Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study

BackgroundThe fulfillment of contractual obligations by rural-oriented tuition-waived medical students (RTMSs) to work in rural medical institutions after graduation directly impacts the improvement of rural health quality. This study aimed to not only quantitatively measure the direct impact of hon...

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Main Authors: Xuewen Zhang, Bing Sun, Zhuang Tian, Bin Yu, Chao Wei, Ying Zhang, Canlei Zheng, Xuejun Chen, Qing Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-07-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2023.1089625/full
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author Xuewen Zhang
Bing Sun
Zhuang Tian
Bin Yu
Chao Wei
Ying Zhang
Canlei Zheng
Xuejun Chen
Qing Liu
author_facet Xuewen Zhang
Bing Sun
Zhuang Tian
Bin Yu
Chao Wei
Ying Zhang
Canlei Zheng
Xuejun Chen
Qing Liu
author_sort Xuewen Zhang
collection DOAJ
description BackgroundThe fulfillment of contractual obligations by rural-oriented tuition-waived medical students (RTMSs) to work in rural medical institutions after graduation directly impacts the improvement of rural health quality. This study aimed to not only quantitatively measure the direct impact of honesty-credit, specialty identity, and career identity on willingness to fulfill the contract of RTMSs but also to quantify the intermediary role of specialty identity and career identity between honesty-credit and willingness to fulfill the contract. The research results provided recommendations for the rural-oriented tuition-waived medical education (RTME) program to achieve its goal of training rural primary healthcare personnel.MethodsFrom March to May 2022, 1162 RTMSs were selected as the research objects. The honesty-credit, specialty identity, career identity, and willingness to fulfill the contract were quantitated using a self-completed questionnaire. Pearson's correlation analysis and structural equation modeling were used for statistical analysis and mediating effect evaluation.ResultsA total of 455 (42.3%) RTMSs had high willingness to fulfill the contract, and honesty-credit had a significant direct positive effect on willingness (β = 0.198, P < 0.001), specialty identity (β = 0.653, P < 0.001), and career identity (β = 0.180, P < 0.001). In the intermediary path between honesty-credit and willingness, career identity [95% confidence interval (CI): 0.007–0.051] had significant mediating effects. Career identity (95% CI: 0.030–0.149) also had significant mediating effects between specialty identity and willingness, and specialty identity (95% CI: 0.465–0.760) had significant mediating effects between honesty-credit and career identity. These results strongly confirmed that honesty-credit, specialty identity, and career identity are early and powerful predictors of the willingness to fulfill the contract of RTMSs.ConclusionThe honesty-credit of RTMSs can predict their willingness to fulfill the contract early, significantly and positively. For the students who fail to pass the credit assessment for many times and have a strong tendency to default, their training qualifications should be canceled in time, so that students who are truly willing to serve rural areas can enter the project, and finally achieve the policy goal of “strengthening the rural primary medical and health system”.
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spelling doaj.art-14dd8d24fe464f44bd7ee2061c1a4d612023-07-17T11:23:53ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-07-011110.3389/fpubh.2023.10896251089625Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional studyXuewen Zhang0Bing Sun1Zhuang Tian2Bin Yu3Chao Wei4Ying Zhang5Canlei Zheng6Xuejun Chen7Qing Liu8School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Public Health, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaSchool of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, ChinaBackgroundThe fulfillment of contractual obligations by rural-oriented tuition-waived medical students (RTMSs) to work in rural medical institutions after graduation directly impacts the improvement of rural health quality. This study aimed to not only quantitatively measure the direct impact of honesty-credit, specialty identity, and career identity on willingness to fulfill the contract of RTMSs but also to quantify the intermediary role of specialty identity and career identity between honesty-credit and willingness to fulfill the contract. The research results provided recommendations for the rural-oriented tuition-waived medical education (RTME) program to achieve its goal of training rural primary healthcare personnel.MethodsFrom March to May 2022, 1162 RTMSs were selected as the research objects. The honesty-credit, specialty identity, career identity, and willingness to fulfill the contract were quantitated using a self-completed questionnaire. Pearson's correlation analysis and structural equation modeling were used for statistical analysis and mediating effect evaluation.ResultsA total of 455 (42.3%) RTMSs had high willingness to fulfill the contract, and honesty-credit had a significant direct positive effect on willingness (β = 0.198, P < 0.001), specialty identity (β = 0.653, P < 0.001), and career identity (β = 0.180, P < 0.001). In the intermediary path between honesty-credit and willingness, career identity [95% confidence interval (CI): 0.007–0.051] had significant mediating effects. Career identity (95% CI: 0.030–0.149) also had significant mediating effects between specialty identity and willingness, and specialty identity (95% CI: 0.465–0.760) had significant mediating effects between honesty-credit and career identity. These results strongly confirmed that honesty-credit, specialty identity, and career identity are early and powerful predictors of the willingness to fulfill the contract of RTMSs.ConclusionThe honesty-credit of RTMSs can predict their willingness to fulfill the contract early, significantly and positively. For the students who fail to pass the credit assessment for many times and have a strong tendency to default, their training qualifications should be canceled in time, so that students who are truly willing to serve rural areas can enter the project, and finally achieve the policy goal of “strengthening the rural primary medical and health system”.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1089625/fullcareer identityhonesty-creditwillingness to fulfill contractRTMSsspecialty identity
spellingShingle Xuewen Zhang
Bing Sun
Zhuang Tian
Bin Yu
Chao Wei
Ying Zhang
Canlei Zheng
Xuejun Chen
Qing Liu
Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
Frontiers in Public Health
career identity
honesty-credit
willingness to fulfill contract
RTMSs
specialty identity
title Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
title_full Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
title_fullStr Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
title_full_unstemmed Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
title_short Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study
title_sort relationship between honesty credit specialty identity career identity and willingness to fulfill the contract among rural oriented tuition waived medical students of china a cross sectional study
topic career identity
honesty-credit
willingness to fulfill contract
RTMSs
specialty identity
url https://www.frontiersin.org/articles/10.3389/fpubh.2023.1089625/full
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