Perceived value, structural barriers, and academic burnout under the “hard science vs. soft skills” paradox: a cross-sectional study among Chinese medical students

Vollständiger Abstract

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Introduction Medical education frequently prioritizes biomedical knowledge over humanistic training, a hierarchy that may be associated with academic burnout. While the tension between “hard science” and “soft skills” is a recognized global challenge, empirical evidence regarding how students' specific cognitive appraisals, especially perceived value and structural barriers, relate to burnout. This study examined the multivariate relationship between these appraisal components and academic burnout among clinical medical students in China. Methods A cross-sectional survey was conducted among 165 undergraduate clinical medical students. Participants completed the Perceived Value Scale, Perceived Barriers Scale, and a modified Academic Burnout Scale. The adapted perceived value and perceived barriers instruments were documented through item-domain mapping, exploratory factor analysis/principal-component extraction, and internal consistency evidence. Canonical correlation analysis (CCA) was used to examine associations between the cognitive appraisal set and burnout dimensions. Results Students reported high perceived value of medical humanities ( M = 4.25) despite moderate structural barriers ( M = 3.06). Perceived value and perceived barriers were not significantly correlated ( r = −0.075, p > 0.05), indicating cognitive decoupling between valuing humanities education and perceiving structural obstacles. The first canonical function was significant ( r c = 0.502, p < 0.001). After distinguishing canonical weights from structure coefficients, the function indicated that higher perceived value and lower perceived barriers were associated with a more favorable burnout profile. Within the burnout set, cynicism showed the strongest structure coefficient (−0.796), followed by academic efficacy (0.682) and emotional exhaustion (−0.678), suggesting that structural barriers were most closely aligned with psychological detachment from learning. Conclusion Perceived value and structural barriers appear to represent related but distinct educational appraisals. The findings suggest that increasing recognition of medical humanities may be insufficient if structural learning costs remain high. Medical education reform may therefore benefit from shifting from an additive model to an integrative model that embeds humanities into clinical learning contexts, reduces perceived barriers, and supports professional development.