Bani Marco, Zorzi Federico, Russo Selena, Del Greco Alexia, Ardenghi Stefano, Rampoldi Giulia, Putoto Giovanni, Invernizzi Pietro, Strepparava Maria Grazia
School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy.
Bicocca Research Centre in Health Services, University of Milano - Bicocca, Milan, Italy.
BMJ Open. 2025 Jul 30;15(7):e093935. doi: 10.1136/bmjopen-2024-093935.
To examine the relevance of global health principles and identify motivational factors influencing international mobility experiences (IMEs) among Italian high school and undergraduate healthcare students, and to compare these motivations between high- and low-income country destinations.
Cross-sectional study.
The study was conducted in Italy, with participants recruited from high schools during open days and from undergraduate healthcare programmes via email invitation.
A total of 423 participants (267 undergraduate healthcare students and 156 high school students aged 18 years or older) were included after excluding cases with incomplete control items; selection was based on voluntary participation with defined inclusion and exclusion criteria.
The primary outcomes were the participants' interest in and perceived probability of undertaking IMEs in high- versus low-income countries. Secondary measures included motivational factors assessed with the Multidimensional Motivations to Study Abroad Scale, empathy levels measured by the Brief Interpersonal Reactivity Index, personality traits assessed via the Ten Items Personality Inventory and self-reported knowledge and perceived importance of global health principles.
In mixed analysis of variance analyses, motivations for IMEs differed by destination among both subgroups: better academic knowledge scored higher for high-income countries (high school (HS): 4.0±0.9 vs 3.3±1.0; university (Univ): 3.7±0.7 vs 2.9±0.7; p<0.001), as did language skills (HS: 4.5±0.7 vs 4.0±1.0; Univ: 4.2±0.5 vs 3.4±0.8; p<0.001) and career perspectives (HS: 4.2±0.9 vs 3.5±1.0; Univ: 3.6±0.6 vs 3.0±0.7; p<0.001). Cross-cultural interest was the only motivation higher for low-income destinations (HS: 4.4±0.8 vs 4.3±0.8; Univ: 4.2±0.6 vs 4.0±0.6; both p<0.01). Additionally, high school students reported greater overall interest in IMEs than undergraduates (4.03±1.04 vs 3.42±1.25; Z=-4.895, p<0.001). Structural equation modelling with bootstrapping confirmed these patterns (all path p<0.001), with 95% CIs indicating robust associations.
The findings suggest that tailored educational interventions integrating global health principles may enhance the motivation for IMEs, with distinct motivational drivers for high- versus low-income country destinations. Further longitudinal research is warranted to explore the temporal dynamics of these associations.
探讨全球健康原则的相关性，确定影响意大利高中和本科医学生国际流动经历（IME）的动机因素，并比较高收入和低收入国家目的地之间的这些动机。
横断面研究。
该研究在意大利进行，参与者通过开放日从高中招募，并通过电子邮件邀请从本科医疗保健项目中招募。
在排除控制项目不完整的病例后，共纳入423名参与者（267名本科医学生和156名18岁及以上高中生）；选择基于自愿参与，并设定了明确的纳入和排除标准。
主要结局是参与者对在高收入和低收入国家进行IME的兴趣和感知可能性。次要指标包括用留学多维动机量表评估的动机因素、用简短人际反应指数测量的共情水平、通过十项人格量表评估的人格特质以及自我报告的全球健康原则知识和感知重要性。
在方差分析的混合分析中，两个亚组中IME的动机因目的地而异：高收入国家在学术知识方面得分更高（高中（HS）：4.0±0.9 vs 3.3±1.0；大学（Univ）：3.7±0.7 vs 2.9±0.7；p<0.001），语言技能方面也是如此（HS：4.5±0.7 vs 4.0±1.0；Univ：4.2±0.5 vs 3.4±0.8；p<0.001）以及职业前景方面（HS：4.2±0.9 vs 3.5±1.0；Univ：3.6±0.6 vs 3.0±0.7；p<0.001）。跨文化兴趣是低收入目的地唯一更高的动机（HS：4.4±0.8 vs 4.3±0.8；Univ：4.2±0.6 vs 4.0±0.6；两者p<0.01）。此外，高中生报告对IME的总体兴趣高于本科生（4.03±1.04 vs 3.42±1.25；Z=-4.895，p<0.001）。采用自抽样法的结构方程模型证实了这些模式（所有路径p<0.001），95%置信区间表明关联稳健。
研究结果表明，整合全球健康原则的针对性教育干预可能会增强进行IME的动机，高收入和低收入国家目的地的动机驱动因素不同。有必要进行进一步的纵向研究，以探索这些关联的时间动态。
