Abstract Background While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic–androgenic steroid (AAS) consumers. Objective This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist’s regarding AAS harm reduction. Methods Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. Results While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. Conclusions Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.

Abstract Background While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. Objective This study aims to understand the attitudes and experiences of AAS users in relation to community pharmacies, with the goal of identifying opportunities for harm reduction interventions and creating safer-use environments. Methods Semi-structured interviews were conducted with eight AAS consumers living in Australia between December 2022 and April 2023. Interview data were analysed using reflexive thematic analysis. Results Participants discussed accessing AAS equipment and overcoming challenges, such as limited access in rural areas. They highlighted the disparity between the availability and accessibility of equipment from pharmacies and needle and syringe programs. Participants expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with users of AAS. Overall consumers supported the idea of AAS safe-injecting kits being available in pharmacies and they were receptive to pharmacies as potential sources of information and support. Conclusions The findings suggest that community pharmacies can further contribute to promoting safer AAS use and providing support for consumers. However, further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.

Introduction: Pharmacy students must achieve learning in the affective domain to attain the professional values that underpin patient-centred practice and self-directed, lifelong learning. An array of learning and teaching activities, including gaming and simulation, are used to achieve affective learning. The aim of this research was to evaluate affective learning in participants of an extended, immersive, gamified pharmacy simulation. Methods: Student teams managed simulated pharmacies, assuming the role of autonomous pharmacists to complete regular, scaffolded, pharmacy-related tasks and safely provide medicines and counselling. The 3-week gamified simulation was designed to develop teamwork and collaborative skills, while enhancing students’ professional identity, confidence and competencies. Affective learning was assessed via analysis of student reflective journals. Final-year pharmacy students completed debriefing and reflection at specific timepoints during participation in the 3-week gamified simulation. The validated Griffith University Affective Learning Scale (GUALS) was used by trained external assessors to evaluate the highest levels of affective learning detected in student reflective journals. Quantitative analysis of GUALS scores was conducted using SPSS 25. Means were computed per student for each week, regardless of journalling frequency, and changes over time compared. Results: From 2016 to 2018, 123 students participated in the simulation, generating 734 reflective journal entries for analysis. Overall, affective learning was evident, and its level increased over the course of the simulation. This was primarily associated with the improvements of female students. Conclusion: An extended, immersive, gamified pharmacy simulation induced and enhanced affective learning in final-year pharmacy students.

INTRODUCTION:Competency-based pharmacist education develops robust professional identities and prepares graduates for future practice to ensure optimal patient outcomes. An extended gamified simulation was developed as a capstone activity for a new Australian Bachelor of Pharmacy (BPharm) program. The simulation was designed to consolidate students' knowledge, skills, and behaviors from prior learning. This research aimed to explore whether participation in an extended gamified simulation could influence pharmacy students' perceptions of their professional competencies.METHODS:Data were collected over three years to compare a superseded Master of Pharmacy (MPharm) program with an incoming BPharm program. Final year students were invited to self-assess their professional competencies at the start and end of their final semester of study, using a digital self-assessment tool which replicated Australia's National Competency Standards Framework for Pharmacists. Participants rated their own competency against the 26 competency standards across five domains on a five-point Likert scale (not at all competent to very competent). This provided pre- and post-data to compare the simulation (BPharm intervention) and a traditional semester (MPharm comparison), in addition to final course grades.RESULTS:From 2016 to 2019, 85 (90.4%) of 94 intervention and 50 (83.3%) of 60 comparison students completed the self-assessment of professional competencies. Participation in the gamified simulation significantly improved students' pharmacotherapeutics grades and pre-post change scores for seven of the 26 competency standards, two of the five domains, and all domains combined of the National Competency Standards.CONCLUSIONS:An extended, gamified simulation enhances the development of pharmacy students' self-assessed professional competencies.

OBJECTIVES:Gamification involves applying game attributes to non-game contexts and its educational use is increasing. It is essential to review the outcomes and the efficacy of gamification to identify evidence to support its use in pharmacy education.THIS ARTICLE:systematically and quantitatively reviews and evaluates the alignment of learning outcomes and the quality of peer-reviewed literature reporting gamification in pharmacy education.KEY FINDINGS:A literature search was undertaken in February 2022 using CINAHL Complete, MEDLINE, Science Direct, Scopus and ERIC databases, via keywords (game* OR gaming OR gamif*) AND pharmac* AND education. Google Scholar was searched using 'gamification of pharmacy education' and 'serious games in pharmacy education'. Data extracted included type of gamified intervention, mode of delivery, game fidelity, intended learning outcomes and outcomes reported. Quality assessments aligned with key aspects of the SQUIRE-EDU Reporting Guidelines. Of 759 abstracts and 95 full-text papers assessed, 66 articles met the inclusion criteria. They described gamification from 12 countries in the education of 8272 pharmacy and health professional students. Gamified interventions ranged from board games to immersive simulations, with escape rooms most frequently reported. Reporting quality was inconsistent, with observed misalignment between intended learning outcomes and outcomes reported, an apparent overreliance on student perceptions as primary data and a lack of reference to reporting guidelines.SUMMARY:Gamification is included in the curricula of many pharmacy degrees, across multiple subject areas. This review identified evidence gaps and reinforces the need for improved quality of gamification research, critical alignment of learning outcomes with evaluation, and use of reporting guidelines.

Background:Pharmacists in many countries have long been involved in some aspect of assisted dying. Since 2016, when Canada enacted legislation permitting medical assistance in dying (MAiD), the number of patients seeking the procedure has increased yearly. Despite the global nature of pharmacists' involvement, little is known about how they experience MAiD practice.Objective:To study how pharmacists experience the practice of caring for patients who seek MAiD.Methods:This qualitative study used semistructured interviews with pharmacists who had cared for patients seeking MAiD. Interviews, conducted between June 2019 and October 2020, were audio-recorded and transcribed verbatim. Data were examined using a modified framework analysis approach. Data were coded and sorted using Quirkos and Microsoft Excel software. Themes were defined through an iterative process involving constant comparison.Results:Nineteen hospital pharmacists representing a range of practice settings in Alberta participated in the study. The experience of caring for patients seeking assistance in dying brought to light 3 themes: finding a place in the process, serving in a caring role, and bearing emotional burdens. Pharmacists' experiences were personal, relational, emotional, and dynamic.Conclusions:Each of the pharmacists experienced MAiD practice in a unique way. Although their roles in MAiD were primarily medication-focused, their experiences highlighted the centrality of patient choices, autonomy, and needs. The results of this study will inform pharmacists (including those not yet engaged in MAiD practice) about the role, and will also be valuable for pharmacy organizations and educators seeking to support pharmacists and the profession, as well as policy-makers seeking to expand pharmacists' roles in MAiD.

OBJECTIVES:To determine the effectiveness of databases in a pharmacy education literature search.METHODS:Six databases (CINAHL, ERIC, Google Scholar, Ovid MEDLINE, Science Direct and Scopus) were compared for effectiveness in identifying pharmacy education literature. Articles were coded for database of retrieval and results cross-referenced. Sensitivity, precision and number of unique retrievals were calculated.KEY FINDINGS:Scopus yielded the highest sensitivity (65%) and precision (47%). The combination of three databases (Scopus, Science Direct and Google Scholar) identified 97% (n = 64) of 66 relevant articles.CONCLUSIONS:Pharmacy education literature searches require more than one database, ideally Scopus, Science Direct and Google Scholar.

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.

So what? What is the point of your research? Why did you undertake your research? What was the need? Where was the gap? What do your results mean? What do they mean for patients? What do they mean for the pharmacy profession? What do they mean for the wider healthcare industry? While research authors aspire to, and often address, some or all of these questions in their manuscripts, when it comes to disseminating research, it is also important to consider the ‘so what’ of publishing. A bad answer to a good question is unhelpful, potentially harmful and a waste of time and resources.[1] Researchers have an ethical responsibility to their participants, funders, employers and readers to consistently and rigorously report their research. Good reporting maximises the utility of findings and avoids unnecessary duplication of research due to incomplete reporting. So, what is important to journals and their readers? Great research is underpinned by a great research question and appropriate methodology, while a great publication is underpinned by adherence to reporting guidelines.

Introduction: Peripheral venous catheters (PVCs) are used to administer antimicrobials, but many fail prior to completion of therapy. While some antimicrobials are known to increase the PVC failure rate, risk profiles for many are unclear. Objective: To synthesize data from prospective PVC studies conducted between 2013 and 2019 to determine associations between common antimicrobials and PVC failure. Methods: A secondary analysis was undertaken of seven randomized controlled trials and two prospective cohort studies from three quaternary hospitals (two adult and one paediatric) in Australia between 2013 and 2019. The primary outcome was PVC failure due to vessel injury (occlusion, infiltration or extravasation) or irritation (pain or phlebitis). Associations between antimicrobial use and PVC failure were explored using multi-variable Cox regression. Results: In total, 5252 PVCs (4478 patients) were analysed; vessel injury and irritations occurred in 19% and 11% of all PVCs, respectively. Vessel injury was significantly associated with cefepime hydrochloride [hazard ratio (HR) 2.50; 95% confidence interval (CI) 1.44-4.34], ceftazidime pentahydrate (HR 1.91, 95% CI 1.11-3.31), flucloxacillin sodium (HR 1.84, 95% CI 1.45-2.33), lincomycin hydrochloride (HR 1.67, 95% CI 1.10-2.52) and vancomycin hydrochloride (HR 1.73, 95% CI 1.25-2.40). Irritation was significantly associated with flucloxacillin sodium (HR 2.58, 95% CI 1.96-3.40). Conclusions: This study identified several antimicrobials associated with increased PVC failure, including some that were already known to be associated and some that had not been identified previously. Research is needed urgently to determine superior modes of delivery (e.g. dilution, infusion time, device type) that may prevent PVC failure. (c) 2022 The Authors. Published by Elsevier Ltd.

Introduction: A gamified simulation was integrated as a capstone event for a new Australian undergraduate pharmacy programme. It aimed to consolidate previous learning and deliver an authentic activity aligned with self-determination theory to develop students’ professional identity and enhance their competence, confidence, and collaborative skills. Description: A full-environment immersive simulation was constructed in which teams of final-year pharmacy students competitively managed their own virtual pharmacies over an extended period. Gamification of the simulation aimed to enhance student motivation and engagement while recognising the consequences of clinical and professional decision-making. Evaluation: Four years of gamified simulation encouraged outstanding student attendance and engagement. The quantitative evaluation revealed high student satisfaction (mean 4.7 out of 5) of the host courses, while the qualitative evaluation revealed that intended outcomes were met through the delivery of authentic, consolidated learning and enhancement of student confidence and professional identity. Conclusion: An extended, gamified simulation may provide a transformative learning event.

In the past year, we have all witnessed epistemic trespassing: the politician, celebrity, friend or relation with no scientific or health background that through arrogance, ignorance or naivety believes that their (often misguided) beliefs on COVID19, its treatment or prevention are correct. We have also witnessed the damage that ignoring the experts, acting on incorrect advice or passing it on have caused. Yet some pharmacy researchers may, either unwittingly or deliberately, be guilty of epistemic trespass. Evidence-based medicine is a cornerstone of pharmacy education; another is patient-centred care. Evidence-based medicine is grounded in the scientific approach including reproducibility, consistency and statistical analysis. The approach is positivist, about who, how many, how much, how often and when. We do power calculations, identify potential participants and randomise with the aim of obtaining an unbiased, representative sample that is likely to detect a significant outcome, intervene according to algorithms and set schedules, adhering...

BACKGROUND:Worldwide, pharmacy practice is changing to include new roles and responsibilities. Laws enabling the implementation of assisted dying are expanding in international jurisdictions. Pharmacy practice in assisted dying is subsequently expanding. However, studies of how pharmacists experience their practice when engaged in assisted dying are absent. To progress research into the lived experiences of pharmacists practicing in assisted dying, the development of an inquiry framework to guide such research is the first step.OBJECTIVE:The objective was to develop a theoretical framework of inquiry for use in subsequent continuing research which may explore the actual experience of pharmacy practice in assisted dying.METHODS:Perspectives were gathered from expert and senior pharmacists who were anticipating the imminent implementation of assisted dying practice. Analysis focused on understanding what aspects of practice experience were important to them. Interview-conversations centred on the question: If you had the chance to talk to experienced pharmacist practitioners who have been involved in the practice of assisted dying, what aspects regarding their experiences, would you like to know about? A conventional approach to qualitative content analysis was utilized to analyze the data.RESULTS:Findings summarized questions posed by pharmacists contemplating the implementation of assisted dying practice. These perspectives formed the foundation of a theoretical inquiry framework constituted by 8 inter-related dimensional range-continuums. Each range-continuum, designed to explore the lived experiences of pharmacists in practice, is defined. Examples of how the inquiry dimensions will be used to inform future exploratory research are offered within the framework.CONCLUSIONS:The theoretical inquiry framework will be used to develop knowledge for pharmacists contemplating participation (or not) in assisted dying practice. It is timely to progress research that reveals the informed experiences of pharmacists that are actually practicing in this area. The framework may be adapted for researching pharmacists' experience in other practice areas and contexts.

BACKGROUND:The COVID-19 pandemic has caused changes that disrupted the status quo of society. As a result, the level of conflict in community pharmacy has increased significantly. With existing conflict research more focused on the management of conflict, it is important to direct attention towards understanding the nature of conflict. This understanding will allow for informed resources to be developed to guide practice, decreasing the occurrence of and negative effects of conflict.OBJECTIVE:This research explored experiences of pharmacists working in community pharmacies, to identify the occurrence and nature of conflicts which may have been motivated by changes resulting directly or indirectly from the COVID-19 pandemic, to provide directions for future research into the nature of conflict.METHOD:Person-to-person semi-structured telephone interviews were conducted. Transcripts were analysed using inductive reasoning to identify themes.RESULTS:Thirteen pharmacists agreed to participate in this study and 9 were interviewed. Analysis revealed 7 themes that described the causes, contributors, management, outcome, and essence of experienced conflict. A model that incorporated existing theory and themes derived from this study was developed to facilitate understanding of the nature of conflict in community pharmacy during the COVID-19 pandemic.CONCLUSION:Conflict in community pharmacy settings follows a defined model with multiple interrelated themes. Guidance from this model may assist pharmacists in reducing occurrences of dysfunctional conflicts during their practice.

Background: The COVID-19 pandemic required pharmacy educators to seek creative and innovative ways of delivering learning outcomes in the virtual environment. Objective Structured Clinical Examinations (OSCEs) have been particularly challenging to deliver online.Objective: To explore the use of asynchronous video interview software as a platform for virtual OSCEs in pharmacy education, and for conducting brief structured research interviews.Method: Fourth year Bachelor of Pharmacy students at an Australian university, were interviewed via asynchronous video interview software (Big Interview) about their perceptions of using the platform for virtual OSCEs.Results: 37 students (92.5%) used Big Interview to complete at least one summative OSCE case during a team-based simulation. Seven research interviews were recorded by six students. Positive comments focussed on facilitation of self-reflection and self-correction in patient questioning and counselling. Negative views concerned the lack of authenticity, including the robotic and artificial nature of interactions.Conclusion: Asynchronous video interview software for pharmacy OSCEs may assist formative learning and self-reflection, offering an adjunct to, but not replacement of, in-person communication

Experiential learning is an important component of pharmacist education and is primarily achieved through supervised placement or simulation. This study explored senior pharmacy students' experiential learning in an extended, immersive, gamified simulation, conducted as a capstone learning activity toward the end of their final year of study, consolidating all prior learning and preparing students for intern practice. The simulation aimed to enhance student confidence, competence and collaboration. The three-week activity involved student teams competitively managing simulated pharmacies, assuming the role of pharmacists to complete all scaffolded assessments, including dispensing prescriptions, clinical cases, verbal counselling, simulated patient cases, interprofessional collaboration, and assignments. Assessments were marked continuously, with consequences of practice acknowledged through gain or loss of 'patients' for the pharmacy. From 2016 to 2018, 123 students completed multiple individual reflective journals (n = 733). Reflective journals were analyzed to explore the student experience, using a mixed methods approach. Initial Leximancer® 4.51 semantic analysis guided thematic analysis, conducted in NVivo® 12. The major themes that emerged were teamwork, patient-centeredness, medicines provision, future practice, and the learning experience. Student participants reported an intense and emotional experience in the gamified simulation, with many students revealing transformation in their skills, behaviors and attitudes over its duration.