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Annals of Pharmacy Education, Safety, and Public Health Advocacy

2026 Volume 6 Issue 2

When Continuing Professional Development Fails to Change Pharmacy Practice: A Theory of Capability Conversion Linking Reflective Learning, Workplace Opportunity, and Sustained Professional Improvement


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  1. Department of Pharmacy Practice and Continuing Education, Faculty of Pharmacy, Utrecht University, Utrecht, Netherlands.
  2. Department of Continuing Professional Development, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
  3. Department of Pharmacy Practice and Health Services Research, Faculty of Pharmacy, KU Leuven, Leuven, Belgium.
Abstract

Continuing professional development (CPD) is intended to support pharmacists' professional growth and improve practice, yet participation, reflective learning, and knowledge acquisition do not consistently translate into sustained changes in clinical behaviour. Existing educational and implementation frameworks identify important determinants of learning and behavioural change but provide a less explicit account of how acquired learning becomes an authorized, enacted, and maintained professional capability. This theory-development article critically integrates pharmacy CPD scholarship, behavioural theory, implementation research, professional identity, and organizational evidence to develop a capability-conversion account of practice improvement. The theory distinguishes acquired learning, authorized workplace opportunity, enacted professional practice, and maintained capability as analytically separate states. Conversion depends on the interaction of reflective interpretation, accessible resources, legitimate clinical authority, collaborative recognition, and opportunities for repeated performance and feedback. The account identifies conditions under which learning remains unused, intended changes are displaced by competing work, initial enactment is interrupted, or established practices deteriorate. It also distinguishes improvement in a targeted activity from overall patient-facing benefit, recognizing that changed work allocation may generate unintended consequences. The theory assigns differentiated responsibilities to pharmacists, CPD providers, employers, professional teams, and regulators and proposes empirically distinguishable relationships for future evaluation. Its principal contribution is an explanation of why professional development may produce knowledge without changing practice and why initial behavioural change may not become sustained improvement. The relationships are proposed theoretical propositions, not experimentally validated causal effects.


How to cite this article
Vancouver
Dubois S, Andersen T, Petersen L. When Continuing Professional Development Fails to Change Pharmacy Practice: A Theory of Capability Conversion Linking Reflective Learning, Workplace Opportunity, and Sustained Professional Improvement. Ann Pharm Educ Saf Public Health Advocacy. 2026;6(2):143-54. https://doi.org/10.51847/NPWzufeIMx
APA
Dubois, S., Andersen, T., & Petersen, L. (2026). When Continuing Professional Development Fails to Change Pharmacy Practice: A Theory of Capability Conversion Linking Reflective Learning, Workplace Opportunity, and Sustained Professional Improvement. Annals of Pharmacy Education, Safety, and Public Health Advocacy, 6(2), 143-154. https://doi.org/10.51847/NPWzufeIMx
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