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Article(id=1240950911489593577, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202310074, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1696608000000, receivedDateStr=2023-10-07, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773795353052, onlineDateStr=2026-03-18, pubDate=1712678400000, pubDateStr=2024-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773795353052, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773795353052, creator=13701087609, updateTime=1773795353052, updator=13701087609, issue=Issue{id=1240950898113966774, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773795349862, creator=13701087609, updateTime=1773795519367, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240951609136567133, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240951609136567134, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1338, endPage=1344, ext={EN=ArticleExt(id=1240950912034853131, articleId=1240950911489593577, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the path of improving the practical ability of master of public health based on qualitative comparative analysis of fuzzy sets, columnId=1240375111455404044, journalTitle=Modern Preventive Medicine, columnName=Talent Development, runingTitle=null, highlight=null, articleAbstract=
Objective

To provide reference for improving and promoting the management and reform of practical ability training of Master of Public Health (MPH).

Methods

Based on the connotation of practical ability, combined with the characteristics of practical ability training in sample colleges, the USEM model of MPH practical ability was constructed, and the multiple realization paths that could improve MPH practical ability were extracted by fuzzy set qualitative comparative analysis.

Results

Eight combined paths were identified including practical interest A* achievement motive B* no practical pressure ~ C* adaptability and strain capacy D* interpersonal communication E* team work and autonomous learning ability F* professional knowledge G* professional skill H* lack of analytical ability and judgement ~ I* implementation ability K* monitoring and evaluation ability L (* represented “and” while ~ represented “not”). Through the interactive comparison of different combination paths, it is found that practical interest, achievement motivation and self-monitoring and evaluation ability are the necessary conditions to improve the practical ability of MPH. Social adaptability had an important influence on the improvement of MPH practical ability. Practical pressure and implementation ability could complement each other in improving MPH practical ability. Practical interest, achievement motivation, analysis and judgment ability and decision planning ability were the core conditions to improve MPH practical ability.

Conclusion

It is suggested to improve practical interest, stimulate achievement motivation, strengthen self-monitoring and evaluation ability, pay attention to the cultivation of social adaptability and improve students’ comprehensive quality, restrict industry mentors by system to give students appropriate practical pressure, and explore the opportunity of situational education and strengthen the ability of situational practice.

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目的

为完善和推动公共卫生硕士（MPH）实践能力培养管理和改革提供参考。

方法

基于实践能力内涵，结合样本院校的实践能力培养特点，构建MPH实践能力USEM模型，采用模糊集定性比较分析方法提炼出可提升MPH实践能力多元实现路径。

结果

最终识别出实践兴趣A *成就动机B*不存在实践压力～C*适应力与应变力D *人际沟通能力E*团队合作与自主学习能力F*专业知识G*专业技能H*不具备分析判断能力～I*执行实施能力K*监控评价能力L等（“*、～”分别表示逻辑符号“和、非”）8条组合路径，各组合路径交互比较发现实践兴趣、成就动机和自我监控评价能力是提升MPH实践能力的必要条件；社会适应能力对提升MPH实践能力有重要影响；实践压力与执行实施能力在提升MPH实践能力方面可互补；实践兴趣、成就动机、分析判断能力和决策计划能力是提升MPH实践能力的核心条件。

结论

提出提高实践兴趣，激发成就动机，加强自我监控评价能力；注重社会适应能力培养，提高学生综合素质水平；制度约束行业导师，给予学生适当实践压力；发掘情景教育契机，加强情景实践能力。

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陈菲，E-mail:
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崔钰婷（2001—），女，硕士在读，研究方向：社会医学与卫生事业管理教育

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崔钰婷（2001—），女，硕士在读，研究方向：社会医学与卫生事业管理教育

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Front Public Health, 2022, 10: 790406., articleTitle=Preparing students for the public health workforce: the role of effective High-Impact educational practices in undergraduate public health program curricula, refAbstract=null)], funds=[Fund(id=1240972164434817433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, awardId=yjg222017, language=CN, fundingSource=2022年重庆市研究生教育教学改革研究重点项目(yjg222017), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240972159275823254, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, xref=null, ext=[AuthorCompanyExt(id=1240972159284211864, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, companyId=1240972159275823254, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Chongqing Medical University, Chongqing 400016, China), AuthorCompanyExt(id=1240972159292600474, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, companyId=1240972159275823254, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=重庆医科大学公共卫生学院，重庆 400016)])], figs=[ArticleFig(id=1240972162740318494, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Figure 1, caption=USEM model of practical competence cognition for masters of public health students, figureFileSmall=LRVeVsX9WpBpVqO11aEzDw==, figureFileBig=oxEp4oBunHaGDCPB9QN7xw==, tableContent=null), ArticleFig(id=1240972162828398883, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=图1, caption=MPH实践能力认知USEM模型, figureFileSmall=LRVeVsX9WpBpVqO11aEzDw==, figureFileBig=oxEp4oBunHaGDCPB9QN7xw==, tableContent=null), ArticleFig(id=1240972162954228014, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 1, caption=

Calibration of conditional variables

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量校准
完全隶属交叉点完全不隶属
实践兴趣A5.0004.5003.000
成就动机B5.0004.0003.000
实践压力C5.0004.0003.000
适应力与应变力D5.0004.0002.500
人际沟通能力E5.0004.0002.500
团队合作与自主学习能力F5.0004.0003.000
专业知识G5.0004.0002.825
专业技能H5.0003.8572.857
分析判断能力I5.0004.0003.000
决策计划能力J5.0004.0003.000
执行实施能力K5.0004.0002.825
自我监控评价能力L5.0004.0002.883
), ArticleFig(id=1240972163050697012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表1, caption=

条件变量的校准

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量校准
完全隶属交叉点完全不隶属
实践兴趣A5.0004.5003.000
成就动机B5.0004.0003.000
实践压力C5.0004.0003.000
适应力与应变力D5.0004.0002.500
人际沟通能力E5.0004.0002.500
团队合作与自主学习能力F5.0004.0003.000
专业知识G5.0004.0002.825
专业技能H5.0003.8572.857
分析判断能力I5.0004.0003.000
决策计划能力J5.0004.0003.000
执行实施能力K5.0004.0002.825
自我监控评价能力L5.0004.0002.883
), ArticleFig(id=1240972163147166009, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 2, caption=

Results of the necessity test

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量一致性覆盖度
实践兴趣A0.6180.858
～实践兴趣～A0.3820.716
成就动机B0.6570.853
～成就动机～B0.3430.709
实践压力C0.4730.836
～实践压力～C0.5270.765
适应力与应变力D0.5590.870
～适应力与应变力～D0.4410.721
人际沟通能力E0.5540.865
～人际沟通能力～E0.4460.726
团队合作与自主学习能力F0.6610.842
～团队合作与自主学习能力～F0.3390.723
专业知识G0.4950.822
～专业知识～G0.5050.775
专业技能H0.4740.835
～专业技能～H0.5260.766
分析判断能力I0.4820.878
～分析判断能力～I0.5180.734
决策计划能力J0.5430.861
～决策计划能力～J0.4570.733
执行实施能力K0.5000.859
～执行实施能力～K0.5000.744
自我监控评价能力L0.5170.860
～自我监控评价能力～L0.4830.740
), ArticleFig(id=1240972163231052098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表2, caption=

必要性检验结果

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量一致性覆盖度
实践兴趣A0.6180.858
～实践兴趣～A0.3820.716
成就动机B0.6570.853
～成就动机～B0.3430.709
实践压力C0.4730.836
～实践压力～C0.5270.765
适应力与应变力D0.5590.870
～适应力与应变力～D0.4410.721
人际沟通能力E0.5540.865
～人际沟通能力～E0.4460.726
团队合作与自主学习能力F0.6610.842
～团队合作与自主学习能力～F0.3390.723
专业知识G0.4950.822
～专业知识～G0.5050.775
专业技能H0.4740.835
～专业技能～H0.5260.766
分析判断能力I0.4820.878
～分析判断能力～I0.5180.734
决策计划能力J0.5430.861
～决策计划能力～J0.4570.733
执行实施能力K0.5000.859
～执行实施能力～K0.5000.744
自我监控评价能力L0.5170.860
～自我监控评价能力～L0.4830.740
), ArticleFig(id=1240972163335909708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 3, caption=

Complex solution results

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*～C*D *E*F*G*H*～I*K*L0.1210.0110.810
A *B*C*D *E*F*G*～H*J*K*L0.1340.0130.827
A *B*D *E*F*G*H*I*J*K*L0.2490.1160.851
A *B*～C*～D *～E*～F*～G*～H*I*J*～K*L0.0980.0130.814
A *B*～C*D *E*F*～G*～H*～I*～J*～K*L0.1030.0110.816
A *B*C*～D *～E*F*～G*～H*I*J*～K*L0.0930.0080.805
A *B*～C*～D *～E*F*～G*～H*I*J*K*L0.1040.0090.808
A *B*C*D *E*F*～G*H*I*～J*～K*L0.0840.0080.801
解的覆盖度0.523
解的一致性0.887
), ArticleFig(id=1240972163415601495, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表3, caption=

复杂解结果

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*～C*D *E*F*G*H*～I*K*L0.1210.0110.810
A *B*C*D *E*F*G*～H*J*K*L0.1340.0130.827
A *B*D *E*F*G*H*I*J*K*L0.2490.1160.851
A *B*～C*～D *～E*～F*～G*～H*I*J*～K*L0.0980.0130.814
A *B*～C*D *E*F*～G*～H*～I*～J*～K*L0.1030.0110.816
A *B*C*～D *～E*F*～G*～H*I*J*～K*L0.0930.0080.805
A *B*～C*～D *～E*F*～G*～H*I*J*K*L0.1040.0090.808
A *B*C*D *E*F*～G*H*I*～J*～K*L0.0840.0080.801
解的覆盖度0.523
解的一致性0.887
), ArticleFig(id=1240972163545624928, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 4, caption=

Intermediate solution results

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*～C*D *E*F*G*H*～I*K*L0.1210.0110.810
A *B*C*D *E*F*G*～H*J*K*L0.1340.0130.827
A *B*D *E*F*G*H*I*J*K*L0.2490.1160.851
A *B*～C*～D *～E*～F*～G*～H*I*J*～K*L0.0980.0130.814
A *B*～C*D *E*F*～G*～H*～I*～J*～K*L0.1030.0110.816
A *B*C*～D *～E*F*～G*～H*I*J*～K*L0.0930.0080.805
A *B*～C*～D *～E*F*～G*～H*I*J*K*L0.1040.0090.808
A *B*C*D *E*F*～G*H*I*～J*～K*L0.0840.0080.801
解的覆盖度0.523
解的一致性0.887
), ArticleFig(id=1240972163696619882, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表4, caption=

中间解结果

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*～C*D *E*F*G*H*～I*K*L0.1210.0110.810
A *B*C*D *E*F*G*～H*J*K*L0.1340.0130.827
A *B*D *E*F*G*H*I*J*K*L0.2490.1160.851
A *B*～C*～D *～E*～F*～G*～H*I*J*～K*L0.0980.0130.814
A *B*～C*D *E*F*～G*～H*～I*～J*～K*L0.1030.0110.816
A *B*C*～D *～E*F*～G*～H*I*J*～K*L0.0930.0080.805
A *B*～C*～D *～E*F*～G*～H*I*J*K*L0.1040.0090.808
A *B*C*D *E*F*～G*H*I*～J*～K*L0.0840.0080.801
解的覆盖度0.523
解的一致性0.887
), ArticleFig(id=1240972163797283187, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 5, caption=

Simple solution results

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*D *E*F0.4090.2870.891
A *～D *～E*～G*～H0.2020.0210.812
A *～D *～G*～H*I0.1640.0000.808
B*～D *～G*～H*I0.1780.0050.804
B*～D *～E*～G*～H*J0.1840.0040.820
B*～D *～E*～G*～H*L0.1710.0000.852
解的覆盖度0.681
解的一致性0.871
), ArticleFig(id=1240972163885363578, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表5, caption=

简单解结果

, figureFileSmall=null, figureFileBig=null, tableContent=
组态原始覆盖度唯一覆盖度一致性
A *B*D *E*F0.4090.2870.891
A *～D *～E*～G*～H0.2020.0210.812
A *～D *～G*～H*I0.1640.0000.808
B*～D *～G*～H*I0.1780.0050.804
B*～D *～E*～G*～H*J0.1840.0040.820
B*～D *～E*～G*～H*L0.1710.0000.852
解的覆盖度0.681
解的一致性0.871
), ArticleFig(id=1240972164006998402, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=EN, label=Table 6, caption=

Results of the group analysis of the realization pathway for MPH practice competence enhancement

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量组态1组态2组态3组态4组态5组态6组态7组态8
实践兴趣A☆★★★★★★★
成就动机B☆★★★★★★★
实践压力C◇☆◇◇☆◇☆
适应力与应变力D☆★★◆★◆◆★
人际沟通能力E☆★★◆★◆◆★
团队合作与自主学习能力F☆★★◇★☆☆★
专业知识G☆☆☆◆◇◆◆◇
专业技能H☆◇☆◆◇◆◆☆
分析判断能力I◇☆★◇★★☆
决策计划能力J☆☆★◇★★◇
执行实施能力K☆☆☆◇◇◇☆◇
自我监控评价能力L☆☆☆☆☆☆☆☆
一致性0.8100.8270.8510.8140.8160.8050.8080.801
原始覆盖度0.1210.1340.2490.0980.1030.0930.1040.084
唯一覆盖度0.0110.0130.1160.0130.0110.0080.0090.008
解的一致性0.887
解的覆盖度0.523
), ArticleFig(id=1240972164137021832, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950911489593577, language=CN, label=表6, caption=

MPH实践能力提升的实现路径组态分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
条件变量组态1组态2组态3组态4组态5组态6组态7组态8
实践兴趣A☆★★★★★★★
成就动机B☆★★★★★★★
实践压力C◇☆◇◇☆◇☆
适应力与应变力D☆★★◆★◆◆★
人际沟通能力E☆★★◆★◆◆★
团队合作与自主学习能力F☆★★◇★☆☆★
专业知识G☆☆☆◆◇◆◆◇
专业技能H☆◇☆◆◇◆◆☆
分析判断能力I◇☆★◇★★☆
决策计划能力J☆☆★◇★★◇
执行实施能力K☆☆☆◇◇◇☆◇
自我监控评价能力L☆☆☆☆☆☆☆☆
一致性0.8100.8270.8510.8140.8160.8050.8080.801
原始覆盖度0.1210.1340.2490.0980.1030.0930.1040.084
唯一覆盖度0.0110.0130.1160.0130.0110.0080.0090.008
解的一致性0.887
解的覆盖度0.523
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基于模糊集定性比较分析的公共卫生硕士实践能力提升路径研究
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崔钰婷 , 陈菲 , 龚琬婷
现代预防医学 | 人才培养 2024,51(7): 1338-1344
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现代预防医学 | 人才培养 2024, 51(7): 1338-1344
基于模糊集定性比较分析的公共卫生硕士实践能力提升路径研究
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崔钰婷, 陈菲 , 龚琬婷
作者信息
  • 重庆医科大学公共卫生学院，重庆 400016

    • 崔钰婷（2001—），女，硕士在读，研究方向：社会医学与卫生事业管理教育

通讯作者:

陈菲，E-mail:
Study on the path of improving the practical ability of master of public health based on qualitative comparative analysis of fuzzy sets
Yu-ting CUI, Fei CHEN , Wan-ting GONG
Affiliations
  • School of Public Health, Chongqing Medical University, Chongqing 400016, China
出版时间: 2024-04-10 doi: 10.20043/j.cnki.MPM.202310074
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摘要
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目的

为完善和推动公共卫生硕士（MPH）实践能力培养管理和改革提供参考。

方法

基于实践能力内涵，结合样本院校的实践能力培养特点，构建MPH实践能力USEM模型，采用模糊集定性比较分析方法提炼出可提升MPH实践能力多元实现路径。

结果

最终识别出实践兴趣A *成就动机B*不存在实践压力～C*适应力与应变力D *人际沟通能力E*团队合作与自主学习能力F*专业知识G*专业技能H*不具备分析判断能力～I*执行实施能力K*监控评价能力L等（“*、～”分别表示逻辑符号“和、非”）8条组合路径，各组合路径交互比较发现实践兴趣、成就动机和自我监控评价能力是提升MPH实践能力的必要条件；社会适应能力对提升MPH实践能力有重要影响；实践压力与执行实施能力在提升MPH实践能力方面可互补；实践兴趣、成就动机、分析判断能力和决策计划能力是提升MPH实践能力的核心条件。

结论

提出提高实践兴趣，激发成就动机，加强自我监控评价能力；注重社会适应能力培养，提高学生综合素质水平；制度约束行业导师，给予学生适当实践压力；发掘情景教育契机，加强情景实践能力。

模糊集定性比较分析法  /  公共卫生硕士  /  实践能力  /  USEM模型
Objective

To provide reference for improving and promoting the management and reform of practical ability training of Master of Public Health (MPH).

Methods

Based on the connotation of practical ability, combined with the characteristics of practical ability training in sample colleges, the USEM model of MPH practical ability was constructed, and the multiple realization paths that could improve MPH practical ability were extracted by fuzzy set qualitative comparative analysis.

Results

Eight combined paths were identified including practical interest A* achievement motive B* no practical pressure ~ C* adaptability and strain capacy D* interpersonal communication E* team work and autonomous learning ability F* professional knowledge G* professional skill H* lack of analytical ability and judgement ~ I* implementation ability K* monitoring and evaluation ability L (* represented “and” while ~ represented “not”). Through the interactive comparison of different combination paths, it is found that practical interest, achievement motivation and self-monitoring and evaluation ability are the necessary conditions to improve the practical ability of MPH. Social adaptability had an important influence on the improvement of MPH practical ability. Practical pressure and implementation ability could complement each other in improving MPH practical ability. Practical interest, achievement motivation, analysis and judgment ability and decision planning ability were the core conditions to improve MPH practical ability.

Conclusion

It is suggested to improve practical interest, stimulate achievement motivation, strengthen self-monitoring and evaluation ability, pay attention to the cultivation of social adaptability and improve students’ comprehensive quality, restrict industry mentors by system to give students appropriate practical pressure, and explore the opportunity of situational education and strengthen the ability of situational practice.

Fuzzy set qualitative comparative analysis  /  Master of public health  /  Practical ability  /  USEM model
崔钰婷, 陈菲, 龚琬婷. 基于模糊集定性比较分析的公共卫生硕士实践能力提升路径研究. 现代预防医学, 2024 , 51 (7) : 1338 -1344 . DOI: 10.20043/j.cnki.MPM.202310074
Yu-ting CUI, Fei CHEN, Wan-ting GONG. Study on the path of improving the practical ability of master of public health based on qualitative comparative analysis of fuzzy sets[J]. Modern Preventive Medicine, 2024 , 51 (7) : 1338 -1344 . DOI: 10.20043/j.cnki.MPM.202310074
正文
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新医科建设倡导一种新的医学教育模式[1]，医学院校为保障向公共卫生体系输送高水平、高质量公共卫生人才，必须构建符合时代需求的公共卫生人才培养模式，重点关注公共卫生硕士教育。公共卫生硕士（masters of public health，MPH）是具有较强的公共卫生领域实践能力和较高的职业素养，能够在公共卫生领域从事多方位公共卫生服务的高素质、高层次应用型人才[2]。MPH教育，是向公共卫生体系输送高层次应用型人才的重要途径[3]，其中实践能力既是MPH教育培养的核心和关键，也是新医科理念下提升MPH教育教学的必备能力。当前国内对于MPH实践能力培养研究已从培养模式发展阶段步入影响因素探究阶段，但仅探讨各影响因素对MPH实践能力的独立影响，而缺少组合因素对MPH实践能力影响的相关研究。模糊集定性比较分析（qualitative comparative analysis of fuzzy sets，fsQCA）方法能够回答运用传统定量回归分析影响因素所不能回答的多重并发的因果关系[4]，已经在经济学及管理学领域得到广泛应用，尝试将其应用于公共卫生实践能力教育研究，构建MPH实践能力认知模型（practcal competence cognitive model，USEM），分析影响MPH实践能力提升的组合路径，以期为公共卫生专业实践培养管理和改革提供参考。
1　材料与方法
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1.1　MPH实践能力理论模型构建
实践能力可以由实践动机、一般实践能力、专项实践能力和情景实践能力四个维度组成。其中，实践动机主要由实践兴趣、实践的成就动机和实践压力构成；一般实践能力包含机体运动、交流、问题情景的感知以及对于一般工具的使用等[5-6]。多数学者在对全日制专业学位研究生的实践能力现状及影响因素进行调查时，认为实践能力包括一般实践能力、专项实践能力和情景实践能力等维度以及适应与应变能力、信息交流能力、人际沟通能力、自主学习能力、专项知识、专项技能、匹配分析力、策划力和执行力等多个指标[7-9]。部分学者基于哲学思辨角度，认为实践能力包括交往能力、一般实践能力、分析和解决问题的能力等[10-11]。还有的学者采用定性分析方法对专业学位硕士研究生的实践能力结构进行梳理、归纳和总结，最终得出实践能力包括实践动机、一般实践能力、专业实践能力、情景实践能力共4个维度，以及实践内生和外生动机、沟通能力、专业知识和技能、执行力等14个指标[12]。
英国学者Mantz York和Peter T Knight[13]从认知社会心理学的角度提出了USEM模型。该模型由专业知识的理解力、实践技能、自我效能感和元认知四部分组成。基于上述相关文献对于实践能力内涵的阐述与USEM模型四个要素含义之间相匹配，并结合所选取样本所属学校的实践能力培养特点，本文构建MPH实践能力认知USEM模型，包括实践动机、社会适应能力、专业实践能力和情景实践能力四个维度，实践兴趣、成就动机、实践压力、适应力与应变力、人际沟通能力、团队合作与自主学习能力、专业知识、专业技能、分析判断能力、决策计划能力、执行实施能力、自我监控评价能力12个指标。见图1。
1.2　研究方法
1.2.1　模糊集定性比较分析方法
模糊集定性比较分析是一种结合定性与定量研究的组态分析方法，该方法对各个影响因素的独立效应进行测量，其对在不同情境中促成了相同结果的因果路径进行分析，可以科学地解读连续前因条件对于结果变量的影响[14]，以研究达成这一结果的组合条件[15]。其分析过程包括条件的必要性分析、条件组态的充分性分析两个步骤。
1.2.2　样本选择与数据收集
采取整群抽样的方法，从重庆市某医科大学3个MPH年级群中随机抽取2021年9月入学的共74名MPH作为调查对象，运用MPH实践能力调查问卷，对问卷所包含的实践动机、社会适应能力、专业实践能力和情景实践能力4个维度、12个指标内容展开调查。
1.2.3　变量设定
本文将确定实践兴趣A、成就动机B、实践压力C、适应力与应变力D、人际沟通能力E、团队合作与自主学习能力F、专业知识G、专业技能H、分析判断能力I、决策计划能力J、执行实施能力K、自我监控评价能力L为条件变量，MPH实践能力考核成绩结果为结果变量。各条件变量均采用李克特计分方法，对完全不符合、不太符合、一般符合、基本符合及完全符合五个选项分别按“1～5”分赋值，并将各条件变量对应的多个指标进行加总平均后再作校准。结果变量以大于90分作为考核优秀标准，低于或等于90分者视为考核良好，将优秀和良好分别赋值为1和0。
1.2.4　变量校准
本文依据杜运周和张明[16]等的校准标准以及样本的实际情况，预设完全隶属、中间点及不完全隶属3个锚点：完全隶属的校准标准为0.95，各条件变量的交叉点的校准标准为0.50，完全不隶属的校准标准为0.05，结果变量为二分类变量，故不需对其进行校准。各条件变量的校准信息见表1。
1.2.5　统计学方法
采用Excel 2019软件录入样本数据，使用fsQCA 3.0软件对样本数据进行分析。首先对样本数据进行校准，使数据转化为[0,1]间的数值；而后进行必要性检验，当一致性大于0.90时，则该条件就是结果的必要条件，以此确定前因条件是否为必要条件；最后将一致性阈值设定为0.80，构建真值表，进行条件组态分析[17]。为验证组态分析结果的敏感性，有必要运用QCA方法运行得到的多元路径组态进行稳健性检验。本文将fsQCA分析中的样本一致性阈值由原来的0.80提升至0.85，再次进行组态分析，路径组合仍有8条，且与原路径组合一致，说明本文所得到的结果较为稳健。
2　结果
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2.1　MPH实践能力提升的单个条件必要性分析结果
在多因素组合路径分析之前，需要对单一变量进行必要性检验，目的是查看是否存在给定结果的必要条件。一般来说，必要的一致性是指条件变量解释结果变量的程度。在QCA中，当结果发生时某个条件始终存在，那么该条件就成为结果的必要条件[18]。一致性作为必要条件的重要检测标准，当一致性大于0.90时，则该条件就是结果的必要条件。表2为使用fsQCA 3.0软件分析的MPH实践能力优秀和良好的必要条件检验结果。从表2中可以看出，所有条件的一致性水平均低于0.90。因此，不存在影响MPH实践能力考核优秀和考核良好的必要条件。
2.2　MPH实践能力提升的条件组态分析结果
对影响MPH实践能力提升的多元实现路径进行组态分析。首先将样本频数阈值设定为1.00，一致性阈值设定为0.80。由表2可知，条件变量的一致性均未超过0.90，则不需要将条件变量设置为必须存在。通过fsQCA软件求出复杂解、中间解和简单解。其中，当前大部分研究采用以中间解为主，简单解为辅进行组态分析结果的描述。当简单解和中间解同时出现前因条件，则其为核心条件，仅出现在中间解则其为边缘条件。本文通过fsQCA软件求出复杂解、中间解和简单解，见表3、4、5。并以中间解为主，简单解为辅，两种解相结合的方式对组态分析结果进行描述，见表6。
由表6可知，解的一致性为0.887（>0.800），解的覆盖度为0.523（>0.500），说明这一组态分析结果解释力较强。组态分析结果显示，促使MPH实践能力提升的路径组合有8条，以路径组合1为例，其余7条路径组合结果阐述参照路径组合1。
路径组合1，实践兴趣A *成就动机B*不存在实践压力～C*适应力与应变力D *人际沟通能力E*团队合作与自主学习能力F*专业知识G*专业技能H*不具备分析判断能力～I*执行实施能力K*监控评价能力L。组态1中未存在核心条件，实践兴趣A 、成就动机B、适应力与应变力D 、人际沟通能力E、团队合作与自主学习能力F、专业知识G、专业技能H、执行实施能力K、自我监控评价能力L作为边缘条件存在，实践压力C和分析判断能力I两个边缘条件不存在，决策计划能力J可存在也可不存在。
3　讨论
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3.1　实践兴趣、成就动机和自我监控评价能力是提升MPH实践能力的必要条件
由fsQCA得到的8条组合路径相比较发现：共同之处在于实践兴趣、成就动机和监控评价能力均同时存在，且监控评价能力均为边缘条件存在，而实践兴趣和成就动机可作为边缘条件存在也可作为核心条件存在，其余条件存在或是可有可无。除此之外，组合路径1与其他七条组合路径也存在一定差异。在组合路径1中，实践兴趣与成就动机均作为边缘条件存在，而这两者在其他的七条组合路径中都属于核心条件存在其中。由此可以看出，不论实践兴趣、成就动机以及监控评价能力是否为核心条件，这三者对于MPH实践能力的提升，是必不可少的条件。这与国内学者时亚楠[19]所提出的通过加强MPH自身主动性、自主性以及根据自身兴趣调整培养计划等方面来提升MPH实践能力的观点相一致。
3.2　社会适应能力对提升MPH实践能力有重要影响
将组态5与组态8进行比较分析可知，相同之处是实践兴趣、成就动机、适应力与应变力、人际沟通能力、团队合作与自主学习能力均作为核心条件存在，决策计划能力、执行实施能力以及监控评价能力都属于边缘条件，但前两者为缺失的边缘条件，而后者则为存在的边缘条件；不同之处在于实践压力、专业技能和分析判断能力是否存在于两条组合路径之中。在组态5中，这三者均作为缺失的边缘条件，而在组态8中，却作为边缘条件存在。由此可见，不论实践压力、专业技能和分析判断能力如何，除实践兴趣、成就动机、监控评价能力外，适应力与应变力、人际沟通能力、团队合作与自主学习能力三者构成的社会适应能力对于MPH实践能力提升占据重要地位，这与国外学者Przybyla SM[20]发现通过设置团队协作任务和项目，加强学生的团队协作与沟通能力等可以实现高影响力的实践教育观点一致。
3.3　实践压力与执行实施能力在提升MPH实践能力方面可互补
由组态6与组态7进行比较发现：相同点在于实践兴趣、成就动机、分析判断能力和决策计划能力均作为核心条件存在，团队合作与自主学习能力作为边缘条件存在，适应力与应变力、人际沟通能力、专业知识和专业技能均作为缺失的核心条件；不同之处是实践压力与执行实施能力在组态6与组态7这两条路径中是否存在。当组态6中存在实践压力时，执行实施能力可以不存在；当组态7中存在执行实施能力时，实践压力可以缺失，由此说明，在适应力与应变力、人际沟通能力和自身专业知识和专业技能不足情况下，实践压力与执行实施能力之间是可以互补的。这与国内学者李云等[21]认为解决问题的能力是MPH培养过程中的核心能力相符合。
3.4　实践兴趣、成就动机、分析判断能力和决策计划能力是提升MPH实践能力的核心条件
将组态4、组态6、组态7两两进行比较可以发现：三条路径的相同点在于实践兴趣、成就动机、分析判断能力和决策计划能力均作为核心条件存在，不同点在于实践压力、团队合作与自主学习能力、执行实施能力三个边缘条件是否存在。其中，对于分析判断能力和决策计划能力所发挥的核心作用与国外学者Elizabeth A[22]发现公共卫生专业学生实践能力提升可以体现在分析和解决公共卫生问题的能力、批判性思维等公共卫生职业所需技能的获得这一观点相符合。
3.5　提升MPH实践能力的对策建议
3.5.1　提高实践兴趣，激发成就动机，加强自我监控评价能力
一方面，可以在MPH实践过程中，结合其自身兴趣点、所在专业具体方向等，有针对性地进行相关专业实践培养和管理，同时，可以根据专业学位的多元学科背景，灵活运用多种实践教学方法，加强对于MPH自身实践兴趣培养，激发其自身的成就动机，让学生能够愿意探究公共卫生中的更多问题和掌握更多的公共卫生相关技能。另一方面，可以从高年级或已毕业的学生中挑合适人选，与正处于实践过程中的学生分享自身实践经验，传输积极正向的专业实践态度和技巧，并加强与其之间的沟通，时刻关注学生心理变化并及时对学生们在实践过程中产生的疑惑或是困难展开解答和帮助，让学生在从事富有挑战性的公共卫生工作时，能够更好更快地接受和适应一些具有挑战性的工作和课题研究，由此促进自我效能感，从而提高学生实现自身成就动机的积极性。除此之外，可以在导师与学生之间建立反馈机制，重点关注学生在实践中对于日常实践工作中发现的问题，以及其根据实际情况不断调整和改变自身实践计划并对计划实施过程进行评价等情况进行反馈，进一步加强其自我监控评价能力。
3.5.2　注重社会适应能力培养，提高学生综合素养水平
为提升MPH专业实践能力，可以通过注重对学生自身适应力与应变力、人际沟通能力、团队合作与自主学习能力等社会适应能力的培养来得以实现。一是鼓励校内导师增加带领学生参与相关研究课题项目的频次，让学生与项目实践近距离接触，使学生在校内导师的指导下学习项目实践所需要的知识技能和专业技能并积累处理突发情况的相应经验，当学生在实践基地参与专业实践时，使得其能够具备较好的适应力与应变力单独主持或是参与校外实践项目；二是可以通过创新和丰富学生的培养方式，促进学生的自主学习，不仅仅局限于课题组及同门之间的相互交流和学习，还可以举办学习沙龙、小组讨论交流会等交流机会，组织拥有相同兴趣爱好、相同专业具体方向的学生一起组成非正式团体，团体成员之间互相交流，对问题一同研究探讨，探寻解决办法，从另一种方式丰富专业知识，增强专业技能，同时还能够提高学生自身人际沟通能力以及团队合作与自主学习能力。
3.5.3　制度约束行业导师，给予学生适当实践压力
行业导师为一线工作者，主要职责是指导学生实践活动。对于提升MPH实践能力而言，这不只是对学生自身能力的挑战，也是对行业导师的一种考验。一方面，需要强调专业实践期间行业导师需要对学生如何利用实践基地的机会提升其自身各方面能力作适当的引导和监督，对行业导师制定考核评价制度，并结合实践基地学生的反馈情况定期对行业导师进行考核。同时，对行业导师的遴选不仅要考察其专业实践能力，还要考察其责任意识以及能否主动的指导学生实践活动，确保对学生实践能力起到正向作用，而不只是挂名导师。另一方面，可以在MPH参与专业实践实践的过程中，行业导师要结合学生在实践基地的实际情况，适当的给予实践压力，为提高学生的执行实施能力激发动力，避免拖延完成实践工作任务、工作效率低以及质量不高等情况的出现。
3.5.4　发掘情景教育契机，加强情景实践能力
在专业实践培养过程中，要注重对MPH分析判断能力、决策计划能力、执行实施能力以及监控评价能力等情景实践能力的培养，可以通过在实践过程中行业导师向其所带教的MPH提供各种丰富、真实的问题情景，将自身在从事工作的过程中遇到的真实问题与学生进行分享，对这些现实问题合理加以利用，作为案例教学，让其成为培养学生情景实践能力的教育契机。即要培养学生从发现问题和思考问题到分析问题再到如何解决问题的逻辑过程，这不仅可以锻炼学生自身善于发现、思考以及分析问题的能力，而且能够促进学生的面对问题时的执行力和对突发问题的应变力，促使学生真正地将研究做到实处，使实践过程中所作的研究具有一定的现实价值。
综上，本文将定量与定性相结合，基于相关文献研究结果，识别了有助于促进MPH实践能力提升的路径组合，相比既往讨论MPH实践能力提升路径的研究拓展了新的研究角度，也为完善和推动MPH专业实践培养管理和改革提供参考。但本文还存在如下局限性：一方面，由于数据限制，本文仅使用MPH实践考核成绩优秀情况作为度量其实践能力提升的结果变量，结果的解释力可能还有待加强。另一方面，该研究样本只选取某一医科大学的MPH，虽然已经构成了典型且数量充足的样本，但是结果的普适性和稳定性方面仍存在不足。
基金
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  • 2022年重庆市研究生教育教学改革研究重点项目(yjg222017)
文献
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doi: 10.20043/j.cnki.MPM.202310074
  • 接收时间：2023-10-07
  • 首发时间：2026-03-18
  • 出版时间：2024-04-10
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  • 收稿日期：2023-10-07
基金
2022年重庆市研究生教育教学改革研究重点项目(yjg222017)
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    重庆医科大学公共卫生学院，重庆 400016

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Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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