Career Pathways Research Articles

Advanced practice providers (APPs) are essential to health system capacity yet remain underrepresented in governance and executive leadership. This narrative review synthesizes existing peer-reviewed and organizational evidence into a five-domain framework for APP leadership integration and assesses its implications for organizational performance. A targeted narrative review was conducted, drawing from peer-reviewed literature, organizational case reports, and industry analyses published between 2013 and 2025. Sources were identified through PubMed, CINAHL, Google Scholar, discipline-specific journals and professional organizations. Inclusion criteria focused on governance, leadership, and organizational integration of Physician Assistants and Advanced Practice Registered Nurses. Given the applied focus on governance, selected greyliterature was included to capture emerging practices. Evidence was synthesized thematically into five domains of APP leadership integration. This approach emphasizes conceptual clarity rather than exhaustive coverage. Five interdependent domains of APP governance integration emerged: (1) governance inclusion and medical staff structures, (2) leadership development and career pathways, (3) operational alignment and role optimization, (4) culture, scope, and policy enablement and (5) measurement, accountability and the business case. Together these domains provide a framework for intentional inclusion of APPs in health system governance. Evidence indicates that APP leadership integration supports workforce retention, improves efficiency, and contributes to financial sustainability. Distinctions were noted between public and private health systems, with mission-driven organizations emphasizing equity and access, and private systems prioritizing return on investment and margin recovery. As a targeted narrative review, this study does not claim exhaustiveness and may be subject to selection and publication bias. The existing literature is largely descriptive, with limited comparative studies or standardized outcome measures. Future research should evaluate governance models across diverse systems and establish benchmarks for measuring the impact of APP leadership. Health systems can strengthen organizational performance by embedding APPs into governance structures, developing leadership pipelines, aligning roles operationally, fostering inclusive cultures, and implementing measurement frameworks. These strategies reduce turnover, improve collaboration and enhance financial and clinical outcomes. While public sector systems may emphasize access and equity, private sector systems may prioritize return on investment and margin recovery, making APP governance integration a valuable strategy across contexts. While prior reviews have cataloged factors influencing APP workforce integration, this is the first narrative review to focus specifically on governance and leadership structures. By consolidating fragmented literature into a five-domain framework, the paper advances the discussion from whether APPs should be included in governance to how their inclusion can be intentionally structured and evaluated to improve system performance.

Introduction Professional identity shapes the effectiveness, motivation, and well-being of allied health clinical educators (CEs). Burnout, characterised by emotional exhaustion, depersonalisation, and reduced personal accomplishment, can undermine these outcomes, diminishing both teaching quality and educator retention. While burnout in healthcare professionals is well documented, limited research has explored its relationship with educator identity among allied health professionals (AHPs), particularly in Asian contexts. This study examines the interrelationship between burnout, job satisfaction, and educator identity among AHP CEs, and identifies contextual factors that influence these experiences. Methods An exploratory qualitative study was conducted across multiple healthcare institutions in Singapore using a constructivist paradigm. Sixteen AHP CEs representing diverse disciplines participated in semi structured focus group discussions guided by Maslach and Jackson’s burnout framework. Data were analysed thematically through iterative coding and team based discussion to identify recurrent patterns and relational dynamics between burnout and educator identity. Results Participants described burnout as a multifaceted experience influenced by workload pressures, limited institutional recognition, and insufficient protected time for educational work. Contributing factors included inadequate career pathways and constrained access to faculty development. A strong sense of educator identity and job satisfaction emerged as protective buffers, whereas weak identification with the educator role appeared to heighten burnout risk. Supportive communities of practice and organisational cultures that value teaching were key in sustaining motivation and professional fulfilment. Discussion These findings underscore the need for systemic and institutional strategies to strengthen the educator identity of AHP CEs. Enhancing professional recognition, fostering collegial support, and promoting meaningful engagement in education may mitigate burnout and sustain a resilient allied health education workforce.

Purpose: The study aims to analyse and compare the features of Continuous Professional Development (CPD) for school teachers in European Union countries and Ukraine. The core objective is to determine the key role of CPD as a driving force in the processes of European integration and to formulate evidence-based recommendations for harmonising the Ukrainian system with European standards and best practices. Methodology: The research is based on a comparative analysis of national Continuous Professional Development systems, drawing upon key EU strategic documents (e.g., Eurydice reports, Council of the EU resolutions) as well as the national regulatory framework governing teacher professional development in Ukraine. Results: The study substantiates that, amid rapid global changes, CPD is a key strategic factor for European integration, as the success of educational reforms critically depends on teachers’ ability to implement innovative, digital, and inclusive approaches that meet the requirements of the European Education Area (EEA). Analysis of EU systems revealed a shared focus on quality and inclusiveness, characterized by: variability and flexibility of programs, priority state funding, relevance of content, emphasis on practical skills, and encouragement of international cooperation and mobility (Erasmus+, eTwinning). The Ukrainian system has successfully transitioned to a flexible, decentralised model, adopting the “money follows the teacher” principle and using certification for independent competence assessment. However, to retain teaching staff, a significant emphasis on financial motivation and clear career pathways remains crucial. Conclusion: The successful implementation of European integration and educational reforms is critically dependent on teachers’ ability for continuous, flexible professional growth and their readiness to implement modern pedagogical approaches. The article concludes by providing specific recommendations for Ukraine’s system improvement, including introducing incentives for micro- qualifications and actively enhancing international mobility and voucher programs.

ABSTRACT This article extends our recent research on workforce professionalism in the South Africa's Early Childhood Care and Education (ECCE) sector. We explore how teachers navigate tensions between professional expectations and systemic challenges that impact educational quality and equity. These tensions are compounded by fragmented governance and structural inequalities. ECCE teachers, predominantly Black African women, face systemic barriers rooted in race, gender and class that undermine SDG 4 (quality education), SDG 5 (gender equality) and SDG 10 (reduced inequalities). Drawing on Black feminist thought, intersectionality theory and the critical ecology of ECCE professions, this study centres teachers' voices to explore their responses to these challenges. Data were collected through an online qualitative questionnaire from 208 ECCE teachers across 73 settings in Ekurhuleni, Gauteng. The findings reveal that teachers navigate resource constraints, governance confusion and intersectional barriers with resilience and strategic agency, often developing localised solutions. These insights highlight the need for dual policy approaches that maintain quality standards while enabling sustainable career pathways. This study contributes to global conversations on ECCE workforce professionalism, particularly in contexts characterised by structural inequities. Our multi-framework approach, underexplored in South African research, offers an intersectional and ecological lens to understand how systemic inequities shape professionalism and sustainability.

This case study explores three vignettes of resistance faced by superintendents and school board members as they attempted to implement equity-centered policy that challenges the status quo. We recount the outcry that followed Superintendent Andrea Kane declaring “Black Lives Matter” in Queen Anne’s County, MD; Superintendent Cheryl Logan introducing a comprehensive career pathways program in Omaha, NE; and School Board Commissioners Alison Collins, Gabriela López, and Faauuga Moliga voting to support marginalized communities in San Francisco, CA. The threats, smear campaigns, and recall elections these leaders of color endured underscore the lengths to which privileged constituencies will go to protect their educational advantage and resist systemic change.

ABSTRACT U.S. adult and workforce education (AWE) policy was created to support improved economic integration and social mobility for vulnerable populations. The primary framing of legislation has been articulated in terms of helping individuals become more financially self-sustaining (and thus not an economic burden on the state and wider society) through the selection of various educational and career pathways. The purpose of this paper is to explore the political framing and rationale of AWE policies through the theoretical lens of individualisation of social risk, using Critical Discourse Analysis (CDA) to examine national-level policy. Individualisation, as a theoretical concept, refers to structural changes to the relations between individuals and society where the notion of ‘the individual’ takes precedence over society. Opportunities, dangers, and life’s uncertainties must be negotiated by individuals, instead of by traditional social institutions. Core aspects of the theory are presented and four examples to illustrate how this ‘individualization’ rationale is embedded in AWE policy. We argue that this ‘individualization’ of public programs may become a form of reverse accountability that moves social risks away from the state and employers by offloading the burdens onto the individuals who have the fewest resources to ‘choose’ and manage the risks.

Introduction: Pediatric cardiology requires extensive training, yet the long-term financial implications across academic subspecialties and private practice remain poorly characterized. A clearer understanding of these differences is essential for career decision-making and workforce planning. Methods: We used a net present value (NPV) framework to model lifetime earnings for pediatric cardiologists across three academic subspecialties (diagnostic, cardiac intensive care, and interventional) under five promotion trajectories and compared them with private practice. Compensation data were sourced from the Association of Academic Administrators in Pediatrics (AAAP), the Association of American Medical Colleges (AAMC), and the Medical Group Management Association (MGMA). Monte Carlo simulations (10,000 iterations) and sensitivity analyses accounted for variation in salary percentile, discount rate, and career length. Results: Lifetime earnings were substantial across all pediatric cardiology career pathways, with NPVs exceeding $7 million (M) in most modeled scenarios (Figure 1). Interventional cardiology yielded the highest NPV at the 50th percentile (Figure 2) under a typical academic promotion trajectory ($7.99M), followed by cardiac intensive care ($7.76M) and diagnostic cardiology ($7M). Private practice produced an NPV of $7.08M at the 50th percentile, with a ramp-up model increasing this to $7.30M; still below interventional and CICU tracks. Academic earnings rose by up to $2.44M through early promotion compared to no promotion, and by up to $867,000 through leadership roles, depending on subspecialty. Salary percentile was the most influential driver of NPV; interventional cardiology at the 90th percentile exceeded $10.4M, and private practice reached $10.76M. Private practice exhibited the widest range of lifetime earnings (Figure 3). Conclusion: Pediatric cardiologists; particularly those in interventional subspecialties or academic leadership; achieve substantial lifetime earnings. At the 50th percentile, academic and private practice careers offer comparable financial outcomes, but private practice shows greater variability. Optimizing academic career pathways through early promotion, high-percentile salaries, or leadership roles can match or exceed private practice earnings. These findings can guide trainee decision-making and inform strategies for recruitment, retention, and compensation equity in pediatric cardiology.

Women are underrepresented within academic general practice, particularly after mid-career. To explore the lived experiences of early- and mid-career female academic GPs and inform ways to reduce attrition through the GP academic career path. This was an in-depth qualitative interview study within the UK. Adapted biographical narrative interpretive method interviews were utilised, analysed thematically using Braun and Clarke's reflexive method, and informed by Bourdieu's theory of practice. Composite narratives were developed as part of the analysis to identify key biographical storylines and to present findings. In total, 39 interviews with a diverse sample of 13 female academic GPs were conducted. Five composite narratives reflecting corresponding themes were generated. Participants described: challenges in 'thriving? or surviving?' in academic general practice; 'feeling on the cliff edge' with precarious careers balanced against fulfilment and creativity; the cumulative burdens of 'doing the juggle'; and living between 'two worlds'. Women who followed conventional academic career pathways appeared more positive within their careers than those who did not. Women who entered later in their GP careers and those who experienced multiple forms of disadvantage reported additional barriers. Participants described their efforts managing practical and ethical tensions between their clinical, academic, and personal responsibilities. Women academic GPs live complex and demanding lives. Different strands of their unfolding life narratives - as clinicians, academics, and partners and/or carers - generate recurrent tensions and conflicting pressures. Experiences are varied. Academic support structures should address (among other things) the career-limiting impact of short-term contracts, mentorship, and inequity in navigating the field.

Promoting equitable learning and career pathways in STEM through positive youth development

Fostering early research readiness among undergraduate nurses and midwives to support the national clinical research impetus: A discussion paper.

This qualitative study, based on interviews with nine participants, explores the post-secondary education and career pathways of refugee-background youth in Scotland. A key finding is that Scotland provides unique supports from state and voluntary sectors. However, these must contend with significant barriers, including academic challenges, and constrained progression from Further Education (FE) to university. This exploratory study, while identifying examples of best practice, concludes that significant structural barriers continue to limit career potential for refugee-background youth.

This qualitative study examined the lived experiences of academic and career pursuits among higher education student tutors who participated in the Tara Basa Tutoring Program. Employing a descriptive phenomenological design, the research examined how tutoring engagement influenced their academic experiences, career aspirations, and personal and professional growth. Using purposive sampling, fifteen (15) student tutors from a state university in Southern Cebu, Philippines, were selected to participate in focus group discussions and semi-structured interviews. Through thematic analysis, the study generated key themes under three main domains of inquiry. For academic experiences, the themes identified were Academic Transformation, Professional Growth, and Self-Awareness and Maturity. Regarding career aspirations, the themes included Clarity of Career Calling and Nurtured Commitment to the Teaching Profession. For personal and professional insights, four themes emerged: Sense of Social Responsibility, Character Development, Resilience and Confidence in Teaching, and Professional Fulfillment. The findings revealed that the Tara Basa Tutoring Program fostered improved academic engagement, strengthened professional readiness, clarified career pathways, and cultivated a more profound sense of social responsibility among tutors. The program played a crucial role in developing both instructional competence and personal values, making a meaningful contribution to the holistic formation of future educators. Based on these findings, the study recommends integrating service-learning initiatives, such as Tara Basa, into teacher education programs, emphasizing their dual role in enhancing learner outcomes and shaping the professional identity of student tutors.

Purpose This paper aims to examine the growing expectation that organizations should adapt professional development programs to align with Generation Z’s digital fluency, communication styles and workplace values. It explores the opportunities and risks of tailoring development initiatives too closely to generational preferences, questioning whether meeting Gen Z “where they are” strengthens or undermines long-term organizational capability. Design/methodology/approach This paper integrates three theoretical lenses, social learning theory, self-determination theory and generational cohort theory, to analyze the behavioral, motivational and cultural dimensions of Gen Z professional development. Insights are drawn from contemporary research on generational identity, digital behavior, strategic human resource management and recent scholarship on the psychological and organizational implications of workforce change. Findings Evidence suggests that while aligning development with Gen Z preferences can increase engagement, overaccommodation risks reinforcing dependency on digital habits, undermining resilience and lowering standards of professional growth. Effective programs strike a balance between personalization and rigor by embedding mentorship, fostering autonomy and competence, supporting overall well-being and linking training directly to career pathways. Organizations that contextualize generational differences within cross-cohort strategies are better positioned to build sustainable engagement and capability. Originality/value This paper contributes to the literature on generational workforce development by reframing the debate around adaptation versus guidance. Rather than treating Gen Z’s expectations as fixed constraints, it emphasizes the role of ethical leadership in calibrating development programs to meet immediate needs while cultivating the critical interpersonal skills essential for long-term organizational success.

BackgroundThis research explores the identity and career aspirations of biomedical science students across disciplines such as cell biology, anatomy, physiology, pharmacology, and pathology. The study examines students’ motivations for choosing these programmes and perceptions of career preparation, with analysis by programme, ethnicity, and gender.MethodsUsing a longitudinal cross-sectional survey guided by Social Cognitive Career Theory, we gathered responses from 172 students in 2023 and 184 in 2024. The questionnaire included both closed and open-ended questions, which we analysed using descriptive and thematic methods.ResultsMost students (76.8%) enrolled due to strong interest in the field. Clinical, research, and industry roles were seen as desirable, while academia, allied health, regulatory affairs, and teaching were less appealing. Postgraduate study became a more prominent career goal for more students enrolled in their capstone courses in the third and final year of the programme (stage III) than for students enrolled in courses/papers taken in the second year of the programme (stage II). Most students (83.7%) felt their programme adequately prepared them for career success, citing labs, field trips, problem-based learning, and assignments as key contributors. However, 22% viewed creativity and entrepreneurship as irrelevant to their future work. Most (73.9%) were confident about career prospects, though grades and competitive entry were concerns.ConclusionsFindings are discussed in relation to Social Cognitive Career Theory, highlighting the importance of authentic work experiences, professional identity development, and clear career pathways for improving student engagement and retention.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-025-08098-3.

ABSTRACT Purpose This study explores how instructional designers (IDs) in higher education understand and experience their professional identity. As distance education grows, IDs occupy a “third space” between faculty and administration, yet their roles remain ambiguously defined and frequently misunderstood. This research addresses a gap in the literature by focusing on IDs’ self-perceptions and career trajectories. Methodology Using hermeneutic phenomenology, the study draws on in-depth, semi-structured interviews with 15 IDs employed at U.S. colleges and universities. Participants were purposefully sampled to ensure diversity in institution type, role, experience, and demographic background. Data were analyzed through a five-step process, including identification of meaning units, thematic coding, and situated narrative development. Findings Two major themes emerged: (1) interactions with faculty – both affirming and disheartening – significantly shape IDs’ sense of professional identity, and (2) participants’ professional identity evolves over time, influenced by their engagement in the field, perceived value, and clarity of career trajectories. While some expressed deep commitment to ID, others voiced uncertainty about long-term prospects due to a lack of role clarity and professional recognition. Practical Implications Findings suggest institutions should support IDs by fostering collaborative partnerships with faculty, clarifying career pathways, and establishing national-level certification or recognition to reinforce their contributions to distance education. Originality/Value This study offers a rare, in-depth exploration of IDs’ professional identity formation in the context of higher education. By applying role theory and third space as conceptual lenses, it advances understanding of how IDs navigate complex institutional relationships and assert their professional legitimacy.

Skill-job alignment remains a significant challenge in vocational education, where students often graduate with limited guidance on career pathways matching their acquired competencies. The gap between vocational training outcomes and dynamic labor market demands underscores the need for intelligent systems that facilitate personalized employment recommendations. To address this, a Machine Learning-Powered Skill-Job Matching Recommendation System is proposed for vocational graduates, integrating a novel hybrid model named Scalable Slime Mould optimized-Adaptive Random Forest Tree (SSM-ARFT). The model utilizes a curated dataset combining vocational student profiles, academic performance, certifications, and job requirement metadata gathered from institutional databases and public employment platforms. Data preprocessing is performed using normalization techniques to ensure uniformity across varying data types. For feature extraction, Principal Component Analysis (PCA) is employed to identify the most influential attributes for job-role alignment. The core framework involves mapping students’ skill profiles to job attributes through multi-level filtering and learning stages. The proposed SSM-ARFT algorithm enhances the ARFT by introducing slime mold-inspired metaheuristics for dynamic feature selection and adaptive learning, ensuring robustness and scalability across varying datasets. This intelligent recommendation system helps guide vocational students toward employment options that are closely aligned with their competencies. The proposed method is implemented by using Python 3.10.1. The models were trained and tested with k-fold cross-validation data. The findings determine that the suggested model outperforms traditional methods in metrics such as precision, F1 score, recall, and accuracy, which range from 91% to 94%. The research concludes that the proposed model offers a practical, scalable solution for effective skill-job matching, thereby enhancing graduate employability in vocational sectors.

ABSTRACTBackgroundDental therapists play a critical role in addressing oral health needs, especially in underserved areas. However, the South African health system faces workforce shortages and challenges retaining mid‐level oral health professionals. Understanding attrition from the perspective of stakeholders involved in training, policy and regulation is key to addressing systemic barriers and improving retention.AimThis study aimed to explore the perspectives of key stakeholders on the factors contributing to attrition among dental therapists in South Africa, focusing on intrinsic and extrinsic influences as guided by Herzberg's two‐factor theory.MethodsThrough a qualitative exploratory study design, in‐depth interviews were conducted with stakeholders to explore their perspectives on dental therapists’ attrition. They were recruited using snowball sampling. All interviews were audio recorded, transcribed verbatim, and coded in NVivo 12. A team of researchers applied thematic analysis to agree on themes and sub‐themes, guided by Hertzberg's ideas of intrinsic and extrinsic factors.FindingsThirteen stakeholders participated in the study. Both extrinsic (policy implementation gaps, inadequate remuneration, limited recruitment opportunities and lack of professional identity) and intrinsic (limited career growth and unclear career pathways) factors were identified as key contributors to attrition. Despite the recognition of their essential role in primary healthcare (PHC), systemic challenges undermined professional satisfaction and retention.ConclusionThe study fulfils its aim by providing a nuanced understanding of attrition from the perspective of stakeholders. Addressing both systemic (extrinsic) and motivational (intrinsic) factors is critical to strengthening workforce sustainability. Policy reforms, structured career pathways and enhanced professional recognition are necessary to retain dental therapists and ensure their integration into South Africa's PHC vision.

This paper examines how high school peer groups influence long-term educational and career outcomes, arguing that peer norms and values, rather than group labels or status, are the significant factors. Traditional stereotypes of “jocks,” “nerds,” and “populars” usually come with the idea that certain affiliations will achieve certain outcomes later in life. However, this paper demonstrates that the norms within peer groups, values, behaviors, and communication have a stronger correlation with developmental outcomes. Studies across psychology, sociology, and economics show that peer networks function as micro-cultures: growing academic achievement, developing aspirations, and affecting long-term income. Norms that prioritize education and goal setting can be linked with positive outcomes like increased chances of academic excellence, while groups with deviant or violent behaviors often hinder success regardless of social status. This paper examines findings from longitudinal and cross-sectional studies to display that adolescents actively change and affiliate themselves with certain group norms, which then guide the formation of values, post-secondary choices, and career pathways. These ideas affect educators and policymakers as well. Based on the findings of this study, they should move beyond simple peer group categorizations and instead create environments that grow and develop positive peer norms. Ultimately, what matters most is not the label of the group, but the values it accepts, as these have lasting effects on academic, social, and occupational trajectories.

ABSTRACT In the context of Donald Trump’s return to office and the escalating geopolitical rivalry between the U.S. and China, this study provides timely insights into how macro-level political and economic forces intersect with micro-level agency in shaping the decisions and lived experiences of Chinese international students. Drawing on the theoretical frameworks of geopolitical economy and student self-formation, this article critically examines how global power dynamics and structural constraints influence international students’ educational trajectories. Based on the semi-structured interviews with 38 Chinese students at a U.S. public research university, the study finds that their decisions to study abroad are shaped by concerns about personal safety, financial constraints, and restrictions on international mobility. However, these students are not merely passive recipients of these external challenges; they actively navigate these political and economic uncertainties by leveraging transnational social networks and digital resources, exploring alternative educational and career pathways, and adapting their aspirations in response to shifting global landscapes. By highlighting the entanglement of geopolitics, race, and higher education, this study calls for a geopolitical turn in higher education research to better theorize how international students are positioned not only through race and class, but also through nation-state rivalry and global restructuring.

This study examines the influence of achievement needs on career achievement and investigates the mediating role of employee competence among staff members of the Class I Correctional Institution in Malang. Employing an explanatory quantitative design, data were analyzed using the Partial Least Squares–Structural Equation Modeling (PLS-SEM) approach. The findings reveal that the need for achievement has a positive and significant effect on both employee competence and career achievement. Furthermore, employee competence exerts a significant positive influence on career achievement and mediates the relationship between achievement needs and career outcomes. These results indicate that employees’ intrinsic drive to excel not only enhances their career achievement directly but also indirectly through competence improvement. Theoretically, this study contributes to the extension of McClelland’s Achievement Motivation Theory by demonstrating its applicability in a high-stress, bureaucratic public organization such as a correctional institution. Practically, the findings highlight the importance of developing programs that simultaneously foster achievement motivation and enhance competencies through training, recognition, and structured career pathways. Strengthening these aspects can improve both individual career advancement and organizational performance within correctional settings.