Nurses’ Participation in Physician Training: A Mixed-Methods Study of Healthcare Professionals’ Perceptions

Aims/Background: In China, the integration of nurses into physician training programs remains inadequately explored despite the international recognition of the critical role of interprofessional collaboration in healthcare education. This study examined healthcare professionals’ perceptions of nurses’ involvement in developing physicians’ clinical competence. Methods: An explanatory sequential mixed-methods design was employed, consisting of a cross-sectional web-based questionnaire followed by semistructured interviews to explain and deepen the quantitative findings. Between November 2023 and December 2023, 336 valid respondents from 60 hospitals across all 16 districts of Tianjin, China, were included, spanning primary through tertiary care institutions. Additionally, 15 healthcare professionals with extensive clinical teaching experience participated in face-to-face semistructured interviews. The quantitative data were analyzed via chi-square tests, whereas the qualitative data underwent Colaizzi’s seven-step phenomenological analysis. Results: Among the 336 respondents (61.0% nurses, 39.0% physicians), the overall awareness, participation, and acceptance rates were 67.3%, 43.2%, and 88.7%, respectively. Statistically significant differences emerged across hospital levels: awareness rates were 57.0%, 69.5%, and 73.7% (p < 0.05); participation rates were 32.0%, 45.8%, and 50.0% (p < 0.05); and acceptance rates were 79.0%, 91.5%, and 94.1% (p < 0.05) for primary, secondary, and tertiary hospitals, respectively. Awareness varied significantly by professional tenure: 80.0% (<5 years), 59.5% (5–10 years), and 66.0% (>10 years) (p < 0.05). Notably, a substantial majority (289 participants, 86.0%) believed that nurse involvement effectively enhances physicians’ clinical competence. Physicians demonstrated greater perceived benefits (93.1%) than did nurses (81.5%) (p < 0.05). Additionally, 298 participants (88.7%) agreed that nurses’ participation in physician training also benefits nurses’ own professional competence—a recognition rate comparable to that for physicians’ competence improvement (86.0%)—suggesting that healthcare professionals perceive bidirectional value in such collaborative educational practices. Qualitative analysis revealed five overarching themes: (1) Nurse participation in physician training is often superficial and informal. (2) Reluctance to participate due to hierarchical and professional barriers. (3) Nurse involvement is perceived to enhance physicians’ clinical and professional competence. (4) Participation supports nurses’ own professional growth and teaching skills. (5) Enhanced mutual understanding and team collaboration between doctors and nurses. These themes collectively reveal both the challenges (e.g., the sub-optimal nature of training and participation barriers) and potential benefits (e.g., improved competence and teamwork) associated with nurse participation in physician training. Conclusion: While healthcare professionals recognize the value of nurse involvement in physician training, notable gaps remain between awareness and participation levels among nurses. The findings underscore the need for systematic institutional support to overcome hierarchical barriers and foster genuine interprofessional education in Chinese medical training programs.