Abstract: The reform of practical teaching in China's medical higher vocational colleges is studied by refering to Germany's “dual system” vocational education model through a questionnaire among 1,707 teachers and students from medical higher vocational colleges across 18 provinces (municipalities) nationwide. The results reveal four major issues in practical teaching at domestic medical higher vocational colleges: restricted faculty development; rigid practical teaching models; outdated textbook reforms with delayed updates; and uneven allocation of teaching resources. Optimized pathways at four dimensions are proposed: empowering teaching faculty development and talent cultivation; reconstructing a virtuous practical teaching system; establishing a three-dimensional dynamic textbook renewal ecosystem; and implementing equipment modernization and resource-sharing mechanisms. The study aims to provide theoretical references and practical guidance for the reform of practical teaching in China's medical higher vocational colleges, facilitate the cultivation of high-quality medical skilled talents meeting primary healthcare needs, promote high-quality development of medical vocational education, achieve precise alignment between vocational education and the primary healthcare sector, and ultimately enhance the service capacity of China's primary healthcare system.

Key words: vocational education, medical vocational colleges, German's dual system, practical teaching