Effectiveness of interactive teaching intervention on medical students’ knowledge and attitudes toward stem cells, their therapeutic uses, and potential research applications

Introduction

The emerging stem cell (SC) biology discipline and the rapid revolution in SC research have radically transformed our thinking of cells, evolution, and disease. Using SCs for clinical applications represents the future of translational medicine since SCs can potentially be used to treat many kinds of difficult diseases that cannot currently be treated (Chang et al., 2018; Protze, Lee & Keller, 2019). Advances in SC research combined with tissue engineering techniques promise therapies to restore or replace damaged tissues (Kwon et al., 2018). This raises the need for medical education to introduce basic SC knowledge and the concept of translational medicine into the life sciences field. At the same time, SC research and applications still raise complex social, legal, ethical, and religious issues (Al-Aqeel, 2005; Curley & Sharples, 2006; Pourebrahim, Goldouzian & Ramezani, 2020), especially in conservative societies (Bouzenita, 2017).

The emerging developments in SC applications are transforming the priorities of undergraduate and postgraduate medical educational programs (Scott, 2015). Today, the traditional academic model for medical education is challenged by an evident gap between the rapidly changing disciplines in basic biomedical sciences and clinical practice. Although medical students have access to SC research theoretical advancements, traditional teaching approaches still fail to bridge this practice gap (Brass, 2009). Thus, updated teaching techniques that facilitate the integration of SC research advancements with clinical practice are critical for medical students to achieve optimum patient care (Knoepfler, 2013). Restructuring medical education to meet the current and future health care needs of SC-based interventions, including new curricula featuring the ethical, legal, and social implications of SC research, are thus a priority (Pershing & Fuchs, 2013; Pierret & Friedrichsen, 2009).

Since the early 1990s, many medical curricula have transitioned from traditional subject-based teaching toward integrated system-based teaching (Ling et al., 2008). Traditional didactic lectures for one hour become monotonous after 15–20 min as students’ participation in the learning process is minimal (Gupta, BhattiK & AgnihotriP, 2015). On the other hand, the interactive teaching approach actively engages learners and interchanges ideas between learners and facilitators (Kaur et al., 2011). The effectiveness of educational interventions in increasing knowledge and attitudes towards SC applications was reported previously by a few studies (Azzazy & Mohamed, 2016; Jin et al., 2018; Kaya et al., 2015).

Although it is currently a hot research topic, SC education for students is uncommon (Pierret & Friedrichsen, 2009). The interactive teaching modality was designed to introduce medical students to the pioneering area of SC biology and shed light on current advances in SC research. Medical students, as future physicians, are expected to answer patients’ questions regarding SCs and help them differentiate between what is realistic and unrealistic regarding SC-based therapies. Also, they should be able to use evolving discoveries in SC research and apply them in the care of patients. Thus, we aimed in this study to gauge the medical students’ knowledge and attitudes toward SCs, their therapeutic uses, and potential research applications and then evaluate the effectiveness of a six-session interactive teaching intervention on their knowledge and attitudes.

Material and Methods

Results

Out of 71 sixth-year medical students invited to participate in this study, 58 initiated the interactive teaching course resulting in a participation rate of 81.7%. The final sample consisted of 48 medical students who initially enrolled and completed the entire six-week course sessions with a completion rate of 82.8%. Out of 48 medical students, 32 (66.7%) were males, and more than half (56.3%) were of Jordanian or Yemeni nationalities. The enrolled Students’ mean age (SD) was 24.0 (1.2) years. Demographic characteristics of study participants are summarized in Table 2.

Knowledge regarding stem cells

The three most common sources of knowledge regarding SCs before the intervention course were lectures (56.3%), social media (45.8%), and books (41.7%), while any participant did not report panel discussions as a source of knowledge (Fig. 1). Detailed information about pre-and post-educational intervention knowledge scores is summarized in Table 3. Pre-intervention, the lowest mean score among knowledge domains was observed with SC research section (1.76 (0.89)), and therapeutic uses (1.84 (0.63)), followed by SC basic knowledge (2.14 (0.30)) and their potential applications (2.66 (0.77)). The mean scores of all knowledge domains were lower than three in the pre-intervention phase of the study. The mean (SD) total knowledge score was 2.09 (0.30) pre-intervention, which is significantly improved to 3.09 (0.41) post-intervention (p < 0.001). Similarly, all knowledge domains’ scores significantly increased following the intervention.

Table 3:

Pre- and post-educational intervention mean knowledge scores and differences (n = 48).

Pre- and post-educational intervention mean scores of students’ knowledge regarding stem cells, their potential applications, therapeutic uses, and research involving them				Differences between pre-and post-educational interventions
	Score	M (SD)	Min–Max	MD	95% CI		p-value
					Lower	Upper
Stem cells: basic knowledge
1- I have sufficient knowledge of different types of stem cells, such as adult and embryonic stem cells.	Pre	1.88 (0.94)	0–4	1.89	1.57	2.23	<0.001*
	Post	3.77 (0.43)	3–4
2- I have sufficient knowledge of the sources of stem cells.	Pre	2.17 (0.78)	0–4	1.50	1.22	1.78	<0.001*
	Post	3.67 (0.52)	2–4
3- I have sufficient knowledge of the therapeutic uses of stem cells.	Pre	2.15 (1.05)	0–4	1.54	1.22	1.86	<0.001*
	Post	3.69 (0.51)	2–4
4- I have sufficient knowledge of the three germ layers (endoderm, mesoderm and ectoderm), and organs and tissues generated from each layer.	Pre	2.67 (1.02)	0–4	1.02	0.70	1.34	<0.001*
	Post	3.69 (0.59)	2–4
5- Cell differentiation is the process by which stem cells become more specialized cell types (true).	Pre	2.85 (0.97)	1–4	0.65	0.38	0.92	<0.001*
	Post	3.50 (0.72)	1–4
6- As a stem cell differentiates, it gradually loses potency and becomes unipotent (true).	Pre	2.23 (1.06)	0–4	0.48	0.13	0.83	0.009*
	Post	2.71 (1.32)	0–4
7- Self-renewing is the ability of a stem cell to produce more stem cells with identical characteristics as the “parent” cell (true).	Pre	2.46 (0.82)	0–4	0.89	0.60	1.20	<0.001*
	Post	3.35 (0.84)	1–4
8- Adult stem cells are pluripotent cells that have the potential to make all cell types of the body (false). †	Pre	1.58 (1.16)	0–4	1.34	0.75	1.92	<0.001*
	Post	2.92 (1.49)	0–4
9- Bone marrow is the only source for adult stem cells (false).†	Pre	2.17 (1.24)	0–4	1.10	0.67	1.54	<0.001*
	Post	3.27 (1.25)	0–4
10- Stem cells can differentiate into many cell types within a germ layer (true).	Pre	2.73 (0.94)	0–4	0.52	0.12	0.93	0.013*
	Post	3.25 (1.02)	0–4
11- Embryonic stem cells are derived from leftover blastocysts after in vitro fertilization (true).	Pre	2.06 (0.76)	0–4	0.90	0.48	1.31	<0.001*
	Post	2.96 (1.34)	0–4
12- Embryonic stem cells are derived from the umbilical cord after childbirth (false). †	Pre	1.35 (0.91)	0–3	0.38	−0.16	0.91	0.165
	Post	1.73 (1.65)	0–4
13- Embryonic stem cells are derived from the trophoblast of blastocysts (false).†	Pre	1.54 (0.65)	0–4	0.25	−0.25	0.75	0.316
	Post	1.79 (1.64)	0–4
The total score of stem cell basic knowledge	Pre	2.14 (0.30)		0.95	0.83	1.09	<0.001*
	Post	3.09 (0.47)
Stem cells: potential applications
14- Stem cells can be used to study early human development (true).	Pre	3.02 (0.84)	1–4	0.40	0.13	0.66	0.004*
	Post	3.42 (0.71)	1–4
15- Stem cells can be used to understand the pathophysiology and analyze disease mechanisms by modeling disease in a culture dish outside the human body (true).	Pre	2.56 (1.09)	0–4	0.92	0.48	1.35	<0.001*
	Post	3.48 (0.83)	0–4
16- Stem cells can be used to test and screen new drug candidates and toxins to figure out their potential side effects (true).	Pre	2.21 (1.09)	0–4	1.27	0.84	1.70	<0.001*
	Post	3.48 (0.83)	0–4
17- Stem cells can be used to replace or restore tissues that have been damaged by disease or injury, such as diabetes, heart attacks, Parkinson’s disease, skin burns, or spinal cord injury (true).	Pre	2.85 (1.09)	0–4	0.73	0.38	1.08	<0.001*
	Post	3.58 (0.85)	0–4
The total score of stem cell potential applications	Pre	2.66 (0.77)		0.80	0.53	1.09	<0.001*
	Post	3.46 (0.59)
Stem cells: therapeutic uses
18- There is a wide range of conditions or diseases for which stem cell therapies have been proven to be safe and effective such as osteoarthritis and multiple sclerosis (false).†	Pre	1.54 (0.97)	0–4	0.69	0.23	1.15	0.004*
	Post	2.23 (1.53)	0–4
19- There is nothing to lose from trying unproven stem cell therapies since they can provide hope for hopeful patients (false). †	Pre	1.71 (1.07)	0–4	0.67	0.24	1.10	0.003*
	Post	2.38 (1.39)	0–4
20- Bone marrow-derived stem cells will spontaneously regenerate into different cell types such as hepatocytes and neural cells without manipulation in the lab (false). †	Pre	1.88 (1.00)	0–4	0.45	−0.01	0.93	0.055
	Post	2.33 (1.53)	0–4
21- If the balance is skewed between differentiation and self-renewing properties of stem cells, it may result in tumor formation (true).	Pre	2.25 (0.79)	0–4	0.63	0.26	0.99	<0.001*
	Post	2.88 (1.04)	1–4
The total score of stem cell therapeutic uses	Pre	1.84 (0.63)		0.61	0.36	0.85	<0.001*
	Post	2.45 (0.80)
22- I would be confident to explain the induced-Pluripotent Stem Cells (iPSCs).	Pre	1.65 (1.16)	0–4	1.75	1.38	2.12	<0.001*
	Post	3.40 (0.71)	2–4
23- I would be confident to explain the transcription factors.	Pre	1.85 (1.19)	0–4	1.28	0.87	1.67	<0.001*
	Post	3.13 (0.89)	0–4
24- Adult cells can be “reprogrammed” genetically to assume stem cell-like state (true).	Pre	1.85 (1.05)	0–4	1.46	1.04	1.88	<0.001*
	Post	3.31 (0.83)	1–4
25- I would be confident to discuss the Somatic Cell Nuclear Transfer (SCNT).	Pre	1.58 (1.07)	0–4	1.48	1.07	1.89	<0.001*
	Post	3.06 (0.10)	0–4
26- I would be confident to explain the differences between therapeutic cloning and reproductive cloning.	Pre	1.81 (1.20)	0–4	1.40	0.96	1.83	<0.001*
	Post	3.21 (0.82)	0–4
27- I would be confident to discuss the mitochondrial replacement therapy.	Pre	1.83 (1.19)	0–4	1.69	1.28	2.10	<0.001*
	Post	3.52 (0.74)	1–4
The total score of stem cell research	Pre	1.76 (0.89)		1.51	1.20	1.82	<0.001*
	Post	3.27 (0.56)
The total knowledge score	Pre	2.09 (0.30)		1.00	0.86	1.15	<0.001*
	Post	3.09 (0.41)

DOI: 10.7717/peerj.12824/table-3

Notes:

M, Mean; SD, Standard Deviation; Min, Minimum score; Max, Maximum score; CI, Confidence Interval; MD, Mean Difference; Pre, Pre-educational intervention; Post, Post-educational intervention

* Significant at p < 0.05 based on paired-samples t-test.

†The code was reversed for the false or misleading statements to be “Four = Strongly Disagree” and “Zero = Strongly Agree”.

The total score of knowledge is the sum of the statements’ scores for the four major domains (stem cell basic knowledge, potential applications, therapeutic uses, and research) for each participant divided by 27.

The mean SC basic knowledge domain score significantly increased from 2.14 (0.30) pre-intervention to 3.09 (0.47) post-intervention (p < 0.001). Post-intervention vs. pre-intervention, participants reported improved the knowledge with different types of SCs (3.77 (0.43) vs. 1.88 (0.94), p < 0.001), sources of SCs (3.67 (0.52) vs. 2.17 (0.78), p < 0.001), therapeutic uses of SCs (3.69 (0.51) vs. 2.15 (1.05), p < 0.001) and three germ layers from which tissues and organs are generated (3.69 (0.59) vs. 2.67 (1.02), p < 0.001). Students’ knowledge of sources of embryonic SCs significantly improved for statements related to leftover blastocysts after in vitro fertilization (2.96 (1.34) post-intervention vs. 2.06 (0.76) pre-intervention, p < 0.001), but not for statements related to umbilical cord (1.73 (1.65) vs. 1.35 (0.91), p =0.165) or trophoblast of blastocyst (1.79 (1.64) vs. 1.54 (0.65), p =0.316).

For potential applications of SC domain, the mean score significantly increased from 2.66 (0.77) pre-intervention to 3.46 (0.59) post-intervention (p < 0.001). Post-intervention vs. pre-intervention, students reported significantly higher knowledge scores regarding potential applications of SCs such as replacing or restoring damaged tissues (3.58 (0.85) vs. 2.85 (1.09), p < 0.001), screening new drugs and toxins (3.48 (0.83) vs. 2.21 (1.09), p < 0.001), modeling disease in a culture dish (3.48 (0.83) vs. 2.56 (1.09), p < 0.001) and studying early human development (3.42 (0.71) vs. 3.02 (0.84), p =0.004).

For SC therapeutic uses domain, the mean total score significantly increased from 1.84 (0.63) pre-intervention to 2.45 (0.80) after the intervention course (p < 0.001). Compared to pre-intervention results, the students became significantly more aware about the side effects of trying unproven SC therapies after the intervention course (2.38 (1.39) vs. 1.71 (1.07), p =0.003) and tumor formation potential if the balance is skewed between cell differentiation and self-renewing properties of SCs (2.88 (1.04) vs. 2.25 (0.79), p =0.001).

In the SC research domain, the mean total score significantly increased from 1.76 (0.89) to 3.27 (0.56) (p < 0.001). Post-intervention vs. pre-intervention, students became more comfortable in giving an explanation of induced pluripotent SCs (3.40 (0.71) vs. 1.65 (1.16), p < 0.001), transcription factors (3.13 (0.89) vs. 1.85 (1.19), p < 0.001), and differences between therapeutic cloning and reproductive cloning (3.21 (0.82) vs. 1.81 (1.20), p < 0.001). Moreover, participants became more knowledgeable that adult cells can be “reprogrammed” genetically to assume an SC-like state (3.31 (0.83) vs. 1.85 (1.05), p < 0.001). Students were also more comfortable discussing mitochondrial replacement therapy (3.52 (0.74) vs. 1.83 (1.19), p < 0.001) and somatic cell nuclear transfer (3.06 (0.10) vs. 1.58 (1.07), p < 0.001).

Discussion

The current study sheds light on the effectiveness of an interactive educational intervention in improving the knowledge and attitudes of medical students toward SCs, their therapeutic uses, and their potential research applications. The intervention course was conducted for six weeks, and different interactive teaching methods were used. The study results indicated that participants’ knowledge about SCs was insufficient in the pre-intervention phase as the mean scores for most knowledge domains and total knowledge were ≤ 2. These findings are concordant with previous studies that revealed poor knowledge regarding various aspects of stem cells banking, donation, and transplantation among the public, university students, and healthcare providers (Azzazy & Mohamed, 2016; Kaya et al., 2015; Lye et al., 2015; Perlow, 2006; Suen et al., 2011; Tuteja, Agarwal & Phadke, 2016). SC knowledge and attitude scores significantly improved following the intervention course. Post-intervention, participants were more interested in expanding their knowledge about SCs and considered well-structured programs or training courses as a successful approach to improve their understanding of SCs. The participants reported positive attitudes regarding the integration of SC education in medical college curricula after the intervention. This study provides a shred of landmark evidence from the Middle East and North Africa to implement the interactive learning approach in the SC teaching field. The excellent knowledge and attitude regarding SCs could be of great benefits not only to medical students but also to the overall health system as it will reflect on future healthcare providers being more informed and better guided to serve their patients with up-to-date information and improve the decision making power regarding SCs as an innovative method of therapy (Perlow, 2006; Tork et al., 2017; Tuteja, Agarwal & Phadke, 2016). This study could enhance medical curriculum development and teaching approaches and bridge the gap between basic sciences and clinical practice.

As future health care leaders, medical students represent a source of information, or misinformation, which may influence patients’ behaviors and serve as a valuable source of information (Davies et al., 2002). This makes the medical school an ideal place to address information misconceptions and emphasize positive attitudes toward SC applications. Therefore, improvements in the region’s medical curricula should seriously consider interactive session models and introduce broader and more scientific resources for students in the healthcare field. This is especially true to follow-up on rapidly advancing scientific topics in the medical fields, where relying merely on available evidence from textbooks may introduce delays in transferring knowledge to medical students.

Before conducting the intervention course, the enrolled students reported poor knowledge about SCs, with the lowest scores observed for SC research knowledge, therapeutic uses, and basic knowledge. However, their knowledge regarding the SC potential applications was relatively good. Following the intervention course, the students’ knowledge was significantly enhanced with better-reported scores, such as SC research knowledge. Significant improvements also spread to the other addressed knowledge domains regarding SCs, including SC basic knowledge, and that knowledge related to SC potential applications, and to a lesser extent, SC therapeutic uses’ knowledge. Previous educational interventions successfully increased the knowledge about SC transplantation and banking among medical, nursing, and law students and showed more positive attitudes toward SC donation following a particular intervention (Azzazy & Mohamed, 2016; Kaya et al., 2015). Innovative SC education using practical experiments to master SC culture and differentiation techniques were also reported to deepen medical students’ understanding of regenerative and translational medicine (Jin et al., 2018). After reviewing the educational interventions that were used in other studies to enhance the students’ knowledge regarding SCs, we found that their educational interventions were for a shorter duration than ours, and they did not use such interactive teaching methods (Azzazy & Mohamed, 2016; Jin et al., 2018; Kaya et al., 2015). Thus, in our study, we were keen to provide a more comprehensive and detailed interactive teaching course for a longer duration that will cover more topics related to SC education, research, and potential applications, unproven SC therapies and tourism, and bioethics in order to design the interactive teaching course in an innovative way that will be more engaging to the medical students (Azzazy & Mohamed, 2016; Jin et al., 2018; Kaya et al., 2015). Besides, study material developed by our research team could be adopted by other schools interested in establishing similar courses, and our interactive teaching courses could be integrated within curricula.

In the current study, the most common sources of knowledge regarding SCs were lectures followed by social media. Social media has created an opportunity to disseminate information regarding unproven SC-based therapies directly to consumers to legitimize providers and their products by using solid emotional appeals such as patient testimonials (Lyons, Salgaonkar & Flaherty, 2021). Other than social media, mass media, including newspapers, television, and radio, are considered a primary source of scientific communication to the public as it can significantly influence public attitudes toward controversial emerging technologies in regenerative medicine, such as the use of leftover blastocysts as a source for embryonic SCs and genome editing (Sharpe, Di Pietro & Illes, 2016). Also, the portrayal of translational SC research in newspapers is highly optimistic and may foster unrealistic expectations regarding clinical translation speed (Kamenova & Caulfield, 2015). Medical students should consider other sources for knowledge based on scientific evidence, such as medical journals and conferences. Unfortunately, none of the medical students in our study chose panel discussions as a source for SC knowledge, despite being considered a valuable way to trigger an exchange of viewpoints regarding ethical controversies surrounding SCs (Arráez-Aybara et al., 2018). Therefore, medical schools are invited to further invest in students’ knowledge about SCs by enhancing exposure to updated medical literature and medical conferences.

This study indicates that the interactive teaching approach effectively improved the levels of knowledge and positive attitudes toward SCs. Furthermore, our interactive learning approach was sufficient to reduce gender gaps in SC knowledge scores, especially the scores related to SC potential applications and SC research since females were significantly less knowledgable than males in the pre-intervention course; however, the gender differences were reduced after the intervention course and became statistically insignificant. Despite the evolving amount of literature indicating the merits of the interactive learning approach, there is still a large gap between educational research and what happens in practice. The traditional didactic lectures still predominate in university classrooms (Liebert et al., 2016; Merideno, Antón & Prada, 2015; Saroyan & Snell, 1997).

Previous studies that compared active learning to the traditional approach using passive learning indicated that interactive teaching methods generally result in longer retention of material, superior problem-solving and higher-thinking skills, more positive attitudes, and higher motivation the students to learn (DIJK & JOCHEMS, 2002; Dodiya, Vadasmiya & Diwan, 2019; McKeachie, 1990; Wheijen, Jones & Rainer, 2002). Also, the students found such classes more fun and less tedious, and they were more satisfied with this teaching approach (DIJK & JOCHEMS, 2002). Miller et al. reported a statistically significant higher average of students’ performance on exams using engaging lectures compared with traditional didactic lectures (Miller, McNear & Metz, 2013). Also, the authors observed increased effectiveness of lectures, decreased distractions, and increased students’ confidence with the material using interactive teaching methods (Miller, McNear & Metz, 2013). Based on our observations while conducting this study and the enrolled students’ feedbacks, the experience of interactive teaching technique was interesting for both students and researchers, and many of the students were enthusiastic about more courses designed with this approach. However, many challenges facing the incorporation of interactive teaching methods, including the limited amount of scientific content that could be covered within the class time, the significant efforts of preparation required by the instructor to create the interactive activities, and the effects of this approach on time available for traditional lectures. Given the rapidly growing amount of knowledge and the unlimited access of students to the information through the internet and other technologies, it may be more important to teach students how to use information rather than learning specific facts. This objective could be achieved by implementation of interactive teaching methods. Thus, medical educators may need to shift the importance of concept over content.

In our study, the participants showed relatively positive attitudes toward SCs before the intervention, and furthermore, their attitudes improved following the intervention even to a lower extent than that observed in knowledge domains. However, negative attitudes related to SC religious controversies actually worsened the post-intervention course. Complex social, legal, ethical, and religious issues arise when emerging biotechnology involves human subjects (Al-Aqeel, 2005), especially in conservative societies. However, Islamic teachings have paid attention to disease prevention and health promotion, and it is crucial to focus more on increasing our understanding of how SC applications could advance the health of human beings to facilitate the adoption of these technologies (Bouzenita, 2017). Within this context, future SC-related interventions should focus on incorporating religious leaders from the medical community to present their points of view related to scientific facts from ethical, moral, and religious perspectives (Aksoy, 2005; Al-Tabba, Dajani & Al-Hussaini, 2020; Fadel, 2012). The current Statute regarding SC use in developing countries is still unclear and not updated; thus, experts of different political, religious, scientific, and medical aspects who are familiar with laws are invited to develop a more comprehensive juridical system (Al-Tabba, Dajani & Al-Hussaini, 2020; Pourebrahim, Goldouzian & Ramezani, 2020). However, although the negative attitudes toward ethical controversies surrounding SC therapies worsened following the intervention; the change in mean attitude scores was not statistically significant. Ethical concerns may be tightly connected to religious concerns and can only be mitigated by openly discussing the lack of religious restrictions related to medical improvements.

Notably, our findings regarding religious and ethical controversies call for incorporating bioethics into the medical curriculum when addressing SC-related topics as ethical concerns were reported to be the obstacle that have obscured the proper potential use of SCs for revolutionizing medicine and treatment options in the future (Hug, 2005). Medical curricula need to be restructured to include SCs or other emerging technologies in biomedicine and include research and healthcare ethics (Abdulrazeq et al., 2019; Brass, 2009; Sarkadi & Schatten, 2012). Adopting new technologies for patient care is challenging since many ethical dilemmas surround it, and future physicians should be prepared to deal with such dilemmas when they arise (Curley & Sharples, 2006).

A few limitations should be mentioned. The sample size was relatively small, and the participants were selected from a single medical school, limiting our results’ generalizability. While response and enrolment rates were not optimal, they are considered sufficient among medical students. Data collection in this study was also limited to quantitative methods; utilizing a qualitative approach supported by quantitative methods would be recommended to provide a richer analysis of the phenomena. A parallel-group with no intervention was not utilized which may introduce testing effects and exacerbate the results. The same survey was utilized pre-and post-intervention that was self-reported by the participants, which might explain that the improvements in knowledge and attitudes scores could be by chance and not due to intervention effects. Finally, this study used an interactive educational approach over a six-week course to improve the students’ knowledge and attitudes toward the SC field without comparison with other learning approaches. It would be interesting for future studies to compare the effectiveness of this interactive educational approach with other types of learning, such as flipped classrooms and traditional dedicated lectures.

Conclusions

This study demonstrates the crucial role of the interactive teaching approach on medical students’ knowledge and attitudes toward SCs, therapeutic uses, and potential research applications. The study results have proven poor knowledge about SCs in the pre-intervention phase, with a significant improvement after the interactive intervention course. As SC utilization becomes more common across specialties, having pre-clinical and clinical curricula educate future physicians on SCs is necessary. Thus, the SC concept such as research skills and SC therapeutic uses should be incorporated into the medical school curriculum to overcome the current shortcomings in SC knowledge and update future physicians with evidence-based medical practice. The study findings also indicate the effectiveness of the intervention course in achieving more positive attitudes toward SCs by the medical students. In addition, the differences in knowledge regarding SCs between males and females have reduced after the intervention course. Thus, the study concluded that an interactive teaching approach might be feasible under the same teaching resources and students’ situations, and thus, it could be considered beneficial to the medical students regardless of gender. Educators can capitalize on the available opportunities to improve the areas of the current SC curricula. Although the interactive intervention course was as short as six weeks, the study outcomes were promising. The appropriate intervention methods should be further tested by their implementation on a large scale in most medical subjects. Also, medical educators and schools are calling for integrating new interactive teaching approaches to address the life sciences instead of traditional teaching methods. Further studies with a larger sample are recommended to evaluate the needed curriculum content development, practical teaching approaches, and the most effective practice matters. Moreover, developing educational programs considering social, ethical, legal, religious, and cultural issues are recommended.

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