Abstract: Objective To analyze the current status and influencing factors of medical ethics cognition and privacy protection attitudes among undergraduate students majoring in medical imaging, and to provide evidence for the staged optimization of ethics education content and scenario-based teaching of imaging data privacy protection. Methods In November 2023, a total of 269 undergraduate students majoring in medical imaging were selected from seven geographical regions in China using a multistage stratified sampling method. A self-designed questionnaire was used to collect data on general information, medical ethics cognition, privacy protection attitudes, and education and training experiences. According to the type of data, the chi-square test was used for intergroup comparisons, and multiple linear regression analysis was performed to identify related influencing factors. Results Among the 269 undergraduates, 183 students (68.0%) were in the high-score group for medical ethics cognition, and 213 students (79.2%) were in the high-score group for privacy protection attitudes. A total of 229 students (85.1%) had studied medical ethics courses or received ethics-related training, among them, 72 students (31.4%) were able to list practical scenarios related to medical imaging ethics; and 192 students (71.4%) had received medical ethics education or privacy protection training. Regarding support for privacy protection measures, 220 students (81.8%) supported strict restriction of data access, 236 students (87.7%) supported strengthening data encryption, and 224 students (83.3%) supported privacy protection education. The distribution of medical ethics cognition score levels differed significantly by grade and by whether students had received medical ethics education or privacy protection training (all P<0.001). The distribution of privacy protection attitude levels differed significantly only by whether students had received medical ethics education or privacy protection training (P=0.039). Multiple linear regression analysis showed that grade, medical ethics education or privacy protection training score, and ethics importance recognition score were positive influencing factors for the total medical ethics cognition score (β=0.417, 0.398, and 1.153, all P<0.001). Training helpfulness for professional development score, privacy protection importance recognition score, and data processing priority score were positive influencing factors for the total privacy protection attitude score (β=0.250, 1.313, and 1.094, all P<0.05). Conclusions Undergraduate students majoring in medical imaging generally showed good medical ethics cognition and privacy protection attitudes, but a gap remained between medical ethics education or privacy protection training and its translation into practice. Medical colleges and universities should provide staged medical ethics education according to students′ learning stages and carry out scenario-based practical teaching focused on restricting data access, strengthening data encryption, and privacy protection education, so as to improve students′ medical ethics cognition and practical ability in privacy protection.

Key words: Ethics, medical, Medical imaging, Privacy, Cognition, Current status, Influencing factors