Totally devoted to you : a qualitative study examining the experiences of sacrifice among pharmacists in rural and regional areas
- Terry, Daniel, Peck, Blake, Phan, Hoang
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang
- Date: 2023
- Type: Text , Journal article
- Relation: Research in Social and Administrative Pharmacy Vol. 19, no. 5 (2023), p. 793-799
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- Reviewed:
- Description: Background: The health of rural and regional communities is routinely identified as poor and access to healthcare services is often limited. Rural and regional pharmacists are well placed to deliver a variety of high-quality services to their community, however there is a limited examination of the complexities of their role in rural contexts. This study seeks to examine the types of personal sacrifices and what impact these may have among pharmacists working in rural and regional communities of Australia. Method: A qualitative approach was adopted to examine the experiences of pharmacists working in public health service and private community pharmacies across 13 rural communities in Australia. Purposive sampling was used to recruit pharmacists as part of a larger study examining the efficacy of a workforce recruitment tool (PharmCAQ). As part of the development of the tool, a one-on-one interview were conducted. Results: A total of 20 participants were recruited. Two major themes emerged: Above all the community and More than just a script monkey that embodies the experiences of pharmacists. Centred around self-sacrifice, the first theme captures the tension that is experienced by these professionals as they tread an unsustainable path for the benefit of the community. The second theme provides some insights into the complex nature of the rural and regional context that is juxtaposed with that of their urban counterparts. Conclusion: Pharmacist in rural and regional areas offer a highly skilled and accessible resource to better address the growing needs of those living in rural and regional areas. Despite the opportunities that exist to expand the role of pharmacists in these areas and to capitalise on their expertise, there is a growing need to find ever better ways to support those who support others. © 2023
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang
- Date: 2023
- Type: Text , Journal article
- Relation: Research in Social and Administrative Pharmacy Vol. 19, no. 5 (2023), p. 793-799
- Full Text:
- Reviewed:
- Description: Background: The health of rural and regional communities is routinely identified as poor and access to healthcare services is often limited. Rural and regional pharmacists are well placed to deliver a variety of high-quality services to their community, however there is a limited examination of the complexities of their role in rural contexts. This study seeks to examine the types of personal sacrifices and what impact these may have among pharmacists working in rural and regional communities of Australia. Method: A qualitative approach was adopted to examine the experiences of pharmacists working in public health service and private community pharmacies across 13 rural communities in Australia. Purposive sampling was used to recruit pharmacists as part of a larger study examining the efficacy of a workforce recruitment tool (PharmCAQ). As part of the development of the tool, a one-on-one interview were conducted. Results: A total of 20 participants were recruited. Two major themes emerged: Above all the community and More than just a script monkey that embodies the experiences of pharmacists. Centred around self-sacrifice, the first theme captures the tension that is experienced by these professionals as they tread an unsustainable path for the benefit of the community. The second theme provides some insights into the complex nature of the rural and regional context that is juxtaposed with that of their urban counterparts. Conclusion: Pharmacist in rural and regional areas offer a highly skilled and accessible resource to better address the growing needs of those living in rural and regional areas. Despite the opportunities that exist to expand the role of pharmacists in these areas and to capitalise on their expertise, there is a growing need to find ever better ways to support those who support others. © 2023
Communities of practice : a systematic review and meta-synthesis of what it means and how it really works among nursing students and novices
- Terry, Daniel, Nguyen, Hoang, Peck, Blake, Smith, Andrew, Phan, Hoang
- Authors: Terry, Daniel , Nguyen, Hoang , Peck, Blake , Smith, Andrew , Phan, Hoang
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 29, no. 3-4 (2020), p. 370-380
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- Description: Aims and objectives: To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses. Background: Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work—a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice. Design: Systematic review and Meta-synthesis. Methods: MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997–2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist. Results: The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses. Discussion: We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers. Relevance to clinical practice: Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes. © 2019 John Wiley & Sons Ltd
- Authors: Terry, Daniel , Nguyen, Hoang , Peck, Blake , Smith, Andrew , Phan, Hoang
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 29, no. 3-4 (2020), p. 370-380
- Full Text:
- Reviewed:
- Description: Aims and objectives: To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses. Background: Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work—a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice. Design: Systematic review and Meta-synthesis. Methods: MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997–2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist. Results: The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses. Discussion: We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers. Relevance to clinical practice: Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes. © 2019 John Wiley & Sons Ltd
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.
Sustaining rural pharmacy workforce understanding key attributes for enhanced retention and recruitment
- 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: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
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- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
- Full Text:
- Reviewed:
- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
Understanding rural pharmacists' perspectives : lived experiences and insights associated with rural recruitment and retention
- Terry, Daniel, Peck, Blake, Phan, Hoang, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 24, no. 1 (2024), p. 8687
- Full Text:
- Description: INTRODUCTION: Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities. METHODS: The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention. RESULTS: The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns. DISCUSSION: The study provides a deeper exploration of the meaning and experiences of factors that previous research has shown are considered advantageous or challenging to the recruitment and retention of pharmacists in rural areas. Through the voices of pharmacists living and working in a rural area, the findings further enlighten our understanding regarding how the multifaceted and complex nature of health workforce planning may be addressed. As such, greater pharmacist recruitment and retention is enabled through adequate financial compensation and incentives, along with additional tax incentives for business and health services. Further, innovation is required to enhance economic sustainability. Locum coverage and intern opportunities also require innovative approaches to address concerns among potential candidates. Lastly, efforts to enable and support social connections such as schooling and spousal employment, while building community connection and a sense of rural community belonging, remain essential to recruit and retain pharmacists. CONCLUSION: Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.
- Authors: Terry, Daniel , Peck, Blake , Phan, Hoang , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Baker, Ed , Schmitz, David
- Date: 2024
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 24, no. 1 (2024), p. 8687
- Full Text:
- Description: INTRODUCTION: Pharmacists serve an important role in rural communities, and in some cases they may be the only health professional available. Their recruitment and retention is a major concern for rural communities and health services; however, a deeper understanding regarding the advantages and challenges of sustaining a rural pharmacy workforce is somewhat limited. The aim of this study was to develop a deeper understanding of pharmacists' perspectives about factors influencing pharmacist recruitment and retention to rural and remote communities. METHODS: The exploratory study, carried out in rural Tasmania and rural Western Victoria, used a qualitative descriptive design. Structured interviews, lasting between 30-60 minutes, were conducted by a single researcher using the Pharmacist Community Apgar Questionnaire via face-to-face, telephone or videoconferencing technology. Data were analysed thematically using verbatim transcription, extraction of significant statements and identification of similarities in formulated meanings, grouping the similar meanings and significant statements that pertained to the phenomena of interest. Specifically, qualitative data were used to provide a deeper understanding of factors identified as key assets, capabilities, or those most challenging for pharmacist recruitment and retention. RESULTS: The advantages and disadvantages rural communities face in recruiting and retaining pharmacists are presented. These insights are linked to the advantages of financial income, incentives and moving allowance. Further advantages include the degree of practice autonomy, breadth of tasks, the perception of the community, loyalty to the pharmacy and its pharmacists, along with community recognition. Challenges associated with the recruitment and retention of pharmacists centred on the need for spousal or partner employment opportunities, having greater proximity to schools, access to social or cultural opportunities, along with good transport connections. Further challenges included housing, the cost of schooling for children, having adequate locum or peer coverage and opportunities to host interns. DISCUSSION: The study provides a deeper exploration of the meaning and experiences of factors that previous research has shown are considered advantageous or challenging to the recruitment and retention of pharmacists in rural areas. Through the voices of pharmacists living and working in a rural area, the findings further enlighten our understanding regarding how the multifaceted and complex nature of health workforce planning may be addressed. As such, greater pharmacist recruitment and retention is enabled through adequate financial compensation and incentives, along with additional tax incentives for business and health services. Further, innovation is required to enhance economic sustainability. Locum coverage and intern opportunities also require innovative approaches to address concerns among potential candidates. Lastly, efforts to enable and support social connections such as schooling and spousal employment, while building community connection and a sense of rural community belonging, remain essential to recruit and retain pharmacists. CONCLUSION: Rural pharmacist recruitment and retention is complex, requiring a multi-pronged approach to implement practical solutions. Given this complexity and the unique features of each rural community, solutions require whole-of-community ownership to create innovative solutions. Recognition of specific advantages and challenges can address key driving factors for pharmacist recruitment and retention in rural communities.
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