Research on the Optimization of the Talent Training Program for Undergraduate Clinical Medicine Major in China from the Perspective of Humanities Education

다국어 초록 (Multilingual Abstract)

Humanistic education is the core educational process that shapes the humanistic literacy and professional values of future medical practitioners. However, current medical humanistic education in China faces the dilemma of educational efficacy, rooted in the broad design of talent cultivation programs that fail to adequately nurture medical students 'humanistic literacy, resulting in a disconnect from the growth logic of knowledge internalization-belief establishment-practice generation among medical students. This systemic rupture in the humanistic education process directly hinders the achievement of educational objectives. To address this, this study adopts an intrinsic perspective from pedagogy, focusing on revealing the mechanisms of educational rupture and constructing implementation pathways, aiming to explore optimization strategies for medical humanistic education programs. Therefore, this study seeks to propose targeted optimization strategies for undergraduate clinical medicine talent cultivation programs in line with the intrinsic requirements of humanistic education, with the goal of enhancing the effectiveness of medical humanistic education and comprehensively improving medical students' humanistic literacy. To achieve the above research objectives, this study focuses on three research questions: What is the current status of medical humanities literacy among Chinese medical students? What are the implementation challenges in cultivating humanities literacy under the current talent training program? How can the humanities literacy of Chinese medical students be improved? This study employs the visualization analysis method based on CiteSpacesoftware, focusing on 2,330 valid articles related to medical humanities education from 2000 to 2024 in the China National Knowledge Infrastructure (CNKI) database, to conduct an in-depth analysis of the current status and hotspots of medical humanities education in China. Taking fourth and fifth-year students majoring in clinical medicine from nine medical schools in Zhejiang Province as research subjects, the study analyzes the current status and challenges of humanistic literacy among undergraduate clinical medicine students in China through questionnaire surveys. By examining the talent cultivation plans for undergraduate clinical medicine students from 14 different medical schools across China, the study employs text analysis to assess the current status and implementation challenges of humanistic literacy at the plan level. Additionally, 12 experts with profound expertise and rich experience in medical education, humanities education, clinical teaching, and educational management from these 14 universities were interviewed using semi-structured interviews to propose supplementary standards for talent cultivation plans. The study reveals a widespread phenomenon among medical students characterized by knowledge without belief and belief without practice, which aligns closely with design flaws in talent development programs and exposes a tripartite disconnect between knowledge, belief, and practice. Innovatively, this research establishes an integrated analytical framework combining the Knowledge-Attitude- Practice Theory with the Taylor's Principle. From a humanistic education perspective, it focuses on cultivating medical students'humanistic literacy and develops the Supplementary Standards for Clinical Medicine Talent Development Program (Medical Humanistic Literacy), comprising four major systems: a concrete, hierarchical goal system; an experiential, integrated curriculum and teaching system; a process-oriented, competency-based evaluation system; and an immersive, supportive educational ecosystem. In summary, this study focuses on cultivating medical students 'humanistic literacy through medical humanities education. From the perspective of improving talent training programs, it confirms the current status and challenges of the Knowledge-Attitude-Practice disconnection in medical humanities education through empirical research. It constructs an integrated framework of Taylor's Principle and Knowledge-Attitude-Practice Theory, providing a powerful theoretical lens for examining issues in medical humanities education. By employing grounded theory methods, it distills a systematic and operational supplementary standard framework from practical wisdom, offering theoretical basis, analytical methods, and concrete practical guidance for Chinese medical schools to optimize talent training programs and enhance medical students' humanistic literacy. However, due to the survey questionnaire sample being limited to a specific region, the generalizability of its conclusions across the country requires further verification. Additionally, it has not yet deeply tracked the implementation process and effects of the supplementary standards in specific teaching and practical fields.

목차 (Table of Contents)

• Ι. Introduction 1
• 1.1 Research Necessity and Research Objectives 1
• 1.2 Research Questions 7
• Ⅱ. Theoretical Background 10
• 2.1 Concept Definition 10
• 2.1.1 Concepts related to medical humanities education 10
• 2.1.2 Talent training program. 15
• 2.1.3 Comprehensive universities'medical schools (departments) and independently established medical institutions 17
• 2.1.4 Clinical medicine major from the perspective of humanities education 19
• 2.2 The Historical Evolution of Humanities Education 20
• 2.2.1 The development of western humanistic education 20
• 2.2.2 The development process of China's humanistic education 22
• 2.3 Introduction to the National Policy Context Related toMedical Humanities Education 25
• 2.4 Theoretical Basis 29
• 2.4.1 Knowledge, Attitude, Practice (KAP) Theory 29
• 2.4.2 Taylor's principle 42
• 2.4.3 Constructivist teaching theory 44
• 2.5 Literature Review 46
• 2.5.1 Trends in the development of medical humanities education 46
• 2.5.2 Cultivating the humanistic literacy of medical students 47
• 2.5.3 The influence of medical humanities literacy on medical education 49
• 2.5.4 Research review on the training program of China clinical medicine specialty talents 50
• 2.5.5 Review of the current research status 55
• Ⅲ. Methodology 58
• 3.1 Research Methods 58
• 3.1.1 Visual analysis based on CiteSpace software 58
• 3.1.2 Questionnaire survey method 59
• 3.1.3 Text analysis method 60
• 3.1.4 Semi-structured interview method 62
• 3.2 Research Subjects 62
• 3.2.1 The research subject of visual analysis of CiteSpace software 62
• 3.2.2 The research subject of the questionnaire survey method 62
• 3.2.3 The research subject of textual analysis method 64
• 3.2.4 The research subject of semi-structured interview method. 67
• 3.3 Research Design 69
• 3.3.1 Questionnaire data analysis process 69
• 3.3.2 Interview data analysis process 70
• 3.4 Basic Framework of Research 71
• Ⅳ. Analysis of the Current Situation of Medical Humanistic Quality of Chinese Medical Students 73
• 4.1 Visualization Analysis of Research Hotspots and Trends of Medical Humanities Education 74
• 4.1.1 Annual statistics on the number of publications issued 74
• 4.1.2 Co-occurrence and centrality analysis of keywords 76
• 4.1.3 Keyword clustering analysis 81
• 4.1.4 Keyword emergence analysis 84
• 4.1.5 Analysis of keyword time zone map and keyword timeline map 86
• 4.2 The Current Status of Medical Humanities Literacy among Chinese Medical Students 89
• 4.2.1 Characteristics of the knowledge dimension 90
• 4.2.2 Characteristics of the attitude or belief dimension 94
• 4.2.3 Characteristics of the practical ability dimension 99
• 4.2.4 Comprehensive evaluation 101
• 4.3 Current Status of Talent Cultivation Programs 102
• 4.3.1 Characteristics of the training objectives 102
• 4.3.2 Characteristics of the training requirements 114
• 4.3.3 Features of the course curriculum. 117
• 4.3.4 Distribution of semesters and characteristics of class hours for the course 122
• Ⅴ. The Implementation Dilemma of Humanistic Literacy Cultivation 134
• 5.1 The Dilemma of Questionnaire Survey 134
• 5.1.1 Floating Knowledge: learning experience and alienation of humanities courses 134
• 5.1.2 Swaying Belief:the collision and confusion between clinical reality and humanistic ideal 136
• 5.1.3 Affective Speechlessness: The action dilemma under the pressure of institution and situation 138
• 5.1.4 Systematic review: insufficient support of teaching system exacerbates KAP fracture 139
• 5.1.5 Merging the Fracture: Constructing the Education Ecology of KAP 139
• 5.2 The Dilemma of Talent Training Program. 141
• 5.2.1 Vague Vision: the lack of behavior of cultivation goal 141
• 5.2.2 The blueprint of suspension: logical distances in the cultivation requirements 148
• 5.2.3 Isolated island: curriculum experience selection and systematic deviation of organization 154
• 5.2.4 Broken time and space:structural break of learning experience organization 159
• 5.2.5 The silent baton: the lack of evaluation orientation 165
• Ⅵ. Suggestions on the Construction of Supplementary Standards for the Training Program of Clinical Medicine Specialty Talents 169
• 6.1 Analysis of the Core Dilemma of Medical Humanities Education Based on the Cross-Validation of Taylor's Principle and KAP Theory 169
• 6.2 The Construction Process of the Supplementary Standard of Talent Training Program (Medical Humanistic Literacy) 174
• 6.2.1 Theoretical foundation and core principles of the "supplementary standards" 175
• 6.2.2 Analysis of interview data 175
• viii 183
• 6.2.3 The framework of the supplementary standards 183
• 6.2.4 Research on quality control 189
• 6.3 The Theoretical Model of Systematic Break and Reconciliation of the Transformation Path of "Knowledge-Attitude-Practice" 195
• Ⅶ. Conclusion 198
• 7.1 Research Meaning 198
• 7.1.1 Theoretical significance 198
• 7.1.2 Realistic meaning 199
• 7.2 The Innovation and Limitation of the Research 200
• 7.2.1 The innovation of this study 200
• 7.2.2 Limitations and Prospects of the Study 202
• References 204
• Appendix 217