目的 建立医学生职业素养发展态势预测模型并加以初步评价。方法 2020年12月采用分层随机抽样的问卷调查法,对汕头大学医学院2015~2019级477名临床医学、护理学和口腔医学专业的学生展开调查,了解其职业素养影响因素。通过单因素分析和多因素logistic回归分析等建立预测模型和评分系统,通过ROC曲线下面积进行初步评价。结果 性别、年级、性格、朋辈关系、“医者之心”教育模式、医疗社会环境和临床实践环境等7个因素为医学生职业素养发展的独立预测因子,其OR和95%CI可信区间分别为2.223[95%CI(1.335~3.704)]、4.705[95%CI(1.761~12.574)]、3.222[95%CI(1.869~5.555)]、3.117 [95%CI(1.867~5.202)]、3.840 [95%CI(2.276~6.480)]、0.479[95%CI(0.282~0.816)]、2.136[95%CI(1.257~3.629)]。预测模型的ROC曲线下面积为0.871[95%CI(0.839~0.903)]。医学生职业素养发展态势评分系统的分值为-1~10分,评分系统的ROC曲线下面积为0.858 [95%CI(0.824~0.891)],其最佳截断值为5分,即分值≥5分可预测医学生职业素养发展态势为积极,反之则为消极。结论 本研究初步建立了医学生职业素养发展态势预测模型,在医学生职业素养培养实践中具有一定的参考性。

Objective To establish a predictive model for the development of medical students' professionalism and conduct preliminary evaluation on it. Methods Questionnaires were used among 477 clinical medicine, nursing and stomatology students from grade 2015 to 2019 in Shantou University Medical College using stratified random sampling in December 2020 to understand the influencing factors of the development of medical students' professionalism, and establish the predictive model and scoring system through single factor analysis and multivariate logistic regression analysis, and conduct preliminary evaluation based on the area under the ROC curve (AUC). Results The results showed that seven factors including gender, grade, personality, peer relationship, the education mode of “Doctor's Heart”, medical social environment and clinical practice environment were the independent predictors of the development of medical students' professionalism (P<0.05),whose OR and 95%CI were 2.223[95%CI(1.335-3.704)], 4.705[95%CI(1.761-12.574)], 3.222[95%CI(1.869-5.555)], 3.117[95%CI(1.867-5.202)], 3.840[95%CI(2.276-6.480)], 0.479[95%CI(0.282-0.816)] and 2.136[95%CI(1.257-3.629)] respectively. The AUC of ROC predicted by the model were 0.871[95%CI(0.839-0.903)]. The score of the scoring system ranged from -1 to 10, whose AUC was 0.858 [95%CI(0.824-0.891)]. With 5 points as the best truncation value of the scoring system, scores larger than 5 predicted the development trend of medical students' professionalism positively, or predicted it negatively. Conclusions The predictive model for the development of medical students' professionalism has been established, which has certain reference value in the practice of cultivating medical students' professionalism.