Stakeholder expectations, experiences, and perceived outcomes: Implementation of a practice-integrated hospital pharmacist foundation residency program.

INTRODUCTION: In 2017, a practice-integrated hospital pharmacist foundation residency program, modelling well-established international programs, was made available to all eligible hosting hospital pharmacy service providers in Australia. The South Australian public hospital pharmacy service implemented the nation's first accredited statewide residency model that also incorporates enrolment and completion of a tailored post-graduate qualification. This study aimed to explore stakeholder perspectives pertaining to implementation and adoption of the South Australian public hospital pharmacy statewide residency program. METHODS: Eligible participants were recruited via purposeful sampling. Stakeholders overseeing preceptors and residents as well as those with authority to influence decision-making for future program planning were invited to participate in semi-structured interviews. Each interview was audio-recorded, transcribed, and organized using qualitative data analysis software. Reflexive thematic analysis was applied to data synthesis, and findings were discussed through the lens of the PRECEDE logic framework. RESULTS: Thirty-three participants were consented and de-identified. Three themes were identified: resource capacity for program sustainability; current and expected future impact on workforce development and career progression; and conflicts around uniformity, selectivity, and individual motivations. CONCLUSIONS: Research findings affirmed program benefits to overall workforce development whilst highlighting persisting program sustainability dilemmas. Findings have highlighted the need for a cost benefit analysis of each aspect of the residency program and the importance of tailoring to individual and site differences. Several strategies were recommended to optimize resources for increased capacity, to better support residents and preceptors, and to reduce program intensity.

"Trying to develop a better workforce": Stakeholders' perspectives of a practice-integrated Australian hospital pharmacist foundation residency program.

BACKGROUND: Practice-integrated education and professional development programs (also known as residencies), have been available to pharmacists in America and the United Kingdom for many years. In 2016, the Society of Hospital Pharmacists of Australia launched Australia's novel Foundation Residency Program to support the development of early-career pharmacists, and has been implemented across many hospitals nationally. This model was adopted by the South Australian (SA) public hospital pharmacy statewide service and was granted full accreditation. The study aimed to explore key stakeholders' expectations and early perceptions of the structure, role and impact of the SA program and in that process, to identify key influencing factors and strategies informing future program planning and design. METHODS: Purposeful sampling was adopted to recruit participants who oversee preceptors and residents, across all employment levels and pharmacy service sites. Stakeholders participated in individual semi-structured interviews. Each interview was audio-recorded and transcribed verbatim. The transcribed dataset was managed using NVivo softwareTM (version 10) and analysed using reflexive thematic analysis through the lens of the PRECEDE-PROCEED logic model framework. RESULTS: Thirty-three staff consented to participate. Participants were de-identified with a randomly assigned code number. Three key themes were identified using reflexive thematic analysis; alignment of program goals and visions, culture shift to prioritising workforce development as core business, program structure supports focused workforce development. CONCLUSIONS: Participants view the residency as beneficial for development of the residents, preceptors, and the hospital pharmacy workforce. The multisite structure was a strength of the program. Whilst it was acknowledged that the rotations, cross-site rotations, and research project presented challenges, they were deemed worth the investment. Overall, it was felt that incremental increases in program capacity will occur over time, as culture changes, and as investing in workforce development becomes core business. The findings have led to several key recommendations to guide program expansion.

Effect of chronic ankle instability on lower extremity kinematics, dynamic postural stability, and muscle activity during unilateral jump-landing tasks: A systematic review and meta-analysis.

OBJECTIVE: To determine if individuals with chronic ankle instability (CAI) demonstrate altered landing kinematics, muscle activity, and impaired dynamic postural stability during a unilateral jump-landing task. METHODS: 21 studies were included from PubMed, MEDLINE, Embase and CINAHL searched on September 26, 2021. Mean differences in joint angles and muscle activity between CAI and controls were analysed as continuous variables and pooled using a random-effects model to obtain standardised mean differences and 95% confidence intervals. Dynamic postural stability measured using time to stabilisation (TTS) was assessed qualitatively. RESULTS: We found greater plantarflexion (pooled SMD = 0.33, 95%CI [0.02,0.65]), reduced knee flexion (pooled SMD = -0.67, 95%CI [-0.97, -0.37]), and reduced hip flexion (pooled SMD = -0.52, 95%CI [-0.96, -0.07]) in CAI after landing. Regarding muscle activity, we observed reduced peroneus longus muscle activation (pooled SMD = -0.77, 95% CI [-1.17, -0.36]) in CAI prior to landing. CONCLUSION: Our study provides preliminary evidence of altered landing kinematics in the sagittal plane and reduced peroneus muscle activity in CAI during a dynamic jump-landing task. These results may have clinical implications in the development of more effective and targeted rehabilitation programmes for patients with CAI.