A study on the relationship between self-efficacy and career identity of rural-oriented tuition-waived medical students based on the mediating effect of vocational outcome expectations

作者：Xiaoying Chen, Yue Chen, Xuebo Zhu · 发表于：BMC Medical Education · 年份：2025 · DOI：10.1186/s12909-025-07422-1 · 被引用次数：3 · 研究领域：Career Development and Diversity、Healthcare professionals’ stress and burnout、Higher Education and Employability

BACKGROUND: Primary healthcare plays a crucial role in providing accessible, affordable, and comprehensive care to meet basic health needs. However, primary healthcare in China faces problems such as insufficient numbers of medical staff and low professional quality, which affect the quality of primary healthcare services. Since 2010, the Chinese government has initiated a rural-oriented tuition-waived medical education (RTME) programme, which has trained many excellent general practitioners for primary healthcare. However, rural-oriented tuition-waived medical students (RTMSs) have a weak sense of career identity and a low willingness to engage in primary healthcare at present, hindering the sustainable development of primary healthcare services. This study, based on social cognitive career theory, takes Zhejiang Province as an example to investigate the career identity levels of RTMSs and explores the demographic factors influencing these levels. It validates the internal relationships and mediation models among self-efficacy, vocational outcome expectations, and career identity. The study provides empirical evidence to enhance the willingness of RTMSs to serve in primary healthcare and to optimize talent training policies. METHODS: A cross-sectional survey was conducted among 428 RTMSs in Zhejiang, China, between November 2023 and March 2024. Participants were selected using multistage stratified random sampling. Descriptive statistics were calculated, and differences betw...