Postgraduate Medical Educators’ Perception of Continuous Professional Development in Pedagogy and Andragogy: The CME and CPD Crossover

This qualitative research study investigates the awareness and perceptions of Continuous Professional Development (CPD) focused on andragogy among three key leaders within a wellness academy specializing in training physicians in the fields of bio-regenerative medicine and anti-aging. These leaders, who play pivotal roles as postgraduate medical educators, were the primary subjects of this study. Through interviews and thematic analysis, this research reveals a significant gap in the awareness and understanding of CPD among the studied educators. The findings demonstrate that they possess a fixed perception, equating CPD with Continuing Medical Education (CME), thus overlooking the broader pedagogical and andragogical dimensions that CPD encompasses. Key findings indicate that these educators have limited knowledge of the evolving methodologies, strategies, and best practices in adult education, which are essential for effective teaching in postgraduate medical education. Their predominant focus on CME, with its emphasis on clinical knowledge and skills, has mired their recognition of the broader educational development opportunities within CPD. This study sheds light on the critical need for professional development initiatives to bridge this awareness gap among postgraduate medical educators. By recognizing and integrating pedagogical and andragogical components, to distinguish it from CME, medical educators can better meet the evolving needs of postgraduate medical education and contribute to the advancement of the field. The findings offer valuable insights for medical education institutions and curriculum developers seeking to enhance the quality and effectiveness of postgraduate medical education through a more comprehensive understanding and integration of CPD principles.


Introduction
Continuous Professional Development (CPD) plays a pivotal role in ensuring that educators remain up-to-date with the latest advancements in teaching methodologies and educational practices.For postgraduate medical educators, CPD in pedagogy and andragogy is particularly crucial as they are responsible for imparting specialized knowledge and skills to future doctors.In the everevolving field of medical education, the ability to adapt teaching approaches and remain current with best practices is vital to fostering a competent and wellprepared healthcare workforce.Are they intentionally involving themselves in professional development initiatives in the direction to acquire the andragogy tools to aid their teaching and learning as postgraduate medical educators?This qualitative interview study aims to capture the rudimentary perception of postgraduate medical educators toward CPD in pedagogy and andragogy.Pedagogy refers to teaching methods tailored for traditional students, whereas andragogy addresses teaching approaches for adult learners.By investigating their perceptions, this study seeks to understand how postgraduate medical educators view the relevance and significance of CPD in enhancing their teaching practices.The perusal gave an overview of the engagement and participation of postgraduate medical educators in CPD activities specifically related to teaching and learning.Understanding the extent to which educators are aware of andragogy/pedagogy solutions, theories, and tools available.These are believed to shed light on their personal knowledge, behavior, gap existing, and whether is it worth indulging in the probability to bridge that gap.

Problem Statement
The problem that stimulated this research is the existent gap in data regarding the state of CPD in Pedagogy and Andragogy awareness among postgraduate medical educators and the lack of encouragement to be inclusive of pedagogy/andragogy specialists into the team.This further reduces their exposure to the tools that will aid them effectively to connect the impact they are creating on the postgraduate medical teaching-learning and the whirlpool of outcomes.To add to this, the subsequent implications of their personal growth as professionaleducator and effectiveness as an educator inevitably affects the lives of patients, making this a valuable effort.As such, this study's intent is to explore the perception of two medical practitioners cum postgraduate medical educators and one holding a key role position (without medical education or training) playing an administrative role.

Study Objectives
1. To gather and categorize the perception of postgraduate medical academics within one postgraduate medical academy towards their CPD in pedagogy and andragogy.2. To identify (if any) differences in perception and engagement in CPD between two medical practitioners who are key postgraduate medical educators and an academic without a medical background who plays an administrative role within one postgraduate medical academy.

Study Questions
❖ What is the perception of postgraduate medical educators on "CPD in pedagogy and andragogy" for their medical teaching practices?❖ What types (are they aware) of CPD activities do these postgraduate medical educators engage in to enhance their teaching skills and knowledge in pedagogy and andragogy?❖ Does the above point of awareness between medical practitioners cum educators and nonmedical academic administrators?

The Purpose
The efficiency of postgraduate medical educators' professional development efforts is believed to be linked to knowing their awareness of CPD in pedagogy and andragogy and do (if) they see the relation of value to their teaching methods which in turn impacts the (broad) outcome of the program and learner experience.It is common for medical practitioners and academics to have compulsory documented commitments to their Continuous Medical Education with obligatory CME points to be annually submitted for the renewal of practice or teaching certification and extension.
The question here is, for postgraduate medical educators, there is no obligation to provide, for example, CPD in andragogy perusal evidence.Ever since teacher training in other fields, such as Engineering and Vocational Education where field experts choose to become educators within their field of expertise shown benefits and positive impact highlighting that such effort is no less important in medical and postgraduate medical education.How are they pursuing or will they pursue this path?The fundamental goal of this study is aimed to gauge whether they are aware of CPD in Andragogy and its key components.This study is attempted by a believer that CPD in andragogy commitment has a positive impact and is overdue, on the development and growth of postgraduate medical educators, their quality of professional life, the teaching and learning process and outcome, and their students' journey in their postgraduate journey.This study intends to capture the actuality of these educators having some comprehension of what andragogy and pedagogy are as solution providers to their teaching careers.This is simply because it has a large room for improvement and it can use some encouragement to nurture the perspective of this group of educators in the belief's direction.

Why is this necessary?
Postgraduate medical educators as medical practitioners are obliged to engage in continuous medical education and submit annual evidence of minimum requirements to stay abreast with medical development.Such obligation or encouragement or emphasis is lower than needed for them to engage in continuous professional development in pedagogy and andragogy.Why is it important for continuous professional development in pedagogy and andragogy to be emphasized or to an extent, made an obligation for postgraduate medical educators?

The Necessity
The are many necessities for CPD in pedagogy and andragogy to simply stand a chance to be made essential for postgraduate medical educators and a few as follows are the focus of this study: i.
To enhance teaching effectiveness -By making CPD in pedagogy and andragogy essential, educators can acquire and refine teaching strategies that are evidence-based and proven to enhance learning outcomes.This, in turn, ensures that medical educators are better equipped to impart knowledge, critical thinking skills, and clinical competence to their students.Effective teaching methods are vital in influencing the learning experiences of postgraduate medical students. ii.
Adapting to Learner Diversity -CPD in pedagogy and andragogy equips educators with the tools and techniques to cater to the unique requirements of adult learners and traditional students alike.It enables educators to tailor their teaching approaches to accommodate diverse learning needs effectively.Medical educators encounter a diverse group of learners with varying learning styles, needs, and preferences.One will so, need to be equipped with tools and techniques to present ways their students can convey empathy to patients.Medical knowledge is undoubtedly key to addressing the content of the curriculum but for an educator to be able to present contextually, one will require tools to teach another on how to empathize with their students first and foremost.CPD in andragogy equips the said need. iii.
Being abreast with educational advancements -Medical education is constantly evolving, with new research and advancements in pedagogy and andragogy.CME is key to medical practice and by no means is it to be compromised or a portion of it is consumed to allocate emphasis that replaces it with CPD in pedagogy and andragogy.However, by making CPD compulsory, educators are encouraged to stay current with innovative teaching methodologies, technologies, and evidence-based practices.This ensures that the educational experiences provided to postgraduate medical students remain up-to-date and relevant.

iv.
Student Satisfaction and quality doctors -Effective teaching directly influences student satisfaction and success in medical education.When educators are well-versed in pedagogy and andragogy, they are better positioned to engage students, create supportive learning environments, and address individual learning needs.Consequently, students are more likely to feel motivated, supported, and successful in their academic pursuits.The brain drain of doctors is a largely documented and reported incident in different developed and developing nations.The recent pandemic added fuel to this occurrence to surface.One of the many root causes of such outcomes is the relationship between senior medical practitioners (who most often are dualrolled postgraduate medical educators) and their relationship with the junior medical candidates.

v.
Growth of medical education and its accreditation standards -Many medical education programs and institutions are subject to accreditation standards that require a focus on continuous quality improvement in teaching and learning.Requiring CPD in pedagogy and andragogy demonstrates the institution's commitment to meeting these standards and continuously enhancing the quality of education provided.

vi.
Postgraduate medical educational challenges -Postgraduate medical education faces challenges such as limited resources, large class sizes in some disciplines such as family medicine, and diverse learning needs to name a few.CPD in pedagogy and andragogy will be able to equip educators with the skills to address these challenges effectively, fostering a more adaptable and resilient educational environment.Such skills are not an inclusion by default in most postgraduate medical educators' induction and continuous medical education program.
The above gives room, to sum up the reasons so as to why making continuous professional development in pedagogy and andragogy essential for postgraduate medical educators is key to ensuring effective and high-quality medical education.The purposeful collaboration between education experts and medical experts needs to intensify.In due course, the investment in CPD for postgraduate medical educators benefits both educators and their students, contributing to the advancement of medical education and, consequently, the healthcare profession as a whole.

Literature Review
Postgraduate medical educators are responsible for shaping the future of doctors in practice, and their own professional development is crucial for effective teaching and mentoring.However, there is much room to implement postgraduate medical educators' continuous professional development in pedagogy and andragogy.The connection between the solutions presented when one sees the postgraduate medical education through the lens of andragogy, the professional himself evolves and most certainly becomes a more skilled solution provider to the list of challenges the postgraduate medical education has on its plate.Medical educators must gain a thorough understanding of online platforms and technologies and comprehend that their own pedagogical approaches to teaching will, in fact, need to change to accommodate the online environment, according to O'Doherty et al.'s integrative review of literature on known barriers and solutions that educators face when developing and implementing online learning programs for medical students and postgraduate trainees 2018.
The findings of this investigation are hoped to fill the gap and provide valuable insights to inform the design and implementation of effective CPD programs tailored to the specific needs of medical educators built on andragogy tools and solutions for postgraduate medical education.However small the acquired data would be, it contributes to the data gap that exists on CPD in Pedagogy and Andragogy consumerism among postgraduate medical educators the out-lay of this study includes pondering on the following 1.The subjects' perception of CPD in andragogy and pedagogy.
2. Are they aware of the existence of andragogy and pedagogy theories, frameworks, solutions, tools, and strength of application to their practice as educators?3. Is the non-medical academy administrator who is a certified teacher cum trainer, exposed to formal andragogy and pedagogy education, have a different (more hopeful) perspective than the others?
As explained by Dent and Harden, although most doctors are generally passionate about clinical teaching, changes have frequently prompted them to prioritize their clinical practice or research duties, which has reduced their time and energy for clinical teaching.The ability of seasoned physicians to teach in the manner to which they were accustomed has also decreased as a result of changes in the content and delivery style of medical education.So, given that they are already under pressure from other contractual obligations, is it viable to re-interest clinicians in medical education?By bridging the gap between the theoretical elements of medical education and the associated language and the actual delivery of enthusiastic instruction, the book was aimed to meet this problem.This was in 2001.We have endured the pandemic and globalization at profound speed and change ever since.As such, today, the said transition ought to be much more proactive and beneficial.Postgraduate medical educators will need to be actively and purposefully taken on the route of exploring pedagogy-andragogy and heutagogy solutions.This is simply because a well understood tool, introduced, and trained becomes powerful in the hands of the user.And, this exploration will be effective when done with specialists in pedagogy and andragogy integrate with medical educators, an intended community learning.
The findings of this investigation are hoped to fill the gap and provide valuable insights to inform the design and implementation of effective CPD programs tailored to the specific needs of medical educators built on andragogy tools and solutions for postgraduate medical education.However small the acquired data would be, it contributes to the data gap that exists on CPD in Pedagogy and Andragogy consumerism among postgraduate medical educators.
According to Sherman and Chappell (2018), CPD in the US is learner-focused and faculty support rather than faculty-driven.The purpose of education is to close the professional practice gaps that exist among healthcare teams and individual practitioners.Longitudinal design interventions, active learning techniques, and adult learning principles are all incorporated by CPD providers.Higher-level outcomes that reflect competence (or intent to change practice), performance, and/or patient outcomes are used by CPD providers to assess the effectiveness of education (p.2).
Lucardie and Busari say that the intervention group's gained knowledge of healthcare law and medical errors significantly improved, and the flipped classroom model (FCM) was thought to be an excellent teaching tool for these topics.

The Fast Forward
In line with the transition in postgraduate medical education where once the professional qualifies, from being competent in using the core andragogy of self-directed learning to an autonomous, self determined learner, the focus now shifts from competency to capability.
Here, Chacko (2018) explained that heutagogy prevails and needs to be seen as a continuum of andragogical adult learning theory.Heutagogical methods are better suited to postgraduate medical education, where learning and teaching are actively taking place among adults.By that time, these adults have developed into mature, autonomous learners who decide for themselves what to learn, how to learn it, and how to assess their own progress.Even in the early stages of professional education, exposure to these methodologies makes learning engaging.But, are the postgraduate medical educators even aware of such teaching and learning concepts, theories, framework, and tools available to them?Chacko (2018) also discussed heutagogy, heutagogical methodologies have become the methods of choice for skilled professionals seeking to advance their expertise in a field populated by knowledgeable patients and colleagues.Because a medical educator in postqualification as a specialist is an autonomous professional who is capable of determining their own learning needs on the job, this places pressure on quality improvement in service delivery.
As discussed above, the problem addressed in this research is the need to acquire the perception and cognitive prevalence of postgraduate medical educators on continuous professional development (CPD) in both pedagogy and andragogy.Understanding how medical educators perceive CPD and its relevance in their teaching practices can shed light on the effectiveness of their professional development efforts as educators.
To add to this, the need to be inclusive and gain insight into a postgraduate medical academy administrator with no medical background's perception came to light.Sherman and Chappell also discussed how new evidence in medicine and healthcare is published at an increasing rate, and how CPD is essential to ensuring that healthcare professionals remain competent in practice and are able to provide high-quality, evidencebased care.Sadly, there are still systems in place all over the world where CPD is not seen as a continuous part of the healthcare education continuum, which poses a serious threat to maintaining the competence of healthcare providers and raising the standard of patient care.Globally, the challenges in CPD include wide variations in its definition and structure, as well as varying standards and levels of oversight by nation or region (2018).
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Methodology
This study employed a qualitative interview to derive the perspective of purposefully selected three candidates, two with clinical and practice medical backgrounds who are still serving and the other was an academy administrator without a medical background, all three linked in one postgraduate training academy.
As an attempt to gather various intricacies of subjects, this method gave room for people to share their viewpoints.This study used interviews with two postgraduate medical instructors and an academy administrator without a medical background to collect data.After being coded and subjected to categorical analysis, the gathered data provided insightful information on these postgraduate medical educators' awareness of pedagogy and andragogy.
The main goal of qualitative study is generally to delve deeply and richly into the experiences, attitudes, and actions of people.It looks for hidden patterns and meanings that quantitative study could miss.The interview methodology is a typical approach here that is hoped to enable us to have in-depth discussions with participants and collect information from them directly.

The Respondents
The background of these three individuals was examined alongside the change and growth brought to the academy.The challenges they have faced during the pandemic and the efforts they took to overcome the challenges to remain viable from the business perspective are commendable.The then contractor personnel helped to strategize and roll out campaigns for the academy, who now became the academy administrator replacing the interviewed academy administrator (ex-employee).The need to know the awareness and ability to empathize and select solution tools available in pedagogy and andragogy was of interest.A well-understood tool deployed strategically over time, well planned, will benefit the academy, and learners and it has to begin with the educators.The respondents are assigned pseudonyms to maintain the anonymity assured when consent to interview was acquired.

The Interview
To create a win-win situation, their preferred mode of responding was followed through.They were provided with a detailed introduction to the intent of this study, its relevance, and their response's importance.All three interviewees agreed immediately although it took substantial follow-up and reminders to acquire the data.They were not keen in face to face interviews due to personal reasons.This study had to compromise their comfort to obtain responses in ways comfortable to the interviewees.All communication was via Whatsapp as they were all preoccupied with travel and existing workload.One medical postgraduate educator (Pseudonym: DK) and the academy administrator (Pseudonym: JS) responded via Whatsapp voice notes to the list of questions provided to them in advance.The other medical postgraduate educator (Pseudonym: VC) responded as typed texts to the questions provided in advance as he shared his discomfort to verbally communicate in English as it is not his first nor second language.To overcome the barriers and to proceed with input versus focusing on limitations, data collection was pursued.
The data collection was done to suit the participants who were given the opportunity to contribute their opinions, knowledge, and existing viewpoint about postgraduate medical education via openended interview questions.To an extent, although there is much room to deepen and enrich the data acquired, allowed participants to express themselves and ensured the gathering of varied data.For analysis, the interviewees' audio was captured and transcribed.
The coding procedure was perused after gathering the raw data.Then, it was thoroughly read to categorically summarize followed by coding to derive the analytical conclusion of the interviewees' awareness of pedagogy and andragogy.A basic categorical analysis after coding was done.Grouping related codes based on keywords derived from summarized data into categories or themes is a component; a categorical analysis was completed.This process makes it easier to spot broad trends and have a better understanding of the subject.It enabled the condensation of broad data into narrowed themes that capture respondents' points of view, aligned to their knowledge of pedagogy and andragogy.
To reduce the risk of jargon or terminology unfamiliar to medical educators, to not to mislead, the respondents are given the description as to what is pedagogy and andragogy prior to perusing with the interview questions.Several major findings from the interviews with the postgraduate medical educators and the academy administrator without a medical background were identified.The study technique used in this study allowed for a rudimentary analysis of the postgraduate medical educators' predicament in this landscape.This approach extends beyond numerical measures and statistical analysis, providing a better comprehension of the human aspects of the respondents, and their role in postgraduate medical education.This illuminates concerning gaps, points at areas of improvement, and a glaring need for intervention and purposeful development.

Data Analysis
The academy administrator has left the position.The goal was to determine if the three respondents had an awareness of andragogy and pedagogy, and their relativity to contributing to the development of the postgraduate medical education they are deploying internationally.

The Academy
The gap that was prevalent in the academic administrator's (no longer with the academy at point of data analysis) work culture was seen to be in the area of convincing the medical educators, to win their collaboration argumentatively from the medical grounds.This was a small setback where generic solutions that were predominantly sales oriented did not convince the medical educators to add to their existing workload.This challenge is hypothesized to be rooted in the lack of medical background of the academic administrator which further reduced the empathy factor to diagnose the andragogy tool fit for the onground challenge.This is a specific issue and may not serve to be generalized across other postgraduate medical institutions as here, clinical hands-on or bedside learning is minimal if not none.
On the other hand, additional information required is that the academy also faced challenges where besides self-directed self-motivated continuous medical education efforts taken by the medical educators in-house, there were no other professional development trainings that were adjuvant to the academy nor made available.This is also seen as a These are the standpoint-acquired data on the respondents' awareness on CPD in andragogy and pedagogy.

The Discussion
The key distractor across the data gathered, transcribed, summarized coded, and categorized is; the respondents have below minimal awareness of andragogy and pedagogy.
The evident lack of clarity on the fundamental difference between CPD in andragogy and pedagogy and CME is prevalent.It is glaring.The CPD in andragogy and pedagogy to improve and enhance their teaching skills which creates an impact on learners' learning experience is seen as one with CME or a part of CME.Essentially, CME is not andragogy or pedagogy solution presenting by origin and function.They are two completely different segments although they do fit under the broad umbrella of Continuous Professional Development of any sector.On one hand, CME is not just a mandatory obligation but a dynamic pathway to excellence in postgraduate medical education where medical knowledge and skill update is the core goal.On the other hand, CPD in pedagogy and andragogy for medical education emphasizes how that goal can be achieved.
The data confirms the mixed viewpoint of the two postgraduate medical educators and the academy administrator.The viewpoint deduction points out that the respondents have a grasp that by pursuing and achieving the conventional medical-specific compulsory CME outcomes made broadly available, the educators ensure their teaching methods are current, relevant, and aligned with the changing needs of adult learners.In an era of rapid scientific evolution and innovative teaching methods, CME empowers medical educators to be effective, adaptable, and responsive, thereby contributing to a higher standard of patient care and overall medical education.Various variables affect how well regular Continuing Medical Education (CME) programs work to improve the andragogy abilities and tool use of medical lecturers and clinician trainers.Although CME programs are intended to offer continual learning opportunities for healthcare professionals, including educators, their effectiveness in enhancing andragogy skills and the efficient use of tools may vary depending on a number of factors such as the relevance of information, choices of teaching methods, interactive learning tools, applicability to medical content, engagement, and learners' experience.However, these not necessarily are noted and developed by medical educators by default.No.This area where stating the obvious, recapitulation of pedagogical/andragogy tools as an option, research, and evidence that it influences efficacy of medical teaching and so forth are most certainly under-developed in postgraduate medical education.Yes, it is essential that CME programs present information that is relevant to the audience.It may substantially improve their andragogy abilities and the efficient use of andragogy technologies provided the material is in line with the unique demands and problems that medical lecturers and clinician trainers confront in their educational jobs.To illustrate how these strategies might be used in instruction, CME programs themselves should use excellent andragogy techniques.If the CME experience exemplifies the finest practices in adult learning, it may be used by educators as a useful model for their own instruction.Active involvement, case discussions, group exercises, and practical sessions may help participants better grasp andragogy tools and how to use them but stated that such methods are andragogy tools and by the reflective intentional presentation of the andragogy solutions available, will add more impact to the change aimed.Yes, interactive teaching strategies enhance learning by reflecting the andragogical concepts but do postgraduate medical educators know what strategies are available for them to deploy?
To suit the various demands and degrees of experience among medical lecturers and clinician trainers, CME programs should ideally include some degree of modification.The special difficulties that educators encounter might not be addressed by a one-size-fits-all strategy.They will benefit if the modification pathways are presented blatantly as opposed to hoping for them to figure it out alongside the CME participation.It is pertinent to note, constant involvement in educational improvement (CPD in pedagogy/andragogy) is just as essential as regular CME especially with the speed of technological intervention flipping learners' experience in knowledge acquisition, and skill practice and application.For andragogy abilities and tool deployment to significantly develop over time, one or a few CME events may not be enough.It may be more beneficial to promote continual learning and involvement in longer-term initiatives or communities of practice.If it is time and cost concerning to host separate CPD in pedagogy/andragogy for postgraduate medical educators, it is even more crucial to offer after-care assistance for CME programs from a pedagogy/andragogy lens.To effectively use the newly learned skills and tools in their instructional situations, medical educators will require assistance.Without continued assistance, the effects of CME with purposeful pedagogy/andragogy reflective exploration can wane with time.The leaders and operators of CME events can improve their program by carefully evaluating the learning outcomes of participants and gathering feedback.This guarantees that the methods and information provided fit the requirements of educators, helping to advance their andragogy abilities.This segment was emphasized by the respondents as well.CME programs have to include a range of learning opportunities, such as online courses, workshops, seminars, conferences, and mentoring programs.Due to the variety, instructors may select solutions that best fit their schedules and learning preferences.This will have to be paired with pedagogy/andragogy solutions and tools.

CME versus CPD in pedagogy/andragogy
Frequent CME programs are beneficial for developing the andragogy abilities and efficient deployment of andragogy tools among medical lecturers and clinician trainers but are multifactorial by nature.The importance of CPD is particularly pronounced when it comes to pedagogy and andragogy in postgraduate medical education.While undergraduate and postgraduate education provides foundational knowledge, CPD ensures educators remain updated with the latest teaching methodologies and scientific advancements.CPD in medical pedagogy and andragogy is distinct from traditional education, demanding adaptability to varying expectations and motivational objectives of adult learners.Constructivism in education emphasizes the importance of prior knowledge and understanding in the construction of information.This approach involves reviewing and reinforcing past knowledge, using hypothetical-deductive reasoning and serves as the foundation for various human interactions.Constructivist cognition is supported by the brain's physical makeup, promoting active learning and educational strategies.It is crucial for educators in medicine and health sciences to understand the foundational tenets of constructivism and its impact on educational theory and clinical practice (Dennick, 2016).

Conclusion
Postgraduate medical educators have a substantial impact on the skills and knowledge of future medical professionals.However, recent research indicates that they might benefit from further training and support, particularly in the areas of adult teaching and learning theories, methodologies, and evaluations.Numerous studies have revealed that a sizable number of postgraduate medical educators lack experience, formal induction, training, support, and exposure in the field of adult teaching and learning.According to Trainor and Richards, Teaching physicians highlighted in this survey highlights key areas medical school and hospital administration may concentrate on to increase support of both teaching physicians and medical educators.Lack of recognition and insufficient assistance are the biggest self-perceived impediments to success.There is still much space for improvement, even though there have been demands for action for years to include medical educators within the framework of academic medicine and more especially to train teaching physicians on the best methods for teaching in the clinical context 2021.When teachers are not exposed to adult teaching and learning theories and methods, they may rely on out-of-date teaching techniques.These approaches might not be successful in enticing adult learners and meeting their diverse learning preferences.This mismatch may hinder both the quality of medical education and the capacity of trainees to develop crucial skills.
As presented by Aitken et al., they explored the evolving understandings of teachers' identities and professional identities, focusing on repertoire development, viewpoint changing, embodied practice, and appreciation of context.Healthcare educators develop a repertory of prospective practices and theories, adopting diverse viewpoints and creating embodied strategies for adapting to different contexts.They also recognize the cultural, political, and social aspects that influence teaching practice, acknowledging the limitations of direct control over settings and the effort required to effect change in complex systems.This subject acknowledges the significant limits that may be placed on teaching practice, the inability of having direct control over many significant settings-related factors, as well as the types of effort required to effect change in complex systems 2022.Instructors' lack of proficiency with a range of assessment methods and tactics may hinder their capacity to accurately evaluate learners' skills and provide beneficial feedback.This limitation on evaluation techniques may result in inaccurate assessments of learners' progress and insufficient suggestions for improvement.Adding to this, the lack of exposure, formal introduction, training, and support in adult teaching and learning has significant repercussions such as where the adult learners may not be completely engaged or have their chosen learning methods taken into account as a result of outdated teaching practices.
Learners' progress may be hampered by a lack of exposure to varied assessment approaches, which may undermine the validity of competence evaluations.Postgraduate medical instructors must get significant training and assistance.Institutions should employ pedagogy and andragogy induction processes to acquaint teachers with adult learning theories and cutting-edge instruction methods.Participating in pedagogy-related workshops, seminars, and online courses can help this group of educators become more proficient.Aitken et al. also stated that postgraduate study can help instructors continue to grow and develop their skills through experimentation, reflection, and discussion with peers.This is mildly prevalent when the data acquired across the three respondents who significantly functioned as peers in the academy is revisited, even the administrator with pedagogy and andragogy fundamental knowledge presented the CPD in a CME context.Kost and Chen stated that it will be a major project and call for structural and cultural change to turn the practice of pimping into a practice of questioning that takes into account purpose, Socratic principles, and adult learning theories.Faculty development initiatives, support from medical departments, and modest, gradual behavior modification tactics will be crucial, as outlined in other disciplines.Although altering questioning habits will be challenging, we cannot afford to put off implementing this new paradigm of asking in medical education since the potential rewards in terms of a better environment that fosters community and learner success are so enormous 2015.
It is generally acknowledged that the lack of formal induction programs substantially restricts instructors' ability to adapt current teaching methods.Without a comprehensive introduction to adult learning theories and pedagogical concepts, teachers find it difficult to meet the specific requirements and features of adult learners, which leads to less successful educational experiences.
According to Mukhalalati and Taylor, to complement more widely used pragmatic viewpoints, educators in the healthcare professions should take into account the philosophical foundations of healthcare professional education as well as the nature of healthcare knowledge.By putting more theoretical thought into healthcare professional education, this way of thinking will assist educators in reorganizing curricula, instructional methodologies, learning objectives, and evaluation methods, thus improving student learning experiences 2019.
To create training programs that meet educators' needs and are flexible enough to change with the changing medical education landscape, collaboration between medical education departments and educational specialists is crucial.

What is the contextual contribution of this research?
Kost and Chen emphasized that transforming the practice of "pimping" into a more constructive approach involving questioning, aligned with purposes, Socratic principles, and adult learning theories, will be a substantial undertaking requiring both structural and cultural shifts.It will necessitate faculty development initiatives, support from medical departments, and the gradual implementation of behavior modification strategies, as seen in other fields.
Although modifying established questioning habits will present challenges, delaying the adoption of this new educational paradigm in medical instruction is not an option, given the enormous potential benefits it holds in terms of creating a more supportive learning environment that enhances community and student success 2015.
It is widely recognized that the absence of formal induction programs severely limits instructors' ability to adapt their teaching methods effectively.In the absence of a comprehensive introduction to adult learning theories and pedagogical concepts, educators struggle to meet the specific needs and characteristics of adult learners, resulting in less effective educational experiences.
According to Mukhalalati and Taylor, educators in healthcare professions should broaden their perspectives beyond practical considerations and consider the philosophical underpinnings of healthcare professional education and the nature of healthcare knowledge.
Incorporating more theoretical aspects into healthcare professional education can aid educators in restructuring curricula, teaching methods, learning objectives, and assessment approaches, ultimately enhancing the learning experiences of students 2019.
To develop training programs that cater to the evolving landscape of medical education and align with educators' requirements, collaboration between medical education departments and educational experts is essential.This work contributes to further validating the need for the induction of medical educators into andragogy and a purposeful, planned collaboration between medical education departments and educational experts is a prevalent gap.

Validation of Findings
A tertiary educator-member checking was conducted, where a colleague from another tertiary institution, in the English language department was requested to review the findings and confirm categorical coding and analytics summary.A face-to-face discussion without formal writing task burden, the reviewer was met.Once the input was acquired, the preconceived conclusion based on research questions, objectives and problem statement was consented.

Ethics
Ethical considerations in this study include obtaining informed consent from participants, ensuring confidentiality and anonymity, and protecting sensitive information, the study complies with ethical guidelines involving human subjects.No potential conflicts of interest is present.

Limitation
The English language proficiency of one of the respondents and the limited time available were the core limitations of this study.The findings from this research, however small, are hoped to add to the existing data that helps with the understanding of how postgraduate medical educators perceive CPD in pedagogy and andragogy and its influence on their roles as educators.This is further aimed to help inform the development of more targeted and effective CPD initiatives, ultimately enhancing the quality of medical education and ensuring that future healthcare professionals receive the best possible training, not only through the Continuous Medical Education pathway but also in academic CPD in pedagogy and andragogy pathway.
The FCM was thought to encourage active learning among residents and facilitate their acquisition of knowledge.FCM interventions improve resident performance and ought to be more structurally integrated into postgraduate medical education (2017).The pandemic challenge initiated change in medical education practical tip by Hall et al. states that daily routines have evolved due to training rotations, distance, and increased concern.Medical educators must adapt their curriculum to enhance learning, maintain efficient care delivery, and ensure competent graduates.They must utilize available training opportunities, adapt to new technology, and prioritize student/faculty welfare.Communication, innovation, collaboration, flexibility, and planning are essential for competency-based medical education 2020.
Teheux et al., intra-professionalcollaboration is crucial in postgraduate medical training, as it develops and reinforces discipline-specific cognitive maps.Multiple intraprofessional rotations in postgraduate training programs expose medical residents to diverse cultures and practices, resulting in high intra-professional learning potential.andhinderlearning, as residents may lose interest in each other's perspectives.These tensions initially appear during postgraduate training, as doctors work and learn in different groups for the first time.Therefore, understanding how to build a collaborative practice-ready health workforce is essential for postgraduate training knowledge.The collaboration between academic experts who can contribute to the parallel construction of tools and solutions hand in hand with medical educators in such settings will surely be a productive and effective partnership.The studies byTeheux et al. alsoshow that obstacles to intra-professional learning in hospitals include stereotyping, geographical distance, technological obstacles, and misalignment of competency frameworks.These findings are context-dependent and cannot be generalized to all contexts.However, improving the alignment of primary and secondary care residency training curricula could lead to more effective inter-professional learning opportunities for residents during postgraduate training (2021).These are the very challenges described by O'Doherty et al. and Chako in 2018.The effort of the priorities above is ongoing and requires to up-the-speed at which the context of each has evolved, a growing demand-supply gap.
However, intraprofessional interactions can lead to productive tensions in communication and teamwork between medical professionals, encouraging learning through pushback, power disparities, and uncertainties.Conversely, conflicts between medical professionals can be unproductive setback as leadership skills, collaborative projects, and training skills or tools introduction were not planned nor made available for almost a decade.Most of the dynamic shifts to equip the self to stay productive throughout the pandemic in the education job description were group initiated with no management role in it.To enhance CME programs, educators are opined to tap into medical networks, attend conferences, engage in active networking with fellow physicians, explore industry trends, and collaborate with non-member associations.These efforts expand horizons, disseminate crucial information, and elevate knowledge levels.As for personal development and challenges, CME is frequently suggested to be a self-directed journey, involving active searches for resources and participation in workshops to learn new methodologies and tools relevant to teaching.While CME activities are beneficial, they require effective time management, with a larger weightage of time allocated to work and minimal for CME.Striking a balance is essential for efficient educators.For postgraduate medical educators to adapt and evolve with teaching techniques and dynamics of development, medical professionals must adapt to evolving teaching techniques, one needs to be ready to transition from traditional face-to-face classrooms to dynamic virtual learning environments and leverage technological tools like Schoology and Moodle for effective skill enhancement.It is also stated that learner and field expert feedback and postgraduate medical education's future growth are closely interlinked.CME may enhance teaching effectiveness by generating student feedback, evaluating program outcomes, and shaping future program continuation based on relevance and usefulness.Feedback surveys before and after CME activities provide insights into individual experiences, enabling constant improvement.
Overall, the raw data had spread out that the Continuous Professional Development in Postgraduate Medical Education especially in pedagogy and andragogy has a huge room for fostering awareness, excellence, and innovation.The highlights of the data point to Continuous Medical Education (CME) as a key priority and is an indispensable facet of postgraduate medical education, serving as a dynamic avenue for acquiring new skills, enhancing teaching methodologies, and staying updated with the latest advancements in the medical field.Medical practitioners' commitment to CME