Introduction: Expertise is an experiential capability that cannot be acquired through formal education alone; rather, it develops through sustained reflection and iterative practice. Despite the importance of expert clinical faculty, the process of attaining this educational expertise has not been systematically conceptualized. This study was conducted to develop a paradigmatic model of the educational competency development process in clinical medical faculty and identify its dimensions, components, and interrelationships.
Methods: This qualitative grounded theory study was conducted in 2024–2025 at Iran University of Medical Sciences using the Corbin and Strauss approach (2015). A total of 15 participants, including 13 clinical faculty members (with at least five years of teaching experience and recognized teaching competence) and 2 medical students, were initially recruited through purposive sampling. Snowball sampling was used solely as a recruitment technique to identify additional information-rich participants. As we collected and analyzed data, we used theoretical sampling. This helped us refine the categories and reach theoretical saturation. Data were collected through semi_structured, in-depth interviews lasting 30–50 minutes (mean: 45 minutes). All interviews were audio-recorded and transcribed verbatim. Data were analyzed concurrently with data collection using the constant comparative method, including open coding, category development, contextual analysis, and theoretical integration. Rigor was ensured through prolonged engagement with the data, member checking, peer debriefing, and the maintenance of an audit trail.
Results: Data analysis led to the emergence of the core category, “Gradual Transformation toward Expertise,” which explains how clinical faculty members evolve from expert clinicians into transformative educators. This process is dynamic, non-linear, and highly context-dependent. Five interrelated themes describe this developmental trajectory: 1) reflection and competence development, 2) experiential learning and clinical observation, 3) mentorship and knowledge transfer, 4) motivational and contextual influences, and 5) barriers and professional transformation. The process was shaped by six contextual factors: a) the complex and dynamic nature of clinical education; b) the need for continuous competency development; c) generational differences in teaching and learning styles; d) workload and competing clinical responsibilities; e) the necessity of integrating practical experience with scientific evidence; and f) an organizational
culture that prioritizes treatment over education. Additionally, causal conditions such as multiple professional pressures and generational gaps further influenced the pace and direction of this
transformation. Overall, the findings depict expertise development as a gradual, evolving process through which faculty members reconcile their clinical and educational roles to become effective
and transformative clinical educators.
Conclusion: Clinical teacher expertise develops through a dynamic interplay of individual effort, experiential learning, and environmental factors. This transformation requires personal commitment to lifelong learning and reflection, supported by organizational initiatives such as faculty development programs, mentoring, and aligned incentive systems. The proposed grounded theory provides a practical framework for designing professional development initiatives and fostering educational settings that enhance expertise in similar non-Western contexts.