建立中醫畢業後臨床技能評估模式

蔡淳娟
義守大學
中醫師的臨床能力是決定中醫醫療品質的重要因素，為了確實掌握中醫師在住院醫師受訓期間，以及獲得中醫醫療機構負責醫師資格時之臨床能力，需要有一套客觀而可靠的臨床檢定測驗，其中將融入中醫望、聞、聽、切四種診療法與理、法、方、藥的技能運用，藉由經絡、穴位的手法診斷，及辨、證、論、治的法則來評量學生的臨床技能能力，適行於台灣與中醫領域，其評量結果將為學生與訓練計畫改進的依據，也藉此為社會大眾健康把關。
本計畫先蒐集臨床評量相關文獻，分析中醫訓練環境與各樣評量工具之優劣，而後召開3次專家會議，討論主題為「定義中醫師臨床能力」、「探討適用於中醫住院醫師受訓期間的臨床評量工具」、「選定中醫PGY住院醫師臨床評量方式」、決定「中醫醫療機構負責醫師技能檢定方式及考試科目」、「中醫二年期PGY完訓辦法」、「中醫技能檢定考試考官之資格及訓練辦法」，最後舉行「成果發表會」。本計畫邀請的專家乃涵蓋產、官、學三大領域，除了多次舉行專家會議外，也以Delphi method(會議的結果以書面方式傳遞到全國相關專家)蒐集資料，彌補專家會議之不足，並為了在短時間內讓專家充分討論，並得到確實的共識證據,本研究使用IRS輔助設計的討論架構，使大眾意見之共識趨近一致。最後建議之必要臨床檢定考試/評量工具或建議測驗，將提供各訓練機構或主管機構作參考。
關鍵字：中醫、臨床教育、考評、認證、PGY、臨床技術

A System of Evaluation and Certification of Clinical Skills in Post Graduate Chinese Medicine

Traditional Chinese medicine (TCM) physicians’ clinical competency plays an important role in determining healthcare quality in Taiwan. In order to guarantee physician competency for practicing Chinese Medicine at the end of PGY residency training, there is a need to establish a system of clinical assessment. The results of the clinical assessment will be applied to improve the training program and certification as well. 
This project will start with literature review of the tools in assessing clinical skills; and compare their weakness/strength and explore the uses in the context of TCM in Taiwan. There will be several meetings for expert focus groups, which identify the minimal requirements of clinical competency, determine the assessment system during the residency training/ qualification of independent practices, the regulation for the completion of the PGY training, and the qualification of the raters and rater training. At the end, we will host a presentation meeting for both the stake-holders and the public. The experts will be from the training hospitals, the academic institutes, and the government. To enhance the effectiveness of the meetings, Delphi method and the classroom technology (e.g., interactive response keypads) will be applied. The results of this project will contribute to the training, assessment and certification of an independent practioner in TCM.
關鍵字：Traditional Chinese medicine, clinical education, assessment, certification, PGY, clinical skills