Factors affecting the quality of training and development provided to non-physician healthcare professionals: a scoping review

Introduction

The healthcare industry continually evolves, with changes and advancements in procedures, treatments, services, and care models (1-4). Also, the sector faces challenges due to demographic and epidemiological transition, technological transformation, and changing patient expectations (3,5,6). Subsequently, training and development (T&D) in the healthcare sector is crucial in ensuring that healthcare professionals have the necessary competencies to provide high-quality care to patients (7,8). At the same time, T&D guarantees that organizations remain viable, resilient, and productive in a rapidly changing environment (9-11).

The research literature proves that investment in human capital, particularly employee T&D, creates and builds an effective organization (12), improves organization and employee performance (13), and enhances effectiveness and customer outcomes (12,14).

In the healthcare sector, professional development and capabilities are associated with high-quality healthcare services for patients (8,15) and better patient experience (16,17). Moreover, T&D improves healthcare professionals’ knowledge, skills, and abilities to implement quality standards and evidence-based practices (18). Additionally, it maintains the level of competency for healthcare professionals and enhances their future career opportunities and job satisfaction (19,20).

Training is a structured effort made by an institution to enhance the job-related knowledge, skills, and abilities of its employees (21). The objective of the training is to enable employees to master the emphasized competencies and apply them in their daily work tasks (22). On the contrary, development refers to the process of expanding healthcare professionals’ capabilities, improving their overall performance, and helping them grow professionally (19). It aims to enhance the employee’s career potential within and beyond the organization.

Ensuring that healthcare professionals are up to date with the latest medical knowledge and practices is tightly linked to T&D (23-25). At the same time, quality T&D fosters healthcare professionals’ continued competency (25,26), considering the growing expansion in healthcare-related knowledge and information. Therefore, it has become necessary for healthcare organizations to ensure the availability of competent, skilled, and capable healthcare professionals and to invest appropriately in a system that continuously develops and updates their knowledge, skills, and abilities. Thus, identifying the factors that affect the quality of T&D offers powerful guidance in transforming and modifying how T&D interventions and opportunities are planned, delivered, and evaluated.

A scoping review approach was utilized to systematically map and summarize the existing literature. Accordingly, this scoping review aimed to identify, map, and synthesize the available literature on the key factors and elements that affect the quality of T&D provided to non-physician healthcare professionals in the context of healthcare organizations. We presented this article in accordance with the PRISMA-ScR reporting checklist (available at https://jhmhp.amegroups.com/article/view/10.21037/jhmhp-23-166/rc).

Methods

Protocol and registration

Based on the research aim, this study was conducted as a scoping review using the updated JBI methodological framework (27). In 2020, the Joanna Briggs Institute (JBI) defined scoping review as a “type of evidence synthesis that aims to systematically identify and map the breadth of evidence available on a particular topic, field, concept, or issue, often irrespective of source within or across contexts (28)”. Furthermore, according to the definition, scoping reviews can clarify concepts, terms, and key definitions in the literature and identify the related factors or attributes.

The scoping review was the most appropriate knowledge synthesis method for the given research objectives, which aimed to identify, map, and report the key factors related to the research concept. Further, the scoping review provides value for incorporating various types of literature (28), as the initial search revealed limited relevant studies. Lastly, based on the right review tool developed by Amog et al., a scoping review was suggested (29). The review protocol was registered in the open science framework under the DOI of 10.17605/OSF.IO/XW6G9.

Eligibility criteria

Participants

In this review, the participants were non-physician healthcare professionals with a healthcare-related specialty or a discipline (excluding students) working in healthcare settings providing patient services. The non-physician healthcare professionals considered within this scoping review included nurses, midwifery professionals, pharmacists, and allied healthcare professionals involved in identifying, diagnosing, and treating diseases and disorders, including nutritionists, speech-pathologists, emergency medical technicians, medical laboratory technologists and technicians, radiologic technologists and technicians, respiratory therapists, physical therapists, occupational therapists, among others (30). Physicians were excluded mainly due to differences in the T&D system, approaches, structures, and needs between physicians and non-physician healthcare professionals. Accordingly, this review focused on non-physician healthcare professionals so it can provide more relevant and valuable insights to improve the quality of their T&D.

Concept

T&D refers to the various programs, activities, and courses the healthcare institutions plan, develop, and systematically deliver (22), which aim to improve and reinforce the healthcare professionals’ existing knowledge, skills, and abilities for better performance and productivity (31). Even though the concept of quality is widely used across all industries, there is no agreed-on definition. Goetsch and Davis define quality as “a dynamic state associated with products, services, people, processes, and environments that meets or exceeds expectations and helps produce superior value (32)”. According to this definition, quality applies to the services, people, processes, and environments.

In this review, quality T&D was the presence of factors and elements that contribute positively to the T&D provided to non-physician healthcare professionals and produce superior value. Accordingly, sources incorporated such components were included. However, sources that discussed online T&D, solely focused on leadership development, addressed specific program development and evaluation or primarily evaluated certain T&D practices and strategies in isolation were excluded from the review. Additionally, sources mainly focused on informal activities that do not directly pertain to structured and formal efforts within healthcare institutions were excluded.

Context

The context for this scoping review was the healthcare settings (i.e., hospitals, primary care centers, clinics, etc.). As the ‘context’ is quite open, the sources of evidence relating to any healthcare contextual setting were eligible for inclusion.

Information sources

All types of studies and grey literature that examined the factors and elements affecting the quality of T&D provided to non-physician healthcare professionals were considered. This review included evidence sources conducted in any geographical area published in English, full-text, and published between 1990–2022 based on the inclusion and exclusion criteria.

Search

In conducting this review, a search strategy was employed to identify published and unpublished (gray) sources of evidence. A systematic literature search of electronic databases ScienceDirect, MEDLINE, CINAHL, and Google Scholar was carried out up to 15 June 2022, guided by the JBI methodological framework for scoping reviews (33).

The framework follows three steps: (I) a pilot and initial search of CINAHL and Google Scholar were used to find the sources of evidence using the search keywords and terms presented in Table 1. The terms and the keywords relating to non-physician healthcare professional T&D found in the initially identified relevant sources of evidence were utilized to develop a comprehensive search strategy for this review; (II) with the help of the library liaison for the medical and health sciences college, a second tailored search was conducted using the identified keywords and terms across the included databases, a sample of the search result is presented in Table S1; (III) manual search through the references of the included sources of evidence was done. Finally, a hand search for the gray literature was also undertaken using the following websites: Centers for Disease Control and Prevention, Google Search, National Health Service, and IntraHealth Organization.

Source of evidence selection

The search in the selected databases was carried out from May 2022 to June 2022. Once the database search was concluded, all the identified sources of evidence were collated and exported into Mendeley version 2.1/2020, and then duplicate records were removed. The selection process followed a three-stage approach; first, the sources of evidence eligibility requirements were applied before data export (English language, full text, publication date 1990–2022). In the second stage, the titles and abstracts of the remaining sources of evidence were then screened for evaluation against the inclusion and exclusion criteria identified in the review. Accordingly, relevant potential sources were returned for a full-text review. Finally, the review team performed a detailed full-text review of the returned sources.

Sources that adequately discussed and identified one or more factors and elements that impact the quality of T&D were included. The reasons for sources of evidence exclusion at the full-text review stage were recorded and reported in the flowchart diagram Figure 1. However, sources were excluded if (I) the focus of the source was on non-healthcare professionals; (II) the source involved students of any health-related specialties; (III) it only targeted physicians’ personnel (medical or dental); (IV) the source discussed leadership training or development; (V) the focus of the source was online T&D; (VI) the source discussed specific skills developments or addressed specific program development or evaluation. Finally, the scope of this review was the T&D activities planned, developed, and systematically delivered by healthcare institutions (formal and structured). Accordingly, sources with other focuses, such as self-learning or development, education, apprenticeship, etc., were excluded. Subsequently, the database search results and the sources of evidence inclusion process were reported in the extraction table (available at https://cdn.amegroups.cn/static/public/jhmhp-23-166-1.pdf).

Figure 1 PRISMA flow chart of study selection. T&D, training and development.

Data charting process and items

The principal reviewer developed an initial data extraction form that the other members reviewed to facilitate the data charting of the included sources of evidence. Additionally, the form was piloted iteratively through the initial search stage, and the form was modified, revised, and approved in a team meeting before the last search. The data extraction form included the following: (I) title; (II) author(s), year, and country; (III) aim(s); (IV) participants (type of healthcare professionals); (V) context (settings); (VI) methodology; (VII) findings (identified factor). Furthermore, two more forms were developed, one for the data extraction from the reviews and another for gray literature sources.

The relevant sources on the factors that affect the quality of T&D provided to healthcare professionals were analyzed. The review team then created a list of sources to be included in the review, which was discussed and finalized collectively through regular meetings. During the charting process, disagreements between the team members were resolved through discussion and feedback to achieve consensus.

Critical appraisal of individual sources of evidence

In alignment with the scoping review guidelines, this section is not required (27,34). Accordingly, no formal critical appraisal (methodological quality assessment) was performed for the included sources of evidence.

Synthesis of results

In line with the fundamental principles of scoping reviews, the synthesis of qualitative data should predominantly assume descriptive qualitative analysis rather than thematic analysis (27). This approach aligns with the overarching objective of scoping reviews: to identify, map, and clarify concepts, definitions, or key characteristics within a given field of inquiry (28). In this review, we do not seek to employ the in-depth thematic or meta-aggregative analysis commonly associated with systematic reviews. Instead, we used a descriptive qualitative technique for basic data coding into specific categories.

Consequently, the data extracted from our search was summarized quantitatively (the numbers of sources) and qualitatively (for the outcomes) to map the quality factors related to healthcare professionals’ T&D. Additionally, we used the following overarching categories for the quality factors: (I) T&D process factors; (II) T&D system factors; (III) work environment factors; and (IV) healthcare professional factors.

The main reviewer analyzed and verified the data with the other research team members. They recited the outcome section for the sources of evidence included and verified the appropriate category. Subsequently, the research team discussed and finalized the listed sources.

Results

Selection of sources of evidence

The search identified 2,499 evidence sources containing the search concepts and terms. The duplicate sources were removed using the Mendeley referencing manager, and 630 sources were screened based on the inclusion and exclusion criteria. However, 464 sources were excluded in the title and abstract screening phase. A total of 166 sources were returned for the full-text review. Finally, 30 sources were selected from the database search to be included in this review, and the reasons for the sources’ exclusion in the full-text review can be found in the flow chart Figure 1. The results of the included sources of evidence and their details are included in the online table (available at https://cdn.amegroups.cn/static/public/jhmhp-23-166-1.pdf). Furthermore, ten sources were identified through gray literature and the search in the references from the included sources.

Additionally, the primary reviewer conducted the sources screening for titles and abstracts. Subsequently, the full-text review of all sources that met the inclusion criteria was conducted in two stages: (I) the primary reviewer reviewed and summarized the full-text sources with reasons for source exclusion; (II) the other research team members independently reviewed the outcome of the first stage, and any disagreement regarding the review outcomes was resolved by discussion.

Characteristics of sources

This review returned 40 sources, of which there were 21 empirical studies from 13 different countries: Australia (n=4), the UK (n=5), and Scotland (n=2), along with one source from each of the following countries: Brunei, Kenya, Congo, China, Korea, Norway, South Africa, New Zealand, Uganda, and Finland. Additionally, 12 reviews and seven gray literature sources were also included. A range of study designs were utilized in the empirical studies: 12 qualitative sources, four quantitative, and five mixed methods.

Twelve of the total included empirical sources were conducted in hospital settings, aside from five sources in healthcare centers, while the rest were in other healthcare settings. Of the 21 empirical sources, 15 included nurses as the main healthcare professionals with different specialty areas. The remaining sources involved pharmacists (n=3) and allied health professionals (n=3).

Synthesis of results

All the selected sources reported one or more factors and elements that positively contribute to the T&D provided to healthcare professionals and subsequently contribute to delivering value and meeting the healthcare professionals’ expectations. Factors affecting the quality of healthcare professionals’ T&D in the included sources were reported under four overarching categories in Table 2.

Category 1: T&D process factors

The review identified multiple factors that pertain to the T&D process. These factors were need assessment, design, development, delivery, evaluation, and follow-up. The relevant elements related to the T&D process factors identified in the included sources are provided in Table 3.

Need assessment

The need assessment plays a significant role in the T&D process, specifically in identifying needs and aligning training with the national health goals, strategic visions of the healthcare institutions, and immediate service requirements (35-40). Additionally, the review found that a thorough need assessment is essential for identifying gaps in skills (39-42) and underlining performance issues (35,43-46). It was a crucial factor in determining where T&D efforts should focus, ensuring that resources and efforts are allocated effectively (47). The needs assessment process enables a systematic approach to address specific competencies and performance improvements, enabling organizations to tailor T&D opportunities to meet the identified needs and bridge existing gaps (41,48). By incorporating a needs assessment, the T&D process becomes more targeted, efficient, and aligned with the overall organizational goals and objectives (35,37,43,47-50). Several sources expressed the necessity of need analysis as a medium to respond to the increased complexity of the healthcare environment and to guide training development (35,50-52). Ultimately, the review found that identifying and prioritizing healthcare professionals’ T&D needs can support the development of tailored and appropriate T&D interventions with the required competencies (41,43,46,47).

Design

A similarly prevalent factor in the reviewed sources was the T&D design as an essential component in the process (35,37-40,42,44-48,50-56,60-66). Several sources highlighted this factor’s significance as a blueprint for T&D. The design factor in the T&D process involves structuring a well-defined opportunity that outlines specific, measurable learning objectives and outcomes (44,54,60,62,63,65,66). This factor also includes developing or selecting suitable learning activities and materials (38,39,45). Additionally, instructional methods and strategies, such as lectures, group discussions, multidisciplinary training, reflective learning, workshops, hands-on activities, or online modules, are decided to convey the training outcomes and targets effectively (35,37,44,51,63). Furthermore, assessment methods should be designed and established to gauge participants’ proficiency and understanding of the training outcomes, ensuring a comprehensive approach to instructional design and content delivery (38,39,42,63).

Development

The development factor focuses primarily on content and learning experience creation and material preparation, as outlined in the design phase (37). This development involves detailed training content, learning materials, evaluation items for assessment, facilitator instructions, handouts, guidelines, and various learning activities that align with the instructional methods and strategies selected during the design stage (38,39,52,64,67). Additionally, technological and practical components, such as e-learning or simulations, are developed and integrated if applicable (38). In many cases, pilot testing is initiated to assess the materials with a small group of participants, identifying and addressing content or delivery issues (38,45). Throughout this process, content is reviewed for clarity, logical flow, accuracy, comprehensiveness, and applicability to facilitate competencies acquisition and practice while incorporating feedback and unifying format and style (41,54,57,64,68).

Delivery

This factor deals with delivering T&D opportunities and interventions in healthcare institutions and implementing the plan. The delivery involves the deployment of qualified instructors or trainers with expertise in their field to provide the content and engage with participants (35,38,48,52,60,63,65). Learners are prepared for the instruction developed (44,52). Additionally, it is vital to ensure that the schedule, lessons, instruction methods, and assessments are implemented systematically as per the plan at suitable times and locations, accommodating participants’ needs and availability (35,38,39,47,60,62,66-68). During training delivery, instructors conduct the sessions and incorporate the evaluation activities to assess participant progress and ensure the attainment of the intended learning outcomes (39,47,52,63,67). Participant engagement is actively fostered through interactive activities, discussions, networking, and practical exercises, enhancing the training experience and promoting effective learning (41,48,51,57).

Evaluation and follow-up

T&D evaluation and follow-up are considered integral to the T&D process. The evaluation as a factor was a central discussion point in most of the included sources. In the evaluation, the effectiveness of the T&D is assessed through a combination of formative and summative evaluation processes (40,52,67). Formative evaluation occurs during the training to make necessary adjustments, while summative evaluation occurs after the implementation to measure the intervention’s overall impact and value (35,37,40,43,45,54,55). Participant feedback is collected to gauge perceptions of content, delivery, and achievements (37,42,53-55,61). Learning outcomes are assessed to determine whether the healthcare professionals have achieved the desired outcomes (37,42,45,48,53,63). A crucial aspect of the evaluation involves follow-up, encouraging participants to apply their newly acquired knowledge or skills to their roles (35,41,58,61,66,69). A feedback loop is established with participants and stakeholders to gather insights for future improvements, ensuring an ongoing improvement based on the evaluation findings (41,42,61).

Category 2: T&D system

The included sources recognized various factors related to the T&D system, including strategy and innovation, policies and practices, resources, and partnerships. Under these factors, several T&D system elements considered in the included sources are presented in Table 4.

Strategy and innovation

The healthcare institution’s strategic effort to develop its workforce competencies and incorporate innovative practices is pivotal in influencing the T&D offered to healthcare professionals. This factor entails a T&D strategy as a road map that communicates and outlines the institutions’ current and future direction and actions toward professional T&D (47,56,62,71). Also, it outlines the importance of innovative T&D approaches and practices as a means for more compelling opportunities supporting the healthcare institution’s priorities and overall human capital development strategies (54,55,67,71). Innovations and research-based practices to overcome sustainability, accessibility, affordability, and relevancy challenges, like e-learning platforms, gamification, competency-based training, fundraising from external sources, cascade knowledge down within the departments following the training, sponsored opportunities, and journal clubs, can significantly improve the effectiveness and foster a supportive culture of continuous growth and development (38,41-44,47,50,51,53,55,64). By considering this domain, healthcare institutions can adapt to evolving changes and needs, ensuring that healthcare professionals’ T&D remains effective, relevant, and up to date.

Policies and practices

Establishing and consistently adhering to clear, effective policies and practices for T&D is crucial. These policies outline the healthcare institutions’ commitment and support to healthcare professionals’ development and their access to training (39,43,45). Well-crafted and implemented policies create a structured framework that ensures fairness, consistency, and transparency (43,47,66). Moreover, they facilitate aligning training with institutional goals and compliance with industry standards and regulatory bodies’ requirements (35,37,44,61,67,71). Effective policies and practices are essential for fostering a culture of continuous learning and optimizing the quality and relevance of T&D opportunities provided to healthcare professionals (38,42,50).

Resources and partnership

This factor delineates components related to the resources and partnership. Adequate and suitable resources for the involved stakeholders, including funds, instructional materials, facilities, and technology, are essential for an effective and comprehensive T&D system (35,45,58,59,63,67,73,74). Furthermore, strategic partnerships with peer institutions, industry, and educational institutions can bring valuable expertise and diverse perspectives to T&D opportunities (38,51,55,57,67).

Category 3: work environment

The work environment is fundamental in the T&D of healthcare professionals. Most of the included sources emphasized specific elements in the healthcare environment that might affect the quality of T&D, including the opportunity for T&D, managerial and organizational support, organizational culture, and climate. Various elements related to the work environment factors were discussed across multiple sources listed in Table 5.

Opportunities and access

The opportunity for T&D is crucial in nurturing a motivated and skilled health workforce (54,67). It supports healthcare professionals’ growth while driving the institution’s overall success (70,74). By providing healthcare professionals opportunities to expand their knowledge and skills, they gain confidence and enhance their ability to perform and overcome evolving challenges (56,68,74). Additionally, T&D opportunities should be affordable and attractive to all healthcare professionals with appropriate quantity and quality (37,41,45,59). Finally, clear and visible communication regarding T&D opportunities and resources is crucial to support healthcare professionals’ accessibility (50,54,71).

Managerial and organizational support

Managerial and organizational support is a cornerstone in the success and effectiveness of the T&D provided to healthcare professionals in the included sources. The commitment and systematic support of the organization and its managers, particularly the direct line manager, foster an environment where learning and skill development are valued (37,41,54,58,61,64,66,70-72). This support entails clear real-time communication and sharing of information, encouragement for participation and involvement, facilitation for professional development, a balanced work-learning equation, and a conducive working environment (35,50,53,59,68,69,73,74). These elements uplift employee morale, enhance performance, and foster a positive learning setup that benefits healthcare professionals and their organizations.

Organizational culture and climate

Healthcare professionals’ T&D quality greatly depends on the organizational culture and climate. A culture that values and encourages learning, development, growth, and innovation fosters a more effective T&D system (42,48,56,57,59,66,67). Similarly, a favorable climate characterized by open communication, engagement, learning, networking, collaboration, recognition, and trust enhances the overall T&D experience (47,54,57,64,66,68,72). In a healthcare organization with such traits, healthcare professionals are more likely to engage actively in T&D initiatives, apply new skills, and contribute to a continuous improvement culture (39,52). As a result, the quality and impact of their training is significantly elevated.

Category 4: healthcare professional’s factors

Healthcare institutions that go beyond solely addressing the T&D process and environmental factors and consider the healthcare professionals who participated in the T&D opportunities and interventions are more likely to enhance the quality of T&D and, therefore, achieve better outcomes. The essential healthcare professionals’ factors influencing T&D found in the included sources were motivation, personal goals and perspective, individual characteristics, and resources. The key elements falling under the healthcare professionals’ factors are included in Table 6.

Motivation

In most of the included sources, healthcare professionals’ motivation is an enabling aspect of the T&D (36-38,43,44,48,52-55,58-63,66,68-70,72-74). In this context, motivation has implications for the entire healthcare organization beyond mere professional development. When healthcare professionals are motivated to learn and grow, they contribute positively to the organization’s overall mission, growth, and impact (36,44,55,62). Motivated healthcare professionals are more likely to engage, return information effectively, and enthusiastically apply the new skills to their context (37,44,52,55,62,69,74).

Personal goals and perspective

The alignment of healthcare professionals’ goals and perspectives with the T&D process profoundly impacts its quality. Engagement and commitment naturally increase when the T&D resonates with the healthcare professionals’ personal goals and aspirations (36,43,53,62,66,69,74). Healthcare professionals who see T&D as a medium to achieve their career goals will invest energy and time while focusing on the learning experience (36,52,54,62,72,74). Moreover, personal perspective, including one’s unique values, beliefs, and viewpoints, affects how healthcare professionals perceive, interpret, and interact with training and learning (36,47,52,54,57,66,74). Therefore, it ultimately guides their choices and actions.

Individual characteristics and resources

In this review, the individual characteristics and resources refer to the distinctive, unique traits, attributes, assets, and capabilities that define an individual’s nature and behavior and affect how individuals achieve their personal and professional goals. These elements are critical in determining healthcare professionals’ T&D effectiveness and quality (45,47,54,68,74). Each healthcare professional brings unique characteristics, including prior knowledge, skills, personal attributes, and resources, to the training experience. Understanding and accommodating these individual qualities can tailor T&D to meet the learners’ needs better (38,45,68,69). Moreover, considering employee resources, such as time, effort, money, or specific tools, can significantly enhance the training process (59,66,74). When individual characteristics and resources are intentionally integrated into T&D, it boosts engagement and optimizes the transfer of competencies to the workplace (52,54,62,63,69). Recognizing and harnessing these elements ensures that T&D becomes a personalized and efficient means for individual and organizational growth.

Discussion

Summary of evidence

This review aimed to identify the key factors that affect the quality of T&D provided to non-physician healthcare professionals in healthcare settings. We identified various factors and elements pertaining to the quality of healthcare professionals’ T&D. First, the T&D process is fundamental for ensuring the competence and success of healthcare professionals. This process is intended to elevate healthcare professionals’ knowledge, skills, and abilities in alignment with the institution’s overarching goals and objectives.

The T&D process encompasses several essential factors and elements. It begins with the need assessment and analysis to identify knowledge, skills, and competencies gaps within the health workforce and determine the T&D requirements (35-59). Next comes the design factor, where T&D opportunities are tailored and structured to address the identified needs and align with requirements (35,37-40,42,44-48,50-56,60-66). As the design outlines, the development factor focuses primarily on content and learning experience creation and material preparation (37-42,50,52-55,57,58,60,63,64,67,68).

In the same vein, delivery involves the actual implementation of training, often using diverse methods to accommodate various learning styles and preferences (35,37,38,40,42-45,47,48,50-52,54,55,57,60,62-68,70). Following this, the evaluation assesses the T&D effectiveness while identifying improvement areas (35,37,40,41,43,45,48,53-55,58,62,63,68,70). Lastly, the follow-up ensures that T&D remains responsive to evolving organizational goals and individual professional development (35,37,39,43,48,52,55,58,61,64-66,68-70). These factors promote the growth of healthcare professionals and enhance competence and organizational long-term success.

Moreover, the included sources identified the following factors under the T&D system: strategy and innovation (35,37,38,40-44,47,50,51,53-57,61-65,67,70-72), policies and practices (35,37-39,42-44,46-48,50,52-55,59-62,65-67,69,71,73), and resources and partnerships (35,38-40,42,45-48,51,53,55,57-59,62-68,72-74) to aid the healthcare institutions in developing the health workforce competencies and incorporating innovative practices.

Likewise, the work environment is found to be critical in the T&D of non-physician healthcare professionals. Most of the included sources emphasize specific elements in the healthcare environment that might affect the quality of T&D, including the opportunity for T&D (37-39,41,42,44,46,50,51,53-59,61,62,67,68,70-74), managerial and organizational support (35-37,41,44,48,50-56,58,59,61,62,64,66,68,70-74), and a positive organizational culture and climate (37,39,42,47,48,52,54-59,62,64,66-68,70,72,74).

Finally, healthcare institutions that look beyond the T&D process and environment and focus on the healthcare professionals who participated in such opportunities will increase the likelihood of successful T&D and achieve better outcomes. This review identified different factors related to the attributes of healthcare professionals that affect the quality of T&D, such as motivation (36-38,43-45,48,52-55,58,59,61-63,66,68,69,72-74), healthcare professionals’ goals, and perspectives (36,38,40,43,47,51,52,54,56,57,59,62,64,66,67,69-74), where career goals and aspirations play a catalyst role in learning. Similarly, the right values, beliefs, and perceptions impact T&D. Lastly, healthcare professionals’ characteristics and resources (35,37-39,42,45,47,48,51-55,58,59,61,62,65,66,68,69,71-74) represent the distinctive individual’s attributes, assets, and capabilities that define an individual’s nature and behavior and affect how individuals achieve their personal and professional goals.

Limitations

A few limitations should be acknowledged in this review. One limitation was that the principal reviewer had personal experience in the T&D provided to healthcare professionals, which might lead to a potential risk of bias. Moreover, the exclusion criteria were rigorous in excluding valuable sources affecting T&D quality, mainly related to physicians and healthcare students. Additionally, the screening of the sources carried out some degree of subjectivity, even though it was carried out independently by the review team. The final limitation was the challenge of grouping the identified factors and elements into distinct categories. This difficulty originates from the interconnected nature of the included variables, which may result in some overlap and complexity in assigning them to specific categories, potentially affecting the precision and accuracy of the categorization process.

Conclusions

T&D is essential and strategic to delivering quality healthcare services that meet the needs of the healthcare system. However, the quality of services in the current changing healthcare environment depends and relies on the quality of healthcare professionals. Therefore, healthcare organizations are recommended to dedicate adequate resources and foster the growth of healthcare professionals’ knowledge, skills, and abilities through effective and comprehensive T&D opportunities and interventions.

This review identified several factors and elements crucial to optimizing the outcomes of healthcare professionals’ T&D and meeting their expectations. Accordingly, awareness of these factors will provide robust guidance to transform and modify how T&D activities and programs are provided. Additionally, proper attention must be given to maintaining an effective system of healthcare professionals’ T&D, considering the factors presented in this review to maximize the impact of such investments.

Acknowledgments

Funding: None.

Footnote

Reporting Checklist: The authors have completed the PRISMA-ScR reporting checklist. Available at https://jhmhp.amegroups.com/article/view/10.21037/jhmhp-23-166/rc

Peer Review File: Available at https://jhmhp.amegroups.com/article/view/10.21037/jhmhp-23-166/prf

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jhmhp.amegroups.com/article/view/10.21037/jhmhp-23-166/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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