Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China
Objectives Continuing medical education (CME) and work commitment are important for rural healthcare workers (RHWs) and rural medical work. The significant association between continuing education and work commitment has been reported in many studies from several different industries. However, very...
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BMJ Publishing Group
2020-08-01
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| author | Jinlin Liu Ying Mao |
| author_facet | Jinlin Liu Ying Mao |
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| description | Objectives Continuing medical education (CME) and work commitment are important for rural healthcare workers (RHWs) and rural medical work. The significant association between continuing education and work commitment has been reported in many studies from several different industries. However, very few studies have analysed the association of CME with work commitment among healthcare workers, let alone among RHWs. This study aimed to identify the significance of CME for the work commitment of RHWs (doctors and nurses) in China.Design and setting The cross-sectional study interviewed RHWs from 11 western provinces in China.Participants In total, 4118 RHWs, consisting of 2490 doctors and 1628 nurses who were working clinically, were included in the study.Primary outcome measures Work commitment (ie, the relative importance of work to one’s sense of self) focussing on the affective component was the dependent variable, and it included four subdomains: pride, concern, and dedication, extracted by exploratory factor analysis of a 5-point Likert scale, and turnover intent, measured by a dichotomous question. CME (ie, a variety of educational and training activities to maintain, develop or increase knowledge, skills and professional performance and relationships) was the independent variable, including three subdomains: opportunity, participation and expectation, measured by three dichotomous questions.Results Of the 4118 respondents, 91.2% reported insufficient opportunities for CME, 21.3% had never participated in CME and 83.3% had a high expectation of CME. The mean scores of pride in, concern for and dedication to work were 3.54, 3.81 and 3.61 (out of a maximum of 5), respectively, and 30.6% presented turnover intent. After adjusting for gender, age, marriage, education, technical title, income and type of rural healthcare organisation, the multivariate analyses suggested that there was a significant positive association between CME and work commitment among RHWs. RHWs who had a significant high-level work commitment were those who reported a sufficient opportunity for CME (β and 95% CI for pride in, concern for and dedication to work: 0.33, 0.23 to 0.43; 0.19, 0.09 to 0.28; and 0.25, 0.15 to 0.35), had participated in CME (β and 95% CI for pride in, concern for and dedication to work: 0.11, 0.04 to 0.19; 0.09, 0.02 to 0.15; and 0.10, 0.03 to 0.17) and had a high expectation of CME (β and 95% CI for pride in, concern for and dedication to work: 0.22, 0.15 to 0.30; 0.21, 0.13 to 0.28; and 0.28, 0.20 to 0.36), and having sufficient opportunities for CME significantly increased the odds of having no turnover intent (OR and 95% CI: 1.70, 1.26 to 2.28). Age, marriage, education, technical title, income and type of rural healthcare organisation were significantly associated with the work commitment of RHWs. Differences were observed between rural doctors and nurses in the association of CME with work commitment.Conclusions CME has a significant positive association with the work commitment of RHWs in China. RHWs’ work commitment should be further improved in future rural health workforce management. In addition, governments, healthcare organisations and professional associations should establish a professional and complete CME system in China to provide sufficient opportunities for CME for RHWs, encourage them to participate and meet their expectations. |
| format | Article |
| id | doaj-art-e90b1c391c554bbfb5a0198c196d078f |
| institution | Kabale University |
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| language | English |
| publishDate | 2020-08-01 |
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| spelling | doaj-art-e90b1c391c554bbfb5a0198c196d078f2024-12-03T04:05:08ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-037985Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in ChinaJinlin Liu0Ying Mao1Department of Social Security, School of Public Policy and Administration, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaDepartment of Social Security, School of Public Policy and Administration, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaObjectives Continuing medical education (CME) and work commitment are important for rural healthcare workers (RHWs) and rural medical work. The significant association between continuing education and work commitment has been reported in many studies from several different industries. However, very few studies have analysed the association of CME with work commitment among healthcare workers, let alone among RHWs. This study aimed to identify the significance of CME for the work commitment of RHWs (doctors and nurses) in China.Design and setting The cross-sectional study interviewed RHWs from 11 western provinces in China.Participants In total, 4118 RHWs, consisting of 2490 doctors and 1628 nurses who were working clinically, were included in the study.Primary outcome measures Work commitment (ie, the relative importance of work to one’s sense of self) focussing on the affective component was the dependent variable, and it included four subdomains: pride, concern, and dedication, extracted by exploratory factor analysis of a 5-point Likert scale, and turnover intent, measured by a dichotomous question. CME (ie, a variety of educational and training activities to maintain, develop or increase knowledge, skills and professional performance and relationships) was the independent variable, including three subdomains: opportunity, participation and expectation, measured by three dichotomous questions.Results Of the 4118 respondents, 91.2% reported insufficient opportunities for CME, 21.3% had never participated in CME and 83.3% had a high expectation of CME. The mean scores of pride in, concern for and dedication to work were 3.54, 3.81 and 3.61 (out of a maximum of 5), respectively, and 30.6% presented turnover intent. After adjusting for gender, age, marriage, education, technical title, income and type of rural healthcare organisation, the multivariate analyses suggested that there was a significant positive association between CME and work commitment among RHWs. RHWs who had a significant high-level work commitment were those who reported a sufficient opportunity for CME (β and 95% CI for pride in, concern for and dedication to work: 0.33, 0.23 to 0.43; 0.19, 0.09 to 0.28; and 0.25, 0.15 to 0.35), had participated in CME (β and 95% CI for pride in, concern for and dedication to work: 0.11, 0.04 to 0.19; 0.09, 0.02 to 0.15; and 0.10, 0.03 to 0.17) and had a high expectation of CME (β and 95% CI for pride in, concern for and dedication to work: 0.22, 0.15 to 0.30; 0.21, 0.13 to 0.28; and 0.28, 0.20 to 0.36), and having sufficient opportunities for CME significantly increased the odds of having no turnover intent (OR and 95% CI: 1.70, 1.26 to 2.28). Age, marriage, education, technical title, income and type of rural healthcare organisation were significantly associated with the work commitment of RHWs. Differences were observed between rural doctors and nurses in the association of CME with work commitment.Conclusions CME has a significant positive association with the work commitment of RHWs in China. RHWs’ work commitment should be further improved in future rural health workforce management. In addition, governments, healthcare organisations and professional associations should establish a professional and complete CME system in China to provide sufficient opportunities for CME for RHWs, encourage them to participate and meet their expectations.https://bmjopen.bmj.com/content/10/8/e037985.full |
| spellingShingle | Jinlin Liu Ying Mao Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China BMJ Open |
| title | Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China |
| title_full | Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China |
| title_fullStr | Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China |
| title_full_unstemmed | Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China |
| title_short | Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China |
| title_sort | continuing medical education and work commitment among rural healthcare workers a cross sectional study in 11 western provinces in china |
| url | https://bmjopen.bmj.com/content/10/8/e037985.full |
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