Search

Objective: To describe pharmacy preceptors' experiences in alternative preceptor models and their perceptions of these models' impact on the knowledge, skills, attitudes, behaviors, and professional practices of both themselves and their students., Methods: Pharmacy preceptors with experience using alternative preceptor models participated in semi-structured interviews. Models included peer-assisted learning (PAL) (≥ two students of the same educational level), near-peer teaching (NPT) (≥ one junior student with ≥ one senior student), and co-preceptorship (CoP) (≥ two preceptors). Interviews were transcribed, coded, and analyzed for themes using the Kirkpatrick framework for evaluating educational interventions., Results: Twenty hospital pharmacy preceptors from 13 institutions were interviewed, and 13 themes were identified. Fourteen preceptors had experience with PAL, 9 with NPT, and 9 with CoP. Preceptors perceived that NPT and PAL fostered comfortable learning environments that supported student success; challenges included increased time teaching multiple students and completing evaluations. CoP allowed preceptors to balance teaching with clinical duties while broadening students' exposure to different practice settings. Preceptors improved skills in time management, communicating feedback, and adapting to individual students' learning needs and styles. Alternative models enabled preceptors to provide care to more patients and complete projects, thus extending their professional practice. They also described that students participating in these models developed a sense of responsibility for patient care and will be primed to work collaboratively with pharmacy colleagues in the future., Conclusions: Preceptors expressed satisfaction with alternative preceptor models. The models enhanced the learning, skill development, and professional practice of both preceptors and students., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: People transitioning from hospital- to community-based care are at increased risk of experiencing medication problems that can lead to adverse drug events and poor health outcomes. Community pharmacists provide medication expertise and support during care transitions yet are not routinely included in communications between hospitals and other primary health care providers. The PhaRmacy COMmunication ParTnership (PROMPT) intervention facilitates medication management by optimizing information sharing between pharmacists across care settings. This developmental evaluation sought to assess the feasibility and acceptability of implementing the PROMPT intervention, and to explore how contextual factors influenced its implementation., Methods: PROMPT was implemented for 14 weeks (January-April, 2018) in the general internal medicine units at two teaching hospitals in Toronto, Canada. PROMPT featured two contact points between hospital and community pharmacists around patient discharge: (1) faxing an enhanced discharge prescription and discharge summary to a patient's community pharmacy and (2) a follow-up phone call from the hospital pharmacist to the community pharmacist. Our mixed-method evaluation involved electronic patient records, process measures using tracking forms, telephone surveys and semi-structured interviews with participating community and hospital pharmacists., Results: The intervention involved 45 patients with communication between 12 hospital and 45 community pharmacists. Overall, the intervention had challenges with feasibility. Issues with fidelity included challenges with the medical discharge summary being available at the time of faxing and hospital pharmacists' difficulties with incorporating novel elements of the program into their existing practices. However, both community and hospital pharmacists recognized the potential benefits to patient care that PROMPT offered, and both groups proposed recommendations for further improvements. Suggestions included enhancing hospital staffing and resources., Conclusion: Improving intraprofessional collaboration, through interventions such as PROMPT, positions pharmacists as leaders of medication management services across care settings and has the potential to improve patient care; however, more co-design work is needed to enhance the intervention and its fidelity.

Objective. To describe students' experiences and perceptions of non-traditional student-preceptor learning models and evaluate the effectiveness of these models on students' learning experience. Methods. Pharmacy students who had completed at least one experiential rotation with a non-traditional learning model participated in semi-structured interviews. Models included peer-assisted learning (PAL; two or more students of same educational level), near-peer teaching (NPT; one or more junior students with one or more senior students), and co-preceptorship (CoP; two or more preceptors). Interviews were transcribed, coded, and analyzed for themes. Themes were mapped according to the Kirkpatrick model for evaluating educational training. Results. Twenty semi-structured interviews were conducted. Forty-three experiences (19 CoP, 14 PAL, 10 NPT) from 14 institutions were described. Many themes overlapped between the three models. In CoP, learners described increased preceptor availability and exposure to different patient care approaches. Challenges arose when preceptors had different expectations. Students overwhelmingly endorsed a multi-learner environment. Both PAL and NPT learners felt supported as collaboration with other learners was readily fostered. Potential challenges in PAL and NPT were difficulties when personalities conflicted and when there was a significant knowledge gap between the learners. All three models allowed for the development of skills, including communication and collaboration. Learners reported an enhanced approach to patient care and professional practice, including approaches to teaching as new preceptors. Conclusion. Pharmacy students and graduates valued their experiences in non-traditional student-preceptor models. Institutions may find support for using these precepting models to increase placement capacity., (© 2019 American Association of Colleges of Pharmacy.)

Contributing to health geography scholarship on the topic, the objective of this paper is to reveal Canadian medical tourists' perspectives regarding their choices to seek knee replacement or hip replacement or resurfacing (KRHRR) at medical tourism facilities abroad rather than domestically. We address this objective by examining the 'talk strategies' used by these patients in discussing their choices and the ways in which such talk is co-constructed by others. Fourteen interviews were conducted with Canadians aged 42-77 who had gone abroad for KRHRR. Three types of talk strategies emerged through thematic analysis of their narratives: motivation, justification, and normalization talk. Motivation talk referenced participants' desires to maintain or resume physical activity, employment, and participation in daily life. Justification talk emerged when participants described how limitations in the domestic system drove them abroad. Finally, being a medical tourist was talked about as being normal on several bases. Among other findings, the use of these three talk strategies in patients' narratives surrounding medical tourism for KRHRR offers new insight into the language-health-place interconnection. Specifically, they reveal the complex ways in which medical tourists use talk strategies to assert the soundness of their choice to shift the site of their own medical care on a global scale while also anticipating, if not even guarding against, criticism of what ultimately is their own patient mobility. These talk strategies provide valuable insight into why international patients are opting to engage in the spatially explicit practice of medical tourism and who and what are informing their choices., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Medical tourism is the term that describes patients' international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients' decision-making in and experiences of these same procedures in their home countries., Methods: Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery., Results: Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives., Conclusions: Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients' pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal characteristics identified here to better advise osteoarthritis patients who are considering seeking care abroad.

Background and Objectives: The upper age limit for allogeneic blood donation varies among countries and blood operators. We assessed the impact of the removal of the upper age limit for donation in Canada from December 2004 to January 2006., Materials and Methods: Starting in December 2004, regular donors were permitted to continue whole blood or apheresis donation past their 71st birthday, provided an annual external medical assessment was performed by their family physician. Regular donors aged from 70 to 74 were sent a letter about the change in criteria, and encouraged to continue donations. Rates of donor adverse reactions and deferrals were calculated for these donors and donors in other age groups., Results: In the 13-month period following implementation of the new criteria, 961 (54%) of regular donors who had received a letter initiated a medical inquiry, and 862 inquiries were completed and returned to Canadian Blood Services. In 98% of cases, the donors' family physician approved ongoing donation. Of the 659 donors who presented to donate, 93% successfully donated. There was only one moderate/severe donor reaction out of 3137 donor attendances for donors aged 71 and older. This rate was not statistically different from the rate in the overall donor population. No donors were deferred for high-risk activities or had positive infectious disease test results., Conclusion: Regular blood donors may safely continue to donate past their 71st birthday. Extra steps in the donation process, such as an external medical inquiry, may not be necessary.