Value Configurations Associated with Artificial Intelligence Literacy Among Medical Students: Findings from NCA and fsQCA

Abstract

Artificial intelligence (AI) is increasingly integrated into healthcare education, clinical decision-making, and future practice. For medical students, AI literacy entails technical understanding, practical competence, ethical awareness, value-based judgment, and responsible engagement. This study examines how culturally embedded value orientations are associated with Chinese medical students’ perceived AI literacy, as assessed using a self-report instrument. In a cross-sectional sample of 1500 medical students enrolled at a comprehensive university in Henan Province, China, AI literacy was assessed using the 12-item Artificial Intelligence Literacy Scale (AILS), a self-report measure whose scores represented perceived AI literacy. Value orientations were measured using the 32-item Chinese Values Questionnaire (CVQ), comprising eight value dimensions. NCA and fsQCA were conducted to examine necessary conditions and configurational associations with membership in the high perceived AI literacy set. No single value dimension met the criterion for set-theoretic necessity with respect to membership in the high self-reported AI literacy set, and no individual condition met the fsQCA necessity consistency threshold of 0.90. Four sufficient configurations associated with high perceived AI literacy were identified, with an overall solution consistency of 0.867 and coverage of 0.383. Moral Self-Discipline and Public Interest repeatedly appeared as core or peripheral conditions. These results suggest that high perceived AI literacy was associated with multiple combinations of value orientations rather than with a single value dimension. High perceived AI literacy was associated with multiple value configurations rather than one dominant value orientation. Empirically, this study applies configurational analysis to understand how value orientations are associated with AI literacy, complementing existing research on knowledge, attitudes, and readiness. These context-bound associations may inform future research on whether medical AI curricula can integrate technical training with ethical reflection and public-oriented professional values.