Modern medicine has both humanistic and social science attributes，making the cultivation of medical humanistic qualities an indispensable theme in contemporary medical education. Given the current situation of low humanistic literacy among medical students in China，exploring possible strategies to enhance this ability has become a critical issue. This study is based on Kirkpatrick’s four-level evaluation model and the dual-training in the medicine and humanities atmosphere. A survey was conducted among 216 medical students， employing fuzzy - set qualitative comparative analysis to identify the multidimensional configuration paths of improving humanistic literacy. The findings reveal that there is a core configuration path that affects the humanistic literacy of medical students through configuration analysis. When medical students exhibit high satisfaction with humanities education courses and actively participate in humanistic activities，coupled with the strong campus humanistic atmosphere，their level of humanistic literacy is consequently elevated. These findings suggest that the humanistic literacy of medical students is influenced by multiple factors，with the “theory + practice”acting as the optimal configuration path to enhance their humanistic literacy.