中医类专业本科实习生临床技能培训需求调查分析

Analysis of the Training Needs for Clinical Skills of Undergraduate Interns in Traditional Chinese Medicine Disciplines

摘要: 目的：调查实习生在实习期间对临床技能培训的需求。方法：选取在成都市郫都区中医医院实习的171名中医学、中医养生学、针灸推拿学专业实习生为研究对象，从学生职业规划方向、培训意愿与影响因素、培训项目需求等方面设计问卷开展调查。结果：中医学类专业实习生职业规划方向占比从高到低依次为：中医内科50.88%、针灸推拿48.54%、中医外科28.07%、科研/教学26.90%、中西医结合18.71%、中医妇科/儿科12.87%。绝大多数实习生对规范化、系统化临床技能培训持接纳、主动参与态度。24项技能培训项目中平均值得分排名前五的项目依次为：徒手心肺复苏及简易呼吸器使用($\overline{x}$ = 4.00)，创伤的现场止血($\overline{x}$ = 3.98)，毫针刺法($\overline{x}$ = 3.95)，常用成人推拿手法套路($\overline{x}$ = 3.94)，内科典型疾病门诊接诊能力($\overline{x}$ = 3.92)与医患沟通技巧($\overline{x}$ = 3.92)。三个专业实习生对绝大多数临床技能培训的需求程度不存在显著的总体组间差异，不同专业实习生的整体培训诉求趋向一致。仅穿刺操作、医患沟通少数条目存在小幅专业差异，且技能培训需求差异与各专业核心培养方向有一致性。结论：以需求为导向设计培训课程。统一面向三个专业实习生设置需求高的急诊急救、中医基本技能、接诊能力等培训课程。同时设置专业模块，中医学专业加强穿刺类、清创缝合等西医技能，针灸推拿专业实习生应加强推拿手法与套路、毫针刺法等技能培训，以满足不同专业实习生的实际需求。

Abstract: Objective: To investigate the demand of undergraduate interns for clinical skills training during their internship. Methods: A total of 171 interns majoring in Traditional Chinese Medicine, Traditional Chinese Health Preservation Medicine, and Acupuncture, Moxibustion, and Tuina from Chengdu Pidu District Hospital of Traditional Chinese Medicine were selected as the research subjects. A questionnaire was designed to investigate students’ career planning directions, training willingness and influencing factors, and training project demands. Results: In terms of career choices, the highest proportion of TCM interns opted for internal medicine of Traditional Chinese medicine, accounting for 50.88%. Followed by acupuncture-tuina practice at 48.54%, surgery of Traditional Chinese medicine at 28.07%, scientific research and teaching work at 26.90%, integrated Traditional Chinese and western medicine at 18.71%, and gynecology & pediatrics of Traditional Chinese medicine with the lowest proportion of 12.87%. Most interns were willing to take part in standardized and systematic clinical skill training initiatives. Among all 24 training items, the top five items with the highest average score were cardiopulmonary resuscitation combined with simple respirator operation (mean = 4.00), field hemostasis for traumatic wounds (mean = 3.98), filiform needle puncture manipulation (mean = 3.95), conventional adult tuina manipulation routines (mean = 3.94), and outpatient consultation skills for typical internal diseases and doctor-patient communication techniques (both mean = 3.92). No obvious overall inter-group differences were observed in most clinical skill demands among the three majors, which meant these students shared similar general expectations for skill training. Minor discrepancies only existed in puncture operation and doctor-patient communication items, and such differentiated demands matched the core training objectives of each corresponding major. Conclusion: Design training courses based on demand. Set up training courses with high demand for emergency rescue, basic skills of Traditional Chinese Medicine, doctor-patient communication, and outpatient diagnosis and treatment for all three professional interns. At the same time, set up distinctive courses tailored to the needs of each major. Interns majoring in traditional Chinese medicine should enhance their training in Western medical skills such as puncture operations and wound debridement and suturing. Interns majoring in acupuncture and massage should enhance their training in massage techniques and Traditional Chinese medicine acupuncture to meet the actual needs of different intern students.