目的 了解中医住院医师规范化培训(简称住培)教师对教学工作的选择偏好,为制定有针对性的教师激励策略提供参考。方法 2024年9至11月,通过参考权威指南、文献回顾、德尔菲法确定中医住培教师教学工作偏好的属性和水平,结合离散选择实验(discrete choice experiment,DCE)进行试验设计,采用分层抽样方法,选取浙江省6家国家级中医住培基地230名教师进行调研,运用混合Logit模型分析教师教学工作选择偏好和支付意愿。结果 本研究共回收有效问卷217份。教学工作月收入、教学工作强度、教学工作氛围、教学工作场地、职称晋升加分、荣誉和培训机会6个属性对中医住培教师教学工作的选择偏好均有显著影响(均P＜0.05);教学工作氛围“和谐”的效用最大(β=0.806),且支付意愿最高(1 409.17元);基准条件下改善单一激励的水平,教学工作氛围(19.6%)、教学工作月收入(13.9%)、教学工作强度(13.6%)概率的提升最大;职称晋升加分“一般”(β=0.162)、“有”荣誉和培训机会(β=0.161)2个属性水平效用较低;不同性别、职称教师的选择偏好存在差异。结论 经济与非经济因素共同影响中医住培教师对教学工作的选择偏好。“和谐的教学工作氛围”是核心驱动因素,而适度的教学收入与合理的工作强度是维持教学动力的基础;当前制度中的职称晋升加分等激励方式的相对吸引力有待提升。因此,建议优先营造和谐的教学氛围,同时保障合理的经济补偿与工作强度,并构建差异化的激励机制与措施,以全面提升中医住培教师的教学积极性。
Objective To investigate the educational work preferences of faculty involved in the standardized residency training of TCM, and to provide a reference for formulating targeted faculty incentive strategies. Methods From September to November 2024, attributes and levels of educational work preferences for TCM residency training faculty were determined by referring to authoritative guidelines, conducting a literature review, and applying the Delphi method. A DCE was designed and combined with a questionnaire survey. Using stratified sampling, 230 faculty members from six national TCM residency training bases in Zhejiang Province were selected for the investigation. A mixed logit model was employed to analyze the faculty′s teaching work preferences and willingness to pay (WTP). Results A total of 217 valid questionnaires were collected. Six attributes—monthly teaching income, teaching workload intensity, teaching atmosphere, teaching venue, credit for professional title promotion, and honors/training opportunities—significantly influenced the teaching preferences of the faculty (all P<0.05). ″Harmonious teaching atmosphere″ demonstrated the highest utility (β=0.806) and the highest WTP (1 409.17 CNY). Under baseline conditions, improving the level of a single incentive resulted in the greatest increases in probability for teaching atmosphere (19.6%), monthly teaching income (13.9%), and teaching workload intensity (13.6%). The attribute levels ″moderate credit for professional title promotion″ (β=0.162) and ″availability of honors and learning opportunities″ (β=0.161) showed relatively lower utility. Preferences varied among faculty of different genders and professional titles. Conclusions Both economic and non-economic factors collectively influence the educational work preferences of TCM residency training faculty. A ″harmonious teaching atmosphere″ is the core driving factor, while appropriate teaching income and reasonable workload intensity form the foundation for sustaining teaching motivation. The relative attractiveness of incentive methods within the current system, such as credits for professional title promotion, needs enhancement. It is recommended to prioritize fostering a harmonious teaching atmosphere, simultaneously ensure reasonable economic compensation and manageable workload, and construct differentiated incentive mechanisms and measures to comprehensively enhance the teaching motivation of TCM residency training faculty.
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