| Traditional Chinese Medicine(TCM)is a unique subject in our country,which condenses the great wisdom of the Chinese nation.It has made great contributions to the lives and health of the Chinese people and the reproduction of the nation for thousands of years,and is also an important part of the World Medicine.The "Healthy China" strategy and the national policy of "Implementing a major project for the revitalization and development of Chinese medicine" directly promote the reform of my country's higher education and talent training system for Chinese medicine,get rid of the self-imprisonment under the Western "scientific" paradigm,and return to the true colors of Chinese medicine.Therefore,it is particularly important to explore the key elements and mechanism of talent training based on the theories of Chinese medicine and the characteristics of clinical diagnosis and treatment.System-based post competency is the core evaluation factor of the current global medical education training quality.Competence is essentially the formation of a comprehensive medical personality based on the "human-oriented" purpose of medicine as a logical starting point,and is the focus of psychological research on medical specialty behavior.Based on the characteristics of TCM theories and clinical diagnosis and treatment methods,combined with the competence standards of TCM doctors,this study takes the experiential intelligence of clinical diagnosis and treatment as the starting point,and uses questionnaire method,behavioral experiment method,eye movement tracking technique and functional Near-infrared spectroscopy(FNIRS)to explore the state of experiential intelligence and cognitive neural mechanisms in clinical diagnosis and treatment of TCM.This paper consists of four parts and six research.The first part uses psychometric methods to verify the applicability of the self-compiled experiential intelligence questionnaire for TCM Physicians,and then uses the questionnaire to explore the characteristics and influencing factors of experiential intelligence of TCM Physicians through measurement.The second part adopts behavioral experiment method to explore the behavioral characteristics of case diagnosis of TCM doctors with different experiential intelligence.The third session adopts eye tracking technology.In this section,we discuss the eye movement characteristics of different types of cases diagnosed by TCM doctors with different experiential intelligence under time pressure.In the fourth part,we simulated on-site diagnosis and used functional Near-infrared spectroscopy(FNIRS)to explore the changes in brain activity of TCM doctors with different experiential intelligence in different stages of diagnosis and treatment.The results were as follows:(1)The experiential intelligence of TCM Physicians includes three dimensions:automation,ability to solve new problems,and ability to reflection.Moreover,the Self-compiled questionnaires has good reliability and validity.The overall level of experiential intelligence was above average,the level of automation was the lowest,followed by the ability to solve new problems,and the level of reflection was the highest.There has different degrees of difference in gender,type,age,time spent in medicine,professional title,etc.basically showing a straight upward trend.In addition,Plastic personality and general self-efficacy have positive predictive power for the experiential intelligence of clinical diagnosis and treatment of TCM,and general self-efficacy is a mediating variable.(2)The diagnostic response time of physicians with high experiential intelligence was significantly higher than the lower.The diagnostic confidence of physicians with high experiential intelligence was significantly higher than the lower.There was no significant difference in diagnostic response times and diagnostic accuracy between high and low empirical intelligence physicians,which indicated that experiential intelligence was a factor affecting the clinical diagnosis and treatment of TCM Physicians.(3)Under time pressure,there were significant differences in the first fixation time in the area of interest 1(primary symptom)and area of interest 3(tongue and pulse information)judged by the prescription.There were significant differences in the number of fixation in the region of interest 2(concurrent syndrome)of syndromes.In high experiential intelligence,the correct rate case diagnosis of high experiential intelligence is higher,the first fixation time is longer,the fixation frequency is less,and the fixation time is less.It is suggested that physicians with high experiential intelligence tend to use heuristic strategy in clinical diagnosis and treatment to process key information at one time.Different diagnosis types have different key information.Syndromic diagnosis mainly takes co-symptom as the key information,while prescription judgment mainly takes main symptom of tongue and pulse information as the key information,and the recognition of tongue and pulse information is the difficulty.(4)In the real situation,the prefrontal cortex(PFC)is significantly activated during the clinical diagnosis and treatment of TCM,and the dorsolateral prefrontal and antinion are the main active areas.However,The activation of the brain regions of the higher and the lower at different stages of diagnosis and treatment is different.During the inspection stage,the higher only activate the left upper frontal gyrus(BA10),and their degree of automation of information integration is stronger than the lower.In the pulse diagnosis stage,the number of channels activated by the higher is less than the lower,and the inferior frontal gyrus(BA45)of the right triangle is significantly activated.Its single-information reasoning automation and attention flexibility are stronger than the lower.During the inquiry phase,the higher activate more channels than the lower,and the left inferior frontal gyrus(BA44/46/47)and the right superior temporal gyrus(BA22/42/43)are activated significantly.Moreover,its flexibility and relevance of actively collecting information are stronger than the lower.During the diagnosis and prescribing stage,the number of channels activated by the higher is less than that of the lower,have significant activation in the right middle frontal gyrus(BA10/45/46)and right superior temporal gyrus(BA22/42/43).There are differences between the higher and the lower in decision-making strategies.The higher tends to use analogy,the lower tends to use algorithmic exploration. |
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