Digital literacy across disciplines scale for medical students: development, validation, and analysis

Abstract

PURPOSE: To develop and validate a Digital Literacy Across Disciplines (DLAD) scale for medical students, analyze its differential performance across gender and major groups, and provide insights for the digital transformation of medical education. METHODS: Based on Zhou Xiaoli's theoretical framework of DLAD, integrated with World Federation for Medical Education (WFME) standards and Accreditation Council for Graduate Medical Education (ACGME) guidelines, a scale was developed through literature analysis, expert review, student feedback, and formal testing ( n = 675). Reliability and validity were assessed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), whereas differences across majors and genders were analyzed via the Kruskal‒Wallis H test and the Mann‒Whitney U test. RESULTS: EFA revealed a four-factor structure (Technology, Competence, Attitude, Knowledge), accounting for 61.5% of the cumulative variance. CFA further validated the model with strong structural validity (CFI = 0.919, TLI = 0.906, RMSEA = 0.069, SRMR = 0.057) and high internal consistency (Cronbach's α = 0.93). The finalized scale comprises four dimensions: Technology (3.71, IQR = 0.57), Attitude (3.75, IQR = 0.75), Knowledge (3.75, IQR = 1.00), and Competence (3.00, IQR = 0.89), with a total score of 3.42 (IQR = 0.67). Significant disparities were observed:Clinical Medicine students scored significantly lower in total score (3.08, IQR = 0.85) and subdimensions (Technology: 3.43, IQR = 1.00); Competence: 2.56, IQR = 1.11; Knowledge: 3.25, IQR = 1.25) compared with Preventive Medicine (3.69, IQR = 0.41, p < 0.001), Medical Imaging Technology (3.67, IQR = 0.79, p < 0.001), and Nursing (3.54, IQR = 0.50, p < 0.001).Female students outperformed males in the Attitude dimension ( p = 0.008, r = 0.1). CONCLUSION: This study developed the first validated DLAD scale for medical education, revealing critical gaps in digital competence and interdisciplinary disparities. Embedding digital diagnosis-treatment simulations into curricula is recommended to enhance skill integration.

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