High resident job performance is essential for effective medical professionalism. To date, few studies have investigated the potential predictors of job performance among residents in standardized residency training (SRT) program in China. Therefore, a nationwide survey among Chinese residents in SRT program was conducted to evaluate the impact of job satisfaction and psychological resilience on job performance. A total of 1146 residents from 9 hospitals were recruited in this study. Demographic and work-related information, job satisfaction, psychological resilience and job performance were collected through questionnaires. Hierarchical regression analyses indicated that, “work pressure”, “doctor-patient conflict”, “intrinsic job satisfaction” and “psychological resilience” were significant predictors of job performance for residents in SRT programs and explained 61.3% of variance, while the three dimensions of psychological resilience (tenacity, strength and optimism) accounted for 27.2% of variance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve showed that resilience had the highest predictive accuracy than another three subscales. This study indicated that intrinsic job satisfaction and psychological resilience had a significant influence on job performance. Strategies and measures to improve residents’ intrinsic job satisfaction and psychological resilience may be efficacious ways to enhance their job performance.

Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students’ critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. 1,075 medical students from the first year to the fifth year attending one of three medical schools in China were recruited via multistage stratified cluster sampling. The Chinese Critical Thinking Disposition Inventory(CTDI-CV) and The Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire were applied to collect data and to conduct descriptive analysis. Stepwise multiple linear regression was used to analyze the data. The critical thinking disposition average mean score was 287.44 with 632 participants (58.79%) demonstrating positive critical thinking disposition. Stepwise multiple linear regression analysis revealed that the rearing styles of fathers, including “overprotection”, “emotional warmth and understanding”, “rejection” and “over-interference” were significant predictors of medical students’ critical thinking disposition that explained 79.0% of the variance in critical thinking ability. Rearing styles of mothers including “emotional warmth and understanding”, “punishing” and “rejection” were also found to be significant predictors, and explained 77.0% of the variance. Meaningful association has been evidenced between parental rearing styles and Chinese medical students’ critical thinking disposition. Parental rearing styles should be considered as one of the many potential determinant factors that contribute to the cultivation of medical students’ critical thinking capability. Positive parental rearing styles should be encouraged in the cultivation of children’s critical thinking skills.

Objectives This study aimed at examining the extent of turnover intention among the Chinese resident physicians who entered the newly established national standardised residency training programme (SRTP), and exploring factors associated with their turnover intention. Design Cross-sectional survey. Setting Ten institutions from five geographical areas in China. Methods 1414 residents were surveyed using paper-based questionnaires and scales regarding their demographics, work situation, attitudes towards SRTP, job satisfaction, psychological resilience, burnout and turnover intention in 2017. The turnover intention was described and compared between categorical groups. Linear regressions were used to select the factors associated with turnover intention. The structural equation model was used to capture the potential mediating effects. Results The mean turnover intention score was 12.45 (SD=4.47). Nearly half (47.87%) of the residents had a high and very high level of turnover intention. Psychological resilience (β=0.066), burnout (β=0.141) and job satisfaction (β=0.022) were positively associated with turnover intention, while specialty (β=−0.135), year of training (β=−0.687), career in medicine (β=−2.191), necessity of training (β=−0.695) and satisfaction with income (β=−1.215) had negative associations with turnover intention. Working hours and nightshift interval indirectly were associated with turnover intention through the mediating effects of burnout. Career in medicine, necessity of training, satisfaction with income, and psychological resilience showed direct effects and indirect effects on turnover intention through burnout and job satisfaction as mediators. Conclusions The turnover intention among Chinese residents was prevalent and unignorable. Burnout was the major contributing factor, while year of training and positive attitudes towards training were protective factors. Burnout and job satisfaction also served as mediators. Interventions targeting these factors should be incorporated in the training programmes to keep a prosperous physician workforce.

Introduction: Shortage and high turnover intention rate of physicians are concerning problems in China. Professional identity has been shown as an influential factor for physicians’ turnover intention. Enhancing physicians’ professional identity in their early phase of career, standardized residency training program (SRTP), may help reduce the turnover rate. This study aimed to investigate the current status of professional identity and explore its associated psychosocial factors among Chinese SRTP trainees, hoping to provide evidence in strengthening the available medical human resources in China.Methods: The final sample was comprised of 2,267 Chinese SRTP trainees in this cross-sectional survey conducted from 9 March to 20 March in 2023. Descriptive statistics were calculated. Bivariate analyses and hierarchical multiple linear regression were used to analyze potential associated factors of Chinese SRTP trainees’ professional identity.Results: The average score of respondents’ professional identity was 47.68 (standard deviation, SD = 8.61). Results from hierarchical multiple linear regression analysis showed that being married (β = 0.066, p < 0.01), having work experience before SRTP (β = 0.036, p < 0.05), being satisfied with annual income (β = 0.062, p < 0.01), psychological distress (β = −0.144, p < 0.001), depersonalization (β = −0.053, p < 0.05), emotional exhaustion (β = −0.380, p < 0.001) and resilience (β = 0.169, p < 0.001) were associated with professional identity (F = 114.301, p < 0.001). All associated factors can explain 41.1% of the variance in professional identity, and individual psychological variables make up a substantial portion (28.6%) of this influence.Discussion: Individual psychological variables are strongly associated with professional identity. Helping SRTP trainees reduce psychological distress, alleviate burnout and enhance resilience may be effective ways to promote the formation of their professional identity.

Background: Critical thinking is one of the seven essential competencies of the Global Minimum Essential Requirements in Medical Education. It is essential to cultivate medical students’ critical thinking as it influences their clinical decision-making. The undergraduate years represent a critical period for medical students in terms of personality development and self-differentiation, which are essential foundations for shaping critical thinking. Therefore, this multicenter cross-sectional study aimed to explore the relationships of critical thinking disposition with personality traits and differentiation of self in medical undergraduates.Methods: A total of 1,338 medical students from three institutions in China were selected for this study using a stratified cluster sampling method. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV), Eysenck Personality Questionnaire (EPQ) and Differentiation of Self Inventory-Revised (DSI-R) were applied to assess medical students’ critical thinking disposition, personality traits and differentiation of self. Multiple linear regression analysis was conducted to test the relationships of critical thinking disposition with personality traits and differentiation of self. Binary logistic regression model was established for sensitivity analysis.Results: Linear regression analysis showed that psychoticism and neuroticism could negatively influence critical thinking disposition [β, 95% confidence interval (CI) = −0.363 (−0.411, −0.316); −0.129 (−0.189, −0.070)]. Conversely, extraversion and differentiation of self could positively influence critical thinking disposition [β, 95% CI = 0.145 (0.096, 0.194); 0.279 (0.224, 0.334)]. The results of the binary logistic regression were consistent with those of the linear regression model.Discussion: This study suggested the potential need for tailored critical thinking development strategies for medical students with different personality traits and degrees of differentiation of self.

Introduction: The Coronavirus disease 2019 (COVID-19) pandemic is a global traumatic event that has profoundly struck individuals’ mental health. However, this might potentially promote positive transformation such as posttraumatic growth (PTG). Studies have indicated that the COVID-19 pandemic negatively affected the well-being of resident physicians, but little is known about PTG among this vulnerable population in China. Therefore, this study investigated the prevalence and associated factors of PTG among Chinese resident physicians after 3-years outbreak of COVID-19.Methods: An online survey was conducted from 9 March to 20 March in 2023. PTG was assessed using the 10-item Posttraumatic Growth Inventory-Short Form (PTGI-SF). Scores ≥30 implied moderate-to-high PTG. We also collected possible associated factors for PTG, including socio-demographic and psychological variables. Data was analyzed by applying descriptive statistics, univariable and multivariable logistic regression models.Results: In total, 2267 Chinese resident physicians provided validated data. 38.7% of them reported moderate-to-high PTG. In the multivariable logistic regression models, age (odds ratio, OR = 1.039; 95% confidence interval, 95%CI = 1.008–1.070), female (OR = 1.383, 95%CI = 1.151–1.662), satisfied or neutral with annual income (OR = 2.078, 95%CI = 1.524–2.832; OR = 1.416, 95%CI = 1.157–1.732), sufficient support at work (OR = 1.432, 95%CI = 1.171–1.751) and resilience (OR = 1.171, 95%CI = 1.096–1.252) were significantly positively associated with moderate-to-high PTG. On the contrary, burnout (OR = 0.653, 95%CI = 0.525–0.812), depression symptoms (OR = 0.700, 95%CI = 0.552–0.889), and stress (OR = 0.757, 95%CI = 0.604–0.949) were significantly negatively associated with moderate-to-high PTG.Discussion: Overall, resident physicians in China experienced relatively high prevalence of PTG that could be associated with several psychosocial factors. Findings may provide evidence to develop interventions for resident physicians to systematically and constructively process traumatic events related to the pandemic and foster their PTG.