The rapid advancement of scientific knowledge presents a challenge to traditional biomedical research-based graduate education paradigms, which often struggle to keep pace with emerging discoveries and evolving needs. To ensure students develop the skills and expertise required for diverse career paths, graduate education must remain dynamic and responsive (1). The traditional academic career path is no longer the dominant choice for graduates, with many pursuing roles in industry, biotechnology, healthcare consulting, government, non-profit, and entrepreneurship. A static curriculum risks becoming outdated, leaving students underprepared to navigate the complexities of modern biomedical and clinical research.

This challenge has become increasingly evident at our institute – the largest graduate unit within the Faculty of Medicine at a major Canadian university. Established in 1968, the institute aspires to be a global leader in biomedical graduate education, advancing human health through translational research that bridges scientific discovery with clinical application (2, 3). With over 700 faculty members and 500 graduate students across 11 clinical departments, the institute has seen growing diversity among both faculty and students (2, 3). However, as new scientific niches emerge, traditional graduate education models have become increasingly resource-intensive and misaligned with the evolving biomedical landscape.

In 2018, as part of the university’s quality assurance program, an external review of the institute was conducted by a panel of experts from outside the university, who held equivalent positions in graduate programs at their own institutions. The reviewers’ final report offered objective recommendations addressing key challenges raised by students, particularly regarding limited access to relevant and up-to-date educational and training opportunities. This external review highlighted the need for a structured effort to assess how well the program was meeting the needs of its diverse stakeholders, which would be instrumental for informing future renewal activities.

In this paper, we describe how the institute evaluated its ability to meet the needs of key stakeholders, including students, alumni, supervisors (faculty members who supervise student research), and faculty members (those involved in teaching and academic leadership). We present our findings, the resulting action plan, and an update on progress to date, guided by the U.S. Centers for Disease Control and Prevention (CDC) Program Evaluation Framework (4, 5).

The CDC Program Evaluation Framework (4) is a systematic approach designed to assess and improve the effectiveness of a program (Fig. 1). It consists of six steps: 1) engage stakeholders, 2) describe the program, 3) focus the evaluation design, 4) gather credible evidence, 5) justify conclusions, and 6) ensure use and share lessons learned. While originally developed to guide public health professionals in program evaluation, this framework is widely applicable across various fields, including graduate education, and serves as a practical guide for understanding program impact and building evidence to inform data-driven improvements that ensure the program meets its goals.

In order to define and contextualize the institute’s graduate programs, we reviewed institutional strategic priorities, university requirements, employer expectations, graduate employment data, prior stakeholder feedback, and relevant policies and procedures. This review helped characterize the program’s structure and intended goals and expectations. Notably, it revealed a lack of clearly articulated program goals and objectives, and curricular gaps that did not fully align with students’ evolving needs or advances in biomedical science. These findings highlighted the need for a comprehensive evaluation to inform program renewal activities.

To gain a comprehensive understanding of the factors influencing the degree to which the program was meeting the needs of its stakeholders, a mixed-methods approach was used to conduct the program review including surveys, interviews, and a focus group. The survey and interview guide were specifically developed based on the identified needs of the external program review and have not been published previously. The survey was created using the Research Electronic Data Capture (REDCap) platform (https://project-redcap.org/), and the interview guide was developed based on the survey findings to gather more detailed insights on identified themes. Both were pilot tested by students and/or members of the institute’s leadership team to ensure face and content validity. The survey, interview, and focus group questions are provided in Supplementary Files 1 to 5.

The student survey assessed current students’ perspectives on their program requirements, course access, learning gaps, and experiences with the Collaborative Specialization Programs (CSPs) (interdisciplinary programs that enable students to gain specialized expertise alongside their main graduate studies) (Supplementary File 1). The survey was distributed through the institute’s online newsletter between July and August 2020. Students who provided their contact information received a small honorarium. Alumni survey focused on support for career planning and assessed the strengths and weaknesses of the CSPs (Supplementary File 2). The survey was distributed through an online community platform for the Faculty of Medicine and through targeted emails from the Faculty of Medicine Advancement Office (March 2021). Faculty/supervisor survey explored the level of faculty engagement within the institute and their views on gaps in graduate research training (Supplementary File 3). The survey was distributed through an email from the institute’s Director in July 2020. Data were analyzed using IBM SPSS Statistics software (https://www.ibm.com/products/spss-statistics), and descriptive statistics were calculated to summarize survey responses.

A focus group of students was held to gain further insights into student experiences (Supplementary File 5). The invitation was distributed through the institute’s online newsletter and the Student Association. All students who expressed interest were invited to join the focus group. Similar to the interviews, the project team discussed any modifications to existing themes or the addition of new emerging themes. When relevant, the original focus group questions were updated to reflect new findings.

The findings from the program evaluation were highly informative and catalyzed several initiatives to improve the overall student learning experience in our institute. While the primary objective of the evaluation was to inform curricular renewal, the results highlighted that the student learning experience is shaped by factors extending beyond course content alone. Past studies have identified multiple contributors to curriculum quality, including program and dissertation length, the extent of supervisory support, student involvement in quality assurance, and students’ perceptions of teaching effectiveness, learning environment, and academic and social self-perceptions (6–9). Additional reported factors include the quality of student-instructor interactions, instructor performance, timely feedback, and institutional support, including for remote learning (9–11). Individual-level characteristics, such as personality traits, gender, and ethnicity, have also been shown to affect student learning (12–14). Consistent with these findings, our evaluation highlighted the critical role of program identity and structure, faculty engagement, and institutional support in contributing to student success and a positive learning experience. Importantly, this evaluation reaffirmed the value of systematic, regularly scheduled review, offering insights, both strengths and challenges, that may otherwise have gone unrecognized. This experience reinforced our commitment to making structured, evidence-informed evaluations an integral part of our quality assurance practices.

However, as emphasized in ‘Step 6: Ensure Use and Share Lessons Learned’ of the CDC Program Evaluation Framework, the true value of evaluation lies in translating findings into action. Findings alone have limited impact unless they inform clear changes in policy, curriculum, and practice. Accordingly, our institute has prioritized implementing corresponding action plans, monitoring their impact, and sharing lessons learned within and beyond the institution. To that end, following the distribution of the internal program review summary report to the institute’s leadership team, a one-day virtual retreat was held in January 2022. Members of the institute’s Leadership Committee and Curriculum Committee, including faculty, staff, and students, convened to discuss each recommendation and develop actionable plans to address the recommendations. In many cases, recommendations were implemented, and their impact evaluated, while others will be assessed during the next program evaluation cycle, scheduled for the 2026–2027 academic year.

Notably, the CDC Program Evaluation Framework provided instrumental guidance in supporting a rigorous, robust, and meaningful evaluation process. Although originally developed for public health initiatives, its actions and evaluation standards aligned well with the institute’s values and offered the flexibility required for application in educational context (4, 5, 15). This approach offers valuable insights for educators in similar contexts, demonstrating how the framework can be effectively adapted to guide program evaluation and curricular improvement in graduate biomedical and clinical research programs. Previous studies have also applied the CDC Program Evaluation Framework in non-public health contexts (16, 17). For example, the results of the evaluation of trends in pressure injuries from an inpatient wound care ward were used to inform nurse education (16). Similarly, Glicksman et al., (17) applied the framework to evaluate a community-of-practice program aimed at improving quality of radiation therapy care in Ontario through province-wide collaboration and policy setting.

The strengths of this study include its systematic approach to program evaluation, guided by the CDC Program Evaluation Framework. This framework provides a structured process, from engaging stakeholders to ensuring use and sharing lessons learned, and demonstrates adaptability beyond public health, including in graduate education settings. Another key strength is the high level of stakeholder engagement, particularly from students and faculty/supervisors. Their active participation enabled the study to go beyond describing the current state of the program, allowing for the collection of robust quantitative and qualitative data on specific challenges and actionable suggestions for improvement. Overall, the study contributes to ongoing discussions in graduate education by highlighting the value of dynamic, responsive programs that align with the evolving needs of students.

A key challenge for graduate programs of this size and diversity is ensuring that the curriculum remains relevant and aligned with the goal of preparing future leaders in biomedical research. Although only about 25% of total students in the institute participated in the voluntary program evaluation, the sample included both doctoral (n = 44, 34%) and master’s (n = 84, 66%) students from diverse academic fields, providing valuable insights into program strengths and areas for improvement. Given the program’s size and diversity, the relatively small but representative sample yielded notably consistent findings across stakeholder groups, providing reassurance to the evaluation results. Of utmost importance is the rapidly evolving landscape of biomedical and clinical research. This implores the institute to remain responsive to the needs of students, supervisors, and faculty. Curriculum renewal efforts must be critically examined and, where necessary, dismantle traditional paradigms that have historically shaped medical, biomedical, and translational science education (18).

In addition to curricular challenges, financial and resource constraints present practical challenges for the graduate program of this size. For example, faculty members hold primary appointments outside the institute and serve in ‘status-only’ roles, meaning they are affiliated with the institute but primarily based elsewhere, often as practicing clinician-scientists, which makes it challenging to secure consistent course leadership each year. To help address these limitations, it became clear from the review that technology must be leveraged to improve the student learning experience and access to resources and streamline administrative tasks for both students and faculty.

The findings from this program evaluation highlight the importance of routine assessment of how the program is meeting stakeholder needs. It exposes the intricate relationship between the quality of students’ learning experiences and the level of engagement among faculty, staff, and stakeholders across the university community. Given the institute’s large size, fostering a sense of connection, and belonging remains essential for sustaining faculty involvement and cultivating meaningful student-faculty relationships. This analysis has already informed tangible improvements in curriculum structure, faculty engagement, and student support, strengthening the graduate program overall. Moreover, the insights gained are not only relevant to our own context but may also offer a useful framework for other institutions seeking to improve their graduate programs. By providing a structured, student-centered approach to curriculum and program evaluation, this work contributes practical guidance for educators in graduate and medical education. In an increasingly dynamic academic and research landscape, the importance of ongoing program evaluation and refinement cannot be overstated. To remain relevant and impactful, graduate programs must actively engage stakeholders, respond to evolving needs, and ensure the graduate training continues to meet the expectations of students, faculty, and the broader scientific community.