| 引用本文: |
尹楠, 廖菁.中医定向医学生培养政策执行的现实阻滞与路径优化——基于史密斯模型的分析[J].湖南中医药大学学报,2026,46(4):829-836[点击复制] |
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| 中医定向医学生培养政策执行的现实阻滞与路径优化——基于史密斯模型的分析 |
| 尹楠,廖菁 |
| (湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 目的 探讨当前中医定向医学生培养政策执行的主要问题，为优化中医定向医学生培养政策执行提供参考。方法 以史密斯模型为理论框架，采用文献资料法、访谈法，剖析2010年至今的相关政策与文献，结合某大学中医定向医学生调研数据，归纳出政策执行问题并提供相应的建议。结果 基于对政策文本和135篇文献的梳理及某大学1 006名中医定向医学生调研数据分析，发现理想化政策的落地实操性不足；执行部门协同性弱，高校人才培养模式与基层需求脱节，乡镇卫生院“重接收、轻使用”；目标群体对政策知晓程度低、认可度低；经济环境与社会环境的支撑不足等因素影响政策的实施效果。结论 基于史密斯模型提出加强政策适应性调整，丰富政策工具类型；加强执行部门的横向协同，纵向联动；提升目标群体对政策的知晓度、认同度；多措并举，优化政策执行环境等对策。以期为基层培养“留得住、医得好”的中医定向医学生提供有益的参考。 |
| 关键词: 中医|定向医学生|政策执行|史密斯模型 |
| DOI：10.3969/j.issn.1674-070X.2026.04.025 |
| 投稿时间：2025-10-22 |
| 基金项目:湖南省教育科学“十四五”规划专项课题(XJK23BXJ022) |
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| Practical obstacles and optimization pathways for implementing cultivation policies for rural-oriented TCM students——an analysis based on the Smith model |
| YIN Nan, LIAO Jing |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To explore the primary issues in the implementation of current policies for cultivating rural-oriented TCM students and to provide references for optimizing the implementation of these policies. Methods The Smith model was used as a theoretical framework, and literature review and interview methods were used to analyze relevant policies and literature from 2010 to the present. Combined with data on rural-oriented TCM students from a certain university, the study identified policy implementation issues and offered corresponding recommendations. Results Based on the review of relevant policy texts and 135 relevant publications, as well as the analysis of survey data of 1 006 rural-oriented TCM students at a certain university, the study found that the implementation of idealized policies is insufficient. Factors affecting policy effectiveness include poor coordination among implementing agencies, a disconnection between the talent cultivation model in higher education institutions and the demand of grassroots units, a tendency among township health centers to "prioritize recruitment over utilization", low awareness and acceptance of the policies by target groups, and insufficient support from the economic and social environments. Conclusion The following strategies were proposed based on the Smith model: enhancing the adaptability of policies and diversifying policy tools;strengthening horizontal coordination and vertical collaboration among implementing agencies; increasing the target groups' awareness of and acceptance toward the policies; and adopting a multi-pronged approach to optimize the policy implementation environment. These measures aim to provide valuable guidance for cultivating rural-oriented TCM students who can "stay and practice effectively" at the grassroots level. |
| Key words: Chinese medicine|rural-oriented medical students|policy implementation|Smith model |
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