endovascular aortic repair at 88.2 percent, treatment of arterial bleeding at 84.5 percent and inferior vena cava filter implantation at 76.2 percent. But the oncologic procedures, the very heart of interventional oncology, were recognized far less often. Venous access port implantation for chemotherapy was correctly assigned by only 54.1 percent of students and hepatic artery infusion chemotherapy by 50.6 percent. Fewer than half correctly identified thermal ablation of renal tumors at 48.8 percent, hepatic tumor ablation at 43.5 percent or image-guided lung biopsy at 42.4 percent. Non-vascular procedures fared worst of all, with vertebroplasty recognized by a mere 20 percent of respondents.

The confusion extended beyond ignorance to outright misattribution. Of the five non-interventional-radiology procedures included as distractors, the majority of students failed to correctly exclude any of them. Removal of adrenal tumors and radiation therapy for bone metastases were correctly recognized as outside the field by only 45.8 percent and 42.4 percent of students respectively, while local treatment of rheumatoid arthritis and proton therapy for pancreatic tumors were correctly flagged by just 37.6 percent and 35.3 percent. In other words, many future physicians cannot reliably distinguish what interventional radiologists do from what surgeons, radiation oncologists or nuclear medicine specialists do, a deficit with real clinical consequences, since referring physicians who misunderstand a specialty’s therapeutic potential may delay or miss referrals and exclude minimally invasive, organ-sparing options from multidisciplinary treatment planning.

Students’ picture of the specialty’s clinical structure was similarly incomplete. On the positive side, 97.6 percent recognized that interventional radiology treats patients with serious illnesses, and around 96 percent acknowledged that it performs potentially life-saving interventions. But when asked about the organizational reality of modern practice, understanding wavered: 69 percent assumed interventional radiology departments run their own outpatient clinics, 65.5 percent believed they admit patients independently, and 64.3 percent thought they conduct ward rounds, while only 41.7 percent knew such departments may have their own inpatient beds. These structures are increasingly common as the specialty evolves from a procedural referral service into a fully clinical discipline responsible for the entire patient pathway, from initial consultation through admission, inpatient care, discharge and follow-up.

The career implications may be the most consequential finding of all. Although 70.6 percent of students expressed interest in interventional radiology, and 61.2 percent wanted to learn more about it, radiology as a career was decisively rejected. Not one student said they would definitely consider it, only 5.9 percent said rather yes, and 78.8 percent ruled it out as rather not or definitely not an option. The most cited reason, given by 57.6 percent, was too little patient contact, followed by too much work on the computer at 51.8 percent and simple lack of interest at 50.6 percent. The authors note that this perception of radiologists as isolated, screen-bound technicians is a widespread stereotype, reinforced by low exposure during training and by the shortage of interventional radiology-managed inpatient beds that limits bedside teaching. A European survey by the Cardiovascular and Interventional Radiological Society of Europe’s Trainee Forum found the same trend, with limited patient interaction the most cited deterrent.

This recruitment crisis arrives at precisely the wrong moment. Cancer remains one of the foremost causes of death worldwide, with 19.3 million new cases and nearly 10 million cancer-related deaths in 2020, and the global burden is projected to rise by 47 percent to approximately 28.4 million new cases annually by 2040. Meanwhile, a shortfall of around 10 million healthcare workers is anticipated by 2030, and shortages of clinical radiologists and interventional radiology specialists, worsened by aging, retirement and burnout, are particularly alarming because these specialties are critical for cancer diagnosis, staging and minimally invasive treatment. Crucially, unlike vascular interventions, which are often performed by other disciplines, interventional oncology procedures are carried out exclusively by interventional radiologists, meaning a shortage of incoming talent could directly limit the quality and accessibility of minimally invasive cancer therapy for years to come.

Part of the problem is structural. In the United States, interventional radiology has been recognized as a primary medical specialty since 2012, and the Integrated Interventional Radiology Residency introduced in 2016 established a structured six-year training pathway reflecting the discipline’s full clinical scope. In Europe, no standardized framework exists: in most countries, including Germany, interventional radiology holds no official subspecialty status and is instead embedded within radiology. It is entirely absent from Germany’s official national undergraduate medical curriculum. CIRSE has developed curricula, including an Interventional Radiology Curriculum for Medical Students that treats interventional oncology as a core area, but implementation of these non-mandatory frameworks remains inconsistent and dependent on local initiative. The result, the authors argue, is a self-perpetuating cycle in which invisibility in the curriculum breeds ignorance among students, ignorance deters career interest, and dwindling recruitment deepens the workforce shortage that keeps the specialty too stretched to teach.

Breaking that cycle, the researchers conclude, requires action on several fronts: establishing formal structural recognition of interventional radiology as a specialty or subspecialty, integrating it and interventional oncology into mandatory undergraduate modules, expanding teaching formats from lectures and symposia to bedside teaching and interdisciplinary case discussions, actively promoting the field as the clinical, patient-facing discipline it has become, and harmonizing training standards across Europe. The evidence suggests even modest interventions work, as short lectures and targeted teaching have been shown to improve student knowledge and career consideration. The authors acknowledge limitations, including the single-institution design, the 28.3 percent response rate that may have attracted students already interested in the field, and the use of predefined answer options that may have shaped responses about career objections. Still, the message is difficult to ignore: a field capable of burning away tumors through a pinhole cannot afford to remain, in the minds of the physicians who will soon refer patients to it, out of sight and out of mind.

Subject of Research: Medical students' knowledge and awareness of interventional oncology and interventional radiology in undergraduate medical education

Article Title: Out of sight, out of mind: interventional oncology’s underrepresentation in undergraduate medical education

Article References: Fröhlich, L., & Mahnken, A. H. (2025). Out of sight, out of mind: interventional oncology’s underrepresentation in undergraduate medical education. CVIR Oncology, 1(1), Article 23. https://doi.org/10.1007/s44343-025-00020-4

Image Credits: AI Generated

DOI: 10.1007/s44343-025-00020-4

Keywords: interventional radiology, interventional oncology, medical education, undergraduate curriculum, cancer treatment, tumor ablation, medical students, workforce shortage, radiology career, Germany, survey study, minimally invasive therapy

The study, led by Demet Koç and Duygu Demirbaş Keskin of the Department of Medical Education at Acıbadem Mehmet Ali Aydınlar University, together with colleagues Melike Şahiner and Levent Altıntaş, set out to map, for the first time at national scale, how Turkish medical schools are confronting the climate-health nexus. The research team distributed an online questionnaire to academic leaders responsible for undergraduate medical education across Türkiye, probing the depth of curricular integration, the perceived effectiveness of existing teaching, faculty preparedness, available educational resources, institutional strategies, and the barriers standing in the way of reform. Fifty-three faculties responded, corresponding to a response rate of 58.9 percent—an unusually broad snapshot of a national medical education system.

The headline numbers are sobering. Just 26 percent of responding faculties reported fully including climate change content in their teaching. Another 32 percent indicated only partial integration, while 42 percent reported no inclusion whatsoever. In other words, in more than four out of ten of Türkiye’s medical faculties, the health consequences of a warming planet—heat-related illness, the spread of vector-borne diseases, respiratory impacts of air pollution, water scarcity, and climate-driven displacement—simply do not appear in the training of future physicians. Where climate content does exist, it is typically embedded within pre-existing mandatory courses rather than delivered through dedicated modules, and it tends to focus on basic concepts and general health impacts rather than applied clinical skills.

The gaps run deeper than mere presence or absence of content. The survey revealed that sophisticated and increasingly essential topics are being left out almost entirely. Climate literacy—the ability to critically interpret climate science and communicate it to patients and communities—was rarely addressed. The mental health dimensions of climate change, including eco-anxiety, trauma following extreme weather events, and the psychological toll of environmental degradation, were similarly neglected. Perhaps most strikingly, climate communication—teaching future doctors how to talk with patients and policymakers about climate-related health risks—was infrequently covered, even though physicians consistently rank among the most trusted voices in public discourse.

Faculty preparedness emerged as a critical weak point. Only 5.7 percent of respondents had received any training on how to teach climate-health content. This means that even in faculties where climate change has formally entered the curriculum, the educators delivering it are, in most cases, self-taught. Medical education researchers have long recognized that curriculum reform without parallel faculty development tends to produce shallow, inconsistent teaching, and the Turkish data conform precisely to that pattern. Without structured training programs, conference workshops, or institutional incentives to build climate-health teaching capacity, early adoption risks being symbolic rather than substantive.

Institutional support was similarly thin. Few faculties reported having dedicated structures—such as curriculum committees tasked with planetary health, designated coordinators, or formal policies—that could drive sustained integration. Student-led initiatives, which have proven to be powerful engines of curriculum change in other countries and in international assessment frameworks such as the Planetary Health Report Card, were likewise rare in Türkiye. The absence of these structural scaffolds suggests that even motivated individual faculty members face an uphill battle: without administrative backing, protected time, and dedicated resources, isolated efforts rarely translate into durable curricular reform.

Perhaps the most telling finding concerns perception. When asked to evaluate the effectiveness of the climate education currently offered at their institutions, 48.4 percent of respondents rated it as ineffective. Yet this pessimism coexists with a striking consensus on the importance of the topic: over 80 percent of respondents rated climate change education as important for medical students, and 83 percent supported the development of a national guidance tool to help faculties integrate climate-health content in a standardized way. That gap—between widespread recognition of importance and pervasive dissatisfaction with delivery—captures the central dilemma of climate education in medical training today. Awareness is not the problem. Structure, resources, and coordination are.

The barriers identified by respondents reflect challenges familiar to curriculum reformers worldwide. Overcrowded curricula leave little room for new content in programs already packed with biomedical science, clinical rotations, and licensing requirements. The absence of national learning objectives or standardized guidance means each faculty must invent its own approach, producing fragmentation and duplication of effort. Limited teaching materials in the local language, scarce expertise, and low institutional prioritization compound the problem. The authors of the study conclude that climate change education in Türkiye’s undergraduate medical programs remains fragmented, underdeveloped, and inconsistently implemented, and that structural and pedagogical barriers are actively hindering progress despite growing awareness.

Why does this matter beyond Türkiye? The World Health Organization has described climate change as the single biggest health threat facing humanity, and the Intergovernmental Panel on Climate Change has documented escalating impacts on food and water security, infectious disease patterns, and extreme heat mortality. Health systems themselves are both vulnerable to these impacts and significant contributors to greenhouse gas emissions, placing physicians at the center of both adaptation and mitigation. International bodies, including the Association for Medical Education in Europe, have urged medical schools to embed planetary health across the training pipeline. A physician who cannot recognize heat stroke in a changing climate, counsel patients during air quality emergencies, or anticipate shifting disease vectors is, by any modern standard, incompletely trained. The Turkish findings therefore serve as a warning for many countries where climate-health education has been championed in declarations and position papers but has yet to reach the lecture hall.

The study’s authors point toward a clear path forward. A coordinated national strategy—anchored by the guidance tool that 83 percent of surveyed educators support—could establish minimum competencies in climate and health, provide ready-made curricular materials, and give faculties a shared framework for implementation. Parallel faculty development initiatives would address the training deficit revealed by the 5.7 percent figure, while institutional investment in dedicated structures and student engagement could sustain momentum over time. The researchers emphasize that undergraduate medical education plays a foundational role in shaping future physicians, and that integrating climate-health content has become an urgent priority. If the medical profession is expected not only to understand the health effects of climate change but also to lead mitigation, adaptation, and advocacy efforts, that preparation must begin in medical school. Türkiye’s national survey has measured the distance between aspiration and reality—and, in doing so, has handed educators, policymakers, and professional bodies a detailed map of exactly what must change.

Subject of Research: Climate change education in undergraduate medical curricula in Türkiye

Article Title: Climate change education in undergraduate medical faculties in Türkiye: a national descriptive cross-sectional study

Article References: Koç, D., Keskin, D. D., Şahiner, M., & Altıntaş, L. (2026). Climate change education in undergraduate medical faculties in Türkiye: a national descriptive cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10395-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10395-4

Keywords: climate change, medical education, Türkiye, undergraduate curriculum, planetary health, curriculum integration, faculty preparedness, cross-sectional study, BMC Medical Education, health impacts, faculty development, national survey

Researchers led by Yu Zhang and Wei Cui of the Fourth Military Medical University in Xi’an, working with colleagues at Xi’an Medical University, distributed a cross-sectional questionnaire to all 109 public institutions approved by China’s Ministry of Education to offer undergraduate dentistry programs between 2021 and 2023. The questionnaire was adapted from validated frameworks used in the United Kingdom, reviewed by five subject-matter experts and pilot-tested before deployment. Forty-nine institutions returned valid responses, a participation rate of 45 percent, but the sample carried considerable weight: it included all 28 institutions holding an official discipline ranking of C-minus or above in the most recent national evaluation, and it spanned all seven major geographic regions of China.

The structural findings show a remarkable degree of consensus on how the subject is delivered. Nearly all responding institutions, 47 of 49 or 95.92 percent, teach dentoalveolar surgery not as a standalone course but embedded within a broader oral and maxillofacial surgery curriculum. Three-quarters of schools, 75.51 percent, schedule the material in the fourth academic year, positioning it after students have completed foundational biomedical coursework and general dental training but before graduation and clinical licensure.

Beneath that structural agreement, however, lies substantial variability in time commitment. For both theoretical and practical instruction, the most commonly reported duration was 10 to 20 hours, yet the actual range was dramatic: theory teaching ranged from as little as 4 hours to as many as 36 hours, while practical teaching spanned from 4 hours to more than 36 hours. That means a student at one Chinese dental school might receive nine times the hands-on surgical instruction of a peer at another institution, a disparity with potential implications for entry-level competence in procedures that carry real risks of nerve injury, fracture and infection.

The content itself follows an internationally recognizable core. Institutions consistently reported covering tooth extraction, local anesthesia, the extraction of impacted mandibular third molars, and the management of post-extraction healing and complications. These are the bread-and-butter procedures of general dental practice, and their prominence reflects the reality that most graduates will perform them daily rather than pursue surgical specialization.

Where the survey offers its most actionable insights is in the details of practical training pathways. Thirty institutions, 61.22 percent, described a progressive training sequence that moves students from instrument familiarization, through phantom-head simulation on artificial jaw models, to supervised peer-to-peer practice of local anesthesia injections. This staged approach mirrors competency-based models advocated in dental education literature, allowing students to build psychomotor skills incrementally before touching a patient. Yet simulation for more complex procedures lagged considerably: only 53.06 percent of schools provided simulation training for the surgical removal of impacted mandibular third molars, 42.86 percent for root or fractured-root removal, and just 36.73 percent for the extraction of other impacted teeth. These are precisely the procedures where inexperienced operators face the steepest learning curves and the highest complication rates.

Digital teaching tools present a similar picture of uneven adoption. Videos were nearly universal, used by 95.92 percent of institutions, and animations were employed by 79.59 percent, reflecting how inexpensive and easily deployed these passive formats have become. Interactive virtual programs, by contrast, were reported by only 24.49 percent of schools. The distinction matters educationally: passive media support observation and conceptual understanding, while interactive simulation platforms provide deliberate practice with feedback, the mechanism most strongly associated with skill acquisition in the surgical education literature.

Pedagogical innovation shows a clear hierarchy as well. Problem-based learning was the most widely adopted active-learning method, reported by 71.43 percent of institutions, followed by case-based learning at 42.86 percent and flipped-classroom teaching at 34.69 percent. These approaches ask students to reason through clinical scenarios before or instead of receiving didactic lectures, and their growing footprint suggests Chinese dental educators are engaging with international trends in health-professions education, even if penetration remains incomplete.

Assessment practices reveal perhaps the most significant gap between theory and practice in Chinese dentoalveolar surgery education. Summative theoretical examinations were nearly universal at 95.92 percent, confirming that knowledge acquisition is rigorously tested. But practical skills assessment was implemented at only 59.18 percent of institutions, and phantom-head assessment, in which students demonstrate operative technique on simulation models, at just 48.98 percent. In other words, at roughly half of Chinese dental schools, a student could complete the surgical component of their degree without ever being formally examined on their ability to perform the procedures they studied.

The authors conclude that undergraduate dentoalveolar surgery education in China has an established framework centered on tooth extraction and local anesthesia, with broad use of practical and digital teaching methods, but that marked variation persists in teaching hours, complex-procedure simulation, interactive digital tools and practical assessment. They suggest that future curriculum development may consider competency-guided learning objectives, strengthened simulation and case-based training, and more comprehensive assessment strategies, while cautioning that the educational effectiveness of such reforms requires empirical evaluation. For a country graduating thousands of dentists annually into a health system where tooth extraction remains one of the most commonly performed surgical procedures, the findings offer a data-driven baseline for national conversations about standardization, and a reminder that what happens in the simulation laboratory may matter as much as what happens in the lecture hall.

Subject of Research: Curriculum structure, simulation training and assessment in undergraduate dentoalveolar surgery education across Chinese dental schools

Article Title: Dentoalveolar surgery education in Chinese undergraduate dental schools: a national survey of curriculum structure, simulation training and assessment

Article References: Zhang, Y., Cui, W., Hu, K., Mo, J., He, F., Wang, Y., Wang, J., Zhang, W., Zhang, Z., Wang, Y., & Xue, Y. (2026). Dentoalveolar surgery education in Chinese undergraduate dental schools: a national survey of curriculum structure, simulation training and assessment. BMC Medical Education. https://doi.org/10.1186/s12909-026-10374-9

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10374-9

Keywords: dentoalveolar surgery, dental education, undergraduate curriculum, simulation training, tooth extraction, local anesthesia, China, BMC Medical Education, problem-based learning, phantom head, assessment, oral and maxillofacial surgery

The research team, led by Helen Maginnis and Agata Oliwa as joint first authors, with Lucy McKay of the charity Medics for Rare Disease and Duncan Cole of Cardiff University School of Medicine among the senior investigators, designed a cross-sectional online survey of 28 items. The questionnaire was adapted from an earlier instrument developed at University Hospitals Leuven and distributed with the help of student networks, including Students for Global Health and the National Student Association for Medical Research, to students at 35 medical schools accredited by the General Medical Council. The survey measured both self-assessed knowledge and awareness of rare disease and an objective knowledge test, alongside questions about educational experience and exposure to people living with rare conditions.

In total, 253 responses were recorded from undergraduate and graduate-entry medical students, of which 126 fully completed responses from 27 medical schools were suitable for analysis. Respondents spanned all years of medical study, although the majority, 79 percent, were in years one to four or undertaking an intercalated degree. The numbers provide a snapshot rather than a census, but the breadth of participating institutions lends weight to the central finding: rare disease education in the UK undergraduate curriculum is patchy, inconsistent and, by the students’ own assessment, frequently inadequate.

The headline figures are striking. The median self-assessed knowledge of rare disease among respondents was just 3 out of 10, indicating that even students who chose to answer a survey on the topic rated their own understanding as low. Objective knowledge, measured with a fifteen-point test, yielded a median score of 9, suggesting a partial but incomplete command of core concepts. More troubling than the raw scores, however, was the trajectory: there was no consistent improvement in self-assessed knowledge, self-assessed awareness or objective test performance as students advanced through their degrees. Whatever learning does occur appears scattered rather than cumulative, dissipated across a curriculum that rarely returns to the topic in a structured way.

The study also probed what does seem to move the needle. Students with greater clinical exposure to people living with rare disease, and those with a personal connection to the rare disease community, reported higher self-assessed knowledge and awareness than their peers. Yet notably, neither form of experience translated into higher objective knowledge scores. This dissociation matters because it suggests that encountering rare disease in the clinic, however valuable for empathy and awareness, does not by itself build the transferable cognitive framework, such as an understanding of inheritance patterns, diagnostic delay, multidisciplinary coordination and the appropriate use of genomic and specialist services, that clinicians need to recognise and manage these conditions.

Preparedness for practice was similarly limited. Just over half of respondents reported receiving some rare disease education during their degree, but only one in five felt prepared to recognise or consider a rare disease in clinical practice. This gap between exposure and readiness echoes the lived experience of patients, who frequently describe years of uncertainty, multiple misdiagnoses and repeated referrals before a definitive diagnosis is reached. The so-called diagnostic odyssey that characterises rare disease is driven in part by a knowledge gap among healthcare professionals, and the RISE findings indicate that this gap begins forming well before graduation.

Encouragingly, the appetite for learning is there. Nearly three-quarters of students surveyed, 73.8 percent, expressed interest in further rare disease education, with lectures identified as the preferred mode of delivery. Free-text responses, analysed thematically, revealed the practical constraints that students believe stand in the way: curriculum overload and the sheer impracticality of memorising detailed information about thousands of individual disorders. Students are not asking to catalogue the entire Orphanet database. They are asking for a framework, a way of thinking about rarity, undiagnosed presentations and coordinated care that can be applied whatever the specific condition in front of them.

The authors argue that the findings point toward educational approaches that combine experiential learning with structured educational support. Clinical encounters and patient narratives can motivate and humanise the subject, but they need to be anchored by explicit teaching, formative assessment and curriculum time that is protected rather than incidental. The theoretical framing of the study draws on Experience-Based Learning and Transformative Learning Theory, both of which hold that meaningful clinical experiences must be processed and integrated through guided reflection and formal instruction if they are to produce durable, applicable knowledge. In other words, a memorable patient story is a beginning, not a curriculum.

The implications extend beyond the medical schools surveyed. The UK’s Rare Diseases Framework, and similar strategies internationally, have committed to faster diagnosis, better coordination of care and increased awareness among health professionals. Those commitments ultimately depend on the baseline training of the workforce. If a substantial proportion of graduating doctors do not feel prepared even to consider a rare diagnosis, then every downstream service, from specialist centres to genomic medicine alliances, inherits a population of clinicians who may not refer appropriately or early. The RISE study, funded by Medics for Rare Disease, provides a quantitative baseline against which curriculum reform can be measured, and its authors suggest that even modest, well-designed additions to undergraduate teaching, aligned with the knowledge and skills students themselves want, could meaningfully shorten the diagnostic journey for the estimated one in seventeen people whose lives are touched by a rare condition. The message from students themselves is unambiguous: they want this education, and the system that trains them now has the evidence to deliver it.

Subject of Research: Medical students' knowledge, experience and education regarding rare disease in the United Kingdom

Article Title: The Rare dISease Evaluation (RISE) study: a survey-based investigation of medical student experience and knowledge of rare disease in the UK

Article References: Maginnis, H., Oliwa, A., Classen, M., Adams, A., Alani, Z., Brooksbank, L., Mercer, C., Nikookam, Y., Pearson, M., Saw, A. M., Steele, A., McKay, L., & Cole, D. (2026). The Rare dISease Evaluation (RISE) study: a survey-based investigation of medical student experience and knowledge of rare disease in the UK. BMC Medical Education. https://doi.org/10.1186/s12909-026-10338-z

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10338-z

Keywords: rare disease, medical education, medical students, RISE study, undergraduate curriculum, UK medical schools, survey research, diagnostic odyssey, Medics for Rare Disease, health professional training, patient preparedness, curriculum reform