Constructing a medical humanistic competency framework for medical undergraduate students in China: a grounded theory approach

Abstract Objectives This study aims to develop a theoretical framework for medical humanities competency (MHC) within the five-year medical undergraduate education in China and suggest effective strategies to enhance MHC of medical undergraduates that can be derived from these studies. Methods Grounded theory methodology was utilized to develop a theoretical framework for MHC. A combination of purposive and theoretical sampling was used to engage 32 participants, including educators and students, from 10 universities spanning seven provinces in China. Data collection involved semi-structured interviews, complemented by supplementary materials like online documents, newspapers, and related literature. The amassed data was analyzed employing Strauss and Corbin’s triphasic coding technique, consistent with the constant comparative method intrinsic to grounded theory. Results A meticulous three-tier coding process discerned 28 third-level categories, 12 subcategories, and four principal categories crucial in formulating the final framework for MHC. This MHC framework embodies core components dubbed as the “4C” framework: comprehension of humanities, communication capacity, cooperation skills, and concern for “LEE” (law abidance, ethical reasoning, and emotional care). Concurrently, the study introduces “4R” (rules, relevance, responsiveness, and reflective practice) strategies to amplify the humanistic competencies of medical undergraduates. Conclusions This research proffers a theoretical MHC framework, positioning itself as a beacon for crafting medical humanistic syllabi in undergraduate medical programs. Medical educators, while acknowledging diverse cultural underpinnings, can adeptly harness both the “4C” framework and the “4R” strategies to nurture and augment the humanistic competence of medical students.