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Article History

Received: 22 September 2025

Accepted: 14 April 2026

First Online: 24 April 2026

Declarations

:

: This study was conducted in accordance with the IMCO Ethics and Biosafety Guidelines and relevant institutional regulations. The IMCO Ethics and Biosafety Committee confirmed that this minimal-risk, classroom-based educational study did not require formal prior ethics approval under institutional policy at the time of the research (ethics approval waiver letter provided). All participants were adults (≥ 18 years). Because the research team included course instructors, specific measures were taken to minimize instructor–student power imbalance and any perception of grade-related coercion. Participation in the research component (permission to use de-identified course performance records for analysis and completion of the end-of-study questionnaire) was voluntary. Students were informed that choosing not to participate would not affect their grades, assessment outcomes, or course standing. All assessments were delivered and graded as part of normal course requirements using a scenario-specific answer key prepared in advance. Blinding to assessment format was not feasible because the formats were implemented as part of routine course delivery; however, analyses were conducted on de-identified data.

: Informed consent to publish anonymized, aggregated results was obtained from participating students. No identifiable personal data are included in the manuscript.

: The authors declare no competing interests.