城乡生源医学生对农村卫生工作能力需求的差异研究OA

Objective To compare differences between medical students from urban versus rural backgrounds in perceived needs for core competencies required for rural health work,and—grounded in Social Cognitive Career Theory(SCCT)—to explore the underlying mech-anism through which students'place-of-origin background shapes competency-need perceptions,thereby providing empirical evidence for implementing differentiated training strategies in higher vocational medical colleges.Methods A cross-sectional survey design was em-ployed.Using convenience sampling,a questionnaire survey was administered to 996 students from a health-related higher vocational col-lege.Participants were categorized by place of origin into an urban-origin group(n=285)and a rural-origin group(n=711).Multivariate analysis of variance(MANOVA)was used to test overall group differences;independent-samples t tests were conducted to compare differ-ences across competency dimensions;and Cohen's d was calculated to estimate effect sizes.Results MANOVA indicated a statistically sig-nificant overall difference between urban-and rural-origin students across the 12 competency ratings(Wilks'λ=0.974,F=2.17,P=0.011).Independent-samples t tests showed that rural-origin students rated the importance of six competencies significantly higher than did ur-ban-origin students(P<0.01).The largest difference was observed for humanistic care and communication(d=0.32,P<0.001),with nota-ble differences also found for comprehensive management(d=0.28,P<0.001)and emergency response(d=0.28,P<0.001).Regarding per-ceived training adequacy,rural-origin students reported significantly higher adequacy scores than urban-origin students in four competen-cies:public health(d=0.15,P=0.035),comprehensive management(d=0.16,P=0.026),information technology(d=0.15,P=0.031),and hu-manistic communication(d=0.18,P=0.009).Conclusion Medical students from rural backgrounds reported significantly greater perceived needs for competencies required in rural health work than those from urban backgrounds and also provided more positive evaluations of training adequacy.This disparity can be interpreted through the SCCT pathway of"background experiences-self-efficacy-outcome ex-pectations,"suggesting that higher vocational institutions should attend to the moderating role of students'place-of-origin background in rural health workforce training and develop a differentiated competency-based training system accordingly.