Abstract
Background
Our medical school has actively encouraged medical students to engage in research. This study aimed to survey students’ perceptions of their research-specific and transferable skills (e.g., teamwork, communication skills), perceived barriers to conducting research, and motivations for participating.
Methods
This cross-sectional descriptive study was conducted at the Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand. Data were collected using a validated self-report 5-point Likert scale survey that assessed the aforementioned aspects. The survey questions underwent formal translation and were subsequently evaluated for inter-rater agreement, reliability, and validity. Multivariable logistic regression was performed to identify associations between various research skills and factors of interest.
Results
A total of 538 responses were collected, representing a response rate of 44%. Of these respondents, 66.5% were medical students in the pre-clinical years, and 50% were female. Additionally, 43% of the students reported prior involvement in research processes, such as proposal writing, data collection, and manuscript publication. Students expressed the highest confidence in research-specific skills like hypothesis generation and data collection while demonstrating the least confidence in biostatistical analyses. Regarding transferable skills, teamwork and working independently received the highest scores, whereas information evaluation received the lowest. The primary reported barrier to conducting research was a lack of interest. Students identified motivations for research, including the perception that “Doing research is useful for my resume,” which aligns with an extrinsic motivation domain. Higher academic years in medical school (OR 1.28 [95% CI: 1.07, 1.53], P = .03) and prior research experience in writing proposals (OR 1.82 [95% CI: 1.57, 3.18], P = .006) were significantly associated with higher overall transferable skills. Furthermore, higher academic years (OR 1.18 [95% CI: 1.05, 1.35], P = .008) and prior research experience were also significantly associated with a higher perception of barriers in conducting research (OR 0.66 [95% CI: 0.45, 0.96], P = .03). Finally, prior experience in proposal writing was associated with higher scores in students’ intrinsic motivation (OR 1.27 [95% CI: 1.08, 2.23], P = .02).
Conclusions
Encouragement should be given to guidance on biostatistical analyses, which can foster research-specific skills and enhance information evaluation for transferable skills. Additionally, interventions aimed at stimulating interest in research among medical students may prove beneficial. Early research involvement, such as proposal writing, has the potential to improve transferable skills, reduce perceived barriers, and enhance intrinsic motivation for conducting research.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12909-025-07800-9.
Keywords: Barriers, Medical students, Motivation, Perception, Research, Transferable skills
Introduction
Studies have demonstrated various benefits of medical student engagement in medical research, which sharpens analytical, questioning, teamwork, and searching skills [1, 2]. These competencies contribute to students’ ability to integrate new knowledge and technology into medical practice. The World Federation for Medical Education has proposed research skills as one of the leading competencies in undergraduate medical education [3]. Early research exposure has been associated with a greater interest in pursuing research-related careers, possibly by fostering intrinsic motivation [4–6]. It is well known that physician-scientists serve as crucial bridges merging medical doctors with scientists. They effectively narrow the gap between medical problems in real practice and appropriate scientific solutions by identifying clinical challenges as physicians and then addressing them through research as scientists [5].
Medical training in Thailand typically spans six years, comprising two main phases. The pre-clinical years (Years 1–3) primarily focus on foundational sciences, including physiology, pathology, pharmacology, microbiology, community medicine, and preventive medicine. Subsequently, the clinical years (Years 4–6) involve rotations across major clinical disciplines such as internal medicine, surgery, paediatrics, obstetrics and gynaecology, and psychiatry. Many countries have integrated research training into undergraduate medical education through a combination of compulsory and elective courses [7–9]. Our institution has similarly promoted student engagement in research [10]. Initially an extracurricular program, research training has been an integral component of the Doctor of Medicine curriculum since 2020, now comprising 11 mandatory credits delivered longitudinally over the six-year program (three years in the pre-clinical phase and three years in the clinical phase). Furthermore, our institution has established a specialized program designed to enhance student engagement in research and cultivate critical thinking and problem-solving skills. This program includes initiatives such as a research market in the first year and research camps throughout the pre-clinical years. It facilitates the matching and mentorship of students by faculty, enabling the exchange of research experiences and the completion of research projects. To foster a research mindset, the development of both transferable and research-specific skills is a primary priority in medical education [11]. Therefore, investigating students’ perceptions not only of their required skills but also of perceived barriers and both intrinsic and extrinsic motivations is crucial for understanding the current situation and for potentially developing effective strategies and programs to improve research experiences among medical students.
Studies investigating in Asia remain limited. A 2016 study from India revealed a positive perception regarding the necessity of research among students but reported an absence of motivation, lack of mentorship, insufficient protected time, and limited access to research forums and discussion groups [12]. Similarly, research conducted in Saudi Arabia demonstrated equally positive attitudes toward research among students in both pre-clinical and clinical years. However, this study also highlighted the lack of protected time and research supervisors as the two primary barriers [13]. More recently, a study from Thailand indicated that both students (n = 78) and advisors (n = 42) commonly identified a lack of knowledge in research design as a significant challenge in conducting research studies (78% and 55% agreement, respectively) [14]. Furthermore, a large-scale study from China (n = 3,273 medical undergraduates) showed that students in earlier academic years generally exhibited a more favourable perception of research and lower perceived barrier scores. Students with prior scientific research experience consistently reported higher levels of motivation, self-efficacy, and curiosity. Conversely, the main barriers identified were a lack of proper mentoring and insufficient knowledge [15].
However, research on the perceptions and experiences of undergraduate medical students regarding research has predominantly been conducted in Western countries. These regions often possess distinct contexts, including variations in medical curricula, student and faculty demographics, and institutional and societal cultures, which may differ significantly from other global regions. The limited number of studies investigating self-perceived research-specific and transferable skills, perceived barriers, and motivations among medical students in developing countries thus necessitated the initiation of this present study.
Methods
We conducted a cross-sectional study surveying all 1,222 undergraduate medical students enrolled at the Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand, between July 2021 and May 2022. The survey questions were adapted from a study on research experience in medical students by Burgoyne et al. [11] and on intrinsic and extrinsic motivations by Ommering et al. [5] Formal permissions were obtained from the respective authors of both studies. The questionnaire underwent a translation process from English to the local language using forward-backward translation techniques performed by native speakers. Prior to its launch, the translated questionnaire was evaluated for inter-rater agreement, reliability, content validity, and face validity. Following minor cultural adaptation to ensure its appropriateness for the local Thai context while maintaining instrument quality, the questionnaire demonstrated acceptable internal consistency/reliability (Cronbach’s alpha coefficient = 0.88), inter-rater agreement (Kappa coefficient = 0.82), and content validity (Content Validity Index = 0.94). Pilot study participants provided comments and suggestions to improve the content and quality of the questionnaire.
The final survey questionnaire comprised sections on demographic data, previous academic background, grade point average (GPA), baseline research experience, including proposal writing, data collection, data entry, manuscript drafting, and publication, as well as students’ intended future specialty training. The GPA, a numerical representation of a student’s academic performance for a semester or program, is calculated on a maximum scale of 4.00 at our institution. A 36-item, five-point Likert scale was employed to assess students’ perceived competency in research-specific skills (8 items) and transferable skills (11 items), their perception of barriers to research (8 items), and motivation, encompassing both intrinsic (5 items) and extrinsic (4 items) factors.
Research-specific skills are defined as competencies directly related to research methodology, encompassing activities such as hypothesis generation, study design, data collection, statistical analysis, and scientific presentation. Conversely, transferable skills refer to individually adaptable competencies that can be applied across diverse situations and workplaces; these include communication, critical thinking, teamwork, and time management.
In this study, higher scores within the skills and motivation domains indicate more positive qualifications, whereas higher scores for barriers reflect greater obstacles to conducting research. Participation in the study was entirely voluntary and anonymous, and all participants provided informed consent before their involvement. Surveys were distributed to students through both an online platform and paper-based questionnaires, with no incentives provided. To prevent duplicate responses, an additional question was included to ascertain prior exposure to the survey (yes/no) via either platform. The study received approval from the Human Research Ethics Committee at our institution (COA.MURA2021/498).
Statistical analyses
All analyses were performed using STATA statistical software 18 (StataCorp, College Station, TX, USA). Data were presented as mean, standard deviation (SD), median, interquartile range (IQR), and proportion, with a 95% confidence interval (CI). Where applicable, the comparison of discrete variables across different groups was assessed using either a Chi-square test or Fisher’s exact test. Univariate and multivariable analyses were conducted using binary and multiple logistic regression for the factors of interest. We pre-defined “high” scores for research-specific skills, transferable skills, perception of barriers, intrinsic motivation, and extrinsic motivation as scores above 60% (specifically, 24/40, 33/55, 24/40, 15/25, and 12/20, respectively). All variables with a P-value < 0.1 were included in the final multivariable analyses via forward stepwise selection. Statistical significance was defined as a P-value < 0.05.
Result
Demographics and baseline data
A total of 538 students responded to the survey, yielding a response rate of 44%. The majority of respondents (66.5%) were in their pre-clinical years (Years 2 and 3), while 33.5% were in their clinical years (Years 5 and 6). No responses were obtained from first- and fourth-year students due to technical and logistical constraints. Demographic and baseline data are presented in Table 1. The gender and hometown distribution of respondents was approximately equal. More than half of the participants reported an accumulated GPA above 3.50. Furthermore, 43% of students had some prior research experience, with the most common activities being proposal writing (37.2%) and data collection (26.6%). At our institution, a research camp facilitates interactions between faculty and students to discuss potential projects; 39% of the surveyed students had participated in this camp prior to the study. The four most frequently preferred specialties for postgraduate training among students were surgery (29.0%), internal medicine (21.8%), orthopaedics (14.9%), and paediatrics (13.9%).
Table 1.
Demographic and baseline data of the undergraduate medical students (N = 538)
| Characteristics | N (%) |
|---|---|
| Females | 271 (50.6) |
| Hometown: Metropolitan | 277 (51.8) |
| High school curriculum (N = 532) | |
| Non-international | 490 (92.1) |
| International | 42 (7.9) |
| Years in medical school | |
| 2nd | 174 (32.3) |
| 3rd | 184 (34.2) |
| 5th | 77 (14.3) |
| 6th | 103 (19.1) |
| Grade point average (N = 435) | |
| ≥ 3.5 | 223 (51.3) |
| 3.00-3.49 | 169 (38.9) |
| < 3.00 | 43 (9.8) |
| Previous research experience | 230 (42.9) |
| Proposal writing | 200 (37.2) |
| Data collection | 143 (26.6) |
| Data entry | 78 (14.6) |
| Manuscript drafting | 27 (5.0) |
| Publication | 11 (2.0) |
| Ever joined the research camp during medical school | 210 (39.0) |
Competency in research-specific and transferable skills (Table 2)
Table 2.
Research-specific and transferable skills based on the 5-point likert scale
| Skills | Mean (SD) |
|---|---|
| Research-specific skills (8 items, total score of 40) | 23.4 (5.6), median 24 (IQR 20,27) |
| Generate research question, hypothesis and objectives | 3.2 (0.8) |
| Designing a study | 2.8 (0.8) |
| Study sampling | 2.8 (0.9) |
| Participant recruitment | 3.0 (0.9) |
| Data collection | 3.2 (0.9) |
| Biostatistical analyses | 2.6 (1.0) |
| Paper preparation | 3.0 (0.9) |
| Paper presentation | 2.8 (1.0) |
| Transferable skills (11 items, total score of 55) | 38.9 (6.4), median 39 (IQR 35,43) |
| Communication-writing | 3.5 (0.9) |
| Communication- oral | 3.4 (0.9) |
| Information gathering | 3.5 (0.8) |
| Information evaluation | 3.3 (0.8) |
| Numeracy | 3.4 (0.9) |
| Teamwork | 3.9 (0.8) |
| Work independently | 3.9 (0.8) |
| Project management | 3.4 (0.8) |
| Time management | 3.4 (0.9) |
| Problem solving | 3.5 (0.8) |
| Critical thinking | 3.6 (0.8) |
The overall average scores, based on a 5-point Likert scale, for the domains of research-specific skills and transferable skills were 2.9 and 3.5, respectively. Students reported the highest confidence in skills related to the generation of research questions, hypotheses, and objectives, as well as data collection. Conversely, they demonstrated the least confidence in biostatistical analyses. Regarding transferable skills, teamwork and working independently received the highest scores, while information evaluation received the lowest scores.
Perception of barrier
The primary barrier to medical students conducting research was identified as a lack of interest, followed by insufficient time and biostatistical support, difficulties in dealing with patients and obtaining ethical approval, and a lack of mentorship. The least frequently cited barrier was the absence of a mandatory research methodology course. Significant differences were observed between pre-clinical and clinical students with regards to barrier in conducting research (Table 3). Clinical-year students perceived that a lack of mandatory courses in research methodology and a lack of mentorship, difficulty in dealing with patients, and difficulty in obtaining ethical approval were barriers when compared to their pre-clinical counterparts with higher scores. Conversely, lack of time, interest, or biostatistical support did not show statistical significant differences when compared between the two groups.
Table 3.
Students’ perception of barrier in conducting research
| Barriers | Mean (SD) | ||||
|---|---|---|---|---|---|
| Overall | Pre-clinical years | Clinical years | P-value (pre-clinical vs. clinical years) | ||
| Total score (8 items, a total score of 40) | 24.4 (5.5) median 25 (IQR 21,28) | 23.7 (5.6) mmedian 24 (IQR 20,27) | 25.9 (5.1) median 26 (IQR 24,29) | < 0.001 | |
| Lack of mandatory courses in research methodology | 2.7 (1.1) | 2.5 (1.1) | 3.1 (1.1) | < 0.001 | |
| Lack of time for conducting research | 3.4 (1.2) | 3.4 (1.2) | 3.5 (1.1) | 0.349 | |
| Financial restriction | 2.8 (1.1) | 2.7 (1.1) | 2.8 (1.0) | 0.306 | |
| Lack of interest in research | 3.6 (1.1) | 3.5 (1.1) | 3.7 (1.1) | 0.057 | |
| Lack of biostatistical support | 3.4 (1.1) | 3.4 (1.1) | 3.6 (1.1) | 0.057 | |
| Lack of mentorship | 2.8 (1.1) | 2.7 (1.2) | 3.0 (1.0) | 0.004 | |
| Difficulty in dealing with patients | 2.9 (1.1) | 2.8 (1.1) | 3.1 (1.0) | 0.002 | |
| Difficulty in obtaining ethical approval for the study | 2.9 (1.0) | 2.8 (1.0) | 3.0 (0.9) | 0.024 | |
Motivations
The average score for the combined 9 questions assessing motivation (intrinsic and extrinsic) for research engagement was 3.3 (SD 0.8). Although extrinsic motivation scores were slightly higher than intrinsic motivation scores, this difference was not statistically significant. No significant differences in motivation scores were observed between pre-clinical and clinical students (Table 4). Among the intrinsic motivation questions, the highest score was recorded for the statement “I can improve myself by doing research” (mean 3.5). Conversely, the lowest score across all motivation questions was for “(Doing) research is fun,” which yielded a mean score of 2.9. As anticipated, the highest score among all motivations was for the statement “Doing research can improve my resume” (mean 3.7), falling within the extrinsic motivation domain.
Table 4.
Motivation in conducting research
| Overall mean (SD) | Median (IQR) | Pre-clinical years (mean, SD) | Clinical years (mean, SD) | P-value (pre-clinical vs. clinical years) | ||
|---|---|---|---|---|---|---|
| Intrinsic motivation* (Total score of 25 in 5 items) | 16.2 (4.6) | 16 (13, 20) | 16.1 (4.4) | 16.2 (4.9) | 0.81 | |
| Extrinsic motivation** (Total score of 20 in 4 items) | 13.9 (3.9) | 14 (12, 16) | 13.7 (3.9) | 14.3 (3.9) | 0.09 | |
| All motivation (Total score of 45 in 9 items) | 30.0 (7.6) | 30 (26, 36) | 29.8 (7.4) | 30.5 (7.9) | 0.31 | |
*Items on 5 intrinsic motivation include “research is interesting”, “research is fun”, “research is challenging”, “I like to solve puzzles and problems” and “I can improve myself by doing research”
**Items on 4 extrinsic motivation include “Doing research can improve my resume”, “Doing research can make me stand out”, “Doing research can improve my chance of getting better job”, and “Doing research can improve my chance of getting into residency and fellowship programs that I want”
Multivariable logistic regression of the interested outcomes
Tables 5, 6 and 7 present the results of the multivariable logistic regression analyses for three primary outcomes: higher transferable skills, perception of barriers, and intrinsic motivation. The regression analyses did not identify any significant independent predictors associated with higher scores on research-specific skills or extrinsic motivation (data not shown). Independent factors significantly associated with higher transferable skills (Table 5) were higher academic years in medical school (Odds Ratio [OR] = 1.28) and prior experience in proposal writing (OR = 1.82). Conversely, while higher academic years in medical school were also associated with a higher perception of barriers in conducting research (OR = 1.18), and prior experience in proposal writing emerged as a protective factor (OR = 0.66). A trend towards significance indicated that students whose hometowns were metropolitan areas reported a higher score on the barrier domain (OR = 1.42, P =.059; Table 6). Table 7 illustrates that students who had participated in a research camp were more likely to exhibit higher intrinsic motivation in the univariate analysis; however, this association was not sustained in the multivariable analyses. Consistent with previous findings, prior experience in proposal writing was an independent factor for higher intrinsic motivation. No significant interactions were detected in any of the multivariable analyses.
Table 5.
Logistic regression to determine the association between various factors and greater transferable skills
| Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|
| OR (95%Cl) | P | OR (95%Cl) | P | |
| Females vs. Males | 1.13 (0.68, 1.86) | 0.64 | - | |
| Hometown: Bangkok metropolitan | 1.11 (0.67, 1.83) | 0.68 | - | |
| Higher years in medical school | 1.25 (1.04, 1.50) | 0.016 | 1.28 (1.07, 1.53) | 0.03 |
| Previous experience on proposal writing | 1.62 (0.93, 2.81) | 0.09 | 1.82 (1.05, 3.18) | 0.006 |
| Ever joined the research camp | 1.12 (0.67, 1.88) | 0.67 | - | |
Table 6.
Logistic regression to determine the association between various factors and higher scores on barrier in conducting research
| Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|
| OR (95%Cl) | P | OR (95%Cl) | P | |
| Females vs. Males | 1.04 (0.73, 1.48) | 0.83 | - | |
| Hometown: Bangkok metropolitan | 1.49 (1.04, 2.13) | 0.03 | 1.42 (0.99, 2.04) | 0.059 |
| Higher years in medical school | 1.23 (1.09, 1.39) | 0.001 | 1.18 (1.05, 1.35) | 0.008 |
| Previous experience on proposal writing | 0.60 (0.42, 0.86) | 0.006 | 0.66 (0.45, 0.96) | 0.03 |
| Ever joined the research camp | 0.59 (0.41, 0.84) | 0.004 | - | |
Table 7.
Logistic regression to determine the association between various factors and higher scores on intrinsic motivation
| Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|
| OR (95%Cl) | P | OR (95%Cl) | P | |
| Females vs. Males | 1.25 (0.89, 1.77) | 0.21 | - | |
| Hometown: Bangkok metropolitan | 0.89 (0.63, 1.26) | 0.51 | - | |
| Higher years in medical school | 1.05 (0.94, 1.18) | 0.37 | - | |
| Previous experience on proposal writing | 1.34 (0.93, 1.91) | 0.11 | 1.27 (1.08, 2.23) | 0.02 |
| Ever joined the research camp | 1.59 (1.11, 2.28) | 0.01 | 1.55 (0.88, 1.82) | 0.20 |
Discussion
This survey-based study, conducted among medical students at a university-based, tertiary care teaching hospital in a developing country, elucidated various perceived aspects related to research among undergraduate medical students. Overall, students rated their transferable skills higher than their research-specific competencies, consistent with findings from Ireland [11]. Since 2016, our faculty has implemented a specialized research-related program aimed at enhancing competencies, particularly in aspects of teamwork and leadership. This initiative may explain the higher scores observed for teamwork within transferable skills, as illustrated in Table 2. Among research-specific skills, biostatistical analyses received the lowest score, a finding similar to a UK cross-sectional survey of British medical students from seven medical schools [16]. We posit that students receive insufficient training and practical experience in biostatistics within the current curriculum, thereby increasing the challenges they face in performing or understanding statistical analyses.
The main barrier to conducting research was identified as a lack of interest in research, followed by insufficient time and biostatistical support. The least frequently cited barrier was the absence of a mandatory course in research methodology. Notably, students in their clinical years reported significantly higher perceptions of barriers related to a lack of formal research education and mentorship. This disparity is likely attributable to the fact that students in the pre-clinical years, unlike their clinical-year counterparts in this study, received 11 compulsory credits for research didactics. Regarding the perceived lack of mentorship, we postulate that clinical-year students may experience a substantially higher clinical service load, thereby limiting their exposure time with potential research mentors and projects. An alternative explanation is that our medical school comprises two distinct medical institutes/centres. Pre-clinical and clinical students primarily study and learn at different institutes, potentially leading to varied perceptions of mentorship influenced by these distinct environments. Further investigations are warranted to fully elucidate this significant finding.
This study found a non-significant higher score in overall extrinsic motivation compared to intrinsic motivation. This aligns with findings from Alamri et al. in New Zealand reported that extrinsic motivation was a stronger driver of research participation than intrinsic motivation [4]. Conversely, a study from the Netherlands revealed the opposite trend [5]. The latter study also found the important finding that intrinsic motivation increased the odds of future research involvement even after adjusting for extrinsic motivation, whereas the effect of extrinsic motivation dissipated after such adjustment. Within the intrinsic motivation domain, the highest score was attributed to the statement “I can improve myself by doing research,” while the lowest score was for “research is fun.” The highest score across all motivation questions was found in the extrinsic motivation domain for the statement “Doing research can improve my resume.” This aligns with a previous UK study which revealed that improving students’ curriculum vitae was a primary driver for research involvement [17]. Furthermore, students involved in extracurricular research were more inclined to agree that this experience should influence selection into postgraduate training programs.
Independent factors associated with higher transferable skills were identified as higher academic years in medical school and prior experience in proposal writing (Table 5). A recent study demonstrates that prior research experience correlates with a higher perception of the need for self-efficacy [6]. This also likely corresponds with the finding in Table 7 that prior experience in proposal writing was a protective factor against a higher perception of barriers in conducting research. Conversely, higher academic years in medical school were also associated with a greater perception of barriers. We postulate that this may be attributable to increased time commitments in clinical service during the clinical years, consequently reducing the time available for students to conceptualize or conduct their own research. Furthermore, experience in proposal writing consistently emerged as an independent factor for higher intrinsic motivation. A recent study by Ommering et al. found that academic success in presenting research correlated with increased intrinsic motivation and research self-efficacy beliefs [18]. A finding indicating a trend towards significance, specifically that students whose hometowns were national metropolitan areas reported a higher score on the barrier domain, is challenging to definitively explain. It is plausible that students who grew up in metropolitan areas prior to entering medical school may have encountered or been exposed to potential obstacles in conducting research outside the academic environment. However, this finding necessitates further exploration.
Strengths and limitations
The key strengths of this study include the assessment of multiple aspects of perception regarding research, encompassing skills, perceived barriers, and motivations, along with the identification of independent factors related to these outcomes, all derived from over 500 medical student responses. However, a response rate of 44% suggests that the sample may not be perfectly representative of the surveyed population.
A limitation of this study is its single-center design within a metropolitan area, which may restrict the generalizability of these findings to national or international contexts. Nevertheless, conducting multicenter national or international studies could introduce substantial heterogeneity due to variations in curricula, institutional backgrounds, and cultures across different medical schools or institutes. Furthermore, this study surveyed students’ perceptions rather than their actual skills (either transferable or research-specific) or barriers to conducting research. Future research employing direct and objective measures of various skills and barriers would significantly enhance our understanding of the genuine situation regarding student research within the medical school setting.
Conclusions
Medical students reported higher scores in transferable skills compared to research-specific skills. Therefore, a greater emphasis on biostatistical education, didactic training in research methodology, and information evaluation should be further encouraged. Further studies are warranted to comprehensively investigate barriers such as lack of interest, insufficient time, or inadequate mentorship throughout the medical school years. Early exposure to research activities, such as proposal writing, may effectively improve students’ transferable skills, alleviate perceived barriers, and enhance intrinsic motivation, factors that could be crucial for their future career paths.
Supplementary Information
Acknowledgements
We thank all personnel from the Division of Medical Education for their help in distributing the survey to the medical students. Pornthep Tanpowpong received Career Development Grant from Faculty of Medicine Ramathibodi Hospital.
Authors’ contributions
K.P., J.T., P.P., S.P., and P.T. designed this study; K.P., and J.T. collected the data; K.P., J.T., and P.T. analysed the data; K.P. and J.T. drafted the first draft of manuscript; P.P. and S.P. commented on the manuscript, conceptual advised and critically reviewed the manuscript; P.T. critically reviewed the manuscript and supervised the whole study process. All authors read and approved the final manuscript.
Funding
Open access funding provided by Mahidol University. Not applicable to this study.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Declarations
Ethics approval and consent to participate
Human Research Ethics Committee at our institution approved the study (COA. MURA2021/498). All participants provided consent to participate. This research adhered in compliance with the Helsinki Declaration.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.