The Health System Impact (HSI) Fellowship program in Canada offers a transformative approach to health services and policy Research (HSPR) training, preparing PhD graduates for diverse career pathways and leadership roles within learning health systems. This commentary builds on Kasaai and colleagues’ evaluation of the HSI Fellowship to discuss the diverse career paths of alumni and highlight the multifaceted benefits of the program. Further, we emphasize the need for future Research and knowledge mobilization to better understand and evaluate Embedded Research roles. Developing a robust evaluation framework is essential to capture the unique impacts of Embedded Research, fostering a culture that prioritizes and integrates it, thereby driving the transformation towards learning health systems.

As Embedded Researchers in Northern Ontario, Canada, we offer our reflections on Kasaai and colleagues’ 2023 “Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program.” In our commentary, we draw on our experiences and what is known about Embedded Research training to examine how to build and strengthen the workforce for equity-centered learning health systems. Does our narrow understanding of outcomes and impacts of Embedded Research training in Canada affect who benefits and which systems can realize the potential of learning health systems? We identify three areas for deeper analysis: outcomes and impacts at the individual, partnership, and system level, knowledge on the social identities and needs of individuals in Embedded Research partnerships, and Research generalism as a complement to Embedded Research. Our recommendations suggest tailored approaches to strengthen the workforce capacity for equity-centered learning health systems in Canada.

Partnerships between academic institutions and healthcare organisations have been proposed as an effective way to integrate academic Research findings into changes in health policy and practice. Bowen and colleagues explore these partnerships from a different angle, analysing them in relation to the experiences of health system leaders. The authors made a call to re-imagine Research, rethinking how we train applied health Researchers, fund health Research and evaluation and design studies and collaborations with the health sector. In this paper, I respond to this call by discussing three strategies we can use to make sure our Research is timely, relevant and responsive to the needs and context of healthcare organisations: the widespread use of rapid Research approaches, the integration of scoping stages in all studies, and the training of applied health Researchers to work in the health system and develop collaborative relationships with staff.

Kasaai et al describe the career trajectories of Embedded scientists trained through the Health System Impact Fellowship (HSIF), showing that 37% of 2017–2019 HSIF alumni continue as Embedded Researchers in health systems. These findings suggest that the HSIF program effectively supports career readiness in health services and policy Research (HSPR). Similarly, the Network of Scholars (NoS) program, launched post-pandemic in Nova Scotia, mirrors these results, with alumni continuing in Embedded roles and mentoring a new cohort of learners from undergraduate to postgraduate levels. NoS has incorporated competencies in quality, project management, and innovation to strengthen training for Embedded scientists, aligning with the mandate of the Institute of Health Services Policy and Research. Since 2021, NoS has supported over 100 learners, contributing to over 300 rapid reviews and 100 rapid evaluations addressing top health system priorities while enhancing learner competencies and advancing Nova Scotia’s Learning Health System (LHS) vision.