Evaluating the impact of a gambling harm focused educational intervention on medical students' self-reported confidence: a non-randomised, single-group pre-post study

Background Gambling 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 Council's 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. Methods A single-group, pre-post study of a teaching session on gambling harm was conducted across three sequential cohorts of Year 4 medical students at King's 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. Results Sixty-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 from 'slightly confident' before the session to 'quite confident' afterwards, with median paired improvements of 1.5 to 2.5 points (all p [&le;] 0.001). Post-session attitudinal responses were positive across all nine items, with lived experience the most strongly endorsed. Conclusions A 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.