【摘要】 1978-2018年我国高等医学教育政策变迁,从历史分析来看,主要表现为以政府为主导的自上而下的强制性政策变迁,呈现出渐进性与断裂性更替的变迁轨迹。回报递增形成了制度的路径依赖,而关键行动者和关键性节点的重要作用导致了制度的断裂。从结构分析来看,高等医学教育政策的演变是在与环境、制度和行动者三者彼此制约和互动影响中的变迁。宏观背景的改变是政策变迁的诱因和外部压力,微观行动者间的互动是政策变迁的内生动力,外部压力和内生动力在制度复合体中融合并形成合力最终导致政策变迁。高等医学教育发展变革应进一步提升人才培养质量,坚持精英化理念和注重本土化构建。更多还原

【Abstract】 From the perspective of historical analysis, policy changes of higher medical education in China from 1978 to 2018 were mainly manifested as changes in government-led top-down compulsory policies, which showed a progressive and ruptured track featuring. The progressive increase in return gives rise to path dependence on institution, while important role played by key actors and key points leads to the rupture of institution. In terms of structural analysis, evolution of higher medical education policy is the change arising from mutual restriction and interaction among environment, institution and actors. Changes in macro-background are inducement and external pressure for policy change. Interaction between micro actors is endogenous impetus for policy change. And external pressure and endogenous impetus are mixed into a force in institutional complex and result in policy change. For the development and reform of higher medical education, it is suggested to further improve the quality of personnel training, adhere to elitism and focus on localization.更多还原