Volunteer Activities among Medical Students in Syria: A Cross-Sectional Study

Volunteer Activities among Medical Students in Syria: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Volunteer Activities among Medical Students in Syria: A Cross-Sectional Study Mohammed Al-Shafie, Omya AL-Hakim, Hamza Abo Hassoun, Abdullah Moghrabi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6854027/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: Participation in volunteer activities is crucial for enhancing medical students' skills. Research shows that those who engage in volunteer work display significantly superior competencies that are not easily acquired through traditional medical curricula. Furthermore, volunteering positively impacts students' academic performance, particularly during their preclinical years. Purpose: This study examines the key factors influencing Syrian medical students' involvement in volunteer activities to enhance these factors. Method: Conducted as a cross-sectional survey, the research includes 2,084 students from various medical faculties—medicine, dentistry, pharmacy, and health sciences—across public and private universities in Syria. A specialized questionnaire was developed and distributed both electronically and physically through faculty-affiliated groups. Logistic regression analysis was employed to identify factors predicting student participation. Results: Findings reveal that 836 students (40.1%) participate in volunteer activities. The most common types of volunteer work among students include academic scientific initiatives (67.7%, n=566 of N=836), non-medical community service (36.8%, n=308), medical educational community activities (25%, n=209), medical service initiatives within communities (13.2%, n=132), crisis response volunteering (17.3%, n=145), and participation in medical social media (17.9%, n=150). Key predictive factors for student participation include urban residency (OR=1.250, p=0.038), prior work experience (OR=2.123, p<0.001), enrollment in a public university (OR=2.467, p<0.001), pharmacy studies compared to health sciences (OR=1.788, p=0.010), early years of university study (p<0.001), and having a volunteering friend or sibling (OR=3.373, p<0.001). However, gender, economic status, and academic performance did not show statistically significant effects. Regarding students' perceptions of volunteering benefits, more than half agreed that it enhances communication skills, improves verbal and written expression, and strengthens their resumes. Less than half believed that volunteering increases opportunities for studying abroad compared to non-volunteers. Conclusion: Given the essential role of medical students in advancing Syrian community development, efforts should focus on reinforcing the influential factors that drive student participation, thereby maximizing their engagement in volunteer work. Humanities/Medical humanities Social science/Education Social science/Social policy Social science/Sociology Volunteering Volunteer Activities Medical Students Medical Education Figures Figure 1 Figure 2 Introduction Volunteering is the act of people’s will in which they benefit each other and contribute to community development (1). Volunteering has become crucial to medical advancement recently, particularly after the Coronavirus Disease 2019 pandemic (COVID-19). An increasing number of medical students have volunteered to help the public health system during this crisis and gain more practical experience in their field (2). Humanitarian values enhance volunteering outcomes by increasing resilience, empathy, and the ability to manage challenges during crises. Volunteers driven by these values participate in patient-centered activities that foster emotional development, while career-focused motivations show limited emotional benefits (3). Engaging in voluntary activities has had many major benefits on medical students’ key skills. Studies suggest that medical students who have done volunteer work are much better at skills that cannot be acquired easily from their medical curriculum, such as teamwork, communication skills, compassion, and altruism (4). Volunteering also positively impacts academic performance among medical students, especially in the pre-clinical years (5). However, these benefits are not the only factor that influences students’ willingness to volunteer. Research presents variable factors that have a great impact on volunteering, such as gender, academic year, and previous volunteer experience (6). In the context of Syria, the healthcare system is facing unique challenges that significantly affect medical education and voluntary engagement. The ongoing crisis and the current difficult economic situation have had a devastating effect on the healthcare sector, generating a lot of challenges in providing medical services (7), even impacting doctors' career paths and career choices in their country (8). This research aims to study different factors that affect Syrian medical students’ engagement in voluntary activities, including age, academic year, GPA, economic condition, peer influence, and whether they are registered in private or public universities. Understanding these factors and their impact on volunteering is essential for developing effective strategies to raise awareness and encourage more medical students to volunteer, leading to a better healthcare system. Materials and Methods Study design: A descriptive cross-sectional study was undertaken between August 2024 and May 2025 to assess engagement in volunteer activities among medical students across Syria. This study encompassed medical students from the Medicine, Pharmacy, Dentistry, and health sciences faculties at both public and private universities in Syria, providing a comprehensive perspective that may enhance generalizability beyond the country. The public universities included Damascus University, Lattakia University, Aleppo University, Homs University, Hama University, and Tartous University, while the private universities included Syrian Private University (SPU), Alsham Syrian Private University (ASPU), Yarmouk Private University (YPU), among others. Data collection and participants: The data collection process employed a structured, self-administered electronic questionnaire developed using the Google Forms platform. It was disseminated via an online link within formal university groups on social media (Telegram®, Facebook®, and Messenger®). These groups are student-centered and were carefully selected to include the entire target population. Additionally, printed copies were distributed at universities, which were then uploaded using an online link. The questionnaire was launched on August 14, 2024, and remained open until October 13, 2024. The questionnaire reached 2110 students, but 17 students declined participation, yielding a response rate of 99.2%. To uphold data integrity, responses were anonymous, and only the statistician had access to the data. Duplicate entries were eliminated, and only complete responses were included. Inclusion and exclusion criteria: Inclusion criteria required responders to be medical students from the faculties of Medicine, Pharmacy, Dentistry, and health sciences, including Health Sciences students at both public and private universities across Syria. Exclusion criteria encompassed individuals whose data were deemed inaccurate, such as students from unrelated faculties, as well as those who failed to fully complete the questionnaire. Following these exclusion measures, nine participants were omitted, resulting in a final sample size of 2084 students. Sample size: The sample size was determined using an online calculation tool (9), based on a confidence level of 95%, a margin of error of 5%, and a population proportion of 50%, yielding an initial sample size of 385. However, given the nature of our study, which seeks to examine the largest possible segment of students, the final sample size was expanded to N = 2084 to ensure greater representativeness and robustness in our findings. Questionnaire: A specialized questionnaire was developed for this study (Supplementary file). The questionnaire is structured into three main sections: the demographic information section (gender, place of residence, financial status, work for financial compensation, university type, faculty, study years, and rating of grades). The second section focuses on students' involvement in various types of volunteer activities, while the final section explores participants' perspectives on the benefits of volunteer activities for volunteers. To classify a student as a volunteer, a minimum participation period of three months in a volunteer activity was required. This criterion was established based on a study conducted in Saudi Arabia on medical students (10), which found that a three-month participation period—particularly in leadership or organizational roles within extracurricular activities, helped mitigate the risk of diminished professional competency among students. Statistical analysis: The study data were analyzed using SPSS software, version 27 (IBM Corp., Armonk, N.Y., USA). Frequencies and percentages were utilized to categorize nominal variables, including gender, place of residence, financial status, and work for financial compensation, university type, faculty, study years, and grade ratings. Binary logistic regression was employed to identify statistically significant predictive factors associated with student participation in voluntary activities. The assumptions required for logistic regression were verified, ensuring that independent variables were either nominal or ordinal. Additionally, the absence of multicollinearity among variables was confirmed through Spearman's correlation test, which indicates a lack of strong correlation between two variables. Adjusted odds ratios (AORs) were reported alongside their corresponding 95% confidence intervals as measures of association. A statistical significance threshold was established at p < 0.05. Ethical considerations: Participation in this study was voluntary, and participants' identities were protected; there were no questions mentioning their names or Emails. This study was approved by the Ethical Committee in the Faculty of Medicine at Damascus University, Syria, and was assigned a serial number (MD-140824-285, 2024/08/14). This study complied with the principles of the Helsinki Declaration. Participants who agreed to participate in the study would select "Yes, I agree to participate" after reading the explanation. They would then proceed to the subsequent sections, which covered socio-demographic information, students' involvement in various types of volunteer activities, and participants' perspectives on the benefits of volunteer activities for volunteers. Individuals who selected "No, I do not agree to participate" were immediately redirected to the conclusion of the questionnaire without submitting any information. Results Socio-demographic Characteristics: The study was conducted on a sample of medical faculty students (Medicine, Dentistry, Pharmacy, and Health Sciences) and included 2084 students. The majority of the students were female, accounting for 61.3%, and most of them were from public universities, comprising 79.4%. Urban residents made up 67.8% of the sample. Regarding economic status, approximately half of the students, 52.2%, were in good economic condition. More than half of the students, 57.2%, had a sibling or friend participating in volunteer activities, and 40.1% of them were involved in volunteer activities. Further details of the sample are provided in Table 1. T able 1 . Socio-demographic characteristics of the participating students (n = 2084). Variable Frequency Percentage Gender Male 807 38.7% Female 1277 61.3% Place of residence Urban 1412 67.8% Rural 672 32.2% Financial status Below average 102 4.9% Average 728 34.9% Good 1087 52.2% Excellent 167 8.0% Work for financial compensation Yes 308 14.8% No 1776 85.2% University type Public 1655 79.4% Private 429 20.6% Faculty Medicine 919 44.1% Dentistry 542 26.0% Pharmacy 460 22.1% Health Sciences 163 7.8% Study years First-year 245 11.8% Second-year 490 23.5% Third-year 549 26.3% Fourth-year 378 18.1% Fifth-year 284 13.6% Sixth-year 138 6.6% Rating of grades Fair 91 4.4% Good 477 22.9% V. good 1047 50.2% Excellent 460 22.1% Honor 9 0.4% Presence of a volunteering brother or friend Yes 1188 57.0% No 896 43.0% Student's engagement in volunteer activities Yes 836 40.1% No 1248 59.9% Predictive Factors Related to Student Volunteer Activities: Table 2 shows the factors that may influence a student's desire to participate in volunteer activities. Gender and economic status had no statistically significant impact (p=0.650 and p=0.132, respectively). However, living in the city and having work experience had a positive impact compared to rural residence (OR=1.250, p=0.038) and lack of work experience (OR=2.123, p<0.001), respectively. Regarding the student's education, studying at a public university positively influenced participation in volunteer activities compared to students at private universities (OR=2.467, p<0.001). Additionally, studying pharmacy had a more significant positive impact on volunteer behavior than studying health sciences (OR=1.788, p=0.010). Volunteer activities were more prominent in the early academic years, with the first year having the most significant impact (OR=3.135, p<0.001), followed by the second year (OR=2.437, p<0.001) and the third year (OR=1.857, p<0.001) compared to the final year. The most influential factor was having a volunteering sibling or friend, which was associated with more than three times the likelihood of volunteering (OR=3.373, p<0.001). The student's rating of grades did not affect their volunteering behavior (p=0.234). Table 2. Binary logistic regression model Variable Reference B OR 95% Confidence Interval for OR P - value LCI UCI Gender Female -0.049 0.952 0.771 1.176 0.650 Place of residence Rural 0.223 1.250 1.012 1.545 0.038* Financial status - - - - - 0.132 Below average - 0.496 1.643 0.925 2.917 0.090 Average - 0.283 1.326 0.892 1.973 0.163 Good - 0.094 1.099 0.754 1.601 0.625 Excellent Reference Work for financial compensation None 0.753 2.123 1.613 2.794 <0.001* University type Private 0.903 2.467 1.838 3.312 <0.001* Faculty - - - - - <0.001* Medicine - -0.137 0.872 0.574 1.324 0.520 Dentistry - 0.179 1.196 0.776 1.844 0.417 Pharmacy - 0.581 1.788 1.149 2.784 0.010* Health Sciences Reference Study years - - - - - <0.001* First-year - 1.147 3.135 2.033 4.834 <0.001* Second-year - 0.891 2.437 1.799 3.300 <0.001* Third-year - 0.619 1.857 1.399 2.464 <0.001* Fourth-year - 0.293 1.340 0.980 1.832 0.067 Fifth-year Reference Rating of grades - - - - - 0.234 Fair - -1.526 0.217 0.035 1.359 0.103 Good - -1.419 0.242 0.041 1.427 0.117 V. good - -1.443 0.236 0.041 1.378 0.109 Excellent - -1.214 0.297 0.051 1.737 0.178 Honor Reference Presence of a volunteering brother or friend None 1.216 3.373 2.750 4.136 <0.001* Types of Volunteer Activities among Participants: Figure 1 shows the types of volunteer activities and the number of participants (N=836) in each activity. Scientific academic volunteer activities dominated the interests of the participants, with 566 volunteers (67.7%) engaged in such activities. This was followed by non-medical community activities (e.g., environmental or religious institutions), in which 308 volunteers (36.8%) participated. Medical educational activities in the community (e.g., lectures on diseases and prevention) were present among a quarter of the volunteers (209), while less than a quarter (17.9%) participated in medical media activities (e.g., raising medical awareness on social media platforms) and in medical activities during crises (17.3%) (e.g., the COVID-19 pandemic and the 2023 Syrian-Turkish earthquake). Only 132 volunteers (15.8%) engaged in medical service activities in the community (e.g., clinics). Participants' Views on the Benefits of Volunteer Activities for Volunteers: Approximately two-thirds of the participants agreed that volunteering enhances communication skills in writing and oral communication for the volunteer. Additionally, 62.5% of the participants believed that volunteer activities are important for supporting a volunteer's resume. Also, 43.4% of the participants agreed that volunteer experiences help students increase their chances of studying abroad compared to non-volunteers. Figure 2 provides detailed opinions on the benefits above. Discussion Volunteering helps overcome challenges and promotes communal development, particularly in Syria, which is confronting significant difficulties that require support from all sectors of society, especially from highly educated college students, predominantly achieved through volunteerism and related initiatives. Consequently, we at the Faculty of Medicine at Damascus University have analyzed the determinants affecting voluntary behavior among students, as well as the types of voluntary activities most favored by them, to devise future strategies aimed at enhancing volunteerism among students, especially those in the medical field. The data reported that volunteering was positively impacted by living in a large city, having prior work experience, attending a public university, and studying pharmacy. It also appeared to be more prevalent during the early years of university, with having a sibling or friend who volunteers having the biggest impact. However, gender, economic status, and grade rating did not affect volunteering behavior. There is no discernible effect of gender, according to the data. This went against our expectations that females are less involved in voluntary activities because they feel more pressured to study, which causes them to devote more time to studying and have less free time to volunteer than their male counterparts (11). Similar results were reported in a study conducted among preclinical medical students in the Southeast United States found that students with voluntary service interest are not significantly different in term of sex (12). On the other hand, our data demonstrated the positive impact of cities compared to rural residency. This was in line with our expectations in light of the poor internet access in the countryside at a time when most voluntary and non-voluntary work requires a strong internet connection. It could also be because almost all volunteering programs and activities take place in cities. According to the previously mentioned American study, there is no significant correlation between resident location and intent to volunteer work with the underserved (12). A cross-sectional study conducted at Korea University among health care and medical students revealed a preference to engage in domestic locations voluntary activities (13). Having work experience also had a positive impact on volunteering compared to the lack of it. A similar study confirmed that professional and managerial employment increases the probability of participation in voluntary activities (14). This may be because previous experience encourages students to break into voluntary work and helps overcome its difficulties. About universities, the data showed that studying at a public university positively influenced participation in volunteer activities compared to students at private universities. This was incompatible with our expectations. Because the reality of students' distribution on public or private universities here in Syria suggests that student of private universities are in much better psychological and lifestyle situation (11). Thus, they are more probable to participate in extra activities such as voluntary programs. A nationwide comparative study between private and public university students’ soft skills in Malaysia revealed that students of public higher education institutions scored higher in all seven measured soft skills (15). These include the fundamental skills needed for voluntary work and teamwork. That can construe our previous result, although extra studies must be done in this area. Volunteer activities were more prominent in the early academic years. That is what is in line with our expectations, and a Swedish study demonstrated different priorities between first and fifth-year Medical students (16). In light of that and the fact that free time becomes less in advanced years, voluntary work will be more in early academic years and less in later years. The students' rating of grades did not affect their volunteering behavior. A study at Mohammed Bin Rashid University of Medicine and Health Science reported the opposite (5). That is, more legible students on the lowest ends of academic performance have differing priorities when it comes to volunteer, as they may be more concerned about using time to improve academic standing. The most influential factor was having a volunteer sibling or friend, which was associated with more than three times the likelihood of volunteering. This result reflects the peer effect and how friends and colleagues drive each other's choices and pathways (17). Not only are volunteering but also students' career choices influenced by their classmates. Also, peer pressure plays a positive role in academic motivation, the development of social skills, and the adoption of healthy habits (18). Regarding the common types of volunteer activities among students, scientific academic volunteer activities dominated the participants' interests, with 566 volunteers (67.7%) engaged in such activities. Similar results were observed in a study conducted in the Kingdom of Saudi Arabia (10), revealing that 44.4% of participants engaged in research and reading activities. The reason behind this participation in fields related to the students' college majors may be attributed to the human tendency to interact and engage with their surroundings, especially in environments where they spend most of their time, as is the case with these students (19). Non-medical community activities (e.g., environmental or religious institutions) had 308 volunteers (36.8%). We found in a similar study that religiously related activities were present among (18.3%) of volunteering university students (20), and a similar study found that such volunteering activities had (6%) among the participants (21). Medical educational activities in the community (e.g., lectures on diseases and prevention) were present among a quarter of the volunteers. A study conducted during the COVID-19 pandemic in the United Kingdom showed that volunteering in medical awareness and education initiatives benefited the volunteers’ medical education (22). On the other hand, medical students’ transition through the early years of medical school from “student” to “teacher” influenced their perception of what their future professional identity should be, in addition to the resulting emotional burden on them (23). Less than a quarter participated in medical media activities (e.g., raising medical awareness on social media platforms) and in medical activities during crises (e.g., the COVID-19 pandemic and the 2023 Syrian-Turkish earthquake). The percentage of volunteering in media activities is small, although using online platforms has several educational benefits, as students identified in a previous study (24). The small percentage of participation in activities during crises can be explained by the need for medical students to be prepared for the reality of crises, emotional aspects, and the associated deaths, although a different study showed that most people expressed a desire to help in any way, and some felt it was their duty to utilize their clinical skills in the face of a pandemic (6). Only 132 volunteers (15.8%) engaged in medical service activities in the community (e.g., clinics). This result can be explained by the fact that medical training in medical schools, in general, has been developed within the traditional health model, which focuses more on health practices centered on procedures and devalues the patient as the protagonist in his health-disease process. Additionally, the experience that a medical student has in the university hospital lacks a wide perspective, which maintains the dominant health system, causing people to view patients in an isolated manner instead of as whole individuals (25). Students are also not usually taught how to assist in ways that align with the community’s actual situation and connect health services, making their training less effective (25). Participants' Views on the Benefits of Volunteer Activities for Volunteers: Approximately two-thirds of the participants agreed that volunteering enhances communication skills in both writing and oral communication for the volunteer. Another study showed that students who participated regularly in volunteer activities possessed significantly higher measures of graduate attributes related to communication skills compared to non-regular and first-time volunteers (26), which aligns with our results. An interesting observation is that the enhancement of soft skills was only seen in students who regularly engaged in community outreach. These volunteers, compared with occasional and first-time volunteers, experienced an improvement in their soft skills, likely due to their general interest in lifelong learning (26). Another study conducted in the Philippines showed that students are attracted to volunteer activities for personal and career growth (27). 62.5% of the participants believed that volunteer activities are important for enhancing a volunteer's resume. A similar study supports this result and demonstrates that learning about volunteering practices, management, and organization contributes to self-development and enhances employability for volunteers. Understandably, students are mindful of the benefits they gain from volunteering, including developing their skills, which prepares them for a better self when seeking future employment (20). 43.4% of the participants agreed that volunteer experiences help students increase their chances of studying abroad compared to non-volunteers. Motivation to volunteer is derived from the life tasks that individuals face (28), which is comprehensible as our study focused on the university student community, since young people volunteer for reasons related to professional growth and learning to enhance their careers and acquire knowledge according to the Socioemotional Selectivity Theory (SST) (29). Conclusion Given the importance of utilizing the capabilities and skills of medical students to contribute to Syrian community development, assessing their participation in volunteer activities was necessary. The findings indicate that while the culture of volunteering is not absent among students, it may not be sufficient to meet societal needs. Efforts can be directed toward reinforcing the factors that were shown to influence student participation to enhance volunteer engagement. Limitations The study used a convenience sampling method instead of random sampling, and it did not include all medical students from universities in Syria. Furthermore, since the study relies on self-reported questionnaires, there is a potential for response bias or inaccurate information. Declarations Ethics declaration: This study was approved by the Ethical Committee in the Faculty of Medicine at Damascus University, Syria, and was assigned a serial number (MD-140824-285, 2024/08/14). This study complied with the principles of the Helsinki Declaration. Participation in this study was voluntary, and participants' identity was protected; no questions could disclose their Identity, such as name or Email. The first page of the questionnaire included an informed consent section. Participants who agreed to participate in the study would select "Yes, I agree to participate" after reading the explanation. They would then proceed to the subsequent sections, which covered socio-demographic information, students' involvement in various types of volunteer activities, and participants' perspectives on the benefits of volunteer activities for volunteers. Individuals who selected "No, I do not agree to participate" were immediately redirected to the conclusion of the questionnaire without submitting any information. Consent for publication: Not applicable. Availability of data and materials: The data that support the findings of this study are available from the corresponding author, but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Competing interests: The authors declare that they have no competing interests. Funding : There was no funding body. Authors' contributions: The manuscript was written by [MA, OA, HAH, AA, LA, TM, and BA]. [MA] contributed to the questionnaire's creation, analyzed students' data, and prepared tables. [MA] did the general planning, and [BA] provided general supervision. All authors read and approved the final manuscript. References Nichol B, Wilson R, Rodrigues A, Haighton C. Exploring the Effects of Volunteering on the Social, Mental, and Physical Health and Well-being of Volunteers: An Umbrella Review. Volunt Int J Volunt Nonprofit Organ. 2024 Feb;35(1):97–128. Shi Y, Zhang S e, Fan L, Sun T. What Motivates Medical Students to Engage in Volunteer Behavior During the COVID-19 Outbreak? A Large Cross-Sectional Survey. Front Psychol. 2021 Jan 15;11:569765. Phillips HE, Jennings RB, Outhwaite IR, Grosser S, Chandra M, Ende V, et al. Motivation to Impact: Medical Student Volunteerism in the COVID 19 Pandemic. Med Sci Educ. 2022 Sep 19;32(5):1149–57. Ali A, Staunton M, Quinn A, Treacy G, Kennelly P, Hill A, et al. Exploring medical students’ perceptions of the challenges and benefits of volunteering in the intensive care unit during the COVID-19 pandemic: a qualitative study. BMJ Open. 2021 Dec;11(12):e055001. Alsuwaidi L, Powell L, Alhashmi D, Hassan Khamis A, Zary N. Volunteering among pre-clinical medical students: Study of its association with academic performance using institutional data. MedEdPublish. 2022 Jun 16;12:24. Badger K, Morrice R, Buckeldee O, Cotton N, Hunukumbure D, Mitchell O, et al. “More than just a medical student”: a mixed methods exploration of a structured volunteering programme for undergraduate medical students. BMC Med Educ. 2022 Dec;22(1):1. Alhaffar MHDBA, Janos S. Public health consequences after ten years of the Syrian crisis: a literature review. Glob Health. 2021 Dec;17(1):111. Sawaf B, Abbas F, Idris A, Al Saadi T, Ibrahim N. Specialty preference and intentions to study abroad of Syrian medical students during the crisis. BMC Med Educ. 2018 Dec;18(1):39. Available from: https://www.calculator.net/sample-size-calculator.html?type=1&cl=95&ci=5&pp=50&ps=&x=Calculate Almalki SA, Almojali AI, Alothman AS, Masuadi EM, Alaqeel MK. Burnout and its association with extracurricular activities among medical students in Saudi Arabia. Int J Med Educ. 2017 Apr 26;8:144–50. Al Houri HN, Jomaa S, Arrouk DMN, Nassif T, Al Ata Allah MJ, Al Houri AN, et al. The prevalence of stress among medical students in Syria and its association with social support: a cross-sectional study. BMC Psychiatry. 2023 Feb 7;23(1):97. Rogers AJG. Medical student volunteerism and interest in working with underserved and vulnerable populations. BMC Med Educ. 2020 Dec;20(1):133. Christa Them ES. Health-Related Counseling of Elderly People in the Domestic Setting. Health-Relat Couns Elder People Domest Setting [Internet]. 2017;2(1). Available from: https://www.opastpublishers.com/open-access-articles/healthrelated-counseling-of-elderly-people-in-the-domestic-setting.pdf Normah Awang Noh HMP. FACTORS INFLUENCING ENGAGEMENT AND TYPE OF VOLUNTEERING ACTIVITIES PREFERRED BY THE PUBLIC UNIVERSITY STUDENT. Malays J Soc Adm [Internet]. 2023;17. Available from: https://mjs.um.edu.my/index.php/MJSA/article/view/46032 Abdul Karim AM, Abdullah N, Abdul Rahman AM, Noah SM, Wan Jaafar WM, Othman J, et al. A nationwide comparative study between private and public university students’ soft skills. Asia Pac Educ Rev. 2012 Sep;13(3):541–8. Diderichsen S, Andersson J, Johansson EE, Verdonk P, Lagro-Janssen A, Hamberg K. Swedish medical students’ expectations of their future life. Int J Med Educ. 2011 Nov 24;2:140–6. Getachew, A. & Defar, A. Peer Group and Institutional Influence as Determinant Factors on Public University Students′ Career Choices. J Organ Cult Commun Confl. 2023;27(3):1–10. MANSI PRAVIN BHUJBAL SV. The Influence of Peer Pressure on Students: Cause, Effect, and Strategies for Intervention. Int J Multidiscip Res. 2024 Sep 28;6(5):28091. Cívico-Ariza A, Colomo-Magaña E, González-García E, Sánchez-Rivas E. Volunteering in the University Context: Student Perception and Participation. Educ Sci. 2020 Dec 15;10(12):380. Mustafa SMS, Radzi FAM, Hamzah KHJK. Participation in and Benefits of Volunteering Activities Among University Students. Int J Acad Res Bus Soc Sci. 2020 Jun 29;10(14):Pages 31-37. Wondimu H, Admas G. The motivation and engagement of student volunteers in volunteerism at the University of Gondar. Discov Glob Soc. 2024 Mar 25;2(1):22. on behalf of the MedEd Collaborative, Byrne MHV, Ashcroft J, Alexander L, Wan JCM, Arora A, et al. COVIDReady2 study protocol: cross-sectional survey of medical student volunteering and education during the COVID-19 pandemic in the United Kingdom. BMC Med Educ. 2021 Dec;21(1):211. Goodwin AM, Oliver SW, McInnes I, Millar KF, Collins K, Paton C. Professionalism in medical education: the state of the art. Int J Med Educ. 2024 Apr 29;15:44–7. Azer SA, Alhudaithi D, AlBuqami F, AlWaily H, AlRabah R, AlKhashan R. Online learning resources and social media platforms used by medical students during the COVID-19 pandemic. BMC Med Educ. 2023 Dec 19;23(1):969. Santos RNLCD, Ribeiro KSQS, Anjos UUD, Farias DND, Lucena EMDF. Integralidade e Interdisciplinaridade na Formação de Estudantes de Medicina. Rev Bras Educ Médica. 2015 Sep;39(3):378–87. Ian I. Llenares. Volunteerism is Associated with Improved Soft Skills of Marine Engineering Students in the Philippines. J Interdiscip Stud Educ. 8(2):57–73. MOTIVATIONS FOR VOLUNTEERISM AMONG FILIPINOCOLLEGE STUDENTS. Nternational J Educ Res [Internet]. 2015 Feb;3(2). Available from: http://www.ijern.com/journal/2015/February-2015/48.pdf Omoto AM, Snyder M, Martino SC. Volunteerism and the Life Course: Investigating Age-Related Agendas for Action. Basic Appl Soc Psychol. 2000 Sep;22(3):181–97. Okun MA, Schultz A. Age and motives for volunteering: Testing hypotheses derived from socioemotional selectivity theory. Psychol Aging. 2003;18(2):231–9. Additional Declarations No competing interests reported. Supplementary Files Supplementaryfileourquestionnaire.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 Dec, 2025 Reviews received at journal 18 Nov, 2025 Reviewers agreed at journal 28 Oct, 2025 Reviews received at journal 09 Oct, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers invited by journal 10 Sep, 2025 Editor assigned by journal 10 Sep, 2025 Editor invited by journal 10 Sep, 2025 Submission checks completed at journal 20 Aug, 2025 First submitted to journal 20 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6854027","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":516557362,"identity":"2c9fd18a-d186-4ac3-8641-e6e757d74930","order_by":0,"name":"Mohammed Al-Shafie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABPUlEQVRIie3QMWvCQBTA8RcOkuWs64VU/QSFSCAtVPpFulwQnLzdwdqUQrKkuDqU+BV0uTnhwCyhri0uTpk6dSgBhfZitxqL3UrJf7jhcT+OdwBVVX8yvDsVVwMVoENARSjZbAdyhpD7M0EF6RE40VRKcFoQ5SgC0Kxjk9S8r2EZOPMf4reXfqcxvteydU4vmioC09TDm+u6L0k+4N+JnT51DcZ71kTg83ZAiSUJpW2esIlQXCVIV3vkuW9KIhxXYJXUcuJ4CKLI4QvmSoIUr4xYG8Y/nKnQMn1Lya2HlDs3flyw6WFiy1ciZybANjAlVH5ygYZsdoikqX3JeNeaC2wbp5S0PaTKdRYRm0sSl+2SBNaK8atGmPiZ/kpHrdZ4+Y5gOGLhUsTrfLBHDiZ2Z3T0fdnoN5erqqqq/nefHoV07kx8Br8AAAAASUVORK5CYII=","orcid":"","institution":"Damascus University","correspondingAuthor":true,"prefix":"","firstName":"Mohammed","middleName":"","lastName":"Al-Shafie","suffix":""},{"id":516557363,"identity":"585b2dd5-0f58-45f5-acfc-25933f621c41","order_by":1,"name":"Omya AL-Hakim","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Omya","middleName":"","lastName":"AL-Hakim","suffix":""},{"id":516557364,"identity":"93e2f159-32ff-431e-88f6-fca550a42179","order_by":2,"name":"Hamza Abo Hassoun","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Hamza","middleName":"Abo","lastName":"Hassoun","suffix":""},{"id":516557365,"identity":"70f13c9d-6ad9-4112-80e5-432c3bfa7003","order_by":3,"name":"Abdullah Moghrabi","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Abdullah","middleName":"","lastName":"Moghrabi","suffix":""},{"id":516557366,"identity":"85ec1a40-f730-4145-a0c8-df01faa8c028","order_by":4,"name":"Leen Altahhan","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Leen","middleName":"","lastName":"Altahhan","suffix":""},{"id":516557367,"identity":"a2752292-f0c4-43f3-a8e4-17c0aa4423b7","order_by":5,"name":"Tarek Majzoub","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Tarek","middleName":"","lastName":"Majzoub","suffix":""},{"id":516557368,"identity":"ebbdc3d9-6ebf-4aba-822b-fb2a1078f0ab","order_by":6,"name":"Bayan Alsaid","email":"","orcid":"","institution":"Damascus University","correspondingAuthor":false,"prefix":"","firstName":"Bayan","middleName":"","lastName":"Alsaid","suffix":""}],"badges":[],"createdAt":"2025-06-09 11:38:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6854027/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6854027/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91611816,"identity":"a8b2d99e-ed40-4f42-a071-bc1ee75ebabc","added_by":"auto","created_at":"2025-09-18 10:01:34","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51784,"visible":true,"origin":"","legend":"\u003cp\u003eTypes of volunteer activities among students\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6854027/v1/0eabe92495c3a28c76704ccd.png"},{"id":91611815,"identity":"ce17d165-d2cc-47b3-af82-c4185b86815e","added_by":"auto","created_at":"2025-09-18 10:01:34","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":95986,"visible":true,"origin":"","legend":"\u003cp\u003eStudents' views on the benefits of volunteer activities\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6854027/v1/9c3b045065452620eaa3f540.png"},{"id":91613636,"identity":"20f693bb-541d-4a77-805f-80964a58f8d1","added_by":"auto","created_at":"2025-09-18 10:17:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1059827,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6854027/v1/a8e2afae-824e-4116-a99b-94c67c2bd5fb.pdf"},{"id":91611817,"identity":"3d94e3ad-6adf-44e1-8894-ecbb6365735d","added_by":"auto","created_at":"2025-09-18 10:01:35","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":18372,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfileourquestionnaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-6854027/v1/53433c945da4a0bf7cff2df7.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eVolunteer Activities among Medical Students in Syria: A Cross-Sectional Study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eVolunteering is the act of people\u0026rsquo;s will in which they benefit each other and contribute to community development (1). Volunteering has become crucial to medical advancement recently, particularly after the\u0026nbsp;Coronavirus Disease 2019 pandemic (COVID-19). An increasing number of medical students have volunteered to help the public health system during this crisis and gain more practical experience in their field\u0026nbsp;(2). Humanitarian values enhance volunteering outcomes by increasing resilience, empathy, and the ability to manage challenges during crises. Volunteers driven by these values participate in patient-centered activities that foster emotional development, while career-focused motivations show limited emotional benefits\u0026nbsp;(3).\u003c/p\u003e\n\u003cp\u003eEngaging in voluntary activities has had many major benefits on medical students\u0026rsquo; key skills. Studies suggest that medical students who have done volunteer work are much better at skills that cannot be acquired easily from their medical curriculum, such as teamwork, communication skills, compassion, and altruism (4). Volunteering also positively impacts academic performance among medical students, especially in the pre-clinical years (5). However, these benefits are not the only factor that influences students\u0026rsquo; willingness to volunteer. Research presents variable factors that have a great impact on volunteering, such as gender, academic year, and previous volunteer experience (6).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the context of Syria, the healthcare system is facing unique challenges that significantly affect medical education and voluntary engagement. The ongoing crisis and the current difficult economic situation have had a devastating effect on the healthcare sector, generating a lot of challenges in providing medical services (7), even impacting doctors\u0026apos; career paths and career choices in their country (8).\u003c/p\u003e\n\u003cp\u003eThis research aims to study different factors that affect Syrian medical students\u0026rsquo; engagement in voluntary activities, including age, academic year, GPA, economic condition, peer influence, and whether they are registered in private or public universities. Understanding these factors and their impact on volunteering is essential for developing effective strategies to raise awareness and encourage more medical students to volunteer, leading to a better healthcare system.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive cross-sectional study was undertaken between August 2024 and May 2025 to assess engagement in volunteer activities among medical students across Syria. This study encompassed medical students from the Medicine, Pharmacy, Dentistry, and health sciences faculties at both public and private universities in Syria, providing a comprehensive perspective that may enhance generalizability beyond the country. The public universities included Damascus University, Lattakia University, Aleppo University, Homs University, Hama University, and Tartous University, while the private universities included Syrian Private University (SPU), Alsham Syrian Private University (ASPU), Yarmouk Private University (YPU), among others.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection and participants:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data collection process employed a structured, self-administered electronic questionnaire developed using the Google Forms platform. It was disseminated via an online link within formal university groups on social media (Telegram\u0026reg;, Facebook\u0026reg;, and Messenger\u0026reg;). These groups are student-centered and were carefully selected to include the entire target population. Additionally, printed copies were distributed at universities, which were then uploaded using an online link. The questionnaire was launched on August 14, 2024, and remained open until October 13, 2024. The questionnaire reached 2110 students, but 17 students declined participation, yielding a response rate of 99.2%. To uphold data integrity, responses were anonymous, and only the statistician had access to the data. Duplicate entries were eliminated, and only complete responses were included.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and exclusion criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion criteria required responders to be medical students from the faculties of Medicine, Pharmacy, Dentistry, and health sciences, including Health Sciences students at both public and private universities across Syria. Exclusion criteria encompassed individuals whose data were deemed inaccurate, such as students from unrelated faculties, as well as those who failed to fully complete the questionnaire. Following these exclusion measures, nine participants were omitted, resulting in a final sample size of 2084 students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was determined using an online calculation tool (9), based on a confidence level of 95%, a margin of error of 5%, and a population proportion of 50%, yielding an initial sample size of 385. However, given the nature of our study, which seeks to examine the largest possible segment of students, the final sample size was expanded to N = 2084 to ensure greater representativeness and robustness in our findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuestionnaire:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA specialized questionnaire was developed for this study (Supplementary file). The questionnaire is structured into three main sections: the demographic information section (gender, place of residence, financial status, work for financial compensation, university type, faculty, study years, and rating of grades). The second section focuses on students\u0026apos; involvement in various types of volunteer activities, while the final section explores participants\u0026apos; perspectives on the benefits of volunteer activities for volunteers. To classify a student as a volunteer, a minimum participation period of three months in a volunteer activity was required. This criterion was established based on a study conducted in Saudi Arabia on medical students (10), which found that a three-month participation period\u0026mdash;particularly in leadership or organizational roles within extracurricular activities, helped mitigate the risk of diminished professional competency among students.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study data were analyzed using SPSS software, version 27 (IBM Corp., Armonk, N.Y., USA). Frequencies and percentages were utilized to categorize nominal variables, including gender, place of residence, financial status, and work for financial compensation, university type, faculty, study years, and grade ratings. Binary logistic regression was employed to identify statistically significant predictive factors associated with student participation in voluntary activities. The assumptions required for logistic regression were verified, ensuring that independent variables were either nominal or ordinal. Additionally, the absence of multicollinearity among variables was confirmed through Spearman\u0026apos;s correlation test, which indicates a lack of strong correlation between two variables. Adjusted odds ratios (AORs) were reported alongside their corresponding 95% confidence intervals as measures of association. A statistical significance threshold was established at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipation in this study was voluntary, and participants\u0026apos; identities were protected; there were no questions mentioning their names or Emails. This study was approved by the Ethical Committee in the Faculty of Medicine at Damascus University, Syria, and was assigned a serial number (MD-140824-285, 2024/08/14). This study complied with the principles of the Helsinki Declaration. Participants who agreed to participate in the study would select \u0026quot;Yes, I agree to participate\u0026quot; after reading the explanation. They would then proceed to the subsequent sections, which covered socio-demographic information, students\u0026apos; involvement in various types of volunteer activities, and participants\u0026apos; perspectives on the benefits of volunteer activities for volunteers. Individuals who selected \u0026quot;No, I do not agree to participate\u0026quot; were immediately redirected to the conclusion of the questionnaire without submitting any information.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eSocio-demographic Characteristics:\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted on a sample of medical faculty students (Medicine, Dentistry, Pharmacy, and Health Sciences) and included 2084 students. The majority of the students were female, accounting for 61.3%, and most of them were from public universities, comprising 79.4%. Urban residents made up 67.8% of the sample. Regarding economic status, approximately half of the students, 52.2%, were in good economic condition. More than half of the students, 57.2%, had a sibling or friend participating in volunteer activities, and 40.1% of them were involved in volunteer activities. Further details of the sample are provided in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT\u003c/strong\u003e\u003cstrong\u003eable 1\u003c/strong\u003e. Socio-demographic characteristics of the participating students (n = 2084).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e807\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e38.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e61.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Urban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e67.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Rural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e32.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFinancial status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Below average\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e4.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Average\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e728\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e34.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e52.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026nbsp;Excellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e8.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWork for financial compensation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e14.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1776\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e85.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUniversity type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e79.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e20.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFaculty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eMedicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e919\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e44.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eDentistry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e542\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e26.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003ePharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eHealth Sciences\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e7.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eFirst-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e11.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eSecond-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e490\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e23.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eThird-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e549\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e26.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eFourth-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e18.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eFifth-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e284\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e13.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eSixth-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e6.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRating of grades\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e4.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eV. good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e50.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e460\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eHonor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of a volunteering brother or friend\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e57.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e43.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudent\u0026apos;s engagement in volunteer activities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e40.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 236px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e1248\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e59.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003ePredictive Factors Related to Student Volunteer Activities:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows the factors that may influence a student\u0026apos;s desire to participate in volunteer activities. Gender and economic status had no statistically significant impact (p=0.650 and p=0.132, respectively). However, living in the city and having work experience had a positive impact compared to rural residence (OR=1.250, p=0.038) and lack of work experience (OR=2.123, p\u0026lt;0.001), respectively. Regarding the student\u0026apos;s education, studying at a public university positively influenced participation in volunteer activities compared to students at private universities (OR=2.467, p\u0026lt;0.001). Additionally, studying pharmacy had a more significant positive impact on volunteer behavior than studying health sciences (OR=1.788, p=0.010). Volunteer activities were more prominent in the early academic years, with the first year having the most significant impact (OR=3.135, p\u0026lt;0.001), followed by the second year (OR=2.437, p\u0026lt;0.001) and the third year (OR=1.857, p\u0026lt;0.001) compared to the final year. The most influential factor was having a volunteering sibling or friend, which was associated with more than three times the likelihood of volunteering (OR=3.373, p\u0026lt;0.001). The student\u0026apos;s rating of grades did not affect their volunteering behavior (p=0.234).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 633px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2. Binary logistic regression model\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% Confidence Interval for OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP - value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.771\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.038*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFinancial status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u0026nbsp;Below average\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.496\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e2.917\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u0026nbsp;Average\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.973\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u0026nbsp;Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.754\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.625\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 473px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWork for financial compensation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.753\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e2.794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUniversity type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.903\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.467\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e3.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFaculty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eMedicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eDentistry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.776\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.417\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003ePharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.788\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e2.784\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eHealth Sciences\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 473px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eFirst-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e2.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e4.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eSecond-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.891\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.799\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e3.300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eThird-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e1.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e2.464\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eFourth-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.980\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.832\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eFifth-year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 473px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRating of grades\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-1.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-1.419\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eV. good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-1.443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-1.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e1.737\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eHonor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 473px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of a volunteering brother or friend\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e2.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e4.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTypes of Volunteer Activities among Participants:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Figure 1 shows the types of volunteer activities and the number of participants (N=836) in each activity. Scientific academic volunteer activities dominated the interests of the participants, with 566 volunteers (67.7%) engaged in such activities. This was followed by non-medical community activities (e.g., environmental or religious institutions), in which 308 volunteers (36.8%) participated. Medical educational activities in the community (e.g., lectures on diseases and prevention) were present among a quarter of the volunteers (209), while less than a quarter (17.9%) participated in medical media activities (e.g., raising medical awareness on social media platforms) and in medical activities during crises (17.3%) (e.g., the COVID-19 pandemic and the 2023 Syrian-Turkish earthquake). Only 132 volunteers (15.8%) engaged in medical service activities in the community (e.g., clinics).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants\u0026apos; Views on the Benefits of Volunteer Activities for Volunteers:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproximately two-thirds of the participants agreed that volunteering enhances communication skills in writing and oral communication for the volunteer. Additionally, 62.5% of the participants believed that volunteer activities are important for supporting a volunteer\u0026apos;s resume. Also, 43.4% of the participants agreed that volunteer experiences help students increase their chances of studying abroad compared to non-volunteers. Figure 2 provides detailed opinions on the benefits above.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eVolunteering helps overcome challenges and promotes communal development, particularly in Syria, which is confronting significant difficulties that require support from all sectors of society, especially from highly educated college students, predominantly achieved through volunteerism and related initiatives.\u003c/p\u003e\n\u003cp\u003eConsequently, we at the Faculty of Medicine at Damascus University have analyzed the determinants affecting voluntary behavior among students, as well as the types of voluntary activities most favored by them, to devise future strategies aimed at enhancing volunteerism among students, especially those in the medical field. The data reported that volunteering was positively impacted by living in a large city, having prior work experience, attending a public university, and studying pharmacy. It also appeared to be more prevalent during the early years of university, with having a sibling or friend who volunteers having the biggest impact. However, gender, economic status, and grade rating did not affect volunteering behavior. There is no discernible effect of gender, according to the data. This went against our expectations that females are less involved in voluntary activities because they feel more pressured to study, which causes them to devote more time to studying and have less free time to volunteer than their male counterparts (11). Similar results were reported in a study conducted among preclinical medical students in the Southeast United States found that students with voluntary service interest are not significantly different in term of sex (12).\u003c/p\u003e\n\u003cp\u003eOn the other hand, our data demonstrated the positive impact of cities compared to rural residency. This was in line with our expectations in light of the poor internet access in the countryside at a time when most voluntary and non-voluntary work requires a strong internet connection. It could also be because almost all volunteering programs and activities take place in cities. According to the previously mentioned American study, there is no significant correlation between resident location and intent to volunteer work with the underserved (12). A cross-sectional study conducted at Korea University among health care and medical students revealed a preference to engage in domestic locations voluntary activities (13).\u003c/p\u003e\n\u003cp\u003eHaving work experience also had a positive impact on volunteering compared to the lack of it. A similar study confirmed that professional and managerial employment increases the probability of participation in voluntary activities (14). This may be because previous experience encourages students to break into voluntary work and helps overcome its difficulties.\u003c/p\u003e\n\u003cp\u003eAbout universities, the data showed that studying at a public university positively influenced participation in volunteer activities compared to students at private universities. This was incompatible with our expectations. Because the reality of students\u0026apos; distribution on public or private universities here in Syria suggests that student of private universities are in much better psychological and lifestyle situation (11). Thus, they are more probable to participate in extra activities such as voluntary programs. A nationwide comparative study between private and public university students\u0026rsquo; soft skills in Malaysia revealed that students of public higher education institutions scored higher in all seven measured soft skills (15). These include the fundamental skills needed for voluntary work and teamwork. That can construe our previous result, although extra studies must be done in this area.\u003c/p\u003e\n\u003cp\u003eVolunteer activities were more prominent in the early academic years. That is what is in line with our expectations, and a Swedish study demonstrated different priorities between first and fifth-year Medical students (16). In light of that and the fact that free time becomes less in advanced years, voluntary work will be more in early academic years and less in later years.\u003c/p\u003e\n\u003cp\u003eThe students\u0026apos; rating of grades did not affect their volunteering behavior. A study at Mohammed Bin Rashid University of Medicine and Health Science reported the opposite (5). That is, more legible students on the lowest ends of academic performance have differing priorities when it comes to volunteer, as they may be more concerned about using time to improve academic standing.\u003c/p\u003e\n\u003cp\u003eThe most influential factor was having a volunteer sibling or friend, which was associated with more than three times the likelihood of volunteering. This result reflects the peer effect and how friends and colleagues drive each other\u0026apos;s choices and pathways (17). Not only are volunteering but also students\u0026apos; career choices influenced by their classmates. Also, peer pressure plays a positive role in academic motivation, the development of social skills, and the adoption of healthy habits (18).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding the common types of volunteer activities among students, scientific academic volunteer activities dominated the participants\u0026apos; interests, with 566 volunteers (67.7%) engaged in such activities. Similar results were observed in a study conducted in the Kingdom of Saudi Arabia (10), revealing that 44.4% of participants engaged in research and reading activities. The reason behind this participation in fields related to the students\u0026apos; college majors may be attributed to the human tendency to interact and engage with their surroundings, especially in environments where they spend most of their time, as is the case with these students (19). Non-medical community activities (e.g., environmental or religious institutions) had 308 volunteers (36.8%). We found in a similar study that religiously related activities were present among (18.3%) of volunteering university students (20), and a similar study found that such volunteering activities had (6%) among the participants (21). Medical educational activities in the community (e.g., lectures on diseases and prevention) were present among a quarter of the volunteers. A study conducted during the COVID-19 pandemic in the United Kingdom showed that volunteering in medical awareness and education initiatives benefited the volunteers\u0026rsquo; medical education (22). On the other hand, medical students\u0026rsquo; transition through the early years of medical school from \u0026ldquo;student\u0026rdquo; to \u0026ldquo;teacher\u0026rdquo; influenced their perception of what their future professional identity should be, in addition to the resulting emotional burden on them (23). Less than a quarter participated in medical media activities (e.g., raising medical awareness on social media platforms) and in medical activities during crises (e.g., the COVID-19 pandemic and the 2023 Syrian-Turkish earthquake). The percentage of volunteering in media activities is small, although using online platforms has several educational benefits, as students identified in a previous study (24). The small percentage of participation in activities during crises can be explained by the need for medical students to be prepared for the reality of crises, emotional aspects, and the associated deaths, although a different study showed that most people expressed a desire to help in any way, and some felt it was their duty to utilize their clinical skills in the face of a pandemic (6). Only 132 volunteers (15.8%) engaged in medical service activities in the community (e.g., clinics). This result can be explained by the fact that medical training in medical schools, in general, has been developed within the traditional health model, which focuses more on health practices centered on procedures and devalues the patient as the protagonist in his health-disease process. Additionally, the experience that a medical student has in the university hospital lacks a wide perspective, which maintains the dominant health system, causing people to view patients in an isolated manner instead of as whole individuals (25). Students are also not usually taught how to assist in ways that align with the community\u0026rsquo;s actual situation and connect health services, making their training less effective (25). Participants\u0026apos; Views on the Benefits of Volunteer Activities for Volunteers: Approximately two-thirds of the participants agreed that volunteering enhances communication skills in both writing and oral communication for the volunteer. Another study showed that students who participated regularly in volunteer activities possessed significantly higher measures of graduate attributes related to communication skills compared to non-regular and first-time volunteers (26), which aligns with our results. An interesting observation is that the enhancement of soft skills was only seen in students who regularly engaged in community outreach. These volunteers, compared with occasional and first-time volunteers, experienced an improvement in their soft skills, likely due to their general interest in lifelong learning (26). Another study conducted in the Philippines showed that students are attracted to volunteer activities for personal and career growth (27).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e62.5% of the participants believed that volunteer activities are important for enhancing a volunteer\u0026apos;s resume. A similar study supports this result and demonstrates that learning about volunteering practices, management, and organization contributes to self-development and enhances employability for volunteers. Understandably, students are mindful of the benefits they gain from volunteering, including developing their skills, which prepares them for a better self when seeking future employment (20).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e43.4% of the participants agreed that volunteer experiences help students increase their chances of studying abroad compared to non-volunteers. Motivation to volunteer is derived from the life tasks that individuals face (28), which is comprehensible as our study focused on the university student community, since young people volunteer for reasons related to professional growth and learning to enhance their careers and acquire knowledge according to the Socioemotional Selectivity Theory (SST) (29).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGiven the importance of utilizing the capabilities and skills of medical students to contribute to Syrian community development, assessing their participation in volunteer activities was necessary. The findings indicate that while the culture of volunteering is not absent among students, it may not be sufficient to meet societal needs. Efforts can be directed toward reinforcing the factors that were shown to influence student participation to enhance volunteer engagement.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThe study used a convenience sampling method instead of random sampling, and it did not include all medical students from universities in Syria. Furthermore, since the study relies on self-reported questionnaires, there is a potential for response bias or inaccurate information.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics declaration:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethical Committee in the Faculty of Medicine at Damascus University, Syria, and was assigned a serial number (MD-140824-285, 2024/08/14). This study complied with the principles of the Helsinki Declaration.\u0026nbsp;Participation in this study was voluntary, and participants\u0026apos; identity was protected; no questions could disclose their Identity, such as name or Email. The first page of the questionnaire included an informed consent section. Participants who agreed to participate in the study would select \u0026quot;Yes, I agree to participate\u0026quot; after reading the explanation. They would then proceed to the subsequent sections, which covered socio-demographic information, students\u0026apos; involvement in various types of volunteer activities, and participants\u0026apos; perspectives on the benefits of volunteer activities for volunteers. Individuals who selected \u0026quot;No, I do not agree to participate\u0026quot; were immediately redirected to the conclusion of the questionnaire without submitting any information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available\u0026nbsp;from the corresponding author, but restrictions apply to the\u0026nbsp;availability of these data, which were used under license for the current study and so are not publicly available.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no funding body.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe manuscript was written by [MA, OA, HAH, AA, LA, TM, and BA]. [MA] contributed to the questionnaire\u0026apos;s creation, analyzed students\u0026apos; data, and prepared tables. [MA] did the general planning, and [BA] provided general supervision. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNichol B, Wilson R, Rodrigues A, Haighton C. Exploring the Effects of Volunteering on the Social, Mental, and Physical Health and Well-being of Volunteers: An Umbrella Review. Volunt Int J Volunt Nonprofit Organ. 2024 Feb;35(1):97\u0026ndash;128. \u003c/li\u003e\n\u003cli\u003eShi Y, Zhang S e, Fan L, Sun T. What Motivates Medical Students to Engage in Volunteer Behavior During the COVID-19 Outbreak? A Large Cross-Sectional Survey. Front Psychol. 2021 Jan 15;11:569765. \u003c/li\u003e\n\u003cli\u003ePhillips HE, Jennings RB, Outhwaite IR, Grosser S, Chandra M, Ende V, et al. Motivation to Impact: Medical Student Volunteerism in the COVID 19 Pandemic. Med Sci Educ. 2022 Sep 19;32(5):1149\u0026ndash;57. \u003c/li\u003e\n\u003cli\u003eAli A, Staunton M, Quinn A, Treacy G, Kennelly P, Hill A, et al. Exploring medical students\u0026rsquo; perceptions of the challenges and benefits of volunteering in the intensive care unit during the COVID-19 pandemic: a qualitative study. BMJ Open. 2021 Dec;11(12):e055001. \u003c/li\u003e\n\u003cli\u003eAlsuwaidi L, Powell L, Alhashmi D, Hassan Khamis A, Zary N. Volunteering among pre-clinical medical students: Study of its association with academic performance using institutional data. MedEdPublish. 2022 Jun 16;12:24. \u003c/li\u003e\n\u003cli\u003eBadger K, Morrice R, Buckeldee O, Cotton N, Hunukumbure D, Mitchell O, et al. \u0026ldquo;More than just a medical student\u0026rdquo;: a mixed methods exploration of a structured volunteering programme for undergraduate medical students. BMC Med Educ. 2022 Dec;22(1):1. \u003c/li\u003e\n\u003cli\u003eAlhaffar MHDBA, Janos S. Public health consequences after ten years of the Syrian crisis: a literature review. Glob Health. 2021 Dec;17(1):111. \u003c/li\u003e\n\u003cli\u003eSawaf B, Abbas F, Idris A, Al Saadi T, Ibrahim N. Specialty preference and intentions to study abroad of Syrian medical students during the crisis. BMC Med Educ. 2018 Dec;18(1):39. \u003c/li\u003e\n\u003cli\u003eAvailable from: https://www.calculator.net/sample-size-calculator.html?type=1\u0026amp;cl=95\u0026amp;ci=5\u0026amp;pp=50\u0026amp;ps=\u0026amp;x=Calculate\u003c/li\u003e\n\u003cli\u003eAlmalki SA, Almojali AI, Alothman AS, Masuadi EM, Alaqeel MK. Burnout and its association with extracurricular activities among medical students in Saudi Arabia. Int J Med Educ. 2017 Apr 26;8:144\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eAl Houri HN, Jomaa S, Arrouk DMN, Nassif T, Al Ata Allah MJ, Al Houri AN, et al. The prevalence of stress among medical students in Syria and its association with social support: a cross-sectional study. BMC Psychiatry. 2023 Feb 7;23(1):97. \u003c/li\u003e\n\u003cli\u003eRogers AJG. Medical student volunteerism and interest in working with underserved and vulnerable populations. BMC Med Educ. 2020 Dec;20(1):133. \u003c/li\u003e\n\u003cli\u003eChrista Them ES. Health-Related Counseling of Elderly People in the Domestic Setting. Health-Relat Couns Elder People Domest Setting [Internet]. 2017;2(1). Available from: https://www.opastpublishers.com/open-access-articles/healthrelated-counseling-of-elderly-people-in-the-domestic-setting.pdf\u003c/li\u003e\n\u003cli\u003eNormah Awang Noh HMP. FACTORS INFLUENCING ENGAGEMENT AND TYPE OF VOLUNTEERING ACTIVITIES PREFERRED BY THE PUBLIC UNIVERSITY STUDENT. Malays J Soc Adm [Internet]. 2023;17. Available from: https://mjs.um.edu.my/index.php/MJSA/article/view/46032\u003c/li\u003e\n\u003cli\u003eAbdul Karim AM, Abdullah N, Abdul Rahman AM, Noah SM, Wan Jaafar WM, Othman J, et al. A nationwide comparative study between private and public university students\u0026rsquo; soft skills. Asia Pac Educ Rev. 2012 Sep;13(3):541\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eDiderichsen S, Andersson J, Johansson EE, Verdonk P, Lagro-Janssen A, Hamberg K. Swedish medical students\u0026rsquo; expectations of their future life. Int J Med Educ. 2011 Nov 24;2:140\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eGetachew, A. \u0026amp; Defar, A. Peer Group and Institutional Influence as Determinant Factors on Public University Students\u0026prime; Career Choices. J Organ Cult Commun Confl. 2023;27(3):1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eMANSI PRAVIN BHUJBAL SV. The Influence of Peer Pressure on Students: Cause, Effect, and Strategies for Intervention. Int J Multidiscip Res. 2024 Sep 28;6(5):28091. \u003c/li\u003e\n\u003cli\u003eC\u0026iacute;vico-Ariza A, Colomo-Maga\u0026ntilde;a E, Gonz\u0026aacute;lez-Garc\u0026iacute;a E, S\u0026aacute;nchez-Rivas E. Volunteering in the University Context: Student Perception and Participation. Educ Sci. 2020 Dec 15;10(12):380. \u003c/li\u003e\n\u003cli\u003eMustafa SMS, Radzi FAM, Hamzah KHJK. Participation in and Benefits of Volunteering Activities Among University Students. Int J Acad Res Bus Soc Sci. 2020 Jun 29;10(14):Pages 31-37. \u003c/li\u003e\n\u003cli\u003eWondimu H, Admas G. The motivation and engagement of student volunteers in volunteerism at the University of Gondar. Discov Glob Soc. 2024 Mar 25;2(1):22. \u003c/li\u003e\n\u003cli\u003eon behalf of the MedEd Collaborative, Byrne MHV, Ashcroft J, Alexander L, Wan JCM, Arora A, et al. COVIDReady2 study protocol: cross-sectional survey of medical student volunteering and education during the COVID-19 pandemic in the United Kingdom. BMC Med Educ. 2021 Dec;21(1):211. \u003c/li\u003e\n\u003cli\u003eGoodwin AM, Oliver SW, McInnes I, Millar KF, Collins K, Paton C. Professionalism in medical education: the state of the art. Int J Med Educ. 2024 Apr 29;15:44\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eAzer SA, Alhudaithi D, AlBuqami F, AlWaily H, AlRabah R, AlKhashan R. Online learning resources and social media platforms used by medical students during the COVID-19 pandemic. BMC Med Educ. 2023 Dec 19;23(1):969. \u003c/li\u003e\n\u003cli\u003eSantos RNLCD, Ribeiro KSQS, Anjos UUD, Farias DND, Lucena EMDF. Integralidade e Interdisciplinaridade na Forma\u0026ccedil;\u0026atilde;o de Estudantes de Medicina. Rev Bras Educ M\u0026eacute;dica. 2015 Sep;39(3):378\u0026ndash;87. \u003c/li\u003e\n\u003cli\u003eIan I. Llenares. Volunteerism is Associated with Improved Soft Skills of Marine Engineering Students in the Philippines. J Interdiscip Stud Educ. 8(2):57\u0026ndash;73. \u003c/li\u003e\n\u003cli\u003eMOTIVATIONS FOR VOLUNTEERISM AMONG FILIPINOCOLLEGE STUDENTS. Nternational J Educ Res [Internet]. 2015 Feb;3(2). Available from: http://www.ijern.com/journal/2015/February-2015/48.pdf\u003c/li\u003e\n\u003cli\u003eOmoto AM, Snyder M, Martino SC. Volunteerism and the Life Course: Investigating Age-Related Agendas for Action. Basic Appl Soc Psychol. 2000 Sep;22(3):181\u0026ndash;97. \u003c/li\u003e\n\u003cli\u003eOkun MA, Schultz A. Age and motives for volunteering: Testing hypotheses derived from socioemotional selectivity theory. Psychol Aging. 2003;18(2):231\u0026ndash;9. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Volunteering, Volunteer Activities, Medical Students, Medical Education","lastPublishedDoi":"10.21203/rs.3.rs-6854027/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6854027/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Participation in volunteer activities is crucial for enhancing medical students' skills. Research shows that those who engage in volunteer work display significantly superior competencies that are not easily acquired through traditional medical curricula. Furthermore, volunteering positively impacts students' academic performance, particularly during their preclinical years. \u003cbr\u003e\n \u003cstrong\u003ePurpose:\u003c/strong\u003e This study examines the key factors influencing Syrian medical students' involvement in volunteer activities to enhance these factors. \u003cbr\u003e\n \u003cstrong\u003eMethod: \u003c/strong\u003eConducted as a cross-sectional survey, the research includes 2,084 students from various medical faculties—medicine, dentistry, pharmacy, and health sciences—across public and private universities in Syria. A specialized questionnaire was developed and distributed both electronically and physically through faculty-affiliated groups. Logistic regression analysis was employed to identify factors predicting student participation. \u003cbr\u003e\n \u003cstrong\u003eResults:\u003c/strong\u003e Findings reveal that 836 students (40.1%) participate in volunteer activities. The most common types of volunteer work among students include academic scientific initiatives (67.7%, n=566 of N=836), non-medical community service (36.8%, n=308), medical educational community activities (25%, n=209), medical service initiatives within communities (13.2%, n=132), crisis response volunteering (17.3%, n=145), and participation in medical social media (17.9%, n=150). Key predictive factors for student participation include urban residency (OR=1.250, p=0.038), prior work experience (OR=2.123, p\u0026lt;0.001), enrollment in a public university (OR=2.467, p\u0026lt;0.001), pharmacy studies compared to health sciences (OR=1.788, p=0.010), early years of university study (p\u0026lt;0.001), and having a volunteering friend or sibling (OR=3.373, p\u0026lt;0.001). However, gender, economic status, and academic performance did not show statistically significant effects. Regarding students' perceptions of volunteering benefits, more than half agreed that it enhances communication skills, improves verbal and written expression, and strengthens their resumes. Less than half believed that volunteering increases opportunities for studying abroad compared to non-volunteers. \u003cbr\u003e\n \u003cstrong\u003eConclusion:\u003c/strong\u003e Given the essential role of medical students in advancing Syrian community development, efforts should focus on reinforcing the influential factors that drive student participation, thereby maximizing their engagement in volunteer work.\u003c/p\u003e","manuscriptTitle":"Volunteer Activities among Medical Students in Syria: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-18 10:01:30","doi":"10.21203/rs.3.rs-6854027/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-24T08:43:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-19T03:52:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"231702628277059962261311751721680425443","date":"2025-10-28T04:36:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-10T01:13:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65443386899388017829677441989319084339","date":"2025-10-10T01:08:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-10T13:07:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-10T13:06:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-10T06:12:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-20T16:59:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"Humanities and Social Sciences Communications","date":"2025-08-20T16:56:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"db332c1a-0194-4344-9c00-17b2e55f3d9c","owner":[],"postedDate":"September 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":54933150,"name":"Humanities/Medical humanities"},{"id":54933151,"name":"Social science/Education"},{"id":54933152,"name":"Social science/Social policy"},{"id":54933153,"name":"Social science/Sociology"}],"tags":[],"updatedAt":"2026-05-04T03:10:31+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-18 10:01:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6854027","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6854027","identity":"rs-6854027","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}