【摘要】 目的:分析湖北省农村订单定向医学生(以下简称“定向医学生”)履约意愿及其影响因素，为推进基层卫生人才队伍建设提供建议。方法:于2023年5-6月采取分层整群抽样法在湖北省定向医学生培养院校中抽取1所本科院校、4所专科院校，对所抽取院校的定向医学生进行问卷调查，运用多因素logistic回归分析定向医学生履约意愿的影响因素。结果:共纳入1114份有效问卷，定向医学生履约意愿率为75.31%。回归分析显示，定向医学生的态度、主观规范和知觉行为控制对履约意愿影响显著(P<0.05)。其中，性别、入学年份、是否主动报考定向医学生、对定向医学生培养方案态度、对农村卫生机构就业意义态度、对农村需要高层次医疗人才态度、母亲学历、家人对定向医学生政策态度、身边定向医学生群体履约率、是否了解农村医疗卫生机构工作情况均对履约意愿有显著影响(P<0.05)。结论:湖北省定向医学生履约意愿相对良好，个人消极态度以及主观规范的负面影响削弱了履约意愿。建议政府部门制定差异化的定向招生政策，加强与基层有关的实践教育和价值培育，发挥新媒体平台的政策宣传效用，健全基层服务福利保障与支持体系，进一步增强定向医学生履约积极性。更多还原

【Abstract】 Objective: To analyze the performance willingness of rural-oriented medical students in Hubei Province and its influencing factors, and provide suggestions for promoting the construction of talent teams in grassroots medical students. Methods: From May to June 2023, a questionnaire survey was conducted among rural-oriented medical students from 1 undergraduate institution and 4 vocational colleges in Hubei Province using stratified cluster sampling. Multivariable logistic regression was used to analyze the effects of attitudes, subjective norms, and perceived behavioral controls on their willingness to fulfill their obligations. Results: A total of 1114 valid questionnaires were included, and 75.31% rural-oriented medical students were willing to fulfill the contract after graduation. Regression analysis showed that attitude, subjective norms and perceived behavioral control all had a significant effect on willingness(P<0.05). Among them, gender, enrollment year, whether actively apply for targeted medicine students, attitude towards the educational program, attitude towards the significance of employment in rural health institutions, attitude towards the need for high-level medical talents in rural areas, mother’s education, family’s attitude towards targeted medical student policies, compliance rate of acquaintances, and whether understand the working environment of the primary health care institutions have an impact on the willingness to fulfill the contract(P<0.05). Conclusion: The willingness rate of rural-oriented medical students in Hubei Province to fulfill the contract was relatively good, while negative attitudes and subjective norms have weakened willingness to fulfill obligations. It is suggested that governments formulate differentiated targeted enrollment policies, strengthen practical education and value cultivation related to grassroots, utilize new media platforms for policy advocacy, improve the welfare guarantee and support system for grassroots services, and further enhance the enthusiasm of rural-oriented medical students to fulfill their contract.更多还原