Abstract
BACKGROUND: Health-professional students increasingly learn via social-media influencers, yet the factors that make these sources trustworthy are unknown. Understanding this is critical for designing effective digital-literacy curricula. We investigated physiotherapy students' behavioural (following, purchasing) and attitudinal (trust) responses to social-media physiotherapy influencers and identified factors associated with higher trust. METHODS: We conducted a cross-sectional, computer-assisted web survey of 314 physiotherapy students from Polish universities. The questionnaire captured demographics, social-media use, influencer engagement, critical-appraisal training and attitudes toward influencer content. We used ordinal logistic regression to examine how demographic, behavioural, and attitudinal variables predicted students' trust in physiotherapy influencers. RESULTS: Most respondents (77.4%) followed at least one physiotherapy influencer and 46% had bought products they endorsed. Overall, 61% expressed high trust. Trust in influencers was most strongly predicted by frequent information-seeking from influencers (OR = 3.54, 95% CI 2.45-5.22), perceiving them as more informative than academic staff (OR = 2.00, 95% CI 1.46-2.76), and intensive Instagram use (OR = 1.41, 95% CI 1.06-1.87). In contrast, age, study year, and prior critical-appraisal training were not significant predictors of trust. Although 62% acknowledged commercial bias, these students still reported high trust and continued engagement, revealing cognitive dissonance. CONCLUSIONS: Physiotherapy students trust social-media influencers for professional knowledge, with platform use and perceived informativeness outweighing formal training in shaping this trust. To address this disconnect, medical-education programmes should move beyond traditional critical appraisal and embed authentic, influencer-based digital-literacy exercises that reflect students' real-world media habits and tackle credibility cues and commercial persuasion.