A study on the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province based on grounded theory

Li Tongtong; Yang Qiuju; Fang Ming; Wang Ying; Liu Di

doi:10.3760/cma.j.cn116021-20260105-02277

您当前的位置：

首页 >

文章列表页 >

A study on the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province based on grounded theory

更新时间：2026-04-27

- A study on the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province based on grounded theory
- Chinese Journal of Medical Education Research Pages: 1-7(2026)
- 作者机构：
  
  1.哈尔滨医科大学马克思主义学院，哈尔滨 150081
  2.哈尔滨医科大学研究生院，哈尔滨 150081
- 作者简介：
  
  Liu Di, Email: diliu85@163.com
- 基金信息：
  
  Key Research Project on Higher Education Teaching Reform in Heilongjiang Province(SJGZY2024053);Special Research Project on Teaching Reform of Ideological and Political Theory Courses under the Higher Education Teaching Reform Program in Heilongjiang Province(SJGSJ2024011);Graduate Research and Practice Innovation Project of Harbin Medical University(YJSCX2025-96HYD)
- DOI：10.3760/cma.j.cn116021-20260105-02277
  CLC： R197.1
- Received：05 January 2026，
  
  Online First：27 April 2026，
- 稿件说明：
移动端阅览
Li Tongtong, Yang Qiuju, Fang Ming, et al. A study on the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province based on grounded theory[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-7.
DOI：

Li Tongtong, Yang Qiuju, Fang Ming, et al. A study on the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province based on grounded theory[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-7. DOI： 10.3760/cma.j.cn116021-20260105-02277.

摘要

目的

系统剖析黑龙江省农村订单定向医学生基层服务价值意愿的核心影响因素，为制定靶向强化策略、夯实基层医疗人才储备提供实证依据。

方法

采用质性研究中的半结构式访谈法，于2025年9月至11月，对黑龙江省2所高校的15名农村订单定向医学生及5名关联人员开展深度访谈。运用Nvivo20软件整理访谈资料，基于扎根理论进行开放式编码、轴心式编码和选择性编码，提炼核心范畴并构建理论模型。

结果

经三重编码，共提炼出137个初始概念、15个初始范畴和7个主范畴，凝练出实践体验、个体认知、外部支持、制度环境4大核心范畴。明确这4大范畴以个体认知为核心，呈现出多向联动、核心统领、功能互补的作用特征，构建起以实践体验为感知起点、个体认知为核心枢纽、外部支持为中间助力、制度环境为底层兜底的内外双圈动态协同模型。

结论

基于4大范畴“起点—核心—助力—兜底”的协同互构逻辑，提出强化基层医疗能力培养、深化多元协同价值引导、夯实制度环境底层兜底的针对性策略，同时为教育、卫生行政等部门及高校提供靶向实践参考，多方协同强化订单生基层服务价值意愿，为健康中国战略下的基层医疗人才队伍建设提供理论借鉴与方法论参考。

Abstract

Objective

To systematically analyze the core influencing factors of the willingness of rural order-oriented medical students to improve the value of grassroots service in Heilongjiang Province

and provide empirical evidence for formulating targeted reinforcement strategies and consolidating the reserve of grassroots medical talents.

Methods

Semi-structured interviews

a qualitative research method

were conducted from September to November 2025 with 15 rural order-oriented medical students and 5 relevant personnel from two universities in Heilongjiang Province. The interview data were organized using NVivo 20 software. Open coding

axial coding

and selective coding were implemented based on grounded theory to extract core categories and construct a theoretical model.

Results

Through the three stages of coding

a total of 137 initial concepts

15 initial categories

and 7 main categories were refined. Four core categories were identified

including practical experience

individual cognition

external support

and institutional environment. These four categories are characterized by multi-directional linkage

core leadership

and functional complementarity

with individual cognition at the core. A dynamic collaborative model of inner and outer circles was constructed

with practical experience as the perceptual starting point

individual cognition as the core hub

external support as the intermediate assistance

and institutional environment as the foundational support.

Conclusions

Based on the collaborative and mutually reinforcing logic of the four core categories

including starting point

core

assistance

and foundational support

this study proposes targeted strategies to strengthen the cultivation of grassroots medical capabilities

deepen the value guidance of diversified collaboration

and consolidate the foundational support of institutional environments. It also provides targeted practical references for departments such as education and health administration

as well as universities

to multi-laterally enhance the willingness of order-oriented students to improve the value of grassroots service

offering theoretical insights and methodological references for the development of grassroots medical talent teams under the Healthy China strategy.

关键词

Keywords

references

国务院 . 国务院关于《医疗卫生强基工程实施方案》的批复: 国函〔2025〕 85 号[EB/OL ] . （ 2025-09-07 ）[ 2026-01-01 ] . https://www.gov.cn/gongbao/2025/issue_12286/202509/content_7041214.html https://www.gov.cn/gongbao/2025/issue_12286/202509/content_7041214.html .

乔雪，尹永田，罗文君，等 . 基于扎根理论的农村订单定向医学生职业认同的影响因素分析：一项质性研究 [J ] . 中国全科医学， 2024 ， 27 （ 22 ）： 2752 - 2758， 2765 . DOI: 10.12114/j.issn.1007-9572.2023.0344 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0344 .

宋茂荣，刘波，宋晶 . 农村订单定向医学生契约精神：现状、背离与回归 [J ] . 卫生经济研究， 2022 ， 39 （ 8 ）： 18 - 20 . DOI: 10.14055/j.cnki.33-1056/f.2022.08.011 http://dx.doi.org/10.14055/j.cnki.33-1056/f.2022.08.011 .

若从彬，司建平，王先菊 . 中医学专业农村订单定向医学生留任基层意愿的影响因素分析 [J ] . 时珍国医国药， 2024 ， 35 （ 6 ）： 1536 - 1538 .

申丽君，李晗歌，王培成，等 . 农村订单定向医学毕业生工作场所患者源暴力、职业倦怠与离职意向的关系研究 [J ] . 中国全科医学， 2024 ， 27 （ 22 ）： 2766 - 2772 . DOI: 10.12114/j.issn.1007-9572.2023.0783 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0783 .

Parsons F . Choosing a vocation [M ] . Boston : University of Michigan Library , 2009 : 98 .

肖水源，杨德森 . 社会支持对身心健康的影响 [J ] . 中国心理卫生杂志， 1987 ， 1 （ 4 ）： 183 - 187 .

Patton MQ . Qualitative Research & Evaluation Methods [M ] . 3rd ed . Thousand Oaks, Calif .: Sage Publications , 2002 : 343 .

朱丽叶·科宾，安塞尔姆·施特劳斯 . 质性研究的基础：形成扎根理论的程序与方法 [M ] . 朱光明，译. 重庆：重庆大学出版社， 2015 ： 27 - 29 .

Krippendorff K . Content analysis: an introduction to its methodology [M ] . Thousand Oaks : SAGE , 2004 .

陈向明 . 质的研究方法与社会科学研究 [M ] . 北京：教育科学出版社， 2000 .

张卓，黄滋淳 . 基于扎根理论的延期博士生学业倦怠形成机制研究 [J ] . 研究生教育研究， 2024 （ 4 ）： 62 - 72 . DOI: 10.19834/j.cnki.yjsjy2011.2024.04.08 http://dx.doi.org/10.19834/j.cnki.yjsjy2011.2024.04.08 .

于海伟，贺涛，曾硕，等 . 医学研究生课程教学问题及对策研究 [J ] . 中华医学教育探索杂志， 2025 ， 24 （ 3 ）： 407 - 411 . DOI: 10.3760/cma.j.cn116021-20231018-01701 http://dx.doi.org/10.3760/cma.j.cn116021-20231018-01701 .

张妮，米亚静，刘洁，等 . 混合式教学在培养农村订单定向医学生“医学遗传学”课程中的应用效果 [J ] . 中国医药导报， 2022 ， 19 （ 10 ）： 81 - 83， 88 . DOI: 10.20047/j.issn1673-7210.2022.10.017 http://dx.doi.org/10.20047/j.issn1673-7210.2022.10.017 .

黄晓丽，温晓年，陈城 . 广东省订单定向培养医学生的职业价值观、专业承诺和学习投入关系 [J ] . 中国卫生资源， 2022 ， 25 （ 5 ）： 650 - 655 . DOI: 10.13688/j.cnki.chr.2022.211357 http://dx.doi.org/10.13688/j.cnki.chr.2022.211357 .

刘莹钰睿，黄巧云，雷安业，等 . 基于学员角度的云南省农村订单定向医学生规范化培训效果评价研究 [J ] . 中华医学教育探索杂志， 2024 ， 23 （ 7 ）： 894 - 900 . DOI: 10.3760/cma.j.cn116021-20230831-01612 http://dx.doi.org/10.3760/cma.j.cn116021-20230831-01612 .

田静，李庆林，高瑞，等 . 政策工具视角下农村订单定向医学生的培养政策文本分析 [J ] . 中华医学教育探索杂志， 2023 ， 22 （ 9 ）： 1299 - 1303 . DOI: 10.3760/cma.j.cn116021-20210612-01406 http://dx.doi.org/10.3760/cma.j.cn116021-20210612-01406 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

An exploration of the core competencies of acupuncture and moxibustion talents based on the grounded theory methodology

Related Author

Zeng Yanling

Liu Cunzhi

Wang Liqiong

Sheng Qing

Zhou Yizhen

Chen Jingyi

Related Institution

School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine

School of Management, Beijing University of Chinese Medicine

School of Traditional Chinese Medicine, Beijing University of Chinese Medicine

⁰