基于纵向追踪设计农村订单定向医学生强制履约期满后的续约行为机制与激励策略研究

农村订单定向医学生免费培养政策是我国破解农村卫生发展瓶颈的重要卫生人才战略，但是订单定向医学生六年强制履约期满后的续约意愿不强，限制政策的长期效果，亟需有针对的激励措施，而明确其履约期满后的续约行为机制是制定激励措施的重要基础。本课题将以“激励机制-工作动机-行为绩效”理论模型为指导，首先构建订单定向医学生履约期满后的续约行为理论模型，遵循量表研制的原则和方法对理论模型中的核心概念进行准确测量。在此基础上，通过纵向追踪调查收集实证数据，借助结构方程模型揭示订单定向医学生履约期满后继续选择在农村工作的行为决策过程及其决定性因素，从而明确其续约行为机制，并提出针对性激励策略，最后采用离散选择实验评价潜在激励策略的预期效果。本课题理论上能够填补我国当前订单定向医学生强制履约期满后续约行为机制和激励策略研究的不足，实践中能够为促进订单定向医学生的续约行为提供准确的管理切入点和有效的激励模式。

The rural-oriented medicalstudents program is an important strategy to overcome a bottleneck problem in the development of rural healthcare services. However, rural-oriented medicalstudents have a low willingness to renew a contract after the expiration of six-year mandatory contract, which limits the effect of the program, and urgently requires effective incentive strategies to increase their willingness to renew a contract. Identifying the behavior mechanism of the contract renewal of rural-oriented medicalstudents after the expiration of mandatory contract is the basis for developing incentive strategies. The present study will construct a theoretical framework of the behavior mechanism of the contract renewal of rural-oriented medicalstudents based on the theory of “motivation mechanism—work motivation—behavior and performance”, and then develop and evaluate instruments to measure key concepts in the framework. Afterward, we will collect data by means of longitudinal follow-up study, and reveal the decision-making process and the determinants of the contract renewal behavior of rural-oriented medicalstudents by applying the structural equation modeling. According to the above result, we will put forward targeted motivation strategies, and employ discrete selection experiment to assess their expect effects. Our study will fill the gap in research on the behavior mechanism of the contract renewal and incentive strategies of rural-oriented medicalstudents after the expiration of mandatory contract, which will provide management measures and effective incentive strategies to promote their willingness to renew a contract after the mandatory contract.