Developing a Global Community of Practice for Pharmacy Workforce Resilience-Meet GRiT

A realist review of programs fostering the resilience of healthcare students: What works, for whom and why?

BACKGROUND

Various programs aimed at fostering the resilience of students have been implemented into healthcare undergraduate and postgraduate educational courses and degree programs. Which of these increase their participants' resilience under which circumstances, for whom and why remains uncertain.

METHODS

A realist review of articles reporting program outcomes as measures of resilience through the use of via validated psychometric surveys was conducted to investigate which contexts favour the development of resilience of healthcare and health sciences students and which mechanisms have to be activated to achieve this outcome.

RESULTS

Thirteen Context-Mechanism-Outcome Configurations were synthesised from data presented in 43 articles. These were combined with theories explaining the theoretical and psychological frameworks underpinning programs to develop a program theory of how and why resilience fostering programs work. Contexts which favour the development of resilience were the use of validated psychological frameworks as program foundation, e.g. Cognitive Behavioural Therapy, mindfulness-based training. Expert facilitation, longitudinal integration into curricula, flexible and multi-modal design and delivery, and opportunities for students to apply and practice resilience-building strategies also created favourable contexts. Meeting students' or practitioners' needs activated mechanisms of trust, engagement and recognition of a program's value and real-world benefits. An increase in resilience was achieved by students developing reflective skills, metacognitive awareness and positive habits of mind.

CONCLUSION

The program theory established via a realist review provides guidance on how the individual resilience of healthcare students can be fostered throughout their undergraduate, postgraduate degrees and early practice, potentially supporting them to flourish and remain long-term in their chosen professional roles.

Finding significant indicators of PharmD academic performance to impact future students

OBJECTIVE

The purpose of this study is to identify which factors, both objective and subjective, from a student pharmacist's background are significantly related to academic performance in the professional PharmD program.

METHODS

Texas student pharmacists in their first three professional years during the 2022-2023 academic year were invited to participate in a 41-item survey to gather data on their undergraduate background, work experience, grit, and academic resilience. The survey responses were paired with the student pharmacist's cumulative grade point average (GPA) to assess the relationships between the variables and academic performance using Mann-Whitney U tests, Kruskal-Wallis tests, and Spearman's correlations.

RESULTS

Two hundred and fifty-one student pharmacists currently enrolled in a PharmD program in Texas responded to the survey invitation. Spearman's rho correlations showed weak positive and significant relationships between GPA and Grit scores as well as GPA and Resilience scores. Additionally, there is a moderate positive and significant relationship between student pharmacists' Grit and Resilience scores.

CONCLUSION

The results suggest that assessing for Grit or Resilience as part of the admission process could aid in identifying future student pharmacists who would experience pharmacy school academic success. Integrating tools that develop Grit and Resilience in the PharmD curriculum could improve student pharmacists' academic performance.

Resources and interventions to support psychological health and wellbeing in the pharmacy workforce: Analysis and use of a health worker 'burnout' toolkit

Background

Pharmacists have experienced declines in psychological health and wellbeing post-pandemic. The phenomena of moral distress, disengagement and burnout are associated with workforce attrition, unfitness to practice and inferior quality of patient care. A working group of the Canadian Pharmacists Association (CPhA) was formed to identify resources and interventions (R&I) for occupational psychological health and wellbeing.

Objective

To characterize R&I from an evidence-based national health worker 'burnout' Toolkit with potential to support the pharmacy workforce.

Methods

All R&I included within a draft 'burnout' Toolkit from the Canadian Health Workforce Network (CHWN) were screened to determine relevancy and usefulness for the pharmacy workforce. R&I with higher grades were data-charted to capture information on topic and content delivery. Final R&I were determined through consensus meetings where 'highly rated' R&I were discussed and selected.

Results

Of 140 original CHWN Toolkit R&I, 53 (37.8%) were of potential relevance or usefulness to improve well-being for most in the pharmacy workforce. Of those 53 R&I, 28 (20% of original) were final selections. The majority of R&I at each stage were focused on 'preventing burnout' and 'promoting mental health' (>60%) rather than 'addressing burnout', 'supporting recovery' or managing specific issues in the workplace (i.e. stigma, discrimination, bullying, hostility, workload). No R&I were specifically developed or studied within the pharmacy workforce.

Conclusions

Health professions may benefit from the CHWN Toolkit and the knowledge translation activity described here. R&I relevant and useful to the pharmacy workforce generally require adaptation for dissemination and/or implementation. The set of final R&I form the basis for orchestrated plans to support the pharmacy workforce with respect to psychological health and wellbeing. There is a relative lack of R&I devoted to addressing and recovering from burnout and workload management issues.

Resilient Coping is More Important Than Previous Virtual Learning Experience: Predicting Pharmacy Student Stress During the COVID-19 Pandemic

Purpose

The COVID-19 pandemic precipitated a swift transition to online learning in medical and health sciences. This study investigated the associations of previous experience with online learning, current confidence with online learning, and resilient coping skills with perceived stress reported by pharmacy students during the emergency transition to online learning.

Methods

Undergraduate pharmacy students (N=113, response rate = 41%) completed an online, self-report, cross-sectional survey during April-June 2020. Measures included Likert items measuring prior experience and current comfort levels with online learning, the Brief Resilient Coping Scale (BRCS), and the Perceived Stress Scale 10-Item Version (PSS-10). Experience, comfort with online learning, reported scores, and internal consistency for the BRCS and PSS-10 were summarized. A linear regression model examined the associations of prior experience with online education, gender, and resilient coping with perceived stress.

Results

Of the 113 respondents (78% female, mean age 22.3 years), > 50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3, respectively, and both scales demonstrated good internal consistency (α > 0.80). BRCS score was the single predictor of the PSS-10 score (r² = 0.18, p < 0.001). Female gender was not a significant predictor (p = 0.11). A multiple regression model explained moderate variation in perceived stress (adjusted R² = 0.19).

Conclusion

PSS-10 and BRCS scores indicated moderate levels of stress and coping skills among students during online teaching. Most students had some prior exposure to online learning, coursework, and examinations. Higher resiliency scores, but not prior online learning experience, predicted lower perceived stress.

The Resilience of Final-Year Pharmacy Students and Aspects of the Course They Found to Be Resilience-Building

Background: This work aimed to investigate final year pharmacy students’ resilience (as determined by the CD-RISC-25 tool), whether students considered certain aspects of the course to be resilience-building, and the role of the university in developing this attribute. Methods: Following ethical approval and an invitation to participate, data were collected from consenting students at Queen’s University Belfast via a pre-piloted paper-based questionnaire. Descriptive statistics were performed. To ascertain significant differences (p < 0.05) by gender, the Welch Two Sample t-test was used for the CD-RISC-25 mean scores and the Mann-Whitney U Test and Chi-squared test for Section B data. Results: The response rate was 80.61% (79/98). The mean CD-RISC-25 score for males was higher (not significantly) than the female mean score (70.39 versus 67.18, p = 0.2355, possible score range 0−100). While 93.67% (74/79) considered the School has a responsibility to develop resilience, <20.00% availed of the free resilience building events. Activities deemed to help build resilience included being able to make mistakes in a safe environment and needing to achieve a high grade to pass assessments. Conclusions: Resilience levels among future pharmacists at Queen’s University Belfast should be improved going forward. A strategy, developed in light of conducting this research (from one institution), will now be implemented to enhance the curriculum with regard to resilience building opportunities.

“I'm at breaking point”; Exploring pharmacists' resilience, coping and burnout during the COVID-19 pandemic

Background

There is a lack of evidence on how the multimodal dynamic process of resilience has impacted personal adaptation of frontline healthcare professionals, working under extreme pressure during the COVID-19 global pandemic.

Objectives

To explore resilience, burnout and wellbeing for UK pharmacists in patient-facing roles, including individual and organisational factors that align to the ABC-X theoretical model of the dynamic process of resilience.

Methods

A non-experimental pragmatist research design was adopted, with a cross-sectional online survey distributed via social media and professional networks between June and July 2020. Quantitative data aligned to a positivist research paradigm was collected using validated scores, to statistically analyse wellbeing, burnout and resilience. Qualitative textual data, consistent with an interpretivist research paradigm, were analysed following an inductive thematic approach.

Results

A total of 199 surveys from pharmacists working within community, hospital and GP sectors were analysed. Wellbeing scores were strongly correlated to resilience scores. Wellbeing and resilience scores were both inversely correlated with burnout scores. Two-thirds of participants were classified as high-risk within the burnout scales.

Key stressors were highlighted by participants, who described how individual resources and perceptions shaped their experience, which overall contributed to their burnout. Organisations that supported pharmacists embraced change and quickly adopted new ways of working, such as teleconsultations, flexible and remote working, redesign of workflow, alongside clear guidance. However, there was also reported frustration at lack of, slow or conflicting guidance from employers.

Conclusions

This study adds to the growing evidence base for how individuals are affected by adverse events in a dynamic environment, alongside the role that employers can play in supporting individual and organisational resilience. It provides an opportunity to learn from pharmacists' responses to the COVID-19 pandemic, and a call to action for healthcare organisations to rebuild and invest resources into sustained support for staff wellbeing.