Mapping educational scholarship in a mixed-financing health system: a scoping review of health professions education research in Singapore

More than a decade since the 2010 landmark Lancet Commission called for systems-based reforms, aligning health professions education (HPE) with health system needs remains a global imperative. The aim of this scoping review was to systematically examine the literature on adult learning among Singapore’s healthcare professionals to provide evidence to guide national improvement and inform global adaptation. The study focuses on Singapore as a case of a system characterized by mixed-financing and open access to specialist care. This scoping review followed the methodological framework established by Arksey and O’Malley, incorporating enhancements by Peters et al. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. We conducted a comprehensive search of the PubMed, ERIC, SCOPUS, and CINAHL in February 2025. Publications and abstracts describing, examining, referencing, or commenting on adult learning in Singapore were included without time restriction. Two reviewers independently screened titles and abstracts, with full-text review confirming relevance. Screening was managed using the Covidence systematic review software. The search identified 762 unique articles, with 58 studies meeting the final inclusion criteria. From these, we systematically mapped the characteristics, quality, and evidence gaps of the HPE research landscape in Singapore. Key characteristics include concentration in nursing and medicine, a predominance of survey-based methods, and a focus on lower-level Kirkpatrick outcomes. While simulation and online learning are increasingly being studied, we identified significant evidence gaps in postgraduate assessment, educational scholarship, multi-institutional studies, and evaluation of higher-level outcomes. The mapped characteristics of Singapore’s HPE research suggest a link between the health system’s structure and research feasibility. Rather than demonstrating causality, our analysis generates a testable hypothesis about this relationship. The study offers a replicable methodology for other systems to map their own research landscapes and provides a clear agenda for future inquiry into these systemic influences, advancing the global goal of contextually relevant HPE.