TY - JOUR
T1 - Beyond the faculty-student dyad
T2 - Disentangling the hidden factors shaping graduate HPE advising success
AU - Meyer, Holly S.
AU - Samuel, Anita
AU - Maggio, Lauren A.
AU - Cleland, Jennifer
AU - Artino, Anthony R.
AU - Scarlett, Emily
AU - Martin, Paolo C.
N1 - Publisher Copyright:
© 2026 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2026
Y1 - 2026
N2 - Introduction: Advising is essential for student success in graduate health professions education (HPE). Advising does not happen in a vacuum, yet most research focuses narrowly on advisor-advisee relationships. To address this gap, this study examines how institutional structures, policies, and programmatic dynamics influence the effectiveness of advising in graduate HPE. Methods: We conducted semi-structured interviews with 15 HPE program leaders across six WHO regions. Using framework analysis guided by Activity Theory and the concept of knotworking, we analyzed how institutional systems shape advising practices. Results: Five institutional factors were identified: (1) strategic advisor recruitment, (2) supportive advising cultures, (3) bureaucratic and resource constraints, (4) advisor training and evaluation, and (5) recognition and support for advisors. Leaders described advising as an adaptive, cross-system process shaped by institutional complexity and evolving student needs. Discussion: Advising in graduate HPE operates beyond dyadic relationships. It is embedded within institutional activity systems and requires ongoing negotiation across structural boundaries. Programs must adopt systemic strategies, such as faculty development, workload alignment, and policy reform, to support effective advising networks.
AB - Introduction: Advising is essential for student success in graduate health professions education (HPE). Advising does not happen in a vacuum, yet most research focuses narrowly on advisor-advisee relationships. To address this gap, this study examines how institutional structures, policies, and programmatic dynamics influence the effectiveness of advising in graduate HPE. Methods: We conducted semi-structured interviews with 15 HPE program leaders across six WHO regions. Using framework analysis guided by Activity Theory and the concept of knotworking, we analyzed how institutional systems shape advising practices. Results: Five institutional factors were identified: (1) strategic advisor recruitment, (2) supportive advising cultures, (3) bureaucratic and resource constraints, (4) advisor training and evaluation, and (5) recognition and support for advisors. Leaders described advising as an adaptive, cross-system process shaped by institutional complexity and evolving student needs. Discussion: Advising in graduate HPE operates beyond dyadic relationships. It is embedded within institutional activity systems and requires ongoing negotiation across structural boundaries. Programs must adopt systemic strategies, such as faculty development, workload alignment, and policy reform, to support effective advising networks.
KW - academic advising
KW - educational measurement
KW - organizational policy
KW - professional development
KW - qualitative research
UR - http://www.scopus.com/inward/record.url?scp=105028003364&partnerID=8YFLogxK
U2 - 10.1080/0142159X.2025.2610405
DO - 10.1080/0142159X.2025.2610405
M3 - Article
AN - SCOPUS:105028003364
SN - 0142-159X
JO - Medical Teacher
JF - Medical Teacher
ER -