期刊论文详细信息
BMC Medical Education
Lifelong learning of Chinese rural physicians: preliminary psychometrics and influencing factors
Deliang Wen3  Yang Liu2  Nan Jiang1  Ziwei Wang1  Honghe Li1 
[1] Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China;School of Public Health, China Medical University, Shenyang, Liaoning Province, China;School of Public Health, Dalian Medical University, Dalian, Liaoning Province, China
关键词: Continuing medical education;    Professionalism;    Rural physicians;    Lifelong learning;   
Others  :  1233380
DOI  :  10.1186/s12909-015-0460-9
 received in 2015-05-06, accepted in 2015-10-09,  发布年份 2015
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【 摘 要 】

Background

There are more than 4.9 million rural health workers undertaking the health care need of rural population of over 629 million in China. The lifelong learning of physicians is vital in maintaining up-to-date and qualified health care, but rural physicians in many developing countries lack adequate medical professional developments. There has also been no empirical research focused on the lifelong learning of rural physician populations. The purpose of this study was to investigate the primary levels of lifelong learning of the rural physicians and to analyze group differences.

Methods

We conducted a cross-sectional study on 1197 rural physicians using the Jefferson Scale of Physician Lifelong Learning (JSPLL). Cronbach’s α coefficient, exploratory factor analysis, independent sample t-test, and one-way ANOVA followed by Student-Newman-Keuls test were performed to analyze the data.

Results

For Chinese rural physicians, the JSPLL was reliable (Cronbach’s α coefficient = 0.872) and valid, with exploratory factor analysis fitting a 3-factor model and accounting for a total of 60.46 % of the variance. The mean lifelong learning score was 45.56. Rural physicians generally performed worse in the technical skills in seeking information domain. Rural physicians with 21-30 working years have a lower score of lifelong learning (P < 0.05) than other phases of working years. Career satisfaction and professional titles had a significantly positive influence on physicians’ orientation towards lifelong learning (P < 0.05). The overall lifelong learning scores of physicians who received more training after completion of medical school were higher than those with less additional post-medical school training (P <0.05).

Conclusions

The JSPLL is effective for the Chinese rural physician population. In order to cope with impacting factors on rural physicians’ lifelong learning, the results of the study reinforced the importance of continuing medical education and career satisfaction for lifelong learning and the need for medical schools and hospitals to provide reasonable strategies and necessary support for rural physicians with different amounts of working years. Providing rural physicians more educational opportunities and helping them access educational resources may be an effective strategy for improving their orientation to lifelong learning.

【 授权许可】

   
2015 Li et al.

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【 参考文献 】
  • [1]National Bureau of Statistics of China (NBSC): Chinese population and employment statistics yearbook, 2013. http://www.stats.gov.cn/tjsj/ndsj/. Accessed 9 May 2014.
  • [2]Bin L, Quan L. The current status and countermeasures of human resource of healthcare in the rural areas of China. Chin J Public Health. 2009; 11:1401-1402.
  • [3]Li X, Cochran C, Lu J, Shen J, Hao C, Wang Y et al.. Understanding the shortage of village doctors in China and solutions under the policy of basic public health service equalization: evidence from Changzhou. Int J Health Plann Manage. 2015; 30:E42-55.
  • [4]Zhang D, Unschuld PU. China's barefoot doctor: past, present, and future. Lancet. 2008; 372:1865-1867.
  • [5]Li X, Liu J, Huang J, Qian Y, Che L. An analysis of the current educational status and future training needs of China's rural doctors in 2011. Postgrad Med J. 2013; 89:202-208.
  • [6]Umland B, Waterman R, Wiese W, Duban S, Mennin S, Kaufman A. Learning from a rural physician program in China. Acad Med. 1992; 67:307-309.
  • [7]Zhao Y, Chen R, Wang B, Wu T, Huang Y. General practice on-the-job training in Chinese urban community: a qualitative study on needs and challenges. PLoS One. 2014; 9:e94301.
  • [8]Xu J, Wu N, Jin SG, Wang F, Wang YX. Analysis of inpatient bed allocation equity and utilization in the city community health service center of China. J Huazhong Univ Sci Technol. 2010; 30:141-144.
  • [9]Yang J, Guo AM, Wang YD, Zhao YL, Yang XH. Human Resource Staffing and Service Functions of Community Health Services Organizations in China. Ann Fam Med. 2008; 6:421-427.
  • [10]Tan S, Fan L, Zhou X. Practice and experience of vertical integration in medical resources. Chin J Hospital Adminis. 2006; 22:761-762.
  • [11]Al-Ahmadi H, Roland M. Quality of primary health care in Saudi Arabia: a comprehensive review. Int J Qual Health Care. 2005; 17:331-346.
  • [12]Drislane FW, Akpalu A, Wegdam HH. The medical system in Ghana. Yale J Biol Med. 2014; 87:321-326.
  • [13]Drislane FW, Akpalu A, Wegdam HH. Establishment of a general medicine residency training program in rural West Africa. Yale J Biol Med. 2014; 87:327-339.
  • [14]Ellard DR, Chimwaza W, Davies D, O'Hare JP, Kamwendo F, Quenby S et al.. Can training in advanced clinical skills in obstetrics, neonatal care and leadership, of non-physician clinicians in Malawi impact on clinical services improvements (the ETATMBA project): a process evaluation. BMJ Open. 2014; 4:e005751.
  • [15]Cancedda C, Farmer PE, Kyamanywa P, Riviello R, Rhatigan J, Wagner CM et al.. Enhancing formal educational and in-service training programs in rural Rwanda: a partnership among the public sector, a nongovernmental organization, and academia. Acad Med. 2014; 89:1117-1124.
  • [16]Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011; 377:1778-1797.
  • [17]Liu L. The legal requirements and problems in converting rural doctors into practicing doctors and assistant practicing doctors. Chin Gernal Prac. 2013; 16:4004-4007.
  • [18]Higgins R. Fostering lifelong learning in the physician assistant student through internet-based continuing medical education. J Physician Assist Educ. 2011; 22:44-47.
  • [19]Statler PM. Professional Education and Development Council of the AAPA (2010) Continuing medical education as the pursuit of lifelong learning. JAAPA. 2010; 23:12.
  • [20]Duffy FD, Holmboe ES. Self-assessment in lifelong learning and improving performance in practice: physician know thyself. JAMA. 2006; 296:1137-1139.
  • [21]Hojat M, Nasca TJ, Erdmann JB, Frisby AJ, Veloski JJ, Gonnella JS. An operational measure of physician lifelong learning: Its development, components, and preliminary psychometric data. Med Teach. 2003; 25:433-437.
  • [22]Kamran A, Hutan A. Life-Long learning for physicians. Science. 2009; 326:227.
  • [23]Committee C. Global minimum essential requirements in medical education. Med Teach. 2009; 24:130-135.
  • [24]Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002; 136:243-136.
  • [25]General Medical Council: Good Medical Practice (2013). http://www.gmc-uk.org/guidance/good_medical_practice.asp. Accessed 15 July 2014.
  • [26]National Health and Family Planning Commission of China, National Development and Reform Commission, Ministry of Education, Ministry of Finance, state administration of traditional Chinese medicine: Chinese National Educational Plan for Rural Physician (2011-2020). http://legal.china.com.cn/2013-10/30/content_30450478.htm. Accessed 20 July 2014.
  • [27]Hojat M, Veloski J, Nasca TJ, Erdmann JB, Gonnella JS. Assessing physicians’ orientation toward lifelong learning. J Gen Intern Med. 2006; 21:931-936.
  • [28]Hojat M, Veloski J, Gonnella JS. Measurement and correlates of physicians’ lifelong learning. Acad Med. 2009; 84:1066-1074.
  • [29]Afonso P, Ramos MR, Saraiva S, Moreira CA, Figueira ML. Assessing the relation between career satisfaction in psychiatry with lifelong learning and scientific activity. Psychiatry Res. 2014; 217:210-214.
  • [30]Wetzel AP, Mazmanian PE, Hojat M, Kreutzer KO, Carrico RJ. Measuring medical students' orientation toward lifelong learning: a psychometric evaluation. Acad Med. 2010; 85:S41-44.
  • [31]Muliira JK, Etyang C, Muliira RS, Kizza IB. Nurses' orientation toward lifelong learning: a case study of Uganda's national hospital. J Contin Educ Nurs. 2012; 43:90-96.
  • [32]Zhang H, Zhao S, Liu T, An M. Investigation and Analysis of Nurses Orientation Toward Lifelong Learning of Upper First- class General Hospitals. Med Philos. 2011; 32:73-75.
  • [33]Zhao S, Zhang H. Investigation and analysis on 550 nurses’ orientation toward lifelong learning in 3A grade hospitals of 5 cities in western Liaoning province and its influential factors. Chongqing Med. 2012; 41:2635-2637.
  • [34]Ma X, Sun Y, Wen D. Investigation and influencing factors of clinicians' orientation toward lifelong learning. Chin Higher Med Educ. 2013; 9:5-6.
  • [35]The Guideline and Standard of National Continuing Medical Education (On Trail). Contin Med Educ. 2001; 15:10-12.
  • [36]American Sponsored by the Educational Research Association (AERA), American Psychological Association (APA), and National Council on Measurement in Education (NCME). Standards for educational and psychological testing. Washington, DC: American Educational Research Association; 1999.
  • [37]Field A. Discovering statistics using SPSS for Windows. 2nd ed. Sage Publications, London; 2004.
  • [38]Measham AR, Alleyne G, Mills A, Musgrove P, Claeson M. Disease control priorities in developing countries. World Bank and Oxford University Press, Washington, DC; 2006.
  • [39]Ryan J. Continuous professional development along the continuum of lifelong learning. Nurse Educ Today. 2003; 23:498-508.
  • [40]Schrock JW, Cydulka RK. Lifelong learning. Emerg Med Clin North Am. 2006; 43:785-795.
  • [41]Simon FA, Aschenbrener CA. Undergraduate medical education accreditation as a driver of lifelong learning. J Contin Educ Health Prof. 2005; 25:157-161.
  • [42]Frankford DM, Patterson MA, Konrad TR. Transforming practice organizations to foster lifelong learning and commitment to medical professionalism. Acad Med. 2000; 75:708-717.
  • [43]Hegney D, Tuckett A, Parker D, Robert E. Access to and support for continuing professional education amongst Queensland nurses: 2004 and 2007. Nurse Educ Today. 2007; 30:142-149.
  • [44]Bahn D. Orientation of nurses towards formal and informal learning: Motives and perceptions. Nurse Educ Today. 2007; 27:723-730.
  • [45]Li TY, He W. Lifetime learning: the only way to become a qualified doctor. Chin J Med Imag Tech. 2009; 25:159.
  • [46]Chen Y, Yang K, Jing T, Tian J, Shen X. Use of text messages to communicate clinical recommendations to health workers in rural China: a cluster-randomized trial. Bull World Health Organ. 2014; 92:474-481.
  • [47]Meng Y, Lz Z, Wang X, Han Y, Huang Y, Li L. The Legal Dilemma and Countermeasures of Rural Doctors Practicing. Med Soci. 2012; 25:63-66.
  • [48]Dyrbye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013; 88:1358-1367.
  • [49]Jacobs JL, Samarasekera DD, Shen L, Rajendran K, Hooi SC. Encouraging an environment to nurture lifelong learning: an Asian experience. Med Teach. 2014; 36:164-168.
  • [50]Merriam SB. The new update on adult learning theory. Jossey-Bass, San Francisco; 2001.
  • [51]Crawford DL: The role of aging in adult learning: Implications for instructors in higher education. http://education.jhu.edu/PD/newhorizons/lifelonglearning/higher-education/implications/. Accessed 15 April 2015.
  • [52]National Health and Family Planning Commission of China (NHFPCC): Medical Licensing Examination eligibility requirements (2006Version). http://www.nmec.org.cn/Pages/ArticleInfo-3-10699.html. Accessed 20 July 2014.
  • [53]Hojat M, Kowitt B, Doria C, Gonnella JS. Career satisfaction and professional accomplishments. Med Educ. 2010; 44:bn969-976.
  • [54]Nakamura E. Relationship between nurses' learning motivation inside/outside the workplace and job/life satisfaction. J UOEH. 2009; 31:377-387.
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