Categorising drivers of curriculum renewal in entry-to-practice health professional education: A scoping review.

Abstract

Introduction: Renewing a health professional education (HPE) curriculum is a significant undertaking, requiring substantial effort and resourcing. However, the factor(s) that should initiate a curriculum renewal remain contentious, and the methods to best assess them are unclear. To begin answering these questions, a comprehensive view of the scope of potential renewal drivers is needed, thus enabling structured inquiry into these (and their interactions) while ensuring no driver categories are being inadvertently overlooked. It would similarly serve as an important checklist for individual institutions undergoing renewal. However, no such list has ever been formulated in a data-driven way. Thus, this scoping review aimed to document the full range of real-world drivers of HPE curricular renewal and create an overarching categorisation of these.

Methods: A systematic search was conducted of the Embase, Medline/PubMed, Global health and CINAHL databases for studies published between 2013 and 2023 describing a completed single-institution curriculum renewal of an entry-to-practice HPE degree. Following independent screening, articles were reviewed and 'extent of renewal', 'renewal characteristics' and the 'initiating driver(s)' of renewal were extracted. Descriptive statistics were generated, and qualitative content analysis performed to generate a categorisation of renewal-initiating drivers.

Results: The search identified 1408 potential manuscripts, and 239 publications describing 247 renewals were analysed. Forty percent were whole-of-degree renewals. Institutions from all continents were represented. Seventy-seven initiating drivers were identified and grouped into 10 categories: 'Regulatory reasons', 'Pedagogical improvements', 'Community/patient needs', 'Learner experience/satisfaction', 'Exceptional events', 'Learner outcomes', 'Industry benchmarking/reputation', 'Practical/business factors', 'Knowledge/skill issues' and 'Periodic renewals'. 'Regulatory reasons' were the most common reason for whole-of-degree renewals and 'knowledge/skill issues' for part-of-degree renewals.

Conclusions: HPE curricula renewals have a wide range of initiating drivers. The proposed categorisation of these should serve as a useful scaffold for institutional curricular review processes and also for directing future scholarly inquiry into curricular renewal.