Fig 1. Hermeneutic methodological framework.

In step 1, we used “naive reading” to build up semantical network to examine the axiology of clinical practice. In step 2, we used structural analysis of semi-structured interviews (SSIs) to examine. The core values of clinical practice. In step 3 we used interpretation analysis of SSIs to explore the axiology (Values space, clusters and Networks) in clinical practice prior to conducting the CME in clinical ethics. After research questions were examined, these results were integrated based on the mutual validation model, which regards the search for convergent findings as validity indicators.We explored potentially strong connections between EBM and VBM using qualitative results, while we inferred the extent of the benefits of novel Networks and clusters. After conducting the CME in clinical ethics intervention, we repeated the analyses (steps 2 and 3), and the full results were integrated.