With the increasingly diversified development of society, the concept of global competence emerges as time requires in order to promote cross-cultural communication ability among outstanding talents, and to enhance their international competitiveness and cultivate their sustainable development capabilities. Medicine is one of the most active and promising disciplines in the field of science and technology in the world. With the rapid development of life science, the transformation of modern medical model and the continuous improvement of medical level, medical education needs to continuously communicate and cooperate with domestic and international top universities and research institutes to cultivate medical talents with cutting-edge medical knowledge and capabilities(Zheng et al., 2020). The key to medical education at this stage is to explore the cultivation and education mode of medical students suitable for the current international environment. Compared with the traditional lecture-based learning(Sivarajah et al., 2019), now all disciplines change to pay more attention to cultivate the clinical thinking and scientific research ability of doctors and medical students(Ribeiro et al., 2020). As teachers, how to cultivate accurate clinical thinking, comprehensive and exquisite scientific research ability, and help medical students to become high quality talents with international competence is essential to be broken through in developing countries' medical teaching.
1.1 The connotation of global competence
The concept of global competence was first proposed by the American Association for International Educational Exchange in its report "Teaching for Global Competence" in 1988(Collins et al., 2021), which emphasizes the necessity of cultivating global competence. After numerous changes, the Organization for Economic Cooperation and Development (OECD) officially released PISA 2018 "Global Competence" assessment framework in December 2017, defining global competence as multi-dimensional capability(Moody et al., 2019). It includes four aspects: the analytical ability of regional, global and cross-cultural issues; the ability to understand and appreciate other people's perspectives and world views; the ability to interact openly, appropriately and effectively with people from different cultural backgrounds; and the ability to act for collective well-being and sustainable development(Laura C et al., 2019). The cultivation of global competence can not only enhance students' cultural self-confidence, but also broaden their international horizons, establish global consciousness, and lay an important foundation for them to stand on the international stage(OCDE, 2018).
Global competence education is essential to cultivating high-quality talents(Kim, 2021). Through important measures such as innovating teaching concepts, building an international teaching platform, guaranteeing the strength of teachers, improving the "systematic curriculum arrangement, practical curriculum content, and standardized after-school sharing" integrated curriculum construction, global competence education mode which accords with the situation of developing countries can be basically established. At the same time, there are four main factors that measure the effectiveness of global competence education, namely situational practice, integration, critical thinking, and transactional experiences(Kerkhoff & Cloud, 2020). Among them, situational practice emphasizes that students should be guided to focus attention on social hot spots in the teaching process, think about problems from multiple dimensions, break the inherent prejudice and learn to accept different cultures(Mikander, 2016). Integration pays more attention to students' comprehensive understanding of multi-disciplines and multi-cultures, allowing students to understand that their own behavior and learning ability can have an impact on the global scale and enhance their awareness of world citizenship(Choo, 2017). Critical thinking is to cultivate students' thinking and expressive ability. By educating diversified, international and marginalized events, students are encouraged to take another's place and cultivate empathy(Yang et al., 2019). Transactional experiences are the output of the above-mentioned teaching methods. Students share and express their view with others by cross-cultural communication through situational experience, actively listening and building up a sense of citizenship, and critically thinking about international events and social hotspots, thus eventually showing the belief in unity with other countries to address the problems(Zong, 2009).
1.2 The necessity of cultivating medical students' global competence
From the perspective of adolescents, studies have shown that the cultivation of global competence has a significant promoting effect on the development of adolescents' mental health, social skills and academic ability(Moody et al., 2019). From the perspective of global citizenship, scholars from Griffith University in Australia said that in the current stage of changing time and frequent global public health incidents, global competence education of citizens should be popularized. Therefore, citizens can have an international perspective, pay more attention to social hot spots and jointly solve social problems through international communication and interaction(Kim, 2021).
At the same time, the comprehensive quality of teachers and their attitude towards cultivating students are also key factors in global competence education. The University of Missouri and other universities in the United States have conducted a survey on the teaching practice cognition of teachers who have participated in graduate global competence education course. Teachers all expressed their expectations for the implementation of global competence teaching, high-performing teachers are more likely to tap into their students' global competence, but specific measures and directions for the implementation of global competence education still need to be improved and implemented(Kerkhoff & Cloud, 2020).
Medicine is a fundamental discipline, and the global competence education of medical students is even more important. The approach to developing medical students' global competence has changed over the past 20 years. At first, the UK cultivated medical students' global competence through the development of surgical course(John, 2010). As one of the four major fields defined by the Global Competence Framework of the International Pharmaceutical Federation, the cultivation of global competence in pharmaceutical care is also being promoted. Redesigning the pharmacy curriculum and cultivating a pharmacy workforce that can make a significant contribution to the appropriate use of medicines is the focus of pharmacy work. Well-known Spanish universities adopted the modified Delphi method to carry out global pharmacy competence education and adjusted pharmacy curriculum, so as to lay a foundation for pharmacists to master new knowledge and skills and carry out superb and effective pharmacy services(Martínez-Sánchez, 2021). In addition, Spain listed students' global competence and evidence-based practical learning ability as one of the comprehensive quality indicators of nursing college undergraduates, aiming to improve the comprehensive ability of medical students and promote the development of national medicine by means of upper-level coordination and lower-level implementation(Ruzafa-Martínez et al., 2016).
Since 2006, China has been constantly learning from the practice of international global competence education and striving to find a global competence education model suitable for developing countries' national conditions(Li & Yuezhu, 2021). At present, China has successively launched global competence training courses for English, ideology and politics, geography and other disciplines(Xinpeng et al., 2021). Tsinghua University has set up the "Global Competence Overseas Practice Course", and has carried out global competence education and teaching practice in diverse methods such as course study and cultural exchange. Southwest Jiaotong University regularly selects and sponsors outstanding graduate students to carry out short-term academic exchanges and social practice in world-renowned universities, research institutions, international organizations and overseas enterprises(Jun & Xia, 2019). However, for medical students who need to master international cutting-edge knowledge and exchange ideas with international friends, there is still a lack of teaching practice in developing countries to cultivate the comprehensive quality of global competence of medical students, such as clinical thinking and scientific research ability(Chengmengxue, 2021). Therefore, it is urgent for teachers to promote global competence education for medical students, facilitate international core literacy training and carry out high-quality course related to global competence.
Based on this concept, the Second Hospital of Jilin University has cooperated with several internationally renowned universities like Oxford University several times to carry out medical core literacy improvement courses, and carry out "The Road to Excellence-Medical Core Literacy Online Training Class", aiming to stimulate students' various potentials, fully demonstrate the satisfactory outlook and rigorous study style of our medical students, and lay a foundation for cultivating medical students' global competence, building a good international academic exchange platform, and optimizing the concept of international teaching and training. Our study will provide an important basis for exploring whether the international medical core literacy curriculum is beneficial to the cultivation of medical students' global competence.