Abstract
This Doctoral research explores the effectiveness of andragogical distance learning in Continuing Medical Education (CME) for healthcare professionals, focusing on the Italian National Institute of Health (ISS). The study integrates three components: (1) a realist-configurative literature review on the relationship between learner satisfaction and learning (Kirkpatrick’s model, Levels 1–2); (2) a quantitative analysis of a large ISS dataset (over 100,000 participants, pre- and post-COVID) to identify predictors of training success; (3) the design of a roadmap for adapting the WHO Global Competency and Outcomes Framework for Essential Public Health Functions to the Italian context. Results highlight that satisfaction alone does not predict learning, but becomes meaningful when linked to active methods, facilitation, and learner motivation. The thesis advances theoretical, empirical, and practical insights to strengthen competency-based CME and the resilience of the public health workforce.