Undergraduate medical, health science, and technical students’ attitudes and knowledge on organ donation and transplantation 

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Raising awareness about organ donation and its medical benefits is one approach that could help dispel misunderstandings, improve willingness to donate, and increase the number of donors. This study aimed to examine the attitudes and knowledge of undergraduate students in medicine, health sciences, and technical fields regarding organ donation and transplantation, as well as to explore potential differences in perspectives across these groups. Methods An observational web-based questionnaire survey was created for Finnish undergraduate medical, health science, and technical students. The survey included both multiple-choice questions evaluated on a Likert scale from 1 to 5 and open-ended questions. Descriptive statistical analyses were used to evaluate the results. Results A total of 559 students completed the questionnaire, comprising 210 (37.6%) medical, 146 (26.1%) health science, and 203 (36.3%) technical students. Willingness to donate was significantly higher among medical and health science students compared to technical students (97.6%, 94.5%, and 85.7%, respectively; p < 0.001). A total of 42 respondents indicated they would not donate their organs after death. The prevalence of non-donors was lower among medical and health science students combined compared to technical students (3.7% vs. 14.3%; 95% CI for the difference: 5.8–16.3%; p < 0.001). Among non-donors, 78.6% expressed willingness to receive an organ if needed. Non-donors were less likely to have shared their opinion on organ donation compared to donors (21.4% vs. 69.2%, p < 0.001). Only 8.8% of respondents felt there is sufficient public discussion about organ donation and transplantation, while 45% considered brain death a valid definition of death. Conclusions Overall, willingness to donate organs after death is high (92.5%), with the highest willingness observed among medical students. A majority of the respondents expressed their will to donate organs and tissues. Most non-donors cited lack of knowledge as the main reason for not donating, though two-thirds of them indicated willingness to receive an organ if needed. Increased awareness about organ donation is necessary. 1. Introduction Organ donation from deceased donors consists of donation after brain death (DBD) and donation after circulatory determination of death (DCD). 1 Organ transplantation is a well-established medical procedure 2 and is often lifesaving for the recipient and sometimes the only treatment for end-stage organ failure. The biggest limiting factor for organ transplantation is the constant shortage of donated organs. 1 In Finland, the primary source for organ transplants remains DBD, but DCD has started to emerge due to a shortage of brain-dead donors. 3 According to the law, organs of a deceased person may be removed unless it is known or there is reason to assume that the person would have objected while still alive (opt-out consent). 4 This opt-out consent where silence is considered tantamount to consent has been considered to increase deceased donor rates, but it has been demonstrated that there is no significant difference compared with opt-in system countries where consent must be explicit. 1 Although, different outcomes have been observed. The introduction of the opt-out system in Wales in December 2015 led to an increase in consent rates compared with the rest of the United Kingdom which retained an opt-in system. 5 Another key ethical concern in organ donation is the role of families in overriding individual donation decisions. This issue is particularly relevant in opt-out systems, where a presumed consent policy may still be overridden by relatives, potentially impacting donation rates. 6 Public and social awareness plays a crucial role in organ donation, particularly in how individuals form attitudes toward donation. Studies suggest that younger generations engage with organ donation information differently, with social media and digital platforms acting as key channels to spread awareness. 7 Research indicates that presumed consent alone does not guarantee higher donation rates, and success depends on public awareness, trust in the healthcare system, and effective communication through media and healthcare professionals. 5 Healthcare professionals play a crucial role in the organ donation process, making their knowledge, attitudes, and willingness to support donation essential in improving donor rates and public trust. Accurate information about organ donation is important to correct common misconceptions, such as beliefs of being too old to donate or that religion prohibits it. Despite widespread support for organ donation, a significant gap exists between those who support it and those who are registered donors. For example, in Finland 83% of adults support organ donation, but only 38% have registered. 8 Increasing awareness can help bridge this gap. A single donor provides an average of over 30 additional life-years to patients in need of transplantation. 9 Awareness of these facts may affect attitudes towards organ donation. According to a 2020 survey conducted in Andalusia, Spain, 80% of medical students and 77% of nursing students supported organ donation. 10 According to a survey conducted in Poland in 2022, 73% of medical student respondents expressed they would agree to donate their organs, with religion having a significant effect on students' willingness to act as an organ donor after death. 11 In a German study, higher-year medical students showed more positive attitudes toward organ donation after death than students who had just started their studies. Health care field (medical, nursing, and other health sciences) did not have a significant effect on the willingness to be an organ donor after death, and 86.5% of respondents would be willing to donate organs. 12 The main purpose of this study was to investigate the attitudes and knowledge of undergraduate medical, health science, and technical students toward deceased organ donation and transplantation. Surveys from various countries show that medical and nursing students generally support organ donation. Despite widespread support for organ donation, there is a significant gap between those who support it and those who are registered donors. By surveying medical and health science students, our study aims to provide insights into how education and exposure to organ donation topics can influence attitudes. The hypothesis was that medical and health science students have more favorable attitudes toward organ donation and transplantation than students in the other fields of study. 2. Material and methods This observational survey study was conducted at the Faculty of Medicine and Faculty of Technology at the University of Oulu, and at the University of Applied Sciences during the autumn of 2023. The survey was sent to approximately 1500 undergraduate medical and health science students and students from different fields at the technical university including architecture, bioanalytics, radiography, occupational therapy, optometry, social work, dental hygiene, digital solutions for well-being, industrial engineering and management, computer science and engineering, environmental engineering, civil and construction engineering, electronics, mechanical engineering, biomedical engineering and process engineering. The Institutional Review Board (IRB) and ethics committee of Oulu University Hospital and the Northern Ostrobothnia Hospital District waived the need for ethical approval or a signed written informed consent from the participants. According to the research policies of the University of Oulu and Oulu University of Applied Sciences, an IRB permit was waived for studies that use general student surveys without requesting personal data. Since the survey contained indirect identifiers, a preliminary data protection assessment and notice were submitted to the National Data Protection Ombudsman which was approved by a data protection specialist and administrative head in Oulu University and Oulu University of Applied Sciences. Data collection adhered to EU GDPR standards and to the Finnish legislation, the Act on the Protection of Privacy in the Processing of Personal Data (1050/2018). A student register information request was filed via the University of Oulu’s digital services (for medical and technical students), and a survey permit was obtained through Oulu University of Applied Sciences' system (for health science students). No additional research permit was required. Information about the survey’s purpose and goals was included in the questionnaire. Students were informed beforehand that by answering the questionnaire the student consented to participation in the survey. Answering the survey was voluntary, and students had the option to stop at any stage of the survey. The questionnaire was based on a Finnish version previously used in similar surveys for healthcare professionals in Finland 13 , and the survey questions in the present study were modified for undergraduate students (Supplementary file 1: The Survey Questionnaire). The material was collected electronically with a Google Forms questionnaire distributed to students using general e-mail lists of the targeted fields of study. Answering was done anonymously, without any identifying data. The questionnaire consisted of both open and multiple-choice questions. Some of the questions used a 5-point Likert scale (1 = totally disagree to 5 = totally agree). In terms of the success of the project, the most critical factors were reluctance to participate in the survey and the low number of responses. To reduce this risk, we twice sent information about participating in the survey via email lists. The electronic materials collected during the research were stored in Oulu University’s data center, to which only the researchers had access. The files were used only for the pre-agreed research purpose. The data were collected and reported in such a way that no individual survey participant could be identified. Descriptive and statistical analyses were performed using SPSS for Windows software (IBM SPSS Statistics for Windows, version 27.0; IBM Corp, Armonk, New York). Categorical data are expressed as numbers (n) and percentages (%). The question of whether the respondent would donate his or her own organs and tissues after death was used to calculate the power analysis and the required sample size. Two different power analysis models were used to calculate the sample size. In the first calculation, the sample size was calculated assuming that 80 percent of all respondents have a positive attitude towards organ donation, which is in line with previous European research. 10 According to the first power analysis, with a confidence interval of 95% and a margin of error of 5%, at least 246 survey respondents were needed. The second power analysis was calculated as above, but with the assumption that the favorability of organ donation among technical students would be 10 percent lower than that of both medical and health science students. To detect this difference, at least 247 technical students and 247 health science students would be required to participate in the survey. Assuming a response rate of about 50 percent, the survey needed to be sent to at least 988 (2 x 494) students. The difference between health science or medical students and technical students is represented as a percentage unit with 95 percent confidence interval. For continuous variables, between-group comparisons were performed using analysis of variances or Welch’s test. 3. Results In total, 559 students completed the questionnaire, of which 210 (37.6%) were medical, 146 (26.1%) health science, and 203 (36.3%) technical students (Table 1 ). The median age of the respondents was 23 years [21–27], 77.6% were female, and 48% were first- or second-year students. The proportion of respondents older than 35 years was highest among health science students compared with medical and technical students (18.5%, 3.8% and 9.4%, respectively). Of the technical students, 14.8% had previous healthcare education and 24.6% of them had work experience in healthcare (Table 2 ). Table 1 Willingness to donate one's organs after death. ALL, n = 559 (100%) Medical students, n = 210 (37.6%) Health science students, n = 146 (26.1%) Technical students, n = 203 (36.3%) p-value Would you donate your organs after death? < 0.001 Yes, n (%) 517 (92.5%) 205 (97.6%) 138 (94.5%) 174 (85.7%) No, n (%) 42 (7.5%) 5 (2.4%) 8 (5.5%) 29 (14.3%) Table 2 Background variables. Regarding willingness to donate *p < 0.001 between medical, health science, and technical students. ALL, n = 559 (100%) Medical students, n = 210 (37.6%) Health science students, n = 146 (26.1%) Technical students, n = 203 (36.3%) Sex Female 434 (77.6%) 170 (90.0%) 133 (91.1%) 131 (64.5%) Age Median 23 (IQR 21–27) 18–24 325 (58.3%) 138 (65.7%) 72 (49.3%) 116 (57.1%) 25–34 179 (32.1%) 64 (30.5%) 47 (32.2%) 68 (33.5%) 35–44 36 (6.5%) 7 (3.3%) 18 (12.3%) 11 (5.4%) 45–54 14 (2.5%) 1 (0.5%) 7 (4.8%) 6 (3.0%) ≥ 55 4 (0.7%) - 2 (1.4%) 2 (1.0%) Academic years 1–2 267 (47.8%) 112 (53.3%) 62 (42.5%) 93 (45.8%) 2–4 201 (36.0%) 63 (30.0%) 72 (49.3%) 66 (32.5%) 4–6 76 (13.6%) 31 (14.8%) 9 (6.2%) 36 (17.7%) > 6 15 (2.7%) 4 (1.9%) 3 (2.1%) 8 (3.9%) Previous education in - Healthcare 109 (19.5%) 24 (11.4%) 55 (37.7%) 30 (14.8%) - Technical 31 (5.5%) 6 (2.9%) 4 (2.7%) 21 (10.3%) - Neither 419 (75.0%) 180 (87.5%) 87 (59.6%) 152 (74.9%) Any work experience in healthcare 231 (41.3%) 81 (38.6%) 100 (68.5%) 50 (24.6%) IQR = interquartile range [25th − 75th percentile] 3.1 Willingness to donate The main outcome, willingness to donate, is presented in Table 1 . Of all 559 students, 517 (92.5%) would be willing to donate their organs after death. A total of 42 (7.5%) respondents would not donate their organs after death. There was a significant difference in the prevalence of non-donors between medical and health science students combined and technical students (3.7% vs. 14.3% [95% CI of the difference: 5.8–16.3%], p < 0.001). Those not willing to donate had less information about the subject compared with those willing to donate (19% vs. 55.1%, p < 0.001,), and had received less education on the subject (7.1% vs. 19.5%, p < 0.013) (Table 4 ). Eight of the students not willing to donate (19%) were worried that their organs would go to someone who does not deserve them. Non-donors less often expressed their own opinions about donation compared with donors (21.4% vs. 69.2%, p < 0.001). Table 3 Comparison of responses from students refusing to donate their organs with those who would donate. Would not donate, n = 42 Would donate, n = 517 p-value Gender, Female 31 (73.8%) 403 (77.9%) 0.45 Age n (%) 0.15 18–24 31 (73.8) 294 (56.9%) 25–34 8 (19.0) 171 (33.1%) 35–44 2 (4.8) 34 (6.6%) 45–54 - 14 (2.7%) ≥ 55 1 (2.4) 3 (0.6%) Field of Study < 0.001 Medical students 5 (11.9%) 205 (39.7%) Health science students 8 (19.0%) 138 (26.7%) Technical students 29 (69.0%) 174 (33.7%) Previous education from healthcare 8 (19.0%) 101 (19.5%) 0.5 “I am willing to receive an organ from a brain-dead donor if needed.”, YES 33 (78.6%) 500 (96.7%) < 0.001 “Do you think it is right that you can get a new organ or tissue transplant even if you refuse to donate your own organs after death?” 0.93 YES 21 (52.5%) 257 (49.7%) Unsure 11 (27.5%) 149 (28.8%) “What is your opinion regarding your close one’s refusal to be an organ donor?”: APPROVE OR DON’T HAVE OPINION 42 (100%) 472 (91.3%) 0.003 “If I have or would have children, I would agree to donate my child’s organs and tissues after death.” YES 11 (26.2%) 398 (77.0%) < 0.001 “Organ donation after death saves lives.” YES 100% 100% “Have you expressed your will to donate organs and tissues?” YES 9 (21.4%) 358 (69.2%) < 0.001 “The patient cannot be an organ donor if…” DON’T KNOW 21 (50.0%) 208 (40.2%) “Brain death is a valid definition of death.” YES 18 (45.0%) 322 (62.4%) “If you answered 'No' or 'I don’t know' to the survey item ‘Brain death is a valid definition of death’, the reason is…” 0.003 Doubts about brain death diagnostics 7 (16.7%) 29 (5.6%) “Lack of information and knowledge about organ donation.” 14 (33.3%) 160 (30.9%) “The decision on the suitability of a potential organ donor’s organs should be made by a transplantation surgeon.” 11 (26.2%) 125 (24.2%) 0.40 “During the past year, have you heard, read, or seen information about organ transplantation or donation?” YES 6 (14.3%) 136 (26.3%) 0.13 “Is there enough information available?” YES 5 (11.9%) 139 (26.9%) 0.24 “I have received education about organ donation and transplantation during my studies.” AGREE 3 (7.1%) 101 (19.5%) 0.013 “I think there is enough public discussion about organ donation and transplantation.” AGREE 2 (4.8%) 47 (9.1%) 0.07 “I have enough information about organ donation and transplantation.” AGREE 8 (19.0%) 285 (55.1%) 0.001 Table 4 Knowledge about and willingness to receive an organ or tissue transplant from a brain-dead donor. All, n = 559 Medical students, n = 210 Health science students, n = 146 Technical students, n = 203 p-value “I have received education about organ donation and transplantation during my studies.” < 0.001 Agree 104 (18.6%) 61 (29.1%) 33 (22.6%) 10 (4.9%) Undecided 50 (8.9%) 24 (11.4%) 17 (11.6%) 9 (4.4%) Disagree 386 (69.1%) 118 (56.2%) 96 (65.8%) 172 (84.8%) Did not answer 19 (3.4%) 7 (3.3%) 12 (5.9%) “During the past year, have you heard, read, or seen information about organ transplantation or donation?” < 0.001 Yes 142 (25.5%) 77 (13.8%) 43 (7.7%) 22 (4.0%) “I have enough information about organ donation and transplantation.” < 0.001 Agree 293 (52.4%) 124 (59.0%) 90 (61.6%) 79 (39.0%) Undecided 71 (12.7%) 24 (11.4%) 11 (7.5%) 36 (17.7%) Disagree 194 (34.7%) 61 (29.1%) 45 (30.8%) 88 (43.3%) Did not answer 1 (0.2%) 1 (0.5%) - - “Do you think there is enough information available about organ donation and transplantation?” 0.14 Yes 144 (38.4%) 82 (39.0%) 93 (63.7%) 7.4 (7.4%) “I think there is enough public discussion about organ donation and transplantation.” 0.56 Agree 49 (8.8%) 17 (8.1%) 18 (12.3%) 14 (6.9%) Undecided 131 (23.4%) 51 (24.3%) 28 (19.2%) 52 (25.6%) Disagree 379 (67.8%) 142 (67.6%) 100 (68.5%) 137 (67.5%) “Do you think it is right that you can get a new organ or tissue transplant even if you refuse to donate your own organs after death?” 0.016 Yes 278 (49.9%) 108 (51.4%) 62 (42.5%) 108 (53.2%) No 119 (21.3%) 43 (20.5%) 28 (19.2%) 48 (23.6%) I don’t know 160 (28.8%) 59 (28.1%) 56 (38.3%) 47 (23.2%) “If in need, I would be willing to receive organ or tissue transplantation from a brain-dead donor.” 553 (95.3%) 203 (96.7%) 142 (97.3%) 188 (92.6%) 0.106 “I would agree to my own child being an organ donor after his/her death.” (opinion regardless of whether the respondent has children or not) 0.025 Yes 409 (73.2%) 169 (80.5%) 103 (70.5%) 137 (67.5%) No 14 (2.5%) 2 (1.0%) 4 (2.7%) 8 (3.9%) I don’t know 136 (24.3%) 39 (18.6%) 39 (26.7%) 58 (28.6%) In addition, 95.3% would be willing to receive an organ if needed. Willingness to receive an organ if needed was highest among those willing to donate (96.7% vs. 78.6%, p < 0.001). Comparing non-donors and donors, there was no significant difference in the opinion as to whether it is right to receive an organ even though one refuses to donate their own organs (52.5% vs. 49.7%). The willingness to have one's own child’s organ(s) donated in case of the child's brain death was lowest in those not willing to donate (26.2% vs. 77.0%, p < 0.001) (Table 3 ). Of all the respondents, 49.9% felt that it would be right to receive an organ even if they would refuse to donate their own organs. This opinion was least common among health science students followed by medical and technical students (42.5%, 51.4% and 53.2%, respectively, p = 0.016). The willingness to have one's own child's organ(s) donated after death was highest among medical students followed by health science and technical students (80.5% vs. 70.5% vs. 67.5%, p = 0.025) (Table 4 ). Of all the respondents, 66.2% did not know their loved one’s intent regarding donating organs or tissues after death. Also, 78.8% agreed that it would be normal to discuss organ donation with their loved ones. Of those who would refuse to donate their organs after death, 50% (21/42) found it natural to discuss organ donation. Further, 361/559 (64.6%) would accept their loved one’s organs being donated even if they did not know if that person had consented or what their opinions were about organ donation, and 8.1% of the students would not accept their loved one’s negative opinion about organ donation. 3.2 Knowledge Of the respondents, 69.1% had not been educated about organ donation and transplantation during their studies (Table 4 ). The percentage of those affirming that they had received education was highest among medical students, second highest among health science students, and lowest among technical students (29.1%, 22.6%, and 4.9%, respectively, p < 0.001). The proportion of medical and health science students who felt they had enough information about the subject was significantly higher than technical students (59.0%, 61.6%, and 39%, respectively, p < 0.001). Of the respondents, 67.8% stated that there is not enough public discussion about organ donation and transplantation. Overall, 60.8% of all students considered brain death to be a valid definition of death, and 36 (16.7%) of the students expressed doubts related to the definition of brain death. The rate of not accepting brain death as a valid definition of death was lower among those not willing to donate than among those willing to donate (45% vs. 62.4%, p < 0.01) (Table 3 ). Out of the 42 respondents who would not donate their organs after death, 19 (45.2%) would like to receive more education and theoretical information about brain death, 18 (42.9%) on how to identify potential organ donors, 19 (45.2%) on tissue donation and transplantation in general, 18 (42.9%) about legislation and how to start a discussion and support loved ones and 18 (42.9%) how to address a patient’s own desire to donate organs. Reasons for refusing to donate organs after death are presented in Table 5 . Table 5 Reasons for refusing to donate organs after death. Medical students Health science students Technical students All Don’t have enough knowledge or information about organ donation. 4/42 2/42 16/42 22/42 Personal reasons 3/42 3/42 2/42 8/42 Religious or philosophical reasons 1/42 3/42 4/42 8/42 Organs might end up being given to someone who does not deserve them 3/42 2/42 3/42 8/42 Belief that one’s organs do not qualify - - 7/42 7/42 Doubts related to brain-death diagnosis 1/42 - 3/42 4/42 Do not trust the healthcare system - - 1/42 1/42 4. Discussion A key objective was to examine whether medical and health science students have more favorable attitudes toward organ donation than technical students. While previous research has primarily focused on healthcare students and professionals, this study includes students from non-health disciplines to compare how different educational backgrounds influence attitudes and knowledge. It also highlights gaps in knowledge and underscores the impact of insufficient education on shaping perspectives on organ donation and transplant. The overall willingness to donate among students is high. Our survey found three main results. First, the highest willingness to donate was among medical students, while more than 10 percent of technical students would not be willing to donate their organs. Second, more than two-thirds of the non-donors were willing to receive an organ if needed. And third, non-donors would like to receive more education and theoretical information about brain death, about how to identify potential organ donors, about tissue donation and transplantation in general, and about legislation. Our survey indicates that medical and health science students have more positive opinions about organ donation than technical students. This finding supports the primary hypothesis of the study and supports the results of previous surveys. 14 The willingness to donate among medical and nursing students is higher than it is among medical professionals and the general population. Based on a national survey of medical professionals in 2020, 88%, 15 and in 2023, 95%, 13 of hospital staff would donate their own organs and tissues after death. In the US, a survey of surgical attendings, residents, and medical students found that willingness to donate correlated inversely with professional experience, with the highest willingness among medical students (77%). 16 In the US questionnaire, previous experiences with the organ procurement procedure influenced physicians’ negative attitudes. The number of non-donors in our study was less than in a study of medical students in Buenos Aires, in which 18.1% were not willing to donate their organs after death. 17 In that study, reasons for refusal included fears about the possibility of not being dead (36.4%), lack of confidence in (25.8%) or lack of information about the organ procurement and transplantation system (14.6%), no interest in organ donation (9.3%), and religious reasons (6%). The main reasons in the present study were the lack of knowledge about organ donation, personal and religious reasons, and concern that organs might end up in someone who does not deserve them. More than half of the students who would not donate their organs after death stated that they do not have enough information about the subject. Thus, increasing public knowledge about organ donation and correcting misleading information would likely result in more positive attitudes. 18 Our study had an open-ended question asking where respondents obtained information about organ donation. However, due to the heterogeneity and wide variation in responses—from official sources (e.g., scientific publications, lectures, work, school) to various media platforms, including social media—we did not analyze it in detail. Other studies have shown that educational information about organ donation on social networks significantly influences public knowledge and attitudes, especially among young people. 7 , 19 For example, a Spanish study found that an audiovisual website about donation and short films published on YouTube, increased support for organ donation (85–97%), willingness to donate (64–79%), and knowledge of brain death (80–92%). 19 In the present study, understanding the source of information would have been valuable, as it can influence perceptions and attitudes toward donation. A notable finding from the survey used in this study was that the attitude toward organ donation is more favorable among medical students than technical students. Interestingly, the same was true of medical students compared with health science students, similar to the findings of a previous study carried out in Spain. 10 Again, a more favorable attitude was associated with students having been educated about the subject during their studies. In our survey, 29.1% of the medical students surveyed had received education about organ donation during their studies compared to 22.6% of the health care students. For comparison, 61.6% of the health care students considered brain death was a valid definition of death, while the number among medical students was 67.6%. It has been found that 20–25 potential organ donors remain unrecognized every year in Finland. 20 Other recent studies have also found that medical and health science students are aware of the fact that they do not receive enough education about the subject during their studies. 10 , 12 , 21 , 22 It is crucial to remedy this early in the education of future health care professionals who may be able to influence organ donation rates. 21 In a large survey of Italian university students, only 40.8% considered themselves informed about medical procedures involving organ donation, and only 15.8% thought they had sufficient legal information. 23 Perhaps another way to fill information gaps would be to offer an educational program delivered by a transplant physician and a transplant recipient. A Japanese study found that such a program may alter the attitudes of medical students towards deceased donation. 24 Furthermore, if college students were aware of the positive attitudes of other college students toward organ donation, they might be more likely to sign the organ donation card and to discuss the topic with their loved ones. 25 The rate of not acknowledging brain death as a valid definition of death was lower among those not willing to donate than among those willing to donate. In a single university survey, 81.3% of medical students accepted the definition of brain death, 26 and according to another study, brain death was considered irreversible by 51% among those not willing to donate. 17 A Canadian survey found that among medical students, only 76% acknowledged that someone could be neurologically deceased while maintaining a heartbeat, and 69% were not aware of the option of non-heart beating donation. 22 The uncertainty associated with general information such as brain death being a valid definition of death was revealed in this study and has been reported in other studies. 12 , 18 Tackmann et al. 12 found that only about half of the students knew all the correct answers to questions regarding brain death. In a national survey conducted in Finland in 2023, 69% of healthcare professionals knew that the declaration of brain death establishes the time of death. 14 The results of the present and previous studies suggest the need for education regarding the definition of brain death. Knowledge about brain death is also lacking in the general population. Previous studies have shown that only one-third of the elderly (> 65 years old) understood the concept of brain death creating negative attitudes toward organ donation. 27 An annual survey conducted in Finland in 2023 also showed that elderly people were more reserved about receiving a transplant organ. 28 In our study, we did not have specific question addressing brain death and whether the respondents have a clear understanding of this concept. According to the results of the most recent poll commissioned by the Kidney and Liver Association in 2023, 83% of Finns are supportive of the idea of donating their organs after death, 86% would accept an organ transplant if needed and and 88% of Finnish healthcare professionals have expressed their will to donate organs.. 15 However, only 38% of Finns have confirmed their will to donate by adding themselves to the organ donor registry. 8 There is also a significant relationship between the extent of positive attitudes toward organ donation held by English medical and nursing students and their personal willingness to donate organs: 74% of the nursing students had already signed a donor card, compared with only 43% of the medical students. 29 Reasons behind refusal to donate organs are various, and one of the biggest factors cited in previous studies is religion. 11 In our study, religion was not a major factor for refusal. Interestingly, the majority of non-donors were women. This conflicts with other studies stating that a person's sex does not reflect their attitude toward organ donation; 11 on the other hand, women have more favorable opinions about organ donation and transplantation. 10 , 22 In this study, we noticed that negative opinions regarding organ donation might be associated with misinformation about organ donation and how organ and tissue procurement is performed (e.g., the misconception that organ donation is incompatible with an open casket funeral). Our survey also asked what words would students use to describe organ donation or what kinds of feelings does organ donation evoke in them. Positive words chosen by most students were “opportunity”, “valuable” and “positivity”. The most chosen negative words were “uncertainty”, “complicated” and “weird”. Also, words such as “painful”, “suspicious”, “fear” and “disrespectful” were chosen. This may reflect general misinformation about organ donation, and how the received information might be interpreted as negative. Another worrying finding about the students' attitudes was that a notable number of them were concerned that their organ would go to someone who would not deserve it. We conclude from this that people can be highly uninformed about the organ donation procedure and organ donation in general, and that their attitudes and beliefs can be overshadowed by false information. We deduce from the results of this and previous studies that educating the public about organ donation and transplantation in general may result in more favorable attitudes and lessen people's concerns. 13 , 18 As has been noted, the level of knowledge of nonmedical students and people in general about organ donation is remarkably low. 13 Another important factor affecting donation rates is uncertainty about a loved one’s consent to donate after death. 11 , 21 Two-thirds of the students in this study would not be able to confirm their loved one’s consent if asked; this can be associated with the subject being undiscussed between relatives. Although almost 80% of the students finds it natural to talk about organ donation with their loved ones, only 42.4% had informed their loved one of their position on this. Surprisingly, although only 33.8% knew their loved one’s position on organ donation, 64.6% would accept organs of their loved ones being donated after death. As McGlade and Pierscionek stated in their survey, 21 being educated about organ donation is associated with being more comfortable initiating conversations about it. 4.1. Strengths and Limitations The sample size was based on a power analysis. The present study includes a diverse range of students from different fields, offering a broad perspective on attitudes toward organ donation. Furthermore, we were able to recruit a relatively large sample size of technical students to compare the impact of study field on the results. We had no information on the response rate, and this may lead to response bias. Also, there is no certainty that students responded to the survey only once, as it was sent to general email lists to protect anonymity. However, double responses are thought to be unlikely because responding was time-consuming and respondent characteristics differ considerably. Also, a positive attitude towards donations and general motivation for participation in questionnaires may have affected willingness to participate in the study. The study relies on self-reported data, which may be subject to bias or inaccuracies. No external motivation factors were used. Our primary focus was on students' overall attitudes rather than their in-depth medical knowledge, and we did not specifically evaluate their understanding of the brain death concept. Including more detailed questions could have provided a deeper insight into students’ comprehension of the organ donation process. The study did not analyze the sources of organ donation information in detail, which could have provided deeper insights into how information influences attitudes. Additionally, the study assumes the information received by students is beneficial without assessing its accuracy or impact. A notable factor was that a majority of the respondents were in their first or second year of their studies; therefore, we were not able to compare the knowledge gained during their studies. Our results may not be generalized to other university-level programs, to other cultural backgrounds or to those who have completed a formal curriculum on organ donation, as well as students ´age and grade of studies, all of which are known to affect attitudes towards organ donation. 30 4.2. Recommendations This study's findings encourage us to enhance organ donation education and target it to undergraduate students. To improve knowledge about organ donation and transplantation among medical and health science students, there should be regularly performed interventions such as lectures during school years. 12 Even a short intervention on the subject can increase students' knowledge and guide them to pay more attention to the subject in the future. 21 This would make the subject more familiar and information more available to the students, especially regarding discussion with patients when necessary. 12 , 22 To improve knowledge about organ donation and transplantation, it is important to implement regular educational programs with precise information and encourage medical students to share information with the public. 31 The effect of education on more favorable attitudes toward organ donation is significant and can be seen in a comparison between early stage and upper stage students. 12 Increasing health care professionals' knowledge may affect every step of the organ donation path, starting from early identification of donors. To address the issue of public awareness, information about organ donation and general information about the whole process—the path of organs from donor to recipients—should be provided in a form that is easy for the public to access and understand. Educating the public, even young students, about organ donation can help dispel myths and misconceptions, raise awareness that leads to more informed decisions, and even influence decisions about joining or intending to join the organ donation registry. 32 , 33 Social media campaigns can have immediate and dramatic impacts on organ donor registration rates. 34 Already proven to be effective, 18 , 31 , 34 social media can be used to raise awareness and serve as a platform for sharing information. However, for future education there are numerous opportunities to create interactive educational tools, intelligent tutorials, personalized virtual learning environments, and chatbots with artificial intelligence 35 to educate students and the general public about organ donation and transplantation. The results of our survey support the conclusion that increased public awareness about organ donation is greatly needed, as most respondents had not seen, heard, or read any information about the subject during the past year. Future studies should analyze the sources of information about organ donation in detail to better understand their impact on attitudes and knowledge. Further, intervention studies should be conducted to assess the effectiveness of educational programs, social media and digital platforms, as well as to track changes in attitudes and knowledge as students progress through their education. 4.3 Conclusion The overall willingness to donate is high among medical, health care and technical students, with the highest willingness found among medical students. A majority of the respondents have expressed their will to donate organs and tissues. Non-donors cited lack of knowledge as the reason not to donate, but two-thirds of the non-donors were willing to receive an organ transplant if needed. More awareness about organ donation is needed through enhancing public awareness using social media platforms, addressing common misconceptions about organ donation and providing education for healthcare professionals. Abbreviations DBD donation after brain death DCD donation after circulatory determination of death GDPR General Data Protection Regulation Declarations Ethics approval and consent to participate The Institutional Review Board (IRB) and ethics committee of Oulu University Hospital and the Northern Ostrobothnia Hospital District waived the need for ethical approval as well as a signed written informed consent from the participants. The survey is in accordance with the Finnish National Board on Research Integrity TENK guidelines 2019 and with the guidelines of the Declaration of Helsinki. According to the research policies of the University of Oulu and Oulu University of Applied Sciences, an IRB permit is waived for studies that use general student surveys without requesting personal data. Since this study survey contained indirect identifiers, a preliminary data protection assessment and notice were submitted to the National Data Protection Ombudsman, which was approved by a data protection specialist and administrative head at Oulu University and Oulu University of Applied Sciences. Data collection adhered to EU GDPR standards and to the Finnish legislation, the Act on the Protection of Privacy in the Processing of Personal Data (1050/2018). A student register information request was filed via the University of Oulu’s digital services (for medical and technical students), and a survey permit was obtained through the Oulu University of Applied Sciences' system (for health science students). No additional research permit was required. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This study was supported only by departmental funding. Conflict of interests The authors have no conflict of interest. Authors' contributions IS, PL, and TA conceptualized and designed the research framework, developed and implemented the methodology, conducted the investigation, performed the formal analysis and interpreted the data, managed and curated the research data, and were responsible for drafting the original manuscript. Additionally, PL and TA supervised the research project. AMK, SS, and HMS participated in conceptualizing and designing the research, developing the methodology, analyzing the data, and drafting and reviewing the original manuscript. SS also managed and curated the research data. All authors read and approved the final manuscript. Acknowledgements Not applicable. Clinical trial number Not applicable References European Parliament Think Tank. 2023. Organ donation and Transplantation, Facts, figures and European Union Action, European Parliamentary Research Service, 2021. [Website] [Search 22.5.2023] Available: https://www.europarl.europa.eu/thinktank/fi/document/EPRS_BRI(2020)649363 Helantera I, Isola T, Lehtonen TK, Åberg F, Lempinen M, Isoniemi H. Association of clinical factors with the costs of kidney transplantation in the current era. Ann Transpl. 2019;24:393–400. 10.12659/AOT.916888 . HUS Health District of Helsinki and Uusimaa. [Website] [Searched 22.5.2023] Available: https://www.hus.fi/ammattilaiselle/elinluovutus-ja-siirtotoiminnan-ammattilaismateriaalia Act on the Medical Use of Human Organs, Tissues and Cells 101/2001. Edita Publishing Oy. [Website] [Searched 25.5.2023]. Available: https://www.finlex.fi/fi/laki/ajantasa/2001/20010101 Madden S, Collett D, Walton P, Empson K, Forsythe J, Ingham A et al. The effect on consent rates for decease dorgan donation in Wales after the introduction of an opt-out system. Anaesth 2020 75(9):1146–52. 10.1111/anae.15055 Shaw D, Georgieva D, Haase B, Gardiner D, Lewis P, Jansen N, et al. Family Over Rules? An Ethical Analysis of Allowing Families to Overrule Donation Intentions. Transplantation. 2017;101:482–7. 10.1097/TP.0000000000001536 . Almela-Baeza J, Febrero B, Ramírez P. Teenagers, audio-visual prosumers and audience generators in the field of organ donation. Health Commun. 2024;39(9):1825–32. 10.1080/10410236.2023.2243661 . YES to organ donation. [Website] [Searched 3.6.2023]. Available: https://www.elinluovutuskortti.fi/ajankohtaista/tuoreen_gallupkyselyn_tulokset_suomalaiset_eivat_tunne_laheisensa_elinluovutustahtoa.1041.news Schnitzler MA, Whiting JF, Brennan DC, Lentine KL, Desai NM, Chapman W, Abbott KC, Kalog Z. The life-years saved by a deceased organ donor. Am J Transpl. 2005;5(9):2289–96. 10.1111/j.1600-6143.2005.01014.x . Martubez-Alarcon L, Rios A, Gutierrez PR, Gomez FJ, Canadas-De la Fuente GA, Garcia-Mayor S et al. Attitudes toward organ donation: differences between medical and nursing Andalusian students. Transplant Proc. 2020;52:496–499. 10.1016/j.transproceed.2020.01.015 Mikla M, Cybulska AM, Schneider-Matyka D, Ríos A, Panzyk M, Kotwas A, et al. A multicentre study of the attitude of medical students towards organ donation and transplantation in Poland. Int J Environ Res Public Health. 2023;20(4):3711. 10.3390/ijerph20043711 . Tackmann E, Kurz P, Dettmer S. Attitudes and knowledge about post-mortem organ donation among medical students, trainee nurses, and students of health sciences in Germany. Anaesthesist. 2020;69(11):810–20. 10.1007/s00101-020-00809-y . Stauffer H-M. and University Hospital donor coordinators, Helsinki, Oulu, Turku, Kuopio and Tampere Universities, coordinated by Helsinki University Hospital National Survey of Organ Donation Attitudes and Practices 2023. Helsinki University Hospital. Nowak E, Pfitzner R, Kozlikc P, Kozynackac A, Durajskic Ł, Przybyłowskib P. Current state of knowledge, beliefs, and attitudes toward organ transplantation among academic students in Poland and the potential means for altering them. Transplant Proc. 2014;46(8):2509–2518. 10.1016/j.transproceed.2014.09.030 Vaskelainen E. and University Hospital donor coordinators, Helsinki, Oulu, Turku, Kuopio and Tampere Universities, coordinated by Helsinki University Hospital. National Survey of Organ Donation Attitudes and Practices 2020. [Searched 23.5.2023]. Kuopio University Hospital. Hobeika MJ, Simon R, Malik R, Pachter HL, Frangos S, Bholat O, et al. U.S. surgeon and medical student attitudes toward organ donation. J Trauma. 2009;67:372–5. 10.1097/TA.0b013e3181ad656e . Atamanuk AN, Ortiz Fragola JP, Giorgi M, Berreta J, Lapresa S, Ahuad-Guerrero A et al. Medical students’ attitude toward organ donation: understanding reasons for refusal in order to increase transplantation rates. Transplant Proc. 2018;50:2976–2980. 10.1016/j.transproceed.2018.03.061 Lewis A, Koukoura A, Tsianos GI, Gargavanis AA, Nielsen AA, Vassiliadis E. Organ donation in the US and Europe: the supply vs demand imbalance. Transpl Rev. 2021;35(2):100585. 10.1016/j.trre.2021.100585 . Febrero B, Almela-Baeza J, Ros I, Pérez-Sánchez B, Pérez-Manzano A, Cascales P, et al. The impact of information and communications technology and broadcasting on YouTube for improving attitude toward organ donation in secondary education with the creation of short films. Patient Educ Couns. 2021;104(9):2317–26. 10.1016/j.pec.2021.02.037 . Elin- ja kudossiirrot. Lääkäriliitto. Accessed February 12. 2025. Available in Finnish at: https://www.laakariliitto.fi/laakarin-etiikka/hoidon-erityiskysymyksia/elin-ja-kudossiirrot/ McGlade D, Pierscionek B. Can education alter attitudes, behaviour and knowledge about organ donation? A pretest-post-test study. BMJ Open. 2013;30(12):e003961. Robert P, Begin F, Ménard-Castonguay S, Frenette AJ, Quiroz-Martinez H, Lamontagne F, et al. Attitude and knowledge of medical students about organ donation: training needs identified from a Canadian survey. BMC Med Educ. 2021;21(1):368. 10.1186/s12909-021-02796-4 . Terraneo M, Caserini A. Information matters: attitude towards organ donation in a general university population web-survey in Italy. Int J Sociol Soc Policy. 2022;42(13–14):1–14. 10.1108/IJSSP-09-2021-0228 . Murakami M, Fukuma S, Ikezoe M, Nakamura M, Yamamoto Y, Yamazaki S, et al. Effect of an educational program on attitudes towards deceased organ donation. Ann Transplant. 2015;14:20. Marshall HM, Feeley TH. A normative approach to shaping college students' attitudes toward organ donation. Commun Stud. 2006;57:435–53. 10.1080/10510970600945969 . Rydzewska-Rosołowska A, Jamiołkowska M, Kakareko K, Naumnik B, Zbroch E, Hryszko T. Medical Students' Attitude Toward Organ Donation in a Single Medical University. Transplant Proc. 2020;52(3):695–699. Febrero B, Ros I, Almela-Baeza J, Pérez-Sánchez MB, Rodríguez JM, Ruiz-Manzanera JJ et al. Knowledge of the Brain Death Concept Among Older People. Transplant Proc. 2020;52(2):506–508. 10.1016/j.transproceed.2019.09.019 Kansalaisten käsityksetelinluovutuksesta. 2023. Published March 2024. Accessed February 12, 2025. Available in Finnish at: https://elinluovutuskortti.fi/wp-content/uploads/sites/4/2024/03/Kansalaisten-kasitykset-elinluovutuksesta-gallup-2023.pdf[1](https://elinluovutuskortti.fi/wp-content/uploads/sites/4/2024/03/Kansalaisten-kasitykset-elinluovutuksesta-gallup-2023.pdf ). Cantwell M, Clifford C. English nursing and medical students’ attitudes towards organ donation. J Adv Nurs. 2000;32(4):961–8. 10.1046/j.1365-2648.2000.t01-1-01556.x . Iniesta-Sepúlveda M, López-Navas AI, Gutiérrez PR, Ramírez P, Ríos A. The willingness to donate organs in medical students from an international perspective: a meta-analysis. Transpl Int. 2022;28:35–10446. Radunz S, Benkö T, Stern S, Saner FH, Paul A, Kaiser GM. Medical students’ education on organ donation and its evaluation during six consecutive years: results of a voluntary, anonymous educational intervention study. Eur J Med Res. 2015;20:23. 10.1186/s40001-015-0116-6 . Byrne M, Stainer B, Symington M, Leighton J, Jackson H, Singhal N, Patel S, Shiel-Rankin S, Mayes J, Mogg J, Bonham T, Smit A, Deutsch E, Thompson E, Wilson C. School education to increase organ donation and awareness of issues in transplantation in the UK. Pediatr Transpl. 2019;23:e13492. 10.1111/petr.13492 . Steenaart E, Crutzen R, Candel MJJM, de Vries NK. The effectiveness of an interactive organ donation education intervention for Dutch lower-educated students: a cluster randomized controlled trial. Trials. 2019;20:643. 10.1186/s13063-019-3882-6 . Cameron AM, Massie AB, Alexander CE, Stewart B, Montgomery RA, Benavides NR, Fleming GD, Segev DL. Social media and organ donor registration: the Facebook effect. Am J Transpl. 2013;13:2059–65. 10.1111/ajt.12312 . Zhang K, Aslan AB. AI technologies for education: Recent research & future directions. Computers Education: Artif Intell. 2021;2:100025. https://doi.org/10.1016/j.caeai.2021.100025 . Additional Declarations No competing interests reported. Supplementary Files Supplementaryfile1Questionnaire.pdf Cite Share Download PDF Status: Published Journal Publication published 18 May, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 23 Apr, 2025 Editor assigned by journal 23 Apr, 2025 Reviews received at journal 21 Apr, 2025 Reviewers agreed at journal 21 Apr, 2025 Reviewers invited by journal 17 Apr, 2025 Submission checks completed at journal 12 Apr, 2025 First submitted to journal 07 Apr, 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-5515096","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":444376932,"identity":"0b1a87f9-0e02-4233-bd55-cf1a3de2a380","order_by":0,"name":"Ida Sinda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIie3PMWsCMRTA8XccxOXVrO+wXL9Cyk2FQr+K4aCTg6ODyEEhLqX3Ba4fogidPQLnIrje0MEuTpmdRM0pdKhNdXTIf0vIL3kB8PmuMAZBBgiPyJsVHjeDKUCMZ8hzHGXhgVCza0niJHC8XCdi+os4T7e5VkszDOVksajIDL5G0HoVGkHcOgcjOb4vKiY/65RFxXxFgPMDcf+FAtVBhpaErHOjNAH1GrJxE15asiU5ybUl2x/yzysglb1cJAJSS7JLCEkVvb91Y6rT5KGodKSw6peFcJO7fLYis94hz8vv2gw1562Xj6UZiCcX+WvUJnE58Pl8Pt9pezDSS+xWQEd5AAAAAElFTkSuQmCC","orcid":"","institution":"University of Oulu","correspondingAuthor":true,"prefix":"","firstName":"Ida","middleName":"","lastName":"Sinda","suffix":""},{"id":444376933,"identity":"9368eb12-8424-43fa-b1e0-4bd6329a9168","order_by":1,"name":"Pasi Lehto","email":"","orcid":"","institution":"Oulu University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Pasi","middleName":"","lastName":"Lehto","suffix":""},{"id":444376934,"identity":"d483c6ca-7cb9-4816-84c5-ec8c98d16511","order_by":2,"name":"Anna-Maria Koivusalo","email":"","orcid":"","institution":"Helsinki University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Anna-Maria","middleName":"","lastName":"Koivusalo","suffix":""},{"id":444376935,"identity":"7825f4cb-d0af-45d6-8b94-4b143cd9e0f2","order_by":3,"name":"Sinikka Sälkiö","email":"","orcid":"","institution":"Oulu University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sinikka","middleName":"","lastName":"Sälkiö","suffix":""},{"id":444376936,"identity":"668d6d0a-cf8b-4474-81b1-76f560bea4eb","order_by":4,"name":"Hilja-Maaria Stauffer","email":"","orcid":"","institution":"Helsinki University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hilja-Maaria","middleName":"","lastName":"Stauffer","suffix":""},{"id":444376937,"identity":"e69a6b4d-944b-4c16-a7a2-06f9919cb0a7","order_by":5,"name":"Tero Ala-Kokko","email":"","orcid":"","institution":"Oulu University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tero","middleName":"","lastName":"Ala-Kokko","suffix":""}],"badges":[],"createdAt":"2024-11-24 17:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5515096/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5515096/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-07304-6","type":"published","date":"2025-05-18T15:57:57+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":83067851,"identity":"bac4a536-81c8-4001-8c2c-5038bc63f221","added_by":"auto","created_at":"2025-05-19 16:07:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1043573,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5515096/v1/4489e975-8cd1-4a1d-896d-b99382a7b2a7.pdf"},{"id":80888384,"identity":"56730821-bdb1-44b6-b447-7758b4d71c85","added_by":"auto","created_at":"2025-04-18 09:25:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":172652,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile1Questionnaire.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5515096/v1/80dec9c6ad891f99f3e307b5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Undergraduate medical, health science, and technical students’ attitudes and knowledge on organ donation and transplantation ","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eOrgan donation from deceased donors consists of donation after brain death (DBD) and donation after circulatory determination of death (DCD).\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Organ transplantation is a well-established medical procedure\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e and is often lifesaving for the recipient and sometimes the only treatment for end-stage organ failure. The biggest limiting factor for organ transplantation is the constant shortage of donated organs.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn Finland, the primary source for organ transplants remains DBD, but DCD has started to emerge due to a shortage of brain-dead donors.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e According to the law, organs of a deceased person may be removed unless it is known or there is reason to assume that the person would have objected while still alive (opt-out consent).\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e This opt-out consent where silence is considered tantamount to consent has been considered to increase deceased donor rates, but it has been demonstrated that there is no significant difference compared with opt-in system countries where consent must be explicit.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Although, different outcomes have been observed. The introduction of the opt-out system in Wales in December 2015 led to an increase in consent rates compared with the rest of the United Kingdom which retained an opt-in system.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAnother key ethical concern in organ donation is the role of families in overriding individual donation decisions. This issue is particularly relevant in opt-out systems, where a presumed consent policy may still be overridden by relatives, potentially impacting donation rates.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003ePublic and social awareness plays a crucial role in organ donation, particularly in how individuals form attitudes toward donation. Studies suggest that younger generations engage with organ donation information differently, with social media and digital platforms acting as key channels to spread awareness.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Research indicates that presumed consent alone does not guarantee higher donation rates, and success depends on public awareness, trust in the healthcare system, and effective communication through media and healthcare professionals.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eHealthcare professionals play a crucial role in the organ donation process, making their knowledge, attitudes, and willingness to support donation essential in improving donor rates and public trust. Accurate information about organ donation is important to correct common misconceptions, such as beliefs of being too old to donate or that religion prohibits it. Despite widespread support for organ donation, a significant gap exists between those who support it and those who are registered donors. For example, in Finland 83% of adults support organ donation, but only 38% have registered.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Increasing awareness can help bridge this gap. A single donor provides an average of over 30 additional life-years to patients in need of transplantation.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Awareness of these facts may affect attitudes towards organ donation.\u003c/p\u003e \u003cp\u003eAccording to a 2020 survey conducted in Andalusia, Spain, 80% of medical students and 77% of nursing students supported organ donation.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e According to a survey conducted in Poland in 2022, 73% of medical student respondents expressed they would agree to donate their organs, with religion having a significant effect on students' willingness to act as an organ donor after death.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e In a German study, higher-year medical students showed more positive attitudes toward organ donation after death than students who had just started their studies. Health care field (medical, nursing, and other health sciences) did not have a significant effect on the willingness to be an organ donor after death, and 86.5% of respondents would be willing to donate organs.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe main purpose of this study was to investigate the attitudes and knowledge of undergraduate medical, health science, and technical students toward deceased organ donation and transplantation. Surveys from various countries show that medical and nursing students generally support organ donation. Despite widespread support for organ donation, there is a significant gap between those who support it and those who are registered donors. By surveying medical and health science students, our study aims to provide insights into how education and exposure to organ donation topics can influence attitudes. The hypothesis was that medical and health science students have more favorable attitudes toward organ donation and transplantation than students in the other fields of study.\u003c/p\u003e"},{"header":"2. Material and methods","content":"\u003cp\u003eThis observational survey study was conducted at the Faculty of Medicine and Faculty of Technology at the University of Oulu, and at the University of Applied Sciences during the autumn of 2023. The survey was sent to approximately 1500 undergraduate medical and health science students and students from different fields at the technical university including architecture, bioanalytics, radiography, occupational therapy, optometry, social work, dental hygiene, digital solutions for well-being, industrial engineering and management, computer science and engineering, environmental engineering, civil and construction engineering, electronics, mechanical engineering, biomedical engineering and process engineering.\u003c/p\u003e \u003cp\u003e The Institutional Review Board (IRB) and ethics committee of Oulu University Hospital and the Northern Ostrobothnia Hospital District waived the need for ethical approval or a signed written informed consent from the participants. According to the research policies of the University of Oulu and Oulu University of Applied Sciences, an IRB permit was waived for studies that use general student surveys without requesting personal data. Since the survey contained indirect identifiers, a preliminary data protection assessment and notice were submitted to the National Data Protection Ombudsman which was approved by a data protection specialist and administrative head in Oulu University and Oulu University of Applied Sciences. Data collection adhered to EU GDPR standards and to the Finnish legislation, the Act on the Protection of Privacy in the Processing of Personal Data (1050/2018). A student register information request was filed via the University of Oulu\u0026rsquo;s digital services (for medical and technical students), and a survey permit was obtained through Oulu University of Applied Sciences' system (for health science students). No additional research permit was required.\u003c/p\u003e \u003cp\u003eInformation about the survey\u0026rsquo;s purpose and goals was included in the questionnaire. Students were informed beforehand that by answering the questionnaire the student consented to participation in the survey. Answering the survey was voluntary, and students had the option to stop at any stage of the survey. The questionnaire was based on a Finnish version previously used in similar surveys for healthcare professionals in Finland \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e, and the survey questions in the present study were modified for undergraduate students (Supplementary file 1: The Survey Questionnaire).\u003c/p\u003e \u003cp\u003eThe material was collected electronically with a Google Forms questionnaire distributed to students using general e-mail lists of the targeted fields of study. Answering was done anonymously, without any identifying data. The questionnaire consisted of both open and multiple-choice questions. Some of the questions used a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;totally disagree to 5\u0026thinsp;=\u0026thinsp;totally agree).\u003c/p\u003e \u003cp\u003eIn terms of the success of the project, the most critical factors were reluctance to participate in the survey and the low number of responses. To reduce this risk, we twice sent information about participating in the survey via email lists. The electronic materials collected during the research were stored in Oulu University\u0026rsquo;s data center, to which only the researchers had access. The files were used only for the pre-agreed research purpose. The data were collected and reported in such a way that no individual survey participant could be identified.\u003c/p\u003e \u003cp\u003eDescriptive and statistical analyses were performed using SPSS for Windows software (IBM SPSS Statistics for Windows, version 27.0; IBM Corp, Armonk, New York). Categorical data are expressed as numbers (n) and percentages (%).\u003c/p\u003e \u003cp\u003eThe question of whether the respondent would donate his or her own organs and tissues after death was used to calculate the power analysis and the required sample size. Two different power analysis models were used to calculate the sample size. In the first calculation, the sample size was calculated assuming that 80 percent of all respondents have a positive attitude towards organ donation, which is in line with previous European research.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e According to the first power analysis, with a confidence interval of 95% and a margin of error of 5%, at least 246 survey respondents were needed. The second power analysis was calculated as above, but with the assumption that the favorability of organ donation among technical students would be 10 percent lower than that of both medical and health science students. To detect this difference, at least 247 technical students and 247 health science students would be required to participate in the survey. Assuming a response rate of about 50 percent, the survey needed to be sent to at least 988 (2 x 494) students. The difference between health science or medical students and technical students is represented as a percentage unit with 95 percent confidence interval. For continuous variables, between-group comparisons were performed using analysis of variances or Welch\u0026rsquo;s test.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eIn total, 559 students completed the questionnaire, of which 210 (37.6%) were medical, 146 (26.1%) health science, and 203 (36.3%) technical students (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). The median age of the respondents was 23 years [21\u0026ndash;27], 77.6% were female, and 48% were first- or second-year students. The proportion of respondents older than 35 years was highest among health science students compared with medical and technical students (18.5%, 3.8% and 9.4%, respectively). Of the technical students, 14.8% had previous healthcare education and 24.6% of them had work experience in healthcare (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eWillingness to donate one\u0026apos;s organs after death.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eALL, n\u0026thinsp;=\u0026thinsp;559 (100%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedical students, n\u0026thinsp;=\u0026thinsp;210 (37.6%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHealth science students, n\u0026thinsp;=\u0026thinsp;146 (26.1%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTechnical students, n\u0026thinsp;=\u0026thinsp;203 (36.3%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWould you donate your organs after death?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e517 (92.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e205 (97.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e138 (94.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e174 (85.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8 (5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBackground variables. Regarding willingness to donate *p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 between medical, health science, and technical students.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eALL, n\u0026thinsp;=\u0026thinsp;559 (100%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedical students, n\u0026thinsp;=\u0026thinsp;210 (37.6%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHealth science students, n\u0026thinsp;=\u0026thinsp;146 (26.1%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTechnical students, n\u0026thinsp;=\u0026thinsp;203 (36.3%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSex Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e434 (77.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e170 (90.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e133 (91.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e131 (64.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedian 23 (IQR 21\u0026ndash;27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e325 (58.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e138 (65.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72 (49.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e116 (57.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e179 (32.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64 (30.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47 (32.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68 (33.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36 (6.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18 (12.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11 (5.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u0026ndash;54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14 (2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (0.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAcademic years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u0026ndash;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e267 (47.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e112 (53.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e62 (42.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e93 (45.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u0026ndash;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e201 (36.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63 (30.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72 (49.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e66 (32.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u0026ndash;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76 (13.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (14.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9 (6.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36 (17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3 (2.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8 (3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevious education in\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e- Healthcare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e109 (19.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e55 (37.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30 (14.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e- Technical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21 (10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e- Neither\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e419 (75.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e180 (87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e87 (59.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e152 (74.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAny work experience in healthcare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e231 (41.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81 (38.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100 (68.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50 (24.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eIQR\u0026thinsp;=\u0026thinsp;interquartile range [25th \u0026minus;\u0026thinsp;75th percentile]\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e3.1 Willingness to donate\u003c/h2\u003e\n \u003cp\u003eThe main outcome, willingness to donate, is presented in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Of all 559 students, 517 (92.5%) would be willing to donate their organs after death. A total of 42 (7.5%) respondents would not donate their organs after death. There was a significant difference in the prevalence of non-donors between medical and health science students combined and technical students (3.7% vs. 14.3% [95% CI of the difference: 5.8\u0026ndash;16.3%], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Those not willing to donate had less information about the subject compared with those willing to donate (19% vs. 55.1%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001,), and had received less education on the subject (7.1% vs. 19.5%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.013) (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Eight of the students not willing to donate (19%) were worried that their organs would go to someone who does not deserve them. Non-donors less often expressed their own opinions about donation compared with donors (21.4% vs. 69.2%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv\u003e\u0026nbsp;\u003ctable border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eComparison of responses from students refusing to donate their organs with those who would donate.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eWould not donate, n\u0026thinsp;=\u0026thinsp;42\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eWould donate, n\u0026thinsp;=\u0026thinsp;517\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender, Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (73.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e403 (77.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (73.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e294 (56.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e171 (33.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34 (6.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45\u0026ndash;54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eField of Study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedical students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (11.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e205 (39.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHealth science students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (19.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e138 (26.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTechnical students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29 (69.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e174 (33.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrevious education from healthcare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (19.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101 (19.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I am willing to receive an organ from a brain-dead donor if needed.\u0026rdquo;, YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33 (78.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e500 (96.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Do you think it is right that you can get a new organ or tissue transplant even if you refuse to donate your own organs after death?\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21 (52.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e257 (49.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnsure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 (27.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e149 (28.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;What is your opinion regarding your close one\u0026rsquo;s refusal to be an organ donor?\u0026rdquo;: APPROVE OR DON\u0026rsquo;T HAVE OPINION\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e472 (91.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;If I have or would have children, I would agree to donate my child\u0026rsquo;s organs and tissues after death.\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 (26.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e398 (77.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Organ donation after death saves lives.\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Have you expressed your will to donate organs and tissues?\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e358 (69.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;The patient cannot be an organ donor if\u0026hellip;\u0026rdquo; DON\u0026rsquo;T KNOW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e208 (40.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Brain death is a valid definition of death.\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18 (45.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e322 (62.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;If you answered \u0026apos;No\u0026apos; or \u0026apos;I don\u0026rsquo;t know\u0026apos; to the survey item \u0026lsquo;Brain death is a valid definition of death\u0026rsquo;, the reason is\u0026hellip;\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoubts about brain death diagnostics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29 (5.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Lack of information and knowledge about organ donation.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e160 (30.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;The decision on the suitability of a potential organ donor\u0026rsquo;s organs should be made by a transplantation surgeon.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 (26.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e125 (24.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;During the past year, have you heard, read, or seen information about organ transplantation or donation?\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e136 (26.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Is there enough information available?\u0026rdquo; YES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (11.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e139 (26.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I have received education about organ donation and transplantation during my studies.\u0026rdquo; AGREE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (7.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e101 (19.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I think there is enough public discussion about organ donation and transplantation.\u0026rdquo; AGREE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47 (9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I have enough information about organ donation and transplantation.\u0026rdquo; AGREE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (19.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e285 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cdiv align=\"char\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eKnowledge about and willingness to receive an organ or tissue transplant from a brain-dead donor.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAll, n\u0026thinsp;=\u0026thinsp;559\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedical students, n\u0026thinsp;=\u0026thinsp;210\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHealth science students, n\u0026thinsp;=\u0026thinsp;146\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTechnical students, n\u0026thinsp;=\u0026thinsp;203\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I have received education about organ donation and transplantation during my studies.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e104 (18.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61 (29.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33 (22.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50 (8.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17 (11.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (4.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e386 (69.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e118 (56.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96 (65.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e172 (84.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDid not answer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;During the past year, have you heard, read, or seen information about organ transplantation or donation?\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e142 (25.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77 (13.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I have enough information about organ donation and transplantation.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e293 (52.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e124 (59.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90 (61.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79 (39.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e71 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36 (17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e194 (34.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61 (29.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88 (43.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDid not answer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1 (0.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Do you think there is enough information available about organ donation and transplantation?\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e144 (38.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82 (39.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e93 (63.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.4 (7.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I think there is enough public discussion about organ donation and transplantation.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49 (8.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17 (8.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18 (12.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e131 (23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e51 (24.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28 (19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52 (25.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e379 (67.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e142 (67.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100 (68.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137 (67.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;Do you think it is right that you can get a new organ or tissue transplant even if you refuse to donate your own organs after death?\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e278 (49.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e108 (51.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62 (42.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e108 (53.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e119 (21.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43 (20.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28 (19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48 (23.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e160 (28.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59 (28.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56 (38.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47 (23.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;If in need, I would be willing to receive organ or tissue transplantation from a brain-dead donor.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e553 (95.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e203 (96.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142 (97.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e188 (92.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I would agree to my own child being an organ donor after his/her death.\u0026rdquo; (opinion regardless of whether the respondent has children or not)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e409 (73.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e169 (80.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e103 (70.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137 (67.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14 (2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2 (1.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e136 (24.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39 (18.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39 (26.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58 (28.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eIn addition, 95.3% would be willing to receive an organ if needed. Willingness to receive an organ if needed was highest among those willing to donate (96.7% vs. 78.6%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Comparing non-donors and donors, there was no significant difference in the opinion as to whether it is right to receive an organ even though one refuses to donate their own organs (52.5% vs. 49.7%). The willingness to have one\u0026apos;s own child\u0026rsquo;s organ(s) donated in case of the child\u0026apos;s brain death was lowest in those not willing to donate (26.2% vs. 77.0%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eOf all the respondents, 49.9% felt that it would be right to receive an organ even if they would refuse to donate their own organs. This opinion was least common among health science students followed by medical and technical students (42.5%, 51.4% and 53.2%, respectively, p\u0026thinsp;=\u0026thinsp;0.016). The willingness to have one\u0026apos;s own child\u0026apos;s organ(s) donated after death was highest among medical students followed by health science and technical students (80.5% vs. 70.5% vs. 67.5%, p\u0026thinsp;=\u0026thinsp;0.025) (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Of all the respondents, 66.2% did not know their loved one\u0026rsquo;s intent regarding donating organs or tissues after death. Also, 78.8% agreed that it would be normal to discuss organ donation with their loved ones. Of those who would refuse to donate their organs after death, 50% (21/42) found it natural to discuss organ donation. Further, 361/559 (64.6%) would accept their loved one\u0026rsquo;s organs being donated even if they did not know if that person had consented or what their opinions were about organ donation, and 8.1% of the students would not accept their loved one\u0026rsquo;s negative opinion about organ donation.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e3.2 Knowledge\u003c/h2\u003e\n \u003cp\u003eOf the respondents, 69.1% had not been educated about organ donation and transplantation during their studies (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). The percentage of those affirming that they had received education was highest among medical students, second highest among health science students, and lowest among technical students (29.1%, 22.6%, and 4.9%, respectively, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The proportion of medical and health science students who felt they had enough information about the subject was significantly higher than technical students (59.0%, 61.6%, and 39%, respectively, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Of the respondents, 67.8% stated that there is not enough public discussion about organ donation and transplantation.\u003c/p\u003e\n \u003cp\u003eOverall, 60.8% of all students considered brain death to be a valid definition of death, and 36 (16.7%) of the students expressed doubts related to the definition of brain death. The rate of not accepting brain death as a valid definition of death was lower among those not willing to donate than among those willing to donate (45% vs. 62.4%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Out of the 42 respondents who would not donate their organs after death, 19 (45.2%) would like to receive more education and theoretical information about brain death, 18 (42.9%) on how to identify potential organ donors, 19 (45.2%) on tissue donation and transplantation in general, 18 (42.9%) about legislation and how to start a discussion and support loved ones and 18 (42.9%) how to address a patient\u0026rsquo;s own desire to donate organs. Reasons for refusing to donate organs after death are presented in Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eReasons for refusing to donate organs after death.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMedical students\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHealth science students\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTechnical students\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAll\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDon\u0026rsquo;t have enough knowledge or information about organ donation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePersonal reasons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eReligious or philosophical reasons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOrgans might end up being given to someone who does not deserve them\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBelief that one\u0026rsquo;s organs do not qualify\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoubts related to brain-death diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo not trust the healthcare system\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1/42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eA key objective was to examine whether medical and health science students have more favorable attitudes toward organ donation than technical students. While previous research has primarily focused on healthcare students and professionals, this study includes students from non-health disciplines to compare how different educational backgrounds influence attitudes and knowledge. It also highlights gaps in knowledge and underscores the impact of insufficient education on shaping perspectives on organ donation and transplant.\u003c/p\u003e \u003cp\u003eThe overall willingness to donate among students is high. Our survey found three main results. First, the highest willingness to donate was among medical students, while more than 10 percent of technical students would not be willing to donate their organs. Second, more than two-thirds of the non-donors were willing to receive an organ if needed. And third, non-donors would like to receive more education and theoretical information about brain death, about how to identify potential organ donors, about tissue donation and transplantation in general, and about legislation.\u003c/p\u003e \u003cp\u003eOur survey indicates that medical and health science students have more positive opinions about organ donation than technical students. This finding supports the primary hypothesis of the study and supports the results of previous surveys.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e The willingness to donate among medical and nursing students is higher than it is among medical professionals and the general population. Based on a national survey of medical professionals in 2020, 88%,\u003csup\u003e15\u003c/sup\u003e and in 2023, 95%,\u003csup\u003e13\u003c/sup\u003e of hospital staff would donate their own organs and tissues after death. In the US, a survey of surgical attendings, residents, and medical students found that willingness to donate correlated inversely with professional experience, with the highest willingness among medical students (77%).\u003csup\u003e16\u003c/sup\u003e In the US questionnaire, previous experiences with the organ procurement procedure influenced physicians\u0026rsquo; negative attitudes. The number of non-donors in our study was less than in a study of medical students in Buenos Aires, in which 18.1% were not willing to donate their organs after death.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e In that study, reasons for refusal included fears about the possibility of not being dead (36.4%), lack of confidence in (25.8%) or lack of information about the organ procurement and transplantation system (14.6%), no interest in organ donation (9.3%), and religious reasons (6%). The main reasons in the present study were the lack of knowledge about organ donation, personal and religious reasons, and concern that organs might end up in someone who does not deserve them. More than half of the students who would not donate their organs after death stated that they do not have enough information about the subject. Thus, increasing public knowledge about organ donation and correcting misleading information would likely result in more positive attitudes.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOur study had an open-ended question asking where respondents obtained information about organ donation. However, due to the heterogeneity and wide variation in responses\u0026mdash;from official sources (e.g., scientific publications, lectures, work, school) to various media platforms, including social media\u0026mdash;we did not analyze it in detail. Other studies have shown that educational information about organ donation on social networks significantly influences public knowledge and attitudes, especially among young people.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e For example, a Spanish study found that an audiovisual website about donation and short films published on YouTube, increased support for organ donation (85\u0026ndash;97%), willingness to donate (64\u0026ndash;79%), and knowledge of brain death (80\u0026ndash;92%).\u003csup\u003e19\u003c/sup\u003e In the present study, understanding the source of information would have been valuable, as it can influence perceptions and attitudes toward donation.\u003c/p\u003e \u003cp\u003eA notable finding from the survey used in this study was that the attitude toward organ donation is more favorable among medical students than technical students. Interestingly, the same was true of medical students compared with health science students, similar to the findings of a previous study carried out in Spain.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e Again, a more favorable attitude was associated with students having been educated about the subject during their studies. In our survey, 29.1% of the medical students surveyed had received education about organ donation during their studies compared to 22.6% of the health care students. For comparison, 61.6% of the health care students considered brain death was a valid definition of death, while the number among medical students was 67.6%. It has been found that 20\u0026ndash;25 potential organ donors remain unrecognized every year in Finland.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Other recent studies have also found that medical and health science students are aware of the fact that they do not receive enough education about the subject during their studies.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e It is crucial to remedy this early in the education of future health care professionals who may be able to influence organ donation rates.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e In a large survey of Italian university students, only 40.8% considered themselves informed about medical procedures involving organ donation, and only 15.8% thought they had sufficient legal information.\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e Perhaps another way to fill information gaps would be to offer an educational program delivered by a transplant physician and a transplant recipient. A Japanese study found that such a program may alter the attitudes of medical students towards deceased donation.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e Furthermore, if college students were aware of the positive attitudes of other college students toward organ donation, they might be more likely to sign the organ donation card and to discuss the topic with their loved ones.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe rate of not acknowledging brain death as a valid definition of death was lower among those not willing to donate than among those willing to donate. In a single university survey, 81.3% of medical students accepted the definition of brain death,\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e and according to another study, brain death was considered irreversible by 51% among those not willing to donate.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e A Canadian survey found that among medical students, only 76% acknowledged that someone could be neurologically deceased while maintaining a heartbeat, and 69% were not aware of the option of non-heart beating donation.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e The uncertainty associated with general information such as brain death being a valid definition of death was revealed in this study and has been reported in other studies.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e Tackmann et al.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e found that only about half of the students knew all the correct answers to questions regarding brain death. In a national survey conducted in Finland in 2023, 69% of healthcare professionals knew that the declaration of brain death establishes the time of death.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e The results of the present and previous studies suggest the need for education regarding the definition of brain death. Knowledge about brain death is also lacking in the general population. Previous studies have shown that only one-third of the elderly (\u0026gt;\u0026thinsp;65 years old) understood the concept of brain death creating negative attitudes toward organ donation.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e An annual survey conducted in Finland in 2023 also showed that elderly people were more reserved about receiving a transplant organ.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e In our study, we did not have specific question addressing brain death and whether the respondents have a clear understanding of this concept.\u003c/p\u003e \u003cp\u003eAccording to the results of the most recent poll commissioned by the Kidney and Liver Association in 2023, 83% of Finns are supportive of the idea of donating their organs after death, 86% would accept an organ transplant if needed and and 88% of Finnish healthcare professionals have expressed their will to donate organs..\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e However, only 38% of Finns have confirmed their will to donate by adding themselves to the organ donor registry.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e There is also a significant relationship between the extent of positive attitudes toward organ donation held by English medical and nursing students and their personal willingness to donate organs: 74% of the nursing students had already signed a donor card, compared with only 43% of the medical students.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eReasons behind refusal to donate organs are various, and one of the biggest factors cited in previous studies is religion.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e In our study, religion was not a major factor for refusal. Interestingly, the majority of non-donors were women. This conflicts with other studies stating that a person's sex does not reflect their attitude toward organ donation;\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e on the other hand, women have more favorable opinions about organ donation and transplantation.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn this study, we noticed that negative opinions regarding organ donation might be associated with misinformation about organ donation and how organ and tissue procurement is performed (e.g., the misconception that organ donation is incompatible with an open casket funeral). Our survey also asked what words would students use to describe organ donation or what kinds of feelings does organ donation evoke in them. Positive words chosen by most students were \u0026ldquo;opportunity\u0026rdquo;, \u0026ldquo;valuable\u0026rdquo; and \u0026ldquo;positivity\u0026rdquo;. The most chosen negative words were \u0026ldquo;uncertainty\u0026rdquo;, \u0026ldquo;complicated\u0026rdquo; and \u0026ldquo;weird\u0026rdquo;. Also, words such as \u0026ldquo;painful\u0026rdquo;, \u0026ldquo;suspicious\u0026rdquo;, \u0026ldquo;fear\u0026rdquo; and \u0026ldquo;disrespectful\u0026rdquo; were chosen. This may reflect general misinformation about organ donation, and how the received information might be interpreted as negative. Another worrying finding about the students' attitudes was that a notable number of them were concerned that their organ would go to someone who would not deserve it. We conclude from this that people can be highly uninformed about the organ donation procedure and organ donation in general, and that their attitudes and beliefs can be overshadowed by false information. We deduce from the results of this and previous studies that educating the public about organ donation and transplantation in general may result in more favorable attitudes and lessen people's concerns.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e As has been noted, the level of knowledge of nonmedical students and people in general about organ donation is remarkably low.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e Another important factor affecting donation rates is uncertainty about a loved one\u0026rsquo;s consent to donate after death.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Two-thirds of the students in this study would not be able to confirm their loved one\u0026rsquo;s consent if asked; this can be associated with the subject being undiscussed between relatives. Although almost 80% of the students finds it natural to talk about organ donation with their loved ones, only 42.4% had informed their loved one of their position on this. Surprisingly, although only 33.8% knew their loved one\u0026rsquo;s position on organ donation, 64.6% would accept organs of their loved ones being donated after death. As McGlade and Pierscionek stated in their survey,\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e being educated about organ donation is associated with being more comfortable initiating conversations about it.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Strengths and Limitations\u003c/h2\u003e \u003cp\u003eThe sample size was based on a power analysis. The present study includes a diverse range of students from different fields, offering a broad perspective on attitudes toward organ donation. Furthermore, we were able to recruit a relatively large sample size of technical students to compare the impact of study field on the results. We had no information on the response rate, and this may lead to response bias. Also, there is no certainty that students responded to the survey only once, as it was sent to general email lists to protect anonymity. However, double responses are thought to be unlikely because responding was time-consuming and respondent characteristics differ considerably. Also, a positive attitude towards donations and general motivation for participation in questionnaires may have affected willingness to participate in the study. The study relies on self-reported data, which may be subject to bias or inaccuracies. No external motivation factors were used. Our primary focus was on students' overall attitudes rather than their in-depth medical knowledge, and we did not specifically evaluate their understanding of the brain death concept. Including more detailed questions could have provided a deeper insight into students\u0026rsquo; comprehension of the organ donation process. The study did not analyze the sources of organ donation information in detail, which could have provided deeper insights into how information influences attitudes. Additionally, the study assumes the information received by students is beneficial without assessing its accuracy or impact. A notable factor was that a majority of the respondents were in their first or second year of their studies; therefore, we were not able to compare the knowledge gained during their studies. Our results may not be generalized to other university-level programs, to other cultural backgrounds or to those who have completed a formal curriculum on organ donation, as well as students \u0026acute;age and grade of studies, all of which are known to affect attitudes towards organ donation.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e4.2. Recommendations\u003c/h2\u003e \u003cp\u003eThis study's findings encourage us to enhance organ donation education and target it to undergraduate students. To improve knowledge about organ donation and transplantation among medical and health science students, there should be regularly performed interventions such as lectures during school years.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e Even a short intervention on the subject can increase students' knowledge and guide them to pay more attention to the subject in the future.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e This would make the subject more familiar and information more available to the students, especially regarding discussion with patients when necessary.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e To improve knowledge about organ donation and transplantation, it is important to implement regular educational programs with precise information and encourage medical students to share information with the public.\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e The effect of education on more favorable attitudes toward organ donation is significant and can be seen in a comparison between early stage and upper stage students.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e Increasing health care professionals' knowledge may affect every step of the organ donation path, starting from early identification of donors. To address the issue of public awareness, information about organ donation and general information about the whole process\u0026mdash;the path of organs from donor to recipients\u0026mdash;should be provided in a form that is easy for the public to access and understand. Educating the public, even young students, about organ donation can help dispel myths and misconceptions, raise awareness that leads to more informed decisions, and even influence decisions about joining or intending to join the organ donation registry.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e Social media campaigns can have immediate and dramatic impacts on organ donor registration rates.\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAlready proven to be effective,\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e social media can be used to raise awareness and serve as a platform for sharing information. However, for future education there are numerous opportunities to create interactive educational tools, intelligent tutorials, personalized virtual learning environments, and chatbots with artificial intelligence \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e to educate students and the general public about organ donation and transplantation. The results of our survey support the conclusion that increased public awareness about organ donation is greatly needed, as most respondents had not seen, heard, or read any information about the subject during the past year.\u003c/p\u003e \u003cp\u003eFuture studies should analyze the sources of information about organ donation in detail to better understand their impact on attitudes and knowledge. Further, intervention studies should be conducted to assess the effectiveness of educational programs, social media and digital platforms, as well as to track changes in attitudes and knowledge as students progress through their education.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Conclusion\u003c/h2\u003e \u003cp\u003eThe overall willingness to donate is high among medical, health care and technical students, with the highest willingness found among medical students. A majority of the respondents have expressed their will to donate organs and tissues. Non-donors cited lack of knowledge as the reason not to donate, but two-thirds of the non-donors were willing to receive an organ transplant if needed. More awareness about organ donation is needed through enhancing public awareness using social media platforms, addressing common misconceptions about organ donation and providing education for healthcare professionals.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDBD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003edonation after brain death\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDCD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003edonation after circulatory determination of death\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGDPR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGeneral Data Protection Regulation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Institutional Review Board (IRB) and ethics committee of Oulu University Hospital and the Northern Ostrobothnia Hospital District waived the need for ethical approval as well as a signed written informed consent from the participants. The survey is in accordance with the Finnish National Board on Research Integrity TENK guidelines 2019 and with the guidelines of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003eAccording to the research policies of the University of Oulu and Oulu University of Applied Sciences, an IRB permit is waived for studies that use general student surveys without requesting personal data. Since this study survey contained indirect identifiers, a preliminary data protection assessment and notice were submitted to the National Data Protection Ombudsman, which was approved by a data protection specialist and administrative head at Oulu University and Oulu University of Applied Sciences. Data collection adhered to EU GDPR standards and to the Finnish legislation, the Act on the Protection of Privacy in the Processing of Personal Data (1050/2018). A student register information request was filed via the University of Oulu\u0026rsquo;s digital services (for medical and technical students), and a survey permit was obtained through the Oulu University of Applied Sciences\u0026apos; system (for health science students). No additional research permit was required.\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 datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\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\u003c/p\u003e\n\u003cp\u003eThis study was supported only by departmental funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIS, PL, and TA conceptualized and designed the research framework, developed and implemented the methodology, conducted the investigation, performed the formal analysis and interpreted the data, managed and curated the research data, and were responsible for drafting the original manuscript. Additionally, PL and TA supervised the research project. AMK, SS, and HMS participated in conceptualizing and designing the research, developing the methodology, analyzing the data, and drafting and reviewing the original manuscript. SS also managed and curated the research data. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEuropean Parliament Think Tank. 2023. Organ donation and Transplantation, Facts, figures and European Union Action, European Parliamentary Research Service, 2021. 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AI technologies for education: Recent research \u0026amp; future directions. Computers Education: Artif Intell. 2021;2:100025. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.caeai.2021.100025\u003c/span\u003e\u003cspan address=\"10.1016/j.caeai.2021.100025\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\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":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5515096/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5515096/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eOrgan shortages remain a primary factor limiting transplant number. Raising awareness about organ donation and its medical benefits is one approach that could help dispel misunderstandings, improve willingness to donate, and increase the number of donors. This study aimed to examine the attitudes and knowledge of undergraduate students in medicine, health sciences, and technical fields regarding organ donation and transplantation, as well as to explore potential differences in perspectives across these groups.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn observational web-based questionnaire survey was created for Finnish undergraduate medical, health science, and technical students. The survey included both multiple-choice questions evaluated on a Likert scale from 1 to 5 and open-ended questions. Descriptive statistical analyses were used to evaluate the results.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 559 students completed the questionnaire, comprising 210 (37.6%) medical, 146 (26.1%) health science, and 203 (36.3%) technical students. Willingness to donate was significantly higher among medical and health science students compared to technical students (97.6%, 94.5%, and 85.7%, respectively; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A total of 42 respondents indicated they would not donate their organs after death. The prevalence of non-donors was lower among medical and health science students combined compared to technical students (3.7% vs. 14.3%; 95% CI for the difference: 5.8\u0026ndash;16.3%; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among non-donors, 78.6% expressed willingness to receive an organ if needed. Non-donors were less likely to have shared their opinion on organ donation compared to donors (21.4% vs. 69.2%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Only 8.8% of respondents felt there is sufficient public discussion about organ donation and transplantation, while 45% considered brain death a valid definition of death.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eOverall, willingness to donate organs after death is high (92.5%), with the highest willingness observed among medical students. A majority of the respondents expressed their will to donate organs and tissues. Most non-donors cited lack of knowledge as the main reason for not donating, though two-thirds of them indicated willingness to receive an organ if needed. Increased awareness about organ donation is necessary.\u003c/p\u003e","manuscriptTitle":"Undergraduate medical, health science, and technical students’ attitudes and knowledge on organ donation and transplantation ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-18 09:25:27","doi":"10.21203/rs.3.rs-5515096/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-23T11:42:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-23T11:41:08+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-21T10:45:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"211973659049573719449225504175430658912","date":"2025-04-21T10:40:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-17T11:54:36+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-12T13:10:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-04-07T13:17:48+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"346cc4ea-6d90-4f59-8763-aabd62ca11c1","owner":[],"postedDate":"April 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-19T16:02:22+00:00","versionOfRecord":{"articleIdentity":"rs-5515096","link":"https://doi.org/10.1186/s12909-025-07304-6","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-05-18 15:57:57","publishedOnDateReadable":"May 18th, 2025"},"versionCreatedAt":"2025-04-18 09:25:27","video":"","vorDoi":"10.1186/s12909-025-07304-6","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07304-6","workflowStages":[]},"version":"v1","identity":"rs-5515096","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5515096","identity":"rs-5515096","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}