背景:医学院的女性人数超过男性。鉴于对乡村医生的需求日益增加以及妇女在乡村医学中的代表性不足,了解女学生农村实践的预测因素对于解决农村地区未来的医疗劳动力短缺至关重要。利用目前的证据,医学院应设法招收具有农村背景和追求初级保健专业兴趣的学生;然而,这是否适用于女性整骨医学生是未知的。
目的:本研究旨在确定农村背景实施家庭医学的计划,对公民义务的动机与女性整骨医学生对最终从事农村医学的态度有关。
方法:对阿肯色州健康教育学院整骨医学学院的女生进行了一项匿名在线调查。调查评估了受访者的农村背景的存在,公民意识的程度,打算练习家庭医学,以及对农村工作和生活的态度。还收集了种族和医学院学习年份的人口统计信息。总的来说,129名学生回答了调查,97个完整的响应进行分析。分层回归用于比较嵌套模型并解释相互作用。
结果:在97名调查受访者中,34.0%自称是一年级学生,37.1%为二年级学生,16.5%为三年级学生,和12.4%的四年级学生。线性回归模型表明,对于阿肯色州健康教育学院的女医学生,具有农村背景与他们在农村环境中实践的态度无关,β=-0.97,标准误差(SE)=1.96,t=-0.49,p>0.05,CI[-4.86,2.92]。公民意识与他们在农村环境中实践的态度有积极的关系,β=0.17,SE=0.07,t=2.44,p=0.016,CI[0.03,0.31],占其方差的4.57%。计划实践家庭医学与学生在农村环境中实践的态度呈正相关,β=4.38,SE=0.85,t=5.15,p<0.001,CI[2.69,6.07],占其方差的20.25%。公民意识似乎缓和了计划实践家庭医学与在农村环境中实践的态度之间的关系,F(1,91)=3.91,p=0.05,R2=0.31。此相互作用项的p值为0.05,但其效应大小测量和图形表示显示出实质性效应。
结论:回归分析表明,对于这项研究中的女性来说,学生的公民意识越强,她对在农村环境中执业的态度越有利。此外,学生练习家庭医学的计划越强,她对最终的农村实践的态度越有利。最后,学生的公民意识影响了有计划实践家庭医学的预测价值。
BACKGROUND: Women outnumber men in medical school. Given the growing need for rural physicians and the underrepresentation of women in rural medicine, understanding predictors of rural practice among female students is imperative for addressing future healthcare workforce shortages in rural areas. Utilizing current evidence, medical schools should seek to admit students with a rural background and interest in pursuing a primary care specialty; however, whether this holds true for female osteopathic medical students is unknown.
OBJECTIVE: This study aims to determine if a rural background, a plan to practice family medicine, and motivation toward civic duty are associated with attitudes toward eventual practice of rural medicine in female osteopathic medical students.
METHODS: An anonymous online survey was administered to actively enrolled female students at Arkansas Colleges of Health Education College of Osteopathic Medicine. The survey assessed the respondents\' presence of a rural background, degree of civic-mindedness, intention to practice family medicine, and attitudes to rural work and life. Demographics of ethnicity and year of study in medical school were also collected. In total, 129 students responded to the survey, with 97 complete responses for analysis. Hierarchical regression was utilized to compare nested models and interpret interactions.
RESULTS: Of the 97 survey respondents, 34.0 % described themselves as first-year students, 37.1 % as second-year students, 16.5 % as third-year students, and 12.4 % as fourth-year students. Linear regression modeling indicated that for female medical students at Arkansas Colleges of Health Education, having a rural background had no relationship with their attitude toward practicing in a rural setting, β=-0.97, standard error (SE)=1.96, t=-0.49, p>0.05, CI [-4.86, 2.92]. Civic-mindedness had a positive relationship with their attitude toward practicing in a rural setting, β=0.17, SE=0.07, t=2.44, p=0.016, CI [0.03, 0.31], accounting for 4.57 % of its variance. Plan to practice family medicine was positively associated with a student\'s attitude toward practicing in a rural setting, β=4.38, SE=0.85, t=5.15, p<0.001, CI [2.69, 6.07], accounting for 20.25 % of its variance. Civic-mindedness appeared to moderate the relationship between planning to practice family medicine and attitudes toward practicing in a rural setting, F(1, 91) = 3.91, p=0.05, R 2=0.31. The p value for this interaction term was 0.05, but its effect size measure and graphical representation revealed a substantive effect.
CONCLUSIONS: The regression analysis showed that, for the women in this study, the greater the student\'s civic-mindedness, the more favorable her attitude toward practicing in a rural setting. Additionally, the stronger the student\'s plan to practice family medicine, the more favorable her attitude toward eventual rural practice was. Lastly, the student\'s civic-mindedness influenced the predictive value of having a plan to practice family medicine.