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McMurtery RE, Palokas M. Counselor bias and contraceptive counseling for women: a scoping review protocol. JBI Evid Synth 2024; 22:925-932. [PMID: 38087992 DOI: 10.11124/jbies-23-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
OBJECTIVE The objective of this review is to identify factors, tools, and interventions related to counselor biases and contraceptive counseling in women. INTRODUCTION Contraceptive counseling is the transfer of knowledge regarding contraceptive methods to aid an individual in selecting, discontinuing, or changing contraception. The counselor should deliver information based on the patient's needs and preferences. The type and quality of the contraceptive information women are provided should not vary based on social or physical factors, such as age, race, religion, sexual orientation, education level, sexual preference, or weight; however, professional bias continues to be a concern in health care. The results of this review may further the understanding of counselor bias and contraceptive counseling. INCLUSION CRITERIA This scoping review will consider studies that include health care professionals providing contraceptive counseling to female patients in any setting or geographic location. Studies reporting on factors, tools, and interventions related to counselor bias and contraceptive counseling will be included. METHODS Databases to be searched are MEDLINE, CINAHL, Scopus, Web of Science, ScienceDirect, JBI Evidence-based Practice Database, Europe PubMed Central, and Cochrane Library. Sources of gray literature will include ProQuest Dissertations and Theses, PaperFirst, and MedNar. The review will include studies published in English from 1994 onward and follow the JBI methodology for scoping reviews. Two independent reviewers will screen the titles and abstracts, then full texts. Data from relevant studies will be extracted using a tool created by the reviewers. The results will be presented as a narrative summary and in diagrammatic or tabular format. REVIEW REGISTRATION Open Science Framework https://osf.io/judp5.
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Affiliation(s)
- Reagan E McMurtery
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michelle Palokas
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, University of Mississippi Medical Center, Jackson, MS, USA
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Gavaza P, Rawal BM, Flynn P. An exploratory qualitative study of pharmacy student perspectives of implicit bias in pharmacy practice. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:43-51. [PMID: 36907693 DOI: 10.1016/j.cptl.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/28/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Implicit biases can contribute to unfair treatment in healthcare and exacerbate healthcare disparities. Little is known about the implicit biases that exist within pharmacy practice and their behavioral manifestations. The purpose of this study was to explore pharmacy student perspectives about implicit bias in pharmacy practice. METHODS Sixty-two second-year pharmacy students attended a lecture on implicit bias in healthcare and engaged in an assignment designed to explore their thoughts about how implicit bias manifests or may manifest within pharmacy practice. Students' qualitative responses were content analyzed. RESULTS Students reported several examples in which implicit bias may emerge in pharmacy practice. Various forms of potential bias were identified including bias associated with patients' race, ethnicity, and culture, insurance/financial status, weight, age, religion, physical appearance and language, lesbian, gay, bisexual, transgender, queer/questioning and gender identity, and prescriptions filled. Students identified several potential implications of implicit bias in pharmacy practice including unwelcoming non-verbal behavior on the part of providers, differences in time devoted to interacting with patients, differences in empathy and respect, inadequate counseling, and (un)willingness to provide services. Students also identified factors that could precipitate biased behaviors such as fatigue, stress, burnout, and multiple demands. CONCLUSIONS Pharmacy students believed that implicit biases manifested in many different ways and were potentially associated with behaviors that resulted in unequal treatment in pharmacy practice. Future studies should explore the effectiveness of implicit bias trainings on reducing the behavioral implications of bias in pharmacy practice.
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Affiliation(s)
- Paul Gavaza
- Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Bhaktidevi M Rawal
- Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Patricia Flynn
- Department of Psychology, Loma Linda University School of Behavioral Health, Department of Preventive Medicine, School of Medicine, Loma Linda, CA 92350, United States.
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Nguyen W, Moles R, O'Reilly C, Robinson J, Brand-Eubanks D, Kim A, Collins JC, El-Den S. Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis. BMC MEDICAL EDUCATION 2022; 22:838. [PMID: 36471288 PMCID: PMC9720991 DOI: 10.1186/s12909-022-03920-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Mental Health First Aid (MHFA) training teaches participants how to respond to mental health crises, including suicide. Little is known about the impact of training on participants' observed MHFA behaviours. This exploratory study aimed to compare MHFA-trained Australian and US student pharmacists' performance and suicide assessment language during simulated patient role-play (SPRP) assessments. METHODS Student pharmacists (n = 265) completed MHFA training and participated (n = 81) in SPRPs with simulated patients (SP) who were people with lived experience of mental illness. Each SPRP was marked by three raters (student, tutor and SP). One-way ANOVA, chi-squared tests and independent samples t-tests were used to compare scores and pass/fail rates, where appropriate. Transcribed audio-recordings of suicide assessments underwent discourse analysis. A chi-squared test was conducted to investigate the differences in how suicide assessment language was coded across six discursive frames ('confident'/'timid', 'empathetic'/'apathetic', and 'direct'/'indirect'). RESULTS Three raters assessed 81 SPRPs, resulting in quantitative analysis of 243 rubrics. There were no significant differences between student pharmacists' mean scores and pass/fail rates across countries. Overall, both cohorts across Australia and the US performed better during the mania scenario, with a low failure rate of 13.9 and 19.0%, respectively. Most students in both countries passed their SPRP assessment; however, 27.8% did not assess for suicide or used indirect language during suicide assessment, despite completing MHFA training. Australian student pharmacists demonstrated, more direct language (76.9% versus 67.9%) and empathy (42.3% versus 32.1%) but less confidence (57.7% versus 60.7%) compared to US student pharmacists, during their suicide assessment; however, these differences were not statistically significant. CONCLUSIONS Findings indicate most MHFA-trained student pharmacists from Australia and the US can provide MHFA during SPRPs, as well as assess for suicide directly, empathetically and confidently. This exploratory study demonstrates the importance of practicing skills post-training and the need for further research exploring participants' hesitance to assess for suicide, despite training completion.
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Affiliation(s)
- William Nguyen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Rebekah Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Jennifer Robinson
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Damianne Brand-Eubanks
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Anne Kim
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
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Addressing cultural competence and bias in treating migrant workers in pharmacies: Pharmacy students learning and changing norms. Res Social Adm Pharm 2021; 18:3362-3368. [PMID: 34857481 DOI: 10.1016/j.sapharm.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Little research addressed training pharmacy students on bias towards vulnerable patients such as migrant domestic workers (MDWs). This study evaluates a module addressing bias and cultural competence when working with MDWs in community pharmacies. METHODS Two cohorts of Lebanese Bachelor of pharmacy students completed this module as part of a core Public Health class. Guided by a social psychology framework, the module involved watching a lecture, discussing an article, watching a video addressing bias in healthcare, and taking an Implicit Association Test. Second, students interviewed one MDW and one pharmacist before filling a reflection worksheet. Students' reflections were analyzed qualitatively using content analysis. Further, to evaluate the module's impact quantitatively, an aggregate perception of helpfulness scale was created and validated. Items addressed students' own experience with the module as well as its impact on pharmacists interviewed by students. RESULTS Of 170 students completing the module and providing qualitative data, 131 were asked to fill a survey addressing perceptions of assignment helpfulness. Of those 131 students, 126 filled the survey. On a scale ranging from zero to four, the composite mean score for helpfulness was 3.4, SD = 0.5. Students reported a positive impact of the interview in improving awareness of bias for pharmacists they interviewed (mean = 3.5, SD = 0.6). Qualitative analysis produced insight into students' experience with the module including challenges in communication with MDWs; MDWs' experience with bias and its repercussions; predictability, or lack thereof, of assignment results; plans to address bias after taking the module; evaluation of interviewed pharmacist's service; and perceived pharmacists' impressions of the assignment. CONCLUSIONS A two-part module shows promise in educating pharmacy students about bias and cultural competence. Engaging target audience including pharmacists can make such experiences meaningful for students while providing a learning opportunity for those health professionals.
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Okorie-Awé C, Crawford SY, Sharp LK, Jaki BU, Kachlic MD. A faculty and staff workshop on microaggression and implicit bias: Knowledge and awareness of student, faculty, and staff experiences. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1200-1209. [PMID: 34330399 DOI: 10.1016/j.cptl.2021.06.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/01/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE This paper describes the context and experiences of a workshop to raise knowledge and awareness of a college of pharmacy's faculty and staff about microaggressive behaviors and implicit biases. The workshop was intended to provide a non-threatening, interactive, and informative professional development program to demonstrate the cumulative marginalizing effects on students, faculty, and staff who may perceive themselves as targets. EDUCATIONAL ACTIVITY AND SETTING A half-day workshop was conducted during July 2018. Participants were initially provided with definitions and categories of microaggression and implicit bias. To bring the subject matter "alive" and foster receptivity, interactive videos were shown with scenarios depicting situations reflective of microaggressions and implicit biases. College faculty, staff, and students made these relatable. To foster objectivity, an outside consultant was hired to facilitate the ensuing roundtable and plenary discussions. FINDINGS Sixty-eight participants responded to a pre-survey designed by the workshop team, and 78% indicated never having attended a training/seminar on microaggression and/or implicit bias. Sixty-two individuals responded to the post-survey with 92% indicating increased knowledge gained from workshop. Anecdotal reports suggested that the workshop had an ongoing impact, as faculty and staff continued the discussions in subsequent months and requested additional training sessions. SUMMARY The workshop heightened awareness and increased faculty and staff knowledge on microaggressive behaviors, implicit biases, and the potential consequences thereof. It also demonstrated the importance of addressing conversations that are perceived as difficult, in order to create a diverse and inclusive workplace and learning environment for all.
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Affiliation(s)
- Clara Okorie-Awé
- Department of Pharmacy Systems, Outcomes and Policy, Associate Dean for Diversity and Inclusion, University of Illinois Chicago, College of Pharmacy, 833 South Wood Street, Chicago, IL 60612, United States.
| | - Stephanie Y Crawford
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Birgit U Jaki
- Institute for Tuberculosis Research (ITR), College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612; Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Marlowe Djuric Kachlic
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
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Collins JC, Chong WW, de Almeida Neto AC, Moles RJ, Schneider CR. The simulated patient method: Design and application in health services research. Res Social Adm Pharm 2021; 17:2108-2115. [PMID: 33972178 DOI: 10.1016/j.sapharm.2021.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/06/2021] [Accepted: 04/25/2021] [Indexed: 11/16/2022]
Abstract
The simulated patient method is becoming increasingly popular in health services research to observe the behaviour of healthcare practitioners in a naturalistic setting. This method involves sending a trained individual (simulated patient among other names), who is indistinguishable from a regular consumer, into a healthcare setting with a standardised scripted request. This paper provides an overview of the method, a brief history of its use in health services research, comparisons with other methods, ethical considerations, and considerations for the development of studies using the simulated patient method in health services research, with examples from pharmacy and other fields. Methods of analysis, mixed-methods, and the use of simulated patients with feedback are also discussed.
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Affiliation(s)
- Jack C Collins
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Wei Wen Chong
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Rebekah J Moles
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carl R Schneider
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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