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Article History

Received: 12 July 2025

Accepted: 23 February 2026

First Online: 20 March 2026

Declarations

:

: This study protocol has been submitted to and approved by the “Medical Ethics Committee of Yantai Affiliated Hospital of Binzhou Medical College” (Approval number: 20250723126). This study strictly adheres to the ethical guidelines for medical research involving human subjects outlined in the World Medical Association’s Helsinki Declaration. All students were informed before the experiment that this was a classroom quiz and that the results would not affect their final academic performance. Informed consent obtained from all the participant. The entire process of data collection strictly adheres to ethical standards to ensure the full protection of participants’ privacy rights and rights.

: All data used in this study were derived from anonymized questionnaires and classroom assessment results of adult students (aged ≥ 18 years). Sensitive personal identification information such as names and student numbers has been completely removed to ensure that individuals cannot be identified by any means. This study falls under the category of “conducting research using anonymized information data” as outlined in the “Ethical Review Measures for Research Involving Human Life Sciences and Medicine. “All participants agreed to publish the paper.

: The authors declare no competing interests.