Could pharmacy technicians play a role in supporting the appropriate and safe use of traditional and complementary medicines?

Across the world traditional and complementary medicine (T&CM) product use is prevalent with some countries reporting greater than 50% of the population using these products. T&CM products are primarily self-selected through retail outlets including pharmacies. Pharmacists across the world generally agree they should play a role in ensuring the appropriate and safe use of T&CM products but report being time and resource poor to do so. In this commentary, it is proposed that pharmacy technicians as members of the pharmacy workforce, who with adequate education, and supportive technologies could support pharmacists in providing guidance to consumers and patients about the appropriate and safe use of T&CM products. Pharmacy technicians play a crucial role in the pharmacy workforce, serving as integral members of healthcare teams fulfilling a wide array of tasks essential for the efficient functioning of pharmacies and ensuring the safe dispensation of medications. They have been described by pharmacists as the "the face of the pharmacy" in the community setting and relied on not only for mitigating and triaging problems, but also be primarily responsible for developing rapport, eliciting trust and even loyalty from pharmacy patrons. As such, there is a momentous opportunity for pharmacy technicians to play a role in providing T&CM advice and triaging the need for pharmacists' intervention where harm, or risk of is identified.

A comprehensive program in academic health professions to enhance faculty recruitment, mentoring, productivity, and retention: The case of RCSI's StAR program.

Top faculty talent recruitment, mentoring, productivity, and retention are paramount for organizational success among institutions of higher learning. Programs would do well to treat these various aspects of faculty management/development as inextricably linked to one another, rather than viewing recruitment or retention in a vacuum. The Strategic Academic Recruitment (StAR) program at the Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences in Dublin was founded to bear these things, along with best practices in faculty development, in mind to enhance organizational effectiveness. This paper provides some background, description, and outcomes of the program thus far, revealing positive trends in scholarly productivity, teaching, program faculty commitment, and the development of future leaders for the institution, even while further evaluation and continued quality improvement for the StAR initiative are called for. It is hoped that the details provided here can be helpful for other academic organizations as they consider any of various initiatives aimed to attract high-quality labor capital, position those faculty for success, and enhance organizational effectiveness and reputation.

Barriers to person-centered service design in pharmacy practice: examples, lessons, and potential solutions.

Despite increased attention to, and frameworks conceptualizing person-centered care, systematic, organizational, and provider-level barriers continue to discourage the development and delivery of person-centered care (PCC) in pharmacy practice and beyond. This commentary describes existing pharmacy-specific literature related to PCC, barriers to PCC within the context of pharmacy practice, and potential solutions to increase person-centeredness in pharmacy services. Literature to substantiate and describe barriers and potential solutions was identified from 2008 to 2023, a period where the emphasis on PCC in pharmacy practice dramatically increased. Overall, pharmacy-specific literature was identified describing four key barriers to PCC. Several potential solutions were identified, including: using innovative and theory-informed approaches to collecting individual need and preference information, employing processes and equipping providers to facilitate trust, changing organizational culture, and aligning quality metrics and financial incentives with PCC. Identified solutions may be used to address individual, organizational, and systematic barriers to promote PCC.

Beyond satisfaction in person-centered pharmacy services.

Patient self-reported satisfaction is commonly used as an assessment of service experience and quality for community pharmacy services. This commentary discusses alternative foundational approaches to evaluating service experience and quality in patient-centered care. It describes historical and recent literature pertaining to the development and use of satisfaction measures for service design and patient experience assessment. It then highlights potential limitations of patient satisfaction as an assessment tool for patient-centeredness and patient experience identified in the pharmacy literature, which include criticisms that use of patient satisfaction may compromise accuracy in measuring quality due to factors such as patients having poor knowledge of and low expectations for quality and having a predisposition toward rating satisfaction highly when experiencing no-cost and/or unfamiliar services. Moreover, satisfaction measurements may change based on service exposure, with patient preferences for service offerings changing with increased service exposure and variation in patient-specific and environmental factors. After discussing limitations and criticism of patient self-reported satisfaction, we introduce alternative assessments methods which may facilitate more accurate assessments of patient experience and patient-centered pharmacy services such as patient-reported outcomes measures (PROMs), patient-reported experience measures (PREMs), and human-centered design techniques such as journey mapping, prototyping, and user testing to design and assess patient-centered pharmacy services. These alternative assessments are rooted in, or related to preferred implementation science approaches to establishing, evaluating, and sustaining pharmacy services.

Defining and supporting a professional role for pharmacists associated with traditional and complementary medicines: a cross-country survey of pharmacists.

Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods: Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists.

Part-Time and Cofunded Pharmacy Faculty and Their Perceptions of Professional and Organizational Identity Formation.

OBJECTIVE: To gain a better understanding of professional and organizational identity formation and workplace climate issues among part-time and cofunded pharmacy faculty. METHODS: This study had a cross-sectional, prospective design using a semistructured interview guide developed by the researchers of this study. The interview guide drew themes from motivating language theory, social provisions, and previous research on professional identity. Pharmacy faculty with varying part-time and cofunded appointments, representing a cross section of demographic characteristics, and working in different types of practice sites and institutions, were invited to participate. RESULTS: Data saturation was reached at 14 participants. Participants had a variety of professional roles, namely teaching and precepting, as well as clinical, research, service, and administrative responsibilities. Three general themes emerged: (1) the struggle with having multiple aspects of professional identity, (2) facing the perception that academia is a "lifestyle" that not all faculty can fully participate, and (3) the need for properly constructed and tailored communication from peers and supervisors. CONCLUSION: A key component to mitigating the struggle with multiple aspects of professional identity and the feeling that part-time and cofunded faculty cannot fully participate in the academic lifestyle seemed to be informed, empathetic, inclusive, and tailored communication from supervisors.

Motivating Language and Social Provisions in the Inculcation of Pharmacy Students' Professional Identity.

Professional identity formation in pharmacy students is a multifaceted, dynamic process stimulated through a variety of experiences, including those in structured classrooms, laboratories, experiential settings, and during interprofessional education. Meaningful faculty communications with students are a critical element in the development process.This commentary situates research findings from studies on communication practices within the frameworks of motivating language theory and social provisions theory to demonstrate how specific language from instructors can impact the formation of students' professional identity. Our objective is to review and extrapolate findings from professional pharmacy literature on communication, as well as literature from outside the profession, to demonstrate how specific strategies can aid in the development and reinforcement of pharmacy students' professional identity. Clear, specific, tailored, empathetic communication by instructors during pharmacy student training promotes students' ability to think, act, and feel like valued contributors during the provision of patient care and interprofessional experiences.

Cultures of support and resilience are associated with certified pharmacy technicians embracing new roles.

BACKGROUND: Various technological, economic, and regulatory factors are creating opportunities for pharmacy technicians to take on additional responsibilities. Technicians in the broader sense have indicated a preference for expanded scope of duties; however, it is not known what drives technicians' greater inclinations to accept these new roles. OBJECTIVE: The purpose of this study was to determine the association of various work-related factors, such as co-worker support, pharmacist-leadership style, future uncertainty, their own organizational commitment, and personal characteristics of technicians, including their resilience, on pharmacy technicians' willingness to take on emerging responsibilities in pharmacy. METHODS: A self-administered questionnaire survey was disseminated through email to a national, randomized sample of 3000 technicians certified through the National Healthcareer Association (NHA). The questionnaire solicited data on willingness to participate in either of 13 emerging responsibilities as well as resilience, perceived transformative leadership behaviors of supervising pharmacists, future uncertainty, coworker support, organizational commitment, and various personal and practice-related variables. Following the use of principal component analyses for item purification and summation of various scale responses, inferential analyses were conducted via independent sample t-tests, one way analyses of variance, and Pearson's product moment correlation, as appropriate. RESULTS: From 2906 surveys delivered, 878 were returned, with 745 of them providing completed responses on willingness to participate in emerging responsibilities. Willingness on most items/responsibilities was highly rated, with many means being at least 4 on a 5-point scale, though some were lower and perhaps a reflection of less exposure to these by way of their personal experience orpractice setting. Technicians' resilience, their coworker support, organizational commitment, and perceived transformative behaviors undertaken by their supervising pharmacists were all highly associated with willingness to engage. CONCLUSIONS: Pharmacists, pharmacy technician peers, and organizations can contribute to a culture that is supportive for pharmacy technicians and may serve to encourage commitment, resilience, and willingness to embrace new, or emerging responsibilities.

Assessing Student Perceptions of Blended and Online Learning Courses in Pharmacoeconomics, Management, and Leadership.

Objective. Blended learning combines traditional face-to-face education with online instruction. This learner-centered approach has been shown to improve student engagement, critical thinking, and performance outcomes. The objective of this study was to assess and trend student pharmacist perceptions of blended and online learning used to teach pharmacy management, leadership, and economics within a Doctor of Pharmacy (PharmD) curriculum.Methods. Qualitative methods were employed using in-depth, semistructured interviews. Second- and third-year student pharmacists were recruited by purposeful and snowball sampling and interviewed to a point of saturation. The interview guide was based on social cognitive theory. Themes identified through initial deductive thematic analysis were categorized by the three domains of social cognitive theory: cognitive, behavioral, and environmental factors. The coding team additionally analyzed the transcripts using inductive thematic analysis to ensure no themes outside of social cognitive theory were missed.Results. Twenty students were interviewed. Themes reveal perceptions that blended learning facilitated greater understanding of course material, increased motivation among learners, provided more flexibility in workload completion, and was a more enjoyable way to learn compared to traditional didactic instruction. Furthermore, blended learning offered additional distinct advantages over traditional and online-only pedagogies.Conclusion. Student pharmacists perceived blended and online learning positively and acceptable for the delivery of a pharmacy course on management, leadership, and economics over traditional didactic instruction. Blended learning may enhance innovation, leadership, management, and economics content delivery and the student learning experience.

Correlations to and potential implications of resilience among certified pharmacy technicians.

OBJECTIVES: To assess resilience among a sample of certified pharmacy technicians in the United States and evaluate associations between resilience and various personal and work-related characteristics and conditions, including coworker support and pharmacist leadership behaviors, and to assess the relationship between technicians' resilience and support from coworkers and commitment to their organization. METHODS: This study employed the use of a self-administered questionnaire survey electronically in a cross-sectional design. The questionnaire was delivered with a response portal open for approximately 6 weeks during the spring of 2022 to a sample of 3000 technicians certified through the National Healthcareer Association. The questionnaire consisted of items comprising the Brief Resilience Scale, an adapted version of the Multifactorial Leadership Questionnaire (A-MLQ), and items measuring aspects of coworker support, future uncertainty, commitment, and turnover, in addition to demographic and practice site-related questions. RESULTS: Usable responses were acquired from 822 respondents, who reported relatively high levels of resilience. Resilience was observed to be positively correlated with pharmacy transformative leadership behaviors measured on the A-MLQ and with coworker support and negatively correlated with future uncertainty. Respondents indicating the highest level of profession commitment reported a statistically higher level of resilience than did others. There were very few relationships observed between resilience and technicians' personal characteristics. CONCLUSIONS: Immutable characteristics (e.g., race/ethnicity, sex, and age) played a very small role in describing resilience among pharmacy technicians. Instead, organizational characteristics of the workplace were shown to be highly associative with resilience of technicians, adding further evidence that organizations and the profession can help facilitate resilience among these important pharmacy support personnel.

Technicians' perception of pharmacist leadership behaviors on their own commitment and turnover intention.

PURPOSE: To evaluate technicians' perceptions of how they are supported and supervised by pharmacists through assessment of various components of pharmacists' leadership behaviors in developing the technician workforce. Additional objectives included evaluating levels of pharmacy technician uncertainty about their future, job commitment, and turnover intention in relation to perceived pharmacist leadership behaviors. METHODS: This study employed a cross-sectional design involving administration of an online questionnaire survey. The target population was technicians certified through the National Healthcareer Association. The questionnaire was disseminated to a random, nationwide sample of 3,000 technicians. It solicited responses to an adapted version of the Multifactorial Leadership Questionnaire (MLQ), a 29-item instrument for measuring the frequency of observed pharmacist supervisory behaviors, which are categorized as transactional, transformative, or both. The questionnaire also inquired as to respondents' levels of future uncertainty, profession commitment, organization commitment, and turnover intentions. RESULTS: Responses were acquired from 882 certified pharmacy technicians, who reported their observance of pharmacy supervisory behaviors, as measured by the adapted MLQ, with moderate frequency. Higher technician-reported levels of transformative leadership behavior by pharmacists were associated with lower levels of future uncertainty, greater profession and organization commitment, and diminished turnover intentions. CONCLUSION: Pharmacists' supervisory behaviors, namely transformative leadership behaviors, may be impactful to pharmacy technicians' attitudes and work-related outcomes. The pharmacy profession's leaders and educators might consider these results in educating current and future pharmacists so as to improve the workplace and, potentially, organizational and profession-wide outcomes in the delivery of care.

Communication in Pharmacy Higher Education to Improve Work-life and Mitigate Burnout.

Objective. To identify the content, style, timing, tone, and initiation of communication that best connotes "reassurance of worth" from peers and supervisors in pharmacy academia.Methods. This study employed semi-structured interviews to acquire in-depth information from pharmacy faculty through a purposive sampling process. Academicians who had published in the area of work-life and/or were deemed likely to make substantial contributions to the interview were asked to participate. Participants represented a cross section of pharmacy faculty in terms of discipline, institution, and demographic characteristics. An interview guide was constructed based on motivating language theory and provisions of social relationships theory. Interviews were conducted via Zoom and transcribed verbatim. Themes were gleaned using open coding, then audited and checked.Results. Data saturation occurred after eight interviews. Two primary themes emerged: guidance, particularly related to professional development and tenure; and reassurance of worth through invited participation, praise, and/or rewards. Interviewees highlighted the importance of empathetic yet practical language among peers, and supervisor-initiated, meaning-making language rather than generic platitudes.Conclusion. Empathetic, personal language that provides guidance and reassurance of worth can enhance pharmacy faculty contributions and mitigate burnout. Invitations to collaborate are seen by faculty as collegial and engaging. This study demonstrated the usefulness of motivating language theory and social provisions in guiding communications among pharmacy academicians.

Variability in perceptions of organizational culture across U.S. colleges and schools of pharmacy.

BACKGROUND: Despite its importance on myriad outcomes, there is little information on the organizational culture of colleges and schools of pharmacy (CSOPs). OBJECTIVES: This study sought to: (1) identify faculty and administrator perceptions across 5 dimensions of organizational culture in CSOPs; (2) describe differences in these perceptions among faculty varying in type of appointment and type of institution where employed. METHODS: A questionnaire survey designed in Qualtrics was distributed via email link to a census sample of 3378 members within 2018 AACP list-servs. Dimensions of organizational culture were adapted from previously validated work describing such specifically within academic pharmacy. Reminders were employed to maximize survey responses. Frequency distributions and chi-square statistics were conducted to describe the data. RESULTS: Responses from 463 faculty and administrators indicated perceived strength in several aspects of organizational culture in U.S. CSOPs, including their emphasis on quality, developing collaborations partnerships with external partners, and promoting personal development. Other facets of culture deemed to be less descriptive amongst CSOPs include their being innovative, managing conflict, and discouraging political maneuvering. There were relatively few differences in perceptions of culture among faculty varying by rank, discipline, or supervisory status. There were a number of differences among respondents varying by type of institution, with those from public and balanced/research-oriented institutions indicating their organizations are more likely to project positively certain components of culture such as empowering people to achieve, fostering innovation, remaining calm in turbulent times, and making employees feel secure in their employment. CONCLUSIONS: This study highlighted aspects of organizational culture at CSOPs that might need to be addressed or communicated more effectively by program leaders. All CSOPs, and particularly those within private and teaching-oriented institutions might endeavor to assess and address aspects of their organizational culture, particularly related to their performance orientation, innovation and stability.

What are academic pharmacy organizations doing to reward performance and retain their star faculty?

BACKGROUND: Evidence suggests that stars in an organization, including academia, drive much of its productivity and reputation. There has been much said within academic pharmacy about recruitment, but little in regard to retaining its top faculty. OBJECTIVE: To identify perceptions among pharmacy faculty on how faculty are currently rewarded; what is done versus what should be done at their institution to recruit and retain star faculty; what is versus what should be done in developing faculty, and compare these perceptions across certain personal and work characteristics. METHODS: A questionnaire survey designed in Qualtrics was distributed via email to a census sample of 3378 members comprising 2018 AACP list-servs. Faculty activities and organization actions were derived from literatures and pilot testing. Frequency distributions and Kruskal-Wallis tests were conducted to describe the data. RESULTS: Responses from 463 faculty indicated scholarly publishing as paramount for receipt of organizational rewards. They indicated that their organizations very infrequently employed action to retain star faculty. They indicated that more should be done to retain stars, and this was largely agreed upon by those in supervisory positions, even though there were a few differences between supervisors and non-supervisors over what is already being done. While there were differences in perception primarily by respondent institution type, there were many more similarities than differences of opinion about actions taken and that should be taken to retain star faculty. CONCLUSIONS: Pharmacy faculty affirmed the salience of scholarly productivity in the allocation of organizational rewards and indicated that certain activities like high-quality clinical practice and good citizenship behaviors were less likely to result in recognition. The results offer considerations for faculty retention strategies and the need for administrators to communicate actions taken to retain star faculty.

Faculty Members' Opinions of What Defines a "Star" in Academic Pharmacy.

Objective. This study sought to identify attributes or performance aspects, most notably those defining what constitutes a "star" faculty in academic pharmacy, and to describe differences in perceptions of the strength of these aspects across faculty varying by discipline, academic rank, experience, type of institution employed, and supervisory experience.Methods. An electronic survey was distributed via email link to a census sample of 3378 members within the2018 American Association of Colleges of Pharmacy (AACP) list-servs. Performance aspects were derived from key literature enumerating academic responsibilities and behaviors. Reminders were employed to maximize survey responses. Frequency distributions and Kruskal-Wallis tests were conducted to describe the data.Results. Responses from 463 persons identified the importance of quality rather than quantity of teaching; publishing in refereed journals, and demonstrating collegiality to be among the more salient aspects defining a star faculty member. There were differences in perceptions of what constitutes a star mostly by institution type employed and among pharmacy practice respondents vs those from other disciplines. Respondents from private institutions indicated that their deans and chairs were less likely to recognize and attempt to retain star faculty. However, responses were generally in the same direction and congruent, even between those with vs without supervisory responsibility.Conclusion. This study highlighted the importance of demonstrating collegiality along with high-quality teaching and productivity as qualities warranting star status in academic pharmacy. Given the importance of faculty stars, academic pharmacy organizations, particularly private institutions, should make an effort to recognize and retain them.

The intersection of pharmacy leadership and management with clinical skills: Education plays a key role.

INTRODUCTION: Clinical pharmacy service expansion is a challenge of scalability, and education can play a big part in the profession's transition to patient care. Underdeveloped staff management and leadership skills may prohibit scalability of innovative patient care service models observed in research and academic pharmacy environments. COMMENTARY: In today's rapidly evolving healthcare industry, formal education in leadership and management may provide the prerequisite skills for frontline pharmacists to innovate and scale clinical care services thereby improving quality patient outcomes. One important component of this is the use of pharmacist-extenders and team-based task delegation to eliminate technical tasks from the pharmacist's workload and maximize time spent in functions requiring professional judgment. IMPLICATIONS: The Academy should develop leadership and management skills in tandem with patient care-related skills to optimize care delivery. Specifically, pharmacy educators should lean into concepts of organizational behavior and evidence-based management. The future of pharmacy is highly dependent on future pharmacist leaders; development of successful leaders is imperative to the profession of pharmacy.

Enhancing point-of-care testing through standardized training and redeployment of pharmacy technicians in the community setting.

Objectives: The primary objective of this study was to assess the impact of a standardized training model for technician-supported point-of-care testing (POCT) on the number of health screenings performed across two states in a large community chain pharmacy. Secondary objectives included the assessment of pharmacist and technician perceptions of advanced roles of the pharmacy technician in POCT service delivery. Practice description: Certified pharmacy technicians (CPhTs) across six regional divisions of a large community chain pharmacy in Tennessee and Ohio participated in a standardized training program prior to implementation of technician-supported POCT. Practice innovation: Standardized training consisted of pre-training assessments, online training modules, post-training assessments, followed by in-person skills-based assessments. CPhT participation was limited to technical tasks of POCT (e.g. sample collections, quality assurance). Evaluation methods: The study addressed its primary objective by comparing total number of health screenings for included pharmacies in 2019 as compared to 2020. Descriptive and inferential statistics were used. Perceptions were assessed using an electronic, Likert-type scale questionnaire. Results: Pharmacies with technician-supported POCT showed a 46% increase in the total number of health screenings performed vs. 2019. The survey found that 74% (106/144) of pharmacists and 83% (34/41) of CPhTs agreed or strongly agreed that technician-supported POCT is acceptable for their practice site. Most pharmacy personnel agreed or strongly agreed that the service was appropriate and feasible for their respective practice sites. Conclusion: This study provided supporting evidence that technician-supported POCT may positively impact the number of health screenings conducted in a community pharmacy setting. Standardization of training may allow for expansion of this service across additional states. Furthermore, pharmacy personnel perceptions were overall positive.