Karen Luetsch

Interprofessional communication training: benefits to practicing pharmacists

Background Interprofessional communication skills are important for pharmacists to build collaborative relationships with other health professionals, integrate into healthcare teams, maximise their effectiveness in patient care in addressing complex care needs and meet the demands of health care reforms. Objective This qualitative study explores clinical pharmacists’ experiences and reflections after completing a learning and practice module which introduced them to a framework for successful interprofessional communication. Setting The postgraduate clinical pharmacy program at The University of Queensland and the clinical pharmacy practice environments of forty-eight hospital and seven community based pharmacists. Method A learning and practice module outlining a framework for successful interprofessional communication was designed and integrated into a postgraduate clinical pharmacy program. Enrolled pharmacists applied newly learnt communication skills in pro-actively initiated, clinical discussions with a health professional in their practice environment. They provided written reflections on their experiences which were analysed using thematic analysis. Main outcome Pharmacists’ perceptions of the impact of applying the communication framework during their interaction with a health professional in their practice setting. Results Themes which emerged from reflections described pharmacists’ confidence and capabilities to successfully conduct a clinical discussion with a health professional after initial apprehension and nervousness about the scheduled interaction. The application of the communication framework enhanced their perception of their professional identity, credibility and ability to build a collaborative working relationship with other health professionals. Conclusions Pharmacists perceived that a learning and practice module for successful interprofessional practice integrated into a postgraduate clinical pharmacy program enhanced their interprofessional communication skills. The development of pro-active, interprofessional communication skills has the potential to increase interprofessional collaboration and pharmacists’ personal role satisfaction. Pharmacists also observed it added value to their professional contribution in health care teams when addressing the demands of increasingly complex health care needs and reforms.

Negotiating "Unmeasurable Harm and Benefit": Perspectives of General Practitioners and Consultant Pharmacists on Deprescribing in the Primary Care Setting.

The use of multiple medicines, known as polypharmacy, poses a risk of harm that is greatest in older adults with multimorbidity. Deprescribing aims to improve health outcomes through ceasing medicines that are no longer necessary or appropriate due to changing clinical circumstances and patient priorities. General practitioners (GPs) and consultant pharmacists (CPs) are well positioned to facilitate deprescribing in primary care in partnership with older adults who present with inappropriate polypharmacy. In this article, we explore GPs’ and CPs’ views about inappropriate polypharmacy, the reasoning they apply to deprescribing in primary care, and identify factors that support or inhibit this process. Using focus group methodology and the Framework Method for thematic analysis, two major themes were discerned from the data—working through uncertainty and risk perception as a frame of reference. The findings provide important insights when devising methods for advancing and supporting deprescribing in primary care.

Enablers and barriers to the use of antibiotic guidelines in the assessment and treatment of community-acquired pneumonia—A qualitative study of clinicians’ perspectives

Community‐acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal.

Developing interprofessional communication skills for pharmacists to improve their ability to collaborate with other professions

ABSTRACT Successful communication between health professionals is a prerequisite for collaborative practice. Clinical pharmacists completed a learning and practice module introducing them to a framework for successful interprofessional communication (IPC) in the course of their postgraduate studies. A face-to-face discussion of a contemporary clinical topic with a health professional was then scheduled, mainly with junior doctors, in their practice setting. An exploratory case study methodology was employed to investigate pharmacists’ written reflections on their experience applying their newly acquired IPC skills. Thematic analysis of reflections developed five categories relating to interprofessional collaboration, learning, and education. Themes describing pharmacists’ preconceptions about the health professional and scheduled interprofessional encounter, how it allowed them to learn about doctors’ and other health professionals’ practice and build collaborative relationships were identified. Reflections also elaborated that applying the communication framework and strengthening of collaboration created opportunities for IPE, with added observations about these increasing potential impact on patient care and change of practice. Analysis of anonymous feedback provided by the health professionals yielded similar themes and was integrated for triangulation. Applying successful IPC skills in healthcare settings may increase interprofessional collaboration and create practice models which facilitate interprofessional learning in health profession programmes.

Certainty rating in pre-and post-tests of study modules in an online clinical pharmacy course - A pilot study to evaluate teaching and learning

BackgroundGraduate and post-graduate education for health professionals is increasingly delivered in an e-learning environment, where automated, continuous formative testing with integrated feedback can guide students’ self-assessment and learning. Asking students to rate the certainty they assign to the correctness of their answers to test questions can potentially provide deeper insights into the success of teaching, with test results informing course designers whether learning outcomes have been achieved. It may also have implications for decision making in clinical practice.MethodsA study of pre-and post-tests for five study modules was designed to evaluate the teaching and learning within a pharmacotherapeutic course in an online postgraduate clinical pharmacy program. Certainty based marking of multiple choice questions (MCQ) was adapted for formative pre- and post-study module testing by asking students to rate their certainty of correctness of MCQ answers. Paired t-tests and a coding scheme were used to analyse changes in answers and certainty between pre-and post-tests. A survey evaluated students’ experience with the novel formative testing design.ResultsTwenty-nine pharmacists enrolled in the postgraduate program participated in the study. Overall 1315 matched pairs of MCQ answers and certainty ratings between pre- and post-module tests were available for evaluation. Most students identified correct answers in post-tests and increased their certainty compared to pre-tests. Evaluation of certainty ratings in addition to correctness of answers identified MCQs and topic areas for revision to course designers. A survey of students showed that assigning certainty ratings to their answers assisted in structuring and focusing their learning throughout online study modules, facilitating identification of areas of uncertainty and gaps in their clinical knowledge.ConclusionsAdding certainty ratings to MCQ answers seems to engage students with formative testing and feedback and focus their learning in a web-based postgraduate pharmacy course. It also offers deeper insight into the successful delivery of online course content, identifying areas for improvement of teaching and content delivery as well as test question design.

Doctor–pharmacist communication in hospitals: strategies, perceptions, limitations and opportunities

Background Effective communication between health professionals contributes to safe and efficient patient care, whereas communication breakdown can lead to adverse patient outcomes and increased healthcare expenditure. Information on how pharmacists and doctors communicate with each other in hospitals is limited. Objective To explore usage and perceptions of communication methods by doctors and pharmacists in hospital settings. Setting Four public hospitals in Australia. Method A mixed method study utilising a pilot questionnaire, semi-structured interviews, and electronic survey was designed. Frequentist statistics and logistic regression were used to analyse survey data. Thematic analysis was conducted to evaluate semi-structured interview data and free-text survey comments. Main outcome measures: Frequency of use of communication methods, perceptions of the convenience, time taken to use, accuracy and effectiveness of each method. Results More than 95% of doctors and pharmacists combined used face-to-face and phone calls to communicate with each other, 70% used a medication management plan, and 62% used progress notes. A preference for oral communication was confirmed with the expressed need for building professional rapport and receiving responses. Perceptions regarding effectiveness of oral communication methods were related to perceptions of their convenience and accuracy. Professional groups described differences in perceived ownership of various modes of communication. Conclusions Preferences for oral communication create potential issues with recall and comprehension. Integrating oral communication features into written communication methods, e.g. creating responses, conversations, building rapport, may change doctors’ and pharmacists’ perceptions of effectiveness. Communication receipt and response functionality in electronic medication and record management systems may improve communication.