临床医学专业学生职业认同量表的修订与验证

冯亚杰; 邹丹丹; 王晨; 赵娟; 李雨泽; 张环宇; 刘俊萍; 刘智新; 王楠; 梁立波

doi:10.3760/cma.j.cn115259-20230511-00482

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中华医学教育杂志

• 医学教育评估 •

ENGLISH ABSTRACT

临床医学专业学生职业认同量表的修订与验证

作者及单位信息

出版日期： 2024 -05 -01 ·

DOI： 10.3760/cma.j.cn115259-20230511-00482

Revision and validation of professional identity scale for medical students

Authors Info & Affiliations

Feng Yajie

Master Degree Candidate, Social Medicine and Health Management Major, Enrolled in 2021, Harbin Medical University, Harbin 150081, China

Zou Dandan

President′s Office, Fudan University Jinshan Hospital, Shanghai 201508, China

Wang Chen

Scientific Research and Foreign Affairs Department, Chongqing Maternal and Child Health Hospital (Women and Children′s Hospital Affiliated to Chongqing Medical University), Chongqing 400010, China

Zhao Juan

Teaching Management Center of the First Affiliated Hospital of Army Military Medical University, Chongqing 400037, China

Li Yuze

School of Stomatology, Jiamusi University, Jiamusi 154007, China

Zhang Huanyu

Master Degree Candidate, Social Medicine and Health Management Major, Enrolled in 2021, Harbin Medical University, Harbin 150081, China

Liu Junping

Master Degree Candidate, Social Medicine and Health Management Major, Enrolled in 2021, Harbin Medical University, Harbin 150081, China

Liu Zhixin

Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China

Wang Nan

Master Degree Candidate, Social Medicine and Health Management Major, Enrolled in 2021, Harbin Medical University, Harbin 150081, China

Liang Libo

Department of Social Medicine, School of Health Administration, Harbin Medical University, Harbin 150081, China

Published： 2024 -05 -01 ·

DOI： 10.3760/cma.j.cn115259-20230511-00482

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摘要

目的修订临床医学专业学生(简称临床医学生)职业认同量表并进行初步验证。

方法2019年11月至2020年5月，基于社会认同理论和既往职业认同研究结果，结合文献内容分析、课题小组讨论形成量表条目池，再通过专家评审增减量表维度和条目，确定临床医学生职业认同量表。2020年6月，采取整群抽样以黑龙江省4所高校的5 807名临床医学生为样本进行大样本实证测量。应用克朗巴赫系数、分半信度和因子分析等方法检验量表信度和效度；对临床医学生职业认同现状进行描述性分析。

结果临床医学生职业认同量表包含职业认知、职业情感、职业承诺、职业行为、职业期望和职业价值观6个维度，共27个条目，总分162分。各维度克朗巴赫系数为0.81～0.94，分半信度系数为0.72～0.91。经主成分分析提取6个公因子后累积方差贡献率达82.32%。临床医学生职业认同总分为(134.24±21.53)分，处于中等偏高水平，其中职业行为维度评分较高[(29.02±5.31)分]。

结论临床医学生职业认同量表具有良好的信度和效度，能够合理反映临床医学生的职业认同现状。

关键词：临床医学;学生，医科;职业认同;量表;信度;效度

ABSTRACT

ObjectiveTo revise and validate the a professional identity scale for medical students and conduct preliminary validation.

MethodsFrom November 2019 to May 2020, a scale item pool was formed based on social identity theory and previous research results on professional identity, combined with literature content analysis and project group discussion. The scale dimensions and items were added and subtraction through expert review to determine the scale of professional identity for medical students. In June 2020, a large sample of 5 807 medical students from 4 universities in Heilongjiang Province was tested by cluster sampling. Kronbach coefficient, split half reliability and factor analysis were used to test the reliability and validity of the scale. The present status of professional identity of medical students was analyzed.

ResultsThe professional identity scale of medical students was composed of 27 items in 6 dimensions, including professional cognition, professional emotions, professional commitment, professional behavior, professional expectations, and professional values. The total score of the scale is 162 points. Cronbach′s coefficients of each dimension were 0.81-0.94, the split reliability was 0.72-0.91. The cumulative variance contribution rate reached 82.32% after extracting six common factors by principal component analysis. The total score of professional identity of medical students was (134.24±21.53) points, which was at a medium high level, and the average score of professional behavior dimension was (29.02±5.31) points.

ConclusionsThe professional identity scale of medical students has good reliability and validity, and can reasonably reflect the status quo of professional identity of medical students.

KEYWORDS： Clinical medicine;Students, medical;Professional identity;Scale;Reliability;Validity

Corresponding author: Liang Libo, Email: mocdef.3ab61tihbll

FUNDING:

National Natural Science Foundation of China（71673073）

COPYRIGHTS:

No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.

All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.

引用本文

冯亚杰,邹丹丹,王晨,等. 临床医学专业学生职业认同量表的修订与验证[J]. 中华医学教育杂志,2024,44(05)：391-396.

DOI:10.3760/cma.j.cn115259-20230511-00482

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职业认同是指一种对待自己所从事职业的态度、价值、信念、知识和技能，是自己对于职业的一种主观认识和接纳程度 ^{[
1
]}。近年来，突发的全球性疫情使临床医学专业学生(简称临床医学生)的职业环境与职业价值认知发生了一定变化 ^{[
2
]}，学生不仅直观地感受到临床工作的风险和艰辛，也重新思考医生的社会责任感和职业使命感 ^{[
3
]}。临床医学生的职业认同是指对所要从事的医生职业基本特征的整体看法，强烈的职业认同感能够使医学生灵活地应对医疗的各种不确定性，同时也能够为未来的医学工作提供指导 ^{[
4
]}，并且其认同程度高低直接影响临床医学生学习热情和未来职业发展的动力 ^{[
5
]}。既往研究显示，我国存在临床医学毕业生高流失率问题，如何减少医学生流失，增加医学生职业认同，尤其将重心倾斜到如何增加临床医学生的职业认同尤为关键 ^{[
6
,

7
]}。同时，以往研究调查了在疫情前后医学生群体的情绪反应和职业认同感，发现疫情后临床医学生的职业认同感和负面情绪的变化有待研究 ^{[
8
,

9
,

10
]}。基于社会认同理论(social identity theory) ^{[
11
,

12
,

13
]}与既往职业认同研究成果 ^{[
14
]}，检索国内外职业认同相关文献，根据社会环境的变化和课题组前期开发研究基础，进一步完善临床医学生职业认同的研究内容与范畴，对本课题组编制的临床医学生职业认同量表 ^{[
15
]}进一步进行增减修改，最终确定了临床医学生职业认同模型，完善了本土化的临床医学生职业认同量表，分析其信度和效度，以期为我国临床医学生职业认同的教育改革提供依据。

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摘要
参考文献

参考文献

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McGowen, KR , Hart LE . Still different afterall 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 .