Perceived preparedness for full-scope pharmacist services among recent Doctor of Pharmacy graduates from Ontario schools of pharmacy.

OBJECTIVES: To examine how recent Doctor of Pharmacy graduates feel about providing full-scope pharmacist services (such as prescribing and immunization) and whether characteristics such as recent graduates' institutional and personal demographics, practice setting (e.g., busyness of practice, time spent directly with patients), or additional education after graduation affect their perceptions of feeling able and sure to perform services. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: Recent graduates from 2 pharmacy schools in Ontario, Canada, who were licensed Ontario pharmacists and provided direct patient care in a community pharmacy setting. OUTCOME MEASURES: Dichotomous variables measured how able (less or more able) and sure (less or more sure) recent pharmacy graduates felt in performing 14 full-scope pharmacist services. RESULTS: Of the 231 survey respondents (23.2% response rate), 120 met the inclusion criteria. Overall, graduates felt prepared to perform these services in practice, although for many services, graduates felt more sure than able. Busier practice settings and services that were provided less frequently had a negative impact on new graduate's perceptions of being able and sure. Respondents who were younger or were pursuing further postgraduate training also felt less able and sure. CONCLUSION: It is important for employers of new graduates and academics who train pharmacy students to recognize and encourage new graduates' feelings of being sure and able to provide full-scope pharmacist services. However, new graduates were not immune to the impacts of busy practice settings on provision of these services and should be supported in their development and interest in further training.

Incorporating sex, gender and vulnerable populations in a large multisite health research programme: The Ontario Pharmacy Evidence Network as a case study.

BACKGROUND: Funders now frequently require that sex and gender be considered in research programmes, but provide little guidance about how this can be accomplished, especially in large research programmes. The purpose of this study is to present and evaluate a model for promoting sex- and gender-based analysis (SGBA) in a large health service research programme, the Ontario Pharmacy Evidence Network (OPEN). METHODS: A mixed method study incorporating (1) team members' critical reflection, (2) surveys (n = 37) and interviews (n = 23) at programme midpoint, and (3) an end-of-study survey in 2016 with OPEN research project teams (n = 6). RESULTS: Incorporating gender and vulnerable populations (GVP) as a cross-cutting theme, with a dedicated team and resources to promote GVP research across the programme, was effective and well received. Team members felt their knowledge was improved, and the programme produced several sex- and gender-related research outputs. Not all resources were well used, however, and better communication of the purposes and roles of the team could increase effectiveness. CONCLUSIONS: The experience of OPEN suggests that dedicating resources for sex and gender research can be effective in promoting SGBA research, but that research programmes should also focus on communicating the importance of SGBA to their members.

"Errors were made:" Public attitudes regarding reconciliation and education in Canada.

The 2015 release of the final report of the Truth and Reconciliation Commission of Canada accelerated the extensive range of educational activities across Canadian jurisdictions dedicated to updating curricula and supporting Indigenous students. How have these initiatives affected educational practices and more general understandings about Indigenous-settler relations? Drawing on data from a survey of public perspectives on education and reconciliation conducted in Alberta and Saskatchewan, this paper addresses the question: What are the current public attitudes regarding reconciliation overall and within Alberta and Saskatchewan schools? We explore these perspectives by highlighting two contrasting orientations - one in which reconciliation is accepted as a form of peaceful coexistence within existing settler colonial frameworks and another in which liberal discourses as well as more openly racist stances serve as a form of democratic colonization that further reinforce those frameworks.

La publication en 2015 du rapport final de la Commission de vérité et de réconciliation du Canada a accéléré le vaste éventail d'activités éducatives menées dans les juridictions canadiennes et consacrées à la mise à jour des programmes d'études et au soutien des élèves indigènes. Comment ces initiatives ont-elles affecté les pratiques éducatives et les compréhensions plus générales des relations entre les autochtones et les colons ? En s'appuyant sur les données d'une enquête sur les perspectives publiques en matière d'éducation et de réconciliation menée en Alberta et en Saskatchewan, cet article répond à la question suivante : Quelles sont les attitudes actuelles du public concernant la réconciliation en général et dans les écoles de l'Alberta et de la Saskatchewan ? Nous explorons ces perspectives en mettant en évidence deux orientations contrastées - l'une dans laquelle la réconciliation est acceptée comme une forme de coexistence pacifique dans les cadres coloniaux existants et l'autre dans laquelle les discours libéraux ainsi que les positions plus ouvertement racistes servent de forme de colonisation démocratique qui renforce ces cadres.

Accelerated Education Program in Radiation Medicine: International Learner Perceptions of Experiences, Outcomes, and Impact.

PURPOSE: The Accelerated Education Program (AEP) at the Princess Margaret Cancer Centre (PM) has been offering continuing medical education courses since 2006. The purpose of this study was to assess learner experiences, perspectives, and outcomes using Kirkpatrick's Four Level Training Evaluation Model (ie, reaction, learning, behavior, results) to ascertain whether it was meeting stated goals. METHODS AND MATERIALS: Past course participants (2010-2018) were invited to participate in a semistructured interview. Interviews were transcribed verbatim; thematic analysis was conducted by a 4-person research team. RESULTS: Seventeen participants including 2 medical physicists, 6 radiation oncologists, and 9 radiation therapists from 6 countries on 4 continents participated in the study. Interviews lasted an average of 25 minutes. Consistently positive outcomes were reported at each level of Kirkpatrick's model. At the reaction level, participants liked the small, interactive case-based design, exposure to renowned faculty and practices from PM and other major centers, and the interprofessional practice (IPP) approach. Suggestions for improvements include enhancing practical content. At the learning level, participants reported gaining new knowledge or skills and new awareness or attitudes. Behavior changes described included sharing learnings with colleagues, implementing changes in practice or techniques, departmental structure, and IPP. Participants described the effects on clinical practice (results) in quality of care, access to care, and academic contribution. Identified barriers to change related to the restricted internal capacity for change and the need for wider staff training. CONCLUSIONS: AEP courses were found to have a positive effect on local practices ranging from confirmation of current practice through to increased access to and quality of advanced radiotherapeutic techniques and care. Our findings confirm that AEP is achieving its goal of "putting innovation to work" and suggest curricular improvements that can enhance these effects.

Strategic Training in Transdisciplinary Radiation Science for the 21st Century (STARS21): 15-Year Evaluation of an Innovative Research Training Program.

PURPOSE: To evaluate the 15-year impact of a transdisciplinary research training program for graduate students, postdoctoral fellows, and clinical trainees focused on radiation science, entitled Strategic Training in Transdisciplinary Radiation Science for the 21st Century (STARS21) with a primary objective to build capacity in radiation research. METHODS AND MATERIALS: Alumni (n = 128) and mentors (n = 41) who participated in STARS21 between 2003 and 2018 were sent an anonymized online survey designed to evaluate the program. Twelve alumni and 7 mentors also volunteered to participate in semistructured interviews. The transcribed interviews were coded and analyzed using NVivo12-Pro software. Alumni employment and publications were assessed from program records and by web-based search queries. RESULTS: Alumni are located in 11 countries, and nearly 90% are employed in a research-oriented career and continue to publish in radiation medicine- or cancer-related fields. Of those invited, 46 alumni (36%) and 12 mentors (29%) completed the online survey. Approximately 87% of alumni valued interdisciplinary collaboration, and 80% indicated that STARS21 had encouraged them to pursue such collaborations. Alumni emphasized that STARS21 assisted their career development, and the majority of alumni and mentors would recommend STARS21 to other trainees (4.48 and 4.58, respectively; 5 = strongly agree). The time invested in the program was perceived by mentors as worthwhile for the knowledge and skills gained by trainees (4.67; 5 = strongly agree), and 64% of mentors indicated that these benefits were associated with improved trainee research productivity. From the alumni and mentor perspectives, the valuable skills acquired from STARS21 included scientific communication (85% and 83%, respectively) and networking (83% and 92%, respectively). CONCLUSIONS: STARS21 is an innovative research training program that promotes interdisciplinary collaboration in radiation medicine research, which is valued by alumni and mentor respondents. Alumni can acquire important skill sets for career development, with a large proportion of alumni currently engaged in radiation research around the world.

Schools as "Really Dangerous Places" for Indigenous Children and Youth: Schools, Child Welfare, and Contemporary Challenges to Reconciliation.

The Truth and Reconciliation Commission of Canada (TRC) final report called attention to the damage induced by government policies and practices and outlined a pathway toward reconciliation in which education and child welfare system reforms play a central role. Drawing from 61 interviews with teachers and parents of Indigenous children in Alberta, this paper addresses the question: what do intersections between schooling and child welfare systems contribute to prospects for meaningful reconciliation between Indigenous and non-Indigenous people in Canada? Findings suggest that, despite formal commitments to acknowledge and address colonial legacies of residential schooling, obligations to fulfill state child welfare and educational objectives continue to situate schools, for many Indigenous families, as "dangerous places."

Le rapport final de la Commission de vérité et réconciliation du Canada (CVR) a attiré l'attention sur les dommages occasionnés par les politiques et les pratiques gouvernementales et a tracé un parcours vers la réconciliation selon lequel les réformes du système d'éducation et de protection de l'enfance jouent un rôle de premier plan. Tirant parti de 61 entrevues réalisées avec des enseignants et des parents d'enfants autochtones en Alberta, cet article aborde la question à savoir : en quoi les interactions entre les systèmes scolaires et de protection de l'enfance contribuent à la possibilité d'une réconciliation significative entre les populations autochtones et non autochtones au Canada? Les résultats suggèrent que, malgré les engagements formels en vue de reconnaître et d'aborder l'héritage colonial des pensionnats indiens, les obligations de remplir les objectifs en matière de système public de protection de l'enfance et d'éducation continuent, pour de nombreuses familles autochtones, à situer les écoles comme étant des « endroits dangereux ¼.

Sex and gender-based analysis in pharmacy practice research: A scoping review.

BACKGROUND: Recognizing the potential effect of sex and gender on health outcomes, there is a shift toward conducting sex and gender-based analysis (SGBA) within health research. However, little is known about the extent to which SGBA has been incorporated into pharmacy practice research. OBJECTIVES: To understand the extent to which SGBA is included in pharmacy practice research. METHOD: Scoping review of English-language studies identified through MEDLINE, Embase, International Pharmacy Abstracts (IPA), and CINAHL (inception to Jan 2014). Two raters independently screened citations to identify titles and abstracts that included key words related to sex or gender and studies that could be categorized as pharmacy practice research. One author extracted data from included studies related to study design, population, intervention/exposure and outcomes, with results reviewed by another. All authors reviewed eligible articles to categorize them based on a previously-developed typology, and to assess four criteria: 1) the inclusion of sex or gender in research objectives, 2) the depth of sex/gender analysis incorporated into study designs and reporting, 3) the inclusion of sex or gender considerations in interpretation of study results, 4) the intentional and accurate use of sex/gender language. RESULTS: Of 458 unique search results, only six articles met the inclusion criteria. Two of these six publications included sex/gender considerations in a model consistent with sex/gender based analysis as described by Hammarström. Three of the six studies inaccurately applied sex and gender terminology, whereas the two studies that featured sex or gender in their primary research question did use these terms appropriately. CONCLUSION: Despite increasing attention on the need for considering sex and gender, there was a paucity of pharmacy practice research publications that conducted SGBA. This presents an opportunity to explore sex, gender and intersectionality when pursuing studies that explore the impact of pharmacists interventions on patient outcomes.

"I Have the Worst Fear of Teachers": Moments of Inclusion and Exclusion in Family/School Relationships among Indigenous Families in Southern Ontario.

Student success is facilitated by strong bonds between families and schools, including a shared sense of purpose and mutual trust. However, for Indigenous peoples these relationships are often broken, undermined by the legacy of residential schooling and assimilative educational practices. Drawing on interviews with 50 Indigenous (mainly Haudenosaunee, Anishinaabe, and Métis) and non-Indigenous parents and educators, this paper examines the ways in which issues of class and race shape interactions between teachers and Indigenous parents. The interviews reveal that legacies of racial discrimination against Indigenous peoples in schooling affect family/school relations among middle-class (MC) and lower-class (LC) parents in different ways. MC parents intensify relations with the school while, in comparison, LC parents tend to disengage as a consequence of their negative schooling experiences. Les relations étroites entre les familles et les écoles, et notamment leurs buts communs et leur confiance partagée, facilitent la réussite des étudiants. Toutefois, au sein des populations autochtones, ces liens sont pour la plupart rompus en raison des conséquences des pensionnats scolaires et des pratiques éducatives d'assimilation. Cette étude s'appuie sur des entretiens avec 50 parents et éducateurs issus de populations autochtones (principalement celles d'Haudenosaunee, d'Anishinaabe et de Métis) et non autochtones pour étudier la manière dont les questions de classe et de race affectent les interactions entre les enseignants et les parents issus de populations autochtones. Ces entretiens montrent que le passé discriminatoire des écoles envers les peuples autochtones a eu des répercussions différentes sur les relations famille/école, selon qu'il s'agisse de parents issus de la classe moyenne ou de parents issus d'un milieu pauvre. Les parents issus de la classe moyenne ont renforcé leurs liens avec l'école alors que les parents des classes inférieures tendent à se désengager du fait de leur expérience scolaire négative.

Evaluation of high-fidelity simulation training in radiation oncology using an outcomes logic model.

PURPOSE: To evaluate the feasibility and educational value of high-fidelity, interprofessional team-based simulation in radiation oncology. METHODS: The simulation event was conducted in a radiation oncology department during a non-clinical day. It involved 5 simulation scenarios that were run over three 105 minute timeslots in a single day. High-acuity, low-frequency clinical situations were selected and included HDR brachytherapy emergency, 4D CT artifact management, pediatric emergency clinical mark-up, electron scalp trial set-up and a cone beam CT misregistration incident. A purposive sample of a minimum of 20 trainees was required to assess recruitment feasibility. A faculty radiation oncologist (RO), medical physicist (MP) or radiation therapist (RTT), facilitated each case. Participants completed a pre event survey of demographic data and motivation for participation. A post event survey collected perceptions of familiarity with the clinical content, comfort with interprofessional practice, and event satisfaction, scored on a 1-10 scale in terms of clinical knowledge, clinical decision making, clinical skills, exposure to other trainees and interprofessional communication. Means and standard deviations were calculated. RESULTS: Twenty-one trainees participated including 6 ROs (29%), 6 MPs (29%), and 9 RTTs (43%). All 12 cases (100%) were completed within the allocated 105 minutes. Nine faculty facilitators, (3MP, 2 RO, 4 RTTs) were required for 405 minutes each. Additional costs associated with this event were 154 hours to build the high fidelity scenarios, 2 standardized patients (SPs) for a total of 15.5 hours, and consumables.The mean (±SD) educational value score reported by participants with respect to clinical knowledge was 8.9 (1.1), clinical decision making 8.9 (1.3), clinical skills 8.9 (1.1), exposure to other trainees 9.1 (2.3) and interprofessional communication 9.1 (1.0). Fifteen (71%) participants reported the cases were of an appropriate complexity. The importance of further simulation events was rated highly at 9.1/10. CONCLUSIONS: High-fidelity simulation training is feasible and effective in a radiation oncology context. However, such educational activities require significant resources, including personnel and equipment.