The study included 168 registered physiotherapist participants in Saudi Arabia, recruited through purposive and snowball sampling. Most participants were aged 18–24 years (54.2%), and 73.8% were female. Researchers administered an online questionnaire containing 20 Likert-scale items drawn from validated Technology Acceptance Model subscales covering perceived usefulness, perceived ease of use, knowledge retention and clinical decision-making. The reported Cronbach’s alpha values were at least 0.80, indicating strong internal consistency for the questionnaire measures.

Data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance and Pearson correlation coefficients, with p < 0.05 used as the significance threshold. Participants reported highly positive perceptions across all four domains. Prior micro-learning use and greater technical proficiency were each associated with more favorable perceptions at p < 0.001, with reported Cohen’s d values ranging from 0.50 to 0.90. A dose–response relationship was also observed between increased exposure to micro-learning and the reported perceptions.

Associations among the measured constructs ranged from r = 0.622 to r = 0.779, all reported at p < 0.0001. Perceived knowledge retention and perceived clinical decision-making were strongly correlated, with r = 0.760. The range across all reported correlations reached r = 0.779, so the knowledge-retention and clinical-decision-making result should be understood as one of the strong associations rather than the single largest correlation reported in the abstract.

The abstract concludes that physiotherapists perceive micro-learning as a practical and effective approach for professional development, with prior exposure and technical proficiency identified as key predictors of acceptance. However, the evidence comes from a cross-sectional online survey in one country using non-random recruitment. Perceptions of knowledge retention and clinical decision-making are not equivalent to objectively measured learning gains or changes in clinical decisions, and the design cannot establish that micro-learning caused the reported associations. The published version is also described as an early version of record that may undergo further editorial changes.

Subject of Research: Physiotherapists’ perceptions of micro-learning for professional development in Saudi Arabia

Article Title: Perceptions of micro-learning modules on knowledge retention and clinical decision-making among physiotherapists: a cross-sectional study

Article References: Shalabi, K. M., Alsharif, Z. A., Almubarak, K. M., Almalki, R. A., Almathami, S. H., Alhakami, B. A., & Almurdi, M. M. (2026). Perceptions of micro-learning modules on knowledge retention and clinical decision-making among physiotherapists: a cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10485-3

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10485-3

Keywords: micro-learning, physiotherapy, Saudi Arabia, cross-sectional survey, knowledge retention, clinical decision-making, Technology Acceptance Model, continuing professional development, Perceptions, modules, knowledge, retention

Physiotherapists were invited to share their experiences and perspectives on microlearning through open-ended survey questions. Researchers analyzed the responses using reflexive thematic analysis with an inductive approach to identify patterns of meaning. The study examined perceived barriers and facilitators, as well as participants’ views about knowledge retention and clinical decision-making; it did not measure objective learning outcomes or establish the effects of microlearning on clinical performance.

Reported barriers included time constraints, workload pressures, concerns about content quality and limited clinical specificity. Participants identified integration into clinical workflows, ease of access and organizational support as facilitators. Case-based learning, visual content and interactive elements were described as important features for enhancing knowledge retention. The abstract reports that physiotherapists perceived microlearning as a form of just-in-time cognitive support that could support rapid recall of clinical information and decision-making at the point of care.

Engagement with credible and contextually relevant content was associated with increased confidence and perceived improvements in patient safety. These are perceptions reported by participants rather than demonstrated improvements in safety or patient outcomes. The authors state that longitudinal and mixed-methods studies should examine microlearning’s integration into physiotherapy education and its impact on knowledge retention, clinical decision-making and practice. Because the supplied evidence is limited to the article abstract, details about participant numbers, recruitment, setting and the full survey instrument are not available here.

Subject of Research: Physiotherapists’ perceived barriers, facilitators and clinical implications of microlearning

Article Title: Microlearning in physiotherapy practice: a qualitative study on barriers, facilitators, and implications for knowledge retention and clinical decision-making

Article References: Shalabi, K., Alsharif, Z., Almubarak, K., Almalki, R., Almathami, S., Alhakami, B., Almurdi, M., & Albasha, N. (2026). Microlearning in physiotherapy practice: a qualitative study on barriers, facilitators, and implications for knowledge retention and clinical decision-making. BMC Medical Education. https://doi.org/10.1186/s12909-026-10488-0

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10488-0

Keywords: microlearning, physiotherapy, continuing professional development, qualitative study, knowledge retention, clinical decision-making, patient safety, thematic analysis, practice, qualitative, barriers, facilitators

The research team, led by investigators at Bogomolets National Medical University, set out to assess the awareness, attitudes, and readiness of pharmaceutical professionals regarding pharmacist prescribing. The timing is significant: Ukraine’s Law on Medicinal Products, adopted in July 2022, provides for the introduction of comprehensive pharmaceutical services in pharmacies from 2027 as a distinct professional activity. Against the backdrop of martial law, workforce shortages, and damaged medical infrastructure, the question of whether pharmacists could take on prescribing duties has moved from theoretical discussion to practical policy consideration.

Perhaps the most striking finding was the profession’s limited familiarity with the very concept it was being asked to evaluate. Only 9.0 percent of respondents reported being well informed about international pharmacist prescribing models, while 55.4 percent were entirely unfamiliar with the practice. This knowledge gap is not surprising given the current legal landscape: pharmacist prescribing is not an established professional function in Ukraine, so pharmacy students receive no specialized training in prescribing competencies. Familiarity with international models can only be acquired through independent learning or professional initiatives.

To give respondents a foundation for evaluation, the researchers introduced them to four models of pharmacist prescribing drawn from international experience. These ranged from collaborative prescribing under agreements with physicians, through restricted independent prescribing limited to specific conditions or medication lists, to full independent prescribing for both diagnosed and undiagnosed conditions. The models reflect a spectrum of professional autonomy seen across countries, from the United Kingdom and Switzerland, where independent prescribing is established, to Ireland and France, where protocol-based supply of selected medicines has recently been introduced.

When asked to rate these models, respondents revealed a clear pattern: support rose as professional autonomy decreased. Collaborative prescribing, in which pharmacists work under agreements with physicians, received the most favorable assessments, while full independent prescribing for undiagnosed conditions drew the strongest opposition. This gradient suggests that Ukrainian pharmacists envision a phased implementation path, beginning with team-based models and gradually expanding autonomy as regulatory and educational systems mature. The preference mirrors international experience, including Slovenia’s collaborative pilot programs and the United Kingdom’s staged evolution from supplementary to independent prescribing.

Despite the overall skepticism, respondents recognized meaningful potential benefits. Improved access to pharmacotherapy and reduced physician workload ranked highest among perceived advantages. These views align with a substantial body of international evidence. A cost-effectiveness analysis in the United States found that managing half of hypertension patients through pharmacist prescribing would save over $10,000 per person across a 30-year horizon, translating to roughly $1.13 trillion in population-level savings. Australian research in emergency departments showed that collaborative prescribing models reduced medication errors and improved documentation of adverse drug reactions.

The barriers identified by respondents were predominantly structural rather than attitudinal. The lack of a clear regulatory framework topped the list, followed by limited access to patient medical records, insufficient interprofessional collaboration, and concerns about professional liability. These concerns are well founded: expanding pharmacists’ clinical roles inevitably increases exposure to legal claims, and professional indemnity insurance has emerged internationally as a key protective mechanism. Respondents also emphasized the need for legal acts, clinical protocols, prescribing standards, and a defined list of medicines eligible for pharmacist prescribing as priority measures.

The survey also probed which medicines pharmacists believed could safely fall under their prescribing authority. Respondents favored lower-risk medicines with well-established safety profiles, particularly anti-inflammatory and analgesic drugs. Support dropped sharply for vaccines, immunobiologicals, and hormonal medicines, reflecting awareness of the higher clinical responsibility and more comprehensive patient assessment these categories demand. This cautious triage of therapeutic categories is consistent with the stepwise approaches adopted in Poland and Spain, where initial prescribing rights were limited to narrowly defined conditions.

Education emerged as perhaps the most formidable challenge. A striking 92.9 percent of respondents considered pharmacists’ existing knowledge insufficient or only partially sufficient for prescribing practice. Yet willingness to undergo specialized training was lukewarm: only about 30 percent expressed readiness to pursue such credentials, while 43.7 percent remained uncertain, likely because the regulatory framework, responsibilities, and practical conditions for applying new competencies remain undefined. When asked about preferred training formats, 42.4 percent favored workplace-based training under experienced professionals, ahead of continuing professional development courses and short-term certificate programs.

The study’s authors conclude that pharmacist prescribing in Ukraine should initially be introduced through collaborative or protocol-based models, with gradual expansion tied to regulatory, educational, and organizational readiness. The wartime context adds urgency: with physicians scarce, medical infrastructure destroyed in affected regions, and rural populations facing uneven access to care, expanding pharmacists’ roles could serve as a critical mechanism for maintaining continuity of treatment. Whether Ukraine’s pharmacy profession, currently cautious and under-informed, can be prepared for this transition will depend on sustained investment in postgraduate education, digital health infrastructure including electronic health records, and the legal architecture that defines professional responsibility.

Subject of Research: Pharmacist prescribing implementation in Ukraine

Article Title: Pharmacists’ perspectives on the implementation of pharmacist prescribing in Ukraine: a nationwide survey

Article References: Komarida, O., Kosyachenko, K., & Sakhnatska, N. (2026). Pharmacists’ perspectives on the implementation of pharmacist prescribing in Ukraine: a nationwide survey. Pharmacia, 73, Article e196917. https://doi.org/10.3897/pharmacia.73.e196917

Image Credits: AI Generated

DOI: 10.3897/pharmacia.73.e196917

Keywords: pharmacist prescribing, Ukraine, pharmacy practice, nationwide survey, professional autonomy, collaborative prescribing, healthcare reform, pharmaceutical education, regulatory framework, martial law, interprofessional collaboration, continuing professional development

The research, published in Frontiers in Public Health by Reem Al-Kattan of King Saud University, set out to measure environmental health literacy, or EHL, among oral healthcare professionals. EHL is a multidimensional concept: it covers not just factual knowledge about environmental hazards, but also attitudes toward them, confidence in one’s ability to respond, and actual practices. The idea is that a professional who can access, understand, evaluate, and apply environmental health information is far better placed to counsel patients, manage waste responsibly, and push their institution toward sustainable operations.

To capture that complexity, the study surveyed 384 oral healthcare workers across Saudi Arabia — 258 dentists and 126 non-dentist personnel, including academicians, dental assistants, and allied health professionals. Participants were recruited through email using convenience sampling, and each completed a structured questionnaire developed by the research team after a literature review, expert content validation, and pilot testing. Responses were recorded on five-point Likert scales, and composite scores across the four domains were standardized to a 0–100 scale. A score of 70 or above was predefined as indicating good environmental health literacy.

The headline result is deceptively simple: overall literacy was moderate, and statistically indistinguishable between the two groups. Dentists averaged 70.5 points, non-dentists 73.4, a difference that fell short of significance (p = 0.090). Roughly half of all participants — 48.1 percent of dentists and 57.9 percent of non-dentists — cleared the good-literacy threshold. In other words, in a profession whose daily work involves hazardous chemicals, sharps, radiation, and high water and energy consumption, about half of the workforce fell below the study’s own bar for adequate environmental health understanding.

Beneath that aggregate parity, however, lay a striking asymmetry. When the researchers broke the scores into domains, non-dentists significantly outperformed dentists on knowledge, scoring 19.02 versus 17.93 on the knowledge subscale, with 64.3 percent achieving good knowledge levels compared with just 51.6 percent of dentists. No significant differences emerged in attitudes, confidence, or practices. The pattern is counterintuitive: the clinicians with the most formal training knew less about environmental health than the assistants and allied staff working alongside them.

The authors offer a plausible explanation. Academicians and allied professionals may have greater exposure to interdisciplinary public health and sustainability initiatives, while practicing dentists are consumed by clinical and administrative demands that leave little room for environmental education. Compounding this, environmental health and sustainability concepts remain thinly integrated into traditional dental curricula — a gap documented in prior work. A 2025 study cited in the paper found that dental students showed greater environmental awareness than practicing dentists, and separate research on Swedish dental and nursing professionals found both groups felt inadequately prepared to discuss climate change and sustainability with patients.

The study’s correlation analysis adds an encouraging note. Across both groups, all four literacy domains were positively and moderately-to-strongly correlated with one another (all p < 0.010). Knowledge tracked with attitude, attitude with practice, practice with confidence — coefficients ranged from 0.70 to 0.83. This interlocking structure supports the multidimensional model of health literacy, in which understanding forms the foundation for favorable beliefs, self-efficacy, and ultimately behavior. It also hints that interventions targeting knowledge could ripple outward into practice, though the cross-sectional design forbids any causal claim.

What actually predicted good literacy? For dentists, regression analysis pointed to three modifiable factors. Those aged 30–49 had roughly three times the odds of good literacy compared with dentists under 30 (adjusted odds ratio 3.01), and those aged 50–65 had more than four times the odds (aOR 4.28). Attendance at environmental health conferences or scientific events was the strongest single predictor, nearly quadrupling the odds (aOR 4.02), and prior formal environmental health training more than doubled them (aOR 2.35). Among non-dentists, the conference effect was even more dramatic: attendees had over twelve times the odds of good literacy (aOR 12.25), though the wide confidence interval and small subgroup sizes warrant caution.

The age gradient among dentists is intriguing. Older practitioners may have accumulated environmental and occupational health information over longer careers, or benefited from more continuing professional development. But the authors are careful to note that the cross-sectional design cannot distinguish whether education builds literacy or whether environmentally minded individuals simply seek out more education. Either way, the practical implication is the same: structured exposure — conferences, formal training, targeted curricula — is the variable most tightly linked to adequate literacy, and prior intervention studies, including a virtual phthalate-literacy program for professionals, have shown measurable gains from exactly such efforts.

The study has honest limitations. Convenience sampling means environmentally engaged professionals were likely overrepresented, so the true literacy of the broader workforce may be even lower than reported. The questionnaire, while piloted and expert-reviewed, was not assessed for internal-consistency reliability or construct validity. The non-dentist group also lumped together academicians, assistants, and allied professionals, so the knowledge advantage may not be uniform across those roles. And the 70 percent threshold was investigator-defined. Still, the core message stands: environmental health literacy among oral healthcare professionals is moderate at best, knowledge gaps favor the non-dentists, and educational exposure is the clearest lever for improvement. As healthcare systems worldwide confront their own carbon footprints — dentistry’s single-use plastics, amalgam separators, and sterilization energy loads among them — the findings argue that sustainability belongs in dental school curricula and continuing education alike, not as an elective afterthought but as core professional competence.

Subject of Research: Environmental health literacy among dentists and non-dentist oral healthcare professionals in Saudi Arabia

Article Title: Environmental health literacy among oral healthcare professionals—a comparison across professional groups

Article References: Al-Kattan, R. (2026). Environmental health literacy among oral healthcare professionals—a comparison across professional groups. Frontiers in Public Health, 14, Article 1933350. https://doi.org/10.3389/fpubh.2026.1933350

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1933350

Keywords: environmental health literacy, dentistry, oral healthcare professionals, Saudi Arabia, sustainable healthcare, dental education, public health, cross-sectional study, knowledge attitudes practices, continuing professional development, Environmental, health

The study was led by María Guadalupe Fontán-Vinagre of the Spanish Institute for Nursing Research, together with colleagues including corresponding author Ivan Herrera-Peco. The team conducted a qualitative descriptive-interpretive investigation with 28 nurses drawn from nine of Spain’s autonomous communities. Eleven of the participants worked in primary care and seventeen in hospital settings. Between January and June 2024, each nurse took part in an individual semi-structured interview, and the researchers deliberately used purposive maximum-variation sampling, recruiting people of different ages, levels of professional experience, care settings, and generalist or expert profiles. This design allowed the team to capture a broad spectrum of perspectives rather than the views of a single professional subgroup.

The clinical anchors of the study were diabetes care and ostomy care, two fields in which nursing knowledge changes rapidly and in which errors in daily practice carry real consequences for patients. By grounding the interviews in concrete clinical contexts, the researchers could move beyond abstract opinions about education and probe what nurses actually need to know, where they look for it, and whether the training they complete translates into better care.

Using thematic and comparative analysis of the interview transcripts, the team identified five interrelated themes that together define clinically useful CPD. The first theme framed continuing professional development as a negotiated professional responsibility, something nurses feel obligated to pursue but must constantly balance against workload and personal constraints. The second, and perhaps most provocative, was the disconnect between credentialing and clinically meaningful learning. Nurses reported that completing accredited education does not necessarily ensure that the learning is relevant or transferable to their daily practice. A certificate, in other words, is not the same as competence.

The remaining themes were contextual alignment, credibility, and adaptive educational architecture. Contextual alignment refers to how well training matches the realities of a nurse’s working environment. Credibility concerns whether the content reflects current evidence and whether educators are genuinely competent. Adaptive educational architecture describes the design of learning itself, including its format, flexibility, and the opportunities it provides for practice. Across all settings, nurses valued up-to-date evidence, content relevant to nursing rather than borrowed wholesale from medicine, skilled educators, practical hands-on learning, accessibility, and organizational support from their employers.

One of the study’s most interesting findings is how sharply the priorities diverge between primary care and hospital care. Nurses in primary care, who manage broad patient populations and must make quick decisions often in isolation, prioritized wide-ranging, concise, and immediately retrievable resources. They need answers they can access in the moment, during a consultation, without wading through lengthy modules. Hospital nurses, by contrast, emphasized specialized knowledge, specific procedures and devices, simulation, and supervised practice. Their learning needs are deeper and narrower, tied to the technologies and acute interventions of the ward. The implication is clear: a one-size-fits-all CPD program serves neither group well.

The study also delivered a nuanced verdict on online education, which expanded dramatically after the pandemic. Digital formats increase flexibility and geographic access, allowing nurses in rural areas or those with family responsibilities to participate in training that would otherwise be out of reach. But the researchers found a dark side: poorly designed online courses can facilitate superficial completion, in which nurses click through material simply to accumulate credits. This finding strikes at the heart of credentialing systems that count hours rather than outcomes. Blended education, which combines online theoretical preparation with in-person experiential learning, was valued precisely because it connects the two, letting nurses study at their own pace and then apply what they have learned under real conditions.

The conclusions of the study carry significant weight for policy. The authors argue that clinically useful CPD depends less on accreditation or on the choice of modality alone than on the alignment of content with clinical needs, care context, credible evidence, educational design, and organizational conditions. Programs, they suggest, should be differentiated by setting and by professional trajectory, so that a newly qualified hospital nurse and an experienced primary care nurse are not offered the same generic package. They also call for meaningful competency assessment, moving beyond attendance records to measures that actually verify what a nurse can do.

Perhaps the most practical recommendation concerns time. The researchers argue that programs must be supported through protected learning time and through opportunities to apply learning in practice. Without dedicated hours carved out of the working schedule, even the best-designed course becomes one more obligation squeezed into an already overloaded shift. And without the chance to use new skills on real patients soon after learning them, knowledge decays rapidly. Organizational support, in this vision, is not a bonus but a structural requirement.

The study was approved by the Research Ethics Committee of Universidad Alfonso X el Sabio and conducted in accordance with the Declaration of Helsinki, with all participants providing written informed consent. It received no specific external funding. As health systems worldwide grapple with aging populations, rising chronic disease, and persistent nursing shortages, the message from these 28 Spanish nurses is both simple and demanding: stop counting certificates and start building education that fits the ward, the consultation room, and the patient in front of you. The quality of nursing care, the study suggests, depends not on how much training nurses complete, but on how well that training is designed, delivered, and made usable where it matters most.

Subject of Research: Factors that make continuing professional development clinically useful for nurses in primary and hospital care

Article Title: What makes continuing professional development clinically useful for nurses? A qualitative study across primary and hospital care in Spain

Article References: Fontán-Vinagre, M. G., Serna-Menor, A., Lucas-Guerra, C., Mata-González, G., Moreno-Sánchez, R., Ayuso-Murillo, D., López-Espuela, F., de la Calle, R. C., & Herrera-Peco, I. (2026). What makes continuing professional development clinically useful for nurses? A qualitative study across primary and hospital care in Spain. BMC Medical Education. https://doi.org/10.1186/s12909-026-10517-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10517-y

Keywords: continuing professional development, nursing education, clinical competence, primary care, hospital care, qualitative research, e-learning, blended learning, diabetes care, ostomy care, Spain, workplace learning

The concept of risk of social exclusion sits at the heart of the study. The researchers define it as a multidimensional construct encompassing economic, social, cultural, health and other aspects of disadvantage and deprivation that can affect a child’s present life and development as well as future life opportunities in adulthood. Crucially, the framework rejects the idea that any single characteristic of a child or their environment determines an unfavorable outcome on its own. Instead, disadvantage emerges from the interaction of multiple risk factors and protective factors present in the child’s individual characteristics and surroundings. This analytical lens differs from, and complements, the broader principle of inclusion: while inclusion is a normative orientation toward equitable participation for all children, the risk-of-social-exclusion perspective identifies specific, potentially cumulative configurations of disadvantage that inclusive practices must be equipped to address. For professional development, this distinction matters because recognizing intersecting risks allows a more differentiated understanding of the knowledge and support teachers actually require.

The scale of the problem is considerable. International research cited in the study suggests that roughly twelve percent of children are exposed to at least two different risks by the time they start school, while a representative Croatian study of children aged five to seven found that twenty percent were at risk of social exclusion. Estimates vary depending on whether teachers or parents make the assessment, with parents reporting somewhat greater exposure. Against this backdrop, the stakes of early childhood education are high: the European Council has emphasized that high-quality early childhood education and care is an essential tool for fighting inequality and educational poverty, capable of preventing early skills gaps and breaking intergenerational cycles of disadvantage. Yet paradoxically, children at risk of social exclusion are more often enrolled in less effective programs than their peers, and the professional needs of the practitioners who teach them remain insufficiently documented.

To fill this gap, the research team, working within the Croatian Science Foundation project MORENEC, conducted semi-structured interviews averaging forty-five minutes with teachers working with children aged five to six. The institutions were purposively selected to capture variation across geography, community size, founder type and institutional scale, spanning nine of Croatia’s twenty-one counties, six boroughs and nine cities, nine public and six private settings, and sizes ranging from two to forty-five educational groups. All participants were female and gave written informed consent. The analysis followed the inductive thematic analysis procedure developed by Braun and Clarke, with three researchers independently familiarizing themselves with the data, generating initial codes and searching for themes before jointly reviewing, defining and naming them. Coding was performed in NVIVO12, and harmonization on a sample of five interviews achieved at least ninety-five percent agreement between the authors.

The first major finding concerns the sheer breadth of risks teachers encounter daily. Among risks arising from children’s own characteristics, developmental difficulties dominated, with speech and language difficulties the most frequently mentioned, followed by behavioral issues ranging from aggression and vulgarity to profound social withdrawal. Risks stemming from family circumstances included divorce, poverty, adoption, neglect and abuse, and these often co-occurred in layered combinations. One teacher described a girl whose parents went through a bitter divorce, who then moved to a new kindergarten and lost her familiar environment, whose father was subsequently killed, and who was only now beginning to show the emotional fallout in the form of sadness, confusion and emerging aggression. A third cluster of risks related to cultural minority identities, including children of Ukrainian refugees, children of Filipino or Albanian parents who did not speak Croatian, Roma children, and children from religious minorities. The diversity and co-occurrence of these risks, the authors note, point to the complexity of the situations teachers are expected to navigate in everyday practice.

When it came to the support available for professional development, a clear pattern emerged: teachers rely overwhelmingly on resources within their own institutions. The most valued forms of support were shared reflection between the two teachers who work with the same group of children, peer learning in communities of practice, and coaching and consultation provided by the pedagogues, psychologists and educational rehabilitation specialists employed in kindergartens. Teachers described daily exchanges of experience in small kindergartens, joint problem-solving with colleagues, and experts who observe a child interacting with the group and then discuss strategies with the teaching team. Yet this picture was far from universal. Several teachers reported a lack of collaboration, colleagues withholding information, expert help that arrives too late or goes no further than a formal meeting with minutes, and institutions missing specialists such as speech therapists or special needs experts entirely. The variation suggests that different organizational cultures prevail across Croatian kindergartens, some functioning as loosely coupled institutions where professional exchange is sporadic rather than systematic.

Support from outside the institution exists but is unevenly distributed. External experts such as speech therapists, psychologists, social workers and social pedagogues occasionally visit, and the national Education and Teacher Training Agency organizes workshops, seminars and trainings, as do universities, non-governmental organizations and bodies like UNICEF. Some teachers described constructive sessions on sensorimotor disorders or modules completed at a faculty of education and rehabilitation sciences. Others reported collaborating with social welfare centers or faculties of education. But a substantial number reported no collaboration at all with the local community or external services, and even enthusiastic participants noted that the volume of support falls short of growing demand. The content of external provision also skews heavily toward children with developmental difficulties, leaving teachers of children facing poverty, family breakdown or minority-related risks largely without targeted training.

The third research question, concerning teachers’ own definitions of their professional development needs, produced perhaps the most actionable findings. On the content side, teachers wanted help understanding concepts of inclusion and social exclusion, practical skills for timely recognition of risk and for supporting children’s socio-emotional development, strategies for handling aggression, tantrums and grief, knowledge about autism spectrum disorders, giftedness and speech and language difficulties, culturally informed approaches to working with Roma and migrant families, and, significantly, communication skills for engaging the parents of vulnerable children, whom several teachers identified as the weakest link in their practice. On the form side, the preferences were unambiguous: small-group workshops, interactive sessions combining a theoretical basis with the sharing of concrete experiences, mentoring and coaching in which experts model their work with real children, and self-directed learning through professional literature. Large-group lectures were explicitly rejected as a waste of time, with one teacher noting she could read the content of an hour-long lecture herself and decide what to apply.

This rejection of lectures carries particular irony, because lectures are the dominant format offered by the national agency responsible for in-service professional development, and most Croatian teachers participate in formal programs only one day a year or less. The study’s discussion situates this mismatch within international evidence: meta-analytic findings indicate that effective professional development programs rely on workplace coaching, combine workshops and lectures, and last forty-five to sixty hours, whereas Croatian provision is characterized by short one-day sessions focused on general pedagogical competences. The authors frame the results through the Who, What and How components of professional development models, and through the tension between outside-in learning, in which expertise is delivered by external authorities, and inside-out learning, in which professionals take responsibility for their own growth. Notably, the teachers expressed both: they craved specialist knowledge and modelling when facing situations that exceeded their competence, while simultaneously embracing peer reflection, learning communities and personal investment in professional literature.

The implications extend well beyond Croatia. The study argues that effective continuing professional development for work with children at risk of social exclusion must be practice-oriented, embedded in professional collaboration, and responsive to context-specific challenges, combining external expertise with the professional learning that happens inside institutions. Responsibility cannot rest with individual teachers alone; institutions must build organizational cultures that support shared reflection, learning communities and access to multidisciplinary expertise, while providers should shape external programs around the needs teachers actually encounter. The authors acknowledge limitations, including the absence of quality indicators in the interview protocol, potential interviewer effects from the nine-person research team, purposive rather than representative sampling, and reliance on self-reported experience rather than observed practice. Still, in a field where twenty percent of children carry risks that their teachers feel unequipped to meet, the message resonates far beyond the kindergarten walls: the professionals closest to vulnerable children are not asking for more lectures, but for the time, trust and collegial structures to learn from each other in the middle of real, messy, everyday practice.

Subject of Research: Continuing professional development of early childhood education and care teachers working with children at risk of social exclusion in Croatia

Article Title: In-service ECEC teachers’ professional development aimed at educating children at risk of social exclusion

Article References: Domović, V., Drvodelić, M., & Bouillet, D. (2026). In-service ECEC teachers’ professional development aimed at educating children at risk of social exclusion. Discover Education, 5(1), Article 1164. https://doi.org/10.1007/s44217-026-02205-2

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02205-2

Keywords: early childhood education and care, continuing professional development, social exclusion, in-service teacher training, Croatia, inclusive education, peer learning, coaching, thematic analysis, educational inequality, teacher collaboration, at-risk children

The review, conducted by Eva Niermeier, Johanna Kroese, Andrés Vidal-Itriago, Wil van der Sanden and Josef Bruers, based at the Academic Centre for Dentistry Amsterdam and partner institutions in the Netherlands, set out to map what the existing literature actually says about EEA-qualified dentists and the variations in continuing professional development, or CPD, across the region. Following the JBI methodological guidance and the PRISMA-ScR reporting framework, the team systematically searched four major databases: MEDLINE, Embase, Web of Science and Scopus. They considered English and Dutch language sources published between 2000 and 2025 that explored postgraduate dental education, specifically the CPD of dentists qualified within the EEA and the United Kingdom. Independent screening and data extraction were carried out, and the resulting findings were mapped and analysed using basic qualitative content analysis.

The search ultimately yielded twenty-seven eligible sources, published between 2002 and 2024. From this body of work, the researchers identified eight overarching themes that together sketch a portrait of a profession on the move, but one whose movement is shaped by forces that are anything but uniform. The picture that emerges is one of genuine tension: free movement of dentists delivers real benefits to destination countries struggling with workforce shortages, yet it simultaneously risks deepening health inequalities in the countries that lose those professionals. And threaded through all of it is the problem that the regulatory scaffolding of the profession, from undergraduate curricula to mandatory CPD hours, differs substantially across Europe.

Why do dentists move in the first place? The review found that migration is driven by a complex interplay of push and pull factors. On the push side sit conditions in the home country: poor working environments, limited professional prospects and, in some cases, economic instability. On the pull side are the attractions of destination countries, with higher remuneration among the most prominent. These are not trivial calculations. A newly qualified dentist weighing a career at home against a career abroad is responding to concrete differences in pay, working conditions and opportunity, and the literature reviewed here suggests those differences remain large enough to sustain substantial migration flows within the EEA.

The consequences of those flows cut in two directions at once. For destination countries, incoming dentists can help fill vacancies and address shortages that would otherwise leave patients waiting for care. This is the promise of free movement in its purest form: labour flows to where it is needed. But for source countries, the departure of trained professionals can be corrosive. The review highlights that mobility risks exacerbating health inequalities in the countries losing their dentists, a dynamic familiar from broader debates about health worker migration. A country that invests in educating a dentist and then watches that dentist practise elsewhere has effectively subsidised another nation’s healthcare system, and the communities left behind may face reduced access to oral healthcare as a result.

Then there is the question of what a dental qualification actually certifies. The review found substantial variations in regulatory structures, undergraduate curricula and CPD requirements across Europe. Although mutual recognition legislation treats EEA dental degrees as equivalent for the purposes of registration, equivalence on paper does not necessarily mean equivalence in the specific competencies a dentist brings to the chair. Different countries emphasise different elements of dental education, allocate clinical experience differently and set different expectations for what a graduate should be able to do. For a migrant dentist, this means that professional integration is not simply a matter of passing a registration threshold; it can require adapting to unfamiliar clinical norms, technologies and patient expectations that their original training did not cover.

The life-long learning dimension compounds the problem. CPD exists to ensure that practising clinicians keep pace with evolving evidence, techniques and technologies, and it is a cornerstone of patient safety in modern healthcare regulation. But because CPD requirements vary so widely across the EEA, a dentist’s obligation to stay current depends heavily on where they happen to practise. The review identifies these variations as posing major challenges both to the professional integration of migrant dentists and to the maintenance of uniform patient safety standards across the region. A dentist who moves from a jurisdiction with rigorous, enforced CPD mandates to one with minimal requirements may find their professional development drifting, while one moving in the opposite direction may struggle to meet unfamiliar mandatory learning obligations on top of the ordinary stresses of relocation.

Perhaps the most striking finding of the review is what the literature does not contain. The authors note that research addressing the implications of variations in CPD requirements across Europe for migrant dentists appears to be limited. In other words, the specific question of how a mobile dentist navigates the patchwork of life-long learning rules, and what that means for their competence and for patient safety, has been largely neglected. Twenty-seven sources over two decades is a modest evidence base for a phenomenon that touches every EEA country, and the gap itself is a finding. Policy in this area has, to a significant degree, been running ahead of the evidence rather than being guided by it.

The review’s conclusions point toward possible remedies. The authors suggest that the benefits of a mobile dental workforce may be enhanced through greater harmonisation of educational standards and CPD requirements across Europe. Harmonisation would not erase national differences overnight, but aligning the core expectations placed on dentists, both at graduation and throughout their careers, would reduce the friction that migrant dentists currently face and would make it easier to guarantee consistent standards of care regardless of where a clinician trained or where they practise. Bodies such as the Association for Dental Education in Europe and the Council of European Dentists have long been involved in efforts to define shared professional standards, including the Graduating European Dentist framework, and the review’s findings give those efforts added weight.

The authors also emphasise the need for robust, data-driven workforce planning, alongside targeted support programmes, to facilitate the effective integration of migrant dentists and contribute to safeguarding public health. Workforce planning grounded in real data would allow countries to anticipate both shortages and surpluses rather than reacting to them, while support programmes could help arriving dentists bridge the gaps between their original training and the expectations of their new professional environment. Taken together, the review makes the case that free movement of dentists is neither an unqualified good nor a problem to be restricted, but a system whose benefits depend on how well the underlying educational and regulatory architecture is aligned. As dental care grows more technologically complex and European workforces remain mobile, the twenty-seven studies assembled here suggest that the quiet machinery of life-long learning may deserve far more attention than it has received.

Subject of Research: Free movement of dentists and variation in continuing professional development requirements across the European Economic Area

Article Title: Free movement of dentists and life-long learning requirements within the countries of the European Economic Area: a scoping review of existing insights and future considerations

Article References: Niermeijer, E., Kroese, J., Vidal-Itriago, A., van der Sanden, W., & Bruers, J. (2026). Free movement of dentists and life-long learning requirements within the countries of the European Economic Area: a scoping review of existing insights and future considerations. BMC Medical Education. https://doi.org/10.1186/s12909-026-10542-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10542-x

Keywords: dentists, European Economic Area, free movement, continuing professional development, migrant dentists, dental education, professional qualifications, harmonisation, patient safety, workforce planning, health inequalities, scoping review

The program in question is the Japanese Surgeons as Educators course, known as JSaE, which was established as a national faculty development initiative to promote structured surgical teaching across Japan. The course runs in two stages, a Basic course followed by an Advanced course, and it has already demonstrated positive educational outcomes in earlier evaluations. Its architects, however, recognized a gap that has been documented across medical education research: even well-designed faculty development initiatives require reinforcement if participants are to retain what they learned and, crucially, implement it in the daily environment of a busy hospital. A systematic review of faculty development initiatives designed to enhance teaching effectiveness, updated as BEME Guide 40, has underscored that one-off workshops rarely produce durable change without follow-up. The JSaE team set out to discover precisely what kind of follow-up their alumni would actually use.

To do this, the researchers conducted a nationwide, cross-sectional survey of JSaE alumni who had completed both the Basic and Advanced courses between May 2023 and February 2025. They distributed an anonymous online questionnaire through the official JSaE alumni mailing list, using the SurveyMonkey platform. The instrument was deliberately practical: it asked about interest in a refresher course, the motivations behind that interest, preferred delivery formats and venues, and the curricular topics that alumni considered highest priority. Responses were analyzed descriptively using item-specific denominators, a methodological choice that keeps each percentage tied honestly to the number of people who actually answered that particular question rather than inflating precision with assumptions about missing data.

The response rate alone makes the findings noteworthy. Of 147 eligible alumni, 109 responded, yielding a 74 percent response rate, a figure that many survey-based studies in medical education would envy. Most respondents were staff surgeons, and gastrointestinal surgery emerged as the most represented specialty, which reflects the demographic weight of that field within Japanese surgical departments. The headline number, though, was the level of demand: 98 of 107 respondents to that item, or 92 percent, expressed interest in attending a refresher course. For a program still in its early phase of national rollout, that is an emphatic endorsement from the very people who have already invested time in completing both course levels.

Why would surgeons who have already finished an intensive two-stage program want to return for more? The survey ranked the motivations, and the leading one was reinforcement of previously acquired knowledge. This aligns closely with what learning science would predict. Ericsson’s work on deliberate practice has argued that the acquisition and, just as importantly, the maintenance of expert performance in medicine requires ongoing, structured engagement rather than a single exposure. Cognitive load theory, developed by Sweller, adds another layer of explanation: complex teaching frameworks, such as models for briefing, intraoperative teaching, and debriefing in the operating room, impose significant mental demands, and without periodic rehearsal the cognitive structures supporting them weaken. The second-ranked motivation, learning updated educational practices, reflects a recognition that the field itself moves. Assessment tools, feedback techniques, and simulation-based methods evolve, and surgeons who teach want to stay current.

The preferences for format and venue reveal a shrewd understanding of how working clinicians actually budget their time. The most popular delivery format was a pre-course workshop linked to an academic society meeting, rather than a standalone event requiring separate travel. When asked where such a refresher should be held, respondents pointed to the annual congress of the Japanese Association for Surgical Education, followed by the Japan Surgical Society and the Japanese Society of Gastroenterological Surgery. This society-linked model solves two problems at once. It reduces the logistical burden of attending yet another meeting in an already crowded professional calendar, and it embeds faculty development within the communities of practice where surgical educators already exchange ideas. Previous needs assessment work by the same research group, both within Japan and across six global regions, has highlighted that surgical trainees and educators face persistent barriers of time and access, making integration into existing gatherings a rational design choice.

On content, the alumni were equally decisive. The highest-priority topics were Assessment of Surgical Performance, Feedback Techniques, and Teaching Surgical Skills. Notably, these priorities align with the core JSaE frameworks already taught in the Basic and Advanced courses, which suggests that alumni are not asking for a fundamentally new curriculum but for deeper, refreshed engagement with the same foundations. The emphasis on assessment echoes findings from the United States, where a study in the American Journal of Surgery defined a pressing need for faculty development specifically in assessment, noting that surgeons are often asked to judge trainee performance without formal training in how to do so reliably. Feedback techniques rank similarly high internationally, since giving effective feedback is among the most consequential and most poorly supported tasks in surgical training.

The broader context in Japan makes this work more than an internal program evaluation. Recent nationwide questionnaire surveys of graduating surgical trainees have documented the current state of the Japanese surgical training system, including facility-based disparities in satisfaction and working conditions across university hospitals, community hospitals, and hybrid-type facilities. Against that backdrop, the quality of teaching that trainees receive is a national concern, not a local one. The establishment of the Japanese Association for Surgical Education itself grew out of an effort to promote systematic surgical education in the country, and the JSaE course represents one of its most concrete instruments. A scoping review of surgical curriculum renewal processes published in Perspectives on Medical Education in 2025 emphasized that successful curriculum change depends on structured needs assessment before redesign, which is exactly the methodological step this survey provides for the program’s next phase.

The study’s authors, led by Akihiko Oshita of Onomichi General Hospital with collaborators spanning institutions from Hokkaido University in Sapporo to the University of Iowa in the United States, conclude that JSaE alumni demonstrated strong demand for a longitudinal, society-linked refresher course. They describe the alignment between the priority topics and the existing core frameworks as a practical foundation for the next phase of national surgical faculty development in Japan. The phrase longitudinal deserves emphasis: the design being contemplated is not another isolated workshop but a continuing relationship between the program and its graduates, delivered at intervals and anchored to the annual meetings where Japanese surgical education already convenes. That model mirrors the Kirkpatrick framework for evaluating training programs, which treats lasting behavioral change in the workplace, rather than immediate satisfaction, as the meaningful endpoint of any educational intervention.

For the international readership of surgical education, the survey offers a template as much as a finding. Needs assessments in continuing professional development have been the subject of their own scoping review, which noted that learning needs assessments are most valuable when they directly shape program design rather than serving as ritual data collection. Here the connection is explicit: 92 percent demand, a named preferred format, three named host societies, and three ranked topics constitute an actionable specification. If the JSaE refresher course proceeds on these terms, Japan will be testing whether society-embedded, reinforcement-based faculty development can close the implementation gap that has long separated what surgeons learn about teaching from what they actually do in the operating room. The results of that experiment will be watched well beyond Japan’s borders, because every country with a surgical workforce struggles with the same quiet problem: teachers trained once, then left to improvise.

Subject of Research: A nationwide needs assessment survey of Japanese surgical faculty development alumni to inform the design of a refresher course for the Surgeons as Educators program

Article Title: Designing the next phase of the Japanese surgeons as educators course: a nationwide needs assessment survey of alumni

Article References: Oshita, A., Poudel, S., Suzuki, A., Imai, K., Takami, H., Kimura, T., Shikama, A., Homma, T., Hida, K., Isobe, M., & Hoshi, H. (2026). Designing the next phase of the Japanese surgeons as educators course: a nationwide needs assessment survey of alumni. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 189. https://doi.org/10.1007/s44186-026-00597-1

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00597-1

Keywords: surgical education, faculty development, Japan, needs assessment, refresher course, surgeons as educators, continuing professional development, assessment of surgical performance, feedback techniques, teaching surgical skills, academic societies, survey research

The review, led by Donald Babamomba Amenah of the University of Maryland School of Nursing together with colleagues in Ghana, the United States, and the United Kingdom, followed the Joanna Briggs Institute methodology and the PRISMA reporting guidelines. The team searched four major bibliographic databases, MEDLINE, CINAHL, Scopus, and Embase, for empirical studies published between 2000 and 2026. From 379 articles initially retrieved, twelve studies met the inclusion criteria, encompassing 2,662 participants drawn from nurses, midwives, and nurse educators across Ghana. Because the underlying evidence combined quantitative measurements with qualitative accounts of lived experience, the authors used a convergent integrated approach, weaving numerical findings and narrative testimony into a single synthesis rather than reporting them in separate silos.

What distinguishes this review technically is its interpretive scaffolding. The authors organized their synthesis around two established frameworks from the learning sciences. The first is Patricia Benner’s Novice-to-Expert Model, which describes how clinical skill develops through five stages, from the rule-governed beginner who cannot yet prioritize among competing demands, to the expert practitioner who perceives situations holistically and acts intuitively. The second is Situated Learning Theory, which holds that professional competence is not simply transferred in classrooms but is constructed through participation in authentic communities of practice, where newcomers learn by working alongside experienced colleagues in real clinical environments. Together, these frameworks allowed the reviewers to classify each reported barrier or facilitator according to where it acts in the developmental trajectory of a nurse, and whether it shapes individual learning or the social and material conditions in which learning happens.

The barriers that emerged were strikingly consistent across the twelve studies, and the reviewers describe them as multilevel and system-driven rather than attributable to individual failings. At the level of education, inadequate structured clinical training was among the most frequently reported problems. Ghanaian nursing students and newly qualified nurses repeatedly encounter a theory-practice gap: the procedures and technologies described in lecture halls diverge from the realities of district hospitals and rural health centers, leaving graduates technically informed but practically unprepared. This gap is compounded by inconsistent competency assessment, meaning that there is no reliable, standardized mechanism for verifying that a nurse can actually perform the tasks their role demands, either at the point of qualification or at any stage afterward.

Workforce shortages emerged as a second dominant barrier, and their effect on competence is more mechanical than it might first appear. When wards are chronically understaffed, experienced nurses have no time to mentor juniors, and junior nurses have no time to reflect on or consolidate what they learn. Supervised practice, the mechanism through which Benner’s novice becomes an expert, simply cannot occur at the necessary intensity. Resource constraints compound the problem: when essential equipment, simulation materials, and training budgets are scarce, opportunities for deliberate practice and skills refreshment shrink accordingly. The review also identified limited managerial support as a recurring theme, with nurse managers often unable to release staff for training, advocate for development resources, or build the kind of workplace culture in which learning is expected and rewarded rather than treated as a luxury.

Against this backdrop of obstacles, the facilitators identified in the review point toward a coherent reform agenda. Structured mentorship and preceptorship programs were the most consistently reported enablers. In such arrangements, a designated experienced clinician takes formal responsibility for guiding a junior colleague through a defined period of supervised practice, providing feedback, modeling clinical reasoning, and gradually transferring responsibility as competence grows. The evidence suggests that when these programs are formalized, with clear roles, protected time, and defined learning objectives, rather than left to informal goodwill, they substantially improve the transition from student to competent practitioner.

Continuing professional development, or CPD, appeared as a second major facilitator, but the review’s findings here carry a caution. CPD in Ghana has historically been fragmented, with workshops and short courses delivered irregularly, unevenly across regions, and without a national framework tying them to competency outcomes. Where CPD was well organized and aligned with actual clinical needs, nurses reported gains in confidence and skill; where it was ad hoc, attendance alone became the measure of success, regardless of whether competence changed. Supportive leadership emerged as a third facilitator that cuts across the others, since managers who prioritize learning create the schedules, resources, and psychological safety that make mentorship and training possible in the first place.

The remaining facilitators identified, competency-based curricula in nursing schools and positive workplace learning environments, reinforce the review’s central analytical claim: competence is produced by a system, not by an individual’s effort alone. A competency-based curriculum defines what a graduate must be able to do, not merely what they should know, and assesses performance against those defined capabilities. A positive learning environment, meanwhile, transforms the ward itself into a classroom, where questions are welcomed, errors are treated as teaching opportunities, and experienced staff see developing juniors as part of their professional identity. Where these conditions coexisted, the studies synthesized in the review found nurses progressing more reliably along the novice-to-expert trajectory; where they were absent, even motivated nurses stagnated.

The policy implications set out by the authors are directed squarely at the Nursing and Midwifery Council of Ghana, the regulatory body that governs standards for the profession. The review calls for competency-based regulation to be strengthened through three institutional mechanisms: the formal institutionalization of structured mentorship and preceptorship programs across the health service, the introduction of systematic competency validation so that skills are verified periodically rather than assumed, and the creation of nationally coordinated continuing professional development that replaces the current patchwork with a coherent, quality-assured framework. The authors argue that these reforms are essential not only for Ghana but for other resource-constrained settings facing similar combinations of workforce shortage, funding limitation, and educational fragmentation, making the findings relevant far beyond West Africa.

The broader significance of this work lies in its reframing of what nursing competence actually is. The evidence assembled here shows that competence is neither a fixed attribute conferred by a diploma nor a personal virtue of diligent individuals, but a dynamic state that decays without reinforcement and grows only within supportive structures. In a global context of health worker shortages and rising demand for safe care, the Ghanaian experience offers a testable proposition: that modest, well-targeted investments in mentorship structures, competency assessment, and coordinated professional development may yield disproportionate returns in workforce capability. For a country striving to retain its nurses and deliver universal health coverage, the review provides something previously missing, a single, rigorous evidence base on which to build the systems that keep clinical skills alive.

Subject of Research: Barriers and facilitators to clinical competency acquisition and maintenance among nurses in Ghana

Article Title: Barriers and facilitators of clinical competency acquisition and maintenance among nurses in Ghana: a mixed methods systematic review

Article References: Amenah, D. B., Vog-Enga, E. W., Afaya, A., Fu, Y., Afaya, R. A., Daniels-Donkor, S. S., Suglow, E., Akwetea, B. L., & Kunaba, L. (2026). Barriers and facilitators of clinical competency acquisition and maintenance among nurses in Ghana: a mixed methods systematic review. BMC Nursing, 25(1), Article 904. https://doi.org/10.1186/s12912-026-05320-5

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05320-5

Keywords: clinical competence, nursing education, Ghana, continuing professional development, mentorship, preceptorship, nursing workforce, competency-based education, systematic review, mixed methods, Benner novice-to-expert model, situated learning

The research, conducted by a team at Universitas Negeri Semarang and published in Discover Education, recruited participants through e-Guru.id, an Indonesian online professional learning network that offers webinars, memberships, and specialized training. All respondents had completed at least one MOOC related to professional development. The sample was predominantly female, with 1,665 women and 866 men, and professionally seasoned: nearly 78 percent were aged 35 or older, and almost 57 percent had at least 15 years of classroom experience. Notably, despite that deep experience, most were newcomers to MOOC learning, with 82.3 percent reporting zero to two years of MOOC use. The authors caution that because recruitment relied on a digitally connected professional network, the sample should not be treated as nationally representative of all Indonesian teachers.

Methodologically, the study is a cross-sectional survey designed to describe and explore rather than to test causal claims. Each of three conceptual domains was measured with five items on a four-point Likert scale, a format chosen to push participants toward a directional response rather than a neutral midpoint. The three domains were Perceived MOOC Effectiveness, covering instructional value, relevance, and professional usefulness; Perceived Professional Competence and Confidence, covering motivation and the perceived ability to apply new knowledge; and Perceived Opportunities and Challenges, covering scheduling flexibility, collaboration, effort, institutional support, and workload. Before any group comparisons, the team validated the instrument with confirmatory factor analysis using IBM SPSS Amos, and the three-factor model showed excellent fit, with a Comparative Fit Index of 0.972, a Tucker-Lewis Index of 0.967, and a Root Mean Square Error of Approximation of 0.057.

The statistical machinery behind the subgroup comparisons deserves attention because it reflects a growing standard of rigor in educational research. Rather than relying on classical analysis of variance, the team used Welch’s independent-samples t-tests and Welch’s one-way ANOVAs, which do not assume equal variances and are better suited to the substantially unequal group sizes in the sample. Because 15 item-level comparisons were run for each demographic variable, the researchers applied Benjamini-Hochberg false discovery rate corrections within each family of tests, and they followed significant omnibus results with Games-Howell post hoc tests. Effect sizes were reported as Cohen’s d for gender comparisons and as eta squared and omega squared for the ANOVAs. Of 75 item-level comparisons across five grouping variables, only three survived correction, a result the authors interpret as evidence of greater similarity than difference across teacher groups.

The descriptive findings tell a coherent story about what teachers value. Within the effectiveness domain, item means ranged from 3.42 to 3.64 on the four-point scale, with the highest rating going to the statement that MOOCs provide valuable resources and materials for improving teaching practice. Close behind were items on the contribution of MOOCs to understanding pedagogical strategies and instructional design, the relevance of content to classroom teaching, and usefulness for professional growth. The lowest item in the domain, though still positive, concerned perceived benefits for student learning, suggesting that teachers were more confident identifying immediate professional gains for themselves than attributing changes in student outcomes to their course participation. The authors stress that student outcomes were not measured independently, so this item reflects perception rather than demonstrated achievement gains.

The competence and confidence results reveal a subtle but important gap. Teachers rated their motivation to teach and share knowledge after MOOC participation highest, at a mean of 3.56, followed closely by perceived improvement in teaching skills. But confidence in applying MOOC-acquired knowledge in practice and in integrating technology into classroom teaching scored slightly lower, at 3.46 and 3.45 respectively. The authors argue this distinction separates professional learning acquisition from professional learning transfer: teachers may absorb knowledge and feel motivated, yet still struggle to translate that knowledge into technology-supported classroom practice. Because the data are self-reported and cross-sectional, the findings capture perceptions of capability rather than independently verified changes in instructional performance.

The opportunities-and-challenges domain produced the most differentiated pattern and the study’s most striking single result. Teachers rated opportunities to collaborate with colleagues across Indonesia highly, at a mean of 3.50, and valued the flexibility of MOOCs amid busy schedules at 3.45. Yet the item measuring difficulty completing MOOCs because of workload or other commitments scored an identical 3.45, and the effort required to keep up with course content scored 3.39. Flexibility, in other words, did not eliminate the demands of participation; it reorganized them. The lowest mean across the entire survey went to institutional support, at just 3.03, with a large standard deviation of 0.92 indicating wide variation in teachers’ experiences of organizational backing. The authors suggest that many participants may not have experienced MOOC learning as embedded within school-level professional development structures.

The subgroup analysis dismantles several common assumptions about who benefits from online professional learning. After false discovery rate correction, age, educational attainment, and teaching experience showed no robust differences on any of the 15 items, challenging narratives that frame digital learning through generational or qualification-based divides. Only two small gender differences survived correction: male teachers reported slightly higher perceived scheduling flexibility and slightly stronger institutional support, with Cohen’s d values of just -0.12 and -0.13. A nominal gender gap in technology-integration confidence vanished after adjustment. The one substantive pattern involved duration of MOOC use: teachers with more than six years of experience rated content relevance significantly higher than newer users, though the omnibus effect was small, explaining less than 1 percent of variance, and the longest-duration group contained only 74 participants. The authors note that causality cannot be inferred; sustained participants may find courses more relevant, or prolonged engagement may sharpen their ability to identify relevant content.

What emerges is a socio-technical picture in which MOOCs are not standalone solutions but components of broader professional learning ecosystems. The authors argue that access to online courses does not automatically become meaningful professional growth, and that knowledge acquired through MOOCs requires opportunities for experimentation, reflection, feedback, and institutional support before it becomes classroom practice. The coexistence of high flexibility ratings with high workload ratings exposes what they call a common misconception: that accessibility translates into ease of participation. For working teachers, flexible delivery shifts rather than removes the burden of allocating time, sustaining motivation, and balancing coursework against teaching and administrative duties. Barriers, they conclude, are organizational and temporal as much as technological.

The practical implications point away from demographic targeting and toward the conditions surrounding participation. The authors recommend designing relevant, practice-oriented content, reducing unnecessary workload, fostering collaborative learning communities, and embedding MOOCs within school-based professional development structures that provide recognition, mentoring, and protected time. They are careful to frame these as priorities for program development whose effects require direct evaluation, not proven interventions. The study’s limitations, including its cross-sectional design, self-reported data, and convenience sampling, restrict causal interpretation and generalizability. Future research, the team suggests, should employ longitudinal, mixed-method, and performance-based designs to examine whether MOOC participation actually changes instructional practice, how perceptions evolve over time, and which institutional conditions sustain engagement. For now, the message for education systems betting on MOOCs at scale is clear: teachers are ready and willing, but the surrounding ecosystem must catch up.

Subject of Research: Indonesian teachers' perceptions of massive open online courses for continuing professional development

Article Title: Indonesian teachers’ perceptions of MOOCs for digital professional development

Article References: Iqdami, M. N., Haryono, Astuti, T., & Widhanarto, G. P. (2026). Indonesian teachers’ perceptions of MOOCs for digital professional development. Discover Education, 5(1), Article 1080. https://doi.org/10.1007/s44217-026-02170-w

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02170-w

Keywords: MOOCs, teacher professional development, Indonesia, online learning, continuing professional development, survey research, institutional support, workload, teacher perceptions, digital learning, Discover Education, statistical analysis