Blended teaching has become increasingly prevalent in higher education, particularly in the post-pandemic era, as it integrates the strengths of online and face-to-face instruction. Within the field of Traditional Chinese Medicine (TCM) pharmacy education, blended approaches offer potential for enhancing student engagement and learning outcomes. Despite the widespread adoption of blended learning, limited empirical research has examined its effectiveness in cultivating students' autonomous learning ability, especially in culturally and infrastructurally diverse contexts such as TCM education in Shaanxi Province, China. This study aims to examine the relationship between blended teaching and students' autonomous learning ability in TCM pharmacy programs, and to investigate whether technological infrastructure moderates this relationship. A quantitative research design was employed using Structural Equation Modeling (SEM) to analyze data from 600 undergraduate TCM pharmacy students across eight institutions in Shaanxi Province. The Autonomous Learning Ability Scale (ALAS) and Blended Teaching Efficacy Survey (BTES) were adapted and validated for the TCM context. The findings reveal a significant positive relationship between blended teaching and autonomous learning ability (? = 0.68, p < 0.001). Technological infrastructure significantly moderated this relationship, with stronger effects observed in urban institutions (? = 0.78) compared to rural counterparts (? = 0.52). Blended teaching enhances autonomous learning by satisfying psychological needs for autonomy, competence, and relatedness, consistent with Self-Determination Theory. The urban-rural disparity underscores the need for equitable digital infrastructure investment. Future research should employ longitudinal designs to establish causal relationships and examine the long-term sustainability of autonomous learning development in TCM education.
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