Multilevel Determinants of Engagement in Lifelong Learning in Orthodontics From Formal to AI-Supported Approaches: Development of a Conceptual Framework Through a Qualitative Study

Abstract Background Lifelong learning (LLL) is increasingly important for health care professionals, particularly within the field of orthodontics, driven by emerging technologies, updated treatment techniques, and rising patient expectations. To maintain competence in current practice, orthodontists are expected to engage in continuous professional development throughout their careers. While the value of LLL is widely acknowledged, engagement levels among orthodontic professionals can vary due to a number of factors. Objective This study aims to investigate how orthodontic professionals perceive and engage with LLL by examining their learning strategies, along with the barriers and enablers. In addition, this study integrates these determinants of professional development to construct a conceptual framework to explain LLL engagement among orthodontic professionals. Methods A qualitative study using semistructured interviews with a topic guide was conducted among 16 orthodontic professionals who were recruited using purposive sampling to ensure diversity in settings and experience levels. Interviews were audio recorded and transcribed verbatim until data saturation was achieved. Data were analyzed using framework analysis informed by the theory of planned behavior. To ensure analytic rigor and credibility, an iterative coding process was performed independently by 2 researchers, with any discrepancies resolved through consensus among the research team. Results All participants believed that LLL was important for clinical improvement and personal fulfillment. However, they reported several challenges, including time constraints, financial restrictions, and limited access to learning resources. Social influences, institutional contexts, technological advancements, and patient expectations were considered key determinants in shaping LLL engagement. The results also revealed a pedagogical shift in LLL activities from formal short course training to the use of generative artificial intelligence for self-directed learning. A conceptual framework illustrating key determinants of LLL engagement was developed. Conclusions LLL engagement was perceived as essential for clinical competence and personal development, which could be influenced by individual, social, institutional, and external factors. The conceptual framework developed in this study demonstrates the key determinants of LLL in orthodontic practice and suggests that multilevel strategies are required to sustain long-term engagement.