Celeste Foster, Emma Tague, Gary Winship, Sarah Doyle
{"title":"Teaching Relational Care for Health Inequalities: Evaluating the Impact of a Program for Community Nurses and Midwives in Primary Care.","authors":"Celeste Foster, Emma Tague, Gary Winship, Sarah Doyle","doi":"10.1097/CEH.0000000000000675","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000675","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xu Liu, Junrui Pu, Mengmeng Han, Wenfeng Xiao, Hong Zhu, Yusheng Li, Siyu Liu
{"title":"Mapping the Global Research Landscape of Continuing Medical Education and Related Continuing Education for Health Professionals Since 1999: A Bibliometric Analysis.","authors":"Xu Liu, Junrui Pu, Mengmeng Han, Wenfeng Xiao, Hong Zhu, Yusheng Li, Siyu Liu","doi":"10.1097/CEH.0000000000000676","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000676","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wendy Kinton, Laine Chilman, Catherine Joyce, Greg Parker, Florin Oprescu, Laura Burritt
{"title":"\"A Role You can Fill\": Education Legitimizes Allied Health and Nursing Roles in Advance Care Planning: A Mixed Methods Study.","authors":"Wendy Kinton, Laine Chilman, Catherine Joyce, Greg Parker, Florin Oprescu, Laura Burritt","doi":"10.1097/CEH.0000000000000659","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000659","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan Sprague, Sean Powell, Sarah Shimer, Craig Robbins, Carol Cain
{"title":"Implementing Quality Improvement Projects Across A Large Integrated Health Care System: Lessons from an ABMS Portfolio Program Sponsor.","authors":"Megan Sprague, Sean Powell, Sarah Shimer, Craig Robbins, Carol Cain","doi":"10.1097/CEH.0000000000000657","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000657","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joanne Goldman, Farah Friesen, Tara Burra, Lindsay Baker, Maria Tassone, Stella L Ng
{"title":"Teaching About Social Practices and Structures in Continuing Professional Development: A Multiple Case Study in Quality Improvement and Interprofessional Collaboration.","authors":"Joanne Goldman, Farah Friesen, Tara Burra, Lindsay Baker, Maria Tassone, Stella L Ng","doi":"10.1097/CEH.0000000000000661","DOIUrl":"10.1097/CEH.0000000000000661","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sean T Massa, Aidan A Ruth, Meher Arora, Jennifer Cash, Jamil R Neme, Brady Wahlstrom, Kristina Dzara
{"title":"Academic Identity of Clinician-Educators After Clinical Practice Ownership Transition.","authors":"Sean T Massa, Aidan A Ruth, Meher Arora, Jennifer Cash, Jamil R Neme, Brady Wahlstrom, Kristina Dzara","doi":"10.1097/CEH.0000000000000669","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000669","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>Supporting clinician-educator academic identity is core to fostering a culture of academic and educational excellence during mergers.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Health Practitioners Learners Differ from Other Learners in Recovery College Courses: An Outcomes Study.","authors":"Julie Bellemare, Catherine Briand, Eugénie Samson-Daoust, Filippo Rapisarda, Galaad Lefay","doi":"10.1097/CEH.0000000000000663","DOIUrl":"10.1097/CEH.0000000000000663","url":null,"abstract":"<p><strong>Introduction: </strong>Health practitioners often work in high-pressure environments with time constraints, organizational demands, and emotional stressors, leading to burnout, psychological distress, and non-recovery-oriented practices. Recovery Colleges (RCs) are learning centers that promote recovery-oriented practices and wellbeing among diverse learners, including health practitioners. However, little quantitative research has examined outcomes for health practitioners in RCs. This study compares outcomes of health practitioner learners with other learner types in an RC course.</p><p><strong>Methods: </strong>A preexperimental, one-group pretest-posttest design with repeated measures was used. A total of 434 learners completed questionnaires assessing wellbeing, anxiety, resilience, and stigma at three time points. Sociodemographic data were also collected.</p><p><strong>Results: </strong>Health practitioners are more likely to hold a master's degree, work full-time, and possess a higher proportion of clinical and theoretical knowledge. Linear mixed models revealed significant effects of time on wellbeing (P < 0.001), anxiety (P < 0.001), resilience (P = 0.011), and stigma (Disclosure/Help-seeking: P < 0.001). Differences were found by learner type for wellbeing (P = 0.004), anxiety (P < 0.001), resilience (P = 0.015), and stigma (Attitudes: P < 0.001; Social Distance: P = 0.032). Health practitioner reported higher wellbeing and resilience, and lower anxiety and stigma scores (Attitudes and Social Distance) than other learners. No significant interaction was found between time and learner types.</p><p><strong>Discussion: </strong>Despite baseline differences and varying sociodemographic profiles, health practitioner learner outcomes are comparable with those of other learners. RC courses support mental health and recovery-oriented practices that address stigma and complement other continuing professional development activities.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy J Wood, Ripa Akter, Douglas Archibald, Merelle Tadros, Scott Rauscher, Susan Humphrey-Murto
{"title":"Evaluating the Short and Long-term Effect of a Health Professions Education Certificate Program for Clinical Faculty.","authors":"Timothy J Wood, Ripa Akter, Douglas Archibald, Merelle Tadros, Scott Rauscher, Susan Humphrey-Murto","doi":"10.1097/CEH.0000000000000664","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000664","url":null,"abstract":"<p><strong>Introduction: </strong>Although faculty development programs are widely implemented and evaluated, there is a need to move beyond short-term outcomes with a focus on local contexts. This study applied the New World Kirkpatrick Model to conduct a structured, theory-informed evaluation of a longitudinal certificate program for clinical faculty and senior trainees.</p><p><strong>Methods: </strong>The Healthcare Education Scholars Program, is an eight-month longitudinal certificate program at the University of Ottawa developed to address career advancement, professional identity, and educational leadership by offering clinical faculty and senior residents structured training in these topics. A retrospective survey was sent to 209 graduates (2009-2023). Quantitative data were descriptively analyzed, and open-ended responses were coded and mapped to the Kirkpatrick levels.</p><p><strong>Results: </strong>The response rate was 35%. Respondents reported high satisfaction with course organization and content (Level 1). Most respondents perceived gains in teaching skills and curriculum development (Level 2), with many applying these skills in educational roles and scholarship (Level 3). Career advancement, leadership roles, and enhanced professional identity were also reported (Level 4).</p><p><strong>Discussion: </strong>This theory-informed evaluation responds directly to calls for more rigorous, mechanism-oriented curriculum research by demonstrating how the New World Kirkpatrick Model can illuminate learning processes, behavior change, identity development, and career advancement within a longitudinal faculty development program. Future research should explore comparative outcomes and strategies to enhance inclusivity and improve scholarly productivity.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julien Galant, Estelle Pilarczyk, Alexandre Niggel, Pierre O Vidal, Pierre Balaz, Nicolas Cazes, Cédric Boutillier du Retail, Aurélien Renard
{"title":"A Theory-Informed Escape Game Integrating Human Factors in Trauma Continuing Professional Development: A Kirkpatrick Level 2 Evaluation.","authors":"Julien Galant, Estelle Pilarczyk, Alexandre Niggel, Pierre O Vidal, Pierre Balaz, Nicolas Cazes, Cédric Boutillier du Retail, Aurélien Renard","doi":"10.1097/CEH.0000000000000666","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000666","url":null,"abstract":"<p><strong>Introduction: </strong>Educational escape games are increasingly used in health professions education, yet most studies focus on undergraduate learners and report primarily satisfaction or short-term knowledge outcomes. Evidence regarding theory-informed escape game design targeting human factors in continuing professional development (CPD) remains limited.The aims of this study were to evaluate the educational impact of a theory-informed, traumatology-focused escape game integrating technical and human factors competencies, using perceived self-efficacy as a Kirkpatrick Level 2 outcome.</p><p><strong>Methods: </strong>We conducted a pre-post study across multiple CPD settings involving 81 emergency physicians, nurses, and trainees. The intervention was structured around the MARCHE algorithm and informed by experiential learning theory. Participants completed a seven-item self-efficacy questionnaire before and after the session.</p><p><strong>Results: </strong>Significant improvements were observed across all technical and nontechnical domains (P < .001), with moderate to large effect sizes (r = 0.57-0.86). Experienced clinicians demonstrated gains primarily in nontechnical skills, whereas less experienced participants improved across all domains.</p><p><strong>Discussion: </strong>A theory-guided escape game may represent a structured approach to reinforcing human factors in trauma CPD. Although limited to self-reported outcomes, these findings suggest that escape games can extend beyond engagement to support targeted nontechnical skills development in experienced clinicians.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Healers to Leaders: A Qualitative Study of Career Paths and Influencing Factors in Chief Physician Roles in Finnish Health Care.","authors":"Sari Huikko-Tarvainen, Kimmo Tarvainen","doi":"10.1097/CEH.0000000000000667","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000667","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined the career trajectories of chief physicians to identify factors influencing advancement into leadership roles and to inform physician leadership development.</p><p><strong>Methods: </strong>Qualitative interviews with 15 hospital-based chief physicians were analyzed using inductive content analysis and thematic categorization.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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).</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}