Beyond novice-to-expert progression: a context-enabled continuing professional development framework derived from nursing practice in resource-constrained South African hospitals
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Maggie Nyelisani1, Lufuno Makhado2
1Department of Advanced Nursing Science, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa.
Abstract:
Continuing professional development (CPD) is frequently organised as a sequence of educational events directed at individual practitioners. In resource-constrained health services, however, participation and learning transfer are shaped by staffing, protected time, leadership, finance, infrastructure, access to current guidance and opportunities to apply learning. Individual-centred and linear developmental models do not adequately explain these interactions. This article proposes the Context-Enabled Continuing Professional Development (CE-CPD) Framework, derived from a programme of research involving a scoping review, qualitative evidence from professional nurses and nurse managers in Limpopo Province, South Africa, and critical engagement with developmental, implementation and CPD-outcomes literature. The framework positions professional learning within four interacting layers: a stakeholder and service ecosystem, organisational enabling conditions, a recurring five-phase workplace learning cycle, and an outcome pathway extending from access and participation to practitioner capability, professional behaviour, team and organisational performance, and patient or population health. Capability development is treated as domain-specific, iterative and potentially non-linear, rather than as an automatic progression from novice to expert. Six propositions specify how contextual readiness, protected opportunity, equitable access, workplace application, knowledge sharing and infrastructure are expected to influence these outcomes. The CE-CPD Framework shifts the explanatory focus from whether professionals attend CPD to whether their organisations make relevant learning possible and ensure its sustainable application. Although derived from nursing evidence, its organisational mechanisms may be relevant across healthcare professions. Interprofessional co-design, prospective testing and equity-sensitive evaluation are required before wider adoption.
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