General Practitioner Engagement with Continuing Professional Development: A Scoping Review Protocol

ABSTRACT

Continuing professional development (CPD) is a cornerstone of lifelong learning for general practitioners (GPs), encompassing both formal (e.g. courses, workshops) and informal (e.g. peer learning, self-directed) activities. While CPD is increasingly mandated through credit-based systems, concerns have emerged that such frameworks may encourage compliance-driven behaviour, limiting relevance to clinical practice and undermining professional autonomy. This scoping review will examine how GPs engage with CPD in terms of decision-making, motivation, and perceived value, and factors influencing their choice of CPD activities. This will be addressed through two sub-questions: (1) What personal, professional, contextual, organisational or systemic factors influence CPD choices? (2) What strategies do GPs use to identify, select, and prioritise CPD activities? A comprehensive systematic search will be conducted across MEDLINE (Ovid), Embase (Ovid), ERIC, Scopus, Informit, and APA PsycINFO, supplemented by grey literature from stakeholder organisations, conference websites, and structured Google searches. Eligible studies will include empirical research on GPs’ CPD engagement in primary care settings within systems that mandate CPD participation. The review will follow JBI methodology and will be reported in accordance with PRISMA-ScR guidelines. By synthesising current evidence, the review seeks to inform the design of practitioner-centred CPD models that support reflective practice, lifelong learning, and improved patient care.

Introduction

Continuing professional development (CPD) is an ongoing process in which healthcare professionals engage in both formal (e.g. courses, workshops) and informal (e.g. peer learning, self-directed) learning activities to expand their knowledge, refine their skills, and enhance professional and personal attributes. This commitment supports the delivery of safe, effective, and up-to-date care, ultimately aiming to improve patient outcomes and community health [1–3].

Nationally and internationally, a General Practitioner (GP) (or family physician) is recognised as a primary care specialist. GPs are trained to deliver comprehensive, continuous, and accessible medical care. They also serve as the first point of contact, addressing the wide-ranging health needs across all patient profiles [4]. For GPs, CPD is a crucial component of lifelong learning.

Across many health systems, CPD is increasingly mandated, often linked to regulatory requirements and credit-based systems that set minimum participation thresholds [5,6]. There is growing concern that existing frameworks may foster compliance-driven behaviour, focusing on accumulating credits rather than addressing meaningful learning, knowledge acquisition or practice gaps [7]. While credit-based systems ensure participation, Cook and Artino [8] call for more tailored, reflective, and outcomes-focused CPD approaches that prioritise meaningful engagement over mere attendance.

Inherent in Cook and Artino’s [8] recommendations is a persistent tension between mandated CPD requirements and the clinician’s desire to identify and pursue their own learning needs. Recent literature underscores this tension, revealing that mandated CPD often fails to reflect individual performance gaps or practitioner-identified needs [9,10]. Moreover, CPD activities frequently lack integration with reflective practice and adult learning principles, further limiting their effectiveness [11]. A shift towards reflective, outcomes-focused CPD is essential to bridge this gap and foster meaningful engagement.

When CPD is primarily compliance-driven, it risks becoming a superficial exercise that misses opportunities for meaningful practice improvement. This approach contributes to professional dissatisfaction and disengagement, as clinicians struggle to see relevance to their daily practice [11,12]. Poorly designed CPD may also fail to equip clinicians for the increasingly complex challenges found in general practice, such as multimorbidity, where fragmented care systems and inadequate guidance hinder effective management [13]. This disconnect between CPD content and clinical realities can compromise the quality and safety of patient care, once again underscoring the need for outcomes-based, reflective CPD models [14].

Identifying and reflecting on knowledge or performance gaps is a critical component of self-regulated learning (SRL), as demonstrated in clinical education contexts [15]. It is, therefore, unsurprising that SRL is increasingly recognised as foundational to effective CPD [16]. Research suggests that when CPD is designed to enhance SRL capacities, through goal setting, self-monitoring tools, and reflective exercises, it improves learner engagement and strengthens the transfer of learning into clinical practice [11,17,18]. Frameworks such as Self-Directed and Self-Regulated Learning in Professional Development (SDRL-PD) [16]) and continuing education studies indicate that integrating SRL principles into CPD may help to reconcile mandated participation with meaningful, self-directed professional growth [18–20].

Studies suggest that GPs’ selection of, and engagement with CPD activities, is influenced by a range of personal, professional, and contextual factors. These include career stage, learning preferences, perceived relevance to patient care, peer influence, and organisational support [11,12]. Despite the availability of diverse CPD formats including lectures, workshops, and interactive sessions, evidence suggests that not all are equally effective or perceived as meaningful in influencing clinical practice [1].

Rationale for Scoping Review

Despite the central role of CPD in professional regulation, there is limited synthesis on how GPs perceive its meaningfulness, particularly about mandated, credit-based requirements, and whether such activities effectively address individual learning needs or practice gaps [21]. Although the literature identifies a range of motivations, barriers, and contextual influences on GP participation in CPD, it remains conceptually and methodologically fragmented. Studies vary widely in their theoretical framing, research design, and focus, ranging from individual experiences to systemic critiques, resulting in a dispersed and often disconnected understanding of CPD engagement [22–24]. With the increasing emphasis on lifelong learning and CPD for GPs, understanding how they engage with, and make choices about CPD activities can aid in facilitating meaningful, practice-relevant education.

The purpose of the review is to explore and describe the depth and breadth of knowledge related to GP’s engagement with CPD, the factors influencing their choices, their perceptions of what makes CPD meaningful, and the role that self-regulation plays [11]. A scoping review is best placed to achieve this aim, given the focus on mapping existing heterogenous literature in a particular area [25,26], as opposed to a systematic review which seeks to obtain all existing evidence to address a specific question [27]. Such a review is warranted to shed light on current evidence on GP decision-making processes, in the hope of aiding educators, policymakers, and regulators in reviewing policies to support meaningful CPD engagement. Given declining GP recruitment and retention challenges [28], understanding GP engagement in CPD, including how they develop meaningful learning goals and plans [11], may help to inform CPD programme design to better meet practitioner and system-level needs. With the increasing complexity of health systems, often driven by ageing populations, rising multimorbidity, and growing demands for accountability, this review is both timely and essential to ensure that educational strategies are not only practical but also sustainable in supporting practitioners and ensuring patient safety [29,30].

Objectives

The objective of this scoping review is to systematically map existing evidence to address the primary research question: “How do GPs engage with CPD in terms of decision-making, motivation, and perceived value, and what factors influence their choice of CPD activities?” Specifically, the review seeks to answer this through the following sub-questions:

1. What personal, professional, contextual, organisational or systemic factors influence how GPs choose CPD activities?

2. What methods or strategies do GPs employ to identify, choose, and prioritise CPD activities?

Methods

This scoping review will follow the methodological framework outlined in the most recent JBI guidance [31]. In reporting, the review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) [32]. As the research is literature-based, ethics approval is not required.

Eligibility Criteria

This scoping review will include studies focusing on GPs/family physicians working in primary care settings and their engagement with CPD. Factors influencing participation, decision-making, motivation, and perceived meaningfulness of CPD activities undertaken will form part of the analysis and interpretation. Studies will focus on both formal and informal professional learning. Research will be considered from all countries with formalised CPD systems to provide depth and cross-system insights. Eligible sources will include primary research (quantitative, qualitative, and mixed methods) as well as grey literature in the form of empirical studies. Systematic, scoping, and narrative reviews will be excluded to avoid duplication of data, as these reviews often include primary studies that may already be captured through direct database searches. To ensure comprehensiveness, however, the reference lists of these reviews will be screened to identify any relevant primary studies that may not have been retrieved through the initial search strategy.

To ensure that the inclusion/exclusion criteria are free from ambiguity and are appropriately weighted, all investigators will independently screen 50 records and full-text papers retrieved from the draft Medline search (discussed below). This calibration exercise will ensure the clarification and utility of the criteria from all reviewers in the screening process (Table 1).

Table 1.

Inclusion and exclusion criteria.

Criteria Type	Inclusion Criteria	Exclusion Criteria
Population	General Practitioners (GPs)/family physicians	Other healthcare professionals (e.g. nurses, pharmacists) Trainees and registrars Studies that include GP data, but that data is not analysed and reported on separately
Concept	Formal or informal engagement with CPD/CME Formal CPD (i.e. structured CPD activities that are organised and delivered by external providers, typically mandatory, credit-based, provider-driven, or regulated, and may include accredited courses, workshops, conferences, online modules, or training programmes that contribute to professional certification, licensing, or compliance requirements) Informal CPD (i.e. activities which are self-directed, experiential, and workplace-based)	Studies that do not focus on engagement with CPD/CME
Context	Primary care settings in healthcare systems with comparable time- or credit-based CPD requirements	Non-primary care settings Primary care in healthcare systems without some form of CPD requirement
Study Types	Empirical research that uses quantitative, qualitative and/or mixed methods	Opinion pieces, commentaries, or editorials Systematic, scoping and narrative reviews (to avoid duplication of data) Study protocols
Date Range	Papers published from 2010 onwards (to emphasise contemporary relevance)	Papers published before 2010
Language	English-language publications	Studies published in languages other than English

Search Strategy

An initial, exploratory search in MEDLINE (Ovid) will be conducted to identify relevant subject headings, keywords, and synonyms connected to the review topic and its key concepts. These terms will inform the development of a comprehensive MEDLINE (Ovid) search strategy (Appendix). Studies published from 2010 onwards will be included to ensure relevance to contemporary CPD frameworks, delivery modalities and regulatory requirements. Earlier literature reflects a substantially different educational and policy context, limiting its applicability to current practice.

This strategy will then be adapted for use across the Embase (Ovid), ERIC, Scopus, Informit, and APA PsycINFO databases. To enhance comprehensiveness, the reference lists of all articles included will be hand-searched to identify any further relevant studies. An experienced librarian will provide guidance on conducting the search.

To identify empirical grey literature globally, a structured and reproducible screening approach will be undertaken. Eligible grey literature will include national libraries, stakeholder organisations, conference websites, and the first 100 retrievals (ranked by relevance) from a Google Advanced Search. Sources will be limited to documents that report primary data and are publicly available. Commentary pieces, opinion articles and documents lacking an empirical basis will be excluded.

Consistent with the objectives of a scoping review, no formal quality appraisal of grey literature will be undertaken. Key contextual characteristic, however (e.g. source type, country of origin, document purpose and study design), will be extracted to enable readers to interpret the nature and scope of the evidence.

Study Selection

All retrieved records will be imported into EndNote (Clarivate Analytics, PA, USA), where duplicate entries will be identified and removed. This step is designed to mitigate any duplicates not highlighted in Covidence (Clarivate Analytics, PA, USA). The remaining unique records will be uploaded into Covidence for screening.

All records and papers will be screened independently by two reviewers, guided by the eligibility criteria. Screening will occur in two phases:

1. Title and abstract screening

2. Full text screening of records deemed potentially relevant based on title and abstract. This reading of the full paper will determine final eligibility.

Any discrepancies between reviewers at either stage will be resolved through discussion and negotiation. If consensus cannot be reached, a third reviewer will be consulted to make the final decision.

Data Charting

Data from the included studies will be extracted using a standardised data charting form specifically developed for this review. This data charting form, created in Covidence, will be developed through dual-reviewer piloting using known papers relevant to the review questions and subsequent consensus.

Charted information is likely to cover key study details (e.g. country, authorship, publication year, study setting), participant characteristics (e.g. age, professional role and gender), study design features (e.g. aims, methodology, design, and analytical perspective), and study findings. Additionally, to effectively answer the research questions, specific charting categories to be piloted include:

• Nature of the CPD programme (mandatory, time-based, accredited,

  credit-based, self-directed)

• Methods and/or factors used to select CPD activities

• CPD topics undertaken and the rationale for choice (if given)

• Stated motivators/barriers to CPD choices

• Implications for practice or further research

Full data extraction will be conducted independently by two reviewers, using the data charting form (as outlined above). This form will be included in the published review. Any disagreements in this process will be resolved through discussion or by a third reviewer.

Mapping and Presentation of Results

Following published scoping review principles [25,33], a two-part approach will be used to map the current evidence on how GPs engage with CPD and the factors that influence their choice of CPD activities:

1. Descriptive Numerical Summary: Study characteristics (e.g. study design, participant demographics, geographic setting, and CPD modalities) will be summarised in tabular form. Frequency of study type, setting, and publication trends will also be reported using visual tools such as bar graphs where appropriate.

2. Narrative Summary:Qualitative findings from the included studies will be synthesised to capture the depth and diversity of perspectives presented, while focusing on:

   1. Factors influencing GPs’ CPD decision-making (e.g. regulatory obligations, personal interests, time constraints)
   2. Strategies or processes used by GPs to identify, select, and prioritise CPD activities.

This approach enables us to capture both the breadth and complexity of CPD engagement as reported in the literature. Themes will be presented in narrative form, accompanied by illustrative quotes or examples where available. Depending on the findings, potential conceptual frameworks include the following:

• Self-Determination Theory [34,35], which is particularly relevant to intrinsic versus extrinsic motivation for CPD engagement

• Self-Regulated Learning Theory [36–38], which will provide insight into how GPs identify learning needs, set goals, and evaluate their progress

• Situativity Theory [39,40], which will aid understanding of how learning is shaped by the interaction between individuals and their environments.

These frameworks represent the multi-level influences on GP engagement in CPD and may support the development of a conceptual model illustrating how individual, organisational, and systemic factors interact to shape CPD participation and its impact. Such a model may serve as a foundation for future empirical research and guide the design of more responsive and meaningful CPD strategies.

Discussion

This scoping review will provide a comprehensive synthesis of how general practitioners engage with CPD, including their motivations, decision-making processes, and the contextual factors that shape their choices. By mapping current evidence across diverse systems and settings, the study aims to shed light on the complexities of CPD engagement and the extent to which current models support meaningful, practitioner-centred learning. The findings will offer valuable insights for educators, policymakers, and regulators seeking to design CPD frameworks that foster reflective practice, enhance professional autonomy, and ultimately improve patient care. In an era of increasing clinical complexity and workforce challenges, this review is both timely and essential to inform sustainable and impactful CPD strategies.

Appendix : Medline (OVID) Draft Search Strategy

#	Searches
1	General practice/or Family Practice/or General Practitioners/or Physicians, family/or Physicians, primary care/or Physicians/
2	(general practi* or GP or family physician* or “family practi* or primary care doctor*” or primary care provider* or family medicine*).tw,kf.
3	Physician*.ti,kf.
4	or/1–3
5	Education, continuing/or Education, Medical, Continuing/or Learning/or self-directed learning as topic/or Education, Medical, Graduate/
6	(continu* medical education or professional development or continu* education or continu* professional education or CME or CPD or life-long learn* or lifelong learn*).tw,kf.
7	(credential?ing or accreditation*).tw,kf.
8	((self-regulat* or self-direct*) adj3 (educat* or learn* or train*)).tw,kf.
9	or/5–8
10	cognition/or cognitive reflection/or metacognition/or intention/or thinking/or decision making/or choice behavior/or judgment/
11	self-assessment/or self efficacy/
12	Motivation/or Drive/or Aspirations, psychological/or Goals/or Sense of agency/or Attitude of health personnel/
13	(Self regulat* or self-direct* or self-select* or self-effica* or self-determin* or self-assess* or self manag*).tw,kf.
14	((learn* or education* or train* or course*) adj1 (need* or preference* or decision* or select* or practices or autonomy or plan* or tailor* or strateg*)).tw,kf.
15	(cognit* or metacognit* or intention* or decision* or choice* or choose or reflect* or motivat* or goal* or drive or agency or agentic or authentic).tw,kf.
16	((barrier* or facilitat* or support* or influenc*) adj5 (learn* or development or engag* or participat* or decision* or priorit* or undertak* or CPD or CME or continu*)).tw,kf.
17	or/10–16
18	4 and 9 and 17
19	limit 18 to english language
20	limit 19 to yr=“2010 -Current”

Funding Statement

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

No data are associated with this article.