Background China's rural-oriented tuition-waived medical education programme has successfully trained a large number of excellent health professionals for grassroots medical institutions. This programme is significant in improving the accessibility of medical services and achieving health equity. Currently, the professional identity of directional medical students is a major concern.
Objective The aim of this study is to examine the level of career identity of Zhejiang rural-oriented tuition-waived medical students(RTMSs), to explore the relationship between career identity, self-efficacy and vocational outcome expectations, and to provide theoretical basis and practical reference for improving the level of career identity of RTMSs.
Methods From January to June 2024, a multistage stratified random sampling method was used to administer an electronic questionnaire to 455 designated medical students in Zhejiang. The survey covered basic information, the Free Medical Students' Professional Identity Scale, the Self-Efficacy Scale, and the Occupational Outcome Expectation Scale. Pearson correlation analysis was used to assess the relationships among professional identity, self-efficacy, and occupational outcome expectations, and AMOS 28 software was used to construct a structural equation model to explore the relationships among these three variables.
Results A total of 455 questionnaires were distributed in this study. 428 valid questionnaires were recovered, with an effective recovery rate of 94.07%. The mean score of the professional identity scale for free medical students in Zhejiang Province was (3.68±0.56) points, the mean score of the self-efficacy scale was (5.21±0.97) points, and the mean score of the career outcome expectation scale was (3.13±0.45) points. Pearson correlation analysis showed significant positive correlations among professional identity, self-efficacy, and career outcome expectations (r1=0.526, r2=0.603, P<0.001). Structural equation modeling results indicated that self-efficacy and career outcome expectations significantly predicted professional identity (β1=0.201, β2=0.645, P<0.001), and career outcome expectations played a partial mediating role between self-efficacy and professional identity.
Conclusion The career identity of rural RTMSs in Zhejiang is at a medium level, and there is a positive correlation between self-efficacy, career identity and vocational outcome expectations, and vocational outcome expectations play a partly mediating role between self-efficacy and career identity. The self-efficacy and vocational outcome expectations of RTMSs can be improved to enhance the career identity of RTMSs.