The evolution and improvement of medical-vocational education policies: a perspective based on the IAD framework

With the increasing aging population, society urgently needs a group of experienced medical professionals. However, current medical vocational education faces many difficulties. Only by formulating scientific, medical, and vocational education policies can we effectively promote the modernization of medical and vocational education. Therefore, it is imperative to streamline policy changes. This study focuses on China's medical-vocational education policy and first divides the policy into four stages. Text analysis methods, such as clustering, examine the key challenges and primary characteristics of policies at various stages of development. Next, the Institutional Analysis and Development (IAD) framework was employed to construct a policy change model and to thoroughly examine the policy change mechanism from the perspectives of natural attributes, community attributes, and application rules. Finally, corresponding countermeasures and suggestions are put forward in response to the shortcomings in developing medical vocational education policies. The research found that the changes in China's medical-vocational education policy show a progressive evolution path of "natural attributes-community attributes-institutional rules." The driving force behind the three changes stems from the coordinated evolution of exogenous variables, adjustments in institutional attributes, and changes in actor interaction modes. In essence, it is the dynamic adaptation of the institutional system to changes in the external environment. The government should continually adapt to the evolving needs of the medical industry and effectively support economic development, a crucial requirement for advancing medical-vocational education. At the same time, it should actively promote the integration of industry and education, as well as cooperation between medical schools in medical vocational education, and actively integrate with international medical vocational education.