A survey on the recognition and working intention responses of medical students to sinking resources reform

Objective To explore the cognition of medical students on the sinking reform of health resources and the influence of the sinking reform on the medical students' willingness to practice medicine. Methods From June 2018 to February 2019, 1 456 valid questionnaires were collected from 8 medical universities of Zhejiang province, and then descriptive analysis, ANOVA and ordinal logistic model were utilized to do empirical study. Results It was found that 44.3% (645 / 1 456) and 21.5% (313 / 1 456) of students, had a low awareness of the sinking reform. Medical students with information by public channels, health policy and anti-violence education have significantly enhanced reform awareness, support and perceived reform effect compared with those without relevant education and by private channel (P<0.05). Health policy education has significant impact on intention to practice medicine (OR=1.274, 95%CI: 1.043~1.557, P=0.018), but 53.2%(774/1 456) did not received policy education. but 53.2% (774/1 456) did not received policy education. 88.5%(1 289/1 456) interviewees regard incidence of healthcare workplace violence as high, with its negative impact on working intention(OR=0.658, 95%CI: 0.601~0.721, P<0.01), and positive effect for low-level hospitals (OR=1.111, 95%CI: 1.014~1.216, P=0.023). The improvement of legal environment shows no impact for working intention(OR=0.932, 95%CI: 0.831~1.045, P=0.229), but positive impact exists for low-level hospitals (OR=1.363, 95%CI: 1.213~1.532, P<0.01). Conclusions Medical students have low reform awareness with limited information through public channel, and insufficient health policy and anti-violence education. More attention should be paid to the impacts of healthcare workplace violence on medical students' working intention, which may be incentivized by more powerful law enforcement. Key words: Sinking resources reform; Medical students; Working intention; Healthcare workplace violence; Health policy education