From Barriers to Competence: Multi‐Institutional Exploratory Study of Perceived Competence, Attitudes, and Barriers in E‐Patient Communication Among Chinese Medical Students

Second‐generation E‐patients producing personal health data demand new clinical communication competencies, but the readiness of medical students—frontline doctors—remains unclear. This 17‐institutional cross‐sectional study of 310 Chinese medical students evaluated perceived competence, attitudes, barriers, and explored relationships via Structural Equation Modeling (SEM). Respondent profiles shifted toward male (70.32% vs. 48.70%), postgraduate (60.32% vs. 44.50%), Double First‐Class university (63.55% vs. 47.06%), and eastern (64.19% vs. 52.94%) students, reflecting heightened issue saliency and professional leverage. While 78.71% of the students held positive attitudes and 55.16% reported high overall competence, granular assessments revealed profound proficiency deficits, specifically in digital clinical data interpretation (proficiency < 30.00%), alongside pervasive situational barriers. Multivariable modeling confirmed positive attitudes as the principal predictor of high competence (OR = 2.282, 95% CI: 1.292–4.032, p = 0.004). SEM further revealed a challenge‐oriented pathway in which acute barrier awareness was positively related to attitudes ( β = 0.394) and subsequent proficiency ( β = 0.439). Despite small sample size limitations, the results underscore a significant mismatch between future physicians' digital health awareness and actual competence. We propose a model‐driven framework to deconstruct communication barriers to catalyze attitudinal elevation and subsequent competence acquisition, preparing such digital‐pioneer students for the data‐rich E‐patient landscape.