Career orientation and its impact factors of general practitioners in Shanghai, China: a cross-sectional study

Policy perception, job satisfaction and intentions to remain in rural area: evidence from the National Compulsory Service Programme in China

BACKGROUND

Exploring factors that may influence general practitioners (GPs)' intentions to remain in rural area is necessary to inform the training and placement of future medical workforce in rural area. However, little is known about how GPs' perception towards the National Compulsory Service Programme (NCSP) and job satisfaction impact their turnover intention. This paper explores GPs' intentions to remain in rural China and how their policy perception and job satisfaction predict the intentions.

METHODS

We conducted a cross-sectional, online survey from December 2021 to February 2022 to investigate GPs' perception towards NCSP, job satisfaction, and intentions to remain in rural area. Eligible participants were GPs who were required to provide health services as part of NCSP at township health centres of 9 provinces which could represent all NCSP GPs in China. Multinomial logistic regression analyses were performed to explore the associations between policy perceptions, job satisfaction, and intentions to remain.

RESULTS

Of 3615 GPs included in the analysis, 442 (12.2%) would like to remain in rural area and 1266 (35.0%) were unsure. Results of the multinomial logistic regression analyses showed that compared with GPs who would leave, GPs with higher perception scores for the restriction on taking postgraduate exam (RRR: 1.93, 95% CI 1.72, 2.16) and the commitment to work for six years (RRR: 1.53, 95% CI 1.31, 1.78) were more likely to remain. In contrast, GPs who had higher perception scores for completing standardised residency training (RRR: 0.75, 95% CI 0.64, 0.88) and passing National Medical Licensing Examinations (RRR: 0.74, 95% CI 0.62, 0.87) were more likely to leave. GPs who were satisfied with the freedom of choosing work methods (RRR: 1.52, 95% CI 1.25, 1.84) and chances of promotion (RRR: 1.60, 95% CI 1.32, 1.94) were more likely to remain.

CONCLUSIONS

This study highlights the significance of policy perception and job satisfaction on GPs' intentions to remain in rural area. Factors such as career advancement and the empowerment of GPs to build on and use their skills and abilities should be taken into account when designing rural placement programmes.

Influential Pathways of Employees' Career Growth: Linkage of Psychological and Organizational Factors Based on Qualitative Comparative Analysis

Implementing the “hierarchical diagnosis and treatment” system highlights the important role of general practitioners as “residents’ health gatekeepers.” Still, the low level of career growth always limits the realization of their service value. Inertial thinking uses a single factor to explain the complexity of career growth in previous studies; in fact, it isn’t easy to assess whether the factor is a sufficient and necessary condition for a high level of career growth. Herein, we have used a set theory perspective to analyze the mechanism of influencing high-level career growth by combining psychological and organizational factors. This research aims to analyze causal complexity relationship between these conditions and results is analyzed in detail. We choose fuzzy-set qualitative comparative analysis (fsQCA) with a sample of 407 GPs to test 5 antecedent conditional variables that can affect their career growth. The variables include professional identity, self-efficacy, achievement motivation, training mechanism, and incentive mechanism. To ensure the universality and diversity of data, the samples were selected from community medical institutions in different regions of China. The results show that three pathways can affect the high career growth of GPs, and the optimal pathway A2 is the linkage matching of high incentive mechanism, high professional identity, high achievement motivation, and high self-efficacy. At the same time, we find that professional identity plays an alternative role in the three pathways. When professional identity is at a high level, as long as achievement motivation and self-efficacy are superior, or achievement motivation, self-efficacy, and achievement motivation are superior, a high level of career growth can be achieved. We broke the shackles of previous studies that only focused on the impact of single factors on the career growth of GPs. From the perspective of set theory, we use configurational thinking to construct Influential pathways of high career growth of GPs by integrating antecedents. The results can provide effective support for improving GPs’ service ability and realizing their service value to protect residents’ health.

Exploration of Entrepreneurship Education by Linear Regression and Psychological Factor Analysis

To study the improvement of the entrepreneurial performance of start-ups and achieve an organic combination of entrepreneurship education and entrepreneurial performance, the entrepreneurial group of college students was taken as the springboard to discuss the entrepreneurial performance of start-ups initiated by college students. First, through questionnaire design and scale selection, the results of the questionnaire survey and the reliability and validity of the scale tool were tested. Second, the variable of college students' entrepreneurial self-efficacy based on psychological factor analysis was introduced. The correlations among entrepreneurship education, entrepreneurial self-efficacy, and entrepreneurial performance were analyzed. Finally, the intermediary role of entrepreneurial self-efficacy was verified by using the hierarchical linear regression analysis method combined with the BARON three-part verification method. The results show that the response rate of the questionnaire is 92%, and the selection of research samples is scientific. The Cronbach's α reliability coefficients corresponding to each scale are all above 0.8, and the common factor variances are all above 0.7. Therefore, the reliability and validity of scale tools are good. Entrepreneurship education, entrepreneurial self-efficacy, and entrepreneurial performance are significantly correlated with each other. The college students' entrepreneurial self-efficacy has a good explanatory ability and plays an intermediary role; in the entrepreneurial innovation learning dimension, its corresponding β = 0.257; in the dimension of school organizational support, the corresponding β = 0.439; in the dimension of social interaction, the corresponding β = 0.238. The results have a reference value for studying entrepreneurship education and the improvement of entrepreneurial performance from a psychological level.