医学教育管理

医学生职业认同在医患关系紧张性感知与从医意愿之间的中介作用

  • 周瑾 ,
  • 张琳 ,
  • 曹译尹 ,
  • 张小帅 ,
  • 张远航 ,
  • 高蕾
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  • 哈尔滨医科大学卫生管理学院卫生管理学教研室,哈尔滨 150081

收稿日期: 2023-09-19

  网络出版日期: 2024-09-03

基金资助

国家自然科学基金青年项目(71904036);黑龙江省高等教育教学改革一般研究项目(SJGY20220292)

The mediating role of professional identity between medical students' perceived tension in the doctor-patient relationship and their willingness to practice medicine

  • Zhou Jin ,
  • Zhang Lin ,
  • Cao Yiyin ,
  • Zhang Xiaoshuai ,
  • Zhang Yuanhang ,
  • Gao Lei
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  • Department of Health Management, School of Health Management, Harbin Medical University, Harbin 150081, China

Received date: 2023-09-19

  Online published: 2024-09-03

Supported by

National Natural Science Foundation of China (71904036); General Research Project on Higher Education Teaching Reform in Heilongjiang Province (SJGY20220292)

摘要

目的 探究医学生职业认同在医患关系紧张性感知与从医意愿之间的中介作用,为更好地培养医学专业人才、稳定专业队伍提供参考。方法 2022年12月至2023年3月,采用整群抽样方法以黑龙江省某医科大学五年制临床医学专业二年级至五年级本科生为研究对象,调查其职业认同、医患关系紧张性感知和从医意愿的状况。采用单因素方差分析、独立样本t检验和Pearson相关分析进行数据分析;采用SPSS 26.0中PROCESS插件验证医学生职业认同、医患关系紧张性感知、从医意愿之间的作用路径。结果 最终纳入分析的971名医学生的职业认同评分为(3.44±0.50)分,医患关系紧张性感知评分为(2.94±0.62)分,从医意愿评分为(2.47±0.54)分,医学生医患关系紧张性感知对从医意愿有负向预测作用(β=-0.17,P<0.001),职业认同在医患关系紧张性感知与从医意愿之间起部分中介作用(β=-0.03,P<0.001)。结论 本研究结果显示,医学生职业认同处于中等偏上水平,仍然有进一步提升的空间。医学生医患关系紧张性感知与从医意愿呈负相关。医学生职业认同在医患关系紧张性感知与从医意愿之间具有中介作用。

本文引用格式

周瑾 , 张琳 , 曹译尹 , 张小帅 , 张远航 , 高蕾 . 医学生职业认同在医患关系紧张性感知与从医意愿之间的中介作用[J]. 中华医学教育杂志, 2024 , 44(9) : 658 -663 . DOI: 10.3760/cma.j.cn115259-20230919-00268

Abstract

Objective This study aims to explore the mediating role of medical students' professional identity between their perception of tension in doctor-patient relationships and their willingness to pursue a medical career, so as to inform better training of medical professionals and stabilizing the professional team. Methods From December 2022 to March 2023, a cluster sampling method was used to enroll undergraduate students from the second to fifth year of the five-year clinical medicine program at a medical university in Heilongjiang Province. The study investigated their professional identity, perception of tension in doctor-patient relationships, and willingness to pursue a medical career. Data analysis was conducted using one-way ANOVA, independent sample t-tests, and Pearson correlation analysis. The PROCESS plugin in SPSS 26.0 was utilized to verify the pathways among medical students' professional identity, perception of tension in doctor-patient relationships, and willingness to practice medicine. Results The final analysis included 971 medical students. The scores for professional identity were (3.44±0.50), perception of tension in doctor-patient relationships were (2.94±0.62), and willingness to practice medicine were (2.47±0.54). The perception of tension in doctor-patient relationships had a negative predictive effect on the willingness to practice medicine (β=-0.17, P<0.001), and professional identity played a partial mediating role between the perception of tension in doctor-patient relationships and willingness to practice medicine (β=-0.03, P<0.001). Conclusions The study reveals that medical students' professional identity is at a moderately high level with room for further improvement. There is a negative correlation between medical students' perception of tension in doctor-patient relationships and their willingness to practice medicine. Professional identity has a mediating effect between the perception of tension in doctor-patient relationships and the willingness to practice medicine.

参考文献

[1] 张东园, 朱棣, 陈静宇, 等. 暴力伤医事件对应届毕业医学生思想认知及择业行径的影响调查[J].中国高等医学教育,2021(6):43-44. DOI: 10.3969/j.issn.1002-1701.2021.06.022.
[2] 常红娟, 袁坤, 史培培, 等. 新冠疫情对高中生从医意愿的影响研究[J].中国高等医学教育,2023(7):41-42. DOI: 10.3969/j.issn.1002-1701.2023.07.018.
[3] 郑致成, 陶磊, 王铭泽. 后疫情时代医学生职业认同与职业规划现状及影响因素研究[J].中国卫生事业管理,2022,39(12):941-945.
[4] 于晨, 吴红斌, 王维民, 等. 中国临床医学生职业认同现状分析[J].中国公共卫生,2023,39(4):437-441. DOI: 10.11847/zgggws1137607.
[5] 侯朝铭, 柏丁兮, 高静, 等. 认知重评对医学生职业认同影响:学业情绪和学习动机的多重链式中介效应[J].中国卫生事业管理,2023,40(2):142-147.
[6] 陈婷. 医学生之医患关系认知现状的分析与改善路径 [J]. 医学与法学, 2021, 13(2): 69-72. DOI: 10.3969/j.issn.1674-7526.2021.02.016.
[7] McGowen KR, Hart LE. Still different after all these years: gender differences in professional identity formation [J]. Professional Psychology: Research and Practice, 1990, 21(2): 118-123. DOI: 10.1037//0735-7028.21.2.118.
[8] 张志乔. 高职学生专业认同度与就业满意度关系探讨[J].中国高教研究,2012(6):98-101.
[9] 梁红霞, 王哲. 2011-2020年医学生职业认同变迁的横断历史研究[J].卫生职业教育,2023,41(24):148-152. DOI: 10.20037/j.issn.1671-1246.2023.24.43.
[10] 吕晔, 刘慧, 尹晓然, 等. 新冠肺炎流行期间医学生职业认同现状调查分析[J].中国医学伦理学,2020,33(8):954-958. DOI: 10.12026/j.issn.1001-8565.2020.08.12.
[11] 马璇璇, 吴红斌, 叶晓阳. 新冠疫情是否提高了医学生的职业认同?——来自全国临床医学本科生调查数据的发现 [J]. 复旦教育论坛, 2021, 19(6): 104-112.DOI: 10.13397/j.cnki.fef.2021.06.014.
[12] 蒋伟. 工匠精神培育与医学生职业认同教育研究[J].中国医学伦理学,2018,31(8):1073-1076. DOI: 10.12026/j.issn.1001-8565.2018.08.27.
[13] 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.
[14] 周浩, 龙立荣. 共同方法偏差的统计检验与控制方法[J].心理科学进展,2004,12(6):942-950. DOI: 10.3969/j.issn.1671-3710.2004.06.018.
[15] Chernick MR. Bootstrap methods:a guide for practitioners and researchers [M]. Hoboken: John Wiley & Sons Inc, 2007: 53-77.
[16] 王凤前, 曲乃强, 牛启超. 医学生职业认同现状调查[J]. 中国公共卫生, 2018, 34(9): 1248-1250.DOI: 10.11847/zgggws1116615.
[17] 何云涓, 卢曼曼, 陈贵梅, 等. 公立医院医务人员焦虑与社会支持、领悟社会支持及应对方式的相关性研究[J].中华疾病控制杂志,2019,23(3):328-331. DOI: 10.16462/j.cnki.zhjbkz.2019.03.017.
[18] 刘琼瑶, 王艳, 周小花, 等. 医患纠纷频发现象对医学生心理影响的调查分析——以长沙市三所医学院校为例[J].中国医学伦理学,2016,29(1):151-153.
[19] 朱可雯, 江申, 徐林燕, 等. 新冠肺炎疫情背景下医学生职业认同感及相关因素研究[J].卫生职业教育,2021,39(10):57-59.
[20] 刘琼瑶, 王艳, 周小花, 等. 医患纠纷现状对医学生心理的影响及对策研究[J].中国医学伦理学,2015,28(6):999-1001.
[21] 刘诗曼, 胡永建, 李涵, 等. 医患关系对医学生职业认同的影响[J].肿瘤基础与临床,2022,35(5):455-459. DOI: 10.3969/j.issn.1673-5412.2022.05.025.
[22] 王丽, 刘群英, 胡婉侠, 等. 疫情期间医学生与非医学生对医务人员职业认知的差异分析[J].南京医科大学学报(社会科学版),2022,22(2):164-168. DOI: 10.7655/NYDXBSS20220211.
[23] Holland JL, Johnston JA, Asama NF. The vocational identity scale: a diagnostic and treatment tool[J]. Journal of Career Assessment, 1993, 1(1): 1-12. DOI:10.1177/106907279300100102.
[24] Michal T, Denise J. Professional identity formation in contemporary higher education students [J]. Studies in Higher Education, 2021, 46(4): 885-900. DOI: 10.1080/03075079.2019.1659763.
[25] 汤国杰. 普通高校体育教师职业认同与工作满意度的关系研究[J].心理科学,2009,32(2):475-477,483.
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