目的 研究医学生对医师职业精神认同现状及其影响因素,探究医师职业精神的培育途径。方法 采用多阶段分层整群随机抽样方法,对来自两所医学院校临床医学专业(五年制、七年制及“5+3”一体化)和口腔医学专业共547名学生进行医师职业精神认同情况问卷调查,并进行统计分析。结果 医学生的医师职业精神综合评分为(4.00±0.460)分,其中,职业意志维度评分最高为(4.33±0.609)分,职业认知维度评分最低为(3.63±0.511)分,总分为5分。是否为“父母建议或指导”和“周遭环境影响”而学医的医学生对医师职业精神综合评分的差异均具有统计学意义(均P＜0.05);不同专业、学制医学生对医师职业精神综合评分的差异具有统计学意义(F=4.571,P＜0.05);“选择成为医师”的不同意愿程度的医学生对医师职业精神综合评分差异具有统计学意义(F=14.066,P＜0.01)。结论 医学生对医师职业精神认同度良好,职业意志较强,职业认知相对较弱。学医动因和专业学制对医学生的医师职业精神有较显著影响。因此,加强医学生的医师职业认知、明确学医初衷和端正学医态度,有助于提升医学生医师职业精神。
Objective To understand physician's professionalism status among medical students and its influencing factors, thus provide methods of improving it. Methods Multi-stage stratified cluster sampling method was used in this study, in which we surveyed on cognition of physician's professionalism among 547 students from two medical colleges by using a 27-item questionnaire. Results Students in two medical colleges have a mean of (4.00±0.460)(total score 5) in physician's professionalism, among which professional will is the highest (4.33±0.609) and medical occupational cognition is the lowest (3.63±0.511). There are significant differences between “parental advice or guidance” and “environmental impact” (all P<0.05) in the mean of physician's professionalism. There is a significant difference in the distribution of physician's professionalism between different majors and educational system (F=4.571,P<0.05). Also, there is a significant difference in the distribution of “weather to become a doctor in the future”(F=14.066,P<0.01). Conclusions Overall, the status of physician's professionalism cognition among students is good. However, professional will is better and medical occupational cognition is worse. Both the reasons for studying medicine and educational system have a significant influence on the professionalism among medical students. Strengthening the medical students' medical occupational cognition, clarifying the intention and attitude of studying medicine, will help to elevate the physician's professionalism.
[1] 卜丽娟.医生职业精神研究[D]. 济南:山东大学,2015.
Bu LJ. The research on doctors' occupational spirit[D]. Jinan: Shandong University,2015.
[2] 陈丽丽.医师职业精神测评量表编制及评价研究[D].唐山:华北理工大学,2015.
Chen LL. The development and evaluation research on the scale of medical professionalism[D]. Tangshan: North China University of Science and Technology,2015.
[3] 杜鹏.论医学院校学生职业精神的培育[D].石家庄:河北师范大学,2014.
Du P. Discussion on cultivation of the professionalism of medical students[D].Shijiazhuang:Hebei Normal University,2014.
[4] 杨昕,曾静,左川,等. 医学教育中医师职业精神评估方法初探[J].医学与哲学,2014,35(4A):68-70.
Yang X, Zeng J, Zuo C, et al. Assessment on medical professionalism in medical education[J]. Medicine & Philosop,2014,35(4A):68-70.
[5] Hanna LA, Gillen J, Hall M. An investigation of final year pharmacy students' moral reasoning ability, and their views on professionalism and fitness to practice panel determinations: A questionnaire study[J]. Curr Pharm Teach Learn, 2017,9(4):652-659. DOI:10.1016/j.cptl.2017.03.016.
[6] 秦鹏,弓姝,张阳,伦施斯.某医科大学临床医学生职业认同调查[J]. 中国卫生统计,2012,29(3):429-432. DOI:10.3969/j.issn.1002-3674.2012.03.047.
[7] 吴琦,周俊,黄祥津,等. 医学生职业认同现状剖析[J]. 中华全科医学,2017,15(9):1542-1545. DOI:10.16766/j.cnki.issn.1674-4152.2017.09.028.
Wu Q, Zhou J, Huang XJ, et al. Analysis on the medical students' professional identity status quo[J]. Chinese Journal of General Practice, 2017,15(9):1542-1545. DOI:10.16766/j.cnki.issn.1674-4152.2017.09.028.
[8] Nie JB, Cheng Y, Zou X, et al. The vicious circle of patient-physician mistrust in China: Health professionals' perspectives, institutional conflict of interest, and building trust through medical professionalism[J/OL]. Dev World Bioeth,2017,18(1):26-36. DOI: 10.1111/dewb.12170.
[9] 钟凤宏. 医学生医师职业精神认知现状调查研究——以大连医科大学的调查为例[J]. 医学与哲学,2017,38(1A):75-77. DOI:10.12014/j.issn.1002-0772.2017.01a.18.
Zhong FH. Investigation and research on cognitive status of medical students' medical professionalism: Taking Dalian Medical University as an example[J]. Medicine & Philosophy,2017,38(1A):75-77. DOI:10.12014/j.issn.1002-0772.2017.01a.18.
[10] 佚名.高等医药院校学生行为规范(试行)[J]. 高等中医教育研究,1991(Z1):84.
[11] Bryan RE, Krych AJ, Carmichael SW, et al. Assessing professionalism in early medical education: Experience with peer evaluation and self-evaluation in the gross anatomy course[J]. Ann Acad Med Singapore,2005,34(8):486-491.
