Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review.
Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review.
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DOI：
10.1136/bmjopen-2016-013501
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发表时间：
2017-02-22
期刊：
影响因子：
2.9
通讯作者：
Scherpbier AJ
中科院分区：
文献类型：
--
作者：
Budhathoki SS;Zwanikken PA;Pokharel PK;Scherpbier AJ
在世界各地，特别是在低收入和中等收入国家，农村地区都存在医生短缺的问题。在农村行医的选择受到许多因素的影响。作为一名医科学生的学习动机是做出这一选择的一个关键决定因素。本研究探讨医学生毕业后到中低收入国家农村地区实习动机的影响。本研究进行了一项系统回顾，以确定对低收入和中等收入国家医学生在农村地区工作动机的影响。纳入报道动机影响的论文，并进行内容分析以选择文章。未以英文发表的文章被排除在本综述之外。农村背景（即在农村地区长大）、在农村地区接受以社区为基础的课程培训、在医疗培训期间尽早接触社区以及医学院设在农村，这些都促使医学生到农村地区工作。人们认为缺乏基础设施、工作量大、医院管理不善和隔离是使医学生在农村地区行医失去动力的卫生设施因素。在低收入和中等收入国家，注重农村背景因素的医学院选择标准和注重农村地区的医学教育课程是更相关的因素。本审查中确定的因素可能有助于低收入和中等收入国家的规划人员、医学教育工作者和决策者设计相关干预措施，以积极影响农村选择，因为农村医生短缺是一个持续和日益严重的问题。
There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern.