Pharmacy education and workforce: strategic recommendations based on expert consensus in Lebanon

Pharmacy students' initial career choices versus subsequent career paths: a cross-sectional study

BACKGROUND

The pharmacy profession offers diverse career paths. Yet, pharmacy students may not be familiar with these various paths and may struggle to choose one that is best suited to their interests, goals, and values. Limited literature has reported on pharmacy students' career interests. However, no studies have evaluated pharmacy graduates' eventual career paths as compared to their initial choices when they were students. Therefore, the primary objective of this study was to compare pharmacy students' initial career choices to their subsequent career paths.

METHODS

This was a descriptive cross-sectional study that analyzed data on pharmacy students' initial career choices when they were enrolled in a career opportunities course and their subsequent career paths following graduation. Data on the initial career choices of students were retrospectively collected from the records of a career opportunities elective course between the academic years 2012 and 2019. Based on previous employment surveys, data on the subsequent graduates' career paths and graduate and postgraduate education were retrieved from the school records. Subsequent graduates' career paths were then compared to their individual students' initial career choices. The paths of graduates with a Doctor of Pharmacy (PharmD) versus Bachelor of Science in Pharmacy (BS Pharm) only holders were analyzed.

RESULTS

The overall subsequent career paths of graduates matched the initial students' career choices in 30.8% of cases. While the top initial students' career choices were community pharmacy (36.1%), clinical pharmacy (31.4%), and pharmaceutical industry (12.9%), the top subsequent graduates' career paths were however the pharmaceutical industry (30.7%), community pharmacy (17.9%), and clinical pharmacy (7.9%). Work in the pharmaceutical industry and community pharmacy and the pursuit of masters and/or PhD were mostly followed by BS Pharm graduates, whereas PharmD holders predominantly pursued clinical pharmacy.

CONCLUSIONS

Pharmacy graduates' career paths infrequently matched their initial career choices as students. Pharmacy curricula should prepare students for diverse career paths.

Considerations for conducting a scoping review in pharmacy education

Interrogating the literature is among the first steps a researcher undertakes when actuating a research project or also when any scholar might seek to know what has been done in an area, best practices for conducting a certain activity, or simply to seek answers for a question ranging from one's own personal curiosity to those that might affect departmental or institutional guidance. Decisions on the type of review process to undertake is one that is not taken lightly. This methods commentary outlines the reasons for conducting a scoping review versus a systematic review for topics related to pharmacy education. Considerations for conducting the scoping review are outlined including considerations for writing a protocol prior to conducting a scoping review, to potential platforms to use for transparency of sharing data, processes related to guidelines for data extraction and types of search strategies utilized.

Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia

Background

Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available.

Objective

This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates.

Methods

Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant.

Results

Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p < 0.001) and ciprofloxacin (from 41% to 90%; p < 0.001) increased significantly between 2017 and 2021.

Conclusion

Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance.

What this study adds

This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues.

The specialized competency framework for industry pharmacists (SCF-IP): validation and pilot assessment

OBJECTIVES

This study aimed to validate a specialized competency framework for industry pharmacists and assess correlates related to the competency domains in a pilot sample.

METHODS

A team of experts assessed the old framework and improved its content validity after a thorough literature review, using the Delphi technique. Domains and their respective competencies and behaviors were re-defined in the framework. Afterward, a web-based cross-sectional study was carried out between March and October 2022, enrolling a convenient sample of ten industry pharmacists who worked in Lebanese pharmaceutical plants. Participants were contacted through the Syndicate of the Pharmaceutical Industries in Lebanon.

RESULTS

The specialized competency framework for Lebanese industry pharmacists comprised seven domains. Behavioral items had appropriate loading on their respective factors, which could involve one, two or three competencies. Cronbach alpha values for all domains were close to one, showing appropriate reliability. Each domain was correlated with at least another one, except for domains related to pharmaceutical and industrial development and emergency preparedness, which were not correlated with other domains. The lowest confidence was found in the research and development domain, particularly among participants with only a PharmD.

CONCLUSIONS

This study validated the specialized competency framework for Lebanese industry pharmacists. Some domains, specifically those related to industrial development and emergency preparedness, were found to diverge from others. Therefore, it would be recommended to include additional education in the emergency preparedness, research and development fields and to integrate industry-specific skills, courses, and training programs into academic curricula. Furthermore, specialized postgraduate degrees may be necessary to produce practice-ready pharmacists to operate effectively in this vital setting.

Competence development as a means of HR management in the field of social work

Professional competences in social services are becoming the subject of interdisciplinary cooperation and require a multidisciplinary approach. The research aimed to identify which professional competences are required by social service managers, to determine which variables influence the expansion of social work competences and to categorize the professional competences. Expansion of social work competences is influenced by many factors according to specific characteristics of the organization. The results were obtained through a questionnaire survey of managers (n = 247) and employees (n = 219). All organizations providing social services in the Czech Republic, according to the Register of Social Service Providers of the Ministry of the Interior of the Czech Republic, were contacted. The results were used for formulating a competency model for social services. The relationship between the selected variables and the expansion of social work competences was tested using a dependency test (χ2). The significant level of value was chosen as α = 0.05. The strength of dependence was calculated using a Cramer's V measurement within 0 ≤ V ≤ 1. The result of the measurement was to test the validity of the hypothesis (hypothesis testing), and the result of the test was related back to the theory (verification). Factor analysis enabled the relationships between the latent variables to be uncovered and allowed two groups to be formed within the professional competences. Results showed a relationship between the expansion of competences through continuing education, the evaluation of personal development and motivation plans, and the establishment of a set of professional competences for each job. The results suggest that achieving a particular competency should be part of a workforce development plan. Factor analysis revealed two groups of professional competences. The first group includes competences such as socio-legal counseling, analytical, methodological, and conceptual activities in the social field, and social counseling and social rehabilitation. The second group includes competences such as professional activities in facilities providing social prevention services, social diagnostics, and identifying the needs of the population and the region.

Validation of the specialized competency framework for pharmacists in hospital settings (SCF-PHS): a cross-sectional study

OBJECTIVES

This study aimed to validate the content of the specialized competency frameworks for pharmacists working in hospital settings (hospital and clinical pharmacists) and pilot the frameworks for practice assessment.

METHODS

This online cross-sectional study was carried out between March and October 2022 among a sample of 96 Lebanese pharmacists working in hospital settings. The frameworks were distributed to full-time hospital and clinical pharmacists, who filled them out according to their role in the hospital.

RESULTS

Overall, the competencies were distributed over five domains for hospital pharmacists (fundamental skills, safe and rational use of medicines, patient-centered care, professional skills, and preparedness for emergencies), while for clinical pharmacists, competencies were distributed over seven domains (quality improvement, clinical knowledge and skills, soft skills, ability to conduct clinical research, ability to provide effective education, use information technology to make decisions and reduce errors, and emergency preparedness). Moreover, Cronbach alpha values were appropriate, indicating sufficient to high internal consistency. Pharmacists were highly confident in most competencies, with some exceptions related to research in emergency settings (data evaluation, research, and reporting).

CONCLUSIONS

This study could validate competency frameworks for clinical and hospital pharmacists, with the competencies and their respective behaviors showing an adequate construct analysis. It also identified the domains that require further development, i.e., soft skills and research in emergency settings. Both these domains are timely and needed to overcome the current practice challenges in Lebanon.

Specialized competency framework for pharmacists in managerial positions in sales and marketing (SCF-PMSM): development, validation, and correlates

BACKGROUND

Pharmacists in sales and marketing roles need specific skills for managerial positions, and a framework for evaluating and developing these competencies is necessary. Currently, no such framework is known to exist.

OBJECTIVE

This study aimed to develop and validate a specialized competency framework for pharmacists in sales and marketing managerial positions and assess correlates related to the competency domains.

METHODS

This web-based study carried out between March and October 2022 enrolled a convenient sample of 60 pharmacists with managerial positions in sales and marketing, contacted by phone, working in the field of sales and marketing from the five governorates of Lebanon (Beirut, Beqaa, Mount Lebanon, South, and North).

RESULTS

The framework demonstrated good construct and structural validity in all domains except for emergency preparedness, which had a low correlation with other domains. Competencies were well correlated with respective domains, and behaviors had excellent loadings on corresponding competencies. As for the correlates of the competency domains, males were more confident than females (p < .05), and participants with more experience (or heavier workload) reported higher competency levels (p < .05), particularly for upper management skills, communication skills, and professional practice. Further, education level was not significantly correlated with declared competency, with experience being the most cited source of competence (68.25%), followed by postgraduate degrees (42.48%) and continuing education sessions (33.93%), while undergraduate education was the least reported (29.5%).

CONCLUSION

This study could develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists. This framework demonstrated good reliability, content, construct, and structural validity in all the domains, with the competencies being well correlated with their respective domains and behaviors having excellent loadings on related competencies, except for emergency preparedness and response. It also revealed a mismatch between what is taught at undergraduate and postgraduate levels and the needs in practice.

Burnout and coping strategies among health system pharmacists in Lebanon: a cross-sectional study

BACKGROUND

Burnout in health system pharmacists has been studied in several countries. To date, no data exists on burnout among healthsystem pharmacists in Lebanon. This study aimed to determine the prevalance of burnout, identify factors and describe coping strategies related to burnout among healthsystem pharmacists in Lebanon.

METHODS

A cross-sectional study utilizing the Maslach Burnout Inventory- Human Services Survey for Medical Personnel (MBI-HSS (MP))was conducted in Lebanon. A convenience sample of hospital pharmacists in Mount Lebanon and Beirut area filled a paper-based survey in person or via a phone interview. Burnout was defined as having an emotional exhaustion score ≥ 27 and/or depersonalization score ≥ 10. To identify factors associated with burnout, the survey also contained questions on socio-demographic characteristics, professional status, hospital characteristics, professional stressors and professional satisfaction. Participants were also asked about their coping strategies. To adjust for potential confounding, a multivariable logistic regression was used to estimate the adjusted odds ratios of factors and coping strategies associated with burnout. The authors also evaluated burnout according to the broader definition, emotional exhaustion score ≥ 27 or depersonalization score ≥ 10 or low personal accomplishment ≤ 33.

RESULTS

Of the 153 health system pharmacists who were contacted, 115 filled the survey (response rate of 75.1%). The overall burnout prevalence reported was n = 50 (43.5%) and was largely driven by high emotional exhaustion n = 41(36.9%). Following multivariate logistic regression, seven factors were associated with increased burnout: older age, B.S. in Pharmacy degree, involvement in student training, no involvement in procurement, divided attention at work, overall dissatisfaction with career, dissatisfaction to neutrality with balance between professional and personal life. Low personal accomplishment was noted in n = 55 (49.5%). The main coping strategies identified were holidays, leisure, hobbies, sports activities, and relaxation. There was no association between the coping strategies used and burnout. The prevalence of burnout according to the broader definition was n = 77 (67%). The factors associated with the broader definition of burnout were older age, overall dissatisfaction with career and dissatisfaction with work life balance.

CONCLUSION

Approximately n = 50(43.5%)of health system pharmacists in Lebanon may be at risk for burnout. If using broader definitions incorporating all three subscales of the (MBI-HSS (MP)), the prevalence of burnout was n = 77(67%). This study highlights the need to advocate for pratice reforms to improve the low personal acoomplishment and recommends strategies to mitigate burnout. Further research to assess the current prevalence of burnout and evaluate effective interventions in alleviating burnout amongst health system pharmacists is needed.

The association of management and leadership competencies with work satisfaction among pharmacists in Lebanon

BACKGROUND

Pharmacists are at the core of the healthcare system and are the most accessible healthcare professionals. Their new roles involve leadership skills, among others. Work satisfaction of pharmacists might affect the quality of the services they provide. Hence, the primary objective of this study was to evaluate the management/leadership skills and work satisfaction of pharmacists and working pharmacy students. The secondary objective was to establish the relationship between management/leadership competencies and work satisfaction.

METHODS

This cross-sectional study enrolled 415 Lebanese pharmacists and fifth-year pharmacy students (undergraduates) working in different pharmacy sectors across Lebanon from August 2021 through October 2021 using the snowball sampling technique and validated tools to assess management/leadership competencies and work satisfaction.

RESULTS

Management/leadership competencies were significantly correlated with work satisfaction (B = 0.288) and inversely associated with being engaged/married (B = - 2.825) and living outside Beirut or Mount Lebanon (B = - 1.873). Pharmacy students did not significantly differ in their leadership/management level from graduate pharmacists. Work satisfaction was significantly associated with management/leadership competencies (B = 0.062) and inversely related to education level (B = - 0.644).

CONCLUSIONS

Pharmacists' work satisfaction and management/leadership competencies are interrelated, although the level of satisfaction seemed lower than the declared level of competencies. These concepts are differentially affected by personal and work-related characteristics. More efforts should be exerted to improve both the satisfaction and management/leadership competencies of pharmacists in Lebanon.