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The absence of in\u2011person environments may have affected professionalism components such as empathy, teamwork, and lifelong learning abilities, while also impacting students\u2019 mental health and wellbeing. The objective of this study was to measure that effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal study was conducted from 2020 to 2023 in the five medical and nursing faculties of Cusco, Peru. Two cohorts were followed: one with prolonged exposure to virtual learning and another with shorter exposure before resuming in\u2011person activities. Empathy (JSE), teamwork (JSAPNC), lifelong learning (JeffSPLL), depression (PHQ\u20119), anxiety (GAD\u20117), wellbeing (SWLS), and family loneliness (SELSA) were assessed with validated instruments, together with sociodemographic and academic variables. Analyses included reliability testing, paired and independent group comparisons, and multivariate regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 417 students (233 medicine) completed both assessments; 137 (33%) had prolonged virtual exposure. Wellbeing was positively associated with lifelong learning, age, and shorter virtual exposure, but inversely with empathy and family loneliness. Risk of depression decreased with teamwork and in nursing students but increased in those enrolled in the clinical phase at baseline. Anxiety was associated with greater family loneliness, while a history of severe COVID\u201119 illness was associated with lower risk. Students with shorter virtual exposure improved in empathy, teamwork, and learning abilities, whereas those with prolonged exposure did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings indicate that prolonged reliance on virtual learning undermines professionalism\u2011related competencies, which are important for students\u2019 mental health and wellbeing. They also highlight the role of family support and the need for medical education to balance technology with in\u2011person training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-09750-2","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:06:19Z","timestamp":1781715979000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Professionalism and mental health in medical and nursing students under prolonged virtual learning: a longitudinal study in Peru"],"prefix":"10.1186","volume":"26","author":[{"given":"Martha H","family":"Gonzales Sota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Berduzco-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"San-Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Gonzalez-\u00c1lamos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-6240","authenticated-orcid":false,"given":"Luis","family":"Vivanco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"9750_CR1","first-page":"15","volume-title":"Measuring medical professionalism","author":"L Arnold","year":"2006","unstructured":"Arnold L, Stern DT. 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BMC Med Educ. 2025;25:57.","journal-title":"BMC Med Educ"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-09750-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09750-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-09750-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:42:16Z","timestamp":1785390136000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-09750-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["9750"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-09750-2","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"7 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in collaboration between institutions in Peru and Spain, in accordance with the Declaration of Helsinki and national regulations. Ethical approval was obtained from the Research Ethics Committee of La Rioja, Spain (CEImLAR\u2011PI\u2011440), and the Research Ethics Committee of the National University of the Altiplano, Peru (03\u2011CIEI\u2011UNA\u2011PUNO), both acting as independent local ethics committees. All participants were informed that their participation was confidential and voluntary. Prior to participation, they signed an electronic informed consent form and were made aware that they could withdraw from the study at any time.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1223"}}