全科医学生的专业认同感现状及其影响因素分析

李嵘; 吴戈; 冯巩; 汪洋

doi:10.16766/j.cnki.issn.1674-4152.002294

全科医学生的专业认同感现状及其影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002294

李嵘^{1, 2},
吴戈^{1, 2},
冯巩³,
汪洋^4, ,

1.
西安医学院第一附属医院学生管理科，陕西西安 710068
2.
西安医学院全科医学院学生管理科，陕西西安 710068
3.
西安医学院全科医学研究所，陕西西安 710068
4.
西安医学院基础医学部，陕西西安 710068

基金项目:

陕西省创新能力支撑计划项目 2017KRM092

详细信息

通讯作者:
汪洋，E-mail：yang.wang@xiyi.edu.cn

中图分类号: R192 R499
计量
- 文章访问数: 323
- HTML全文浏览量: 198
- PDF下载量: 14
- 被引次数: 0
出版历程
- 收稿日期: 2020-04-18
- 网络出版日期: 2022-03-03

Professional identity and influencing factors amongst general practitioner students

LI Rong^{1, 2},
WU Ge^{1, 2},
FENG Gong³,
WANG Yang^{4
, ,}

1.
Department of Student Management, the First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi 710068, China

摘要

摘要: 目的了解全科医学专业农村免费订单定向学生(以下简称定向生)和全科医学专业非定向学生(以下简称非定向生)的专业认同感现状及其影响因素。方法编制面向全科医学生的专业认同感调查问卷，问卷包括4个维度: 专业认知、专业情感、专业学习行为、专业匹配。选取西北地区某医学类地方高校，通过校园一卡通大数据系统，分阶段分层次随机抽取大一至大五年级定向生和非定向生602人为研究对象，进行全科医学专业认同感的问卷调查；运用描述性统计分析、t检验、相关性分析、二分类logistic回归分析数据。结果有效问卷602份，专业认同感总均分为(3.52±0.55)分, 其中518人(86.05%)专业认同感较高。专业认知、专业情感、专业学习行为、专业匹配的总均分分别为(3.51±0.72)分、(3.24±0.81)分、(3.78±0.58)分、(3.55±0.66)分。单因素分析发现，定向与非定向、不同年龄阶段、年级、定向地区、高考分数、生源地、专业选择咨询方式的学生专业认同感差异有统计学意义(均P＜0.05)；二分类logistic回归分析显示，低年级及入学前经过专业选择咨询的学生，其专业认同感显著高于高年级和未经专业选择咨询的学生(均P＜0.05)。结论该校全科医学专业学生，其专业认同感目前总体处于较高水平，定向与非定向、不同年级和是否进行过专业选择咨询，是影响专业认同感的3个主要因素。建议应重视学生青少年时期的心理素质教育；分层次分阶段进行政策解读和就业指导；设立专业的全科医学咨询或宣传团队，从全科医疗体系队伍建设的根源上解决实际问题，坚定资源供给侧方向，提升学生的专业认同感。
- 全科医学 /
- 专业认同感 /
- 基层医疗 /
- 青年学生 /
- 供给侧结构
Abstract: Objective To understand the status quo and influencing factors of the professional identity of rural free order-oriented students (hereinafter referred to as "directional students") and non-directional students (hereinafter referred to as "non-directional students") of general practice medicine. Methods A questionnaire on the professional identity of general medical students was prepared, which included four dimensions: professional cognition, professional emotion, professional learning behaviour and professional matching. Taking a medical local university in Northwest China as the research object, 602 directional and non-directional students from freshman to fifth grade were randomly selected by stages and levels through the Campus All-in-one Card big data system to conduct a questionnaire survey on the professional identity of general medicine. Descriptive statistics analysis, t test, correlation analysis, classification and logistic regression analysis were used for statistical processing. Results A total of 602 questionnaires were valid, and the total score of professional identity were (3.52±0.55) points. A total of 518 (86.05%) cases had high professional identity. The total mean scores of professional cognitions, professional emotion, professional learning behaviour and professional matching were (3.51±0.72) points, (3.24±0.81) points, (3.78±0.58) points, (3.55±0.66) points, respectively. The results of single-factor analysis showed that orientation and non-orientation, different age stages, grades, orientation regions, college entrance examination scores, students' origin and major selection consulting methods all had statistical significance with students' professional identity (all P < 0.05). Using binary logistic regression analysis, it was found that the professional identity of the students in the lower grades and who had received professional selection consultation and before entering school was significantly higher than that of the students in the higher grades and who had not received professional selection consultation (all P < 0.05). Conclusion The professional identity of general medical students is at a high level at present, and the main factors affecting the professional identity are orientation and non-orientation, different grades and whether they have had professional choice consultation. The suggestions are as follows: pay attention to students' psychological quality education in adolescence, carry out policy interpretation and employment guidance in layers and stages, set up a professional general practice consultation or publicity team to solve practical problems from the root of the team construction of the general practice medical system, strengthen the direction of resource supply side, and improve the professional identity of general practice students.
- General practitioner /
- Professional identity /
- Community medical /
- Youthful student /
- Supply side structural

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表 1 全科医学专业学生专业认同感的比较(x±s，分)

项目	类别	个案数	专业认知	专业情感	专业学习	专业匹配	专业认同
性别	男性	226	3.11±0.76	3.22±0.48	3.73±0.58	3.50±0.65	3.48±0.37
	女性	376	3.54±0.68	3.25±0.78	3.80±0.56	3.57±0.66	3.54±0.53
t值			2.491	0.132	2.011	1.787	2.028
P值			0.115	0.717	0.157	0.182	0.155
定向与非定向	定向	392	3.53±0.71	3.36±0.77	3.74±0.58	3.65±0.63	3.57±0.54
	非定向	210	3.46±0.71	3.02±0.82	3.84±0.56	3.35±0.66	3.42±0.54
t值			1.506	25.472	4.027	29.499	11.072
P值			0.220	< 0.001	0.045	< 0.001	< 0.001
年级	19级	206	3.62±0.73	3.39±0.81	3.83±0.57	3.63±0.64	3.62±0.55
	18级	177	3.57±0.66	3.33±0.80	3.88±0.51	3.66±0.59	3.61±0.49
	17级	168	3.39±0.71	3.07±0.78	3.66±0.58	3.41±0.71	3.38±0.56
	16级	44	3.21±0.75	2.82±0.76	3.56±0.68	3.23±0.65	3.21±0.51
	15级	7	3.14±0.46	3.35±0.72	3.71±0.35	3.32±0.67	3.38±0.41
F值			5.272	7.480	5.500	7.008	9.843
P值			< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
独生子女	否	480	3.53±0.72	3.28±0.80	3.78±0.57	3.58±0.65	3.54±0.54
	是	122	3.44±0.73	3.09±0.85	3.81±0.60	3.44±0.70	3.44±0.57
t值			1.433	5.222	0.269	4.581	3.028
P值			0.232	0.023	0.604	0.033	0.082
生源	农村	546	3.52±0.72	3.27±0.80	3.79±0.56	3.58±0.65	3.54±0.54
	城市	56	3.41±0.71	2.96±0.83	3.74±0.69	3.23±0.68	3.33±0.56
t值			1.165	7.651	0.266	14.552	7.033
P值			0.281	0.006	0.607	< 0.001	0.008
专业选择咨询	没有咨询	14	2.98±0.92	2.57±1.04	3.31±0.83	3.25±0.89	3.03±0.67
	随便听说	76	3.40±0.72	2.99±0.79	3.72±0.55	3.40±0.70	3.37±0.56
	咨询过	223	3.24±0.63	2.93±0.66	3.56±0.57	3.36±0.65	3.27±0.46
	一般咨询	183	3.64±0.62	3.48±0.63	3.88±0.49	3.74±0.54	3.68±0.40
	专业咨询	106	3.99±0.72	3.77±0.94	4.19±0.42	3.78±0.69	3.93±0.55
F值			28.140	34.111	29.896	13.914	44.172
P值			< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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表 2 变量赋值情况

变量	赋值
定向/非定向	0=定向；1=非定向，以非定向为对照
年龄	连续性变量
性别	0=男；1=女，以“女”为对照
年级	0=19级；1=18级；2=17级；3=16级；4=15级
高考分数	连续性变量
独生子女	0=非独生子女；1=独生子女，以“独生子女”为对照
生源	0=农村；1=城市，以“城市”为对照
专业选择咨询	0=没有咨询；2=随便听说；3=咨询过；4=一般咨询；5=专业咨询
专业认同感	0=低；1=高

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表 3 全科医学院专业学生专业认同感各个因素的二元logistic回归分析

项目	B	SE	Wald χ²	P值	OR(95% CI)
性别(男)	-0.365	0.246	2.204	0.138	0.817(0.428~1.124)
定向生	0.745	0.286	6.794	0.009	2.106(1.203~3.686)
年龄	-0.010	0.122	0.007	0.932	0.990(0.779~1.258)
年级	-0.382	0.174	4.795	0.029	0.683(0.485~0.961)
高考分数	-0.008	0.007	1.367	0.242	0.992(0.979~1.005)
非独生子女	0.183	0.298	0.376	0.540	1.201(0.669~2.155)
农村	0.300	0.404	0.551	0.458	1.350(0.611~2.981)
专业选择咨询	0.572	0.110	26.832	＜0.001	1.771(1.472~2.199)

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参考文献(16)

[1]	高艳, 乔志宏, 宋惠婷. 职业认同研究现状与展望[J]. 北京师范大学学报(社会科学版), 2011(4): 47-53. doi: 10.3969/j.issn.1002-0209.2011.04.006
[2]	FUGATE M, KINICKI A J, ASHFORTH B E. Employability: A psycho-social construct, its dimensions, and applications[J]. J Vocat Behav, 2004, 65(1): 14-38. doi: 10.1016/j.jvb.2003.10.005
[3]	原会建, 邬伊男. 高校专业认同的影响因素及其培养: 以Z校社会工作专业为个案[J]. 江西社会科学, 2019, 39(11): 246-253. https://www.cnki.com.cn/Article/CJFDTOTAL-JXSH201911029.htm
[4]	赵嘉路, 贾晓明. 促进博士生专业认同的影响因素探究[J]. 学位与研究生教育, 2020(2): 54-59. https://www.cnki.com.cn/Article/CJFDTOTAL-XWYY202002010.htm
[5]	赵丽. 农村订单定向医学生职业认同现状调查及影响因素分析[J]. 医学教育研究与实践, 2019, 27(6): 989-993. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYX201906017.htm
[6]	柏珂, 王虹, 陈勤, 等. 农村订单定向免费医学生的职业认同感研究[J]. 泸州医学院学报, 2012, 35(6): 640-643. doi: 10.3969/j.issn.1000-2669.2012.06.030
[7]	任立军, 马波, 高林萍. 安徽省某高校农村订单定向医学生培养现状研究[J]. 九江学院学报(自然科学版), 2018, 33(2): 106-108. https://www.cnki.com.cn/Article/CJFDTOTAL-JJYX201802029.htm
[8]	董海军, 朱东星. 社会调查中高质量问卷的设计[J]. 晋阳学刊, 2019(5): 115-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JYXK201905014.htm
[9]	余旭辉. "六·二法则"巧做调查问卷: 在研究性学习中如何制作调查问卷[J]. 湖北教育(政务宣传), 2019(10): 22-24. doi: 10.3969/j.issn.1003-4390.2019.10.007
[10]	王文广. 西部某高校农村订单定向医学生职业认同现状调查分析[D]. 昆明: 昆明医科大学, 2015.
[11]	张丽莉. 医学生职业认同现状及影响因素研究[D]. 上海: 华东师范大学, 2010.
[12]	于晓松. 新中国成立70年以来中国全科医学发展与展望[J]. 中华全科医学, 2019, 17(11): 1797-1799. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201911001.htm
[13]	陈丹丹, 李君荣. 以供给侧改革为抓手大力推进分级诊疗实施[J]. 中国集体经济, 2018(5): 49-51. doi: 10.3969/j.issn.1008-1283.2018.05.025
[14]	李香钻. 从供给侧发力, 打造健康"守门人": 罗富和谈基层卫生技术人员培训[J]. 民主, 2017(12): 26-28. https://www.cnki.com.cn/Article/CJFDTOTAL-MINZ201712011.htm
[15]	王国文, 史秀欣, 马东平, 等. 山东全科医生职业认同与社会支持关系[J]. 中国公共卫生, 2016, 32(6): 818-820. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201606025.htm
[16]	潘红霞, 赵立英. 智媒时代青年学生意见表达及舆论引导[J]. 未来传播, 2019, 26(6): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-CMXB201906017.htm