The effectiveness and impact on performance of pharmacy-related competency development frameworks: A systematic review and meta-analysis

BackgroundCompetency frameworks for education, training and development are widely used in the health professions, including pharmacy. Published studies suggest that competency frameworks have an impact on professional performance. Professional performance that is consistent with up-to-date knowledge and skills influences health care quality and patient safety. This review assessed the effectiveness of competency frameworks in facilitating improvement in pharmacists’ performance.MethodPubMed/Medline, CINAHL, Embase, ERIC, PsycINFO and Scopus electronic databases were searched to identify relevant literature. The findings of the included studies were synthesised qualitatively, and via a meta-analysis. The meta-analysis evaluated the odds of improved competency behaviour as a proxy measure of impact on pharmacists’ performance. Study quality was assessed using 12 criteria adapted from the EPPI-Centre guidelines v0.9.7. The protocol for this review is registered on PROSPERO with reference number CRD42018096580.ResultsIn total, nine interventional studies were identified for review. The review findings showed observable and significant improvement in pharmacists’ performance when competency frameworks are used to appraise performance, identify knowledge gaps, and tailor learning activities. A meta-analysis that involved a total of 348 pharmacists undergoing repeat peer assessment showed pooled odds for improved competency behaviour of 4.41 (95% CI: 1.89–10.29, I² = 83%). Subgroup analyses showed pooled odds with corresponding 95% CI of 6.50 (1.77–23.97, I² = 77%) vs 2.95 (0.59–14.72, I² = 93%) for the studies that were conducted in countries within or outside Europe, respectively; 10.51 (3.73–29.62, I² = 24%) vs 2.39 (0.96–5.95, I² = 87%) for studies with reassessment conducted at ≤6 months from baseline, or more, respectively; 6.68 (1.63–27.45, I² = 88%) vs 2.80 (0.86–9.07, I² = 74%) for studies involving hospital or community pharmacists, respectively; and 2.80 (1.22–6.45, I² = 77%) for studies with low risk of bias.ConclusionThese findings suggest competency frameworks facilitate improvement in pharmacists’ performance; however, further evaluative studies are needed.     

Competency development for pharmacy: Adopting and adapting the Global Competency Framework

BackgroundWith current accelerated changes in the role of the pharmacists across different sectors, evidence-based developmental tools are needed to re-define the scope of practice for early career pharmacists (foundation level) and to support pharmacists’ career development. This study aimed to develop a foundation competency framework for pharmacists in Kuwait using the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) in an adopt and adapt approach.MethodsA 4-phase adopt and adapt approach was followed to develop the Kuwait Foundation Competency Framework (KFCF). Phase one involved translating the FIP GbCF, into Arabic using parallel translation. Phase two utilises 2 consensus panels validation involving pharmacists from public and private sectors. Phase three involved a national survey to all registered pharmacists in Kuwait. The final phase involved focus groups with pharmacists and a consensus panel validation with key policy and decision makers in the pharmacy practice and education sectors in Kuwait. Qualitative data were thematically analysed, while quantitative data were analysed using IBM SPSS Statistics for Windows.ResultsThe translation phase yielded a bilingual framework that could be utilised by pharmacists in Kuwait. The initial validation phase identified 70 behavioural statements (out of the GbCF's 100) as ‘highly relevant’ or ‘relevant’ to pharmacy practice in Kuwait. Findings from the national survey identified a list of behaviours that could be adapted in Kuwait context as well as competencies that were perceived as least relevant to Kuwait practice. The final validation phase generated a list of 98 behavioural statements to be included in the KFCF along with recommendations and an action plan to facilitate the adaptation of the framework.ConclusionThis study presents the first bilingual (Arabic/English) pharmacy foundation competency framework that builds on the FIP GbCF. The KFCF could be utilised as a developmental tool to support pharmacists’ performance at foundation level.     

Design fundamentals of mentoring programs for pharmacy professionals (Part 1): Considerations for organizations

Mentoring programs have been offered by organizations within and outside of healthcare for years. This commentary examines the literature under the prism of design fundamentals for these programs, drawing particular considerations for schemes aimed at pharmacy professionals. The central argument presented is that mentoring can be used as a vehicle to support pharmacists to learn from others and each other, to reinforce and own their professional identity so that the uniqueness of the pharmacy profession is established within a global health landscape of constant change. In this Part 1 of a series of papers, a wealth of literature, theories, and evidence are presented aiming to inform the general structure and logistical considerations for both in-person and distance mentoring programs.     

Design fundamentals of mentoring programs for pharmacy professionals (Part 2): Considerations for mentors and mentees

Developing a mentoring program is multifactorial, and organizations developing such programs must be reflective in considering their own organizational culture to determine the goals and outcomes assessment of a mentoring program that aligns with the organization's mission and values. Part 1 of this series of papers on devising mentoring programs for pharmacy professionals paid mind to their structure, logistical concerns, and basic design consideration. Designing a program, though, cannot be successful without consideration of the people involved, and the very human process that is mentoring and being mentored. This Part 2 paper takes into account the human needs of mentors and mentees, both independently and as pairs or groups involved in a potentially intimate and caring relationship that lasts anywhere from several months, to potentially a lifetime should the relationship be successful. As such, this commentary pays careful attention to the evolving roles each person plays and what this means to administrators overseeing or assessing the results and implications from such a program so as to strive for maximum organizational effectiveness for employing institutions and self-actualization for persons involved in the program.     

Pharmacist perceptions of competency: Identifying priority areas for a competency program development at an academic medical center

Background

Competency-based education models can serve as valuable resources for providing quality continuing education and professional development in healthcare. However, competency development programs can be stifled by scarce stakeholder involvement and insufficient recognition of resource challenges. Engaging pharmacists in program development can inform program design and prioritization of needs.

我国执业药师职业规范的构想

通过对我国其他行业职业规范的解读,以及对国外现有的药师职业规范的理解,在我国执业药师法律制度保障暂时缺失的现状下,提出制定中国执业药师职业规范的构想,以保证执业药师能够更规范地从事药学工作.     

A modified-Delphi study of a framework to support the potential implementation of pharmacist prescribing

BackgroundThere is an extensive evidence base of the effectiveness and safety of pharmacist prescribing around the globe. There is therefore potential to develop a framework to support the implementation in Qatar to achieve the National Vision 2030 of establishing a comprehensive world-class healthcare system by better utilisation of its healthcare workforce.AimTo determine the levels of agreement amongst key stakeholders regarding a framework for the potential development and implementation of pharmacist prescribing in Qatar.MethodA quantitative, consensus-based modified Delphi study involving stakeholders in Qatar with key strategic positions of health policy influence (directors of medicine/nursing/pharmacy, lead administrators, health-related academics, patient safety leads, professional regulators) was conducted. Delphi statements were developed from extensive literature reviews, semi-structured interviews, pharmacist prescribing frameworks implemented in other countries, and based on the Consolidated Framework for Implementation Research. The scope of the statements included definitions and scope of prescribing, education and training, and governance, were validated with eight specialists from UK and Qatar, and presented as an online Delphi. Consensus was set at 70% or higher agreement and less than 15% disagreement for each statement.ResultsThirty-three experts agreed to participate in the Delphi, with a response rate of 94% for Round 1 and 91% for Round 2, at which point the Delphi stopped. Consensus was achieved for 38 out of 47 statements indicating that a collaborative prescribing model was preferred, and that experience and additional training were required along with robust governance. Consensus was not reached in relation to independent prescribing, prescribing controlled drugs, and ordering certain diagnostic/monitoring investigations (e.g. ECG, X-ray).ConclusionHigh levels of agreement were attained for statements, which can constitute a framework for the development and implementation of pharmacist prescribing in Qatar. Further work is required to translate this framework into healthcare policy and practice.     

Developing consensus around the pharmaceutical public health competencies for community pharmacists in Scotland

Objective The new community pharmacy contract in Scotland will formalise the role of pharmacists in delivering public health services. To facilitate assessment of education and training needs it is necessary to define the relevant public health competencies for community pharmacists. The objective of this research was to define and develop consensus around such competencies. Methods The “Skills for Health National Occupational Standards for Public Health Practitioners” was used to define an initial set of competencies. A two stage Delphi technique was undertaken to develop consensus. An expert panel, representing public health and pharmacy stakeholders, rated their agreement with the importance of each competency, with the agreement level set at 90%. Main outcome measures Level of agreement (%) with each public health competency; those competencies achieving more than 90% agreement with importance for community pharmacy practice. Results Ten organisations (83% of those invited) and a total of 30 members (88%) agreed to take part in the process. In round 1 of the Delphi, responses were received from 25 (83%) individuals and 22 (73%) in round 2, with consensus being achieved for 25/68 (37%) competencies in round 1 and a further 8/68 (12%) in round 2. Conclusion Public health competencies for community pharmacists achieving consensus predominantly focused on health improvement activities at individual and local community levels and ethical management of self rather than those relating to surveillance and assessment and strategic development. There is a need to research community pharmacists’ views of these competencies and to systematically assess their education and training needs     

A global evidence review of systemic factors influencing participation in pharmacy professional development activities

BackgroundChanges to the pharmacy profession have meant that a pharmacy degree can no longer serve as an endpoint to professional training within pharmacy. Continuing learning and training are imperative in order to provide high-quality healthcare services. Investing in healthcare workers’ education and training not only has a positive impact on employment rates and economic growth but also results in remarkable improvement in health and population outcomes.ObjectivesTo identify factors affecting pharmacists’ participation in Continuing Education (CE) or Continuing Professional Development (CPD) activities.MethodsRelevant literature was identified through a systematic search of the following databases: EMBASE, (CINAHL Plus, SCOPUS, PsysINFO, PubMed, Australian Education Index (AEI) and British Education Index (BEI).ResultsTwo hundred eighty-seven studies were screened, and thirty-two studies were included in this review. Reviewing the retrieved studies identified four factors that may influence pharmacists’ participation in professional development activities. Factors identified comprised: attitudes, access to needs-based education, support, and policy.ConclusionUnderstanding the connection between needs-based education, systems of support, and professional policies may help leaders and policy makers to make more informed decisions with regards to pharmacy workforce development by creating better strategies for pharmacists’ education, training, and career development.     

Views, attitudes and self-assessed training needs of Scottish community pharmacists to public health practice and competence

Objective To assess the education and training needs of community pharmacists to support the delivery of an expanded public health role. Setting Community pharmacy in Scotland. Method Two focus groups of community pharmacists (n = 4 in each) in geographically distinct regions of Scotland explored issues of public health function, competencies and education and training. Findings from thematic analysis were used to develop a draft postal questionnaire. Following piloting, pharmacist managers from a random sample of 500 community pharmacies in Scotland were contacted by telephone to ascertain the number of pharmacists working in each pharmacy in the following 14-day period. A survey pack containing questionnaires for each identified pharmacist working in the study period was sent by post to the pharmacist manager in each pharmacy. The questionnaire contained items on: demographics; views and attitudes towards: public health; competencies for public health practitioners; and education and training needs. One postal reminder was sent 2 weeks later. Main Outcome Measures Main themes identified from focus group discussions; questionnaire response rate; views and attitudes towards public health competencies and education and training. Results Four hundred and fifteen managers agreed to participate, providing 904 potential participants. The response rate was 25% (223/904). Most (n = 179, 80%) were aware of the term ‘pharmaceutical public health’. While a majority saw the importance of public health to their practice (n = 177, 79%) agreeing/strongly agreeing, they were less comfortable with the term ‘specialist’. Respondents viewed competencies relating to health promotion (n = 192, 86%) more relevant than surveillance (n = 70, 31%), risk management (n = 29, 13%) and strategic developments (n = 12, 5%). Responses indicated a desire for education and training with more than half (n = 121, 54%) agreeing/strongly agreeing that they had a need now, with 69% (n = 153) expressing a future need. Conclusion Results should be interpreted with caution due to the response rate. However, this research highlights the self assessed gap in competence related to pharmaceutical public health for community pharmacists in Scotland.     

Using a global systematic framework tool to guide the advancement of the pharmacy workforce education and training on a national level

BackgroundSystematic education and training strategies play a critical role in preparing a competent pharmacy workforce to meet the evolving healthcare needs of nations. Reports have shown that investing in healthcare workers' education and training not only has a positive impact on employment rates and economic growth but also results in measurable improvement in health and population outcomes. The goal of this study was to evaluate the use of globally validated workforce goals as a guide to the planning and advancement of the Kuwait pharmacy workforce's education and training.MethodsA mixed-approach qualitative study involving representatives of key stakeholders was conducted. Focus group interviews were carried out with pharmacists with patient and non-patient facing roles (N = 33). In addition, semi-structured interviews with the three main pharmacy Continuing Professional Development (CPD) providers in the country were conducted. Data were analysed using a framework analysis method. Interviews were transcribed verbatim and data were analysed and coded using MAXQDA-12. The International Pharmaceutical Federation Workforce Development Goals (FIP WDGs) were used as the framework for data analysis.ResultsParticipants’ responses highlighted three main priorities: the importance of initial and post-graduation needs-based education (WDG 2), the need for competency development and competency frameworks (WDG 5), and the crucial role of active policy and regulations that would enforce the profession development (WDG 9). Investing in competency development was seen the top priority for the pharmacy workforce in Kuwait.ConclusionThis study provided insights into areas in need of systematic development for pharmacy workforce in Kuwait including foundation training for early career pharmacists, competency development and competency frameworks, and policies and regulations that would enforce the profession development. In addition, the use of the FIP WDGs framework was found to offer a framing device to better understand and identify priorities and needs for pharmacy workforce development.     

Using the Internet to develop an international learning community of pharmacists

Until recent years, the level of interaction across a profession, necessary to provide for an optimum learning environment which supports professional development, has only been significantly possible in face-to-face interaction and has therefore been place and time dependent. With the explosive development of the Internet, communication barriers are breaking down and international interaction, networking and collaboration is becoming increasingly possible. This short report describes the manner in which an Internet-based postgraduate study programme, entitled Enhancing Pharmacy Practice has made use of these communication opportunities to develop an international learning community of pharmacists. Programme evaluation data collected from surveys completed online by participants and content analysis of online discussion groups during the first four modules of the programme, demonstrates that there is a high level of interaction amongst participants. It also suggests that this interaction has contributed to the learning experience and professional growth of the participants and impacted positively upon their practice.     

Measuring a state of mind indicative of thriving using the Student Pharmacist Inventory of Professional Engagement (S-PIPE)

Background

Professional engagement has importance to the professional of pharmacy, and in particular the growth of student pharmacists. Measurement of this construct would allow investigation of factors that may increase or decrease professional engagement.

Sustainability of innovations in healthcare: A systematic review and conceptual framework for professional pharmacy services

BackgroundImplementation science emerged to address the challenges associated with the incorporation of evidence-based innovations into practice. Once the challenge is overcome, the ultimate goal is to achieve the sustainability of innovations to promote their continuity and long-term integration. Conceptual approaches and assessment tools have been designed to assess the sustainability of innovations in research and practice environments. However, the variability of approaches and tools available becomes a challenge for policymakers, researchers and practitioners, particularly when deciding how to evaluate the sustainability of innovations.ObjectivesTo identify conceptual approaches and assessment tools for the sustainability of healthcare innovations and to develop a specific discipline-based framework for the sustainability of professional pharmacy services.MethodsA systematic literature review was conducted in January of 2019 using PubMed, Scopus, and Web of Science. General information regarding the conceptual approaches (based on Nilsen's classification), assessment tools and the factors affecting the sustainability of the healthcare innovations was retrieved.ResultsFrom 3123 articles screened, 132 articles were selected from which 106 conceptual approaches and 26 assessment tools were identified. Several key factors moderating the sustainability of the innovations in healthcare were identified (e.g. funding, adaptation). A framework for the sustainability of professional pharmacy services is proposed based on these factors. It presents three performance domains influencing the service sustainability (i.e. environment, social and economic).ConclusionsThe identified approaches in different healthcare settings have allowed the adaptation and design of a specific framework for pharmacy. The core factors included in the proposed framework are moderators of the sustainability process and should be considered in sustainability studies and evaluations. This framework will guide pharmacy practice researchers and practitioners to measure and achieve the sustainability of professional pharmacy services. Furthermore, the adaptation of this framework will allow its application to other healthcare settings. (Registration number CRD42018092160).     

药师在糖尿病患者教育中的作用及工作方法

目前我国糖尿病患者人数逐年上升,糖尿病患者教育越来越受到重视.本文介绍了我国糖尿病患者教育的现状,分析了药师在糖尿病患者教育中的作用和优势,探讨了药师开展糖尿病患者教育的工作方法.     

执业药师政策与药学教育改革

执业药师资格制度的试行和全面推开 ,为药学教育提出了新的课题。因此 ,如何适应执业药师政策变化 ,使高等药学教育同执业药师资格制度接轨 ,认真研究专科药学人才定位 ,构筑科学合理、具有专科特点和药学特色的课程体系 ,已成为药学专业教学改革的切入点