{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T10:16:23Z","timestamp":1772705783384,"version":"3.50.1"},"reference-count":37,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71273098"],"award-info":[{"award-number":["71273098"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,12,22]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether experiences of off-the-job training in domestic (DT) and overseas study (OS) settings are associated with work performance and work\u2013family conflict in physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>We conducted a national cross-sectional survey in 77 public hospitals across seven provinces in China between July 2014 and April 2015. Participants were 3182 physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Participants were categorised into four groups: none, DT only, OS only and DT and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Work performance was assessed by work engagement, career attrition and patient-centred care. Work\u2013family conflict was assessed by affecting care for family, feeling guilty towards family and receiving complaints from family.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 25.89% participants had experienced DT only, 8.71% OS only and 8.47% DT and OS. After adjustment for potential confounders, participants who had experiences of DT and OS compared with those with no training were more likely to report positive work performance (pride in work: OR=2.11, 95% CI: 1.43 to 3.10; enjoyment of work: OR=1.67, 95%\u2009CI: 1.11 to 2.51; turnover intention: OR=0.54, 95%\u2009CI: 0.38 to 0.77; early retirement: OR=0.63, 95%\u2009CI: 0.45 to 0.89; and exhaustion: OR=0.66, 95%\u2009CI: 0.45 to 0.98) and less work\u2013family conflicts (feeling guilty towards family: OR=0.51, 95%\u2009CI: 0.35 to 0.74; and complaints from family: OR=0.66, 95%\u2009CI: 0.47 to 0.91). We found no obvious association between DT\/OS experience with patient-centred care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Physicians with DT and OS experiences are more likely to have better work performance and less work\u2013family conflict than those without such experience. Physicians face increasing pressure to pursue continuing education and experience associated distress. Therefore, hospitals and government policy-makers should promote DT and OS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053280","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T13:32:16Z","timestamp":1641907936000},"page":"e053280","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Association of off-the-job training with work performance and work\u2013family conflict among physicians: a cross-sectional study in China"],"prefix":"10.1136","volume":"12","author":[{"given":"Xiaoyu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Media and Communication, University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zixin","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beizhu","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-1837","authenticated-orcid":false,"given":"Yuan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"2025121510302049000_12.1.e053280.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12909-019-1601-3","article-title":"Relationship between burnout and career choice regret among Chinese neurology postgraduates","volume":"19","author":"Tian","year":"2019","journal-title":"BMC Med 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