Continuing education for professionals is becoming increasingly important, especially in complex sociotechnical settings like healthcare, to ensure up-to-date clinical competence. Digital learning platforms oer exibility and accessibility, but oen fail to align with the realities of clinical work. This qualitative study explores how User-Centered Design (UCD) principles can improve the design and eectiveness of digital continuing medical education (CME). The research setting is in Swedish healthcare, and focuses on a digital learning platform used by resident doctors as part of their specialist training. Guided by UCD and adult learning theories, the study draws on semi-structured interviews to examine user experiences, challenges, and preferences. Thematic analysis identied key areas aecting platform use, including content relevance, usability challenges, unclear communication, learning formats, workload constraints, and specic suggestions for improvement, such as personalization and exible design. The ndings highlight socio-technical issues where system design aects user behavior and organizational outcomes, and contribute practical recommendations for platform development, emphasizing the importance of involving end-users in the design and evaluation of digital CME tools to enhance engagement, usability, and learning outcomes. Theoretically, this study illustrates how digital learning is embedded in the social context of clinical work, extending discussions on user-centered digital learning in healthcare settings.
The digitalization of society has rapidly transformed the way we work, live, and learn. In many
professions, including healthcare, professionals must continually update their knowledge and skills
to remain relevant in their professional roles and practices throughout their careers [
continuously develop and rene their skills, opening new possibilities for learning by oering
exibility, accessibility, and self-paced education [
exible, focused, and manageable within tight schedules [
In this paper, we argue that a stronger focus on user feedback and real-world practice conditions is necessary when designing learning platforms that consider the dependency between the context and the system to better assist doctors in maintaining and developing their skills. Usercentered design (UCD) oers a practical and evidence-based approach to addressing the mentioned challenges, as it emphasizes designing systems that are grounded in a deep understanding of users' behaviors, needs, and work environments [15]. Rather than relying on assumptions, this approach involves users throughout all stages of development, from identifying problems to prototyping and testing, ensuring that the nal product is both usable and meaningful in real-world contexts [16]. While digital education has been widely studied in higher education and formal academic settings, there is comparatively less research examining how digital platforms support informal, selfdirected learning for healthcare professionals within clinical environments. This qualitative study addresses that gap by exploring the lived experiences of resident doctors using a digital CME platform within a Swedish hospital setting. Resident doctors are a particularly relevant user group because their learning is embedded in time-pressured, unpredictable work settings that demand both exibility and relevance. The aim of the study is to identify and analyze how current platform design supports or hinders learning within the context of clinical work, and to develop recommendations grounded in user experience and educational theory. By focusing on the specic user group of resident doctors in specialist training, this research contributes both theoretical insights into the applicability of UCD in medical education and practical guidance for improving digital learning environments in healthcare. We pose the following research question: How could digital learning platforms be designed to support the continuing medical education of resident doctors?
The remaining part of the paper is structured as follows: Section 2 presents related research on digital learning in medical settings, followed by a presentation of theories on adult learning and user-centered design that have guided the paper. Section 3 outlines the methodology used for data collection and analysis. The empirical ndings from interviews with resident doctors are presented in Section 4 and further discussed in Section 5. Finally, Section 6 presents our conclusion, highlighting the study's contributions, implications for practice, limitations, and suggestions for future research.
Among the medical workforce, resident doctors face unique challenges in engaging with
continuing medical education (CME). These doctors are still in training while working full-time in
hospitals, oen under high pressure. Traditionally, CME was delivered through face-to-face
workshops, conferences, and seminars, allowing doctors to meet experts, attend lectures, and
sometimes participate in hands-on training [17]. While these formats are useful, they oen require
doctors to take time o from work, travel to other cities, and adjust their schedules. Many nd it
challenging to balance ongoing learning with the demands of daily practice. Therefore, if CME is
not exible, targeted, and eciently delivered, it risks being sidelined or seen as a burden. [
Understanding how doctors prefer to learn is therefore essential for designing eective digital
platforms. Doctors juggling clinical responsibilities tend to favor platforms that allow them to set
their own pace while also oering chances for collaboration and community. Although exibility is
appreciated, there is still a strong need for personal feedback, social interaction, locally relevant
content, and active dialogue, rather than passive modules [
While previous research oers valuable insights into the potential and challenges of digital CME
platforms, studies oen emphasize user satisfaction and access to resources while overlooking
context-specic design strategies or implementation barriers [
Taken together, ndings from the literature show that when digital learning platforms are
thoughtfully designed, they oer important benets such as exibility, improved access to learning,
and professional growth. However, aligning with the socio-technical approach, their eectiveness
is shaped not just by technology, but by how well they are adapted to the needs, work routines,
and learning cultures of medical professionals. The importance of designing learning technologies
around the real needs and daily routines of users has long been emphasized in participatory
approaches to design and development, where users are not passive recipients but active
cocreators of the system [26, 27]. Socio-technical co-design can be applied to collaboratively design
digital technology, educational content, and social situations within the same process [30]. As
studies in healthcare demonstrate, it can also involve doctors in co-designing the content of a
learning platform and utilizing it for collaboration and knowledge sharing [28]. A growing body of
research indicates that user experience (UX) and design quality have a signicant impact on the
eectiveness of digital learning platforms. This reects a broader trend towards UCD, which calls
for involving end users in all phases of development, from identifying problems to evaluating
prototypes. As shown in [16], co-design with residents in virtual care settings led to tools that were
more aligned with clinical workows. Similarly, engaging students with emotionally and
cognitively challenging content through an interactive “digital escape room” increased both user
satisfaction and knowledge retention [
In summary, there is an increasing interest in understanding how digital learning platforms can
be co-designed, not only for convenience and static content delivery, but with a strong emphasis on
usability, pedagogical quality, and clinical relevance to support meaningful learning outcomes [
adult learning theory to help explain how digital learning environments can be structured to support continuing medical education in clinical settings.
UCD theory is both a philosophical framework and a practical approach that focuses on actively
involving users throughout the design and development process to ensure that their needs,
behaviors, and experiences are at the center of the design process [32, 33]. Rather than assuming
what users need, UCD emphasizes direct consultation with users, observation of their behavior,
and incorporation of their feedback during requirements gathering, prototyping, and usability
testing [29]. UCD can vary in intensity, from minimal user consultation to deep partnerships where
users co-create products with designers. Key practices include needs analysis, iterative testing, and
involving stakeholders such as primary, secondary, and tertiary users [29]. The ultimate goal is to
produce systems that are easy to learn, ecient to use, and aligned with users’ real-world
workows and mental models. The principles of UCD are not new; they build upon decades of
work in the Scandinavian socio-technical tradition of participatory design, which has since the
1970s advocated for democratic and collaborative approaches to system development. This
tradition holds that users, particularly those aected by workplace technologies, should be actively
involved in shaping the tools they use [26, 27, 30]. These inherently socio-technical values remain
as relevant and continue to inuence the contemporary design and development of information
systems. It emphasizes a critical and reective approach that reinforces the idea that system
eectiveness depends not only on technical performance but also on how well it aligns with users’
social, professional, and organizational contexts [
Since its early formulation, UCD theory has continued to evolve, incorporating new methods and responding to emerging challenges in technology development. Usability testing became a core component, emphasizing the importance of observing users performing real tasks to identify issues and improve designs [29]. However, UCD’s growth also introduced challenges, such as the need for resources and longer development timelines, as involving users throughout all stages of the design and evaluation process through interviews, prototyping, and testing requires time, funding, and interdisciplinary coordination [32]. Still, UCD remains a leading approach for ensuring that technology is human-centered, adaptable, and eective in a wide variety of application areas.
Adult learning theory emphasizes the distinct ways adults approach learning and argues that adult learners possess unique characteristics, such as a preference for autonomy, practical application, and using past experiences as a foundation for learning [33]. These studies recognize that adults bring prior knowledge, experiences, and specic learning needs into educational settings, requiring approaches dierent from traditional childhood education [33, 34]. Over time, adult learning theory has become foundational for professional development, workplace learning, and continuing education initiatives. It emphasizes several key principles that distinguish adult learners from younger students, such as that that they are self-directed, internally motivated, and focused on learning that addresses real world problems [33] In medical context, Taylor and Hamdy [34] further argue that learning in medical education must integrate multiple adult learning approaches such as experiential learning, reective practice, and problem-based learning to accommodate doctors’ need for contextualized, practice-oriented education. Adults value learning experiences that build on their prior knowledge, are relevant to their current professional roles, and oer opportunities for immediate application. Learning environments should therefore be collaborative, respect learners' autonomy, and encourage active participation and reection [28].
knowledge retention, and supports the development of meaningful skills for adult learners in various contexts, recognizing that adult learners benet from opportunities to collaborate, reect, and apply knowledge in authentic contexts [33]. Rather than viewing adults as passive recipients of information, adult learning theory positions them as active participants in their own development.
that are problem-centered and applicable to their professional lives [33], and medical professionals in particular, require exible, clinically relevant learning embedded in their practice context [34]
platforms in the context of medical education. UCD focuses on the development of digital learning platforms based on the needs, behaviors, and real-life contexts of users. Adult Learning Theory explains how adult learners, such as resident doctors, engage most eectively with learning that is relevant, problem-oriented, and self-directed.
be designed to support continuing medical education for resident doctors. The study setting is in
sites for approximately 250 resident doctors undergoing specialist training. The digital learning platform (hereinaer referred to as ‘the learning platform’) currently includes six courses designed to support their ongoing medical training, combining both online and oine learning elements.
activities, while the oine parts may involve practical exercises or group-based discussions. The goal of the learning platform is to oer exible access for resident doctors to complete training despite busy clinical schedules. However, concerns have been raised about whether the platform's structure, interface, and content truly meet the needs of resident doctors. Some feedback suggests that the system may not be fully aligned with the pace and demands of their working environment. This study aims to explore these concerns in more detail, focusing specically on the experiences and perspectives of resident doctors.
Empirical data were collected through a total of seven interviews, conducted with resident doctors working at the selected hospital at the time. Respondents were selected through purposive sampling [35] based on their direct involvement in specialist training and regular use of the hospital’s digital learning environment. Semi-structured interviews were chosen to allow for a balance between consistency and exibility, ensuring that key themes were explored while giving respondents space to elaborate on their individual experiences. An interview guide was developed, and a pilot interview was conducted prior to the main data collection. The pilot interview was not included or analysed as part of the empirical data but helped assess whether the questions were understandable, relevant, and appropriately sequenced. Minor adjustments were made based on feedback from the pilot interview, improving the ow and clarity of the nal interview protocol.
availability and preference. Each interview lasted approximately 30 to 45 minutes. All sessions were audio recorded with informed consent and transcribed verbatim. Ethical principles were observed throughout the entire process, in accordance with good research practice as outlined by the Swedish Research Council [36].
Clarke’s [37] six-phase approach, to explore how resident doctors experience the digital learning platform. The purpose of this method was to identify recurring patterns across the interview data and provide a rich, grounded understanding of participants’ perspectives. Themes were then rened, clearly dened, and checked for coherence and distinctiveness. Special care was taken to maintain the context of participants’ narratives, avoiding over-fragmentation during the coding process. This helped preserve the richness and meaning of their responses while highlighting common patterns. In total, seven interviews were conducted and included in the nal analysis. In the analysis, the nal interview did not introduce any additional themes, but it conrmed and strengthened the patterns identied in the previous interviews. Since no new concepts were identied in the last interview, the research group determined that the main patterns and ndings had been thoroughly captured. Respondent validation, also known as member checking, allowed participants to reect on the interpretations of their input, helping to ensure that ndings genuinely represent their experiences. These practices enhance both credibility and conrmability, key markers of quality in qualitative research [35].
The ndings are presented below based on six interrelated themes derived from the analysis, which illustrate how resident doctors interact with, make sense of, and sometimes resist the learning platform within the context of their specialist training. Table 2 presents a summary of the key themes, along with example codes, participant quotes, and short interpretive notes to explain their relevance.
A recurring concern across interviews was that the content oered oen lacks specicity and direct relevance to the residents' clinical practice. Notably, respondents working in specialized elds such as psychiatry and internal medicine found the content too broad or generic to meet their practical and educational needs: “Not very much, especially because it’s not really tailored to psychiatry. The content is more general, not focused on my specialty.” (R6). Similarly, respondents highlighted the disconnect between the platform’s course oerings and the day-to-day realities of their work: “They are not specic for internal medicine. They are more broad courses that are required
general and is not useful a doctor, it doesn't really for residents' specic help me that much.” specialties or daily practice.
The platform is dicult to navigate, with login issues, poor search functionality, and inconsistent layouts causing frustration.
It’s unclear what residents need to do and when. They oen rely on emails instead of the platform for guidance. “[…] I tried to nd a course, I cannot nd what I'm looking for, or I nd too much… Yeah, the navigation part, mostly.” “I've only done the ones I got an email about, that you have to do this, then I've done them.”
formats to suit dierent learning needs. “[…] So, for me, it would be better to use an interactive learning base.”
“Usually outside of the work. Late at night before the course starts, if there is an assignment I need to take in or usually before the deadline.” "[…] I’d like to see dierent sections like video courses, required courses, etc. so, I can easily nd what I need without guessing or searching too much." for every kind of residency […]” (R4), and emphasized that the learning platform was not their preferred platform for actual learning: “I have never used the learning platform for the purpose of it's like if I want to learn something I don't go to the learning platform. 90% of the time is because I have to” (R5). These perspectives suggest a common frustration among respondents, in that they perceive the platform as fullling administrative requirements while failing to support deeper, specialty-specic learning.
However, respondents also shared more nuanced and positive views, as reected in the following quote, acknowledging that while not all courses were completed, those that were felt appropriate and useful: “I think it's the material is really good the courses. I've taken are really good, so. I think it's ne.” (R1). Likewise, although the limited medical value for daily work was acknowledged, the platform's role in providing access to required formal education was still recognized: “For my daily work as a doctor, it doesn't really help me that much but for the A and B targeted courses, I think the the learning platform is quite good because you can nd all these courses here”. 5.2.
Many respondents experienced problems with navigation in the learning platform, partly related to the broad scope and lack of targeting, designed for the entire region: “for both nurses and doctors and other specialties. So, it's very diuse and hard to navigate. (R3). Several participants described diculties locating specic courses or understanding how to navigate the platform. One respondent described their repeated confusion when using the system: “I feel like I'm a bit confused always when I'm in the learning platform, like I'm clicking around and I don't really understand what will happen[…]” (R1). This sense of disorientation was echoed also by other resident doctors, who found the layout inconsistent and unhelpful across courses: “Each course has its own style. So, it's not the same for each course within the learning platform. So, I don't like that as well because it doesn’t give an easy-to-use structure” (R3).
The platform’s lack of lters or sorting mechanisms was another source of frustration, as one respondent pointed out, referring to initial confusion during login and overwhelming search results, particularly when trying to nd relevant material: “The login in the learning platform was a little bit strange. When I just search, I see what comes up. You go through so much stu (…) Alphabetic relevance is not really relevant, it could be based on, like, required regional courses or subject.” (R5). The platform’s lack of intuitiveness and the amount of time spent searching were oen emphasized: “Yes, it’s hard to nd what I need. The layout isn’t user-friendly. I spend too much time searching.” (R7), along with a critique of the lack of instructions: “[...] I oen have to search a lot to nd what I’m looking for.” (R6). In contrast, however, one respondent had a notably dierent experience, describing the platform as straightforward and showing little frustration: “Pretty straightforward, I suppose. No complications, really.” (R4). Another respondent also provided a more ambivalent view, acknowledging that it was “cluttered” but manageable for their purposes: “I think like as I mentioned I think it's a bit cluttered and it's hard to really understand what I have to do or even why” (R2). 5.3.
Across the interviews, respondents expressed that the learning platform oen lacks clarity, in terms of clear communication of expectations, such as what courses to take, what assignments are required, and when tasks must be completed: “I think, I know there are obligatory things you have to do. But I saw it now, I haven't done all of them. I've only done the ones I got an email about […]” (R1).
the platform, sometimes resulting in missed obligations: “Honestly, I don't really go to the learning platform that oen. So, it's very easy to miss something that you actually have to do.” (R2).
the platform itself to receive instructions: “We don’t actively use the platform for planning. We receive instructions via email, then go to the platform to register or report.” (R6), and direct access to the relevant content: “Most oen we get like an email from the hospital that this course has to be done, click here, and then it's easier to nd that way.”(R3).
However, clarity may vary depending on the individual course: “[...]Partly depending on the course, they have given you information on what to do and so on, yeah.” (R3). Some respondents expressed more positive experiences regarding communication, describing the course information as sucient: “I think it has all the courses that we need to apply to. So, I would say it does the job well.” (R4), highlighting that course requirements and preparation instructions were typically provided: “They usually explain the assignments and then we can also easily access it in the learning platform the requirements for attending the course are enlisted there in the rst page.” ( R5). Despite this relative clarity, respondents mentioned that they had not used the platform frequently in recent months, suggesting that their memory of these processes might be limited or outdated. While some respondents found the platform sucient in providing course-related information, the learning platform was generally experienced as something to be “checked o” when required. 5.4.
The interviews revealed diverse preferences when it comes to learning formats, but it was evident that respondents generally emphasized a preference for interactive and practical learning experiences, beyond passive digital content. As one respondent noted: “I prefer videos and documents. I don’t use interactive modules much. In general, I learn better from books or from inperson teaching with a supervisor.” (R6) In-person learning was also favored because screen-based sessions were perceived as tiring and less engaging: “I personally prefer in person, it’s much more tiring to be focused on a screen, especially when three people are holding a lecture.” (R5).
Videos were perceived as helpful when they’re relevant and not too long, but respondents also appreciated the exibility of reading: “Visual content is nice, but sometimes it's nice to just like read a document because you can do it whenever you want” (R2). Respondents expressed appreciating variety in learning channels, suggesting that seeing, hearing, and reading the same material through dierent formats helped with memory and comprehension: “I like when you're learning something that you kind of it’s a way to learn something so you actually know it you read it in a book and then you see it online in a video […]” (R1). Even when digital formats are used, respondents generally emphasized that engagement and structure matter more than the medium itself and there was a shared view that content should be aligned with the topic and learning goal. As one respondent explained: “It all depends on the type of course that you take I don't think the learning platform has been a platform useful for digital content.” (R5). The importance of combining theory with real-world practice was highlighted: “Probably a mix of both, because you learn all the practical things, but you're also required to read up on the theoretical matters.” (R6). Generally, the participating resident doctors preferred short, visual, and interactive content, particularly videos, a preference reecting their need to learn in short bursts during unpredictable and high-pressure clinical schedules. 5.5.
The inuence of clinical workload and time constraints on the resident doctors’ ability to engage with the learning portal was a prominent theme across the interviews. Some respondents found time during work hours to engage with the platform, but most described diculties in prioritizing it due to busy schedules, oen pushing platform-related tasks to evenings or moments of minimal demand. The following quote illustrates how workload aects engagement, noting that learning activities on the platform are frequently completed outside regular hours: “Usually outside of the work. Late at night before the course starts, if there is an assignment I need to take in before the deadline.”… “Even if you get study time, then you need to use the study time to catch up with the administrative load” (R5). A similar approach was described to t platform tasks into short breaks during the workday, suggesting limited dedicated time for structured learning: “I usually try to do that during working hours when I have a spare half hour or something.” (R2) or, as another respondent admitted, to skip non-mandatory tasks on busy clinical days: “During my clinical days, there is a lot of things to do so, I don't think I go if I don't have to on those days.” (R1).
Most platform usage happens outside work hours, as the clinical setting is oen too demanding for focused online learning: “I mostly use it outside of work!” (R3). Interestingly, however, not everyone experienced workload as a barrier. Respondents also took a more neutral position, suggesting that their clinical schedule allowed for sucient exibility to engage with the platform during working hours: “I usually do it I think during working hour and there's enough time to do, yeah!” (R4) The issue of prioritization also arose indirectly: “We don’t actively use the platform for planning. We receive instructions via email, then go to the platform to register or report.” (R6). While they didn’t explicitly cite time pressure, respondents noted a general underuse of the platform, possibly related to limited time or perceived value 5.6.
User-driven suggestions for personalization and exible design All respondents oered specic, oen overlapping suggestions on how the learning platform could be improved, centered around platform structure, enhancing relevance, and making the system more user-friendly and engaging. A common theme was the need for better ltering and personalization. Several residents suggested that the platform should be tailored more specically to their medical specialty or residency year: “Make it more tting more to a specic category that is not so broad, that it's a little bit narrower, but more relevant.”…“It seems to be a platform for everybody, which makes the platform too busy without really any purpose.”(R5). The lack of intuitive design and logical categorization was also a concern that could be addressed by a personalized interface based on the user’s role: “Maybe it should be more personalized for who are logged in. Now you get everything, and you have to nd what is relevant for me.”. (R3).
A practical suggestion related to performance tracking and planning was likewise suggested: “It would be helpful to have like my own page okay for you this year is important… you have to do these courses within this time frame” (R2). Respondents emphasized the need for reminders or a more proactive system to keep users informed of relevant courses: “If the platform was more attractive to use like there will be courses about this and that in the the learning platform this week, if there is anything that is important or interesting for you I think it would be good.” (R7) Overall, respondents called for a clearer, better-structured layout that allows for easier navigation: “I would make it clearer and better structured. For example, when I log in, I’d like to see dierent sections like video courses, required courses, etc.” (R6). Socially oriented improvement ideas were also proposed, such as incorporating opportunities for peer interaction: “If there would be some way to have like some sort of a social interaction with other residents and maybe somehow share our dierent sources of information.” (R4). While not everyone had concrete suggestions, there was broad agreement that the platform in its current form could benet from being redesigned with the resident experience in mind. As one of the resident doctors concluded: “We really need a more user-friendly system. That would help us use it more eectively during our residency.” (R6)
Overall, the feedback suggests a need for more targeted, intuitive, and interactive design to create a exible and adaptive learning environment that supports the development throughout all stages of training. Despite frustrations, residents oered concrete, forward-looking suggestions for improving the platform, including specialty lters, progress dashboards, and learning recommendations. Their feedback reects a readiness to participate in the platform’s future development.
In this paper, we have explored how resident doctors experience and engage with the digital learning platform as part of their continuing medical education during residency. By integrating resident doctors' lived experiences with theoretical frameworks of user-centered design (UCD), adult learning theory, and prior research on digital CME, the following discussion section outlines the structural shortcomings and potential opportunities for enhancing the platform as a meaningful learning tool within the residency context. The discussion addresses i) how the design and usability of the learning platform align with or diverge from the practical needs of resident doctors; ii) how the platform supports learning in practice, focusing on content relevance, motivation, and learning formats; and iii) the user-driven solutions that emerged from participants’ suggestions for improvement.
First, our ndings point to a misalignment between the structure of the learning platform and
the working realities of resident doctors. Respondents found much of the platform’s content to be
too generic and insuciently connected to their clinical specialty or stage of training, which
reduced the perceived value of the platform and discouraged voluntary engagement. From a UCD
perspective [38], this suggests that the learning portal, in its current form, lacks the adaptive
structures necessary to support specialized roles eectively, which is essential in complex elds
such as internal medicine or psychiatry. Designed as a regional platform for a broad user group,
including nurses, administrative sta, and physicians from various specialties, the platform does
not account for the highly contextualized learning needs of doctors in specialist training. Aligning
with the socio-technical approach, our ndings, in this regard, conrm the importance of
contextual relevance in the design and development of information systems [
Findings from this study further suggest that the platform’s design does not adhere to basic
usability principles from user-centered theory, which emphasize the importance of clarity,
consistency, and predictability in system interfaces [38]. While some resident doctors were able to
navigate the platform without issues, many found the navigation and interface confusing and
unintuitive, particularly in relation to login procedures, inconsistent course structure, the lack of
ltering options, and a general need for user guidance. The lack of structure not only undermines
user autonomy, as emphasized in adult learning theory [39], but also leads to underuse or passive
compliance rather than active learning engagement. Furthermore, the analysis revealed that the
lack of structured guidance or learning pathways led resident doctors to rely on external
communication (such as emails or supervisors) instead of engaging with the platform. This signals
a breakdown in the platform’s role as a self-contained system for managing and organizing
learning. In contrast, eective learning platforms are expected to integrate communication,
scheduling, and progress tracking in a seamless way [
Secondly, according to the study ndings, whether online, in-person, or blended, the underlying
desire among resident doctors is for relevant, accessible, and well-designed learning experiences.
However, although the learning platform is intended to support resident doctors' continuing
medical education, the lack of relevance to their actual clinical practice reveals a weakness in the
platform’s educational value, in terms of reecting the needs of adult learners, who are most
motivated when learning is immediately applicable to their real-life roles. When content lacks
specicity, users perceive it as an administrative obligation rather than an educational resource, a
nding supported by prior studies on digital education in medical settings [
Another challenge raised by residents relates to their motivation to use the platform, as usage
was driven by external requirements rather than intrinsic interest, oen prompted by email
reminders used out of obligation rather than personal initiative. This reects a problem oen seen
in systems designed without sucient user autonomy or control, where learners feel more like
passive consumers than active participants, or when the content lacks clinical relevance or
interactive features [
Thirdly, we identied specic user-driven solutions based on the respondents' suggestions for
improvement. Their recommendations revealed a shared vision for what an improved platform
could look like, one that better reects their real-world needs and supports their CME
development. The aforementioned concerns relevant to clinical practice indicate a need for the
platform to adopt a more segmented content structure, where learning materials are ltered based
on the user’s specialty and stage of training. Such segmentation not only improves relevance but
also enhances motivation by providing learners with a sense of ownership over their educational
journey, in line with adult learning theory [34, 39] and supported by empirical ndings [e.g., 16].
The user-driven ideas proposed by resident doctors, such as personalized checklists or structured
dashboards that display courses relevant to their specialty and training level, suggest basic yet
powerful interface enhancements that could signicantly enhance usability and reduce the time
spent navigating the system. From a UCD perspective, integrating such features would reect a
shi toward designing with, rather than just for, the user —an approach that has long been
advocated in the socio-technical tradition of participatory design [
that oers access, support, clarity, and meaningful guidance throughout their learning, reinforces the importance of enabling learners to shape their own pathways, engage actively, and connect educational material with lived clinical experiences [33, 34].
Based on the ndings of this study and guided by the theoretical frameworks of user-centered design and adult learning theory, this paper concludes with the following proposed design principles to inform the development of digital platforms for continuing medical education (CME), particularly within clinical training environments.
Ensure clinical relevance of content: Learning materials should reect the clinical practice
areas and specializations of resident doctors. When content is general or lacks relevance to
real-world tasks, learner engagement and motivation decline [
Embed clear guidance and learning expectations: Instructions, course structures, deadlines,
and progress indicators should be fully integrated into the platform environment. Learners
should be able to understand their requirements and track their progress without needing
to rely on external communication [
Support microlearning and time-conscious design: Content should be presented in short, manageable modules that t into the demanding and fragmented schedules. Features such as bookmarking, time estimates, and resume functionality can further support exible learning [22, 25].
Enable personalisation and adaptive learning pathways: Platforms should provide personalized learning suggestions based on specialties, progress, and preferences. Such features enhance relevance, autonomy, and learner motivation [19, 39].
Facilitate social interaction and constructive feedback: Peer interaction, reective practice,
and opportunities for tutor feedback should be integrated to foster engagement and deeper
learning. Social features also contribute to professional identity formation and knowledge
sharing [
Together, these principles provide a strategic foundation for improving the usability, relevance, and educational eectiveness of digital CME platforms in clinical environments. It supports the idea that platforms developed without end-user involvement oen miss the mark, appearing functional but failing to meet learners’ needs. Designing with users, not just for them, leads to digital tools that are more engaging, easier to navigate, and more likely to be integrated into clinical practice. This participatory approach is especially relevant when designing platforms for resident doctors, who balance intense clinical demands with ongoing educational requirements.
Using a qualitative approach grounded in user-centered design and adult learning theory, this study has examined the experiences of resident doctors in using a digital learning platform as part of their continuing medical education (CME). The ndings indicate that, although the learning platform is accessible and widely available, barriers arise from a disconnect between the platform design and the lived realities of healthcare professionals. Identied challenges include content relevance, usability challenges, unclear communication, learning formats, workload constraints, and specic suggestions for improvement, such as personalization and exible design. While the study was limited by its small sample size and single-site scope, it provides a foundation for further research that could include multiple institutions, comparative studies, or quantitative evaluation of redesigned features. Future work may also investigate how dierent user groups, such as supervisors or nurses, interact with similar platforms, thereby extending the scope of UCD in clinical education.
In sum, this study contributes to a growing body of socio-technical research advocating for more user-informed development of educational technologies in healthcare. It also addresses gaps in the literature by demonstrating how UCD can be applied in a hospital setting, transitioning from a content-driven to a needs-driven approach, and developing systems that are not only functionally sound but also educationally meaningful and contextually relevant. Based on our ndings, this paper argues that eective digital CME tools cannot be designed in isolation from their users. The main contribution is a set of design considerations that others can use to ensure that digital learning technologies not only meet technical standards but also respond meaningfully to the needs of those they are intended to serve. In doing so, they can become more than information delivery systems they can become trusted, integrated tools for lifelong professional development in healthcare.
Declaration on Generative AI
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