Identifying barriers, facilitators and behaviour change techniques to the adoption of the full scope of pharmacy practice among pharmacy professionals: Using the Theoretical Domains Framework.

BACKGROUND: As pharmacy evolves, pharmacy professionals continue to struggle to practice to their full scope. A theoretically-informed intervention to change practice can support pharmacy professionals in providing full scope services. The Theoretical Domains Framework (TDF) can inform the design of a behaviour change intervention to improve the uptake of full scope services among pharmacy professionals. OBJECTIVES: This study aimed to: (1) identify barriers and facilitators influencing the adoption of full scope services among pharmacy professionals, and (2) identify optimal behaviour change techniques (BCTs) to address the identified barriers and facilitators. METHODS: A three-step, mixed method study was conducted. First, a 24-item TDF-based survey was sent via email to users of a national computer-based educational platform (n = 2696). Second, TDF-based interviews were conducted with a convenient sample of survey respondents and analyzed using the framework method. Finally, validated linkages were used to link BCTs with corresponding barriers and facilitators, then interview data were analyzed using a deductive approach to guide the selection of the BCTs. RESULTS: A total of 225 participants completed the survey and 24 telephone interviews were conducted (17 pharmacists, 7 pharmacy technicians). A number of key barriers were identified on an individual level (e.g., lack of clear professional identity and limited decision-making skills in ambiguous cases) and on an organizational level (e.g., lack of social support from managers and concerns about making more errors with the current workflow). Mapping the barriers and facilitators to BCTs yielded 18 BCTs to support the adoption of full scope services, including modeling, rehearsal/practice, and social support. CONCLUSIONS: This study highlighted several barriers that need to be addressed to facilitate pharmacy professionals working to their full scope, including professional collaboration, professional identity, and adequate training. A comprehensive intervention combining skills training with modeling, social support, and decision-making tools could encourage practice change.

Effects of computer-based education on health professionals' knowledge, skills, and behavior: A scoping review.

BACKGROUND: Computer-based platforms are rapidly growing as a promising way to deliver education to health professionals (HPs). However, evidence to support the use of computer-based education to change professional behavior and clinical practice and to guide the selection of design features of computer-based educational platforms is lacking in the existing literature. OBJECTIVES: To address the current gaps in knowledge, a scoping review approach was used to explore the effects of computer-based education on HP knowledge, skills, and behavior as the primary objective. A secondary aim was to determine the design features of computer-based educational platforms that enhanced user satisfaction. METHODS: The scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were first identified through searches in 7 scientific databases. Studies were then selected through independent screening by 2 reviewers. Finally, the data of selected studies were extracted and charted using Excel (Microsoft Corporation). RESULTS: Seventeen studies were selected for inclusion. The included studies were conducted on a wide range of HPs and used computer-based educational platforms with varying features, duration, clinical content, and offerings of accreditation. All studies reported at least 1 of the following outcomes: HPs' acceptance, attitude, and satisfaction; knowledge and skills; and behavior; however, none of the studies evaluated the degrees of change in patient outcomes. Only 2 studies used theoretical frameworks to develop their platform, with mixed impact on effectiveness and consistent effect on satisfaction. In addition, the platforms employed newer features such as tailored feedback and instant messaging. CONCLUSION: Computer-based education can enhance HP knowledge, skills, and behavior. Future studies should explicitly outline the features that further improve learning outcomes and construct their interventions around well-grounded theory to improve the effectiveness of computer-based education on changing HP behavior.