The results demonstrated that most students do not feel knowledgeable and did not receive a passing score for adverse effects and approved indications.Notably, four studies used the same instrument , which was developed by the Regional Alcohol and Drug Abuse Research  Center at Ben Gurion University of the Negev . The search strategy resulted in data from ten countries: The United States, Canada, Serbia, Russia, Israel, Spain, South Africa, Malta, Belarus, and Poland. As shown in Table 2, which summarizes the distribution of studies by country and discipline, the largest number of studies  took place in the United States where the legalization of medical cannabis varies by state. Furthermore, medical cannabis is not legal in all of the remaining countries examined. Twelve studies out of the 23 examined, in eight of the ten countries, focused on the field of medicine, and examined the education of medical cannabis in the medical school curriculum. Pharmacy was the second most common field of study making up seven out of the 23 studies and was examined in three countries. Finally, two studies examined the topic in the field of nursing, two articles focused on the field of psychology, and one study surveyed nurse practitioner programs. In general, it was found that there was no structured curriculum or competencies on medical cannabis in most schools. Four studies revealed that students receive most of their education on medical cannabis from extracurriculars and sources outside of school. We also found that this aligns with the belief commonly expressed among students that they lack adequate education, mentorship, and guidance on this subject. In the studies assessed, students overwhelmingly reported that they do not feel knowledgeable or comfortable to counsel patients on medical cannabis, mostly due to a lack of evidence-based knowledge. However, students’ beliefs about the efficacy of medical cannabis varied depending on culture, religion, location, and prior personal use. For example, one study in Israel reported that religious students were more likely to have negative attitudes about medical cannabis.In addition, a study in Malta and Russia found that secular students were more likely to recommend medical cannabis than religious students.

Students in several studies also cited prior personal use as a factor influencing knowledge, where it was determined that, in general, these students had more knowledge on this subject and were more likely to recommend medical cannabis to patients. Faculty perspectives were also considered in five of the studies analyzed. Three of these studies focused on pharmacy curriculum, and in all three studies, the faculty described that medical cannabis was included in their curriculum. In a study based in Ohio,vertical grow rack over half of the faculty surveyed from multiple states with legalized medical cannabis stated that medical cannabis was incorporated in the curriculum either as an elective or required course.Another study from the same year concurred with these findings, reporting that over half of the respondents claimed that medical cannabis education is included in the first two years of school. The third study from Canada described that medical cannabis is taught, but there is limited teaching time to about 4 h and there is no standardized curriculum.The results of these studies also indicated that some schools are hoping to expand upon or include medical cannabis into their curriculum if not already present. The two additional studies including faculty focused on the fields of nurse practitioners and medicine, and there was agreement that trainees require more education on medical cannabis and are unprepared to counsel patients on this topic with the current education they are receiving.Cannabis is recently emerging as a potential therapeutic agent in many places, and regulatory frameworks are accordingly evolving around the world. Therefore, the objective of this study was to identify and assess the current literature about medical cannabis education among trainees and faculty of health professions, and to examine their prominent beliefs and views related to their competency to integrate cannabis into their clinical work once graduated. Overall, trainees in all health disciplines reported on low levels of perceived knowledge on medical cannabis and lack of formal education on this topic. Correspondingly, they expressed feeling unprepared to counsel patients on appropriate use of medical cannabis. Studies that have surveyed curriculum/education deans at academic institutes affirmed the lack of structured and standardized education. These results disclose the large gap between the need of guidance on medical cannabis by patients and the professional capacity of healthcare providers to deliver such guidance.The beliefs reported by trainees align with those reported by certified healthcare professionals. Specifically, cannabis was perceived to potentially benefit certain conditions, but was additionally considered to cause physical or mental harms as an addictive substance. These views reflect the innate conundrum of cannabis, as being a potential therapeutic agent but also a substance of abuse.Although cannabis has been used for medical purposes throughout history, only in recent years is it being reintroduced as an optional part of modern pharmacopeia.

Nonetheless, the legal status of medical cannabis varies among states and countries, and the relevant legal frameworks differ considerably. However, major differences were not observed between studies conducted in places where medical cannabis is legal as opposed to where it is not . Indeed, despite the fact that our scoping review revealed a limited amount of research done to assess attitudes and knowledge of medical and allied healthcare trainees about medical cannabis, there appears to be a uniform lack of education and desire to learn more about this field, regardless of its legal status. Students are not merely educated in medical schools, but are also being indoctrinated to adhere to professional norms and conceptions. While the biomedical model of medicine is a dominant paradigm in healthcare, it, in fact, clashes with the integration of cannabis into the medical practice, similar to herbal medicines as well as to other complementary practices. Ostensibly, trainees’ attitudes and perceived knowledge may be influenced from various factors, which are not necessarily related to the current state of scientific evidence. For example, one study pointed to religion as a factor which may influence perceptions about medical cannabis,and another study suggested that personal experience may be associated with more perceived knowledge on medical cannabis.Finally, a considerable amount of students reported getting their information about medical cannabis from non-scientific sources, and previous studies suggest that sources such as the online sources may have an impact on attitudes towards medical cannabis.Inevitably, there is a tangible mismatch between the reported beliefs of trainees and the current evidence-base as outlined in the 2017 NASEM report. Clearly, the lack of education on medical cannabis ought to be addressed. Currently, however, academic programs for health professions lack any structured and uniform curriculum, and previous research points to resistance among academic administrators to such additions to the core curriculum. Moreover, the Accreditation Council for Graduate Medical Education  or equivalent regulatory bodies worldwide offer no guidance for how to tackle the current educational gap. As a result, only sporadic institution-level efforts are being made to incorporate medical cannabis into the curriculum. For example, the Lerner College of Medicine in the University of Vermont has created an online course on medical cannabis, which has drawn more students than expected, but this is a non-credit course that is not integral to the medical education program.Furthermore, there is currently no standardized resource  to facilitate proper evidence-based education on medical cannabis.Given the scarcity of formal curricula within academic centers, establishing a set of ACGME-approved competencies appears to be a high priority that can aptly facilitate the development of medical cannabis education. This scoping review is inherently restricted by the limitations of the studies which were included in our analysis. Indeed, poor and inconsistent methodologies have been applied in most of the studies reviewed, which have used cross-sectional designs to survey non-representative samples; moreover, sample sizes were not justified and consisted of low response rates. In addition, the instruments which were used are not validated or uniform, and such flaws clearly undermine the ability to adequately draw comparisons between the findings and form robust conclusions. Indeed, a validated and uniform instrument is warranted in order to facilitate the generation of reliable information.

In this context, the instrument developed by the RADAR Center in Israel is noteworthy, as it has already been used in several studies worldwide.An additional limitation is that we only searched for literature in English. However, we assume that studies around the world are generally published in peer-reviewed literature in English. Notwithstanding its limitations, this novel study sheds light on the current status of medical cannabis grow racks education, and it may serve to direct the developments of future studies and academic endeavors alike. Since modern health care education is normally based on competencies, we suggest that a formal set of competencies related to medical cannabis should be established in order to guide the formation of curricular inclusion. This would dictate the scope of courses that are needed for providing adequate education, which may vary across healthcare disciplines. Although curricula are indeed horrendously overloaded, we argue that this should not serve as a reason for excluding medical cannabis from healthcare curricula. Academic education on medical cannabis may only be feasible with the support of governmental granting agencies, such as the NIH, in order to avoid potential biases andconflicts of interest if such programs were to be sponsored by the industry. In conclusion, while the medical cannabis landscape is developing, medical and allied health students are not properly educated and knowledgeable on this emerging field of clinical care. This appears to be common across disciplines and countries. Given the massive gap between public interest in medical cannabis and lack of qualified practitioners offering balanced guidance, it is essential that future providers are trained appropriately and enter the workforce well equipped with knowledge based on a set of approved medical cannabis competencies. It is well documented by the Greek historian Herodus  and the Greek physician, pharmacologist and botanist, Pedanius Dioscorides that ancient Greeks cultivated and used cannabis to treat medical conditions such as inflammation, earache, edema, nosebleeds and tapeworms.Cannabis cultivation, commerce and use were illegal in Greece during the 20th century.In 2013, the use of Cannabis Sativa L  with tetrahydrocannabinol  0,2%, was legalized for medical purposes by Law 4139.In 2017, Greece became the sixth country of the European Union partnership to produce and market cannabis-related products.Following this action, in 2018, the Greek state passed legislation  which permitted cannabis cultivation for the production, distribution and commerce of Cannabis Sativa L  0,2 %, and related/derived products.This action involved the Greek National Organization for Medicines; however, the legislation does not identify the medical conditions for which cannabis can be administered, or the healthcare professionals who are entitled to prescribe/administer cannabis for medical purposes.

Additionally, there are no official sources of information or training on medical cannabis  in Greece; and, only a few Greek associations on patient rights provide information on this topic via their webpage.Distribution, commerce and use of cannabis for recreational purposes continue to remain illegal in the country. Within this context, MC appears to be an important issue for the Greek nursing profession and, especially, students who after graduation are expected to manage MC-related therapies or be employed in substance use therapeutic settings. However, there is a lack of usable information about Greek student attitudes, beliefs and knowledge towards MC. Furthermore, internationally, few studies have investigated the MC issue among nursing students; what information is available tends to focus on such professions as medicine and pharmacy and issues about MC legalization. Regarding Greece, specifically, only one study was found that qualitatively explores the attitudes of Greek physicians on the use of MC. This study of only 10 physicians highlighted a lack of robust information and training on MC by government organizations.The present study aimed to assess the attitudes, beliefs and knowledge of Greek university nursing students towards MC. It was hypothesized that these conditions are associated with year of study and student undergraduate or postgraduate academic status. Cluster sampling was performed on 49–66 participants, depending on year of study . This method ensured better representation of the NKUA nursing students.