Development and psychometric validation of the medical humanistic care scale

A BSTRACT Objectives: This study aimed to develop and validate the “Medical Humanistic Care Scale” (MHCS), a novel multidimensional instrument tailored to the Taiwanese healthcare education context. The scale addresses the limitations of existing tools by integrating social, institutional, and ecological dimensions essential for modern medical education. Materials and Methods: An initial item pool was established through literature review and focus group interviews. The validation process was conducted in two phases: a pilot phase ( N = 155) using exploratory factor analysis (EFA) to determine the latent structure, and a formal phase ( n = 331; including medical and nursing students and postgraduate year trainees) using confirmatory factor analysis (CFA) to examine construct validity, reliability, and demographic variations. Results: EFA identified a 16-item, four-factor structure: Patient Care, Institutional Care, Self-awareness, and Social Care, explaining 65.93% of the total variance. CFA supported a four-factor second-order model with a good fit ( χ 2 [100] =334.65, comparative fit index = 0.93, root mean square error of approximation = 0.08). The total scale demonstrated excellent internal consistency (Cronbach’s α =0.93) and discriminant validity. Multiple regression analyses revealed that after controlling for demographic covariates, professional discipline was a robust predictor only for Institutional Care (β = −0.21, P < 0.01), whereas Patient Care was primarily driven by volunteer experience (β = 0.25, P < 0.001). Conclusion: The MHCS demonstrates strong psychometric properties and high measurement efficiency. By incorporating “Institutional Care” and “Social Care” (including environmental stewardship), it enables a comprehensive assessment of humanistic competence within the Competency-based Medical Education paradigm. The scale serves as a reliable empirical tool for longitudinal tracking of professional identity and evaluating the impact of educational interventions.