A Study on the Current Situation and Factors Influencing the General Practice Ability of Clinical Undergraduate Students in China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants and Procedures
2.2.1. Expert Selection for the Delphi Method
2.2.2. The Subjects of Semi-Structured Interview
2.2.3. The Subjects of the Reliability and Validity Analysis of the Questionnaire and the Empirical Research
2.3. Research Methods
2.3.1. Literature Review Method
2.3.2. Delphi Method
2.3.3. Semi-Structured Interview Method
2.3.4. Questionnaire Survey
2.4. Ethical Considerations
2.5. Statistical Analysis
3. Results
3.1. The Results of the Literature Analysis
3.2. The Results of the Semi-Structured Interviews
3.2.1. General Information of Expert
3.2.2. Topic Extraction
3.3. Results of the Expert Consultation
3.3.1. General Information of the Experts
3.3.2. The Level of Expertise, Degree of Opinion Coordination, and Level of Authority Exhibited by the Experts
3.3.3. The Results of Expert Consultation
- (1)
- The results of the first expert consultation
- (2)
- The results of the second expert consultation
3.3.4. The Outcome of the Weightings of GPA-MU
- (1)
- The maximum eigenvalue (λmax) and consistency results
- (2)
- The outcome of weights and combination weights
3.4. Reliability and Validity Analysis of the GPA-MU
- (1)
- General information of subjects
- (2)
- Reliability test of the GPA-MU
- (3)
- Validity test of the GPA-MU
3.5. Current Situation of General Practice Ability of Clinical Medical Undergraduates in Hunan Province
3.5.1. The Socio-Demographic Information of the Participants
3.5.2. General Practice Ability Score of Clinical Medical Undergraduates in Hunan Province
3.6. Analysis of Influencing Factors on the Current Situation of Clinical Medical Undergraduates’ General Practice Ability in Hunan Province
3.6.1. Single Factor Analysis
3.6.2. Multivariate Analysis
4. Discussion
4.1. The Scientific Rigor of the Conducted GPA-MU Scale
4.2. The Reliability and Validity of the GPA-MU Scale
4.3. General Medicine Ability Level of Clinical Medical Undergraduates in Hunan Province
4.4. Influencing Factors of Clinical Medical Undergraduates’ General Practice Ability Level in Hunan Province
5. Strengths and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Classifications | n (%) |
---|---|---|
Gender | Male | 8 (53.3%) |
Female | 7 (46.7%) | |
Academic qualifications | Bachelor’s degree | 2 (13.3%) |
Master’s degree | 5 (33.3%) | |
Doctor | 8 (53.4%) | |
Professional title | Entry level | 2 (13.3%) |
Intermediate level | 5 (33.3%) | |
Senior | 8 (53.4%) | |
Years of work experience | 5–15 | 5 (33.3%) |
16– | 10 (66.7%) | |
Research field | Primary healthcare management | 2 (13.4%) |
General practice | 6 (40.0%) | |
General practice education | 4 (26.6%) | |
Health policies | 1 (6.6%) | |
Medical education | 2 (13.4%) |
Indicators | The First Round | The Second Round | ||||||
---|---|---|---|---|---|---|---|---|
Primary | Secondary | Tertiary | Total | Primary | Secondary | Primary | Total | |
Kendall’s W | 0.667 | 0.488 | 0.570 | 0.518 | 0.667 | 0.639 | 0.657 | 0.630 |
df | 28.000 | 81.933 | 383.225 | 456.843 | 28.023 | 107.361 | 405.008 | 519.980 |
v | 2 | 11 | 46 | 61 | 2 | 11 | 42 | 57 |
P | 0.014 | <0.001 | <0.001 | <0.001 | 0.014 | <0.001 | <0.001 | <0.001 |
Variables | Classifications | Number (n) | Percentage (%) |
---|---|---|---|
Gender | Male | 103 | 46.4 |
Female | 119 | 53.6 | |
The place of origin of the students | Rural | 144 | 64.9 |
Urban | 78 | 35.1 | |
Grade | Fourth year | 81 | 36.5 |
Fifth year | 141 | 63.5 | |
Students who have signed clinical work agreements | Yes | 54 | 24.3 |
No | 168 | 75.7 | |
The major of your college entrance examination is clinical major or not | Yes | 190 | 85.6 |
No | 32 | 14.4 | |
The degree of understand about general practitioners | Not really understand | 19 | 8.6 |
Don’t understand much | 42 | 18.9 | |
General understand | 123 | 55.4 | |
Better understand | 30 | 13.5 | |
Understand very well | 8 | 3.6 | |
Internship time | 1 week and under | 52 | 23.4 |
2 weeks | 71 | 32.0 | |
3 weeks | 15 | 6.8 | |
4 weeks and above | 84 | 37.8 | |
What do you think of the salary and wages of general practitioners? | Very bad | 19 | 8.6 |
Poor | 50 | 22.5 | |
Average | 137 | 61.7 | |
High | 14 | 6.3 | |
Very high | 2 | 0.9 | |
How is your sense of identity for general practitioners? | Lower | 9 | 4.1 |
Low | 32 | 14.4 | |
Average | 129 | 58.1 | |
Higher | 42 | 18.9 | |
Very high | 10 | 4.5 | |
What do you think of the employment prospects for general practitioners? | Very bad | 7 | 3.2 |
Poor | 28 | 12.6 | |
Average | 109 | 49.1 | |
High | 65 | 29.3 | |
Very high | 13 | 5.9 | |
Will you choose to become a general practitioner after graduation? | Yes | 55 | 24.8 |
No | 167 | 75.2 |
Index | Number of Items | Cronbach’s α Coefficient |
---|---|---|
Total | 43 | 0.977 |
A1 | 17 | 0.921 |
B11 | 5 | 0.740 |
B12 | 5 | 0.808 |
B13 | 4 | 0.883 |
B14 | 3 | 0.813 |
A2 | 19 | 0.973 |
B21 | 5 | 0.894 |
B22 | 5 | 0.888 |
B23 | 3 | 0.891 |
B24 | 3 | 0.905 |
B25 | 3 | 0.918 |
A3 | 7 | 0.896 |
B31 | 3 | 0.899 |
B32 | 3 | 0.802 |
B33 | - | - |
KMO | 0.944 | |
Bartlett Spherical Test | Approximate Chi-square | 9798.468 |
df | 903 | |
p-value | 0.000 |
Factors | Characteristic Root | Rotational Front Difference Interpretation Rate | Explanation Rate of Variance After Rotation | ||||||
---|---|---|---|---|---|---|---|---|---|
Characteristic Root | Variance Interpretation Rate % | Accumulation% | Characteristic Root | Variance Interpretation Rate % | Accumulation % | Characteristic Root | Variance Interpretation Rate % | Accumulation % | |
1 | 22.823 | 53.076 | 53.076 | 22.823 | 53.076 | 53.076 | 12.685 | 29.501 | 29.501 |
2 | 2.510 | 5.838 | 58.914 | 2.510 | 5.838 | 58.914 | 7.771 | 18.073 | 50.703 |
3 | 1.754 | 4.080 | 62.994 | 1.754 | 4.080 | 62.994 | 5.285 | 12.291 | 62.994 |
4 | 1.466 | 3.409 | 66.402 | - | - | - | - | - | - |
5 | 1.241 | 2.887 | 69.289 | - | - | - | - | - | - |
6 | 1.059 | 2.463 | 71.752 | - | - | - | - | - | - |
7 | 1.059 | 2.463 | 71.752 | - | - | - | - | - | - |
8 | 0.992 | 2.307 | 74.059 | - | - | - | - | - | - |
9 | 0.751 | 1.747 | 77.766 | - | - | - | - | - | - |
10 | 0.732 | 1.702 | 79.468 | - | - | - | - | - | - |
11 | 0.656 | 1.526 | 80.994 | - | - | - | - | - | - |
12 | 0.631 | 1.467 | 82.461 | - | - | - | - | - | - |
13 | 0.592 | 1.378 | 83.838 | - | - | - | - | - | - |
14 | 0.545 | 1.268 | 85.107 | - | - | - | - | - | - |
15 | 0.534 | 1.243 | 86.350 | - | - | - | - | - | - |
16 | 0.480 | 1.115 | 87.465 | - | - | - | - | - | - |
17 | 0.407 | 0.947 | 88.412 | - | - | - | - | - | - |
18 | 0.402 | 0.935 | 89.347 | - | - | - | - | - | - |
19 | 0.387 | 0.900 | 90.247 | - | - | - | - | - | - |
20 | 0.376 | 0.875 | 91.122 | - | - | - | - | - | - |
21 | 0.355 | 0.826 | 91.948 | - | - | - | - | - | - |
22 | 0.329 | 0.765 | 92.712 | - | - | - | - | - | - |
23 | 0.312 | 0.725 | 93.437 | - | - | - | - | - | - |
24 | 0.291 | 0.676 | 94.113 | - | - | - | - | - | - |
25 | 0.246 | 0.571 | 94.684 | - | - | - | - | - | - |
26 | 0.234 | 0.545 | 95.229 | - | - | - | - | - | - |
27 | 0.210 | 0.488 | 95.717 | - | - | - | - | - | - |
28 | 0.204 | 0.473 | 96.190 | - | - | - | - | - | - |
29 | 0.177 | 0.412 | 96.602 | - | - | - | - | - | - |
30 | 0.170 | 0.395 | 96.998 | - | - | - | - | - | - |
31 | 0.160 | 0.372 | 97.370 | - | - | - | - | - | - |
32 | 0.147 | 0.341 | 97.711 | - | - | - | - | - | - |
33 | 0.136 | 0.317 | 98.028 | - | - | - | - | - | - |
34 | 0.127 | 0.295 | 98.322 | - | - | - | - | - | - |
35 | 0.110 | 0.255 | 98.577 | - | - | - | - | - | - |
36 | 0.106 | 0.246 | 98.823 | - | - | - | - | - | - |
37 | 0.095 | 0.221 | 99.044 | - | - | - | - | - | - |
38 | 0.090 | 0.210 | 99.254 | - | - | - | - | - | - |
39 | 0.085 | 0.197 | 99.451 | - | - | - | - | - | - |
40 | 0.075 | 0.173 | 99.624 | - | - | - | - | - | - |
41 | 0.067 | 0.156 | 99.781 | - | - | - | - | - | - |
42 | 0.054 | 0.126 | 99.906 | - | - | - | - | - | - |
43 | 0.040 | 0.094 | 100.000 | - | - | - | - | - | - |
Name | Factor Load Matrix | ||
---|---|---|---|
Factor 1 | Factor 2 | Factor 3 | |
C111 | 0.533 | ||
C112 | 0.629 | ||
C113 | 0.738 | ||
C114 | 0.645 | ||
C115 | 0.695 | ||
C121 | 0.630 | ||
C122 | 0.699 | ||
C123 | 0.662 | ||
C124 | 0.669 | ||
C125 | 0.597 | ||
C131 | 0.591 | ||
C132 | 0.522 | ||
C133 | 0.673 | ||
C134 | 0.707 | ||
C141 | 0.692 | ||
C142 | 0.544 | ||
C143 | 0.599 | ||
C211 | 0.511 | ||
C212 | 0.652 | ||
C213 | 0.713 | ||
C214 | 0.664 | ||
C215 | 0.569 | ||
C221 | 0.846 | ||
C222 | 0.719 | ||
C223 | 0.779 | ||
C224 | 0.660 | ||
C225 | 0.406 | ||
C231 | 0.774 | ||
C232 | 0.703 | ||
C233 | 0.783 | ||
C241 | 0.833 | ||
C242 | 0.793 | ||
C243 | 0.807 | ||
C251 | 0.800 | ||
C252 | 0.687 | ||
C253 | 0.796 | ||
C311 | 0.617 | ||
C312 | 0.550 | ||
C313 | 0.426 | ||
C321 | 0.503 | ||
C322 | 0.674 | ||
C323 | 0.571 |
Dimension | Item | Factor Loading | CR | AVE |
---|---|---|---|---|
A1 | C111 | 0.618 | 0.935 | 0.691 |
C112 | 0.727 | |||
C113 | 0.781 | |||
C114 | 0.791 | |||
C115 | 0.775 | |||
C121 | 0.729 | |||
C122 | 0.646 | |||
C123 | 0.724 | |||
C124 | 0.708 | |||
C125 | 0.616 | |||
C131 | 0.644 | |||
C132 | 0.674 | |||
C133 | 0.717 | |||
C134 | 0.614 | |||
C141 | 0.642 | |||
C142 | 0.615 | |||
C143 | 0.773 | |||
A2 | C211 | 0.716 | 0.973 | 0.659 |
C212 | 0.691 | |||
C213 | 0.847 | |||
C214 | 0.769 | |||
C215 | 0.862 | |||
C221 | 0.909 | |||
C222 | 0.875 | |||
C223 | 0.848 | |||
C224 | 0.865 | |||
C225 | 0.832 | |||
C231 | 0.896 | |||
C232 | 0.797 | |||
C233 | 0.808 | |||
C241 | 0.804 | |||
C242 | 0.743 | |||
C243 | 0.870 | |||
C251 | 0.785 | |||
C252 | 0.826 | |||
C253 | 0.714 | |||
C311 | 0.873 | 0.899 | 0.667 | |
C312 | 0.859 | |||
C313 | 0.831 | |||
C321 | 0.648 | |||
C322 | 0.824 | |||
C323 | 0.646 | |||
C331 | 0.611 |
χ2/df | RMSEA | NFI | GFI | IFI | CFI | |
---|---|---|---|---|---|---|
Total scale | 2.408 | 0.072 | 0.945 | 0.961 | 0.976 | 0.956 |
A1 | 2.309 | 0.092 | 0.903 | 0.905 | 0.941 | 0.940 |
A2 | 2.550 | 0.083 | 0.923 | 0.921 | 0.950 | 0.949 |
A3 | 2.525 | 0.084 | 0.908 | 0.901 | 0.922 | 0.921 |
Variables | Classifications | Number (n) | Percentage (%) |
---|---|---|---|
Gender | Male | 145 | 45.60 |
Female | 173 | 54.40 | |
The place of origin of the students | Rural | 207 | 65.10 |
Urban | 111 | 34.90 | |
Grade | Fourth year | 118 | 37.10 |
Fifth year | 200 | 62.90 | |
Students who have signed clinical work agreements | Yes | 72 | 22.60 |
No | 246 | 77.40 | |
The major of your college entrance examination is clinical major or not | Yes | 271 | 85.20 |
No | 47 | 14.80 | |
The degree of understand about general practitioners | Not really understand | 26 | 8.20 |
Don’t understand much | 63 | 19.80 | |
General understand | 174 | 54.70 | |
Better understand | 45 | 14.20 | |
understand very well | 10 | 3.10 | |
Internship time | 1 week and under | 78 | 24.50 |
2 weeks | 92 | 28.90 | |
3 weeks | 21 | 6.60 | |
4 weeks and above | 127 | 39.90 | |
What do you think of the salary and wages of general practitioners | Very bad | 24 | 7.50 |
Poor | 70 | 22.00 | |
Average | 196 | 61.60 | |
High | 25 | 7.90 | |
Very high | 3 | 0.90 | |
How is your sense of identity for general practitioners? | Lower | 63 | 19.80 |
Low | 43 | 13.50 | |
Average | 182 | 57.20 | |
Higher | 13 | 19.80 | |
Very high | 17 | 5.30 | |
What do you think of the employment prospects for general practitioners? | Very bad | 9 | 2.80 |
Poor | 99 | 11.60 | |
Average | 153 | 48.10 | |
High | 36 | 31.10 | |
Very high | 21 | 6.60 | |
Will you choose to become a general practitioner after graduation? | Yes | 61 | 19.20 |
No | 257 | 80.80 |
Scores | Maximum | Minimum | ± s |
---|---|---|---|
Total | 43 | 131 | 83.75 ± 14.97 |
General practice service ability | 17 | 53 | 32.60 ± 5.64 |
Public health service ability | 19 | 57 | 37.82 ± 7.59 |
Knowledge absorption ability | 7 | 21 | 13.33 ± 2.57 |
Variables | Classifications | M (P25, P75) | Z/H | p |
---|---|---|---|---|
Gender | Male | 85.0 (82.0, 89.0) | −0.078 | 0.938 |
Female | 85.0 (82.0, 88.0) | |||
The place of origin of the students | Rural | 86.0 (84.0, 89.0) | −3.365 | 0.001 |
Urban | 85.0 (76.0, 87.0) | |||
Grade | Fourth year | 86.0 (84.0, 89.0) | −1.605 | 0.109 |
Fifth year | 85.0 (79.5, 87.0) | |||
Students who have signed clinical work agreements | Yes | 86.0 (82.5, 90.5) | −1.517 | 0.129 |
No | 85.0 (82.0, 87.3) | |||
The major of your college entrance examination is clinical major or not | Yes | 85.0 (82.0, 88.0) | −0.833 | 0.405 |
No | 86.0 (84.0, 89.0) | |||
The degree of understand about general practitioners | Not really understand | 89.0 (86.0, 99.5) | 23.586 | <0.001 |
Don’t understand much | 86.0 (83.0, 89.0) | |||
General understand | 85.0 (82.0, 87.3) | |||
Better understand | 85.0 (72.5, 86.0) | |||
understand very well | 62.0 (43.0, 84.0) | |||
internship time | 1 week and under | 85.0 (79.0, 88.5) | 21.01 | <0.001 |
2 weeks | 85.0 (82.0, 89.0) | |||
4 weeks and above | 86.0 (84.0, 89.0) | |||
What do you think of the salary and wages of general practioners | Very bad | 89.0 (88.0, 94.0) | 17.238 | 0.002 |
Poor | 86.0 (84.0, 91.5) | |||
Average | 85.0 (81.0, 87.0) | |||
High | 85.0 (83.0, 91.0) | |||
Very high | 128.5 (126.0, 131.0) | |||
How is your sense of identity for general practitioners? | Lower | 83.5 (74.0, 87.0) | 18.405 | <0.001 |
Low | 85.0 (81.0, 89.0) | |||
Average | 85.0 (84.0, 88.0) | |||
Higher | 85.0 (88.0, 114.5) | |||
Very high | 79.0 (55.0, 86.5) | |||
What do you think of the employment prospects for general practitioners? | Very bad | 89.0 (88.0, 110.0) | 12.541 | 0.014 |
Poor | 85.0 (82.0, 91.0) | |||
Average | 85.0 (84.0, 87.0) | |||
High | 85.0 (80.5, 87.0) | |||
Very high | 89.0 (88.0, 110.0) | |||
Will you choose to become a general practitioner after graduation? | Yes | 86.0 (84.0, 92.3) | −2.463 | 0.014 |
No | 85.0 (82.0, 87.0) |
Factors | Variables | Assignment |
---|---|---|
General practice ability score | Y | 0 = “≤85”; 1 = “>85” |
Gender | X1 | 0 = “Male”; 1 = “Female” |
The place of origin of the students | X2 | 0 = “Rural”; 1 = “Urban” |
Are you an oriented student? | X3 | 0 = “Yes”; 1 = “No” |
Whether clinical medicine is your first choice for higher education | X4 | 0 = “Yes”; 1 = “No” |
The degree of understand about general practitioners | X5 | 0 = “low”; 1 = “high” |
Internship time | X6 | 0 = “Under 2 weeks”; 1 = “2 weeks and over” |
What do you think of the salary and wages of general practitioners | X7 | 0 = “Low”; 1 = “High” |
How is your sense of identity for general practitioners? | X8 | 0 = “Low”; 1 = “High” |
What do you think of the employment prospects for general practitioners? | X9 | 0 = “Poor”; 1 = “Good” |
Will you choose to become a general practitioner after graduation? | X10 | 0 = “Yes”; 1 = “No” |
Variables | B | SE | Wald | p | OR (95%CI) |
---|---|---|---|---|---|
The place of origin of the students | −1.056 | 0.311 | 11.499 | 0.001 | 0.403 (0.236–0.688) |
Degree of understanding | −4.524 | 1.248 | 13.144 | 0.000 | 0.011 (0.001–0.125) |
Internship time | 1.118 | 0.371 | 9.084 | 0.003 | 3.058 (1.478–6.327) |
Salary and wage | 0.911 | 0.363 | 6.284 | 0.012 | 2.486 (1.220–5.068) |
Professional identity | 0.914 | 0.377 | 5.893 | 0.015 | 2.496 (1.193–5.222) |
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Ou-Yang, H.-J.; Huang, Y.; Qin, L.-L. A Study on the Current Situation and Factors Influencing the General Practice Ability of Clinical Undergraduate Students in China. Healthcare 2025, 13, 733. https://doi.org/10.3390/healthcare13070733
Ou-Yang H-J, Huang Y, Qin L-L. A Study on the Current Situation and Factors Influencing the General Practice Ability of Clinical Undergraduate Students in China. Healthcare. 2025; 13(7):733. https://doi.org/10.3390/healthcare13070733
Chicago/Turabian StyleOu-Yang, Hai-Jing, Ying Huang, and Lu-Lu Qin. 2025. "A Study on the Current Situation and Factors Influencing the General Practice Ability of Clinical Undergraduate Students in China" Healthcare 13, no. 7: 733. https://doi.org/10.3390/healthcare13070733
APA StyleOu-Yang, H.-J., Huang, Y., & Qin, L.-L. (2025). A Study on the Current Situation and Factors Influencing the General Practice Ability of Clinical Undergraduate Students in China. Healthcare, 13(7), 733. https://doi.org/10.3390/healthcare13070733