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

INTRODUCTION: 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. METHODS: 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. ETHICS AND DISSEMINATION: Ethical approval has been sought and approved by Royal College of Surgeons, Ireland Ethical Committee (REC number: 212622783). We will aim to write up and publish the full synthesis as a journal article. We will also discuss ways of dissemination outside of academia with our PPI group.

The experiences of migrant pharmacists: A phenomenographical study.

Objectives: To understand the experiences of migrant pharmacists in Ireland as they applied for recognition of their qualifications and registration with the national accrediting body. Methods: Semi structured interviews were conducted with eight participants recruited using purposive sampling. Interview transcripts were subject to a phenomenographic study using a stepwise, inductive approach. Results: Data analysis led to the development of a number of categories or descriptions of understanding that provided insight into the ways that participants experienced and conceptualised the phenomenon under study. Five categories of description were identified. These are (1) the migrator, (2) the navigator, (3) the student again, and (4) the registrant. For some, an additional category, (5) the mentee, was experienced. Within these categories, variation in participants' experiences was explored. Conclusions: Participants reported a variety of reasons for migration, and upon embarking on the process, applicants were required to take on a variety of roles, with variation within each role dependent on a number of personal and external factors. Applicants faced personal, administrative, experiential and regulatory hurdles prior to registration, all of which should inform the development of future iterations of this and similar processes.

Pharmacist-led medicines optimisation service in an inpatient mental health setting.

Medicines optimisation ensures that people get the best possible outcomes from their medicines. As those with severe mental illness (SMI) are frequently prescribed psychotropic medicines with potentially significant side-effects, poor adherence to treatment and physical morbidity are common. This results in suboptimal symptom control, physical health problems and negative health outcomes. The specialist mental health pharmacist (SMHP) is best placed to provide leadership for medicines optimisation in the inpatient mental health setting. By adopting a patient-centred approach to providing information, improving adherence, screening, initiating and maintaining medicines, and supporting self-advocacy, the SMHP can ensure the patients' experience of taking medicines is optimised. As there is currently limited understanding of what a baseline clinical pharmacy service in a mental health setting looks like, we aim to outline a framework for pharmacist-led medicines optimisation for those with SMI. This framework is suitable to be scaled and adapted to other settings.

Pharmacy student attitudes to mental illness and the provision of mental health care: a repeated cross-sectional survey.

BACKGROUND: Attitudes to mental illness are an important factor in the willingness of professionals to engage in mental health care. AIM: The aim of this study was to understand attitudes of undergraduate pharmacy students in Ireland to severe mental illness and the provision of medicines optimisation services as well as the variation in these attitudes throughout the undergraduate course. METHOD: A survey instrument was compiled using existing published research and validated questionnaires. The survey was distributed to students in their first, third and Master of Pharmacy years annually between 2014 and 2019. Although designed as a longitudinal study, following the matching process there were a limited number of students who completed more than one survey and therefore data were treated as independent samples. RESULTS: The overall average response rate was 25% per survey (n = 191 participants) Notwithstanding generally positive attitudes, a sizeable proportion of students felt people with severe depression and schizophrenia were hard to talk to (n = 48, 25.3%; n = 54, 29.2%) Less than half of MPharm students expressed confidence and competence in caring for people with more severe mental illnesses such as bipolar disorder and schizophrenia and 29% (n = 60) of students would feel awkward asking someone about their antipsychotic medication. Almost two thirds (n = 120, 63.8%) expressed an interest in a career in mental health. CONCLUSION: Irish pharmacy students have generally positive attitudes towards people with severe mental illness and provision of medicines optimisation services. There is an opportunity to improve pharmacy graduates perceived competence and confidence to provide mental health services.

A National Needs Assessment in Simulation Based Training in Vascular Surgery.

OBJECTIVES: The aim of this research was to ascertain the highest need areas for vascular simulation, in order to tailor training for the highest impact. DESIGN, PARTICIPANTS AND SETTING: A needs assessment was conducted according to best practices using the Delphi method. All consultant vascular surgeons/trainers in the training jurisdiction (n=33) were approached through an independent intermediary to contribute and generate a prioritized list of procedures for training. The research team were blinded to participant identities. Three rounds were conducted according to the Delphi process and scored according to the Copenhagen Needs Assessment Formula (CAMES-NAF). RESULTS: A final list of 34 vascular procedures was selected and prioritized by surgical trainers. Principles of arterial repair and endarterectomy/patching were considered the highest priority. Complex major interventions such as open abdominal aortic aneurysm (AAA) repair, carotid endarterectomy, and endovascular aortic repair (EVAR) consistently ranked higher than rarer, such as first rib resection and more basic procedures, such as foam injection for varicose veins. Major lower limb amputations typically ranked lower overall compared to arterial interventions. Surgical trainers generally agreed with the ranking according to the CAMES-NAF. There was some disagreement for a select few procedures such as iliac stenting (which rose 13 places) and open radial artery exposure (which fell 6 places) on subsequent iterations. CONCLUSIONS: Core operative principles and common major operative cases should remain the priority for vascular technical skills training. Other procedures which may be less invasive, but have the potential for major complications should also not be overlooked. In designing simulators the main focus should center on specific skill acquisition for commonly performed major procedures and management of the recognized potential complications. Lower limb amputations are considered adequately taught in clinical practice, or are too challenging to simulate in simulator models apart from cadaveric models.

Cardiometabolic risk in people under 40 years with severe mental illness: reading between the guidelines.

People with severe mental illness (SMI) have a shorter life expectancy than the rest of the population. Multimorbidity and poorer physical health contribute to this health inequality. Cardiometabolic multimorbidity confers a significant mortality risk in this population. Multimorbidity is not restricted to older people and people with SMI present with multimorbidity earlier in life. Despite this, most screening, prevention and treatment strategies target older people. People under 40 years with SMI are underserved by current guidelines for cardiovascular risk assessment and reduction. Research is needed to develop and implement interventions to reduce cardiometabolic risk in this population.

Supporting pharmacy students' preparation for an entry-to-practice OSCE using video cases.

BACKGROUND AND PURPOSE: Objective structured clinical examinations (OSCEs) are widely used, including in licensure examinations. OSCEs assess diverse skills in a structured manner, but can be stressful for students and have a significant organisational burden for faculty. Case-based video OSCE preparation resources were developed for students preparing for a licensure OSCE. The study aimed to examine student engagement, compare scores awarded by students to performances at specific competence standards with faculty scores, and examine usability, usefulness, and acceptability of the video cases. EDUCATIONAL ACTIVITY AND SETTING: Final year pharmacy students (n = 149) enrolled in an integrated master of pharmacy programme in Ireland were invited to participate. Six sets of recorded OSCE-based video cases were developed, comprising multiple recordings of the same case scenario, with each pitched at a different level of performance. Students watched and scored the video cases. Usability, usefulness, and acceptability were evaluated via questionnaire. FINDINGS: One or more video cases were accessed by 70.5% of students. Score ratings awarded by the students, when compared to faculty ratings, showed an overall trend towards inter-rater agreement between students and faculty. Students felt positively in terms of the usability, usefulness, and acceptability of the videos. SUMMARY: Video cases designed to support OSCE preparation for a high-stakes national pharmacy licensure examination were widely used by students and were perceived to be usable, useful, and acceptable. Such video cases may be a feasible alternative to additional mock OSCEs to support student preparation.

The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE).

BACKGROUND: The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. METHODS: A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21-0.4, moderate if 0.41-0.6, substantial if 0.61-0.8, and good if 0.81-1.0. RESULTS: Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. CONCLUSIONS: OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. TRIAL REGISTRATION: This article does not report the results of a health care intervention on human participants.

A scoping review of the methods and processes used by regulatory bodies to determine pharmacists' readiness for practice.

BACKGROUND: There is an expectation from government, regulatory bodies, patients, the public, and other healthcare professions that pharmacists are competent professionals who can practice independently. Regulation of the profession requires pharmacy graduates to register with a recognised regulatory body before being considered 'ready to practise' independently. OBJECTIVE: To examine the methods and processes used by national regulatory bodies to determine pharmacists' readiness to practise. METHODS: A scoping review was conducted using three electronic databases (Embase, Scopus, CINAHL) and websites of national regulatory bodies. Articles were eligible for inclusion if they described the methods and processes used by regulatory bodies to determine pharmacists' readiness to practise. Data were extracted relating to readiness to practise, the registration exam and the role of newly qualified pharmacists, post-registration. Extracted data were collated using narrative descriptive summaries and accompanying tables. RESULTS: Identified data sources referred to registration of pharmacists across 11 different countries. No sources provided a definition for the term 'ready to practise'. Ten countries were identified as holding a registration examination with varying formats and curricula. Written and oral exams, competency based written assessments, Objective Structured Clinical Examinations and a combination of these were identified with written exam being the most popular (n = 8). In all but one country, the regulator was responsible for delivery of the exam. In most cases (n = 7), the exam was mapped to a pre-defined set of competencies with only a few (n = 4) explaining how these competencies were developed. Only two sources made reference to the role of the newly qualified pharmacist post-registration. CONCLUSION: The review has established a paucity of research and publicly available information on the methods and processes used by national regulators to determine pharmacists' readiness to practise. There is no pharmacy definition of being 'ready to practise'. Assessment methods vary widely and, currently, no gold standard is apparent.

Key stakeholders' views, experiences and expectations of patient and public involvement in healthcare professions' education: a qualitative study.

BACKGROUND: Patients and the public have an integral role in educating healthcare professionals. Authentic partnerships between higher education institutions and patients and the public are essential. This study examined key stakeholders' views, experiences and expectations of patient and public involvement (PPI) including the nature of the involvement and requirements for partnership. METHODS: Purposive and snowball sampling was used to recruit key stakeholders, including patients and members of the public involved in health professions education, and academics interested in PPI. Focus groups were held with patient and public participants, providing the opportunity to gain multiple perspectives in an interactive group setting. Academics with an interest in PPI were interviewed using a semi-structured approach. Topic guides were derived from the literature and piloted prior to data collection. Focus groups and interviews were conducted until data saturation was achieved. All data was audio-recorded, transcribed, anonymised and thematically analysed. RESULTS: Four focus groups were conducted involving 23 patient and public participants (median number of participants per focus group of 6). Nine interviews were conducted with academics (face-to-face [n = 8] or by telephone [n = 1]). Five themes were developed: previous experiences of PPI, training requirements, challenges/barriers to PPI, facilitators of PPI and future ideas for PPI. All participants held positive views of the value of PPI. Participants had mixed views in terms of training, which depended on the level of involvement, but similar views on the challenges and facilitators for PPI in education. There was agreement that PPI requires institutional vision and investment to build strong relationships and a culture of PPI best practice. CONCLUSIONS: There is a need for more strategic and formal involvement of patients and the public to ensure that that PPI becomes sustainably embedded in health professions education.

Educating pharmacy students through a pandemic: Reflecting on our COVID-19 experience.

The impact of the COVID-19 pandemic on pharmacy education worldwide has been immense, affecting students, educators and regulatory agencies. Pharmacy programmes have had to rapidly adapt in their delivery of education, maintaining standards while also ensuring the safety of all stakeholders. In this commentary, we describe the challenges, compromises and solutions adopted by our institution throughout the pandemic, the lessons learnt, adaptive measures taken, and strategies to develop and future-proof our curricula.

A Systematic Review and Pooled Prevalence of Delirium in Critically Ill Children.

OBJECTIVES: Pediatric delirium is a neuropsychiatric disorder with disrupted cerebral functioning due to underlying disease and/or critical care treatment. Pediatric delirium can be classified as hypoactive, hyperactive, and mixed. This systematic review was conducted to estimate the pooled prevalence of pediatric delirium using validated assessment tools in children (Cornell Assessment of Pediatric Delirium, Pediatric Confusion Assessment Method for the ICU, PreSchool Confusion Assessment Method for the ICU, Pediatric Confusion Assessment Method for the ICU Severity Scale, and Sophia Observation Withdrawal Symptoms Pediatric Delirium scale), identify modifiable and nonmodifiable risk factors, and explore the association of pediatric delirium with clinical outcomes. DATA SOURCES: A systematic search of PubMed, EMBASE, and CINAHL databases was undertaken for full articles pertaining to pediatric delirium prevalence. STUDY SELECTION: No language or date barriers were set. Studies were included where the following eligibility criteria were met: study design aimed to estimate pediatric delirium prevalence arising from treatment in the intensive care setting, using a validated tool. Only randomized controlled trials, cross-sectional studies, or cohort studies allowing an estimate of the prevalence of pediatric delirium were included. DATA EXTRACTION: Data were extracted by the primary researcher (D.S.) and accuracy checked by coauthors. DATA SYNTHESIS: A narrative synthesis and pooled prevalence meta-analysis were undertaken. CONCLUSIONS: Pediatric delirium, as determined by the Cornell Assessment of Pediatric Delirium score, is estimated to occur in 34% of critical care admissions. Eight of 11 studies reporting on subtype identified hypoactive delirium as most prevalent (46-81%) with each of the three remaining reporting either hyperactive (44%), mixed (57%), or equal percentages of hypoactive and mixed delirium (43%) as most prevalent. The development of pediatric delirium is associated with cumulative doses of benzodiazepines, opioids, the number of sedative classes used, deep sedation, and cardiothoracic surgery. Increased time mechanically ventilated, length of stay, mortality, healthcare costs, and associations with decreased quality of life after discharge were also found. Multi-institutional and longitudinal studies are required to better determine the natural history, true prevalence, long-term outcomes, management strategies, and financial implications of pediatric delirium.

A realist evaluation exploring simulated patient role-play in pharmacist undergraduate communication training.

BACKGROUND: Effective communication between pharmacists and patients is essential and improves health outcomes. Simulated patients (SPs) are trained to reproduce real-life situations and can help pharmacy students to develop and adapt their communication skills in a safe, learner-centred environment. The aim of this research was to explore how SP and pharmacy student role-play supports communication training. METHODS: A mixed methods realist evaluation approach was adopted to test an initial theory relating to SP role-play for pharmacy students. The intervention tested involved complex communication cases in a men's and women's health module in year three of a new MPharm programme. This SP session was the first such session, of the programme which exclusively focused on complex communication skills for the students. Data collected comprised video-recordings of both training and mock OSCE sessions, and from student focus groups. Communication videos were scored using the Explanation and Planning Scale (EPSCALE) tool. Scores from SP and mock OSCE sessions were compared using the Wilcoxon-signed rank test. Focus groups were conducted with students about their experience of the training and analysed thematically, through a realist lens. Data was analysed for Context-Mechanism-Outcome configurations to produce modified programme theories. RESULTS: Forty-six students (n = 46/59, 78 %) consented to their video-recorded interactions to be used. Students identified contextual factors relating to the timing within the course and the setting of the intervention, the debrief and student individual contexts. Mechanisms included authenticity, feedback, reflection, self-awareness and confidence. Negative responses included embarrassment and nervousness. They distinguished outcomes including increased awareness of communication style, more structured communication and increased comfort. However quantitative data showed a decrease (p < 0.001) in communication scores in the mock OSCE compared with scores from training sessions. Modified programme theories relating to SP training for pharmacy students were generated. CONCLUSIONS: SP role-play is a valuable communication skills training approach. Emphasis should be placed on multiple stakeholder feedback and promotion of reflection. Time limits need to be considered in this context and adjusted to meet student needs, especially for students with lower levels of communication comfort and those communicating in languages different to their first language.

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

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.

How can pharmacists develop patient-pharmacist communication skills? A realist synthesis.

OBJECTIVE: To understand how pharmacists develop patient-pharmacist communication skills. METHODS: A realist synthesis approach was used to understand how educational interventions work to improve patient-pharmacist communication. Initial programme theories were developed through a scoping search and stakeholder focus groups (faculty, students, patients and public). A systematic search was then conducted for evidence to test initial theories. Included papers were assessed for relevance and rigour. Extracted data was synthesised to refine the initial programme theories and develop modified programme theories. RESULTS: Forty-seven papers were included in the final synthesis. Role-play with simulated patients and peers, video recording and lectures were the most widely reported interventions. Repeated practice, feedback, reflection and confidence were among the mechanisms by which interventions work. Modified programme theories relating to interactions of role-play, experiential learning, video recording, self-assessment and workshops were developed. CONCLUSIONS: Outcomes of communication education interventions are influenced by the level of learner. Educational interventions that promote reflection are particularly useful. PRACTICAL IMPLICATIONS: There are a wide range of theory-informed interventions, which should be used in a programmatic approach to communications education. A longitudinal programme of communication skills training, with intervention choice based on level of learning, is important.

Prescribing pattern of antipsychotic medication for first-episode psychosis: a retrospective cohort study.

OBJECTIVE: Guidelines for antipsychotic use in first-episode psychosis (FEP) recommend that medication be chosen initially on the basis of side effect profile with doses at the lower end of the range. Our objective was to describe the pattern of antipsychotic use in FEP over a period of 21 years in the context of changing clinical guidelines and the development of specialist early intervention in psychosis (EIP) services. SETTING: A community-based mental health service in South County Dublin (population 187 000) and a large private hospital. PARTICIPANTS: Participants included 465 patients with FEP (146 from an epidemiological study (1995-1999) and 319 from a specialist EIP service (2005-2016)). Treatment with antipsychotic medication did not exceed 30 days at study entry. OUTCOME MEASURES: This is a descriptive study of prescribing practices in the context of service development and changing guidelines. RESULTS: First-generation antipsychotics were prescribed for 65% of the early cohort compared with 4.3% of the EIP cohort. Olanzapine was initially prescribed for 79.7% of EIP patients. Initial doses of medication were frequently low (≤50% British National Formulary (BNF) maximum) in both cohorts (71% and 78.6%). The demographic and clinical factors investigated did not influence the initial choice of antipsychotic medication significantly. Univariate logistic regression analysis suggested inpatient treatment setting was associated with a higher initial dose (>50% BNF maximum) of antipsychotic medication. Increasing dose requirements over the first month of engagement with an EIP service was associated with poorer global functioning at baseline, greater positive symptoms at baseline and the inpatient treatment setting. However, these associations were not seen in the multivariable model. CONCLUSIONS: Second-generation antipsychotic prescribing predominates, but guidelines are often overlooked when choosing olanzapine notwithstanding lower initial dosages. EIP services should include proactive support for optimising medicines in line with evidence-based guidelines.

Early longitudinal community pharmacy placements: Connection, integration and engagement.

BACKGROUND: Longitudinal placements are defined as involving "a regular, recurrent placement in the same setting with the same supervisor over a period of time". "Continuity" is the organising principle for promoting learning through continuity of care, curriculum and supervision. Longitudinal placements are widely used in medicine, but less is known about their use in pharmacy and whether the educational principles translate to community pharmacy practice. OBJECTIVE: This study sought to explore if a longitudinal community pharmacy placement (LCPP) for Year 2 pharmacy students promoted learning through student patient-centeredness, curricular integration, and growing professional engagement. METHODS: An explanatory mixed methods study design was used. Quantitative data for the study was collected prior to and after the LCPP using a questionnaire incorporating a validated measure of professional engagement and items relating to patient-centeredness and curriculum integration. Pre and post-responses were compared using the Wilcoxon-signed rank test. To further understand the quantitative findings, semi-structured interviews were conducted with students, supervisors and practice-educators and thematically analysed through a constructivist lens. RESULTS: There was a 78% response rate (47/60 paired responses) to the questionnaire and 25 interviews were conducted. There was quantitative and qualitative evidence of patient connection during LCPPs, yet some students had limited opportunities to connect with people. Curriculum integration was enhanced by the longitudinal nature of the placement. There was a significant increase in the sum scores of the S-PIPE instrument indicating enhanced professional engagement. Qualitatively there was evidence that engagement was promoted through role modelling and supervision, but continuity was compromised with changing supervisors. CONCLUSIONS: An early LCPP promotes learning by providing opportunities for curriculum integration and professional engagement. It may be worth considering as a way to enhance integration through experiential learning in curriculum design. The placement needs to be of a sufficient length to enable repeated patient interaction and ideally provide continuity of supervision for maximum benefit.

'Both useful in their own way': Video podcasts and typed solutions as feedback on undergraduate pharmaceutical calculations skills assessment.

INTRODUCTION: Accurately completing pharmaceutical calculations is a core professional skill for pharmacists. To date, few studies have focused on to providing feedback on calculations, or the role of technology in feedback provision. This study aimed to develop a theory-informed video podcast-based method of providing formative feedback and evaluate student perceptions. METHODS: First-year pharmacy students (n = 53) completed a formative pharmaceutical calculations assessment. Two forms of feedback were designed and evaluated; typed solutions (traditional format commonly used/seen in textbooks) and video podcasts informed by instructional design theory (novel format). RESULTS: A survey was completed by 70% (37/53) of students. Specific features of video podcasts reported useful included hearing reasoning, and the ability to pause and rewind. Most (76%) reported positive attitudes towards video podcasts, considered them useful (75%) and helpful for learning (79%). A comparable number (76% and 71% respectively) felt positively about typed solutions. The majority (51%) preferred to receive both types rather than podcasts alone (24%), or typed solutions alone (8%). Free-text responses indicated both were used in different ways; typed solutions for quick verification and video podcasts for clarification. CONCLUSIONS: Video podcasts appear to be a potentially helpful additional method of delivering feedback that afford specific advantages. They can be readily developed by faculty with minimal expense/difficulty. However, as respondents indicated that they used both kinds of feedback in different ways to support their learning, and indicated a preference to receive both types, they should be considered an addition rather than replacement for typed solutions.