Background: Continuing professional development (CPD) programs demonstrate substantial variability in efficacy as evaluations of such programs tend to focus on program inputs, outputs, and outcomes, while overlooking the mechanisms underlying intended outcome changes. By shifting the focus from whether CPD works to how, why, and in what contexts it works, we can better inform deliberate CPD program design, development, and delivery.

Methods: Using a realist synthesis design, we developed a mechanistic model that provides an evidence-and theory-informed framework, drawing upon reflections from different fields of CPD and extensive literature regarding educational and behavioral theory, and integrating social, behavioral, cognitive, and learning theories with evaluative data. 

Results: Five distinct mechanisms were developed, which include: motivation transformation, expert influence, confidence development, self-efficacy facilitation, and community of practice expansion. The mechanistic model provides opportunities to match program mechanisms to the needs of health professionals and health systems, including in primary care. 

Implications: Drawing on our findings, this presentation will describe each of the five mechanisms and explore the use of the mechanistic model to design, deliver, and evaluate CPD programs. We will also identify several ways in which this model can be useful for various CPD stakeholders, including primary care, health professionals, and policymakers. Further, we will present a foundation for a series of conceptual shifts in CPD.