北京地区中医规培经典教育现况调研

A Questionnaire Survey on Beijing Area Training of Doctors’Thinking in Diagnosis and Treatment Based on TCM Classic Education

[目的]调查中医住院医师规范化培训(以下简称中医规培)的经典教育现状及需求,助力中国式的规培模式改革。[方法]采用课题组专家自制调查问卷,调研北京地区4所规培基地的中医规培医师的经典教育现况,并统计分析。[结果]共362名参与者接受调查,348份问卷纳入统计,有效率96.1%。从现状来看,当前培训模式下形成的主体诊疗思维为“中西参杂、不中不西”;从问题与原因来看,经典学、考和实践比例偏低,或与身份属性、培训年限与状态等因素有关;从需求而言,多数参与者支持将经典教育纳入规培制度,希望在不增加总工作量的前提下,通过数字化方式增加一定比例的经典内容,以培养中医诊疗思维,如《伤寒论》《金匮要略》《黄帝内经》等书目。[结论]基于中医诊疗思维培养的规培目标,现行规培模式亟待改革,以体现中医学特色。中医经典是凸显中医学特色的关键抓手,经典思维是中医诊疗思维的核心内容。目前规培过程中经典及经典思维培养尚不足,数字化为经典思维培养的落地带来可能,能够全面评价规培医师对中医经典的掌握程度以及运用经典思维指导临床实践的能力。

[Objective]To investigate the current situation and demand of classical education in the standardized training of traditional Chinese medicine(TCM)residents,to help reform the model of Chinese-style training.[Methods]The questionnaire made by the experts of the research group was used to investigate the doctors in 4 bases and statistical analysis was made.[Results]A total of 362 participants were investigated,and 348 questionnaires were included in statistical analysis,with an effective rate 96.1%.For the current situation,the main diagnosis and treatment thinking formed under the current training mode was“mixed Chinese and western,neither eastern nor western”.For the problems and reasons,the proportion of classical study,examination and practice were all low.It was related to identity attribute,training years,training state and so on.For the requirement,most participants supported the inclusion of classical education in the reform of the training system.It was hoped that under the premise of not increasing the total workload,a certain proportion of classical contents can be added by digital means to cultivate the thinking of TCM diagnosis and treatment,such as Treatise on Febrile Diseases,Synopsis of Golden Chamber and Huangdi’s Inner Classic.[Conclusion]Based on the training goal of TCM diagnosis and treatment thinking,the current training mode needs to be reformed to reflect the characteristics of TCM.TCM classics are the keys to highlight the characteristics of TCM,and training classic thinking is core content of TCM diagnosis and treatment thinking.At present,the training of classics and classical thinking is seriously insufficient in the process of training.Digital technology brings the possibility to the intelligent transformation of classical thinking.It can comprehensively evaluate the mastery level of TCM classics and the ability of translating classical thinking into clinical practice.