Professional commitment of eight-year medical doctoral degree program students in China: the mediating role of self-efficacy, learning engagement, and academic performance

Abstract

Abstract Background Research on the professional commitment of student in eight-year medical training program medical is sparse. Studying professional commitment in this population, especially its association with academic performance, can enhance the understanding of professional loyalty in future doctors. This study aimd to investigate the self-efficacy, academic performance, professional commitment, and learning engagement of eight-year program medical students, examine the relationship between self-efficacy and academic performance, and explore the mediating roles of professional commitment and learning engagement on the associations between self-efficacy and academic performance. Methods This was a cross-sectional study conducted in a Chinese medical university in March 2022. Data on students’ socio-demographic characteristics was collected, and self-reported questionnaires including General Self-Efficacy Scale (GSES), Professional Commitment of Undergraduates Scales (PCUS), Utrecht Work Engagement Scale-Student (UWES-S) were completed. Academic performance was ascertained using course examination scores in the most recent year. We examined the relationships between the study outcomes and subsequently conducted a structural equation model (SEM) analysis to examine the mediating roles of professional commitment and learning engagement on the relationship between self-efficacy and academic performance. Results A total number of 402 medical students were included in this study. The direct effect of self-efficacy on academic performance was not significant. Professional commitment and learning engagement were mediators in the relationship between self-efficacy and academic performance. Students in the clinical practice stage had significantly lower professional commitment and learning engagement (P < 0.001) than students in the pre-medical and medical course stages, but there was no difference in self-efficacy. The professional commitment of students from low-income families (< 3000 yuan per month) was significantly lower than that of students from high-income families (> 5000 yuan per month) (P = 0.005). Conclusions This study is the first to investigate professional commitment among students in the eight-year medical program, and to explore the intermediary role of professional commitment plays in academic performance. Findings from this study can help in rethinking the role of professional commitment among students of long-term medical programs and in developing more effective counseling methods for students in the clinical practice stage and those from low-income families.