A grounded theory approach to exploring the experiences of community pharmacists in Lebanon to a triple whammy of crises: The Lebanese financial crisis, COVID-19 pandemic, and the Beirut port explosion.

Background: Community pharmacists like other health care professionals in Lebanon have been grappling with a series of multifaceted, country-wide and ongoing challenges that have formed the impetus for this research. We aimed to explore experiences of community pharmacists in Beirut, Lebanon, during three concurrent crises in 2020: the Lebanese financial crisis, COVID-19 pandemic and the Beirut Port explosion. Methods: A qualitative approach using a constructivist grounded theory methodology was employed. Between October 2020 and February 2021, semi-structured interviews were conducted with purposefully recruited community pharmacists working in Beirut. All interviews were conducted virtually, and data collected were analysed using inductive reasoning, with open coding and concept development. Results: Thirty-five participants (63% female, mean age 30) were interviewed online. Emergent categories and theoretical concepts included 1. painting the picture - pharmacists describing the context/setting; 2. impact of the crises - on community pharmacists, the profession, patients and the system; 3. response to the crises - of community pharmacists, the profession (+ practice), patients and the system; and 4. need for advocacy and leadership. A theory was developed about "unsustainable resilience" in the scheme of ongoing crises. Conclusions: The findings revealed a shared sense of futility and despair among pharmacists collectively as a profession, as well as a sense of unsustainable healthcare systems in Lebanon, and environments impacting on the resilience of pharmacists at an individual level. A call for action is needed for urgent sustainable structural and financial reforms, advocacy and planning for future resilient systems, as well as a resilient pharmacy profession and protection of pharmacists' wellbeing and livelihood.

An evidence-led review of the FIP global competency framework for early career pharmacists training and development.

BACKGROUND: The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) for early career pharmacists is an evidence-driven guide for pharmacist professional development. First published in 2012, the FIP GbCFv1 contains a structured assembly of competencies for pharmacists in four broad areas: pharmaceutical public health; pharmaceutical care; organisation and management; and professional/personal. FIP is committed to support the advancement of pharmacy around the world, and in light with the expansion of the type of services that pharmacists may provide to their patients and the advances in technology and therapeutics, revising and updating the GbCF is imperative. OBJECTIVE: The aim of this project was to revise and update the first published iteration of the FIP GbCFv1 (2012) to ensure currency and continued relevance. METHODS: This is a qualitative study that employed four rounds E-Delphi method. A group of international experts (n = 29) was convened to revise the GbCFv1 through an iterative approach with repeated and synchronised rounds of analysis and revision focusing on the currency of the competency areas and associated behavioural statements. The revision was conducted between January to August 2020. RESULTS: The number of behavioural statements increased from 100 to 124 behavioural statements, with 23 competency domains, but remain structured within the competency clusters. Three new competencies were added to the GbCF (emergency response, digital literacy, and interprofessional collaboration) and one competency was renamed from self-management to leadership and self-regulation. CONCLUSIONS: The process undertaken to revise the GbCFv1 are described, resulting in a valid and transnationally relevant GbCFv2. In the GbCFv2, the number of competencies and associated behavioural statements increased due to important additions including emergency response, digital literacy, interprofessional collaboration and an expansion of leadership and self-regulation. This process provides an assurance of relevancy and currency for a 'fit for purpose' early career competency development framework for global implementation.

Pharmacy-related research for health in the Arab region: An analysis informed by WHO's global strategy on research for health.

In 2012, WHO (the World Health Organisation) published a strategy on research for health based on the premise that policies and practices in support of health worldwide should be grounded in the best scientific knowledge derived from high-quality research. This strategy focuses attention on five interrelated goals: organisation, capacity, priorities, standards, and translation.1 Whilst knowledge production and publication in many Arab countries have been on the rise, the overall global share of the Arab region in health research publication is smaller than its global share of population or wealth.2 Inspired by the five WHO goals on research for health, this commentary shares factors and recommendations for consideration to enhance pharmacy-related research in the Arab region. These recommendations include establishing strategies for pharmacy-related research to address the context and local needs of the host country, creating intranational and intraregional collaborative research avenues, investing in research capacity, and fostering a culture of research in the workplace.

Developing a Global Community of Practice for Pharmacy Workforce Resilience-Meet GRiT.

Workforce resilience in pharmacy is required to ensure the practice, education, and administrative systems remain viable and sustainable over time and when facing challenges. Whether it is addressing burnout of pharmacists or students, or the structure and policies/procedures of employment and professional organizations, working to increase resilience across all individuals and sectors is essential to relieve pressure and promote better well-being, especially during the recent pandemic. The purpose of this article is to describe the development of a community of practice global group focused on development of resilience within the pharmacy workforce that is inclusive of students, pharmacy interns/preregistration and registered pharmacists. The steering group meets monthly and has representation of 24 members across eight countries. Members meet to discuss pertinent issues they are facing in practice, as well as to share and progress ideas on education, research, and practice initiatives. To date, members have collectively implemented resilience training in pharmacy education, researched burnout and resilience in both students and pharmacists, and facilitated international collaborations both within and outside core group members. Future activities will focus on strengthening the community of practice in order to harness the power of the collective.

Multidisciplinary academic perspectives during the COVID-19 pandemic.

To date, the outbreak of the novel coronavirus (COVID-19) has infected more than 5 million people and caused around 350 000 deaths globally. In most countries, the world as we knew it came to a sudden stop and this led to the biggest shift of employees to remotely conduct their work. Academic institutions were extensively affected, as teaching and assessment activities were hampered, and graduation ceremonies were cancelled. In addition, there was an imminent disruption in academic and research activities including face-to-face conferences and conventions. Among many challenges, academics had to grapple to remain engaged professionally and socially with students and colleagues. Digital technology being an integral part of life has become essential for connectivity and communication. In this commentary, multidisciplinary academics from Kuwait and Saudi Arabia share perspectives and experiences in adapting to the COVID-19 reality. From healthcare sciences to engineering, and from business to education, this paper highlights the role academics play in combating professional and social challenges during COVID-19.

Rethinking Competence: A Nexus of Educational Models in the Context of Lifelong Learning.

Competency-based education (CBE) "derives a curriculum from an analysis of a prospective or actual role in modern society and attempts to certify students' progress on the basis of demonstrated performance in some or all aspects of that role". This paper summarizes pertinent aspects of existing CBE models in health professions education; pharmacy education presented as an example. It presents a synthesis of these models to propose a new diagrammatic representation. A conceptual model for competency-based health professions education with a focus on learning and assessment is discussed. It is argued that various elements of CBE converge to holistically portray competency-based learning and assessment as essential in initial education and relevant to practitioners' continuing professional development, especially in the context and importance of pursing lifelong learning practices.

Pharmacy students' medication history taking competency: Simulation and feedback learning intervention.

INTRODUCTION: Obtaining accurate patient medication histories and performing medication reconciliation are core pharmacy practice skills that optimize patient safety at transitions of care. Competency-based learning and assessment of medication reconciliation skills are essential methods in undergraduate pharmacy education. The aim of this study was to investigate the impact of an in-classroom simulation- and feedback-driven training activity on pharmacy students' medication reconciliation skills, self-perceived confidence, and overall student satisfaction. METHODS: Over a three-day learning activity in 2016, pharmacy students from a private university in Jordan were assessed by roleplay on their ability to conduct a simulated patient medication interview, obtain the Best Possible Medication History, reconcile the history against a hospital medication chart, identify discrepancies, and document findings. Students received immediate feedback and observed peers undergo the assessment process. Pre- and post-simulation questionnaires and supplementary focus groups enabled collection of quantitative and qualitative data pertaining to student self-perceived confidence, perceptions, experiences, and usefulness of the course. RESULTS: Assessment-based competency scores demonstrated significant improvement in student performance during the activity. Self-perceived confidence scores significantly improved after the medication reconciliation training intervention. Focus group content analysis yielded positive responses such as students valuing receiving feedback on performance and recommendations for future training. CONCLUSIONS: Simulation with feedback was a useful tool to teach pharmacy students medication reconciliation in Jordan. Subsequent to the study, medication reconciliation and interactive teaching methods were added to curriculum to supplement traditional teaching modalities.

The Revised Basel Statements on the Future of Hospital Pharmacy: What Do They Mean for Saudi Arabia?

OBJECTIVES: To describe the current hospital pharmacy practice in Saudi Arabia according to the revised Basel statements. METHODS: A review of the available data based on published literature in the subject area was carried out. KEY FINDINGS: The original Basel Statements were developed at the 2008 Global Conference on the Future of Hospital Pharmacy in Basel, Switzerland. Representatives from 98 countries, including Saudi Arabia, attended this conference. The revision of the Basel statements simplified and merged many of the original Basel statements. In addition to making the Basel statements more concise, the revision added new statements to reflect global trends and the expanded responsibilities of hospital pharmacists. CONCLUSION: The release of the Basel statements represents an important opportunity to bring Saudi Arabian practices into complete concurrence with international standards and to identify areas that should be prioritized.

Identifying perceptions of academic reform in pharmacy using a four-frame organizational change model.

BACKGROUND: In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. OBJECTIVES: To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. METHODS: A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. RESULTS: Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. CONCLUSIONS: Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change.

Stakeholders' Perspectives on Quality Assurance of Pharmacy Education in the Eastern Mediterranean Region.

Objective. To explore pharmacy stakeholders' perspectives in the Eastern Mediterranean Region (EMR) on pharmacy education and quality assurance. Method. Thirty-two interviews were conducted with professionals from 15 EMR countries, exploring pharmacy education in the region. Themes were mapped to the five pillars of the International Pharmaceutical Federation's Global Framework on Quality Assurance of Pharmacy Education. Results. Nine challenges were identified across the framework on country-, institution-, and faculty-level. These challenges were political-socioeconomic instability; limited accreditation and quality assurance measures; insufficient engagement of professional organizations; disconnect between academia, practice and regulatory sectors; curricula shortcomings; skills-gaps; absence of competency frameworks; inconsistencies in pre-registration training; and professional development mechanisms. Conclusion. Vast inter-/intra-regional variability in pharmacy education and quality assurance measures was revealed. The lack of pharmacy-specific national/regional competency frameworks and quality assurance systems has implications for stakeholders in the profession. Progress in this area is crucial for pharmacy education in the EMR.

Competency-based pharmacy education in the Eastern Mediterranean Region-A scoping review.

BACKGROUND: The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) was developed as a mapping tool to provide guidance for foundation level pharmacy practice and professional development. The Eastern Mediterranean Region (EMR) with a deep rooted pharmacy history is yet to adopt an explicit competency framework. OBJECTIVE: To review the literature for evidence of competency-based pharmacy education in the EMR, including pharmacists' and pharmacy students' perceptions of knowledge and skills acquired during training at undergraduate, post-graduate, and life-long learning levels. METHODS: Six electronic databases were searched for articles published between 1990 and 2014. Titles and abstracts were screened according to the inclusion criteria. Full articles identified for inclusion were assessed and mapped to a relevant domain of the GbCF. RESULTS: Totally, 57 studies met the inclusion criteria. The majority of studies portrayed pharmacists' and pharmacy students' opinions regarding educational aspects of their experiences. Participants generally cited the need for more practice-based training, modernization of curriculum, continuing pharmacist education and greater involvement in public health promotion, and research to strengthen professional competency. Interventional studies-enhanced knowledge and skills after training was provided to pharmacists and pharmacy students. No studies pertaining to the organization and management domain of the GbCF were found. CONCLUSION: Despite paucity of studies that specifically investigated aspects of competency-based pharmacy education in the EMR, results provided impressions of what participants perceived as beneficial, or lacking in their education to attain certain competencies. Results point toward the need to implement a competency framework specific to the EMR.