某综合性大学医学生转专业决策历程的质性研究

Decision-making process of changing major for medical students in a comprehensive university： a qualitative study

目的探讨综合性大学医学生从医学专业转入其他专业的决策历程及相关影响因素。方法访谈对象为6名已从医学专业转入其他专业的二年级本科学生。按照诠释现象学分析法进行研究设计．通过半结构式深入访谈完成收集资料，访谈聚焦于学生转系的决策历程及影响因素。对访谈过程进行录音并转录成文字稿，应用诠释现象学分析六步法对转录资料进行分析。结果研究对象即使已离开医学专业，对医生职业仍表达了高度认同感；同时也觉得学医很苦、很累，付出往往不能得到同等回报，因而缺乏职业自信。部分研究对象谈及他们曾经对医学生的未来充满好奇，网络及学长等是其获得职业相关信息的主要途径，但往往为负面信息所困扰。尽早开展医学生生涯适应力教育．加强医学生的职业认同感并提升其对负面信息的防御能力，有助于应对医学生转系及未来转职率高发的现状。结论基于学生视角，探讨医学生转换专业的决策历程，有助于教育者了解处于基础医学阶段医学生的生涯适应现状，为促进其职业认同、稳定职业思想的教育策略的制定提供指导，以避免医学人才培养的浪费。’

Objective To explore the decision-making process of medical students who turned the major from the medicine to other majors, and the related factors that hindered them continuing to study the medicine. Methods According to the design of interpretative phenomenon logical analysis, semi-structured in-depth interviews were used to collect the data. Participants were six undergraduate students who had moved from medical major to another major. Interviews were recorded on audio-tape with .the students＇ permission and then transcribed verbatim. The transcribed interviews were analyzed according to six steps of interpretative phenomenological analysis. Results Even if the participants had left the medical major, they still expressed a strong sense of professional identity for the doctor. However, they also admitted that the pro- fessional process of medicine students was very hard and tired, and couldn＇t get the equal return for their payment. They thus were lack of confidence for the future. Some of the participants talked about the fact that they had been curious about the future of medical students. Internet and seniors were the main avenues for obtaining job-related information, but they were often plagued by the negative information. Education about career adaptation should be carried out as soon as possible, to strengthen the professional identity of medical students, and enhance their ability to defend against negative information, which could help to deal with the status of high turnover rate for medical students. Conclusion Based on the students＇ perspective, exploring the decision-making process of turning major for medical students will contribute to the educators taking effective strategies to improve the students＇ career identity, stabilize their professional thought, and reduce the loss of the medical students.