Research On China’s Higher Medical Education Policy(1978-2021)

With the continuous development of society and the rapid progress of the medical field,the demand for medical technology and services is increasing,and the cultivation of medical talents has become an urgent task.In this process,higher medical education plays a crucial role,not only in improving the national health level,but also in cultivating excellent medical talents and promoting the continuous progress of medical technology.The Chinese government is well aware of the importance of higher medical education.Since 1978,with policy as the driving force,China’s higher medical education has achieved significant reform and innovation results.These policies have played a crucial role in promoting the development of higher medical education,making policy research on higher medical education an important issue that must be paid attention to.Therefore,only through in-depth,systematic,complete,and scientific research on relevant policies can we continuously improve and innovate existing policies,promote China’s higher medical education to continuously climb new heights,and contribute to the health and well-being of the people throughout the country.Therefore,this study is based on the perspective of policy text analysis,guided by education policy theory,social structure change theory,policy discourse theory,and policy process theory.Using literature research,content analysis,social network analysis,LDA theme analysis,and PMC index model analysis,qualitative and quantitative analysis is conducted on 159 higher medical education policy literature published at the central level from 1978 to2021,By attempting to explain the core issues in the policy text of higher medical education,namely "why(policy motivation)","who will do(policy subject)","how to do(policy tool)","what has been done(policy theme)",and "how has been done(policy text effectiveness)",we can discover the characteristics and shortcomings of higher medical education policies in the development process.While grasping policy laws,Provide a basis for policy optimization of future higher medical education policies.When answering "Why",the results showed that the development of higher medical education policies was divided into four stages: the restructuring and recovery stage(1978-1984),the exploration and expansion stage(1985-2000),the reform and optimization stage(2001-2013),and the collaborative reform stage(2014-2021).The driving force for the development of these stages mainly came from changes in the economic,political,and educational environment,The Chinese government is constantly searching for environmental factors in the dynamic changes of the decision-making environment for higher medical education,leading the development of medical education in China time after time.A total of 159 policies on higher medical education were collected,mainly in the form of notices,opinions,and methods.The number of policies has shown an increasing trend year by year.When answering ’Who will do it?’,it was found that a total of 22 entities were involved in the formulation of higher medical education policies.From the perspective of the publication situation,the main policy was to publish policies separately,supplemented by joint publication of policies.The cooperation network structure between multiple department entities that jointly publish documents has gradually improved through stage development,presenting a "center coordination" network structure form.A "cooperation team" for higher medical education policies has been formed,mainly consisting of six ministries,but the Ministry of Education and the National Health Commission are the core departments within the team,leading the policy cooperation relationship.And in the formulation of higher medical education policies,a "two person transfer" governance form was formed by the Ministry of Education and the National Health Commission.When answering ’how to do’,a two-dimensional analysis framework was constructed for higher medical education policy tools,and 159 higher medical education policy texts were classified and encoded,resulting in a total of 1070 policy text content analysis units.Based on this,a comprehensive analysis was conducted on the selection characteristics of policy tools for higher medical education,and it was found that the number and structure of policy tools evolved with the evolution of stages.A usage structure has been formed that presents command based tools as the main tool,supplemented by functional expansion tools,and supplemented by advisory and induced tools,reward based tools,and authoritative restructuring tools.However,there is a dual imbalance between the category structure and the internal structure of policy tools in terms of structure.When answering ’What has been done’,LDA theme modeling was used to transform complex textual data of higher medical education policies into easily understandable medical education themes.By segmenting,cleaning,and processing 159 policy text data,various key areas and core topics of higher medical education policy content were ultimately condensed into 15 themes,which were classified into 8 categories based on their relevance,namely: medical graduate training;Construction of grassroots medical talent system;Standardized management of medical education;Quality management of medical education;Medical education guarantee system;Ideological and political construction of medical education;Training of Traditional Chinese Medicine Talents;Standardized training for resident physicians.And it was found that in the four stages,8 types of policy themes changed with different focuses in each period,and the content included under the policy themes of higher medical education also showed a gradual development.In addition,through the analysis of the changing process of different themes over time,the development trend of the themes was determined,and it was predicted that "medical graduate training","traditional Chinese medicine talent training",and "standardized training of resident physicians" will become the main directions of future higher medical education policies,clarifying the policy development path to a certain extent.When answering ’How did you do it?’,considering factors such as policy effectiveness,14 typical and representative policy texts from 2001 were selected for policy effectiveness analysis,including X1(policy nature),X2(policy effectiveness),X3(policy perspective),X4(policy focus),X5(policy area),X6(policy receptor),X7(incentive measures),X8(policy function),X9(policy evaluation)X10(policy citation)establishes a quantitative evaluation framework for the PMC index model policy from ten dimensions to clarify the effectiveness and shortcomings of higher medical education in China.It is found that the overall design of higher medical education policy is relatively reasonable,and the advantages of policy design are relatively obvious.However,there are still areas for optimization in the four aspects of policy design: X2(policy effectiveness),X7(incentive measures),and X8(policy implementation).Based on the above analysis and summary,this study believes that in the future,China’s higher medical education policies should be mainly optimized from four aspects: firstly,adhering to the leadership of the Party and promoting the continuous development of China’s higher medical education;Secondly,strengthen inter departmental coordination and cooperation to enhance policy synergy;Thirdly,adopt policy tools scientifically and appropriately to improve the effectiveness of tool use;The fourth is to optimize and improve policy content and improve the policy system.