Developing the Clinical Skills Training Tool: A Theory-Informed Framework to Strengthen Continuing Professional...

Continuing professional development (CPD) is essential for maintaining competency and quality in healthcare practice, yet low- and middle-income countries (LMICs) often lack practical guidance to design, implement, and sustain CPD programs. While implementation science frameworks provide theoretical structure, accessible tools to operationalize these frameworks for rehabilitation workforce development remain limited. This study describes the development and pilot testing of the Clinical Skills Training Tool (CSTT); a theory-informed, planning and evaluation tool to support contextually relevant CPD development for rehabilitation professionals.

The CSTT was developed using implementation science frameworks, including the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and the Consolidated Framework for Implementation Research (CFIR), and incorporated the Kirkpatrick model to guide CPD evaluation. The tool was piloted between 2021 and 2024 with multidisciplinary rehabilitation stakeholders in Myanmar, Ukraine, Uganda, and Pakistan. Data were collected through stakeholder workshops, structured planning activities, guided reflections, and evaluation of CPD programs developed using the tool. Qualitative framework-informed analysis was used to assess usability, feasibility, contextual adaptation, and implementation factors influencing tool use.

A total of 191 stakeholders participated in CSTT pilot implementation across 4 countries. The tool supported systematic identification of workforce training priorities, structured CPD program design, and development of evaluation strategies. CSTT-supported programs demonstrated improvements in stakeholder knowledge, clinical confidence, and adoption of structured evaluation practices. Stakeholders successfully adapted the tool across diverse health system contexts while maintaining fidelity to core planning processes. Iterative refinement improved usability, clarity, and sustainability guidance.

The CSTT operationalizes implementation science frameworks into a practical, adaptable tool to support CPD planning and evaluation in LMIC rehabilitation settings. By bridging the gap between implementation theory and workforce development practice, the CSTT provides a scalable approach to strengthening rehabilitation workforce capacity and supporting sustainable CPD systems across diverse global contexts.