Lesley Diack

Interprofessional education in practice

Background:  Undergraduate interprofessional education (IPE) is perceived by many in health and social care education to reduce barriers between the professions. In Aberdeen there has been an IPE programme with Robert Gordon University and University of Aberdeen, and 10 health and social care courses since 2003. The steering groups reported to the Scottish Government in 2008. It was recommended that IPE should be extended from classroom‐based learning experiences to practice‐based learning experiences.

Pharmacist prescribing in primary care: the views of patients across Great Britain who had experienced the service

Objective  To evaluate the views of patients across primary care settings in Great Britain who had experienced pharmacist prescribing.

A systematic review of the literature on ‘medication wastage’: an exploration of causative factors and effect of interventions

Introduction Reducing any wastage, including that of medications, is a paramount objective in promoting appropriate utilisation of finite resources. The objective was to systematically review the published literature, the possible causative factors associated with medication wastage and the effectiveness of any interventions to reduce wastage. Method A systematic review of studies published in English was identified from the following databases: Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, PubMed, Science Citation Index and The Cochrane Library. Data extraction and critical appraisal was undertaken independently by two researchers. Results and discussion Title, abstract and full paper screening reduced the 14,157 studies to 42. A general definition of medication wastage was reported in one paper only. ‘Medication changed’, ‘patient death’, ‘resolution of patient’s condition’ and ‘expired medications’ were most commonly cited reasons for wastage. Only two studies were identified reporting wastage as a research outcome measure following intervention. Conclusion The systematic review has identified a limited literature on medication wastage with a lack of consistency of terms. There is a paucity of robust research focusing on the impact of healthcare interventions on outcomes around medication wastage.

Playing interprofessional games: reflections on using the Interprofessional Education Game (iPEG).

Abstract This report explores the relevance of gaming in IPE curriculum design with the use of the Interprofessional Education Game (iPEG) as an activity aimed to achieve positive interprofessional learning outcomes for students. It was designed to enable the understanding of professional roles and responsibilities in patient/client care settings. We provide a description of its implementation and evaluation with first year student cohorts (900+ per cohort) over a 3-year period within an established interprofessional education (IPE) programme. The game encapsulates fun and memorable learning styles to explore professional stereotypes and team approaches to care delivery. It can be a valuable teaching tool for those designing IPE curriculum. Evaluation data from students and staff were mainly positive. We discuss the use of the game and its potential to be adapted in flexible and creative ways to assist educators in consider incorporating gaming within their own IPE programmes.

Applying the Delphi technique to define 'medication wastage'

Objective The aim of this study was to apply the consensus-based Delphi technique to define ‘medication wastage’ and its contributory factors. Method The Delphi technique was employed in this study, applying a minimum agreement consensus level of 75%. An expert panel comprising 26 professionals and six patients was recruited and communicated with by email. Round 1 comprised open-ended questions focusing on proposing a definition for ‘medication wastage’ and listing possible contributing factors. In round 2, respondents were requested to rank eight definitions of ‘medication wastage’, derived from round 1, in order of preference. Themes related to contributory factors were presented as 5-point Likert statements. Round 3 included statements that did not meet consensus in round 2. Results Twenty-seven consented to participate, 23 of whom responded to both rounds. Of the eight options for defining ‘medication wastage’, the highest ranked was ‘Medication wastage refers to any medication which expires or remains unused throughout the whole medicines supply chain. Also refers to the unnecessary or inappropriate consumption of medications by patients, or the unjustified non-adherence to treatment guidelines by healthcare professionals. Medication wastage poses a financial burden on patients themselves and the states economy and requires adequate education of all people concerned’. Themes related to factors associated with wastage included physical/environmental, social/psychological (patient/practitioner) and cultural. Conclusions A high level of consensus was achieved on a definition of medication wastage from a diverse panel of academics, practitioners, government officials, officials from non-governmental organisations, and patients in Malta.

Interprofessional education in the Arabic-speaking Middle East: Perspectives of pharmacy academics

ABSTRACT The current status of interprofessional education (IPE) in Arabic Middle Eastern countries is largely unexamined and there is a need to assess IPE and collaborative practice in these countries. As faculty attitudes towards IPE are believed to be one of the main factors that affect the successful integration of IPE into the different healthcare curricula, this article aims to explore the attitudes and views of pharmacy academics in Arabic-speaking Middle Eastern countries towards IPE and collaborative practice. The findings from this article are part of a larger study investigating pharmacy’s perspectives of IPE and collaborative practice in Qatar and the Middle East. An online survey which included three validated scales was used to gather information from pharmacy academics at 89 pharmacy schools in 14 countries. The response rate was 107 out of 334 (32%) and the majority of the respondents were from Jordan, Qatar, Lebanon, and Saudi Arabia. Statistical analysis was completed descriptively as well as inferentially using a series of independent t-tests. Overall pharmacy academics had positive attitudes towards IPE. The majority of the respondents, 90.8% (n = 99), perceived IPE to be important. Age, likelihood to engage in IPE, and years of IPE experience were the factors that were related to faculty members’ attitudes towards IPE. Highly perceived barriers for implementing IPE included cultural challenges for each profession, scheduling common courses, and activities in addition to limited resources. The study findings indicated that pharmacy academics in the Middle East are ready to pursue IPE. These results can serve as impetus for implementing IPE in Middle Eastern countries.

A comprehensive systematic review of pharmacy perspectives on interprofessional education and collaborative practice.

Introduction: Pharmacists are key professionals in the collaborative working process and are integral members of the healthcare team. However, there is paucity of information regarding their perspectives towards interprofessional education (IPE) and collaborative practice. Aims: The aim of this systematic review is to synthesise, summarise and evaluate the quality of the quantitative and qualitative literature related to the perspectives of pharmacy students, pharmacy faculty and practising pharmacists toward IPE and collaborative practice. The perspectives included their views, experiences and attitudes with a special focus on their perceived benefits and challenges in relation to IPE and collaborative practice. Methods: An integrated mixed method systematic review was conducted. Four electronic databases were searched for articles published in English between 2000 and 2015. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the studies. Results: Twenty‐nine articles were identified meeting the selection criteria from the first initial search of 8512 articles. Seventeen articles (59%) targeted pharmacy students, 11 articles (38%) focused on practising pharmacists and 1 study (3%) was related to pharmacy faculty. The majority of studies were conducted in the United States (n = 13), were published in the last five years (83%, n = 24) and employed quantitative methods (52%, n = 15). The two commonly used survey instruments to measure the perspectives were: different versions of the RIPLS (35%, n = 6) and the IEPS scale (35%, n = 6). Fourteen of the 29 studies were rated as low quality (MMAT = 25%), eight studies were rated as average quality (MMAT = 50%), four were rated as high quality (MMAT 75%) and three were rated as very poor quality (MMAT 0%). No studies were rated with 100% MMAT quality. Overall, the findings suggest that pharmacy students, practicing pharmacists and faculty valued interprofessional education and collaborative practice and had positive attitudes towards it. Five main findings have been identified from this review: heterogeneity in reporting IPE research, traditional professional image of the pharmacist, lack of longitudinal follow‐up, lack of IPE research on faculty and paucity in mixed method studies in terms of quality and numbers. Conclusions: These findings will provide an opportunity to stakeholders and policy makers to develop and implement IPE activities that are meaningful, comprehensive and unique. Sustained efforts are required not just in undergraduate curricula but also in healthcare settings to improve and promote an interprofessional culture at individual and organisational level.

Perspectives of pharmacy students in Qatar toward interprofessional education and collaborative practice: a mixed methods study

ABSTRACT In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students’ attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students’ perspectives. These were on the pharmacy students’ perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession). Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students’ perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care.

Perspectives of practising pharmacists towards interprofessional education and collaborative practice in Qatar

Background Healthcare is provided by a variety of different professionals, including pharmacists who are integral members of the team, and all are expected to work collaboratively to provide quality care. Little is known about the perceptions of pharmacists in Qatar towards interprofessional collaboration. Positive attitudes towards interprofessional education are essential to successful implementation of interprofessional collaboration. Therefore, to develop effective collaboration strategies in practice settings, it was essential to survey the attitudes of practising pharmacists towards collaboration. Objective To explore the awareness, views, attitudes and perceptions of practising pharmacists in Qatar towards interprofessional education and collaborative practice. Setting Community, hospital and primary healthcare settings in Qatar. Methods This was a two-staged sequential explanatory mixed method design. It utilised a quantitative survey (Stage 1), based on a modified version of the Readiness for Interprofessional Learning Scale. This was followed by a qualitative stage, utilising focus groups (Stage 2). Main outcome measures (1) Qatar pharmacists’ attitudes towards interprofessional education and collaborative practice; (2) Practising pharmacists’ perspectives in relation to enablers, barriers and recommendations regarding interprofessional education and collaborative practice. Results 63% of the practising pharmacists (n = 178) responded to the survey. Three focus groups followed (total n = 14). High scores indicating readiness and positive attitudes towards interprofessional education were reported for pharmacists working in hospital, community and primary healthcare settings. Qualitative analysis identified three overarching themes in relation to the enablers, barriers and recommendations for practising pharmacists working collaboratively. The enabling themes were: professional and patient related benefits, and current positive influences in Qatar; the barriers were patients’ negative perceptions; the status of the pharmacy profession and current working practices and processes; the recommendations related to improving patients’ perceptions about pharmacists and enhancing the status of pharmacy profession in Qatar. The findings from this study highlighted two major observations: the lack of existence of collaborative practice and hierarchy and power play. Conclusion Pharmacists demonstrated willingness and readiness to develop interprofessional learning and collaborative practice with significant steps already taken towards improving collaborative working practices in different care settings.

Experiences of Supervision at Practice Placement Sites

Background. Whilst placement supervision and clinical education programmes are of significant value in shaping the behaviours of undergraduate healthcare students, appropriate provisions which are efficacious to the learner are somewhat lacking, particularly for students studying on UK MPharm programmes. Objectives. To explore and explain the value of placement supervision to the personal development and employability of undergraduate pharmacy students. Methods. Students participated in a week long community pharmacy pilot programme, a result of a collaborative effort between the School of Pharmacy and Life Sciences and a small consortium of community pharmacies. Students and stakeholders were asked to evaluate their experiences via separate questionnaires which had been developed to elicit views and attitudes. Key Findings. Feedback from students and stakeholders towards the experience was overwhelmingly positive with multiple benefits being reported. Of particular prominence was the emphasis in student feedback on the value of placement supervision to their professional and personal development. Findings were indicative of a development in clinical practice proficiencies, core skills, and improvement in decision-making practice. Conclusions. The benefits of clinical supervision to the professional and personal development of MPharm students are well documented, although attracting professional pharmacy supervisors is proving a problematic task for educational providers in the UK.