Qualitative research on influencing factors for choice of secondary disciplines in eight-year medical students based on the self-determination theory

Qiao Jing; Han Wei; Li Ke; Qi Jianguang

doi:10.3760/cma.j.cn116021-20241104-02023

您当前的位置：

首页 >

文章列表页 >

Qualitative research on influencing factors for choice of secondary disciplines in eight-year medical students based on the self-determination theory

Investigation Research | 更新时间：2025-08-28

- Qualitative research on influencing factors for choice of secondary disciplines in eight-year medical students based on the self-determination theory
- Chinese Journal of Medical Education Research Vol. 24, Issue 8, Pages: 1058-1063(2025)
- 作者机构：
  
  北京大学第一医院教育处，北京 100034
- 作者简介：
  
  Qi Jianguang, Email: qjg2006@126.com
- 基金信息：
  
  Undergraduate Teaching Reform Project of Peking University in 2025
- DOI：10.3760/cma.j.cn116021-20241104-02023
  CLC： R-05
- Received：04 November 2024，
  
  Published：20 August 2025
- 稿件说明：
移动端阅览
乔静, 韩为, 李珂, 等. 基于自我决定理论的八年制医学生二级学科专业选择影响因素的质性研究[J]. 中华医学教育探索杂志, 2025, 24(8): 1058-1063.

Qiao Jing, Han Wei, Li Ke, et al. Qualitative research on influencing factors for choice of secondary disciplines in eight-year medical students based on the self-determination theory[J]. Chinese journal of medical education research, 2025, 24(8): 1058-1063.
乔静, 韩为, 李珂, 等. 基于自我决定理论的八年制医学生二级学科专业选择影响因素的质性研究[J]. 中华医学教育探索杂志, 2025, 24(8): 1058-1063. DOI： 10.3760/cma.j.cn116021-20241104-02023.

Qiao Jing, Han Wei, Li Ke, et al. Qualitative research on influencing factors for choice of secondary disciplines in eight-year medical students based on the self-determination theory[J]. Chinese journal of medical education research, 2025, 24(8): 1058-1063. DOI： 10.3760/cma.j.cn116021-20241104-02023.

摘要

目的

基于自我决定理论，分析临床医学专业八年制医学生二级学科专业选择的影响因素。

方法

采用目的抽样和描述性现象学研究方法，选取14名北京大学医学部某附属医学院的2018级和2019级临床医学专业八年制学生进行半结构式访谈。运用主题框架法分析访谈资料，提炼主题。

结果

通过对访谈资料的分析，共得到3个维度，6个一级主题（含19个二级主题）：①自主感维度（兴趣因素、价值观因素）；②胜任感维度（个人特质因素、学科要求因素）；③归属感维度（科室因素、导师因素）。

结论

基于兴趣和价值观的自主感、个人能力与学科特点匹配的胜任感、科室氛围及导师带来的归属感是影响八年制医学生二级学科专业选择的重要影响因素。应关注学生兴趣培养及价值观引导、重视二级学科早接触、提供胜任力培训、促进学生与科室导师的良好互动，以提升学生的归属感，从而优化八年制卓越医生的培养模式。

Abstract

Objective

To analyze the influencing factors for choice of secondary disciplines in eight-year medical students majoring in clinical medicine based on the self-determination theory.

Methods

Fourteen eight-year students majoring in clinical medicine in 2018 and 2019 from an affiliated medical school of Peking University Health Science Center were selected to conduct semi-structured interviews using purposive sampling and descriptive phenomenological study methods. The thematic framework method was used to analyze the interview data and refine the theme.

Results

Through the analysis of interview data

a total of 3 dimensions were obtained

including 6 first-level topics and 19 second-level topics: ①autonomy dimension (interest factor and value factor); ②dimension of competence (personal trait factor and subject requirement factor); and ③belonging dimension (department factor and mentor factor).

Conclusions

The sense of autonomy based on interests and values

the sense of competence matched with personal ability and the characteristics of the discipline

and the sense of belonging brought by the atmosphere of the department and the mentor are important factors influencing the choice of secondary disciplines in eight-year medical students. Teachers and teaching managers should pay attention to the cultivation of students' interests and value guidance

early contact with secondary disciplines

provision of competency training

and promotion of good interaction between students and department tutors

so as to enhance students' sense of belonging and optimize the training model of eight-year excellent doctors.

关键词

Keywords

references

林蕙青，谢阿娜 . 坚持改革创新，实现八年制医学教育新发展 [J ] . 协和医学杂志， 2022 ， 13 （ 1 ）： 1 - 4 . DOI: 10.12290/xhyxzz.2022-0011 http://dx.doi.org/10.12290/xhyxzz.2022-0011 .

罗友晖，侯建林，郑辉 . 临床医学八年制学生就业分析及其对人才培养的启示 [J ] . 中华医学教育探索杂志， 2023 ， 22 （ 6 ）： 843 - 846 . DOI: 10.3760/cma.j.cn116021-20220814-01306 http://dx.doi.org/10.3760/cma.j.cn116021-20220814-01306 .

Ntoumanis N , Ng JYY , Prestwich A , et al . A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health [J ] . Health Psychol Rev , 2021 , 15 ( 2 ): 214 - 244 . DOI: 10.1080/17437199.2020.1718529 http://dx.doi.org/10.1080/17437199.2020.1718529 .

Ten Cate TJ , Kusurkar RA , Williams GC . How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59 [J ] . Med Teach , 2011 , 33 ( 12 ): 961 - 973 . DOI: 10.3109/0142159X.2011.595435 http://dx.doi.org/10.3109/0142159X.2011.595435 .

Palinkas LA , Horwitz SM , Green CA , et al . Purposeful sampling for qualitative data collection and analysis in mixed method implementation research [J ] . Adm Policy Ment Health , 2015 , 42 ( 5 ): 533 - 544 . DOI: 10.1007/s10488-013-0528-y http://dx.doi.org/10.1007/s10488-013-0528-y .

Huang H , Wang HHX , Donaghy E , et al . Using self-determination theory in research and evaluation in primary care [J ] . Health Expect , 2022 , 25 ( 6 ): 2700 - 2708 . DOI: 10.1111/hex.13620 http://dx.doi.org/10.1111/hex.13620 .

Hirsh DA , Crampton PES , Osman NY . Applying self-determination theory to stem medical schools' clinical teacher sustainability crisis [J ] . Med Educ , 2024 , 58 ( 1 ): 118 - 128 . DOI: 10.1111/medu.15181 http://dx.doi.org/10.1111/medu.15181 .

严楠，方卫纲 . 定性研究在医学领域中的应用 [J ] . 中华全科医师杂志， 2018 ， 17 （ 6 ）： 478 - 482 . DOI: 10.3760/cma.j.issn.1671-7368.2018.06.018 http://dx.doi.org/10.3760/cma.j.issn.1671-7368.2018.06.018 .

韩芸峰，刘思源，李佳禾，等 . 八年制临床医学专业学生神经外科执业意愿及其影响因素的调查分析 [J ] . 中华医学教育杂志， 2024 ， 44 （ 3 ）： 171 - 175 . DOI: 10.3760/cma.j.cn115259-20230404-00358 http://dx.doi.org/10.3760/cma.j.cn115259-20230404-00358 .

马妍，马新然，叶珊，等 . 器官系统整合课教学模式在临床医学八年制学生神经系统见习中的应用效果 [J ] . 中华脑血管病杂志（电子版）， 2024 ， 18 （ 4 ）： 360 - 364 . DOI: 10.11817/j.issn.1673-9248.2024.04.011 http://dx.doi.org/10.11817/j.issn.1673-9248.2024.04.011 .

张家宇，舒涛，袁野，等 . 学习理论视角下国内外医学课程整合现状的比较与思考 [J ] . 中华医学教育探索杂志， 2022 ， 21 （ 6 ）： 786 - 790 . DOI: 10.3760/cma.j.cn116021-20200509-00902 http://dx.doi.org/10.3760/cma.j.cn116021-20200509-00902 .

Lee HJ , Ahn M . Consensual qualitative research on the internship experience and development of career identity of Korean doctors [J ] . BMC Med Educ , 2021 , 21 ( 1 ): 12 . DOI: 10.1186/s12909-020-02451-4 http://dx.doi.org/10.1186/s12909-020-02451-4 .

张崇友，陈健 . 长学制医学生早期科研训练实践教学改革初探：以哈尔滨医科大学2010级七年制临床医学为例 [J ] . 继续教育研究， 2019 （ 5 ）： 99 - 102 . DOI: 10.3969/j.issn.1009-4156.2019.05.018 http://dx.doi.org/10.3969/j.issn.1009-4156.2019.05.018 .

肖琪严，曹爽婕，王兆伦，等 . 临床医学专业八年制学生就业状况和工作满意度调查 [J ] . 中国高等医学教育， 2020 （ 1 ）： 3 - 4 . DOI: 10.3969/j.issn.1002-1701.2020.01.002 http://dx.doi.org/10.3969/j.issn.1002-1701.2020.01.002 .

胡方园，徐江，陆敏，等 . 八年制临床医学生康复医学启蒙见习课程建设探索 [J ] . 中华物理医学与康复杂志， 2021 ， 43 （ 2 ）： 181 - 183 . DOI: 10.3760/cma.j.issn.0254-1424.2021.02.018 http://dx.doi.org/10.3760/cma.j.issn.0254-1424.2021.02.018 .

张雪原，罗希，谢晨妹，等 . 北京地区某高校医学研究生退学原因分析和对策研究 [J ] . 中华医学教育杂志， 2021 ， 41 （ 10 ）： 914 - 918 . DOI: 10.3760/cma.j.cn115259-20210517-00642 http://dx.doi.org/10.3760/cma.j.cn115259-20210517-00642 .

李青华，张晓英，吕伟，等 . 医学生视角下“双师型”教师师德师风现状探索 [J ] . 中国继续医学教育， 2024 ， 16 （ 15 ）： 111 - 117 . DOI: 10.3969/j.issn.1674-9308.2024.15.023 http://dx.doi.org/10.3969/j.issn.1674-9308.2024.15.023 .

黄菲 . 基于角色期望理论的硕士研究生选择导师的行为模式 [D ] . 武汉：华中科技大学， 2022 . DOI: 10.27157/d.cnki.ghzku.2022.002493 http://dx.doi.org/10.27157/d.cnki.ghzku.2022.002493 .

刘啸，李彦 . 临床教学氛围评价工具的编制研究 [J ] . 中国病案， 2021 ， 22 （ 4 ）： 89 - 91， 112 . DOI: 10.3969/j.issn.1672-2566.2021.04.032 http://dx.doi.org/10.3969/j.issn.1672-2566.2021.04.032 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Research and practice of Sino-French eight-year clinical medical program in Wuhan University

Discussion on the establishment of health management as Master degree awarding program under first-level discipline of clinical medicine

Problems in the theory teaching of general practice course for eight-year program of clinical medical students

Application and evaluation of case-based learning + Seminar teaching method based on Toulmin model in education and teaching of clinical medicine

Related Author

Li Yue

Yu Mingxia

Yu Feng

孙荣

曾凡玲

张俊辉

王永红

刘婧

Related Institution

Department of Teaching Office, The Second Clinical College of Wuhan University/Zhong Nan Hospital of Wuhan University

School of Medicine, Wuhan University

重庆医科大学附属第一医院健康管理中心

北京大学人民医院教育处

北京市西直门南大街11

⁰