Setting the agenda for clinical pharmacy in Qatar: thematic and content analyses of news media headlines

Public awareness of the role of pharmacists and availability of pharmacy services in Qatar is low. As per agenda-setting theory, mass media may be contributing toward this problem by selecting and disseminating headlines and stories according their own objectives and not those of the profession. The objective of this study was to examine the agenda set by mass media organizations in Qatar pertaining to the profession of pharmacy and to determine the frequency of professional identifiers that appear within news headlines. Publicly available news headlines published between November 2016 and November 2018 were obtained from local news websites. Thematic analysis was performed using agenda-setting theory to explore how the public's agenda was set for pharmacy practice in Qatar. Content analysis was used to determine the proportion of headlines that contained a professional identifier linking the news report to the pharmacy profession. A total of 81 headlines were included in the analysis. The agenda for pharmacy practice in Qatar was set according to two themes: achievement and outreach/engagement. Achievement related to awards, use of new technologies, interprofessional education, and novel student training accomplishments. Outreach/engagement reported student and pharmacist involvement upon completion of a health awareness event. Approximately half (47%) of headlines contained a professional identifying word linking the headline to the profession of pharmacy. The findings of this study demonstrate that the mass media's agenda for the pharmacy profession in Qatar does not inform the public of pharmacist's services or expanded scopes of practice. Furthermore, a lack of professional identifiers within headlines likely limits the public's agenda of pharmacist roles. The pharmacy profession must work collaboratively with news media to better align the public's agenda with pharmacists' roles and services

Evaluation of Qatari and Canadian Pharmacy Students Learning Together about Cultural Competency using Videoconference Educational Activities

Background: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care. Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1) student knowledge and confidence pertaining to cultural competency concepts, (2) attitudes and perceptions towards being a culturally competent pharmacist, and (3) academic performance related to cultural competency case studies. Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25) and the University of Saskatchewan in Saskatoon, Canada (n=85) participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85) worked collaboratively (via video conference) with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1) a pre and post session survey measuring student knowledge and confidence; (2) pre and post session student self-reflections; and, (3) student academic performance on care plans and an observed structured clinical exam (OSCE). Results: The survey identified small but statistically significant (p<0.05) improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81) of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the students who worked collaboratively across the two schools compared with those who did not. Conclusion: The cultural competency student activity showed small improvements in pharmacy student knowledge, attitudes and confidence, but did not affect academic performance. Future research in this area could utilize a greater diversity of methodological approaches, including a focus on student self-reflection and qualitative assessment, to better capture student competency.   Type: Original Researc

Changes in student perceptions after a semester-long interprofessional education activity in Qatar

AbstractObjectivesInterprofessional education (IPE) is rapidly becoming integrated into university accreditation standards worldwide. However, the impact of IPE on student learning and practice is largely unknown in the Middle East. This report describes a semester-long IPE course-based activity and evaluates student perceptions towards professional roles.MethodsPharmacy and Human Nutrition students from Qatar University completed a 15-week IPE activity that required students to work in groups to complete two assignments after an introductory event. The data were collected during meetings with students and faculty about their overall experience and course assignments. Perceptions regarding professional roles were determined by a pre- and post-reflection questionnaire.ResultsAfter completion of the assignments, fourteen students (37%) noted changed perceptions of themselves, as well as of the other healthcare profession. Twelve of fourteen (86%) noted changes regarding perceptions of the roles of the other healthcare profession, while 2/14 (14%) noted changes regarding perception of their own professional roles. Three of fourteen (21%) reported that their changed perceptions towards IPE were unfavourable. These changed perceptions largely focused on specialised roles of the respective professions.ConclusionsA semester-long IPE experience was deemed beneficial in a Middle Eastern context. Future events and research should focus on fostering collaboration and interprofessional communication to enhance student attitudes and eventual preparation for interprofessional practice

Evaluation of Qatari and Canadian Pharmacy Students Learning Together about Cultural Competency using Videoconference Educational Activities

Background: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care. Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1) student knowledge and confidence pertaining to cultural competency concepts, (2) attitudes and perceptions towards being a culturally competent pharmacist, and (3) academic performance related to cultural competency case studies. Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25) and the University of Saskatchewan in Saskatoon, Canada (n=85) participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85) worked collaboratively (via video conference) with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1) a pre and post session survey measuring student knowledge and confidence; (2) pre and post session student self-reflections; and, (3) student academic performance on care plans and an observed structured clinical exam (OSCE). Results: The survey identified small but statistically significant (p<0.05) improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81) of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the students who worked collaboratively across the two schools compared with those who did not. Conclusion: The cultural competency student activity showed small improvements in pharmacy student knowledge, attitudes and confidence, but did not affect academic performance. Future research in this area could utilize a greater diversity of methodological approaches, including a focus on student self-reflection and qualitative assessment, to better capture student competency.   Type: Original Researc

Exploring the influence of cultural orientations on assessment of communication behaviours during patient-practitioner interactions

Background Research has shown that patients’ and practitioners’ cultural orientations affect communication behaviors and interpretations in cross-cultural patient-practitioner interactions. Little is known about the effect of cultural orientations on assessment of communication behaviors in cross-cultural educational settings. The purpose of this study is to explore cultural orientation as a potential source of assessor idiosyncrasy or between-assessor variability in assessment of communication skills. More specifically, we explored if and how (expert) assessors’ valuing of communication behaviours aligned with their cultural orientations (power-distance, masculinity-femininity, uncertainty avoidance, and individualism-collectivism). Methods Twenty-five pharmacist-assessors watched 3 videotaped scenarios (patient-pharmacist interactions) and ranked each on a 5-point global rating scale. Videotaped scenarios demonstrated combinations of well-portrayed and borderline examples of instrumental and affective communication behaviours. We used stimulated recall and verbal protocol analysis to investigate assessors’ interpretations and evaluations of communication behaviours. Uttered assessments of communication behaviours were coded as instrumental (task-oriented) or affective (socioemotional) and either positive or negative. Cultural orientations were measured using the Individual Cultural Values Scale. Correlations between cultural orientations and global scores, and frequencies of positive, negative, and total utterances of instrumental and affective behaviours were determined. Results Correlations were found to be scenario specific. In videos with poor or good performance, no differences were found across cultural orientations. When borderline performance was demonstrated, high power-distance and masculinity were significantly associated with higher global ratings (r = .445, and .537 respectively, p < 0.05) as well as with fewer negative utterances regarding instrumental (task focused) behaviours (r = −.533 and − .529, respectively). Higher masculinity scores were furthermore associated with positive utterances of affective (socioemotional) behaviours (r = .441). Conclusions Our findings thus confirm cultural orientation as a source of assessor idiosyncrasy and meaningful variations in interpretation of communication behaviours. Interestingly, expert assessors generally agreed on scenarios of good or poor performances but borderline performance was influenced by cultural orientation. Contrary to current practices of assessor and assessment instrument standardization, findings support the use of multiple assessors for patient-practitioner interactions and development of qualitative assessment tools to capture these varying, yet valid, interpretations of performanceScopu

Investigating pharmacy students’ therapeutic decision-making with respect to antimicrobial stewardship cases

Background: Antimicrobial stewardship programs (ASPs) play a big role in minimizing antimicrobial resistance. Pharmacists are essential members of the health care team and in order for them to fulfill roles on ASP teams and become antimicrobial stewards, they must be prepared adequately by pharmacy schools prior to entry into actual practice. Although programming has been implemented into entry-to-practice programs worldwide, little is known about how students interpret antimicrobial stewardship (AMS) data and arrive at clinical decisions. We aimed to explore students’ cognitive processes and determine how they formulate therapeutic decisions when presented with AMS cases. Methods: This was a qualitative study conducted using a case study approach, in which a sample (n=20) of pharmacy students was recruited to interpret AMS cases. Semi-structured 1-on-1 interviews were arranged with each participant. A think-aloud procedure with verbal protocol analysis was adopted to determine students’ decision-making processes. Thematic analysis was used to interpret themes from the interview data. Results: Two themes were interpreted from the data: students’ focus and students’ approach to case interpretation. Students’ focus relates to external factors students consider when interpreting AMS case data and use to make and justify therapeutic decisions including patient-centered factors, drug-related factors, AMS interventions, and pharmacist’s role. Students’ clinical reasoning describes the approach that students use to interpret the data and the decision-making processes they employ to arrive at a clinical decision including a systematic approach versus non-systematic approach. Conclusions: Students vary in their focus and the cognitive strategies used to interpret AMS cases. Findings support the notion that clinical reasoning and decision-making should be explicitly taught in pharmacy curricula, in order to help students become aware of their own cognitive processes and decision-making abilities.This study was completed with funding from an Internal Student Grant from Qatar University (QUST-2-CPH-2020-9)

A Standardized Narrative Profile Approach to Self-Reflection and Assessment of Cross-Cultural Communication

Objectives: 1) to explore clinical assessor’s values regarding behaviours related to cultural aspects of care, 2) to generate standardized narrative profiles regarding cultural behavioural outcomes within clinical teaching settings, and 3) to rank order standardized narrative profiles according to performance expectations. Methods: Ten interviews were completed with clinicians to determine values and performance expectations for culturally competent behaviours. Transcripts were produced and coded. Six narrative profiles were developed based on data obtained. Twenty clinicians categorized profiles according to performance expectations and rank ordered. Intraclass correlation coefficients (ICCs) determined inter-rater reliability. Clinicians rated usability of profiles in clinical training settings. Results: Eighteen categories were coded with communication, awareness and ability most frequently reported with each ranging from 9.6-11.5% of the utterances. Consensus for categorization of all profiles was achieved at a level of 70% (ICC = 0.837, 95% CI 0.654-0.969). High inter-rater reliability was achieved for rank ordering (ICC = 0.815, 95% CI 0.561 to 0.984). Seventeen (85%) clinicians agreed that the profiles would be usable in clinical training settings. Conclusions: Standardized narrative profiles may aid assessment and self-reflection for student performance within culturally diverse interactions. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. &nbsp; Type:&nbsp;Original Researc

Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

Objectives The global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives. Design We conducted a document analysis to examine authorship of recent publications to explore current international representation. Data sources The table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase. Eligibility criteria The journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis. Data extraction and synthesis The table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable). Results A total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time. Conclusions Diversity in health professional education scholarship, as marked by nation of authors’ professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.Scopu