Emergency department presentations during the COVID-19 pandemic in Queensland (to June 2021): interrupted time series analysis.

OBJECTIVES: To assess emergency department (ED) presentation numbers in Queensland during the coronavirus disease 2019 (COVID-19) pandemic to mid-2021, a period of relatively low COVID-19 case numbers. DESIGN: Interrupted time series analysis. SETTING: All 105 Queensland public hospital EDs. MAIN OUTCOME MEASURES: Numbers of ED presentations during the COVID-19 lockdown period (11 March 2020 - 30 June 2020) and the period of easing restrictions (1 July 2020 - 30 June 2021), compared with pre-pandemic period (1 January 2018 - 10 March 2020), overall (daily numbers) and by Australasian Triage Scale (ATS; daily numbers) and selected diagnostic categories (cardiac, respiratory, mental health, injury-related conditions) and conditions (stroke, sepsis) (weekly numbers). RESULTS: During the lockdown period, the mean number of ED presentations was 19.4% lower (95% confidence interval, -20.9% to -17.9%) than during the pre-pandemic period (predicted mean number: 5935; actual number: 4786 presentations). The magnitudes of the decline and the time to return to predicted levels varied by ATS category and diagnostic group; changes in presentation numbers were least marked for ATS 1 and 2 (most urgent) presentations, and for presentations with cardiac conditions or stroke. Numbers remained below predicted levels during the 12-month post-lockdown period for ATS 5 (least urgent) presentations and presentations with mental health problems, respiratory conditions, or sepsis. CONCLUSIONS: The COVID-19 pandemic and related public restrictions were associated with profound changes in health care use. Pandemic plans should include advice about continuing to seek care for serious health conditions and health emergencies, and support alternative sources of care for less urgent health care needs.

Virtualized Gamified Pharmacy Simulation during COVID-19.

Extended and immersive gamified pharmacy simulation has been demonstrated to provide transformative learning in pharmacy education, preparing graduates for real-world practice. An international consortium of universities has implemented local adaptations of the Pharmacy Game into their curricula. From early 2020, pharmacy academics modified the delivery of gamified simulation in response to the COVID-19 pandemic, while still aiming to deliver the important learning outcomes of enhanced communication, collaboration, confidence and competence. Australian universities went into full lockdown from March 2020, and the critical gamified simulation at Griffith University was delivered entirely virtually in 2020. An array of synchronous and asynchronous approaches and software platforms was employed, including Microsoft Teams, Forms and Stream plus the online interview platform Big Interview. These allowed for the simulation activities, including dispensing, counselling and clinical cases, to be conducted by students online. In 2021, Griffith University conducted hybrid delivery of its Pharmacy Game, balancing student participation both in person and online. Microsoft Power Apps was added to the hosting platform to enhance the simulation interface, and Power Virtual Agent artificial intelligence chatbots, with natural language processing, were used to enable asynchronous clinical interaction. The combination of learning technologies provided the means to deliver successful gamified simulation in the virtual and hybrid environments while still achieving outstanding learning outcomes from the capstone activity. This paper details the technologies used to virtualize the Australian Pharmacy Game and the analytics available to educators to assess student participation, engagement and performance.

Provision of externally accredited immunisation certification within an Australian Professional Pharmacy University programme: a survey of graduates on benefits and outcomes.

OBJECTIVES: In Australia, pharmacists may become authorised immunisers by obtaining additional credentialling from certified providers. Some Australian Universities are providing externally accredited immunisation training to final year pharmacy students. Student satisfaction has been demonstrated, but graduate views on benefits and outcomes are yet to be determined. The aim of this study was to evaluate graduates' perceptions of providing an accredited immunisation certification during their University pharmacy programme. METHODS: A survey was sent to Griffith University pharmacy graduates of 2016-2020 inclusive. Respondents who completed the accredited immunisation training at University were asked to rank their agreement with five statements on a five-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree). Further information, including free-text responses, was collected on current area of practice and involvement in vaccinations. KEY FINDINGS: Of the 46 graduates who completed the survey, 42 (91.3%) completed the accredited immunisation training at University. Statements that the accredited immunisation training was considered a valuable additional offering to the pharmacy programme and the time commitment was worthwhile resulted in a mean agreement of 4.74 ± 0.73 and 4.64 ± 0.76, respectively. The majority of respondents (n = 27, 58.7%) were providing immunisations on a daily, weekly or monthly basis with over half reporting becoming more actively involved in immunisation due to COVID-19. CONCLUSIONS: Pharmacy graduates valued completing an externally accredited immunisation training within their University programme and reported benefits to their employability and current roles. Incorporating externally accredited training into the curriculum can ensure graduates are prepared and skilled in continually expanding roles for pharmacists.

Learner attitudes towards a virtual microbiology simulation for pharmacy student education.

INTRODUCTION: Simulation for education has become popular, but much literature on this modality fails to critically examine the learner's experience, focusing instead on learning outcomes. Learner attitudes should be scrutinised and monitored to appraise a technology-enhanced learning experience as student perceived educational benefits of technology-enhanced learning is reported to be more important than the intrinsic characteristics of any particular medium or tool. This study sought to evaluate pharmacy students' attitudes toward a virtual microbiology simulation. METHODS: The virtual microbiology simulation (VUMIE) was compared with a traditional wet laboratory (lab) in a second-year integrated pharmacotherapeutics course for bachelor of pharmacy students. Data were collected using surveys deployed at baseline (pre-intervention), post-intervention (VUMIE or wet lab), and endpoint (post-interventions). Statistical and qualitative thematic analyses were performed. RESULTS: Learners found the simulation valuable, and outcomes suggest that it is possible for technology-enhanced learning activities to replace face-to-face instruction to some extent, which may be useful given the current challenges with in-person education resulting from COVID-19. More students reported a specific preference for the wet lab rather than VUMIE. CONCLUSIONS: Although technology-enhanced simulation can produce a similar learning experience to a traditional wet lab, this evidence is not sufficient to completely replace the traditional lab experience for clinical courses of study. Technology-enhanced simulation could be considered for just-in-time training before exposure to traditional lab activities, for specific skill acquisition using deliberate practice, and perhaps for standardised assessment for clinical microbiology education.