Evaluating the impact of a gambling harm focused educational intervention on medical students' self-reported confidence: a non-randomised, single-group pre-post study
- 1king's college london
Abstract
BackgroundGambling harm is a significant public health concern that is systematically under-recognised in clinical practice. Despite the recent inclusion of gambling disorder in the General Medical Councils Medical Licensing Assessment content map, gambling harm has been largely absent from undergraduate medical education in the United Kingdom, and structured evaluations of gambling harm teaching delivered to medical students have not, to our knowledge, been reported.
MethodsA single-group, pre-post study of a teaching session on gambling harm was conducted across three sequential cohorts of Year 4 medical students at Kings College London during the 2025-2026 academic year. Outcome measures were collected immediately after the teaching with no follow-up. The session was delivered online by Gambling Harm UK, a registered UK charity, and comprised lived experience testimony and teaching with public health and clinical components. Self-reported confidence across six domains was assessed pre-and post-session on a five-point scale, alongside nine post-session attitudinal statements. Paired confidence data were analysed using the Wilcoxon signed-rank test with Hodges-Lehmann estimates of the median paired difference, with a Bonferroni-corrected significance threshold of p < 0.008 applied within each cohort.
ResultsSixty-eight paired responses were analysed (completion rates of 28%, 24%, and 32%). Statistically significant improvements in self-reported confidence were observed across all six domains in each cohort. Median confidence rose fromslightly confident before the session toquite confident afterwards, with median paired improvements of 1.5 to 2.5 points (all p [≤] 0.001). Post-session attitudinal responses were positive across all nine items, with lived experience the most strongly endorsed.
ConclusionsA single online teaching session on gambling harm was associated with significant and consistent improvements in self-reported confidence in recognising and responding to gambling harm across three cohorts of medical students. Whether these gains translate into changes in clinical behaviour requires longer-term, multi-site evaluation with behavioural outcome measures. Medical schools should consider how gambling harm teaching might fit within their curricula and evaluate its introduction, with the aim of normalising asking about gambling in routine social history taking alongside alcohol and smoking.
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BibTeX
@misc{albukai2026evaluating,
title = {{Evaluating the impact of a gambling harm focused educational intervention on medical students' self-reported confidence: a non-randomised, single-group pre-post study}},
author = {M. Albukai and A. Lovell and B. Jones and K. Patel},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.01.26361237},
url = {https://www.medrxiv.org/content/10.64898/2026.09.01.26361237v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Evaluating the impact of a gambling harm focused educational intervention on medical students' self-reported confidence: a non-randomised, single-group pre-post study
AU - M. Albukai
AU - A. Lovell
AU - B. Jones
AU - K. Patel
PY - 2026
DA - 2026/09/01
PB - medRxiv
DO - 10.64898/2026.09.01.26361237
UR - https://www.medrxiv.org/content/10.64898/2026.09.01.26361237v1
AB - BackgroundGambling harm is a significant public health concern that is systematically under-recognised in clinical practice. Despite the recent inclusion of gambling disorder in the General Medical Councils Medical Licensing Assessment content map, gambling harm has been largely absent from undergraduate medical education in the United Kingdom, and structured evaluations of gambling harm teaching delivered to medical students have not, to our knowledge, been reported. MethodsA single-group, pre-post study of a teaching session on gambling harm was conducted across three sequential cohorts of Year 4 medical students at Kings College London during the 2025-2026 academic year. Outcome measures were collected immediately after the teaching with no follow-up. The session was delivered online by Gambling Harm UK, a registered UK charity, and comprised lived experience testimony and teaching with public health and clinical components. Self-reported confidence across six domains was assessed pre-and post-session on a five-point scale, alongside nine post-session attitudinal statements. Paired confidence data were analysed using the Wilcoxon signed-rank test with Hodges-Lehmann estimates of the median paired difference, with a Bonferroni-corrected significance threshold of p < 0.008 applied within each cohort. ResultsSixty-eight paired responses were analysed (completion rates of 28%, 24%, and 32%). Statistically significant improvements in self-reported confidence were observed across all six domains in each cohort. Median confidence rose fromslightly confident before the session toquite confident afterwards, with median paired improvements of 1.5 to 2.5 points (all p [≤] 0.001). Post-session attitudinal responses were positive across all nine items, with lived experience the most strongly endorsed. ConclusionsA single online teaching session on gambling harm was associated with significant and consistent improvements in self-reported confidence in recognising and responding to gambling harm across three cohorts of medical students. Whether these gains translate into changes in clinical behaviour requires longer-term, multi-site evaluation with behavioural outcome measures. Medical schools should consider how gambling harm teaching might fit within their curricula and evaluate its introduction, with the aim of normalising asking about gambling in routine social history taking alongside alcohol and smoking.
ER -