The pharmacy community apgar questionnaire : a modified Delphi technique to develop a rural pharmacist recruitment and retention tool
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
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- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review
- Terry, Daniel, Peck, Blake, Hills, Danny, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
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- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
Occupational self-efficacy and psychological capital amongst nursing students : a cross sectional study understanding the malleable attributes for success
- Terry, Daniel, Peck, Blake, Smith, Andrew, Nguyen, Hoang
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Nguyen, Hoang
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 1 (Mar 2020), p. 159-172
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- Description: With a predicted shortfall in the worldwide nursing workforce, efforts to understand attributes that influence attrition and workforce longevity remain fundamental. Self-efficacy and the broader construct of psychological capital have been linked to positive workplace-based attributes in occupations. The aim of the study was to examine the relationship between general self-efficacy, occupational (nursing) self-efficacy, and psychological capital and their predictive factors among nursing students. A cross sectional design was used to address the aims of the study where all nursing students studying a three-year bachelor's degree were invited to complete a questionnaire examining traits that might assist in the preparation for, and longevity in, a nursing career. Although the participating nursing students demonstrated high levels of general self-efficacy, their reported levels of nursing-specific self-efficacy were significantly lower. Psychological capital measures indicated that students had high levels of belief, hope, and resilience concerning their capacity to commit to and achieve goals, succeed now and into the future, and overcome obstacles. The findings suggest an opportunity exists for education providers to nurture the malleable aspects of self-e fficacy and psychological capital, while developing greater capacity to bounce back and overcome the challenges that nursing students may encounter in their undergraduate academic training, and to reduce attrition as they prepare to enter the workplace.
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Nguyen, Hoang
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 1 (Mar 2020), p. 159-172
- Full Text:
- Reviewed:
- Description: With a predicted shortfall in the worldwide nursing workforce, efforts to understand attributes that influence attrition and workforce longevity remain fundamental. Self-efficacy and the broader construct of psychological capital have been linked to positive workplace-based attributes in occupations. The aim of the study was to examine the relationship between general self-efficacy, occupational (nursing) self-efficacy, and psychological capital and their predictive factors among nursing students. A cross sectional design was used to address the aims of the study where all nursing students studying a three-year bachelor's degree were invited to complete a questionnaire examining traits that might assist in the preparation for, and longevity in, a nursing career. Although the participating nursing students demonstrated high levels of general self-efficacy, their reported levels of nursing-specific self-efficacy were significantly lower. Psychological capital measures indicated that students had high levels of belief, hope, and resilience concerning their capacity to commit to and achieve goals, succeed now and into the future, and overcome obstacles. The findings suggest an opportunity exists for education providers to nurture the malleable aspects of self-e fficacy and psychological capital, while developing greater capacity to bounce back and overcome the challenges that nursing students may encounter in their undergraduate academic training, and to reduce attrition as they prepare to enter the workplace.
Traversing the funambulist's fine line between nursing and male identity : A systematic review of the factors that influence men as they seek to navigate the nursing profession
- Terry, Daniel, Peck, Blake, Carden, Clarissa, Perkins, Alicia, Smith, Andrew
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
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- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
- Full Text:
- Reviewed:
- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
Health professional students' rural placement satisfaction and rural practice intentions : a national cross-sectional survey
- Smith, Tony, Sutton, Keith, Pit, Sabrina, Muyambi, Kuda, Terry, Daniel, Farthing, Annie, Courtney, Claire, Cross, Merylin
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
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- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
- Full Text:
- Reviewed:
- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
Lived experiences and insights into the advantages important to rural recruitment and retention of general practitioners
- Terry, Daniel, Nguyen, Hoang, Schmitz, David, Baker, Ed
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
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- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
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