基于“出声思考法”的中医诊疗思维过程探究

Exploration of Thinking Process in TCM Diagnosis and Treatment Based on Think-aloud Protocol

中医诊疗思维过程是对四诊信息处理后做出诊断,并对疾病相关中医药信息处理拟定治疗方案的过程。这一过程具有典型的信息加工特点;而以信息加工观点研究认知过程是现代认知心理学的主流。因此借鉴现代认知心理学中恰当的方法有助于揭示中医诊疗思维过程。在诊疗中,医者的思维几乎都在沉默状态下完成,因此语言分析这一揭示思维过程的手段就失去了作用。出声思考法是思维主体在问题解决过程中利用外部语言进行思考,使其思维轨迹能被研究者直接捕捉的思考方法。由此可见,出声思考法能够使隐性的诊疗思维显性化。探讨了出声思考法在研究中医诊疗思维中的应用,并通过一则临床病例在准备、实施、分析和获取4个阶段加以说明。

Clinical thinking process of Traditional Chinese Medicine includes the diagnosis based on the data obtained from the four examinations and the treatment after analyzing the related information. It has the typical characteristics of information processing. However,the view of information processing is the mainstream of cognitive psychology for cognitive process researching in modem times. Therefore, that use the appropriate methods of modern cognitive psychology for refer- ence can help to reveal the clinical thinking process of Traditional Chinese Medicine. In the diagnosis and treatment, doc- tors think in a silent way. In that case ,linguistic analysis loses its role in revealing thinking. Think -aloud protocol is a method used for tracing thoughts, which needs the subject apply phonic language in thinking so that the researcher can get useful information directly. Thus, this method can make implicit thinking explicit in the diagnosis and treatment. In this paper, the author explores the application of think -aloud protocol in researching clinical thinking process of Traditional Chinese Medicine;and explains the application through a clinical case in four stages.