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Article History

Received: 24 March 2026

Accepted: 30 July 2026

First Online: 7 August 2026

Declarations

Ethics approval and consent to participate: The Cantonal Ethics Committee Bern (Kantonale Ethikkommission Bern, Switzerland) determined that the project did not fall within the scope of the Swiss Human Research Act (HRA) and therefore did not require formal ethics approval (BASEC No. Req-2025-00794). The study was based exclusively on fully anonymized examination data, ensuring participant confidentiality and preventing individual identification. The processing of these data for research purposes was carried out in accordance with Articles 5 and 15 of the Bernese Cantonal Data Protection Act (KDSG), in conjunction with the statutory research and quality assurance responsibilities of the University of Bern under Articles 2 and 5 of the Bernese University Act (UniG). On this basis, no additional formal informed consent to participate was required. To ensure transparency, all candidates were informed that their anonymized examination data could be used for research purposes, including publications, and were given the opportunity to opt out of such use; however, no candidate chose to do so. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

Consent for publication: Not applicable, as this manuscript does not contain any identifiable individual participant data.

Competing interests: The authors declare no competing interests.