INTRODUCTION:Interprofessional education (IPE) remains an important component of curriculum training among health and allied health trainees. Additional research is needed regarding the challenges for facilitators in implementing such educational endeavors. METHOD:Therefore, this qualitative study examined the perspectives of those leading the IPE process and facilitators in planning and implementing an online real-time (synchronous) university-based IPE curriculum. RESULTS:Respondents (n = 7) described the following nine themes that facilitated or challenged the planning and implementation of the IPE curriculum: (1) shared vision and commitment to implementing IPE, (2) emphasizing core competencies in interdisciplinary collaboration, (3) engagement and effort, (4) importance of buy-in, (5) maximizing experiential education, (6) balancing faculty involvement and expectations in IPE development, (7) balancing educational content for diverse experience levels, (8) challenges in staffing continuity for sustaining IPE initiatives, and (9) need for dedicated leadership and resources in IPE implementation. DISCUSSION:These findings explore IPE implementation among a unique constellation of professions that are rarely included in IPE literature and can provide insight for starting, re-evaluating, and improving IPE education and practice.
INTRODUCTION:Implicit bias contributes to health care disparities. Addressing implicit bias is one focus of health professions education and learners desire instruction in the topic. Few faculties received skills-based instruction in addressing implicit bias during their own education and training and often feel ill-equipped to facilitate this instruction. Recognizing faculty are both learners and teachers in addressing implicit bias, the authors developed a longitudinal faculty development program informed by the implicit bias recognition and management (IBRM) framework. METHODS:The program, IBRM for Faculty (IBRM4Fac), comprised 8 sixty-minute sessions delivered virtually from November 2020 to March 2021 at an academic safety-net health system. Program goals were skills development, including restoring rapport with patients, debriefing biased encounters, and addressing bias from patients. An external expert in IBRM led each session; materials included slides, worksheets to guide skills-development, and an audience response system. The mixed-methods program evaluation used preprogram/postprogram surveys. RESULTS:Approximately 50 faculty primarily from the department of medicine were invited to participate in the program, N = 17 (34%) participated. Significant improvements occurred in 9/10 surveyed domains of IBRM (P < .05). Narrative responses analyzed through reflexive thematic analysis yielded three themes: (1) Personal strategy development; (2) Personal obstacles to sustained organizational change; and (3) Systemic barriers to sustained organizational change. DISCUSSION:IBRM4Fac enhanced faculty confidence in addressing implicit bias, and helped faculty overcome identified challenges to implement strategies for teaching, role-modeling, and systems change in addressing implicit bias. Despite a small sample, our program could inform faculty development in addressing implicit bias in clinical and teaching encounters.
INTRODUCTION:Continuing medical education (CME) and related continuing education for health professionals support lifelong learning and professional competence, yet a comprehensive synthesis of this CME-centered literature remains limited. METHODS:A bibliometric analysis was conducted using the Web of Science Core Collection. Original articles and reviews published since 1999 were retrieved. VOSviewer, CiteSpace, and R were used to analyze publication trends, national and institutional contributions, coauthorship networks, reference cocitation, and keyword evolution. RESULTS:A total of 1567 publications were identified. Annual publication output followed a quadratic growth pattern and accelerated substantially after 2019. The United States had the highest publication output, while emerging countries such as China showed rapid growth. Institutional analysis highlighted the role of academic medical centers, particularly the University of Toronto and its affiliated University Health Network. CME studies were mainly published in medical education and continuing education journals, including the Journal of Continuing Education in the Health Professions, BMC Medical Education, and Medical Teacher. Cocitation analysis showed that the knowledge base of CME research is grounded in early evidence evaluating CME effectiveness and later educational evaluation frameworks. Keyword analyses indicated a recent shift toward continuing professional development. DISCUSSION:Research on CME and related continuing education for health professionals has expanded substantially over the past two decades and is increasingly embedded within a broader framework of professional learning and competency development. The growing prominence of continuing professional development reflects an evolving emphasis on lifelong learning, performance improvement, and the integration of education with health care system outcomes.
INTRODUCTION:Internationally, nurses need to learn and develop relational skills that enable them to engage therapeutically with patients. Relational skills are crucial in contexts of socioeconomic deprivation, where patients face high levels of adversity, inequality, and poor health. They are defined as the interpersonal skills needed to bring about clinical change, while also enhancing staff well-being and support. Educators continue to grapple with how best to design and deliver educational programs that enhance relational skills in the nursing workforce. We report on a realist evaluation of a psychodynamically informed relational care educational program for primary care nurses, identifying outcomes, impacts, and mechanisms of change. METHODS:Mixed methods with a prospective cohort, within a realist evaluation framework. Predefined outcomes were assessed at pre, mid, post, and 3-month follow-up, using validated measures (Professional Quality of Life V and Therapeutic Relationship Assessment Scale-Nursing). The context and mechanisms through which outcomes were realized, and impacts were investigated through multiple data sources over the course of the program. RESULTS:Statistically significant increases were observed in compassion satisfaction, self-awareness, and knowledge. Reductions were observed in burnout and secondary traumatic stress. Empathy toward service users increased. Participants reported multiple well-being and patient-focused impacts associated with program engagement. Early indicators suggest these were sustained over time. DISCUSSION:Results highlight the value and impact of psychodynamically informed, relationally focused education approaches for staff working with service users experiencing high levels of health inequality and multimorbidities. A pedagogical model for effective delivery is presented. Future research should test the theory of change and outcomes under experimental conditions and long-term follow-up of outcomes.
INTRODUCTION:The implementation of advance care planning (ACP) has traditionally been confined to medical officers and specialist nurses. This study evaluated the effect of a multimodal Advance Care Planning Education (ACPEd) program for allied health professionals and generalist nurses. METHODS:Conducted within a regional health service in Queensland, Australia, the study used a single-arm, explanatory sequential mixed methods design involving 30 participants completing a three-hour workshop, and a learning circle attended by 10 participants. Quantitative data were collected through preintervention and postintervention surveys assessing perceived confidence, knowledge, skills, and role legitimacy. Qualitative data from the learning circles explored changes in clinical practice and role identity. RESULTS:Significant improvements were observed in confidence, t (29) = -7.820, P= <.001; knowledge, t (27) = -12.87, P= <.001; and skills, t (29) = -6.814, P= <.001. There was no significant change in perceived health professional roles, t (26) = 2.182, P= .19, indicating a strong belief that all health professional groups have a role in ACP. Three overarching themes emerged: prioritizing ACP, recognizing role legitimacy, and evolving perspectives on engagement. Despite persistent barriers including time constraints and team dynamics, participants demonstrated increased capacity and intent to initiate ACP discussions, with the ACP Tracker a key facilitator for clinical care. DISCUSSION:The findings suggest that targeted, interprofessional education may support the development of role identity and legitimacy for ACP among allied health professionals and generalist nurses. The ACPEd program is a scalable model for embedding ACP into practice, with implications for policy and professional development.
INTRODUCTION:Kaiser Permanente's National Quality Improvement (QI) Continuing Certification/Maintenance of Certification Program, an American Board of Medical Specialties Portfolio Program Sponsor, engages physicians in clinical improvement through organization-specific QI projects that fulfill continuing certification/maintenance of certification requirements. This study describes the program's structure, project development, and design choices that increase physician participation and organization-wide impact, and how this structure is applicable to many different types and sizes of health care organizations. METHODS:The program integrates national and regional leadership, with projects originating from grassroots (local leaders) and executive (national initiatives) levels. Data were collected through physician self-attestations on outcomes and reflections, aggregated and analyzed quantitatively and qualitatively at multiple levels. Case studies illustrate key success factors. RESULTS:Over 13 years, 7145 physicians have completed projects, with 88% meeting improvement thresholds. In 2024, 375 physicians engaged in 42 different projects, with 85% achieving at least one project goal. Case studies of grassroots and executive projects showed comparable clinical improvements, with 94% and 86% achievement rates, respectively. DISCUSSION:Engaging physicians in synergistic projects that support organizational priorities increases the impact of individual contributions. Flexibility in design and collaboration between regional and national teams are critical to effectively drive physician engagement and improvement. Supporting both grassroots and executive level QI projects allows for tailored interventions and broad alignment, enhancing physician participation and patient care.
ABSTRACT:Generative AI is rapidly evolving with the potential to change the way we think about and provide continuing professional development (CPD) and faculty development (FD), yet educators may lack practical and theoretically informed guidance for its integration. This Forum article introduces the Pedagogical-Ethical-Preparation-Creative-Administrative-Large Data (PEPCAL) framework to support CPD/FD leaders in teaching about and using GenAI. Developed from the authors' international teaching experience in GenAI, evolving literature, and inductive feedback, PEPCAL provides a heuristic matrix with two intersecting axes: how we begin to teach GenAI (Pedagogical Design, Ethical Considerations, and Preparation/Practical Application) and how health professions educators may use GenAI in their teaching (Creative Applications, Administrative Educational Tasks, and Large Data Insights). The framework highlights opportunities for GenAI to enhance multimodal learning, curriculum design, feedback, and data-informed decision-making, while building a foundation in ethics, environmental impact, pedagogical design, and avoiding deskilling and burnout. PEPCAL is intended to complement existing CPD frameworks and learning theories, prompting educators to move from tool-driven experimentation toward education-first adoption, adapting to different educational contexts in CPD and FD. The authors have found it helpful in training CPD/FD providers to responsibly implement, evaluate and iteratively refine GenAI-enabled CPD/FD, as well as help foster conversations around complex and evolving sociotechnical issues.
Introduction: Continuing professional development (CPD) about social processes and structures (eg, power relations, organizational policies) in health care has been minimally explored. This study examined the teaching of social practices and structures in the domains of interprofessional collaboration and quality improvement, and the education paradigms used, with particular attention to transformative education. Methods: This case study included three CPD cases at two university-affiliated Centres. Data collection included observations (n = 42.5 hours), interviews with program/Centre leads and guest presenters (n = 13), and documents. Paradigms of education informed the interpretive thematic analysis conducted. Results: A range of concepts related to social practices and structures were introduced across sessions (eg, systemic racism, unconscious bias). An examination of education purpose, role of teacher-learner, and teaching modalities, demonstrated that varied paradigms of education (eg, cognitivist, constructivist) were drawn on to teach these topics, with efforts toward transformative approaches. Programs were largely oriented to practical learning and application, with the teacher positioned as expert or learners being encouraged to interact with, and learn from each other. However, participants recognized additional education purposes aligned with a transformative paradigm, to question and shift learners' perspectives, making efforts to align teacher-learner roles and learning modalities. There were tensions, though, working across paradigms; session formats and learner/sponsor expectations influenced paradigms used. Discussion: Findings provide insights to how to incorporate content about social practices and structures into interprofessional collaboration and quality improvement CPD. Given the multiple and sometimes competing education goals, positioning paradigms of education as coexisting layers may be more effective than viewing them as mutually exclusive.
INTRODUCTION:The academic identity of clinician-educators is critical to supporting the broader mission of health care organizations. Mergers are increasingly common, but when private and academic institutions merge, they may threaten clinician-educator academic identity and negatively impact their work as educators. The effect of these mergers on academic identity-specifically for clinical educators-has not been systematically investigated. We aim to understand the effect of a merger between our academic institution and a not-for-profit regional health care system on the academic identity of clinician-educators. METHODS:Two theories of organizational change framed our qualitative interview study. A semistructured interview guide was designed following the theoretical framework elements. Fifteen academic clinician-educators who experienced the merger were invited to a Zoom interview. Selected candidates were at the academic rank of Professor or Associate Professor, were noted to have leadership roles within the academic institution and represented varied clinical specialties including surgical, medical, hospital-based, and clinic-based disciplines. Data were coded using deductive directed content analysis to identify professional identity-related response patterns that would illuminate potential change in identity, consideration of alternative employment, shift in motivation, or reduced organizational loyalty. RESULTS:The data coalesced into the four theoretical framework elements. Clinician-educators articulated their transition reactions, detailed how they define their identity, noted varying degrees of continuity perceptions, and articulated resistance considerations and actions. The initial uncertainty and workplace changes were distracting and may weaken clinician-educator academic identity. DISCUSSION:Supporting clinician-educator academic identity is core to fostering a culture of academic and educational excellence during mergers.
INTRODUCTION:This study examined the career trajectories of chief physicians to identify factors influencing advancement into leadership roles and to inform physician leadership development. METHODS:Qualitative interviews with 15 hospital-based chief physicians were analyzed using inductive content analysis and thematic categorization. RESULTS:Four main career path types emerged: (1) planners systematically preparing for leadership through education and interim roles; (2) opportunists advancing by seizing emerging opportunities, often with external encouragement; (3) reluctant leaders initially avoiding leadership but transitioning because of circumstances or mentorship; and (4) challengers pursuing leadership to challenge themselves or improve systems. DISCUSSION:These paths illustrate the multifaceted, context-dependent nature of physicians' leadership progression, reflecting a gradual shift from clinical expertise to leadership roles shaped by intrinsic motivations (desire for effect, growth, and change), professional identity dynamics (including clinical legitimacy and identity reconciliation), perceived leadership competence (self-efficacy, preparedness, education, and training), and organizational context (mentoring, culture, and structural opportunities and challenges).
INTRODUCTION:The war in Ukraine has disrupted health and education systems, limiting access to in-person continuing education at a time of increasing rehabilitation needs. Courses on an online learning platform were expanded and translated into Ukrainian to support both immediate and long-term professional development. This study examined how rehabilitation professionals and educators engaged with an online learning platform and how they perceived its relevance for clinical practice and teaching. METHODS:A convergent mixed-methods design was used. Data were collected from platform analytics, an anonymous online survey, and semistructured interviews. Platform analytics captured participation and completion trends after the translation of more than 400 courses into Ukrainian. The survey (n = 231) explored course selection, application of new knowledge, barriers and facilitators to implementation, and perceived practice changes. Interviews (n = 8) provided deeper insight into how participants integrated online learning into clinical care and education. Quantitative and qualitative data were analyzed separately and integrated during interpretation. RESULTS:Between October 2024 and September 2025, 2189 Ukrainian users completed 21,647 courses, including 11,784 completed in Ukrainian translation. Survey respondents self-reported greater confidence, improved use of evidence-informed decision making, and changes in clinical and teaching practices. Common barriers included limited equipment and difficulty adapting content, whereas facilitators included course relevance, language accessibility, and personal motivation. Interview analysis generated two themes: translating online learning into complex case management and enhancing classroom teaching through online resources. DISCUSSION:This case highlights engagement with accessible, contextually adapted online learning supported professional development and knowledge sharing during a period of significant system disruption.
BACKGROUND:Feedback is fundamental to health professions education and essential for workplace-based assessment. Unfortunately, most educators lack formal training and access to evidence-based programs that incorporate experiential learning and real-time interactions. OBJECTIVE:This study investigates the extent to which feedback delivery ratings provided by artificial intelligence (AI)-powered avatars are considered acceptable and reliable in comparison with feedback delivery ratings created by faculty participants and peer observers. METHODS:After an interactive lecture on high-quality feedback, participants worked in small, facilitated four-person groups to deliver feedback in structured scenarios using AI-powered avatars. After each scenario, participants, peers, and the avatar independently rated feedback delivery using the DOCS-FBS scale (1-3; 1 = not done, 3 = successfully done). Scenario complexity was assessed with a nine-item scale (1-4; 4 = most complex). Multisource feedback ratings, postsession surveys, and group debrief data were analyzed with descriptive statistics, paired-sample t tests, and analysis of variance. RESULTS:Participants rated session quality as very good (38%) or excellent (62%). Most found avatar-based feedback practice very or extremely effective (82%) and expressed strong interest in future avatar training (80%) and postworkshop access (74%). Participants reported high engagement and valued detailed rationales from the avatar. Peer observer ratings (2.82 ± 0.08) were significantly higher than both self-ratings (2.53 ± 0.39, P < .001) and avatar ratings (2.62 ± 0.32, P < .001). No differences emerged between self and avatar feedback delivery ratings. CONCLUSIONS:Using AI-powered avatars in feedback training sessions provide reliable feedback delivery ratings, are well received by participants, and can serve as a pragmatic solution for those leading professional development efforts.
INTRODUCTION:Pediatric advance care planning is an iterative process that supports families in sharing their values, hopes, and preferences for their child's future medical care. Advance care planning rarely occurs in the neonatal intensive care unit (NICU), and if it does, it is often without the benefit of high-quality practitioner training. We evaluated a multimodal, high-fidelity pediatric advance care planning training for NICU and palliative care practitioners. METHODS:We conducted a pilot evaluation study of the Respecting Choices® Next Steps Family-Centered Pediatric Advance Care Planning facilitator training. Training included online modules, live class, and mock interviews with standardized patients. Learners reported self-efficacy, barriers, and utilization before, after, and 3 months after training. Analysis included paired t tests adjusted for multiple tests. RESULTS:A total of 18 practitioners completed the training and certification. Advance care planning self-efficacy increased after training (difference = 0.68, 95% CI [0.34 to 1.0]) and remained stable after 3 months (difference = 0.03, 95% CI [-0.24 to 0.3]). Practitioners' confidence in performing individual steps of advance care planning increased significantly 3 months after training compared with baseline. Eleven learners reported applying learned skills in their practice, and six learners reported facilitating advance care planning with 13 families. DISCUSSION:Pediatric advance care planning facilitator training was effective and used by an interdisciplinary group of practitioners working in the NICU. Future work includes incorporating advance care planning into NICU workflow, supporting skill maintenance, and studying effect on patient care.
ABSTRACT:Artificial intelligence (AI) is transforming how health care professionals develop, maintain, and express competence across the span of their careers. Traditional continuing professional development has been shaped by a paradigm of what has been called cognitive scarcity (or informational resource scarcity) where clinicians had limited opportunity to find, read, synthesize, and interpret evidence, and learning systems evolved to deliver knowledge in periodic, curated updates. Emerging AI systems-large language models, multimodal analytic tools, predictive algorithms, and reflective agents-disrupt this scarcity by creating cognitive abundance (or informational resource abundance). These systems generate real-time evidence syntheses, contextual insights, adaptive learning trajectories, and continuous performance feedback. Using ten Cate et al.'s (2024, Medical competence as a multilayered construct. Med Educ , 58, 93) multilayered model of competence-canonical, contextual, and personalized-this paper analyzes how AI can both enhance existing educational processes and fundamentally reshape the developmental landscape. AI shifts clinicians from being knowledge stewards to orchestrators of distributed cognition, from experiential learners to data-informed practitioners, and from using opportunistic continuous personal development to continuous reshaping of professional identity. Continuing professional development must evolve to cultivate AI literacy, hybrid reasoning, interprofessional coherence, and ethical stewardship in work environments where cognition is abundant. The contents of long-term memory of clinicians will shift from a predominance of biomedical facts needed to steer daily clinical work, to new procedural inquiry skills needed to find, select, and evaluate the validity of information for clinical decision making.
INTRODUCTION:Physicians who successfully integrate into their rural community are more likely to remain, yet little is known about whether international medical graduates (IMGs) face unique challenges in navigating the process of integration compared with locally trained physicians. This study explores how new-to-rural-practice Canadian medical graduates (CMGs) and IMGs in British Columbia experience the integration process. METHODS:Participants included CMGs and IMGs new to rural practice in British Columbia. Participants completed a semistructured interview and data was analyzed using a deductive coding process. RESULTS:Twelve CMGs and 10 IMGs participated. Integration involved two complementary processes: learning how to navigate the contextualized, varied demands of rural practice and identifying as a member of the community. IMGs tended to face a steeper learning curve to meet their community's needs. Some physicians navigated integration by seeking local mentorship. DISCUSSION:This study suggests that CMGs and IMGs navigate a similar integration process but IMGs face additional barriers in doing so. Mentors are a promising means to support integration, especially for IMGs and CMGs unfamiliar with rural living, by building professional competence and facilitating social identification.
Clinicians and nonclinicians, such as recovery coaches and care navigators, serve important roles in addiction treatment. Literature is limited regarding what interprofessional training is needed to care for clients with opioid use disorder (OUD). The Kentucky Opioid Overdose Prevention and Education Network (KY-OPEN) is a virtual education series developed as part of the HEALing (Helping End Addiction Long-Term) Communities Study providing education on evidence-based practices for treating OUD. This article describes KY-OPEN's development, curriculum, engagement, and early impact. KY-OPEN curriculum development aimed to ensure adequate interprofessional health literacy regarding fundamentals of OUD treatment. Participants were recruited through weekly newsletters distributed among study personnel and partnering community members. Six and 16-month post-launch surveys evaluated engagement, utility of KY-OPEN topics, and perceived confidence in skill development. The 68-session curriculum, delivered from January 2021 to June 2022, had a mean of 23 people attend each live session and 1713 asynchronous recorded session views during delivery. Survey results indicated high satisfaction with content, high professional relevance, and high confidence in addressing stigma, providing appropriate referrals, and educating others about OUD. Virtual interprofessional education can successfully engage and provide helpful training to clinicians and nonclinicians about OUD.
INTRODUCTION:Peer coaching is a promising strategy for continuing professional development for enhancing physicians' skills and mitigating burnout. Coaching may be particularly important for helping rural physicians maintain or extend their traditionally broader scope of practice, yet little is known about what motivates rural physicians to engage in coaching. To address this gap, the purpose of this study was to investigate rural physicians' motivation to participate in a peer coaching program. METHODS:This study analyzed semi-structured interviews with 22 rural physicians who participated in the Coaching and Mentoring Program offered by University of British Columbia's continuing professional development. Interviews, which were originally collected for program evaluation, were analyzed using template analysis within a constructivist framework. Deductive codes were informed by expectancy-value theory and self-determination theory, while inducive codes captured novel insights. RESULTS:Four key themes emerged: (1) Participants valued closing perceived gaps between their current skills and their evolving scope of practice; (2) credible and invested coaches fostered expectancies of success; (3) experiences during the coaching journey facilitated ongoing motivation; and (4) competing demands threatened ongoing motivation. DISCUSSION:This study suggests that coaching programs for rural physicians should be responsive to the varied demands that drive rural physicians to seek coaching and support meaningful coach-coachee interactions to foster sustained engagement. Future research should seek the perspective of non-participants and compare peer versus professional coaching models.
ABSTRACT:Artificial intelligence (AI) transforms how clinicians, teams, and patients make decisions and learn. That changes the activity systems in which continuing professional development (CPD) occurs. Most CPD scholarships focus on specific AI applications but lack frameworks to explain broader sociotechnical shifts across health care. This paper combines Cultural-Historical Activity Theory with a Unified Theory of Emergent System Evolution to examine how AI induces contradictions within and between activity systems and how those contradictions accelerate structural changes in learning, collaboration, identity, and governance. Cultural-Historical Activity Theory helps us observe how AI shapes tools, rules, roles, and community structures, whereas the four-phase evolutionary model describes how learning systems progress through recognizable developmental patterns: egocentric, technocentric, ecocentric, and holocentric. AI enhances transformation by amplifying tensions, creating new forms of distributed cognition across individual, team, organizational, professional, and societal levels, and ultimately, enabling expansive learning. The framework provides a conceptual toolset for designing learning ecosystems that are adaptive, relational, ethical, and resilient to changes in AI-enhanced clinical and CPD contexts.
INTRODUCTION:A research competent workforce is essential for embedding and sustaining evidence-based practice with health and care services. Despite strategic emphasis, many practitioners lack the confidence, skills, and opportunities to engage in research. This study explored the experiences of health and care practitioners from a range of clinical and nonclinical roles undertaking a project-based research internship. It aimed to identify key barriers and enablers to research engagement. METHODS:A qualitative study was conducted with participants engaged in a 12-month research internship program in the north west of England. Using normalization process theory as a framework, an online semistructured group interview was held with six interns postprogram. Data were analyzed thematically and mapped to normalization process theory domains: coherence, cognitive participation, collective action, and reflexive monitoring. RESULTS:Four themes were identified: discovering purpose from initial uncertainty; negotiating commitment and researcher identity; applying research practice within real-world contexts; and establishing a sense of research legitimacy. Subthemes provide nuance around clarifying expectations, balancing responsibilities, support structures, adapting to organizational constraints, and the internship as a foundation for future practice. DISCUSSION:The internship program successfully contributed to the development of confidence and researcher identity among novice practitioners. Engagement was maintained through supervision, peer interaction, and pastoral input from coordinators, while workload pressures and differing expectations across stakeholders created challenges. Future delivery should continue to prioritize supportive supervision, peer connection, and pastoral input, while also attending to alignment of expectations, reliable provision of protected time, and training timing that aligns with project milestones.
