理论与实践的割裂关系长期以来一直是社会工作专业发展中的难题，为解决这一问题，需要进入实践情境中，以社会工作者实践的脉络出发，探索其实践过程中对知识的 运用与反思，以促进社会工作者实践中理论与实践的融合。不同社会工作实务领域中运 用的知识有所差别，且医务社会工作领域对社会工作者专业性要求更高，其实践情境更 为复杂，更能够凸显社会工作实践的特点。同时，处于职业初期的社会工作者时常处于 知识运用的“严谨与适切”的两难，其理论与实践的矛盾感与割裂感更强烈。 因此，本研究以反映性实践理论为指导，通过目的性抽样与滚雪球抽样的方式，选择 14 名处于职业初期的医务社会工作者展开半结构访谈，探索其实践过程中对知识的运用与反思的情况，以下为研究发现。 职业初期的医务社工知识的来源，主要为经验、培训、专业论坛、督导、社会工作教育、实践情境中的重要他人、专业期刊、书籍几个方面。职业初期的医务社工知识运用与反思的过程中，医学知识与社会工作知识共同发展、相互影响。医学知识是不断累积的，并随着与社会工作知识的融合，其运用方式更为人 性化。在此基础上，社会工作知识的运用与反思大致为 3 个阶段，包括：自我怀疑—— 补充知识、自我接纳——积累知识、自我重构——融合知识，这三个阶段并非是相互孤立的，是环环相扣、平稳过渡的过程。纵观整个过程，呈现出整体性与累积性、确定性 与不确定性的特点，理论与实践的关系也从割裂走向融合。 影响职业初期的医务社工知识运用与反思的多重因素，包括职业初期医务社工的个 人特质、医疗情境的互动、组织内部的氛围、专业教育的取向四个方面。 研究立足于社会工作实践情境，关注一线实践者的日常话语，以期为迷茫、矛盾的投身于一线实践情境的社会工作者们反思与审视其专业实践助以绵薄之力，并从实践角度反思与回应社会工作理论与实践割裂的问题提供浅薄之见。

The separation between theory and practice has long been a difficult problem in the development of social work professionals. To solve this problem, it is necessary to enter a practical context, start from the context of social worker practice, and explore the utilization and reflection of knowledge in their practical process, in order to promote the integration of theory and practice in social worker practice. Considering that the knowledge applied in different practical fields of social work varies, and the medical and social work field requires higher professionalism of social workers, the practical situation is more complex, and the characteristics of social work practice can be more prominent. At the same time, social workers in the early stages of their careers often face a dilemma of "rigor and appropriateness" in the application of knowledge, resulting in a stronger sense of contradiction and separation between theory and practice. Therefore, guided by the theory of reflective practice, this study conducted semi- structured interviews with 14 medical social workers in their early career stages through purposive sampling and snowball sampling to explore their utilization and reflection of knowledge during the practical process. The following are the research findings. The sources of medical and social work knowledge in the early stages of career mainly include experience, training, professional forums, supervision, social work education, important others in practical situations, professional journals, and books. in the process of utilizing and reflecting on medical and social work knowledge in the early stages of career, medical knowledge and social work knowledge develop together and influence each other. Medical knowledge is constantly accumulated, and with the integration of social work knowledge, its application becomes more humane. On this basis, the use and reflection of social work knowledge can be roughly divided into three stages, including: self doubt - supplementing knowledge, self-acceptance - accumulating knowledge, self reconstruction - integrating knowledge. These three stages are not isolated from each other, but a process of interlocking and smooth transition. Throughout the entire process, there are characteristics of wholeness and accumulation, as well as certainty and uncertainty. The relationship between theory and practice has also shifted from fragmentation to integration. There are multiple factors that affect the utilization and reflection of knowledge in medical social workers in the early stages of their careers, including the personal characteristics of medical social workers in the early stages of their careers, the interaction of medical situations, the internal atmosphere of the organization, and the orientation of professional education. The research is based on the practical context of social work, paying attention to the daily discourse of frontline practitioners, in order to provide humble insights for social workers who are confused and contradictory in their professional practice, and to reflect and respond to the problem of the separation between social work theory and practice from a practical perspective.