In response to the challenges posed by the profound integration of generative artificial intelligence(AI)into medical education,this consensus proposes a logically coherent,medically distinctive,forward-looking,and operable AI proficiency framework for medical educators(competency items of medical educators’ AI proficiency,CAIP-ME).Through systematic literature review,preliminary framework construction,multiple rounds of expert pre-study,and a structured Delphi method involving extensive consultations with 60 interdisciplinary experts,the core competency items and assessment standards for AI proficiency among medical educators were demonstrated and calibrated.The framework encompasses five core dimensions and 25 specific competency items.The five dimensions are value recognition and ethical foundation,technical understanding and tool application,teaching integration and innovative practice,learning assessment and precise empowerment,and professional development and ecosystem co-construction.Competency items are categorized into 11 foundational competency items essential for all educators and 14 developmental competency items for those pursuing excellence.Each competency item is described in terms of its conceptual definition and key behavioral manifestations,accompanied by observable assessment indicators.This consensus aims to provide a scientific basis for the professional development of medical educators and the faculty building in medical institutions,while establishing a key reference standard for educator competency development in the context of digital transformation in medical education.

To cultivate composite medical professionals capable of adapting to the development of intelligent healthcare,this consensus is grounded in the competency-based medical education,integrating the competency model and Miller’s pyramid of clinical competence. A two-round Delphi method involving a multidisciplinary expert panel was conducted,combined with a systematic literature review,to develop a 21-indicator artificial intelligence(AI) literacy competency list for medical students across three domains:knowledge (8 indicators),skills (8 indicators),and attitudes (5 indicators). Furthermore,the consensus proposes a practical assessment system:standardized testing for the knowledge domain,situational judgment tests for the attitudes domain,and objective structured clinical examinations incorporating AI-related scenarios for the skills domain. In addition,a longitudinal assessment strategy spanning the phases of admission,preclinical training,and clinical training is recommended. The competency list and assessment framework established in this consensus demonstrate strong scientific rigor,authority,and practical applicability,and can serve as an important reference for medical schools seeking to advance the deep integration of AI and medical education and to cultivate composite medical talents suited to the era of intelligent healthcare.

The research and innovative applications of generative medical artificial intelligence(GMAI)are rapidly advancing in the healthcare field.Significant breakthroughs of GMAI have been achieved in areas such as generating diagnostic suggestions,optimizing treatment plans,and assisting doctor-patient communication,profoundly reshaping the paradigm of clinical diagnosis and treatment.However,the open-ended nature of GMAI’s generation raises novel ethical challenges,including algorithmic bias,ambiguous accountability,data privacy breaches,and insufficient cultural adaptability.Current ethical governance lags behind technological implementation,necessitating the establishment of a standardized governance framework.Our research team assembled a multidisciplinary panel of experts spanning medical ethics,clinical medicine,medical artificial intelligence,hospital management,public health,and law.According to the governance logic of “prevention-control-remediation” and integrating international norms with domestic policies,this consensus was developed through two rounds of expert consultation to unify opinions and perspectives.It aims to provide a reference for the specific practice of clinical ethical review in the research and clinical application of GMAI and to establish an authoritative guidance framework for the clinical ethical governance of GMAI,tailored to China’s cultural context and national requirements.

By comprehensively utilizing literature analysis to trace the disciplinary evolution and theoretical foundations of palliative medicine globally and domestically,and employing comparative research to examine the discipline accreditation standards and implementation practices from internationally recognized bodies,including the Royal College of Physicians and Surgeons of Canada and the American Board of Medical Specialties,we clearly define the conceptual definitions and logical relationship between palliative care(as clinical practice)and palliative medicine(as an academic discipline).On this basis,we systematically examine the core issues in constructing palliative medicine as a discipline,including its intrinsic development logic(knowledge system architecture)and extrinsic support(institutional frameworks).By analyzing international experiences in discipline development,we propose a context-specific development strategy to promote the systematic and standardized institutionalization of palliative medicine in China.

We examine the status and path of the discipline construction of palliative medicine from both knowledge and institutional dimensions.From the knowledge dimension,palliative medicine is driven by the demand of the times and has significant interdisciplinary characteristics.From the institutional dimension,the development direction of palliative medicine remains to be clarified,despite the established foundation.It is recommended that the boundaries of palliative medicine,hospice care and other secondary disciplines of clinical medicine be clearly defined from the knowledge dimension.From the institutional dimension,establishing a pilot master’s degree program in palliative care is proposed as a key breakthrough,and the collaboration of multiple stakeholders should be promoted to advance the institutionalization and knowledge innovation of this discipline.

A review of the development course of palliative care reveals that its goal of alleviating suffering determines the indispensability of the social dimension in this field.As palliative care emerges in response to the general trends such as aging and disease spectrum changes of social development,it naturally becomes one of the key solutions to social issues including the difficulties in caregiving and hospitalization for end-of-life patients.Beyond its social value,the comprehensiveness and localization of care emphasized by palliative care also require the support and intervention of theoretical perspectives such as social support and sociocultural adaptation.Through the framework of suffering and care,medicine and social sciences have achieved significant interdisciplinary integration in palliative care.

Palliative medicine is a newly emerging branch of clinical medicine,with palliative care forming the core of its clinical practice.It is experiencing dynamic progress in China.This paper analyzes the similarities and differences among four definitions of palliative care to reveal the theoretical breakthroughs emerging from its localization process.From the perspective of body philosophy,it elucidates the shift in clinical reasoning from symptom management to holistic care.Palliative care,grounded in the integrity of the human body,implements the holistic care that approaches patients’ pain,suffering,social relationships,and meaning making as an integrated system.This paper argues that the body possesses dual ontological status as both a site of medical intervention and an existential medium of intersubjectivity.And the body philosophy provides one of the philosophical foundations for the practice and disciplinary development of palliative medicine.

Objective To explore how physicians exercise agency in palliative care under cultural,technological,and institutional constraints. Methods This study integrated death narratives with participatory observation in a palliative care center of a tertiary hospital in Beijing and systematically analyzed the data by reflexive thematic analysis. Results Physicians faced three structural constraints:medical familism at the cultural level,which hindered information sharing and patient autonomy;a technology-first tendency leading to overtreatment and misaligned goals;and institutional resource shortages with marginalized values.In response,they employed three key agency strategies:acting as communication mediators to build trust;serving as decision navigators to refocus families on patient interests;and coordinating care networks to address psychosocial and spiritual needs. Conclusions Physicians demonstrate contextual and strategic agency in palliative care,creating space to improve care under structural constraints.This study provides empirical support for localized practice and highlights the need for institutional reinforcement of physician agency.