Student Satisfaction with Pharmacopuncture Education and the Need for Curriculum Improvement

Abstract

Objectives

This study aimed to evaluate students’ satisfaction with pharmacopuncture education and associated learning materials, and to identify perceived needs for curriculum and textbook improvement, providing empirical evidence to inform future enhancements in pharmacopuncture education within Korean Medicine (KM) curricula.

Methods

A cross-sectional descriptive survey was conducted among third-year students at the College of Korean Medicine, Sangji University, following completion of a pharmacopuncture course. A 15-item online questionnaire assessed pre-course expectations, post-course fulfillment, perceived adequacy of practice opportunities, textbook usefulness, and areas for improvement. Quantitative data were analyzed using paired t-tests, correlation analysis, and chi-square or Fisher’s exact tests. Exploratory logistic regression analyses were conducted for supplementary purposes only. Qualitative data from open-ended responses were analyzed thematically.

Results

Fifty-six students participated in the survey. The mean post-course fulfillment score (8.07 ± 1.62) exceeded the pre-course expectation score (7.57 ± 2.33), although the difference was not statistically significant (p = 0.122). Fulfillment was positively correlated with pre-course expectations (r = 0.317, p = 0.017) and adequacy of class hours (r = 0.387, p = 0.003). Cross-tabulation indicated an association between Hyeolmaek pharmacopuncture (Q10) and fulfillment (p = 0.049), whereas practice-related variables tended to be associated with lower fulfillment. Exploratory regression analyses yielded wide confidence intervals and were therefore not used to draw definitive conclusions. Qualitative findings reinforced these results, particularly highlighting the need for expanded hands-on learning and updated, clinically applicable materials.

Conclusion

Students reported high overall satisfaction with pharmacopuncture education but emphasized the need for expanded practical experience and improvements in learning materials. Enhancing hands-on training and modernizing textbook content to reflect current evidence may improve the quality and relevance of pharmacopuncture education in KM programs.

INTRODUCTION

Korean medicine (KM) education aims to cultivate both academic knowledge and clinical competency, and requires continuous improvement to reflect contemporary scientific and educational needs. Pharmacopuncture, which integrates principles of pharmacology and acupuncture, is a core subject that bridges theory and clinical practice. The quality and relevance of its teaching materials directly affect students’ learning outcomes and their ability to apply knowledge in clinical settings. Despite its centrality in the curriculum, the educational resources and textbooks used in pharmacopuncture have undergone limited systematic evaluation from the learners’ perspective.

Previous studies on KM education have examined curriculum quality, student satisfaction, and influencing factors. Kim et al. surveyed current practices in pharmacopuncture education across KM colleges and identified inconsistencies in textbook utilization and insufficient practical training opportunities [1]. Jeong et al. (2020) and Han (2024) analyzed student satisfaction and its determinants, reporting that inadequate clinical applicability, lack of integration across courses, and unsatisfactory educational environments were key contributors to dissatisfaction [2, 3]. Similarly, Lee et al. (2025) emphasized that direct patient interaction and active instructor guidance strongly predict satisfaction during clinical clerkships [4]. A recent trend analysis revealed that, over the past two decades, KM education research has focused primarily on curricula, teaching methods, and learning satisfaction [5]. However, few studies have directly examined textbooks or investigated the need for revision based on student feedback.

In parallel, numerous studies have examined the recognition and application of KM Clinical Practice Guidelines (CPGs) in clinical settings. Choi and Kim (2017) reported that surveys assessing clinicians’ awareness during the development of CPGs for climacteric and postmenopausal syndrome provided critical insights into real-world clinical needs [6]. Similarly, Ahn et al. (2021), Kim et al. (2023), and Lee et al. (2025) demonstrated that identifying practitioners’ experiences and perceived needs is essential for improving the usability and dissemination of CPGs for growth disorders, gastric cancer, and dizziness, respectively [7-9]. These studies share a common implication: incorporating the perspectives of actual users, whether clinicians or patients, is vital for achieving standardization and enhancing the quality and practicality of guidelines. Notably, Lee et al. further emphasized that increasing CPG utilization requires integration into educational materials and continuing education programs [10].

These converging lines of evidence from both educational and clinical guideline research underscore the importance of user-centered feedback in improving quality and relevance. However, while prior studies have examined student satisfaction with curriculum design, teaching methods, and clinical training, no research has directly investigated pharmacopuncture textbooks, which serve as the primary learning resource connecting theoretical understanding to clinical practice. In the absence of such evidence, revisions of pharmacopuncture textbooks have largely relied on expert consensus rather than on empirical evaluation of students’ learning experiences and needs.

Therefore, this study aimed to investigate KM students’ satisfaction with the pharmacopuncture textbook currently used in undergraduate education and to identify their perceived needs for its revision. By analyzing student responses through a cross-sectional survey, this study provides foundational data to guide future textbook development and curricular improvement. Ultimately, this study extends the established concept of user participation from clinical guideline development to the design of educational material, thereby advancing evidence-based, learner-centered education in KM.

MATERIALS AND METHODS

1. Study design and participants

This cross-sectional descriptive survey was conducted among students enrolled in the College of KM, Sangji University. All third-year students were invited to participate, and those who voluntarily consented were included in the analysis. No other exclusion criteria were applied. Data were collected anonymously using a self-administered online questionnaire (MoAform, Seoul, Korea). The study protocol was approved by the Institutional Review Board of Sangji University KM Hospital (approval no. SJIRB-Human-25-009), and all participants provided informed consent before participation. Statistical analyses were performed using R statistical software (version 4.5.1; R Foundation for Statistical Computing, Vienna, Austria).

2. Questionnaire development and content validity

The questionnaire was newly developed by the authors to assess students’ satisfaction with pharmacopuncture education and their perceived needs for curriculum and textbook improvement. Item generation was informed by a review of previous studies on medical education, clinical skills training, and pharmacopuncture curricula, as well as the educational objectives of pharmacopuncture courses in KM colleges.

To enhance content validity, the initial draft of the questionnaire was reviewed by pharmacopuncture instructors with experience in undergraduate education. Items were evaluated for clarity, relevance, and alignment with course objectives, and minor revisions were made before administration. Given the exploratory nature of the study, the questionnaire was designed to capture a broad range of learner perceptions rather than to function as a psychometrically validated measurement instrument.

3. Survey variables and assessment criteria

The questionnaire comprised 15 structured items grouped into three categories: (1) continuous variables, (2) categorical variables, and (3) open-ended qualitative responses. The full questionnaire is provided in the Supplementary Materials. The items were developed by a pharmacopuncture instructor based on previous studies in medical education and textbook evaluation.

Continuous variables (Q1, Q3-Q5) included pre-course expectation (Q1), post-course fulfillment (Q3), textbook difficulty (Q4), and adequacy of lecture hours (Q5). Responses were rated on an 11-point numerical rating scale (0-10), where 0 indicated “not at all” and 10 indicated “extremely high.”

Categorical variables (Q2, Q6-Q13) included expectations for the course (Q2), preferred semester (Q6), weekly class hours (Q7), perceived usefulness of textbook content (Q8), areas requiring supplementation (Q9), topics requiring revision (Q10), evaluations of clinical content (Q11-Q12), and suggestions for educational improvement (Q13). Some items allowed up to two responses per respondent, and results were presented as the proportion of respondents selecting each option.

Open-ended questions (Q14-Q15) asked participants to describe beneficial aspects of the pharmacopuncture course (Q14) and to provide suggestions for improvement (Q15). These qualitative data were later coded and grouped thematically.

The primary outcome variable was fulfillment (Q3), representing overall satisfaction with pharmacopuncture education. For comparative analysis, responses were dichotomized into high (≥ 8) and low (≤ 7) fulfillment groups.

4. Statistical analysis

Descriptive statistics were used to summarize response trends. Continuous variables were presented as mean ± standard deviation (SD) and range, whereas categorical variables were expressed as frequencies and percentages. A paired t-test was used to compare pre-course expectations (Q1) and post-course fulfillment (Q3). Pearson’s correlation coefficients were used to assess the associations among continuous variables (Q1-Q5). Chi-square or Fisher’s exact tests were used to examine associations between fulfillment level (Q3 ≥ 8 vs. ≤ 7) and categorical factors (Q6-Q13).

An exploratory logistic regression analysis was conducted for supplementary purposes due to the limited sample size (n = 56) and was not intended for confirmatory inference. Variables with p < 0.10 in univariate analyses were entered into the multivariate model. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Qualitative data were analyzed thematically. Keywords and phrases were grouped into categories (e.g., strengths, areas for improvement, and revision priorities). Interrater reliability was ensured through independent coding by two researchers, with discrepancies resolved through discussion until consensus was achieved.

RESULTS

1. Descriptive statistics of continuous variables

A total of 56 students participated in the survey. The mean pre-course expectation (Q1) was 7.57 ± 2.33, and the mean post-course fulfillment (Q3) was 8.07 ± 1.62, resulting in a mean difference of 0.50 points. This difference was not statistically significant (t = –1.57, p = 0.122).

The mean scores for textbook difficulty (Q4) and adequacy of class hours (Q5) were 5.66 ± 1.97 and 7.21 ± 2.27, respectively (Table 1).

Table 1.

Descriptive statistics of continuous variables (n = 56)

Variable	Mean ± SD	Range	Main response tendency	Interpretation
Q1. Pre-course expectation	7.57 ± 2.33	0-10	10 (28.6%), 8 (26.8%)	Generally high expectation
Q3. Post-course fulfillment	8.07 ± 1.62	5-10	10 (30.4%), 7 (25.0%)	High fulfillment
Q4. Textbook difficulty	5.66 ± 1.97	0-10	5 (37.5%), 6 (17.9%)	Moderate difficulty
Q5. Adequacy of class hours	7.21 ± 2.27	3-10	10 (28.6%), 5 (21.4%)	Generally sufficient

Paired t-test (Q1 vs. Q3): Δ = +0.50; t = –1.57; p = 0.122 (not significant).

SD, standard deviation.

Overall, students reported relatively high levels of satisfaction, as reflected in the mean scores for textbook difficulty and adequacy of class hours.

2. Correlation analysis among continuous variables

Pearson’s correlation analysis (Table 2) indicated that fulfillment (Q3) was moderately and positively correlated with the adequacy of class hours (Q5) (r = 0.387, p = 0.003).

Table 2.

Correlation matrix among continuous variables

Variable	Q1. Pre-course expectation	Q3. Post-course fulfillment	Q4. Textbook difficulty	Q5. Adequacy of class hours
Q1. Pre-course expectation	1.000	0.317 (p = 0.017)	0.233 (p = 0.083)	0.409 (p = 0.002)
Q3. Post-course fulfillment	0.317 (p = 0.017)	1.000	0.151 (p = 0.267)	0.387 (p = 0.003)
Q4. Textbook difficulty	0.233 (p = 0.083)	0.151 (p = 0.267)	1.000	0.233 (p = 0.083)
Q5. Adequacy of class hours	0.409 (p = 0.002)	0.387 (p = 0.003)	0.233 (p = 0.083)	1.000

Pearson’s correlation coefficients; statistically significant correlations (p < 0.05) are highlighted in bold.

Pre-course expectation (Q1) was positively correlated with both fulfillment (Q3) (r = 0.317, p = 0.017) and adequacy of class hours (Q5) (r = 0.409, p = 0.002).

No significant correlations were observed between textbook difficulty (Q4) and the other continuous variables.

These findings suggest that higher initial expectations and greater perceived adequacy of class hours are associated with increased fulfillment.

3. Frequency analysis of nominal variables

Multiple-response items are summarized in Table 3.

Table 3.

Frequency analysis of key nominal variables

Category	Option	n	% of respondents	% of responses	Remarks
Q6. Appropriate semester	3rd year, 1st semester	41	73.2	43.6	Most preferred
	3rd year, 2nd semester	27	48.2	28.7	-
	4th year, 1st semester	10	17.9	10.6	-
	2nd year, 2nd semester	9	16.1	9.6	-
	2nd year, 1st semester	4	7.1	4.3	-
	4th year, 2nd semester	3	5.4	3.2	-
Q7. Appropriate weekly hours	2 hours in 1st semester	34	60.7	48.6	Most preferred
	4 hours in 2nd semester	22	39.3	31.4	-
	4 hours in 1st semester	10	17.9	14.3	-
	8 hours in 2nd semester	4	7.1	5.7	-
Q8. Useful textbook contents	Variety of formulations	30	53.6	30.0	Top item
	Usage methods and precautions	26	46.4	26.0	-
	Meridian/Palgang/Bee pharmacopuncture	20	35.7	20.0	-
	Advantages and treatment principles	18	32.1	18.0	-
	External preparation examples	6	10.7	6.0	Lowest

Multiple responses are allowed for certain items (up to two selections per respondent). Percentages are calculated relative to the total number of respondents (N = 56).

The most frequently selected timing for pharmacopuncture education was the first semester of the third year (73.2%), followed by the second semester (48.2%). The most frequently selected class duration was 2 hours per week (60.7%), followed by four hours per week (39.3%).

The most useful textbook content areas were the introduction to pharmacopuncture formulations (53.6%) and instructions on their use and precautions (46.4%). The areas most frequently requested for improvement included the addition of newly developed formulations (48.2%), procedures incorporating new medical technologies (44.6%), and recent domestic and international research trends (37.5%).

Among topics regarded as outdated or requiring revision, Hyeolmaek pharmacopuncture (46.4%), Hyeolgi-boyang pharmacopuncture (39.3%), and thread-embedding therapy (35.7%) were most commonly cited. Students reported the highest satisfaction with descriptions of pharmacopuncture treatments for common diseases (64.3%), followed by explanations of treatment frequency, duration, and prognosis (53.6%).

Commonly reported shortcomings in the clinical section included an overly broad scope of formulations (53.6%), lack of updated diagnostic or imaging data (35.7%), and insufficient focus on common clinical conditions (35.7%).

For overall course improvement, securing sufficient practice opportunities was the most frequently selected (62.5%), followed by textbook revision (39.3%) and lectures centered on clinically applied formulations (28.6%).

4. Cross-tabulation of fulfillment level (Q3 ≥ 8 vs. ≤ 7) and related variables

Fulfillment was dichotomized into high (≥ 8) and low (≤ 7) groups. Chi-square or Fisher’s exact tests were performed to assess associations with survey items related to educational factors (Table 4). Differences in p-values between cross-tabulation and univariate logistic regression analyses reflect differences in the statistical methods used. Given the small sample size and sparse cell counts, chi-square and Fisher’s exact test results were prioritized for interpretation.

Table 4.

Cross-tabulation of fulfillment level (Q3 ≥ 8 vs. ≤ 7)

Variable	Category	Low fulfillment (≤ 7) n	High fulfillment (≥ 8) n	χ²	p-value	Interpretation
Q9. Institutional status	Not selected	20	4	3.45	0.063	Tendency toward higher fulfillment
	Selected	18	14
Q9. Newly developed formulations	Not selected	9	15	2.51	0.114	No significant difference
	Selected	20	12		-
Q10. Hyeolmaek pharmacopuncture	Not selected	17	13	3.89	0.049	Significant association
	Selected	7	19		-
Q13. Practice expansion required	Not selected	7	14	0.70	0.403	No significant difference
	Selected	17	18
Others (Q11-Q12)					> 0.05	No significant difference

Fisher’s exact test is applied when expected cell counts are < 5; otherwise, Pearson’s chi-square test is used. Statistically significant p-values (p < 0.05) are indicated in bold.

For Q9 (areas for improvement), students who selected “newly developed pharmacopuncture formulations” showed a higher proportion of low fulfillment (62% vs. 38%), although this difference was not statistically significant (p = 0.114). Conversely, those emphasizing “institutional status” as an area for improvement had a higher proportion of high fulfillment, although the difference did not reach statistical significance (p = 0.063).

For Q10 (areas requiring revision), “Hyeolmaek pharmacopuncture” was significantly associated with fulfillment (χ² = 3.89, p = 0.049), with a higher proportion of high fulfillment among students who recognized the need for its revision.

For Q13 (urgent needs for improvement), students who selected “securing practice sessions” exhibited a higher proportion of low fulfillment (48.6% vs. 33.3%), although this association was not statistically significant (p = 0.403).

Overall, practice-related variables tended to show negative associations with fulfillment, suggesting that limited hands-on opportunities may be associated with lower satisfaction.

5. Exploratory logistic regression analysis

Given the limited sample size (n = 56) and the large number of potential predictors (> 20), logistic regression analyses were conducted strictly for exploratory purposes (Table 5). Univariate analyses were first performed for variables related to educational satisfaction, and a multivariate model was subsequently constructed, including only variables that met the predefined inclusion criterion (p < 0.10).

Table 5.

Exploratory logistic regression analysis of factors associated with fulfillment (Q3 ≥ 8)

Variable	OR	95% CI	p-value	Interpretation (exploratory)
Univariate analysis
Q9. Institutional status	3.89	1.08-14.00	0.038	Positive association (exploratory)
Q10. Hyeolmaek pharmacopuncture	3.55	1.15-10.97	0.028	Positive association (exploratory)
Q9. Newly developed formulations	0.36	0.12-1.07	0.067	Marginal association
Q11. Visual materials satisfaction	3.00	0.83-10.90	0.095	Marginal association
Q13. Practice expansion needed	0.53	0.17-1.63	0.267	No significant association
Multivariate analysis
Q9. Institutional status	2.44	0.86-11.99	0.22	Non-significant
Q10. Hyeolmaek pharmacopuncture	3.18	0.96-9.77	0.06	Marginal association
Q9. Newly developed formulations	0.53	0.12-1.45	0.33	Non-significant
Q11. Visual materials satisfaction	2.56	0.67-9.94	0.19	Non-significant

OR, odds ratio; CI, confidence interval.

Logistic regression analyses are conducted for exploratory purposes only due to the limited sample size (n = 56). Results should not be interpreted independently of cross-tabulation. Variables are included in the multivariate model only if they meet the predefined inclusion criterion (p < 0.10) in univariate analyses. Q13 is analyzed univariately for descriptive purposes but is excluded from the multivariate model. Interpretation of results prioritizes cross-tabulation and qualitative analyses over regression estimates.

In univariate logistic regression analyses, institutional status (Q9) (OR = 3.89, 95% CI: 1.08-14.00, p = 0.038) and Hyeolmaek pharmacopuncture (Q10) (OR = 3.55, 95% CI: 1.15-10.97, p = 0.028) were associated with fulfillment.

Variables showing marginal significance (p < 0.10) included newly developed formulations (Q9) (OR = 0.36, p = 0.067) and satisfaction with the visual materials (Q11) (OR = 3.00, p = 0.095). The need for practice expansion (Q13) demonstrated a non-significant negative association with fulfillment and was therefore excluded from the multivariate model.

In the multivariate model, no variables demonstrated statistically significant associations with fulfillment.

Given the wide confidence intervals and exploratory nature of the regression analyses, definitive conclusions were not drawn. Accordingly, interpretations regarding practice opportunities and Hyeolmaek pharmacopuncture were primarily based on cross-tabulation and qualitative findings rather than regression results.

6. Qualitative analysis of open-ended responses

Among the 56 participants, 46 provided valid open-ended responses (82.1%) (Table 6).

Table 6.

Thematic analysis of open-ended responses (n = 56)

Question	Theme	Frequency (n (%))	Example quotation
Q14. Positive aspects of the course	Hands-on learning and demonstration	24 (42.8%)	“It was helpful to watch and practice the pharmacopuncture procedure directly.”
	Instructor’s clarity	8 (14.3%)	“The professor explained everything calmly and clearly.”
	Systematic content & clinical linkage	9 (16.1%)	“It helped me understand which pharmacopuncture types to use for each disease.”
	Clinical applicability	5 (8.9%)	“I gained a sense of how to apply pharmacopuncture in practice.”
	No valid response	10 (17.9%)	-
Q15. Areas for improvement	Lack of practice opportunities	12 (21.4%)	“There should be more opportunities to perform actual pharmacopuncture.”
	Need for more clinically focused content	8 (14.3%)	“More disease-specific explanations would be helpful.”
	Textbook update and modernization	3 (5.4%)	“Textbooks should reflect the latest research.”
	Visual and case material	3 (5.4%)	“Adding Radiaologies and case studies would be helpful”
	Increase in instructional hours	1 (1.8%)	“We need more instructional hours”
	No valid response	29 (51.8%)	-

Regarding positive aspects (Q14), the most frequently identified theme was hands-on learning and demonstrations (42.8%), followed by systematic organization of content and its linkage to clinical practice (16.1%) (Fig. 1). A Representative comment was: “It was helpful to watch and practice the pharmacopuncture procedure directly.”

Figure 1.

Frequency of open-ended responses (n = 56).

For areas requiring improvement (Q15), the most frequently cited theme was insufficient opportunities for practice (21.4%), followed by the need for more clinically focused and specialized content (14.3%), textbook updates (5.4%), and improved visual or illustrative materials (5.4%). Many respondents expressed a desire for “more opportunities to perform actual pharmacopuncture procedures.”

The qualitative findings were consistent with the quantitative results, suggesting that expanding practical training opportunities and updating educational materials are associated with enhanced satisfaction with pharmacopuncture education.

7. Summary of key findings

Although the mean fulfillment score (8.07) exceeded the mean pre-course expectation (7.57), the difference was not statistically significant. Pre-course expectation (Q1) and perceived adequacy of class hours (Q5) were positively correlated with fulfillment (Q3). Cross-tabulation analyses indicated a significant association between Hyeolmaek pharmacopuncture (Q10) and fulfillment, whereas perceptions regarding the need for expanded practice opportunities (Q13) showed a tendency toward lower fulfillment. Overall satisfaction was interpreted primarily based on descriptive statistics, cross-tabulation results, and qualitative findings. Open-ended responses emphasized the importance of hands-on learning, textbook updates, and stronger integration with clinical practice. Collectively, these findings suggest that enhancing practice-based components and updating textbook content to reflect recent clinical evidence may be associated with student satisfaction in pharmacopuncture education.

DISCUSSION

1. Background and study purpose

Pharmacopuncture is a core component of KM education that bridges theoretical knowledge and procedural skills essential for clinical competence. Despite its clinical importance, few studies have systematically evaluated student satisfaction or curricular needs in this field since Kim et al. identified inconsistencies in pharmacopuncture education across KM colleges [1]. This study was designed to address this gap by assessing student satisfaction with pharmacopuncture education and learning materials, including the current textbook, and evaluating students’ perceptions of the need for content revision and expanded practice. The study aimed to identify key educational strengths and areas for improvement to inform future curriculum revision.

2. Students’ satisfaction with pharmacopuncture education

This cross-sectional survey examined students’ satisfaction with the current pharmacopuncture education and learning materials, including the current textbook, and perceived needs for content revision.

Overall, students reported a relatively high level of satisfaction, with a mean fulfillment score of 8.07 ± 1.62, exceeding the pre-course expectations score of 7.57 ± 2.33. Although this difference was not statistically significant, it suggests that the pharmacopuncture course generally met student expectations.

A consistent pattern emerged across quantitative and qualitative analyses: students who reported fewer hands-on practice opportunities tended to exhibit lower fulfillment. While this trend suggests that limited practice exposure may be associated with reduced satisfaction, the cross-sectional design precludes causal inference.

These findings suggest that, although the current pharmacopuncture curriculum largely meets learners’ expectations, limited opportunities for active participation remain a key source of dissatisfaction, a pattern also observed in other KM education studies. [2, 11]. Collectively, these results highlight that student satisfaction with clinical skills education may be strongly influenced by the extent of experiential engagement rather than theoretical instruction alone.

3. Perceived need for textbook revision and modernization

Notably, students who recognized the need to revise outdated content, particularly sections on Hyeolmaek and Coenzyme Q10 pharmacopuncture, reported higher overall satisfaction. This observation may reflect differences in how students engage with and evaluate their educational experience.

Recognition of outdated material suggests a desire for textbooks and curricula aligned with current evidence and modern formulations. Similar trends have been reported in KM guideline research, where clinicians emphasized the importance of continual updates to maintain clinical relevance [6, 8, 9]. Therefore, the modernization of pharmacopuncture textbooks may be considered not merely a content revision but part of a broader pedagogical shift toward evidence-based education.

Open-ended responses reinforced these findings, highlighting the value of clinically applicable, demonstration-based learning and of up-to-date textbooks that reflect current formulations and evidence.

4. Integration of experiential and simulation-based learning

The demand for increased hands-on experience aligns with established educational principles that professional competence is actively constructed through participation, reflection, and practice rather than passive knowledge acquisition.

Recent research in professional health education supports this approach: simulation-based and case-based learning improve cognitive and psychomotor competencies, as well as learners’ confidence, motivation, and clinical reasoning [12-15]. Similarly, blended learning models that integrate traditional lectures with digital and simulation components foster deeper engagement and critical thinking [14].

Incorporating these experiential frameworks into pharmacopuncture education may help bridge the gap between theoretical learning and clinical application, enabling students to develop procedural proficiency in a safe, structured, and evidence-oriented environment. Such approaches may contribute to standardized skill acquisition and improved clinical confidence.

5. Educational implications for curriculum reform

Several strategies may inform future reform of the pharmacopuncture curriculum. Expanding hands-on practice should be prioritized, potentially through simulation-based or objective structured clinical examinations (OSCE)-style modules that allow repetitive, safe skill training. Modernization and revision of course content based on students’ needs are also essential. These revisions include updating textbooks to reflect current pharmacopuncture formulations, incorporating new medical technologies into procedures, and incorporating recent domestic and international research. Emphasis should also be placed on clinically prevalent diseases, integrating the latest diagnostic and imaging data, and revising outdated or inconsistent topics such as Hyeolmaek pharmacopuncture.

These strategies align pharmacopuncture education with global trends in medical pedagogy, while preserving the integrative and patient-centered principles of KM. Implementing such reforms may enhance student satisfaction and promote the development of clinical competence and professional readiness. Additionally, adopting a competency-based framework that links learning outcomes to clinical performance indicators could further strengthen alignment between education and practice.

6. Limitations and future directions

Some limitations should be acknowledged. First, the study was conducted at a single institution with a small sample size (n = 56), which may limit generalizability. Second, reliance on self-reported data introduces potential recall and response biases. Third, the cross-sectional design precludes the determination of causal relationships between educational factors and satisfaction. Fourth, exploratory regression analysis was constrained by the limited sample size, leading to wide confidence intervals and potentially unstable estimates.

Furthermore, pharmacopuncture courses are often elective, and textbooks and instructional approaches vary across KM institutions. Therefore, findings should be interpreted as exploratory evidence reflecting learner perceptions within a single institutional context rather than as representative of all KM programs.

Despite these limitations, the study provides preliminary insights into students’ perceptions of and educational needs regarding pharmacopuncture education. Future research should include multi-institutional samples and objective assessment tools (e.g., OSCE-based evaluations) to examine the long-term effects of curriculum reform. Qualitative methods, such as focus group interviews, would also be valuable for exploring students’ learning experiences and perceptions in greater depth.

CONCLUSION

This study evaluated student satisfaction with pharmacopuncture education and identified factors associated with fulfillment. Although overall satisfaction was high, perceptions of insufficient practical experience were consistently associated with lower levels of fulfillment. These findings suggest that expanding practice-based learning and implementing regular, evidence-based textbook revisions may be essential for enhancing the quality and relevance of pharmacopuncture education. Strengthening experiential learning and aligning curricular content with real-world clinical practice may improve Korean medical students’ educational effectiveness and readiness. However, these findings should be interpreted cautiously, as they represent preliminary data from a single institution.

SUPPLEMENTARY MATERIALS

Supplementary data is available at https://doi.org/10.3831/KPI.2026.29.1.126.