目的 调查医学生从医信念情况及其影响因素,为增强其医学生的从医信念提供依据。方法 2021年1月至2月,以上海交通大学医学院2017~2020级五年制和八年制临床医学专业本科医学生为研究对象,采用自制问卷调查其从医信念情况。采用多元线性回归方法进行影响因素分析。结果 778名医学生参加了调查,从医信念评分为(88.72±16.83)分。医学生参与讲座等活动的频率(b=0.130,P<0.001)、学习中获得的帮助(b=0.204,P<0.001)、教师的人文教育水平(b=0.085,P=0.014)、基于案例学习等教学方法的效果(b=0.245,P<0.001)、职业规划课程帮助程度(b=0.067,P=0.028)、认为未来医患关系将逐渐改善的看法(b=0.088,P=0.002)与个体从医信念相关;与女性、高年级(大学三年级及以上)、必修课程成绩在后50%的医学生相比,男性(b=0.094,P<0.001)、低年级(b=0.109,P<0.001)、必修课程成绩在前50%者(b=0.136,P<0.001)的医学生从医信念更强,上述变量可以解释医学生从医信念变异的46.8%。结论 医学生从医信念尚有进一步提升的空间。医学生学习中获得的教学资源与支持以及对未来医患关系发展的看法是其从医信念的影响因素。可以通过开展职业规划教育、丰富人文课程、举办相关讲座、参与志愿活动、丰富教学方法等途径强化医学生的从医信念,同时多关注女性、学习成绩较低者和高年级医学生,并发挥媒体在改善医患关系方面的积极作用。

Objective To investigate the current situation of medical students' medical belief and to analyze the influencing factors, so as to provide the basis for improving their medical belief. Methods From January to February 2021, the five-year and eight-year medical undergraduates of Shanghai Jiao Tong University School of Medicine enrolled from 2017 to 2020 were selected as the survey subjects. A self-made questionnaire was used to investigate their medical belief, and the influencing factors were analyzed by multiple linear regression method. Results A total of 778 medical students participated in the survey and the score of medical belief was 88.72±16.83. The results of multiple liner regression analysis showed that the frequency of participating in activities such as lectures (b=0.130, P<0.001), help obtained during learning process (b=0.204, P<0.001), humanistic education level of faculty (b=0.085, P=0.014), effect of teaching method like case-based learning (b=0.245, P<0.001), degree of help from career planning courses (b=0.067, P=0.028) and views that the doctor-patient relationship will gradually improve in the future (b=0.088, P=0.002) are related to one's medical belief. In population with following characteristics like female, higher grades (junior and above) and those with required courses scores ranking on bottom 50% of required courses scores have a weaker belief while the males (b=0.094, P<0.001), lower grades (b=0.109, P<0.001) and ranking on top 50% of required courses scores (b=0.136, P<0.001) have stronger medical belief. The above variables can explain 46.8% of the variation in medical belief. Conclusions There is still space for further improvement in medical students' belief. The teaching resources and supports obtained by medical students during learning process and their views on the doctor-patient relationship in the future are the influencing factors of medical belief. It is recommended to improve career planning and enrich humanistic education, optimize lectures and encourage volunteer activity, and enrich teaching methods to improve medical students' medical belief. More attention should be paid to students of females, higher grades and those with lower scores. Media support is also necessary to improve the doctor-patient relationship, which further strengthen students' medical belief.