Work-study programmes in postgraduate nursing education: A multi-stakeholder framework for learning-practice integration and workforce sustainability.

BACKGROUND: Global nursing shortages require educational models that strengthen workforce capacity while advancing professional competence. Conventional postgraduate pathways often require extended leave from employment, which can intensify staffing pressures, increase financial burden for students, and perpetuate the theory-practice gap. Work-study programmes (WSPs) which integrate protected study time with ongoing clinical practice, offer a potential solution but remain under-defined in postgraduate nursing education, particularly in Asian health-system contexts. AIM: To explore multi-stakeholder perspectives on postgraduate WSPs and develop a framework for integrating learning, practice, and workforce sustainability. METHODS: A qualitative descriptive study was conducted using semi-structured focus groups and interviews with 20 stakeholders: five postgraduate WSP students, five clinical nurse facilitators, five academic faculty members, and five adjunct lecturers. Data were analysed inductively using thematic analysis and subsequently interpreted through Donabedian's Structure-Process-Outcome model and Kolb's Experiential Learning Theory, which were selected a priori as sensitising frameworks to support interpretation and framework development. RESULTS: Findings were organised across three domains. WSP structure included definitions of WSPs, distinctive programme features, stakeholder roles and collaboration, and policy and guideline development. Effective implementation processes comprised learning and teaching strategies, constructive assessment approaches, and implementation facilitators and barriers. Programme evaluation and outcomes included evaluation approaches and perceived impacts of successful WSP implementation. These elements were synthesised into a multi-stakeholder framework that explicates how WSPs integrate learning and practice while supporting workforce sustainability. CONCLUSION AND IMPLICATION: WSPs represent a promising education model for aligning postgraduate nursing education with workforce needs. The proposed multi-stakeholder postgraduate WSP framework advances conceptual understanding by linking structural enablers, educational processes, and multi-level outcomes to support learning-practice integration and workforce sustainability. The framework provides practical guidance for programme design, implementation, and evaluation.