Pharmacist and student evaluation of a preceptor training program in a regional Australian University: a multi-method study.

BACKGROUND: Increased emphasis on workplace-based learning within pharmacy curricula has led to a focus on the quality of preceptors and the provision of preceptor training, with a diverse range of training programs for preceptors being developed across the globe. To ensure that preceptors are trained appropriately and deemed to be competent in their role, it is essential that all training programs are suitably evaluated. This research aimed to evaluate an online preceptor training program at a regional Australian University. METHODS: Kirkpatrick's four level model for assessment of training was used to evaluate this program. A multi method approach included a preceptor post training survey and interviews and a student survey evaluating the preceptor. Preceptor survey data were analysed using descriptive statistics and content analysis, while inductive thematic analysis was used to analyse the interviews. Student evaluations of trained and untrained preceptors were compared to determine whether training had impacted on student-rated preceptor effectiveness. RESULTS: Twenty-eight preceptor post-training surveys were received, ten preceptor post-training interviews were conducted, and 35 student surveys were completed. The program was rated positively overall, with notable mention by preceptors of the interactive networking session. Following their first post-training student placement, preceptors found that their overall confidence levels had improved, particularly in relation to student management, evaluating students and providing feedback. Student evaluations of preceptors revealed improved ratings of trained versus untrained preceptors, especially as effective communicators. CONCLUSIONS: This study demonstrated that training had a positive impact on preceptor attitudes, behaviour and confidence levels. From the perspective of the student, training was also found to improve preceptor performance. These results highlight the beneficial effects of training for preceptors, to optimize the student placement experience and their preparation for future practice.

Do the attitudes and practices of Australian pharmacists reflect a need for education and training to provide care for people who are transgender?

BACKGROUND: Many transgender and gender diverse (TGD) people access care through community pharmacy in Australia. However, there is limited information available about the role of Australian pharmacists in providing care for TGD people. OBJECTIVE: To explore the attitudes, practices, and training needs of pharmacists in the provision of care for TGD people in Australia. METHOD: Pharmacists Australia-wide were invited to participate in an online survey through Facebook, e-newsletters of pharmacy organizations and a professional pharmacy journal. Quantitative data were analysed for descriptive and inferential statistics. A Fisher exact test was used to investigate associations between two variables. Results with P value <0.05 were considered statistically significant. Content analysis was used to analyse data from free-text responses. RESULT: Of the 169 respondents, the majority were female (75.1%), aged below 40 years (74%) and with less than 10 years of working experience as a pharmacist (58%). Although 95% of the sample agreed that they had an important role in the provision of care for TGD people, only 29.6% were confident about their knowledge of pharmacotherapeutic treatments for gender affirmation. Only 2.4% had received education about TGD care at university, and only 5.3% received any TGD healthcare training over the past 5 years. CONCLUSION: Although pharmacists had a positive attitude and recognized their role in TGD care, they expressed a lack of confidence in their knowledge to be a barrier to providing quality care. Most recommended the need for more education about TGD healthcare in pharmacy curricula and continuous professional education activities.

Look-alike medications in the perioperative setting: scoping review of medication incidents and risk reduction interventions.

BACKGROUND: Look-alike medications, where ampoules or vials of intravenous medications look similar, may increase the risk of medication errors in the perioperative setting. AIM: This scoping review aimed to identify and explore the issues related to look-alike medication incidents in the perioperative setting and the reported risk reduction interventions. METHOD: Eight databases were searched including: CINAHL Complete, Embase, OVID Emcare, Pubmed, Scopus, Informit, Cochrane and Prospero and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Key search terms included anaesthesia, adverse drug event, drug error or medication error, look alike sound alike, operating theatres and pharmacy. Title and abstracts were screened independently and findings were extracted using validated tools in collaboration and consensus with co-authors. RESULTS: A total of 2567 records were identified to 4th July 2022; however only 18 publications met the inclusion criteria. Publication types consisted of case reports, letters to the editor, multimodal quality improvement activities or survey/audits, a controlled simulation study and one randomised clinical trial. Risk reduction intervention themes identified included regulation, procurement, standardisation of storage, labelling, environmental factors, teamwork factors and the safe administration. CONCLUSION: This review highlighted challenges with look-alike medications in the perioperative setting and identified interventions for risk reduction. Key interventions did not involve technology-based solutions and further research is required to assess their effectiveness in preventing patient harm.

Evaluation of a transgender health training program for pharmacists and pharmacy students in Australia: A pre-post study.

Background: Disparities in healthcare for transgender and gender diverse (TGD) people are well-recognized, with pharmacists reporting a lack of knowledge impacting confidence in their interactions with TGD people. Therefore, a training program in TGD healthcare was designed to address this knowledge gap. Objective: To evaluate the impact of the TGD healthcare training program on the awareness, knowledge, and behaviour of pharmacists and pharmacy students in Australia. Method: An online training program was evaluated by pre-and post-test surveys, which assessed the knowledge and awareness of participants, and three-month post-training interviews, which examined the effect of training on pharmacists' practice when providing care to TGD people. Data were analyzed using paired t-tests, content and thematic analysis. Result: Fifty-six pharmacists and twenty-one pharmacy students completed the training and pre-and post-test surveys. Ten pharmacists were interviewed post-training. There was a significant improvement in the awareness (pharmacists, p ≤0.001; students, p = 0.006), knowledge (pharmacists and students, p ≤0.001) and total (pharmacists and students, p ≤0.001) post-test scores for both groups. Interviewed participants found the training program comprehensive and relevant to their practice. Conclusion: This study has demonstrated that educational interventions improve TGD healthcare awareness and knowledge for pharmacists and students with the potential to improve healthcare provision to TGD people and promote inclusivity in society.

Pharmacists' roles in assisted reproductive technology.

Background: The global issue of infertility has prompted an increased reliance on Assisted Reproductive Technology (ART) for conception. In Australia, patients have previously accessed ART medications through specialist clinics, however recently due to modifications in ART medication subsidisation, community pharmacists now dispense and counsel patients on ART medications. Patients residing in rural and remote locations face challenges in accessing fertility clinics, which are primarily located in metropolitan and large regional cities. Objective: To investigate the perceived role, experience, confidence, and training requirements that pharmacists have in relation to providing ART medications and counselling to patients. Methods: Purposive sampling related to location of practice, pharmacist experience with ART and self-classification as an ART specialist was used to recruit 19 Australian pharmacists from rural, remote, large regional, and metropolitan areas, who participated in semi-structured interviews based on the Consolidated Framework for Implementation Research (CFIR). Interview transcriptions were transcribed, imported into NVivo, analysed using thematic analysis and mapped to CFIR domains and constructs. Results: Of the nineteen pharmacists interviewed, six were from rural and remote areas and thirteen were from metropolitan or large regional areas. Eight participants perceived themselves as specialist pharmacists in ART, all of which were in metropolitan or large regional locations. Three CFIR domains were identified as relevant for this study, which were further developed, with data mapped to eleven constructs under those domains. Emergent themes were identified that contributed to the pharmacist role including patient needs, external policies, fertility clinics, pharmacist experience and training, procuring ART, and the personal attributes of participants. Some constructs and themes differed between participants dependent on self-reported specialisation status and geographical location (e.g., self-efficacy), whereas others were consistent (e.g., knowledge and belief about the intervention). Pharmacists considered their role not to be limited to the supply and counselling of medication, but to also involve a support role for patients undergoing an emotionally difficult and sensitive journey, without guaranteed success. Conclusion: This study reveals the diverse role of Australian pharmacists in ART, influenced by location, experience, and confidence. Pharmacists have an important role to play in reducing barriers to ART access by offering fertility education, addressing concerns, providing medications and counselling, and monitoring patient well-being, improving outcomes for this cohort of patients particularly in rural and remote areas.

Pharmacist-Led Interventions for Medication Adherence in Patients with Chronic Kidney Disease: A Scoping Review.

BACKGROUND: Patients with chronic kidney disease (CKD) are routinely prescribed complex medication regimes. Medication reconciliation, medicine reviews, patient counselling and disease state and medication education are all key pharmacist-led interventions, which can improve medication adherence in patients with CKD. AIM: To characterize peer reviewed literature on the role of pharmacists in supporting medication adherence of patients with chronic kidney disease and highlight the impact they might have in the health outcomes for patients. METHOD: This review was performed in accordance with the Scoping Review Framework outlined in the Joanna Briggs Institute Reviewer's Guide. Four electronic databases were searched (Medline (Ovid), Emcare, Scopus and Web of Science) for all relevant literature published up until November 2022. A total of 32 studies were reviewed against an exclusion and inclusion criteria, with findings from each study categorized into barriers, interventions, perceptions, financial implications and outcomes. RESULTS: Eight eligible studies were identified, where pharmacists' interventions including medication reconciliation, medicine reviews, patient counselling and disease state and medication education, were all reported to have a positive effect on medication adherence. Although pharmacy services in chronic kidney disease were acceptable to patients and pharmacists, these services were under-utilized and limited by logistical constraints, including staffing shortages and time limitations. Patient education supplemented with education tools describing disease states and medications was reported to increase patient adherence to medication regimes. CONCLUSIONS: Pharmacist-led interventions play an integral role in improving medication adherence in patients with chronic kidney disease, with their inclusion in renal care settings having the potential to improve outcomes for patients.

How Should We Prepare Our Pharmacist Preceptors? Design, Development and Implementation of a Training Program in a Regional Australian University.

Increased experiential learning within pharmacy education has highlighted the need for quality preceptors, leading to a recent focus on their development and training. This study describes the design, development and implementation of a pharmacist preceptor training program in a regional Australian University. The design of this program utilized the results of a previously conducted scoping review of preceptor training programs and a comprehensive preceptor training needs analysis. In addition, participation was sought from an expert advisory group, comprising preceptors and pharmacy professional organizations. Program materials were developed and transferred onto a suitable online learning platform for implementation. Post-training program evaluation will follow Kirkpatrick's model of training evaluation criteria, gaining feedback from both preceptors and students. The four flexible online modules that were designed are aligned with the main preceptor roles: role model, educator, mentor and assessor. The program also included a small-group online interactive networking session and an online discussion forum. Following implementation, 28 pharmacist preceptors completed the training. Preliminary feedback on the training program was extremely positive, particularly to the interactive networking activity. Future programs will continue to be adapted to reflect stakeholder feedback and optimize student placement experiences.

How can we help you? A qualitative study of the provision of care to culturally and linguistically diverse clients in community pharmacy.

OBJECTIVES: Clients from culturally and linguistically diverse (CALD) backgrounds experience challenges in receiving care from community pharmacies, resulting in poorer health outcomes compared with the majority population. The aim of this study was to explore migrants' and pharmacy staff's understanding of the facilitators for the delivery of care to CALD clients. METHODS: Focus groups were conducted with predominantly older, female Nepali-speaking migrants. Individual interviews were undertaken with pharmacists and pharmacy assistants. Verbatim and translated transcripts were inductively coded to establish themes. KEY FINDINGS: Three major themes emerged: getting the message across, building trust, and improving understanding. Key findings included the need to increase the use of professional interpreters, and empathy and patience from pharmacy staff. Modifications to communication using re-phrasing and more detail about the community pharmacy system in post-arrival orientation for migrants are required. CONCLUSIONS: Multilingual staff is an effective way to overcome the language barrier, but its use is limited by staff resources. Pharmacy staff should be required to use the services of professional telephone interpreters to surmount language barriers. Modification of communication techniques and having an empathetic attitude improve communication and care provision. Pharmacists should liaise with migrant support services to provide orientation for new arrivals.

Identifying the barriers to kidney transplantation for patients in rural and remote areas: a scoping review.

BACKGROUND: Populations in rural and remote areas have higher rates of chronic kidney disease and kidney failure than those in urban or metropolitan areas, and mortality rates for chronic kidney disease are almost twice as high in remote areas compared to major cities. Despite this, patients residing in regional, rural, or remote areas are less likely to be wait-listed for or receive a kidney transplant. The objective of this scoping review is to identify specific barriers to kidney transplantation for adult patients residing in rural and remote areas from the perspectives of health professionals and patients/carers. METHODS: Studies were identified through database (MEDLINE, CINAHL, Emcare, Scopus) searches and assessed against inclusion criteria to determine eligibility. A descriptive content analysis was undertaken to identify and describe barriers as key themes. RESULTS: The 24 selected studies included both quantitative (n = 5) and qualitative (n = 19) methodologies. In studies conducted in health professional populations (n = 10) the most prevalent themes identified were perceived social and cultural issues (80%), burden of travel and distance from treatment (60%), and system-level factors as barriers (60%). In patient/carer populations (n = 14), the most prevalent themes were limited understanding of illness and treatment options (71%), dislocation from family and support network (71%), and physical and psychosocial effects of treatment (71%). CONCLUSIONS: Patients in regional, rural, and remote areas face many additional barriers to kidney transplantation, which are predominantly associated with the need to travel or relocate to access required medical testing and transplantation facilities.

Pharmacy Students' Perspective on Business Management for the Community Pharmacist.

OBJECTIVE: Pharmacy students are important future stakeholders in community pharmacy, with business management being an integral part of practice. Thus, this study aims to determine pharmacy students' perceptions of the business management skills required of the community pharmacist and how these skills should be taught within the pharmacy curriculum. METHODS: An explanatory sequential mixed-methods design involved the administration of an online survey to pharmacy students in years 1 and 4 across 2 Australian universities, followed by focus groups to gather in-depth perceptions. Survey responses were analyzed using descriptive statistics, and associations between years 1 and 4 and outcomes were explored. A hybrid approach of inductive and deductive thematic analysis was used for focus group transcriptions. RESULTS: A total of 51 pharmacy students responded to the online survey, with 85% agreeing that business management is an essential part of the community pharmacist's skill set. Students indicated a preference for learning management during their community pharmacy placement, university workshops, and via mentorship. Although thematic analysis of student focus groups revealed a preference for learning clinical skills during their university education, business management was also recognized as important. Enthusiasm for management, however, could be increased by exposure to mentors who display leadership and are passionate about business management. CONCLUSION: Pharmacy students considered business management as intrinsic to the role of community pharmacists and recommended a multimethod teaching approach to learning these skills. These findings could be used by pharmacy educators and the profession to inform both the content and the delivery of business management in pharmacy curricula.

Pharmacy preceptor training: addressing the challenges of clinical supervision in community practice.

Pharmacist preceptors are fundamental to experiential placements and their training is considered essential to provide a quality and consistent student placement experience. To optimise the impact of training, the views of key stakeholders are required to inform the design of a training program. This commentary aims to synthesise the perceptions of the stakeholders, including community pharmacy preceptors, academic staff and students on preceptor training requirements. Their opinions were sought to gain an understanding of preceptor roles and associated skills and attributes, training and support requirements, and barriers and enablers to training. Responses indicated a preference for a flexible online training program, with content including an overview of the university curriculum and expectations, teaching strategies, how to provide feedback and student management. A role was identified for the university to acknowledge the work of preceptors and ensure that they are included in their plans for future experiential placement activities and curriculum development. Several barriers were identified, which challenged precepting, providing the opportunity for this commentary to focus on preceptor training that will address these key challenges, in the context of a clinical teaching environment.

"I don't know much about providing pharmaceutical care to people who are transgender": A qualitative study of experiences and attitudes of pharmacists.

Background: Globally, with the increased visibility, the number of transgender people accessing healthcare services has risen in the last decade. Although pharmacists are required to provide equitable and respectful care to all patients, their experiences interacting with trans and gender-diverse (TGD) people and attitudes towards the provision of care are largely unknown. Objectives: This study aimed to determine the experiences and attitudes of pharmacists providing care to TGD people in Queensland, Australia. Methods: Within a transformative paradigm, this study used semi-structured interviews conducted in person, over the phone, or through the Zoom app. Data were transcribed and analyzed by applying the constructs of the Theoretical Framework of Accessibility (TFA). Results: A total of 20 participants were interviewed. Analysis revealed all seven constructs across interview data, with affective attitude and self-efficacy being the most frequently coded constructs, followed by burden and perceived effectiveness. The least coded constructs included ethicality, intervention coherence, and opportunity cost. Pharmacists had positive attitudes towards providing care and interacting professionally with TGD people. Prime challenges in delivering care were being unaware of inclusive language and terminology, difficulty building trusted relationships, privacy and confidentiality at the pharmacy, inability to locate appropriate resources, and lack of training in TGD health. Pharmacists felt rewarded when they established rapport and created safe spaces. However, they requested communication training and education to improve their confidence in delivering care to TGD people. Conclusion: Pharmacists demonstrated a clear need for further education on gender-affirming therapies and training in communication with TGD people. Including TGD care in pharmacy curricula and continuous professional development activities is seen as an essential step towards pharmacists improving health outcomes for TGD people.

From Identity to Ambugity: Exploring Interprofessional Collaboration Opportunities for Pharmacists in Rural and Remote Australia.

Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and remote communities. This study aims to explore exercise physiologist and podiatrist perceptions of interprofessional practice opportunities with pharmacists. Role theory provided a framework for this qualitative study. Interviews were conducted, recorded, transcribed, and thematically analysed according to the constructs of role theory (role identity, role sufficiency, role overload, role conflict, and role ambiguity). The perceptions of participants varied, largely due to the lack of understanding of the role and scope of the practice of a pharmacist. Participants acknowledged and adopted a flexible approach to the way in which they delivered health services to meet the needs of the community. They also described a more "generalist" approach to care, owing to the high prevalence of disease and disease complexity, along with a lack of staffing and resources. The potential for increased interprofessional collaboration was supported and identified as a strategy to manage significant workloads and provide improved patient healthcare. The application of role theory to this qualitative study provides insight into perceptions of interprofessional practice that may inform future development of remote practice models of care.

Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review.

BACKGROUND: Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. OBJECTIVE: The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. METHODS: A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. RESULTS: A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. CONCLUSIONS: While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..

Answering the Call for Community Pharmacists to Improve Healthcare Delivery to Trans and Gender Diverse People: Guide for Designing, Implementing, and Evaluating an Online Education Program in Australia.

BACKGROUND: Trans and gender-diverse people visiting pharmacies may not always receive optimum care due to pharmacists' lack of knowledge and confidence to provide such care. This situation prompts a need for training. OBJECTIVES: This paper aimed to describe a guide to the design, implementation, and evaluation of a training program on transgender healthcare for pharmacists in Australia. METHODS: The Implementation Mapping Framework provided a foundation for the design, implementation, and evaluation of this training program. Through active involvement in the program development, trans and gender diverse people and pharmacists guided the program design, ensuring alignment with the cultural, social, and healthcare contexts. RESULTS: The needs analysis highlighted the necessity for training for pharmacists to improve their cultural awareness and pharmacotherapeutic knowledge about transgender healthcare. Applying a novel Gender Inclusivity in Pharmacy Framework, online modules-(1) Transgender healthcare-language, terminology, and key healthcare issues, (2) Gender-affirming therapies, and (3) Case studies in transgender healthcare-were developed to enable the implementation of a training program. CONCLUSION: The Implementation Mapping Framework and the Gender Inclusivity in Pharmacy Framework proved effective tools for providing an education program for pharmacists.

Pharmacy Student Perceptions of the Roles and Attributes of Pharmacist Preceptors in Australia.

The pharmacist preceptor is key to the success of pharmacy student experiential placements with a recent focus being placed on the quality of preceptors. This study sought to investigate student perceptions of the ideal roles and attributes of pharmacist preceptors to inform the development of a preceptor training program. This was a mixed methods study using an online survey of pharmacy students from levels two to four of an undergraduate pharmacy honours program at a regional Australian university followed by qualitative, semi-structured focus group interviews. Surveys were analysed using descriptive statistics and content analysis while interviews were thematically analysed. Thirty-seven complete survey responses were received, and three student focus groups were conducted. Students identified the key role of preceptors in linking theory to practice and felt that the role of the preceptor in student assessment should focus on practical skills, such as communication and professionalism. There was overall strong agreement between the quantitative and qualitative findings on the ideal preceptor attributes with good communication, enthusiasm for the profession and the provision of clear and honest student feedback thought to be most important. Students regarded these attributes as essential for a good preceptor-student relationship to promote learning in the practice environment.

"Treat us as a person": A narrative inquiry of experiences and expectations of interactions with pharmacists and pharmacy staff among people who are transgender.

Background: Despite the increased visibility of transgender and gender diverse (TGD) people, little is known about their interactions with pharmacists and pharmacy staff while accessing care from the pharmacies. Objectives: The objective of this study was to explore the experiences and expectations of the TGD people regarding their interactions with pharmacists and pharmacy staff in Queensland, Australia. Methods: This study is situated in a transformative paradigm and utilized narrative inquiry to conduct semi-structured interviews with TGD participants. An interview guide based on the relevant literature and the constructs of the Theoretical Framework of Accessibility was developed. Purposive and snowball sampling was used to recruit people who identified as TGD and had previously visited pharmacies to access care. Depending on participants' preferences, interviews were conducted face-to-face or via phone or Zoom application. Interviews were recorded, transcribed, and organized in chronological stories. Data were analyzed to derive themes from the participant stories. Results: A total of 22 participants (transwomen = 11, transmen = 8, non-binary trans masculine = 3) were interviewed. Two major themes were identified, (1) Challenges of accessing care from the pharmacy and (2) Making the most of the interactions between TGD people and pharmacists. Major challenges of accessing care from pharmacies included anticipated anxiety of accessing care, healthcare system constraints, compromised privacy and confidentiality at the pharmacy, and being challenged about their gender. Many avoided interacting with pharmacists and staff or kept their interactions minimal. Participants recognized that pharmacists play a meaningful role in TGD health and provided insights about how pharmacists can improve care provision to TGD people. Conclusion: Cultural and pharmacotherapeutic education in transgender health are crucial for Australian pharmacists and staff to provide inclusive, respectful, and person-centered care to TGD people.

Telmisartan Tablets Repackaged into Dose Administration Aids: Physicochemical Stability under Tropical Conditions.

Dose administration aids (DAAs) are commonly used to assist patients with chronic disease to manage multiple medications and thus improve adherence. Several brands of telmisartan, commonly prescribed for hypertension, are available in Australia. Manufacturer's storage advice is to leave tablets in the blister strip until administered to patients. This study aimed to investigate the stability of telmisartan tablets when repackaged and stored in DAAs, to identify a brand, which is sufficiently stable to be repackaged. All available brands of telmisartan tablets in Australia, which contain different excipients, were repackaged into DAAs and stored at 30 °C, 75% RH for 28 days before screening, using visual inspection and physical testing. A candidate brand was then selected for physicochemical and photostability testing using pharmacopoeial methods. Repackaged Mizart® tablets were shown to be sufficiently stable, when repackaged and stored under tropical conditions (30 °C, 75% RH) for 28 days. Several of the other brands were deemed inappropriate for repackaging, due to physical instability, highlighting the importance of considering not only the drug, but also excipients to ensure the stability of repackaged medicines. Although the repackaging of telmisartan tablets is not advised, this study provides evidence to support the Mizart® brand as an option for pharmacists to recommend for repackaging.

Perspectives of Complementary and Alternative Medicine use by cancer patients in a regional hospital in North Queensland, Australia.

OBJECTIVES: This study aimed to investigate CAMs used, and reasons for and disclosure of this use by cancer patients in a regional hospital in North Queensland, Australia. METHODS: Patients attending the Day Oncology Unit of the Townsville University Hospital were invited to participate in a self-completed questionnaire or telephone interview regarding perspectives of their CAM use. Data were analysed using descriptive statistics and chi-squared and independent t-tests were performed to allow comparison between the responses by CAM users and non-users. RESULTS: 102 completed questionnaires were used in the analysis, where 40.2 % of respondents were found to be using some form of CAM. Cannabis, magnesium, and massage were the most prominent therapies used, with cannabis use in cancer, not commonly reported in prior literature. The main reasons given for using CAM were to treat symptoms of cancer, side-effects of treatment or to improve general health. Two-thirds of these respondents disclosed their CAM use to health professionals mostly to obtain a professional opinion or due to concerns of interactions with cancer treatment. CAM users were statistically more likely to have used CAM prior to their cancer diagnosis and have lower emotional wellbeing than non-users. Non-CAM users indicated that a lack of knowledge of CAM or concerns regarding interactions with cancer treatment were the most popular reasons for not adopting these therapies. CONCLUSION: While lower than the averages of previously published CAM use, our study highlights that there is still a significant group of cancer patients in the North Queensland region using CAMs.

Exploring the nursing student experience at a remote Australian university campus: a qualitative study.

BACKGROUND: Nurses constitute most of the rural and remote Australian health workforce, however staff shortages in these regions are common. Rural exposure, association, and undertaking rural clinical placements can influence health students' decision to work rurally after graduation, however attending university in rural and remote regions has been shown to be a great contributor. An improved understanding of these nursing students' experiences may inform changes to teaching and support strategies for these students, which in turn could improve their retention and completion rates, contributing to a more sustainable rural and remote Australian nursing workforce. This study aimed to explore and describe students' experiences of studying nursing in the context of a satellite university campus located in a remote town, with a focus on education delivery methods, staff, support, student services, and barriers and enablers to successful study. METHODOLOGY: Nine students participated in this qualitative descriptive study. Semi-structured interviews were undertaken, allowing participants to reflect on their experiences as nursing students in the context of a geographically remote satellite university campus. The resulting data were grouped into common themes and summarised. RESULTS: Students were generally positive regarding lectures delivered by videoconference or recorded lectures, as they allowed for greater flexibility which accommodated their busy personal lives. Face-to-face teaching was especially valuable, and students were particularly positive about their small cohort size, which enabled the creation of strong, supportive relationships between students, their cohort, and teaching and support staff. However, barriers related to student demographics and some difficulties with course engagement and campus staffing were experienced. CONCLUSIONS: The experiences of nursing students at remote university campuses are different from those experienced by traditional, metropolitan university students. Although these nursing students face additional barriers unique to the remote campus context, they benefit from a range of enabling factors, including their close relationships with other students, staff, family, and their local community.