UAE Health Sciences Students Report Positive Views, Yet Few Register as Organ Donors
A cross-sectional survey in Ras Al Khaimah found a striking split between opinion and action: most health sciences students expressed generally favorable attitudes toward organ donation, but only 28.0% were registered donors. In a field where future clinicians are expected to counsel families, explain brain death, and support transplant referrals, that gap matters immediately. Students who will soon work inside the health system already carry the same barriers that shape public donation rates: incomplete knowledge, trust concerns, and uncertainty about what registration actually means.
The study surveyed 428 undergraduate students at Ras Al Khaimah Medical and Health Sciences University in the United Arab Emirates, across medicine, dentistry, pharmacy, and nursing. Investigators used a structured self-administered questionnaire to assess knowledge, attitudes, and donor registration status. The population was young, medically oriented, and embedded in a setting where organ donation has received growing attention through the national Hayat program. Even within that environment, registration remained far below what a health system would want from future frontline educators.
One sentence captures the central problem: positive sentiment did not translate into donor registration.
Knowledge Gaps Were Most Visible Around Brain Death and Eligibility
The mean knowledge score was 7.77 ± 2.85 out of 19, a level that points to real gaps in basic transplant literacy. Specific weaknesses were identified in understanding the definition of brain death, donor eligibility, and legal requirements. Those are not minor technicalities. Brain death determination is the cornerstone of deceased donation, and confusion around it can erode confidence in the entire donation process, especially when family conversations depend on clear explanations of what death means in clinical terms.
Poor knowledge also affects behavior in a more subtle way. If students do not fully understand how donation works, they are less likely to complete registration, discuss their wishes with relatives, or correct myths when those myths surface in the community. In a multicultural setting such as the UAE, where beliefs and family influence can shape end-of-life decisions, incomplete understanding can quietly suppress donor enrollment long before a formal refusal ever occurs.
The most frequently reported barrier among students who had not registered was lack of awareness, cited by 39.0% of non-registered participants. That finding suggests the issue is not simply reluctance or opposition. A large segment of the cohort appears to remain outside the registration pathway because the process, purpose, or practical implications of enrollment have not been fully absorbed.
Attitudes Were Positive, but Trust and Body Integrity Concerns Persisted
The mean attitude score was 41.58 ± 6.61 out of 65, indicating generally positive views toward organ donation. Even so, students voiced concerns that mirror well-known barriers in donation science: fears of organ misuse, body disfigurement, lack of trust, and reduced quality of medical care. These concerns are clinically important because they touch the credibility of the entire transplant chain. If a person worries that signing up as a donor could somehow alter the care they receive, the barrier is not informational alone; it is relational and institutional.
In practical terms, trust functions like an invisible precondition for donation. Students who believe the system will not protect patients, respect the body, or honor consent are less likely to move from approval in principle to formal registration. The mismatch between favorable attitudes and low enrollment suggests that attitude scores alone do not capture the emotional and cultural friction that stands between endorsement and action.
Registration behavior, in this study, did not track neatly with knowledge or attitude scores. Neither measure was significantly associated with donor registration. That finding is important because it implies that education alone, while necessary, may not be sufficient. Knowledge can rise without registration if the surrounding barriers — misconceptions, family dynamics, and mistrust — remain untouched.
Registration Varied by Nationality, Course, and Family Background
Multivariable logistic regression identified several groups with lower adjusted odds of registration. Non-Arab students had lower odds of being registered than Arab students, including Emiratis, with an adjusted odds ratio of 0.149 (95% CI 0.072–0.310; p < 0.001). Compared with medical students, the odds of registration were also lower among students in pharmacy (aOR 0.050), dentistry (aOR 0.032), and nursing (aOR 0.024), each with p < 0.001. Students with a medical parental educational background also showed lower adjusted odds of registration than those with a non-medical parental background (aOR 0.129; 95% CI 0.063–0.264; p < 0.001).
Those associations raise an important question about how medical identity and family context interact with donor behavior. One possibility is that students in medicine receive more direct exposure to the donor process and therefore may feel greater clarity or confidence about registration. Another is that differences in nationality, family background, and clinical training reflect deeper cultural pathways influencing how organ donation is discussed at home and in the classroom. The data do not prove mechanism, but they do show that registration is unevenly distributed even within a health sciences population.
What Medical Educators Can Do with These Findings
This study points toward a clear educational target: registration behavior needs to be addressed directly, not assumed from positive attitudes. For students, that means teaching should go beyond definitions and slogans. Curricula need to explain brain death, eligibility criteria, legal safeguards, and the consent process in plain language. They also need to confront the persistent fears that donation could distort care, damage the body, or expose families to misuse.
For institutions, the findings argue for culturally tailored outreach. In a university with students drawn from multiple national and social backgrounds, the same message will not land equally with everyone. Educational campaigns have to account for the fact that awareness, trust, and family influence may differ by discipline and background. A program aimed only at increasing factual knowledge may improve test scores without changing donor behavior.
This was a cross-sectional snapshot, so it cannot determine how attitudes or awareness evolve over time, and it cannot show whether any specific intervention would improve registration. Even so, the numbers are hard to ignore: positive views were common, actual registration was not, and the gap was widest where awareness and trust were weakest. For transplant systems that depend on public confidence, that gap is the part that demands attention now, not later.