针刺操作技术标准化考核之构想——来自欧美外科技术定量评估的启示

针刺操作技术是针刺治疗的核心。传统针刺操作技术考核主要基于专家的主观判断,缺乏必要的信度及效度。我国针刺操作的量化研究已经取得了一定的研究成果,但距离建立完善的标准化考核体系仍有较大差距。外科技术的定量评估在欧美早已广泛开展,针刺治疗作为一种微创外科治疗手段,可以借鉴国外外科技术评估中成熟的理论及方法,例如运用量表评估针刺操作行为、运用精密仪器测试针刺操作主要技术指标等;在此基础上建立常用针刺手法标准数据库;同时应当根据针刺操作的特点,积极设计高仿真人体模型或训练标准化病人以客观评估"得气感",从而逐步建立起适合针刺操作技术的标准化考核体系。

Ideas of standardization evaluation on acupuncture skills: enlightened by quantitative appraisal of surgical skills in Europe and North America

Acupuncture manipulation skills are the core of acupuncture therapy. Traditional acupuncture skills evaluation is based on experts' subjective assessment which is deficient in reliability and validity. Certain progresses on the quantitative research on acupuncture skills have been made in China, while there is still a long way to go before the formation of the consummate standardization evaluation system on acupuncture skills. Actually, quantitative appraisal on surgical skills has been developed for a long time in Europe and North America. Since acupuncture could be considered as a kind of skills of minimally invasive surgery because small wounds would be generated by needles, the theories and methods in surgical quantitative appraisal could be utilized. For instance, scales could be designed to evaluate the operation modes in acupuncture skills and precise instruments could be used in the measurement of acupuncture skills. Then standard databases on common acupuncture manipulations would be built. Moreover, in terms of the characteristics of acupuncture skills, high-fidelity simulators should be designed or standardized patients should be trained for the assessment of "Deqi" (arrival of qi)feelings. Thereby, an appropriate standardization evaluation system for acupuncture skills would be created gradually.