Curriculum evolution and documentary evidence of competency alignment in a hospital-embedded undergraduate health...

Undergraduate Health Services and Management (HSM) programmes are expected to integrate management, medicine, public health, digital capability and workplace learning. Hospital-embedded delivery may provide access to authentic organizational settings and interdisciplinary expertise, but distributed teaching can fragment curriculum ownership, competency progression and assessment. This study examined longitudinal evolution and documentary evidence of competency alignment in a hospital-embedded undergraduate HSM programme in China.

A longitudinal document analysis and competency-oriented curriculum-mapping case study was conducted from programme approval in 2020 to first-cohort graduation in 2026. Of 18 unique materials assessed, 15 programme-specific documents formed the empirical corpus, including original and revised training plans, course and teaching-unit records, faculty-development materials, internship documents, quality-assurance instruments and aggregate graduate-destination data. Documentary evidence was assessed using 33 indicators across seven domains and traced through five analytical stages: stated, curricularised, practiced, assessed and fed back. Each indicator was rated as explicitly represented, partially represented or not identified. A second reviewer independently rescored all indicators.

Graduation requirements increased from 165 to 184.5 credits, required courses from 47 to 55, and five elective courses were listed in the revised plan. Management was positioned more clearly as a principal discipline, while biomedical, digital-health and artificial-intelligence content expanded. The 40-week internship covered hospital, public-health, community and industry settings and specified activity requirements, but no programme-wide cross-placement competency rubric was identified. Of 33 indicators, 11 (33.3%) were explicitly represented, 21 (63.6%) were partially represented and one (3.0%) lacked identifiable documentary evidence. Practice education showed the strongest documentary representation, whereas longitudinal digital-health competency development, programme-level assessment and completed feedback cycles were less fully documented. Reviewers agreed on 31 of 33 ratings (93.9%), with a quadratic-weighted Cohen's kappa of 0.893.

Hospital embedding provided documented access to interdisciplinary teaching resources and diverse workplace-learning settings, but evidence of coherent competency progression, comparable assessment across settings, applied digital-health learning and completed feedback cycles remained limited. Curriculum ownership, longitudinal competency mapping, common assessment mechanisms and systematic feedback may help strengthen programme coherence. We propose a provisional, case-derived resource-to-capability conversion framework for further investigation in distributed professional programmes.