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Article History

Received: 5 January 2026

Accepted: 27 August 2026

First Online: 1 September 2026

Declarations

Ethics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki and established ethical principles for research involving human participants. The study protocol was approved by the Nihon University School of Medicine Ethics Committee (Approval No. 2024-21). Accordingly, an opt-out consent procedure, approved by the Ethics Committee, was used for both students and tutors. Information about the study, including its purpose, was posted on the Nihon University School of Medicine website, and students and tutors were notified via email to ensure they had the opportunity to decline participation. Students were assured that their participation or withdrawal from the study would have no effect whatsoever on their grades. All collected data were anonymized and stored securely. AI was utilized exclusively for linguistic refinement and editing of the manuscript. No scientific content, study design, research methodology, data analysis, interpretation of results, or conclusions were generated by AI. All scientific decisions and manuscript revisions were made solely by the authors.

Consent for publication: Not applicable. No individual participant data or identifying images are included in this article.

Competing interests: The authors declare no competing interests.