title: Lifelong learning of Chinese rural physicians: preliminary psychometrics and influencing factors.
abstract: BACKGROUND
  There are more than 4.9 million rural health workers undertaking the health care need of rural population of over 629 million in China. The lifelong learning of physicians is vital in maintaining up-to-date and qualified health care, but rural physicians in many developing countries lack adequate medical professional developments. There has also been no empirical research focused on the lifelong learning of rural physician populations. The purpose of this study was to investigate the primary levels of lifelong learning of the rural physicians and to analyze group differences.
  
  
  METHODS
  We conducted a cross-sectional study on 1197 rural physicians using the Jefferson Scale of Physician Lifelong Learning (JSPLL). Cronbach's α coefficient, exploratory factor analysis, independent sample t-test, and one-way ANOVA followed by Student-Newman-Keuls test were performed to analyze the data.
  
  
  RESULTS
  For Chinese rural physicians, the JSPLL was reliable (Cronbach's α coefficient = 0.872) and valid, with exploratory factor analysis fitting a 3-factor model and accounting for a total of 60.46 % of the variance. The mean lifelong learning score was 45.56. Rural physicians generally performed worse in the technical skills in seeking information domain. Rural physicians with 21-30 working years have a lower score of lifelong learning (P < 0.05) than other phases of working years. Career satisfaction and professional titles had a significantly positive influence on physicians' orientation towards lifelong learning (P < 0.05). The overall lifelong learning scores of physicians who received more training after completion of medical school were higher than those with less additional post-medical school training (P <0.05).
  
  
  CONCLUSIONS
  The JSPLL is effective for the Chinese rural physician population. In order to cope with impacting factors on rural physicians' lifelong learning, the results of the study reinforced the importance of continuing medical education and career satisfaction for lifelong learning and the need for medical schools and hospitals to provide reasonable strategies and necessary support for rural physicians with different amounts of working years. Providing rural physicians more educational opportunities and helping them access educational resources may be an effective strategy for improving their orientation to lifelong learning.
authors.affiliation: School of Public Health, China Medical University, Shenyang, Liaoning Province, China. honghe-li@hotmail.com.|Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China. honghe-li@hotmail.com.
authors.forename: Honghe
authors.initials: H
authors.lastname: Li
authors.affiliation: School of Public Health, China Medical University, Shenyang, Liaoning Province, China. wang-ziwei@hotmail.com.|Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China. wang-ziwei@hotmail.com.
authors.forename: Ziwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Research Center for Medical Education, China Medical University, Shenyang, Liaoning Province, China. ndjiang@live.ca.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.affiliation: School of Public Health, China Medical University, Shenyang, Liaoning Province, China. cmu_ly@hotmail.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: School of Public Health, Dalian Medical University, Dalian, Liaoning Province, China. deliang_wen@hotmail.com.
authors.forename: Deliang
authors.initials: D
authors.lastname: Wen
mesh_terms: D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D004502:Education, Medical, Continuing / Q000379:methods / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D019035:Rural Health Services / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult