School of Education, Faculty of Humanities, Arts and Social Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
Perspect Med Educ. 2024 Nov 22;13(1):572-584. doi: 10.5334/pme.1384. eCollection 2024.
International medical students (IMSs) experience various problems preventing them from making career decisions. Assessing the difficulties involved in the career decision-making process is instrumental for identifying the sources of their career indecision, which may assist them in making more informed career decisions. This study aims to develop and validate an instrument to measure career decision-making challenges of IMSs in China, who are mainly from low- and middle-income countries.
A new scale, INternational meDical studEnt Carrer decISION-making Scale (INDECISION Scale) was developed utilising data from IMSs in China. Initial item generation stemmed from a literature review and qualitative interviews (n = 20), with items adapted or formulated referencing phrasing used in prior instruments. Subsequent expert validation and cognitive interviews (n = 6) informed adjustments, followed by a pilot study (n = 52) and focus group discussions (n = 6). Exploratory factor analysis (EFA) was performed on data from four Chinese universities (n = 334), followed by confirmatory factor analysis (CFA) on data from eight other Chinese universities (n = 514). Convergent validity (n = 102) and test-retest reliability (n = 86) were evaluated using subsets of respondents.
The EFA retained 21 items, identifying six factors: unreadiness; lack of self-knowledge; lack of options knowledge; external complexity; lack of decision-making competence; and negative mentality. The CFA confirmed the six-factor model, demonstrating satisfactory model fit indices. Convergent validity and test-retest reliability were supported.
The INDECISION Scale exhibits adequate psychometric properties, helping IMSs systematically navigate their decision-making process, allowing for individual challenges to be effectively identified for discussion in counselling. This study serves as a starting point for further research on career indecision and career guidance for IMSs.
国际医学生（IMS）在职业决策过程中会遇到各种问题，从而阻碍他们做出职业选择。评估职业决策过程中所面临的困难对于确定他们职业决策犹豫不决的原因至关重要，这可能有助于他们做出更明智的职业决策。本研究旨在开发和验证一种用于测量在中国的国际医学生（IMS）职业决策挑战的工具，这些学生主要来自中低收入国家。
利用来自中国 IMS 的数据，开发了一种新的量表，即国际医学学生职业决策量表（INDECISION 量表）。初始项目生成源自文献回顾和定性访谈（n=20），并参考先前工具中的措辞改编或制定项目。随后的专家验证和认知访谈（n=6）提供了调整意见，随后进行了预研究（n=52）和焦点小组讨论（n=6）。对来自四所中国大学的数据（n=334）进行探索性因素分析（EFA），然后对来自其他八所中国大学的数据（n=514）进行验证性因素分析（CFA）。使用部分受访者评估了聚合效度（n=102）和重测信度（n=86）。
EFA 保留了 21 个项目，确定了六个因素：准备不足；缺乏自我认知；缺乏选项知识；外部复杂性；缺乏决策能力；和消极心态。CFA 证实了六因素模型，显示出令人满意的模型拟合指数。聚合效度和重测信度得到支持。
INDECISION 量表具有足够的心理测量学特性，帮助 IMS 系统地指导他们的决策过程，使个人挑战能够有效识别并在咨询中进行讨论。本研究为 IMS 的职业决策犹豫不决和职业指导的进一步研究提供了一个起点。
