National health survey data as a resource for nursing education: a comparative study of nursing students’ and young adults’ perceptions of the health system

Preparing nursing students to critically appraise healthcare systems is a key educational priority. National health opinion surveys, although widely used by policymakers, remain underexplored in nursing education as tools to foster critical thinking and systems-level awareness. This study aimed to examine nursing students’ perceptions of the Spanish health system compared with those of young adults from the general population, and to consider the potential use of national health surveys as a proposed educational application arising from this comparative study. A two-site, single-university descriptive comparative design was applied. Data were collected from third-year nursing students at the Santiago de Compostela and Lugo campuses of the University of Santiago de Compostela ( n = 97) and compared with secondary data from young adults aged 18–25 included in the 2024 Spanish Health Barometer ( n = 411). Selected items from the Spanish Health Barometer were administered to the student group, and the resulting responses were compared with the corresponding data from the national dataset. Comparative analyses were conducted using an omnibus chi-squared test and Welch’s t-tests, with effect sizes and Benjamini–Hochberg-adjusted q-values reported. Students assigned a higher mean rating to the overall functioning of the health system than young adults in the national dataset (7.00 vs. 6.47; p < 0.001; g = 0.326). However, the categorical item showed a different pattern: fewer students considered that the system worked quite well (4.1% vs. 11.0%), whereas more judged that fundamental changes were required (40.2% vs. 31.1%). Students also reported higher ratings for hospital emergency services ( p < 0.001; g = 0.312) but lower trust in primary care physicians ( p < 0.001; g = − 0.318) and lower ratings for the time dedicated by physicians ( p < 0.001; g = − 0.423). All these differences remained significant after Benjamini–Hochberg correction. Trust in nurses did not differ significantly between groups. Nursing students and young adults showed a mixed pattern of perceptions of the Spanish Health System. National health survey data may provide a useful basis for comparing professional and public perspectives, although the educational application proposed in this study requires formal implementation and evaluation. National survey data represent a potentially useful resource for nursing education. Future intervention studies should evaluate whether their structured use supports critical thinking, systems literacy, and policy awareness.