通讯作者: 王志锋, zhfwangwf@163.com

DOI：10.12201/bmr.202012.00015

Impact of Adverse Events During Clinical Clerkship on Medical Students Career Intention

• 摘要：摘要 目的：基于中国临床医学生培养与学生发展调查（China Medical Students Survey，CMSS）2019年的数据，探究临床实习阶段负性事件生对医学生从医意向的影响，为改善临床实习微环境提供针对性建议。方法：采用描述统计分析“个人生活重大负性事件”、“职场不公负性事件”和“职业特性负性事件”的发生范围和频率，并描述医学生的从医意向情况；使用logistic回归分析各类负性事件对从医意向的影响程度。结果：91.6%的医学生毕业后会选择成为医生，87.3%的医学生表示临床实习期间经历过负性事件，各类负性事件的发生范围从大到小依次为：“职业特性负性事件”、“职场不公负性事件”、“个人生活重大负性事件”。“经历负性事件的医学生”是“未经历负性事件的医学生”不从医几率的1.54倍，各类负性事件对从医意向的影响程度不同，影响程度由高到低依次为：“个人生活重大负性事件”、“职场不公负性事件”、“职业特性负性事件”。结论：依据各类负性事件的发生情况及其对医学生从医意向的影响特点，应采取不同的措施改善临床实习微环境：对临床实习阶段发生的个人生活重大负性事件予以关注，主动降低职场不公负性事件的发生频率，对职业特性负性事件则应加以利用，从而降低临床实习微环境中负性事件对医学生从医意向的负面影响。

  关键词： 临床实习；负性事件；医学生；从医意向; ; ; 

   

  Abstract: Abstract Objective: This paper analyzed the impact of adverse events during clinical clerkship on medical students career intention based on China Medical Students Survey (CMSS), in order to better understand how the microenvironment in clinical learning can be improved. Methods: Descriptive statistics were used to describe medical students career intention and the prevalence and frequency of three types of adverse events: adverse major life events , workplace injustice events and occupation-specific events. Logistic regression was used to analyze the impact of adverse events on medical students’ intention to become doctors. Results: 91.6% of the medical students chose to become doctors after graduation. 87.3% of them experienced adverse events during clinical clerkship, and the “adverse occupation-specific events” were the most widely occurred one, followed by the adverse workplace injustice events and adverse major life events. Medical students who experienced adverse events were 1.54 times more likely to abandon medicine career than those who did not experience adverse events. Different types of adverse events had different degrees of impact on medical students’ career intention: the adverse major life events had the greatest impact, followed by the adverse workplace injustice events and the adverse occupation-specific events. Conclusion: We suggested different measures for improvement of microenvironment in clinical clerkship, based on the characteristics of adverse events in terms of their prevalence and degree of impact. More attention and care should be given to medical students who suffered adverse major life events during clinical clerkship. The incidence of adverse workplace injustice events should be reduced. The adverse occupation-specific events should be properly utilized to train medical students to build a solid foundation for their future clinical practice.

  Key words: clinical clerkship; adverse events; medical student; career intention

  提交时间：2021-03-29

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2020-12-04	bmr.202012.00015V1	下载

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