Bioecological Theory of Human Development and Medical Education: Scoping Review

Introduction Postgraduate medical training is essential for consolidating clinical competencies and professional identity. Bronfenbrenner’s Bioecological Theory of Human Development (BTHD) and its PPCT model (Process–Person–Context–Time) provide a framework for analyzing the interaction between residents and their training environments at the micro, meso, exo, macro, and chronosystem levels. However, its explicit use in medical education research remains limited. Objective To map studies applying the BTHD in postgraduate medical education, identify levels of analysis, describe methodologies and key findings, and detect research gaps. Materials and Methods A scoping review was conducted following Arksey and O’Malley and the PRISMA-ScR guidelines. Articles published between 2015 and 2025 in PubMed, Scopus, BVS Salud, Epistemonikos, and Web of Science, in English and Spanish, that explicitly applied the BTHD/PPCT to clinical contexts of medical training were included. Peer-reviewed theoretical, qualitative, quantitative, and mixed-methods studies were considered. Results Four relevant studies were identified. Ellaway et al. proposed an ecological model to adapt training programs to systemic changes. Gruppen et al. integrated all levels of the model to redesign more human-centered curricula. Nolan and Owen identified structural barriers to equity and diversity across multiple levels. Jones et al. highlighted the influence of interpersonal, organizational, and cultural factors on student well-being. Conclusion The BTHD and PPCT enable the understanding of medical training as a complex, intersystemic process, supporting the design of inclusive and culturally sensitive interventions. Despite its analytical value, its incorporation into empirical studies remains limited, creating opportunities to strengthen the evidence base and guide educational policies toward integral human development in medical contexts.