基于中医教学查房及疑难病例讨论的中医规培教学质量提升探索
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C975;R-4

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广东省中医药局科研项目(20241128)


Exploration of Enhancing Teaching Quality in Standardized Training of Chinese Medicine Practitioners Based on Chinese Medicine Teaching Ward Rounds and Complicated and Refractory Miscellaneous Disease Case Discussions
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    摘要:

    目的:探索有效提升中医医师规范化培训(以下简称“中医规培”) 教学质量的方法。方法:在 肝病科中医规培教学中,系统实施以强化中医临床思维与“病证结合”理念为核心的中医教学查房与疑难病例 讨论。于2024年1月—2025年9月期间,采用问卷调查法,对完成轮训的中医规培医师进行教学效果评估。问 卷涵盖中医教学查房与疑难病例讨论的效果、有价值环节、改进需求等10个维度。结果:共发放问卷40份, 回收有效问卷39份,有效回收率97.50%(39/40)。中医教学查房获高度认可:74.36%(29/39) 的规培医师认 为其对整体临床能力的提升帮助极大,94.87%(37/39) 的规培医师认为其最能提升临床思维能力。疑难病例 讨论中,82.05%(32/39) 的规培医师认为“中医辨证论治思路讲解”最具价值,97.44%(38/39) 的规培医师 肯定其提升临床思维能力的作用。超过八成的规培医师认同中医教学查房与疑难病例讨论是帮助理解“病证结 合”理念最有效的方式。同时,调查结果提示了改进方向:“病例选择的恰当性”是教学查房最需改进的环节, 而增加“典型病例的深度剖析”与“中医特色疗法实践”等内容的需求最为集中。结论:中医教学查房与疑难 病例讨论是培养中医规培医师中医临床思维的有效方式,可显著提升其辨证论治能力与综合诊疗水平;结合研 究结果与讨论,今后应优化“病例筛选机制”、深化教学内容设计、注重“启发式教学”运用,同时促进中西 医思维在临床教学中的有机融合,进一步提升规培教学质量。

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    Abstract:Objective:To explore effective methods for improving the teaching quality of standardized training of Chinese medicine practitioners. Methods: In the standardized training teaching within the Hepatology Department, Chinese medicine teaching ward rounds and complicated and refractory miscellaneous disease case discussions were systematically implemented,with a core focus on strengthening Chinese medicine clinical thinking and the concept of "integrating disease and syndrome." From January 2024 to September 2025,a questionnaire survey was conducted to evaluate the teaching effectiveness among Chinese medicine trainees who had completed their rotations. The questionnaire covered 10 dimensions, including the effectiveness of teaching ward rounds and complicated and refractory miscellaneous disease case discussions,valuable components,and improvement needs. Results:A total of 40 questionnaires were distributed,and 39 valid questionnaires were recovered,yielding an effective recovery rate of 97.50% (39/40). Chinese medicine teaching ward rounds received high recognition: 74.36% (29/39) of trainees believed they greatly enhanced overall clinical abilities, and 94.87% (37/39) considered them most effective in improving clinical thinking skills. Regarding complicated and refractory miscellaneous disease case discussions, 82.05% (32/39) of trainees identified "explanation of Chinese medicine syndrome differentiation and treatment thinking" as the most valuable component, while 97.44% (38/39) affirmed their role in enhancing clinical thinking abilities. Over 80% of trainees agreed that both methods were the most effective approaches for understanding the concept of "integrating disease and syndrome." Meanwhile, the survey results indicated directions for improvement: "appropriateness of case selection" was identified as the aspect most needing improvement in teaching rounds,while the demand for "in-depth analysis of typical cases" and "practice of Chinese medicine characteristic therapies" was most concentrated. Conclusion: Chinese medicine teaching ward rounds and complicated and refractory miscellaneous disease case discussions are effective methods for cultivating Chinese medicine clinical thinking among standardized training trainees, significantly enhancing their syndrome differentiation and treatment abilities and comprehensive diagnostic and therapeutic abilities. Based on the research findings and discussion, future efforts should optimize the "case screening mechanism," deepen the design of teaching content,emphasize the application of "heuristic teaching," and promote the organic integration of Chinese and western medicine thinking in clinical teaching to further improve the quality of standardized training.

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石美凤,陈沿任,欧金龙,蒋俊民,吴树铎.基于中医教学查房及疑难病例讨论的中医规培教学质量提升探索[J].新中医,2026,58(10):218-226

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  • 在线发布日期: 2026-05-28
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