Abstract: Professionalism education for medical students is a crucial teaching task in medical schools. This study constructs a four-dimensional educational pathway for clinical medicine freshmen' professionalism education in the second classroom, based on the core theoretical frameworks of knowledge philosophy and interactive teaching theory. The four dimensions are: ″unidirectional transmission-explicit knowledge″, ″bidirectional transmission-explicit knowledge″, ″unidirectional transmission-tacit knowledge″ and ″bidirectional transmission-tacit knowledge.″ These dimensions are implemented across four educational modules: professional perception, value orientation, humanistic sentiment, and sense of responsibility. A survey of 296 clinical medicine students in five-year and eight-year programs from the 2021 and 2022 cohorts was conducted in March 2024 through questionnaires to assess the effectiveness of their improvement in professionalism. The results indicate that medical freshmen showed the most significant improvement in humanistic sentiment and sense of responsibility. Students rated educational pathways with stronger practical experiences more favorably, suggesting the need to further optimize the design of explicit educational pathways and enhance the integration of extracurricular educational content with the first classroom, as well as its alignment with students' daily studies and campus practices.

Key words: Questionnaires, Clinical medicine freshmen, Professionalism education, Second classroom, Theoretical framework, Implementation path