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 ( r = 0.360, p < 0.01), flow ( r = 0.565, p < 0.01), and media literacy ( r = 0.460, p < 0.01). Flow ( β = 0.732, p = 0.001; Δ R 2 = 0.008) and media literacy ( β = 0.900, p = 0.001; Δ R 2 = 0.009) significantly moderated the association between web-based learning environment and knowledge sharing, although the incremental explained variance was small. 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.