目的 了解中医药院校高年级学生的从医信心现状及其影响因素,为中医药教学改革提供参考。方法 2021年3月,采用问卷调查方法调查3所中医药院校450名已参与临床实习的高年级学生的从医信心现状和影响因素,采用描述性统计对数据进行分析。结果 55.1%(248/450)的学生从医信心不足,临床能力不足[80.0%(360/450)]是其主要原因。临床思维能力弱[75.3%(339/450)]和动手实践能力弱[70.9%(319/450)]是影响学生临床独立诊疗能力的主要因素。85.1%(383/450)的学生认为中医理论知识讲解应紧密联系临床实际。结论 高年级中医学生从医信心不足,临床实践能力不足等是其主要影响因素。应当深化中医临床教学改革,提升学生对基层医疗发展的认知,加强对学生的人文关怀,从而提高学生的临床实践能力,坚定其从医信心。

Objective To understand the current situation and main influencing factors of confidence in being a doctor among senior students in traditional Chinese medicine (TCM) universities, and to provide reference for the TCM teaching reform. Methods In March 2021, 450 senior students who had participated in clinical practice in 3 TCM universities were selected as the sapmle. Questionnaire survey was used to investigate the status quo and influencing factors of their medical confidence. Descriptive statistics and Pearson correlation analysis were used to analyze the data. Results Totally 55.1% (248/450) of the students have insufficient confidence in medical profession, and the main reason is the lack of clinical ability [80.0% (360/450)]. Weak clinical thinking ability [75.3% (339/450)] and weak practical ability [70.9% (319/450)] are the main factors affecting students' clinical independent diagnosis and treatment ability. 85.1% (383/450) of the students think that the explanation of theoretical knowledge of traditional Chinese medicine should be closely related to clinical practice. Conclusions The senior TCM students lack confidence in medical profession, and the main influencing factor is the lack of clinical practice ability. Universities should deepen the reform of clinical teaching of TCM, improve students' cognition of the development of grass-roots medical treatment, and strengthen humanistic care for students, so as to improve students' clinical practice ability and strengthen their medical confidence.