2.1 Study design, setting, and participants
A cross-sectional study was conducted from April 23 to May 20,2020. Convenient sampling of healthcare professionals (doctors and nurses) and medical students in mainland China were recruited nationwide online. All participants were invited to complete the questionnaire online via Questionnaire Star (https://www.wjx.cn).
The online questionnaire collected the following information, general information, professional value before and after the outbreak of COVID-19, the Connor-Davidson Resilience scale and one question about career choice regret affected by the COVID-19. A pilot study was conducted before the survey to make sure all the questions/items were clear and unambiguous. Details of each part are as described below.
The following information were collected from all the participants, including gender, age, educational level, the reason of career choice for healthcare professionals/ major choice for medical students, whether have experienced verbal violence or physical violence during medical practicing, the willingness to participate in treatment or nursing during public health emergencies and the degree of fear of the coronavirus. In addition to the above, doctors and nurses were also asked if they participated in the treatment or nursing of patients with COVID-19, and medical students were asked whether their current major was the first choice, whether have had started internship in the hospital .
Professional value before and after the COVID-19 outbreak
This part contains 5 items to investigate the professional value of the participants before and after the outbreak of COVID-19. Each item using a 5- Likert response scale, response options ranged from “non-conformity” to “full conformity” (score brange,5-25) and a higher score indicated lower professional value evaluation.
The Connor-Davidson Resilience scale (CD-RISC)
The scale was developed by Connor and Davidson(11) and was revised by Yu(12), comprises 3 dimensions (competency, toughness, and adaptability), 25 items rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The internal consistency coefficient of the questionnaire is 0.89, which has good reliability and validity.
Career choice regret
This part contains one question for all the participants “ after the outbreak of COVID-19, I regret the choice I made about my career”. Response options were “strongly agree”, “agree” ,“neutral”, “disagree” and“strongly disagree”; responses of “strongly agree” or “agree” indicated with career choice regret, “disagree” and“strongly disagree” indicated without career choice regret.
2.3 Statistical analysis
Categorical data are presented as frequencies and percent, continuous data are described by mean and standard deviation or median and interquartile range (IQR) as appropriate. Mann-Whitney U or Kruskal-Wallis H test were performed to test the association of career choice regret with the following categorical variables, identity, gender, whether experienced physical violence during practicing, whether experienced verbal violence during practicing, the reason of career/major choice , major, work intention after graduation , whether current major was the first choice, whether have had started internship in the hospital, whether participated in the treatment or nursing of patients with COVID-19. Test for Linear Trend was used to test the association of career choice regret with the fear level after the COVID-19 outbreak. Paired t test or Wilcoxon signed-rank test were used to measure the change of professional value during COVID-19. Multinomial logistic regression analysis was performed to identify factors associated with regret of choice of career among all the participants, a subgroup analysis was also done among potential healthcare professionals (medical students).All statistical analyses were conducted in SPSS version 26.0 (IBM, Chicago, IL, USA), and p<0.05 was considered to be statistically significant.
2.4 Ethics statement
This study was approved by Peking University People’s Hospital Ethical Committee [No:2020PHB181-01]. The online survey was anonymous. Informed consent was obtained from all subjects(age≥18), if subjects are under 18, from a parent and/or legal guardian when they accessed the online survey. All methods were carried out in accordance with relevant guidelines and regulations.
2.5 Patient and Public Involvement
Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.