Cultural Intelligence as a Partial Mediator of Adaptation-Innovation Link: A Bayesian Study of International Medical Students in China

Background International medical students' adaptation challenges and innovative capacities are crucial in global medical education.While cultural intelligence links to academic outcomes and sociocultural adaptation connects to professional development, minimal research examines how these constructs collectively influence innovative behavior. Method This cross-sectional study surveyed 180 international medical students across three Chinese universities between March and May 2025. Participants completed the Cultural Intelligence Scale, Sociocultural Adaptation Scale, and Innovative Behavior Scale. Demographic characteristics were analyzed using t-tests and ANOVA. Relationships between variables were examined through Pearson correlation, stepwise regression, and Bayesian mediation analysis implementing four MCMC chains with 3,000 burn-in and 5,000 post-burn-in iterations. Results Cultural intelligence emerged as the strongest predictor of innovative behavior ( β  = 0.52, P  < 0.01), followed by cultural empathy and relatedness ( β  = 0.18, P  < 0.01) and scholarship status ( β  = 0.16, P  < 0.01). Bayesian mediation analysis revealed significant positive direct effects between sociocultural adaptation and innovative behavior ( β  = 0.456), sociocultural adaptation and cultural intelligence ( β  = 0.282), and cultural intelligence and innovative behavior ( β  = 0.191). Cultural intelligence partially mediated the relationship between sociocultural adaptation and innovative behavior, with the indirect effect ( β  = 0.054) constituting approximately 10.6% of the total effect. Conclusions Cultural intelligence acts as an independent predictor and partial mediator in promoting innovative behavior among international medical students. Educational interventions should integrate cultural intelligence development with structured cross-cultural experiences, addressing both direct and indirect pathways through which sociocultural adaptation influences innovation in medical education contexts.