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Article History

Received: 5 October 2024

Accepted: 12 November 2025

First Online: 22 January 2026

Competing interests

: The authors declare no competing interests.

: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and received approval from the Institutional Review Board of I-Shou University, Taiwan (Approval No. IRB 2024025; Approval Date: January 25, 2024). The approval encompassed the collection and qualitative analysis of anonymized written reflections from international medical students who participated in a one-day service-learning activity at a juvenile correctional school in southern Taiwan on March 12, 2024. The facility operates under the supervision of the Correctional Agency, Ministry of Justice, Taiwan, and all on-site procedures adhere to strict institutional privacy and security regulations. No recording devices, such as mobile phones, cameras, or audio recorders, were permitted during the activity, and access was limited to authorized faculty members accompanied by official staff. The approved protocol covered study design, data collection, and the handling of anonymized student reflections, ensuring that no identifiable information concerning juveniles was collected or analyzed.

: All participating international medical students were fully informed about the study’s objectives, procedures, and confidentiality safeguards before the service-learning activity. Participation was entirely voluntary, and each student provided written informed consent on March 11, 2024, before the activity. Students were assured that choosing not to participate would have no impact on their coursework, evaluations, or academic standing. The consent process was implemented by the course faculty and research team as described in Supplementary Material S (Program context: structure of the service-learning activity) and Supplementary Material S (Reflection prompts for student participants). The written reflections were collected solely for research purposes and were anonymized before analysis to ensure the protection of personal identity and confidentiality. The data contained no identifiable information about the students or the juveniles they interacted with during the activity. These measures upheld the principles of voluntary participation, autonomy, and data protection throughout the research process.