Moderating effects of media literacy and flow on the association between web-based learning environment and knowledge sharing among medical students: a cross-sectional study.

Background: Online learning has become an integral part of medical education, and understanding the factors associated with medical students' knowledge sharing is important for designing effective learning environments. Objective: This study examined the associations among web-based learning environment, media literacy, flow, and knowledge sharing, and tested whether media literacy and flow moderate the association between web-based learning environment and knowledge sharing. Methods: A cross-sectional online survey was conducted from July to September 2021 in China. Of 1,200 undergraduate medical students invited, 987 valid responses were retained (response rate 82.25%; 70.7% women). Hierarchical linear regression with mean-centered variables was used to examine factors associated with knowledge sharing and to test the moderating effects of flow and media literacy. Results: The mean knowledge sharing score was 3.91 ± 0.58. Knowledge sharing was positively correlated with web-based learning environment ( Conclusion: The association between web-based learning environment and knowledge sharing was stronger among medical students with high flow or high media literacy. These findings suggest that improving the web-based learning environment and integrating media literacy education may support knowledge sharing; causal conclusions require longitudinal or interventional evidence.