Educational activities as a pathway to postgraduate standardization: a qualitative study

Educational activities (EAs) in health professional education play a crucial role in healthcare training curricula through a variety of methods, such as lectures, small-group discussions, simulation, case-based learning, and workplace-based experiences, that aim to develop knowledge, specific skills, and professional behaviours for clinical practice. In postgraduate education, EAs are frequently organised around learning competencies and Entrustable Professional Activities (EPAs)/national standards. However, there are few studies on how these activities systematically translate into structured postgraduate programs. A qualitative research study using descriptive and comparative document analysis was conducted in consecutive stages to identify gaps in the curricula of the postgraduate training programs of the Saudi Commission for Health Specialities (SCFHS). At first, the data, including 124 randomly sampled curricula, were independently reviewed and coded by two reviewers, after which the results were categorised into themes and subthemes. Then, these themes were further developed into more comprehensive themes and subthemes as a proposed educational framework through a literature review and discussions with a team of experts. Initially, four key themes emerged regarding the structuring of EAs in the reviewed curricula. The four key themes were: Academic Instruction, Experiential Learning, Self learning and Evaluation, and EAs framework design recommendation. Additionally, these reviews noted significant variations and a lack of congruence in the educational activities implemented by training programs. To address this variability, expert discussions were undertaken to refine and standardise the thematic structure. This resulted in the development of a comprehensive framework comprising five major themes: Academic Activities, Practice-based Learning, Skills Training and Procedures, Scholarly Project, and Professional and Personal Development. The integration of EAs into a cohesive structural framework better prepares trainees for clinical competency, professional behaviour, and practice readiness. The proposed framework provides a robust approach to implementing and evaluating competency-based postgraduate medical education programs.