目的：探索高职院校智慧健康养老服务与管理专业在人才培养中的现实困境及优化路径。方法：采用便利抽样法，对江苏省某高职院校该专业的279名学生开展问卷调查和质性分析，运用量化描述性统计与质性主题编码法，评估学生对专业核心能力自评、职业认知及对人才培养方案的评价。结果：能力认知特征：学生的专业核心能力各维度自评呈非均衡性分布（均值为3.92-4.05分），其中沟通能力（4.05分）得分最高；64.50%的学生认可专业价值，82.80%的学生担忧工作中的复杂人际互动。培养困境：课程内容存在“更新时滞”，56.63%认为教学内容陈旧，69.18%学生认为实用高阶能力训练不足；实践环节存在“硬件代差”，61.65%学生认为实习机会短缺、岗位单一；软能力培养存在“去情境化”倾向，前沿硬能力教学滞后于行业数智化发展，48.03%学生对软能力训练评价“一般”。结论：养老产业需求和人才培养体系之间存在结构性错位，需要通过建设智慧化实训平台、开展情境化综合训练、推行项目式学习等路径，促进人才供给与产业升级的协同发展。

Objective：To investigate pedagogical challenges in the Smart Healthcare and Elderly Care Management major and develop student-centered optimization strategies in higher vocational colleges. Methods：A mixed-methods approach was implemented among 279 vocational students，evaluating core competencies，vocational cognition，and training effectiveness. Results：Students' self-assessments of their core professional competencies showed an uneven distribution across dimensions（mean scores ranged from 3.92 to 4.05），with communication skills（4.05 points）receiving the highest score. While 64.50% perceived professional value，82.80% reported concerns about complex interpersonal interactions. Key challenges comprised insufficient practical training（69.18%），outdated content（56.63%），scarce internships（61.65%），and mediocre soft skill cultivation（48.03%）. Conclusion：The findings revealed a structural misalignment between training and industry needs. Developing intelligent simulation platforms，scenario-based training，and project-based learning are recommended to better synchronize talent supply with industrial upgrading.