The Development and Evaluation of the Interprofessional Education Facilitation Program for Health Professionals Using the Attention, Relevance, Confidence, and Satisfaction (ARCS) Model of Instructional Design.

Background It is important to learn interprofessional education (IPE) facilitation skills to promote interprofessional collaboration in healthcare. Nonetheless, to date, only a handful of IPE facilitation programs have been developed through research. Objective The objective of this study was to create an IPE facilitation program for healthcare professionals who wanted to promote interprofessional collaboration in their organizations based on the tenets of instructional design and evaluate its effectiveness. Methods This study's methodology was a mixed method based on relative subjectivism. We developed a two-day IPE facilitation program to learn IPE facilitation skills and promote interprofessional collaboration in the participants' own organizations. The program was developed based on the instructional design principles of the attention, relevance, confidence, and satisfaction (ARCS) model, measuring the participants' Interprofessional Facilitation Scale (IPFS) scores at three time points: before the first day, after the second day, and approximately one year after the course was completed. A one-way analysis of variance test was used to compare IPFS means at the three time points, and open-ended statements were qualitatively analyzed using thematic analysis. Results Twelve healthcare providers (four physicians, two pharmacists, one nurse, one rehabilitation worker, one medical social worker, one clinical psychologist, one medical secretary, and one other) participated in the completed IPE facilitation program. Their IPFS scores increased significantly from 17.4 ± 16.1 before the program to 38.1 ± 9.4 after the program and remained at 35.1 ± 11.7 for one year (p = 0.008). In addition, qualitative analysis suggested that the knowledge and skills learned in the program could be applied in the participants' workplaces, which helped them maintain their IPE facilitation skills. Conclusion We developed a two-day IPE facilitation program based on the ARCS instructional design model, and the participants' IPE facilitation skills scores increased and were maintained one year later.

[The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences].

　The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences was held at Act City Hamamatsu, Japan, with a total of 2634 participants in attendance. The theme of the meeting was realized through a number of new concepts, such as a debate symposium, information sessions, nurses' workshops, and so on. The results obtained from the participation questionnaire (n=438), which were aggregated up to 1 month following the end of this year's meeting, revealed that 89% of the participants at considered it to have been appealing. In particular, 63% of the participants favored the adoption of a debate symposium whereby it was possible to ask and respond to questions in real time. In the free comments section of the questionnaire, the participants expressed how they felt the debate symposium made it easy to give their opinions, and that this element might be further developed in the future. They also stated that they found the introduction of the Clica system effective in terms of making the annual meeting an active learning place. One issue that was highlighted concerned the observation that the hall used to host the symposium was designed as a concert venue, which meant it was highly shielded from the outside environment, in addition to access to the internet being blocked. I hope that many of the projects from this Annual Meeting will serve to guide the future style of the Society's Annual Meetings.

[Designing the Annual Meeting and Active Learning System].

　At the 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences our theme centered on active learning systems where adult learners engage on their own initiative. Many of the participants were pharmacists active in clinical practices. Regardless of their specialized skill-sets, pharmacists are constantly faced with difficult challenges in their daily work. Passive, one-way lectures are one resource for them, but unfortunately such lectures provide limited insights for resolving concrete problems. The present meeting aimed to show participants how to obtain information they need to solve specific real-world problems. This paper summarizes how we planned this year's meeting, including details about the debate symposium, social lunch, and online questionnaires. All these elements had the end goal of enabling learners proactivity to become their own best resource for learning. It is sincerely hoped that the design and execution of this meeting will prove resourceful for future annual meetings.

[The pharmacist-physician collaboration for IPW: from physician's perspective].

Interprofessional work (IPW) is increasingly important in various settings including primary care, in which the role of pharmacists is particularly important. Many studies have shown that in cases of hypertension, diabetes, dyslipidemia, and metabolic syndrome, physician-pharmacist collaboration can improve medication adherence and help to identify drug-related problems. Some surveys and qualitative studies revealed barriers and key factors for effective physician-pharmacist collaboration, including trustworthiness and role clarification. In Japan, some cases of good collaborative work between pharmacists and physicians in hospitals and primary care settings have been reported. Still, community pharmacists in particular have difficulties collaborating with primary care doctors because they have insufficient medical information about patients, they feel hesitant about contacting physicians, and they usually communicate by phone or fax rather than face to face. Essential competencies for good interprofessional collaboration have been proposed by the Canadian Interprofessional Health Collaborative (CIHC): interprofessional communication; patient/client/family/community-centered care; role clarification; team functioning; collaborative leadership; and interprofessional conflict resolution. Our interprofessional education (IPE) team regularly offers educational programs to help health professionals learn interprofessional collaboration skills. We expect many pharmacists to learn those skills and actively to facilitate interprofessional collaboration.

[The pharmacist-nurse collaboration for IPW: from nurse's perspective].

  The concept of interprofessional work (IPW) is becoming increasingly important recently and the role of nurses in IPW seems critical. In Japan, the problem of burnout and turnover of nurses has been recognized, and the solution seems embedded in the scheme of IPW, because it appears to improve their job satisfaction and recognition as health professionals. However, many obstacles lie ahead, such as "tribal conflict" between health professionals including between pharmacists and nurses. Although failure to understand the roles of other professionals or competencies may seem to hamper with the promotion of collaboration, we must realize that even a lack of understanding among nurses exists. The authors believe that the solution is to understand and respect not only other professionals but also colleagues of the same profession.

[Trial of interprofessional education for effective IPW].

  To work collaboratively in healthcare practice, health professionals should learn not only the competencies of their own specialties but also those of other professions so as to promote effective interprofessional work (IPW), thus optimizing patient/client outcomes. For this reason interprofessional education (IPE) is urgently needed. Since the establishment of Centre for the Advancement of Interprofessional Education (CAIPE) in 1987, many IPE programs have been developed and implemented worldwide. Currently, our Japan Society for Instructional Systems in Healthcare (JSISH) IPE program project team is conducting a study to develop an effective and versatile IPE program according to the framework of instructional design (ID). The main categories of learning goals of our program are intellectual skills and attitudes among Gagne's five categories. Therefore we designed our program to start from the drama (skit or video) of a bad example of IPW for learners to see and discuss the barriers of interprofessional collaboration. The drama of IPW seems to enhance attention and relevance for learners; both of which are components of the ARCS model. We expect every health professional including pharmacists to learn about IPW competencies through participating in our IPE program, enabling us further to pursue the ideal patient/client/family-centered care together.

[Elucidating obstructive factors for IPW from the pharmacist position in clinical practice].

  In Japan, many health professionals do not seem to have adequate understandings of the competencies and specialties of other professionals. The competencies of pharmacists are especially overlooked because their expected roles have been changing rapidly in recent years and may vary depending on context in various settings. Due to this lack of understanding physicians themselves often perform therapeutic drug monitoring (TDM), and pharmacists sometimes suggest unnecessary prescription proposals to physicians without considering their treatment plans. Although "community and hospital pharmacist collaboration" has been emphasized for many years, many pharmacists in both settings still do not understand one another's situation. How can we make pharmacists' competencies appropriately understood and respected by other health professionals? What should we do to promote interprofessional work (IPW) with more incorporation of pharmacists so as to pursue patient/client/family-centered care? The key to success in IPW seems to lie in the answers to these questions.

[Education of pharmacists to enable a connection between physicians and persons unaware of their mental illness].

  Pharmacists work in places where they often get in contact with people who may have trouble with their illness, patients and patients' family with prescription, and customers who purchase over-the-counter (OTC) drugs and/or daily goods. Pharmacists can also identify excessive or unsuitable use of OTC drugs resulting from a psychiatric disorder. Moreover, they are in a position in which they can also find the normal-dose addictions and fatigued patient's family resulting from their daily patient's care. Since the consultation to a pharmacist is free of charge, many people often go to the pharmacist to talk about their health concerns. If pharmacists can get in contact with persons who are not aware of their mental illness and send them to the primary care physician, the pharmacists may contribute to prevent suicide and find the unrecognized psychiatric disorder. However, since pharmacists have little knowledge regarding to the psychiatric disorder, they cannot actively contact with this type of people. This article will argue about the methodology and education for pharmacists to connect undiagnosed patients to the appropriate medical care. It is proposed that the pharmacists should encourage the undiagnosed psychiatric patients to contact with the primary care physician. In addition, pharmacists should recommend the change of prescription to the medical doctors who examine the patients expected the addiction to the prescribed drug.

[Moral dilemmas of the pharmacist--ways of coping with ethical problems in light of case studies].

Pharmacological education in Japan has focused less on the cultivation of medical care providers than on fostering personnel who could develop and manufacture medical products. Pharmacists who passed the national board were able to take part in providing medical treatment even if they lacked the knowledge or capabilities required in a clinical setting. Given both this educational background and the systematic problem that there was no division of labor in the pharmacological field, and given that they operated in a work environment where there was almost no opportunity for direct contact with patients, pharmacists for many years lacked self-awareness as persons who handle medical products that can affect human lives, and failed to take full account of their role as administrators of these products. However, there has been a significant change in the role of pharmacists and in the environment in which they operate since the pharmacist discipline was first established. Whereas in the past the job of pharmacists was simply to deal with the materials of medical products, the job has changed to involve dealing directly with patients. Currently, most pharmacists are engaged in work that provides direct support to people. Ethical behavior is demanded in clinical situations that involve people's interaction with one another. The need is urgent, therefore, for us to apply an understanding of ethical theory and conduct systematic case method-based ethical education to cultivate an ethical outlook among pharmacological students and pharmacists.