Research in pharmacy education - lessons from programme design and development at a new School of Pharmacy

Pharmacy education is an evolving field, influenced by a complex relationship between National, European and International policies, regulation and practice. The opening of a new School of Pharmacy, at a time of great change, provided the context for the research question: How is pharmacy education, delivered by a new School of Pharmacy, with new undergraduate and postgraduate curricula, novel teaching and assessment strategies, reflected in student perception, performance and preparedness for professional practice, and what are the lessons for educators? The thesis addresses three major areas; interprofessional education, competency assessment and evaluation. Quantitative methods, including the use of validated tools (Readiness for Interprofessional Learning Scale, Attitudes to Health Professionals Questionnaire, Course Experience Questionnaire), and relevant research (\u22MPharm: Where are we now\u22 and the \u22Pharmacy Education and Accreditation Reviews\u22 reports) were employed. Analysis of examination results and tracking of student progress was also undertaken. An unexpected finding was that early interprofessional education was less successful than anticipated. Views on professional identity and stereotypes influenced a desire for uniprofessional education. However, online interprofessional education can facilitate learning of large groups of geographically dispersed professionals and may offer potential for postgraduate interprofessional education. The research highlights the value of the Objective Structured Clinical Examination (OSCE) for assessing competency in pharmacy, but emphasises the importance of embedding quality assurance into the design and delivery with due regard for validity and reliability. The research indicates that it is helpful to reflect on the outcomes to determine if assessment policies are robust and credible. Evaluation strategies are important in the development of new programmes. The introduction of the National Pharmacy Internship Programme provided a unique and previously unexplored opportunity to move beyond student perception, evaluate outcomes at entry-to-practice and benchmark the quality of education. Some additional significant findings emerge from tracking student progress. There is no evidence that a lack of advanced second-level science education has a deleterious effect on performance. Graduate students perform better than school leavers, despite having significantly lower points on entry. their merit in considering a graudate entry programme, although it is not the currently proprosed strategy for pharmacy education in Ireland. Pharmacy education, delivered by a new School of Pharmacy using novel and outcomes focused teaching and assessment strategies was reflected well in student perception, performance and preparedness for practice. The research is timely and important as Ireland moves towards the development of a new five-year integrated programme where the students are prepared to directly enter professional practice

What works for whom, how and why in mental health education for undergraduate health profession students? A realist synthesis protocol. [Protocol]

It has been shown that mental health education can support positive attitudes of health profession students towards people with mental health challenges, which supports them to provide optimal healthcare to this group. There are many different approaches to designing and delivering mental health education to health profession students. Each has their own advantages and disadvantages, and often mental health education programmes incorporate a multimodal approach in order to reap the benefits of a variety of teaching and learning approaches. The aim of this study is to understand the current landscape of teaching and learning approaches to mental health education for undergraduate health profession students. We will examine the features of successful outcomes for health profession students for: Learning environment. Knowledge development and retention. Confidence. Motivation. Preparedness for professional practice. For this, a realist synthesis has been chosen in order to review the literature. Realist synthesis lends itself to the review of complex interventions such as mental health education for undergraduate health profession curricula because it seeks to uncover the range of different mechanisms and context configurations that produce different outcomes. Health profession education and education practice, in general, is complex. A patient and public involvement (PPI) group is involved throughout this study and includes undergraduate health profession students, and members of the St John of Gods Hospital Consumers and Carers Council who are involved at every stage of the research. This study will engage with a stakeholder group who will support the refining of the programme theory

A Transatlantic Conversation About Critical Thinking and Writing in STEM

Abstract included in text

How can pharmacists develop patient-pharmacist communication skills? : a realist review protocol

Background: Good patient-pharmacist communication improves health outcomes. There is, however, room for improving pharmacists’ communication skills. These develop through complex interactions during undergraduate pharmacy education, practice-based learning and continuing professional development. Research is needed to determine how best to approach teaching patient-pharmacist communication. Methods: The aim of the research is to understand how educational interventions develop patient-pharmacist interpersonal communication skills produce their effects. A realist review approach will be used to synthesise the literature to make sense of the complexities of educational interventions. Our review will iteratively progress through the various stages of clarifying scope, locating existing theories, searching for evidence, appraisal of papers, data extraction and synthesis. A scoping review revealed a number of substantive theories, which will be used to build an initial programme theory. This will be explored through available published evidence, which we will find by searching databases such as Medline, EMBASE, PsychInfo, ERIC, Scopus and Web of Science. Judgements will be made on the relevance and rigour of the retrieved literature and will be taken into consideration during analysis and synthesis. Synthesis, testing and refinement of the theories will describe and explain the links between contexts, mechanisms and outcomes of educational interventions for communication development in pharmacy. Discussion: The realist review will provide an analysis of what works when, for whom, how and why, for educational interventions for interpersonal patient-pharmacist communication development. We will also explore barriers to successful communications training and acknowledge any limitations. Ultimately, we plan to provide pharmacy educators with evidence for how best to incorporate educational interventions for communications skills development into pharmacy curricula and for life-long learning opportunities for pharmacists

Interdisciplinary Communication Skills - Facilitating Students from Different Disciplines to Learn with, from and about each other

Our group project involves exploring interdisciplinary communication skills and collaborative learning across STEM disciplines. In order to examine the topic we completed a literature review and surveyed staff about their views on interdisciplinary communication and collaborative learning at undergraduate level. We also held two focus group sessions on the topic with staff from three institutions. Though one of our intended project outcomes was a design model for interdisciplinary approaches to communication skills, as a result of the literature review we have redefined our purposes and will instead, in the first instance, present guiding principles for the effective integration of interdisciplinary communication skills training into existing and future programmes. In this paper we outline the first draft of these principles which recognise interdisciplinary collaboration as a pedagogical ‘trading zone’ and see the development of communications between the disciplines as a necessary response to the realities of world complexity, the dissolving of boundaries between subjects, the need to combat excessive specialisation, the drive for rounded graduates who possess scientific literacy, critical and creative thinking, and expanded expertise, vocabulary and tool sets, in addition to the ability to communicate to wider audiences. In this context we report on how these principles have been impacted by the very recent moves to integrate arts-based subjects with STEM disciplines - moving from STEM to STEAM. We suggest that this is an important transition from which benefits for the student should arise

Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease

Funding: This project has received funding from the Erasmus+ Programme of the European Union under the grant agreement no. 2019–1-PT01-KA203– 061389. The Funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The European Commission’s support for the production of this publication does not constitute an endorsement of the contents, which reflect the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.Background: Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. Methods: The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. Results: Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists’ feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. Conclusions: A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.publishersversionpublishe

Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants\u27 motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy

Design and Evaluation of a New National Pharmacy Internship Programme in Ireland

Objective. To design, deliver and evaluate a National Pharmacy Internship Programme to meet the educational needs of pharmacy graduates for registration as competent pharmacists, recognising the learning by way of an educational award. Methods. The programme was designed as a twelve month, full-time, blended-learning, competency-based programme leading to an educational award at Master’s Level. Intern performance was assessed academically and by pharmacy tutor (preceptor) appraisals. Interns who demonstrated competency were invited to sit the Professional Registration Examination (PRE). Feasibility and performance were evaluated and a longitudinal approach allowed intern and tutor views to be compared to the former pre-registration year. Results. Overall performance in the PRE was good and relatively consistent with almost all interns proceeding to register as pharmacists. Interns expressed a view that the programme had enabled them to develop the knowledge, skills and overall competencies required for future independent practice as a pharmacist. Tutors considered the programme to have built on prior learning and provided a sufficiently rounded experience for professional practice. Tutors also expressed the view that the programme was an improved educational experience over the former, less structured, pre-registration training. Conclusion. The National Pharmacy Internship Programme was a structured, competency-based programme at Master’s Level. The education and training was perceived to be an improvement on the previous pre-registration year. The programme quality assured pharmacy education outcomes at entry-to-practice on a national basis, and uniquely recognised the learning by way of an educational award

The Future Direction of Inter-Professional Education in Ireland: Insights From Focus Groups With Key Stakeholders

Rationale: An inter-professional education (IPE) masterclass symposium titled, ‘The journey to team-based healthcare’, was jointly hosted by the School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), the Irish Institute of Pharmacy and the Bill Gatton College of Pharmacy in East Tennessee State University in May 2017. The masterclass provided a comprehensive overview of IPE initiatives based on the extensive experience of senior academics from the host institutions, which included staff from pharmacy, nursing and medicine. The masterclass was attended by healthcare professionals, policy makers and educationalists working in Ireland. As part of the symposium, focus groups were conducted with a sample of symposium attendees to determine their opinions and perceptions, as key stakeholders, regarding the development, implementation and future direction of IPE in Ireland. Methods: Focus groups were conducted with symposium attendees using a topic guide that was developed based on previous literature. Questions explored participants’ views and experiences on a range of topics including development and implementation of IPE activities, and key priorities for developing future IPE initiatives. Thematic analysis was conducted to identify key themes. Findings: Three focus groups were conducted each involving five to six participants (total 16 participants: nine female). Preliminary themes have been identified and further analysis is ongoing. Discussion/conclusion: The research findings will help to inform the future development and direction of IPE initiatives at both undergraduate and postgraduate level within the host institutions and could help in the development of an IPE strategy for undergraduate and post-graduate teaching across Ireland

Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits

Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.Peer reviewe