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.

Previous work by the International Pharmaceutical Federation Education Initiative (FIPEd) demonstrates that even though some country-specific variations occur in pharmacy practice, there exists a set of practice-related competencies that are globally applicable. This study aimed to evaluate the transnational comparability of the Royal Pharmaceutical Society Advanced Pharmacy Framework (RPS-APF, Great Britain) and the Advanced Pharmacy Practice Framework for Australia (APPF). The objective was to obtain preliminary data on the transnational applicability of the developmental competencies contained in the two frameworks.A crossover mapping study involving 42 advanced-level pharmacists from four countries was conducted. Qualitative interview (n = 17) was also carried out to explore practitioners' perception of the frameworks.The average postregistration experience of the practitioners in the crossover study was 19 years. Directly observed within-subject agreement per advanced practice competency ranged from 45% to 86%. This agreement was significant for 87% of the competencies evaluated (k ≥ 0.21; P ≤ 0.05). The lowest agreement was in the 'governance' competency (k = 0.13; P = 0.21). Wilcoxon sum rank test showed a statistically significant within-subject difference in the 'collaborative practice' cluster (P = 0.043). This was not observed in the other five advanced practice clusters. From the qualitative interviews, practitioners generally perceived the two compared advanced-level frameworks as similar in content and indicated they found the described competencies to be useful for clarifying expectations of practice and identifying skills development needs.These findings provide preliminary evidence of the comparability and transnational applicability of the advanced pharmacy practice competencies contained in the two national competency development frameworks evaluated.

Evidence from published literature in pharmacy practice research demonstrate that the use of competency frameworks alongside standards of practice facilitate improvement in professional performance and aid expertise development. The aim of this study was to evaluate pharmacists’ perception of relevance to practice of the competencies and behaviours contained in the FIP Global Competency Framework (GbCF v1). The overall objective of the study was to assess the validity of the GbCF v1 framework in selected countries in Africa.

Background Competency frameworks that prompt personal and professional development have become an important component of lifelong learning; they are driven by healthcare professionals’ need for development and professional recognition. This study aimed to evaluate the self-assessed competencies of community pharmacist-preceptors by using Croatian Competency Framework (CCF) and to identify competencies to be improved. The secondary aim was to explore the association between community pharmacists’ characteristics (i.e. age, education etc.) and self-assessed competency performance. Methods The study subjects were community pharmacist-preceptors who provide support to and mentor student trainees enrolled in pre-registration training for pharmacy students. At the beginning of their mentorship, the pharmacist-preceptors assessed their competencies on a four-point Likert scale by using the Croatian Competency Framework (CCF), a validated tool for assessment and self-assessment of community and hospital pharmacists. Data were collected via e-mail in the period from October 2015 to April 2016. Results Of the 260 community pharmacists approached, final analysis included 223 respondents. The response rate was 85.8%. Community pharmacist-preceptors assessed themselves as the most competent in competencies pertaining to the cluster “Organization and management competencies” (M = 3.64, SD = 0.34), while they considered themselves as the least competent in the competencies pertaining to the cluster “Pharmaceutical public health competencies” (M = 2.75, SD = 0.77). Younger pharmacists with a postgraduate qualification who worked for large pharmacy chains in the capital city area and who had been in their current posts for a shorter period perceived themselves to be more competent. Conclusion This research represents the first analysis of the CCF in practice and identifies community pharmacist-preceptor competencies that require improvement. Consequently, areas for additional professional education were defined. Implementing modalities to measure and support development of preceptors’ competences is essential for improvement of student training programmes.

In November 2016, the International Pharmaceutical Federation (FIP) endeavored to create an environment to foster a shared vision to lead a transformative pharmaceutical workforce roadmap. Three milestone documents were developed and presented at the Global Conference on Pharmacy and Pharmaceutical Education. Workshops with the key themes and connecting Pharmaceutical Workforce Development Goals (PWDG) were conducted and analyzed. This Note serves to summarize the key aspects of these workshops, reporting on the innovative approaches used to generate guidance for stakeholders regarding implementation.INNOVATION:Seven workshops with a uniform structure were developed. These were designed to improve communication, harmonise outcome-generation, and allow for aggregate analysis. A team of seven conducted each workshop, each team consisted of: a Chair, a facilitator, one rapporteur, and four speakers purposively selected from FIP member organisations and other key stakeholders with expertise for sharing a variety of perspectives. Guidelines and templates were developed for all roles and each team was briefed in advance.KEY FINDINGS:Approximately 200 personnel participated in the seven workshops, with around 20 country representatives per workshop, covering all six World Health Organisation regions. Three key aspects of workforce transformation, using the PWDGs, were explored in each workshop: drivers for implementation; challenges to implementation; and ways of encouraging implementation. Drivers for implementation mentioned were enhancing collaboration and engagement. Challenges to implementation were identified as variance in terminology. Several ways of encouraging implementation were acknowledged, such as communication strategies, advocating for workforce development and sharing best practices to foster partnerships.NEXT STEPS:The unique format of the workshops, the innovative approach to include stakeholders across an array of settings and the parallel structure in all the seven workshops, aided in creating reliable findings. The achievability of the PWDGs depends on several factors. Engagement with stakeholders and engagement from and between professional associations are important factors to achieving workforce development goals.

Background: The World Health Organization (WHO) estimates that there is a global healthcare workforce shortage of 7.2 million, which is predicted to grow to 12.9 million by 2035. Globally, people are living longer with multiple co-morbidities and require increased access and use of medicines. Pharmacists are a key component of the healthcare workforce, and in many countries, pharmacists are the most accessible healthcare profession. This paper identifies key issues and current trends affecting the global pharmacy workforce, in particular workforce distribution, country economic status, capacity, and workforce gender balance.Methods: National professional pharmacy leadership bodies, together with other contacts for professional bodies, regulatory bodies, and universities, were approached to provide country-level data on pharmacy workforce. A descriptive and comparative analysis was conducted to assess each country's pharmacy workforce.Results: A total of 89 countries and territories responded to the survey. To standardise the capacity measure, an analysis of the population density of pharmacists (per 10 000 population) was performed. The sample mean was 6 pharmacists per 10 000 population (n = 80). There is considerable variation between the surveyed countries/ territories ranging from 0.02 (Somalia) to 25.07 (Malta) pharmacists per 10 000 population. African nations have significantly fewer pharmacists per capita. Pharmacist density correlates with gross national income (GNI) and health expenditure. The majority of pharmacists are employed in community settings, followed by hospital, industry-related, academia, and regulation. There is a greater proportion of females in the pharmacy workforce globally, with some WHO regions showing female representation of more than 65 % with an increasing trend trajectory.Conclusions: Pharmacy workforce capacity varies considerably between countries and regions and generally correlates with population-and country-level economic indicators. Those countries and territories with lower economic indicators tend to have fewer pharmacists and pharmacy technicians; this has implications for inequalities regarding access to medicines and medicine expertise.

Objective. To adjust and validate the Global Competency Framework (GbCF) to be relevant for Croatian community and hospital pharmacists. Methods. A descriptive study was conducted in three steps: translation, consensus development, and validation by an expert panel and public consultation. Panel members were representatives from community pharmacies, hospital pharmacies, regulatory and professional bodies, academia, and industry. Results. The adapted framework consists of 96 behavioral statements organized in four clusters: Pharmaceutical Public Health, Pharmaceutical Care, Organization and Management, and Personal and Professional Competencies. When mapped against the 100 statements listed in the GbCF, 27 matched, 39 were revised, 30 were introduced, and 24 were excluded from the original framework. Conclusions. The adaptation and validation proved that GbCF is adaptable to local needs, the Croatian Competency Framework that emerged from it being an example. Key amendments were made within Organization and Management and Pharmaceutical Care clusters, demonstrating that these issues can be country specific.

Poster presented at the 5th PCNE Working Symposium 2016: “Work in Progress – Progress in Work”, 19-20 February 2016, Hillerod, Denmark.

Across the globe, a "fit for purpose" health professional workforce is needed to meet health needs and challenges while capitalizing on existing resources and strengths of communities. However, the socio-economic impact of educating and deploying a fit for purpose health workforce can be challenging to evaluate. In this paper, we provide a brief overview of six promising strategies and interventions that provide context-relevant health professional education within the health system. The strategies focused on in the paper are:1. Distributed community-engaged learning: Education occurs in or near underserved communities using a variety of educational modalities including distance learning. Communities served provide input into and actively participate in the education process.2. Curriculum aligned with health needs: The health and social needs of targeted communities guide education, research and service programmes.3. Fit for purpose workers: Education and career tracks are designed to meet the needs of the communities served. This includes cadres such as community health workers, accelerated medically trained clinicians and extended generalists.4. Gender and social empowerment: Ensuring a diverse workforce that includes women having equal opportunity in education and are supported in their delivery of health services.5. Interprofessional training: Teaching the knowledge, skills and attitudes for working in effective teams across professions.6. South-south and north-south partnerships: Sharing of best practices and resources within and between countries.In sum, the sharing of resources, the development of a diverse and interprofessional workforce, the advancement of primary care and a strong community focus all contribute to a world where transformational education improves community health and maximizes the social and economic return on investment.

The International Pharmaceutical Federation Education Initiative (FIPEd) launched the 2013 FIPEd Global Education Report (available at: [www.fip.org/educationreports][1]) in September 2013. This is the first publication of its kind to provide a baseline on the current status and transformation of

Barriers to delivering quality pharmacy education in developing countries have been identified as limited infrastructure, access to teaching resources, academic staff development, and research capacity.1 In 2010, the International Pharmaceutical Federation (FIP) and the United Nations Educational, Scientific and Cultural Organization (UNESCO) signed an agreement to develop a FIP UNESCO-UNITWIN Global Pharmacy Education Development (GPhED) program. The GPhED network strives to raise the standard of education globally and incorporate best practices through shared resources, expertise, and experience. UNESCO and FIP consider one of the essential factors favoring development in the field of professional competence the exchange of experience and knowledge between universities and other learning institutions. Additionally, collaborative practice by university teachers, researchers, and administrators from different regions across the world could benefit the entire professional community. The aims of the FIP UNESCO-UNITWIN program are global higher education and its development, with a special interest in African nations and low-income countries, empowerment of women as pharmaceutical scientists and academics, sustainable health workforce development, academic capacity building, quality assurance, and accreditation standards, which are all compatible with the overarching aims of UNESCO.2,3 Objectives of the program include promotion of an integrated system of research, training, information, and documentation in the field of pharmacy education through “Centres of Excellence,” which will facilitate intra-regional cooperation. Sharing in all areas is the key and to this end the GPhED program is currently developing three areas of activity that focus on sharing of teaching and learning resources, pharmaceutical education expertise and experience, and research capacity. Resource sharing within the program is being facilitated through SABER (Sharing and Building Educational Resources), an online platform (www.saber.monash.edu) from which resources can be downloaded, used, and shared internationally between academic institutions to improve teaching and learning. Enhanced pharmacy education creates better pharmacists, but creating high-quality student learning resources takes time and money. Sharing educational resources makes sense so students can benefit and learn more, especially in a global profession such as pharmacy where teaching needs are often similar. Sharing and collaborating creates and strengthens partnerships based on goodwill and a shared commitment to educational excellence. The SABER platform is a place to share, discover, acquire, and re-purpose resources for pharmacy education. It also encourages the collaborative creation of new content. SABER is available to educators in pharmacy schools around the world, hosting quality-assured educational resources and providing a trustworthy source of relevant and current material. Being multi-tiered, it allows various access levels for a broad range of users. SABER’s intuitive interface allows users to quickly find existing assets, and up-to-date social-networking tools let them build peer networks to adapt resources and create new material. The site is administered by Monash University on behalf of the GPHeED network and is accessible to all for free. Under a Creative Commons license, SABER enables academics anywhere in the world to share something as simple as an image or a PowerPoint presentation, to large purpose-designed teaching programs in areas relating to pharmacy and pharmaceutical science. The success of SABER depends on academics contributing resources they have developed to share via the database. Another important component in the GPhED program is the formation of the African Centre of Excellence in Pharmacy Education. Ideally, the Centre will facilitate the sharing of ideas, skills, resources, and good practice, including staff exchange for skills and capacity building. The Centre will provide a forum for discussion and debate on trends and developments in pharmacy education, facilitated by network partners, including NGOs and professional agencies, and coordinated by the founding partners. Africa was chosen to establish the first FIP UNESCO-UNITWIN Centre of Excellence because the region is in great need of a pharmacy workforce and lacks educational resources for universities.4 A recent meeting of the 5 founding partner countries – Ghana, Namibia, Nigeria, Uganda and Zambia – was held in Lusaka, Zambia to determine the future activities of the Centre. Five domains for the Centre of Excellence were determined (communication, capability, quality, innovation, and clinical). Each founding partner agreed to take the lead in one of these domains and coordinate projects or activities within them. The founding partners developed and agreed to a communications strategy and will contribute to advocacy, local network building, and communications to ensure the wider success of the Centre of Excellence. Proposed projects of the Centre include a survey of African colleges and schools of pharmacy to establish a database of academic capacity and expertise to facilitate intra-regional sharing of expertise through a visiting academic program. Another project is the development of a “Lab-box” of basic laboratory equipment to improve students’ ability to undertake laboratory experiments to support their learning of basic science concepts. The Centre of Excellence will invite additional countries to become part of the centre to expand its activities and provide a broader base of communication and support in the region. Centre of Excellence activities will also seek to promote gender equality and empowerment for women academics and scientists in collaborative research and policy development. The GPhED hopes to foster international collaborative research by having prospective research students complete a higher degree in their home university in Africa under the guidance of a local supervisor and an experienced international researcher with expertise in the chosen research area. The hope is that the arrangement of shared supervision will enable collaboration in policy synthesis and strategic development, with a focus on international development issues and sustainable practitioner development policies. Public health or service delivery projects are favored by the African universities due to the limited laboratory facilities available, but such projects will contribute relevant health data in the country and increase the capacity for improved health programs and delivery of pharmacy services. The FIP UNESCO-UNITWIN Global Pharmacy Education Development network is in the nascent stages of development, but through the goodwill, enthusiasm, and support of academics across the globe, sharing educational resources, expertise, and experience through such networks will facilitate the provision of quality pharmacy education in developing countries.

Background and objectives Many maternal and child health related deaths in Pacific Island Countries may be prevented with readily available medicines provided by suitably trained health personnel. A systematic approach to improving essential medicines supply management competency has begun in the region with the need to develop a competency framework for primary health care personnel in the Pacific Islands identified as a priority. The aim of this research is to determine the competencies required by primary health care personnel involved in essential medicine supply managment at the primary health care level within Pacific Island Countries. Population Primary health care personnel ( nurses, midwives, health extension officers, nurse aids) working at the facility level within Pacific Island Countries. Methods Through a process of participatory action research, academics, Ministry of Health officials and health personnel, worked together to develop and validate a competency framework suitable for the region. Three cycles of participatory action research were conducted: cycle one - a draft competency framework was developed using existing frameworks, validated by workplace observation and survey; cycle two – the draft framework was presented and discussed at eight workshops to validate and finalise the framework; cycle three – the final competency framework was validated using an online survey tool. Results A validated competency framework with a high degree of relevance was generated for primary health care personnel at the facility level (Level 1). The framework contains 70 competencies, organised into four clusters, addressing supply, professional practice, public health and patient related competencies specific for the primary health care environments of Pacific Island Countries. Interpretation The four competency clusters represent a focus on the supply system, professional practice, public health and the patient. This four dimensional focus reflects the importance of addressing medication selection, procurement, distribution, use, and management for an effective medicines supply system. Conclusion Primary health care personnel including nurses and nurse aids responsible for EMSM and its supervision at the facility level, are encouraged to use this tool when considering appropriate training and when monitoring staff effectiveness in their local environments. This framework could be used as a basis to develop similar frameworks in other international environments.

While opinion leaders in developed countries are calling for curricula to prepare students for specialized areas of pharmacy,[1-4][1] developing countries are seeking patient-centered curricula and public health pharmacy to meet their changing health environments.[5][2] In addition, there may be

ABSTRACTBackgroundScarcity of health personnel with relevant competence is an impediment to achieving the UN health‐related Millennium Development Goals in many Pacific‐Island Countries (PICs). A systematic approach to improving essential medicines supply management and workforce competence has begun in the region. The development of a pharmacy competency framework has been identified as a priority.AimTo develop a validated pharmacy competency framework for PICs.MethodAcademics, Ministry of Health officials and health personnel collaborated to articulate a competency framework using participatory action research. The draft framework was revised via a process of workplace interviews and focus groups in Vanuatu and Papua New Guinea with wider regional validation undertaken using an online survey tool.ResultsA validated pharmacy competency framework was developed for PICs. 113 competencies required for delivery of pharmacy services, organised into four clusters: organisation and management (n = 24), professional/personal (n = 24), pharmaceutical public health (n = 24) and pharmaceutical care (n = 24) were identified.ConclusionThe pharmacy competency framework for PICs is service‐based and not cadre‐specific, allowing wide application to the Pacific region where a myriad of personnel provide pharmacy services. Pharmacy service personnel in PICs are encouraged to use this tool when training staff and monitoring their effectiveness in local environments.

Key messages • Access to quality medicines and competent, capable health care professionals are fundamental aspects of any health care system. Pharmaceutical human resources should ensure the uninterrupted supply of quality medicines to the population, their management, and responsible use, as vital components in improving the health of nations. • Multi-stakeholder collaboration incorporating best-available evidence is required to inform needs-based pharmaceutical human resources planning. When relevant, well-informed stakeholders partner to address workforce issues, there are greater possibilities for coordinated workforce planning and implementation. • Pharmacy workforce per capita varies considerably between countries and regions and generally correlates with country level economic development indicators. Countries and territories with lower economic indicators, such as those in Africa, tend to have relatively fewer pharmacists and pharmacy support workers. This has implications for observed inequalities in access to medicines and medicines expertise. In addition, some countries and territories have many times more pharmacies than pharmacists, which may imply a renewed need for supervision of medicines and medicines use. • Strategic frameworks and policies related to the pharmacy workforce are being successfully developed and implemented at the country level through multi-stakeholder processes involving ministries of health, health professional associations, regulators, and educators to drive and achieve both competence and practitioner excellence for care quality. • Improving workforce performance - productivity, competency and the ability to adapt to new roles - is an on-going challenge in the increasingly dynamic environment of rising health care costs, increased demand for health services, and increased burden of chronic diseases. Fuelled in part by an increased focus on patient care and inter-professional collaboration, these elements provide the opportunity for pharmacists to use their professional skills to provide safe, high quality, and cost-effective pharmaceutical services for the benefit of populations. Leadership is a key aspect in empowering pharmacy professionals to maximize these opportunities and to innovate and shape their practice. • Investment in transforming and scaling up professional education is crucial, as education provides the foundation for building a capable health care workforce. The capacity to provide pharmaceutical services in each country is dependent upon having an assured, competent workforce and an integrated academic workforce to train sufficient numbers of new pharmacists and other support staff at both foundation and advanced levels. Ongoing effort is needed to ensure capacity building of skilled medicines expertise meets the pharmaceutical health needs of populations. • A needs-based education strategy allows local systems to best assess the needs of its community and then develop (or adapt) the supporting educational system to produce a workforce relevant to these needs. National health care demands are diverse and complex, often varying widely within and between regions. Although broad and general frameworks may be beneficial at the macro level, a “one-size-fits-all” system does not offer the authenticity needed for full engagement and sustainability at the local level. • Pharmaceutical Human Resources continue to be a priority issue for FIP Education initiatives (FIPEd) to engage collaboratively with all stakeholders; we need to work together towards developing a profession that can meet present and future societal and pharmaceutical health needs around the world (www.fip.org/education).

OBJECTIVES:To measure Croatian community pharmacists' progress in competency development using the General Level Framework (GLF) as an educational tool in a longitudinal study.METHODS:Patient care competencies of 100 community pharmacists were evaluated twice, in 2009 and in 2010 in a prospective cohort study. During this 12-month period, tailored educational programs based on the GLF were organized and conducted, new services and standard operating procedures were implemented, and documentation of contributions to patient care in the pharmacist's portfolio became mandatory.RESULTS:Pharmacists' development of all GLF patient care competencies was significant with the greatest improvements seen in the following competencies: patient consultation, monitoring drug therapy, medicine information and patient education, and evaluation of outcomes.CONCLUSIONS:This study, which retested the effectiveness of an evidence-based competency framework, confirmed that GLF is a valid educational tool for pharmacist development.

Achieving adequate control of serum phosphate (P) is one of the most difficult challenges facing clinicians caring for patients with end-stage kidney disease. Despite the global acceptance of the consequences of elevated P and despite a large number of therapeutic options targeting this mineral disorder, almost no discernible progress has been made toward routinely achieving the international recommendation of a P level of < 4.6 mg/dL. More than 80% of patients on dialysis receive phosphate binders, leading to a tremendous pill burden estimated at nearly 11 pills per patient per day, and yet, the proportion of patients achieving a serum P < 5.5 mg/dL has decreased over the last decade, and nearly 80% of patients do not maintain a serum P < 5.5 mg/dL over a 6-month period. Elevations of P are a key component of what is now commonly referred to as chronic kidney disease–mineral and bone disorder (CKD-MBD), a systemic disorder affecting the skeleton and vasculature and is consistently associated with an increased risk of all-cause mortality, cardiovascular (CV) mortality, and vascular calcification. A recent analysis of the Dialysis Outcomes and Practice Patterns Study (DOPPS) demonstrated that globally, fewer than 17% of patients achieve a P < 4.6 mg/dL over a 6-month period. In this analysis, a time-averaged P between 5.5 and 6.5 mg/dL was associated with a 40% increase in CV mortality, and a time-averaged P ≥ 6.5 mg/dL was associated with a doubling of CV mortality. Effective P control requires thoughtful attention to all aspects of phosphate homeostasis, including diet, dialysis prescription, control of secondary hyperparathyroidism, and individualized prescription of medication to reduce intestinal phosphate absorption.

OBJECTIVES:To assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF).METHODS:The competencies of 100 community pharmacists working in 38 community pharmacies were evaluated using an adapted version of the GLF.RESULTS:Pharmacists demonstrated the best performance in the competency areas drug specific issues and provision of drug products; the poorest performance was in the competency areas evaluation of outcomes and monitoring drug therapy. Pharmacists' behavior varied the most in the following areas: ensuring that the prescription is legal, prioritization of medication management problems, and identification of drug-drug interactions.CONCLUSIONS:Competencies were identified that need to be developed to improve pharmacist interventions in community settings. This study provides the first data on pharmacists' performance in Croatia and serves as a starting point for future studies and actions.

The Pharmacy Education Action Plan of the World Health Organization (WHO) United National Educational, Scientific and Cultural Organization (UNESCO) International Pharmaceutical Federation (FIP) is oriented towards identifying locally determined needs and pharmaceutical services and using those to