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The Individual and Joint Effects of Cumulative Confirmed Cases and Attention Level of COVID-19 on Medical Students' Professional Identity: A National Cross-Sectional Study in China

21 Pages Posted: 13 Dec 2021

See all articles by Qiao Liu

Qiao Liu

Peking University - Department of Epidemiology and Biostatistics

Chen Yu

Peking University - National Center for Health Professions Education Development

Ana Xie

Peking University - National Center for Health Professions Education Development

Weimin Wang

Peking University - National Center for Health Professions Education Development

Jue Liu

Peking University - Department of Epidemiology and Biostatistics

More...

Abstract

Background: The novel coronavirus disease 2019 (COVID-19) pandemic’s impacts on medical students’ professional identities (PI) were unclear with contrary conclusions in previous studies. We aimed to assess the individual and joint effects of cumulative confirmed cases and attention level of COVID-19 on medical students’ professional identity in China. 

Methods: We used data from a national cross-sectional study (the China Medical Student Survey) conducted in 2020, involving a nationally representative sample of medical students from all the 121 medical colleges. We collected cumulative confirmed cases of COVID-19 in 34 provinces, and matched case data with medical students based on the dates they were investigated. Linear and logistic regression models were used to assess the associations of exposures with continuous and binary outcomes, respectively. 

Findings: During June 18, 2020 to July 20, 2020, a total of 30395 medical students were involved, with 30147 valid questionnaires (99·18%). The mean PI score of all the 30147 medical students was 3·82, and 10819 (35·89%) medical students’ PI scores were 4 or above. The possibility of PI score ≥ 4 decreased per 1 standard deviation increasing of log (cumulative confirmed cases of COVID-19) (adjusted odds ratio (aOR) = 0·93, 95% confident interval (CI), 0·89 – 0·99). Compared to medical students in the first quartile of cumulative confirmed cases (< 238 cases), those in the second quartile (238 – 589 cases) had a significantly decrease in PI score (mean difference = -0·05, 95% CI, -0·07 ­– -0·03) and the possibility of PI score ≥ 4 (aOR = 0·85, 95% CI, 0·79 – 0·91). The joint effects of less cumulative conformed cases and more attention to the pandemic further increased the PI of medical students, in both additive and multiplicative scales. 

Interpretation: Medical students’ PI increased along with less cumulative confirmed cases of COVID-19. Joint effects of less cumulative confirmed cases and more attention to the pandemic could further increase the PI. Multifaceted and multisectoral actions are needed to stabilize and further improve medical students’ PI. Global cooperation is needed to control the COVID-19 pandemic, which will contribute to the promotion of medical students’ PI.

Funding: This study was funded by the Major Project of the National Social Science Foundation of China (AIA210011). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the paper. The authors appreciate the works by the CMSS collaborators.

Declaration of Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics Approval Statement: The study was approved by the Institutional Review Boards at Peking University (IRB00001052-20069).

Keywords: Professional identity, Medical students, COVID-19, Joint effects.

Suggested Citation

Liu, Qiao and Yu, Chen and Xie, Ana and Wang, Weimin and Liu, Jue, The Individual and Joint Effects of Cumulative Confirmed Cases and Attention Level of COVID-19 on Medical Students' Professional Identity: A National Cross-Sectional Study in China. Available at SSRN: https://ssrn.com/abstract=3984115 or http://dx.doi.org/10.2139/ssrn.3984115

Qiao Liu

Peking University - Department of Epidemiology and Biostatistics ( email )

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Chen Yu

Peking University - National Center for Health Professions Education Development ( email )

Beijing
China

Ana Xie

Peking University - National Center for Health Professions Education Development ( email )

Beijing
China

Weimin Wang

Peking University - National Center for Health Professions Education Development ( email )

Beijing
China

Jue Liu (Contact Author)

Peking University - Department of Epidemiology and Biostatistics ( email )

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

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