How can we become reflective traditional Chinese medicine practitioners
2021-10-28
There are three basic characteristics of reflective traditional Chinese medicine practitioners: independent reflective consciousness, practical reflective methods and reflective ability from shallow to deep. Medical practitioners and practitioners should devote themselves to cultivating the above three characteristics in their personal academic cultivation, school and social education and training. The medical case reflection method with medical case as the carrier plays a more and more important role in the training of modern traditional Chinese medicine talents. To be a reflective TCM practitioner, practitioners must pay attention to medical cases and be familiar with the method of medical case reflection. Traditional Chinese medicine practitioners are good at thinking and have high-level reflection ability, which is mainly reflected in their ability to put forward new problems in medical works and medical activities, obtain effective schemes for the treatment of difficult diseases, and even have innovative ideas on the theory of traditional Chinese medicine. Answering the question of how to become a reflective TCM practitioner involves not only subjective factors such as the individual knowledge background and effort of practitioners and practitioners in the field of traditional Chinese medicine, but also objective factors such as school training, teacher guidance and social education. Based on many factors, the author summarizes three basic characteristics of reflective traditional Chinese medicine practitioners: independent reflective consciousness, practical reflective methods and reflective ability from shallow to deep. Medical practitioners and practitioners should devote themselves to cultivating the above three characteristics in their personal academic cultivation, school and social education and training. Diligent in thinking: forming a conscious consciousness of reflection The so-called reflective consciousness refers to a psychological need for reflection. If practitioners and practitioners think that they need to constantly strengthen their medical ethics and improve their medical ethics and skills through reflection, it shows that they have a sense of reflection. With a self-conscious sense of reflection, medical practitioners can "wander" everywhere in diagnosis, treatment, conversation, reading and other behaviors in lectures, recitations, discussions, internships and other occasions. They can always think, study problems and keep thinking. The word "diligent in thinking" can be regarded as a vivid expression of reflective consciousness. Schools and teachers are responsible for training and guiding medical practitioners, but they mainly rely on the self-cultivation of medical practitioners and practitioners. From the perspective of medical practitioners and young traditional Chinese medicine practitioners, only through the repeated strengthening of the process of "problem guided thinking", can we gradually develop the habit of extending thinking anytime and anywhere, that is, form a conscious consciousness of reflection. "The Analects of Confucius · eight Yi chapters" says: "when a son enters the imperial temple, he asks questions about everything." Mao Zedong advocated "learning Confucius' questions about everything" in his article "opposing Ben Ben Ben ism", and asked "Communists should ask a why for everything" in his article "rectifying the party's style". In real life, problems exist all the time and everywhere. As long as medical practitioners and practitioners can fully understand the epistemological significance of "problems", they can constantly identify and ask questions, so as to open the door of reflection to dispel doubts and doubts. For example, it is a problem for young students to "read" classic medical works. How to understand the meaning of words, words and sentences is a problem, and it is also a problem to doubt the existing interpretation; When young TCM doctors go out with their teachers, they may have questions about the teacher's four diagnosis process, syndrome differentiation results, prescription selection, classic prescription or timely prescription. They think with the above problems, or consult the literature, or ask teachers, or discuss and communicate with classmates and colleagues. As long as they continue to gain from the problem seeking and taste the sweetness of "problem guided thinking", they will form a positive feedback effect in the process of knowledge seeking, thus strengthening the reflection consciousness based on "problems". In terms of teaching teachers, teaching doctors and apprentices, we should create more scenes and opportunities for medical practitioners and young traditional Chinese medicine practitioners to "guide thinking". For courses such as selected readings of internal classics, typhoid fever, various theories of traditional Chinese medicine, basic theories of traditional Chinese medicine, prescriptions, internal medicine of traditional Chinese medicine and emergency medicine of traditional Chinese medicine, the lecturer can adopt problem teaching method, situational teaching method and case teaching method, take problems as the guide in the classroom, lead out and spread the course content, and assign students thinking questions for reflection training after class, Let students gradually get used to seeking true knowledge in the problem or problem chain. The various academic viewpoints expounded in textbooks are not the "ultimate truth" of perfection. The classical prescriptions and time prescriptions handed down since ancient times are far from covering all the diseases suffered by people in modern society. Therefore, traditional Chinese medicine should be upright and innovative, and traditional Chinese medicine should evolve and develop. The ultimate goal of teachers' preaching, teaching and dispelling doubts is not to provide ready-made academic conclusions and treatment principles and prescriptions to students and disciples, but to focus on leading ideas, cultivate their reflection consciousness of "intention" everywhere through "blank" teaching activities, so that they can put forward new problems in thinking and obtain new thinking results in solving new problems. Good at thinking: mastering practical reflection methods The reflection activities of medical practitioners and practitioners usually need to be carried out with the help of media means and corresponding carriers, so as to form their own characteristic reflection methods. In reading the self-reported manuscripts of the growth experience of many famous traditional Chinese medicine practitioners, the author found that the media means of thinking activities of traditional Chinese medicine practitioners are mainly words in their study stage and early practice stage. It is often said that "a good memory is not as good as a bad pen." famous old Chinese doctors usually do not use pen and ink, do not read, do not write, and do not have clinical certificates. They generally attach importance to using words to assist their memory and thinking activities. With the help of various texts written by themselves, they promote the process of reflection and improve the efficiency of thinking. They are good at thinking because they can flexibly use the reflection method based on text media. In a word, the reflection methods that practitioners and practitioners should master mainly include note reflection method and medical case reflection method. The "notes" as the carrier of note reflection method include lecture notes, reading notes, practice notes at the school stage, teacher follow-up notes at the early stage of medical practice, waiting notes, clinical evidence notes, etc. When summing up the experience of "diligent writing", Ren Yingqiu, a famous traditional Chinese medicine scientist, said that reading notes can take different forms, such as outline combing, content abbreviations, viewpoint excerpts, experience notes, multi Book Synthesis and so on. Guo Ziguang, a master of traditional Chinese medicine, developed the habit of reading, taking notes and making cards when he was young. More than 20 years later, he classified and sorted out the parts related to treatise on febrile diseases from tens of thousands of cards, and published the new edition of treatise on Febrile Diseases soup syndrome in 1983. Internship notes, teacher follow-up notes, doctor's notes and clinical certificate notes are post records of internship, teacher follow-up, doctor's service, clinical certificate and other scenes by medical practitioners and practitioners. The writing process of notes is to orderly sort out what individuals have seen and heard, and these written records after preliminary reflection are valuable materials for writers and other doctors to extend their thinking. Some notes recording the words and deeds of well-known doctors and clinical practice have become notebook medical books after the reprocessing of the writer's thinking. In recent years, several publishing houses have published such books, such as the doctor's diary, learning medicine with Professor Lu Zhizheng, the doctor's notes of Huihe with India, the notes of Cheng Xinnong, a medical master of one needle and one earth, and the inheritance of Hu Xishu and Feng Shilun's six classics and eight principles. Medical records are written records about the symptoms, syndrome differentiation, prescriptions, medication, etc. of doctors in medical activities. They are also called test cases, treatment and test cases and medical records. The medical case reflection method with medical case as the carrier plays a more and more important role in the training of modern traditional Chinese medicine talents. To be a reflective TCM practitioner, practitioners must pay attention to medical cases and be familiar with the method of medical case reflection. First of all, medical practitioners and young TCM practitioners should strengthen TCM thinking training with the help of famous medical records. The medical record texts handed down through the ages are the thinking achievements of the predecessors in the process of diagnosis and treatment. Qiu peiran, a master of Chinese medicine, suggested that beginners start with simple medical records, read and think, and analyze and compare multiple medical records of the same disease and syndrome. Reading famous medical records is actually simulating their thinking process under the guidance of famous doctors. Secondly, young TCM doctors should actively write medical records on the basis of reflecting on their own clinical practice. In order to summarize their own diagnosis and treatment experience, traditional Chinese medicine practitioners need to "reread" the previous medical records on the basis of making curative effect judgment in the follow-up visit, reflect on the syndrome differentiation results and the right and wrong gains and losses of sending prescriptions, and sort them out and compile them into readable medical records. Some of these medical records may not reach the level of public publication, but the reflection in the process of sorting and compiling can make doctors experience irreplaceable thinking training. Good at thinking: develop the ability of reflection from shallow to deep The depth of cognitive achievements obtained through reflection is closely related to everyone's reflective ability. In terms of on-the-spot cooperation, the reflection ability of medical practitioners is mainly reading reflection ability and teacher reflection ability, and the reflection ability of medical practitioners is mainly medical reflection ability and reading reflection ability. Both medical practitioners and practitioners need to read a lot. Reading reflection ability is very important for medical practitioners and practitioners. The reflective ability of doctors has an evolutionary process from the shallow to the deep, from the outside to the inside, from the stage of studying in youth, the stage of attending doctors to the stage of independent medical practice. "Reading" the same famous medical work and trying to figure out the same famous saying of medical work, because doctors have differences in knowledge structure and experience, they will have different experiences and Understandings after reflection. Lu Guangxin, a master of traditional Chinese medicine, once said that the classics of traditional Chinese medicine, including the discussion of a few numbers, may have a different understanding every time you read them. "Good Qi exists in the body, evil cannot be done" is a famous saying from the Yellow Emperor's Internal Classic, which is often quoted by doctors and scholars. Some scholars believe that these eight words express the dialectics of the relationship between good and evil, and some doctors regard them as a brief summary of the health care theory of supporting the right and eliminating evil. After decades of repeated thinking, Mr. Lu Guangxin's understanding of the famous saying "good Qi exists in the body, evil cannot be done" has been gradually deepened in the process of gradually improving his reflective ability. He interpreted these eight words as "the healthy medical ecological model of traditional Chinese medicine", that is, the existence of healthy qi is the stability of the internal environment; Evil cannot be done, that is, as long as there is a stable internal environment, people can resist the interference of disease and evil. Reflective ability involves not only the depth of thinking, but also the accuracy of thinking. Traditional Chinese medicine practitioners are good at thinking and have high-level reflection ability, which is mainly reflected in their ability to put forward new problems in medical works and medical activities, obtain effective schemes for the treatment of difficult diseases, and even have innovative ideas on the theory of traditional Chinese medicine. To develop reflective ability, practitioners and practitioners need to pay special attention to the following two points. First, building a reasonable knowledge structure on the basis of constantly absorbing new knowledge is the prerequisite for the development of reflective ability. The Yellow Emperor's Canon of internal medicine says: "those who master Taoism know astronomy, geography and personnel." medicine is a life science related to people, and doctors need extensive and profound knowledge accumulation. Although knowledge is not equal to ability, the formation of reflective ability must be based on knowledge and integrate relevant knowledge. Knowledge increases by one inch and reflection ability increases by one point. Zhang CiGong, a famous doctor, put forward the academic proposition of "developing the ancient meaning and integrating new knowledge" in the early 1930s. Today, we can interpret it from the perspective of knowledge structure and innovation of traditional Chinese medicine and from the perspective of developing reflection ability. Today's traditional Chinese medicine practitioners should not only have a solid foundation in traditional culture, but also absorb new knowledge in many fields and disciplines, including modern natural science knowledge, western medicine knowledge, humanities and social sciences
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