What makes continuing education effective : perspectives of community pharmacists

Objective To explore how different aspects of the professional environment for Australian community pharmacists are perceived to be influencing the effectiveness of continuing education models in improving practice.

Setting Australian community pharmacy.

Methods A convenience sample of practising community pharmacists (n = 15) was recruited using the 'snowballing' technique to participate in one of four focus group teleconferences. Each focus group examined continuing education experiences from different professional perspectives and training needs (recent graduates, experienced practitioners, specialist practitioners and rural/remote practitioners).

Key findings Facilitation of professional development by accreditation bodies, and new challenges resulting from the introduction of cognitive services were seen to promote a favourable environment for continuing education engagement. Complex continuing education delivery models combined with high costs and excessive workloads made it more difficult to engage with continuing education systems or try to apply knowledge to the workplace.

Conclusion Results support findings from previous research that practice development requires a multifaceted approach with continuing education as just one component. Affordable and integrated models of continuing education are required in order to optimise efficacy for participants.

Barriers to pharmacist participation in continuing education in Australia

Background: The pharmacy profession recognises of the need for continuing education (CE), however, the rate of participation in organised CE remains low. Little is known about the reasons for low participation rates in CE, particularly in the Australian context. Aim: This research aimed to identify the barriers to participation of Australian pharmacists in CE. Method: Focus groups were held with Australian community pharmacists, grouped into experienced pharmacists, recently qualified pharmacists, pharmacists with specialist-training needs, and pharmacists practising in rural or remote areas. Focus group transcripts were thematically analysed. Results: Barriers identified by pharmacists included time constraints, accessibility - in terms of travel and cost, relevance, motivation, quality and method of CE delivery. Participants provided ideas to improve uptake of CE. Conclusion: The major barriers identified were time, accessibility and relevance of content. To improve uptake of CE a wider variety of flexibly delivered programs supplemented with in-depth workshops could be utilised.

The evolution of a state-wide continuing education programme for allied health professionals

Allied health professionals require continuing education (CE) to maintain and improve competencies and standards of care. Research suggests that professional access to CE in rural areas can be difficult.

This article uses an action research framework to describe the development and implementation of a CE programme for allied health professionals in a rural area in Australia, and its subsequent evolution into a state-wide programme. To evaluate programme relevance, attendance and perceived clinical relevance, physiotherapists (n = 75) in southwest Victoria were surveyed 1year after commencement of a CE programme. A secondary outcome was the perceived effect on clinical practice.

More than two-thirds (68.6%) of physiotherapists attended at least one workshop, 57.2% attended four or more sessions and 22.9% attended at least one of the two conducted courses over the period. In addition, 20% of the physiotherapists perceived that attending the programme had a large positive effect on their therapeutic skills, whereas 68.6% reported some effect. From a regional CE programme for physiotherapists the programme evolved into a state-wide programme for 22 allied health professions.

Community pharmacists' preferences for continuing education delivery in Australia

Introduction: New technologies such as the Internet offer an increasing number of options for the delivery of continuing education (CE) to community pharmacists. Many of these options are being utilized to overcome access- and cost-related problems. This paper identifies learning preferences of Australian community pharmacists for CE and identifies issues with the integration of these into contemporary models of CE delivery.
Methods: Four focus group teleconferences were conducted with practicing community pharmacists (n = 15) using a semistructured format and asking generally about their CE and continuing professional development (CPD) experiences.
Results: Pharmacists reported preferences for CE that were very closely aligned to the principles of adult learning. There was a strong preference for interactive and multidisciplinary CE. Engaging in CPD was seen as valuable in promoting reflective learning.
Discussion: These results suggest that pharmacists have a strong preference for CE that is based on adult learning principles. Professional organizations should take note of this and ensure that new CE formats do not compromise the ability of pharmacists to engage in interactive, multidisciplinary, and problem-based CE. Equally, the role of attendance-based CE in maintaining peer networks should not be overlooked.

Building professional capital : New Zealand social workers and continuing education

In a qualitative study of the engagement of New Zealand social workers in continuing professional education the construct "professional capital", a form of symbolic capital, explains complex links between perceived status within institutional settings and the aspirations of practitioners. Strategies for developing greater engagement in scholarship and research are recommended.

Facilitating learning in continuing education: some important sources

If higher education institutions are to respond effectively to the demands for continuing education, they will need to change their assumptions about the design of courses and the facilitation of learning. Despite many decades of development of new approaches to teaching and learning, courses in universities and polytechnics are normally still organised around the structures of the academic disciplines and the interests of the teaching staff. Learning-centred and problem-based courses, which can be especially appropriate in continuing education are rare particularly in those professional subjects where the potential for continuing education provision may be the greatest. The aim of the paper is to consider briefly the contributions ofthree groups of people to the ways in which learning can be facilitated in continuing education courses. These are Malcolm Knowles and his associates on teaching and learning strategies, John Heron and his associates on facilitation skills and the needs of adult learners, and the Sydney group based on the Australian Consortium on Experiential Education on fostering learning from experience and problem-based learning.

Acceptability of videoconference technology for the delivery of continuing education to rural pharmacists

Aim: To investigate whether a rural continuing education (CE) program delivered by videoconference can enhance access to, and uptake of, CE among pharmacists and determine their satisfaction with videoconference for the delivery of CE. Method: A postal survey was sent to 33 registered pharmacists in south-west Victoria and south-east South Australia who had attended at least one videoconference CE session organised in that region. Results: Respondents worked in different areas of pharmacy, and 40% worked in more than one area of pharmacy. The use of videoconference facilities has increased access to and participation in CE generally, and most participants (88%) have found it to be an acceptable medium for delivery. Increased access to high-quality CE opportunities, and reduced travel time for CE were seen as the principal benefits of the medium. Negative aspects included technical glitches, organisational issues, and the time-lag in voice transmission. Overall, most participants were happy to receive a substantial proportion of their contact CE using this medium. Conclusions: Videoconference technology is a valuable tool for the delivery of carefully structured CE sessions in rural and remote areas with an appropriate information technology infrastructure.

A rural model for delivering regional continuing nurse education by videoconference : a pilot project

Background : The South West Alliance of Rural Health (SWARH) is an alliance of 33 health care agencies scattered across South West Victoria over a total area of approximately 46 000 square kilometres. SWARH was established to develop and install information technology (IT) infrastructure, hardware and software for all acute public hospitals in the region. The Rural Intercampus Learning Environment Project (March 2003-March 2004) piloted the use of the SWARH regional area IT network to deliver a program of continuing education to Division 1 registered nurses, utilising the expertise of local health professionals. The study was funded by the Department of Human Services, Victoria.

Aims & rationale/Objectives : Establish partnerships for multi-site delivery of programs.
Develop existing educational programs and resources for video and intranet delivery (including IT training and change management).
Collaboratively deliver educational programs utilising SWARHnet to six rural sites.
Explore issues related to the use of the technology in continuing education for rural nurses and the implications for practice.

Methods : Key informant interviews, paper-based audits, and focus groups informed the development of the schedule of the program. Session participants completed a 2-page evaluation questionnaire.

Principal findings : Participants must own the process.
Videoconferencing should be considered an adjunct to traditional education programs.
Videoconferencing most suitable for short education sessions as opposed to full-day workshops.
IT problems are unpredictable and frustrating for all concerned.
IT awareness/training of staff is essential.

Implications : The project proposes a model for coordinating and delivering regional continuing education which has been shown to improve access to education programs across multiple sites. It provides a sustainable organisational framework for the program, which could be applied in continuing professional education programs of other rural health professions, such as dentistry, medicine, allied health and pharmacy.

Presentation type : Poster

Barriers to continuing medical education in Australian prevocational doctors

To determine perceived barriers to continuing education for Australian hospital-based prevocational doctors, a cross sectional cohort survey was distributed to medical administrators for secondary redistribution to 2607 prevocational doctors from August 2003 to October 2004. Four hundred and seventy valid questionnaires (18.1%) were returned. Only seven per cent (33/470) did not identify any barriers to continuing education. Barriers identified the most were lack of time (85% [371/437]), clinical commitment (65% [284/437]), resistance from registrars (13% [57/437]) and resistance from consultant staff (10% [44/437]). Other barriers included workload issues (27% [27/98]), teaching program inadequacies (26% [25/98]), lack of protected time for education (17% [17/98]), motivational issues (11% [10/98]) and geographic remoteness (10% [10/98]). Australian graduates (87%) identified lack of time more frequently than international medical graduates (77%) (P=0.036). Perceived barriers did not differ significantly between doctors of differing postgraduate years.

The primary health professional education : current models and barriers to participation

Introduction
Continuing Education (CE) for health professionals is a life-long process which endeavours to update or enhance knowledge, refine skills, reinforce professional values and support the delivery of professional practice. It plays a pivotal role in the maintenance of professional competence and in the past decade participation in CE has become an expectation of, rather than an option for, practising health professionals. The time and resources required from organisers and participants in
CE and the need to ensure practical outcomes justifies a review of current models being used for its delivery. This entails an understanding of the purpose of CE, a consideration of how it should be delivered, and the role played by assessment in achieving the goals of CE.
Aim of Report
The overall aim of this study is to identify important considerations and subsequently make recommendations for the development of an ideal model(s) of CE for community pharmacy.
Goals of Report
1. Define CE and its role.
2. Identify and assess current CE delivery models.
3. Examine the current status of continuing education and registration requirements for pharmacists.
4. Identify barriers to participation in CE.
5. Identify components and considerations for developing a model of CE delivery.
Methods
The following methods were employed for this project:
1. Literature review
A number of electronic databases were systematically searched in order to profile current trends and concepts in CE. CE structures currently in use were investigated by directly accessing the websites of appropriate associations.
2. Stakeholder interviews
A series of semi-structured interviews were completed with stakeholders from CE delivery organisations across a range of professions including pharmacy.
3. Community pharmacy focus groups
A series of focus group teleconferences were held with groups of pharmacists thought to have distinct CE needs: experienced pharmacists (qualified more than 5 years), recently-qualified pharmacists (5 years or less), rural/remote pharmacists, and pharmacists with specialist training
needs (such as Home Medication Reviews). These focus groups asked about participants’ experiences and opinions in relation to many aspects of CE including its delivery and its assessment.

Optimising the impact of education for community pharmacy in Australia

Aims & rationale/Objectives : This paper examines the extent to which different models of community pharmacist continuing education (CE) are evidence-based. It also describes the impact of varying education models on attendance and attitudes within the profession.

Methods : A literature review was conducted to establish principles that should be applied to health professional education, and pharmacy in particular. Interviews were conducted with representatives from four organisations involved in the education of pharmacists to understand their current models. Four focus groups were held with community pharmacists to understand their educational experiences and attitudes.

Principal findings : The purpose of CE is to improve the clinical performance of health practitioners. Literature examining outcomes from CE underlines the importance of adult learning principles. Focus groups supported the view that consideration of these principles is beneficial. These principles, including problem-based learning, clinical applicability, relevance, and active involvement in the learning process, are currently incorporated into educational models to varying extents. Access problems such as cost, distance, insufficient flexibility in delivery, and poor promotion of educational opportunities prevent many pharmacists from taking responsibility for their own learning. A lack of appropriate assessment by some registering authorities is counterproductive to achieving CE outcomes in clinical practice. Participants already engaged in continuing professional development (CPD) agreed with the principles of its introduction.

Discussion : Optimising outcomes from CE requires considerable input from numerous stakeholders. The recent introduction of mandatory pharmacist CPD across Australia should encourage an individual focus on learning outcomes. Focus group participants are likely to be education enthusiasts and may not represent the views of the entire profession.

Implications : This study identifies the need for a system-wide approach for achieving outcomes from CE. It is therefore advisable that a coordinated strategy be developed by all stakeholders for education delivery so as to optimise the impact of CE.

The politics of resistance to workplace cultural diversity education for health service providers : an Australian study

This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals, recruited from over 17 different organizational sites. Participants included cultural diversity educators, ethnic liaison officers, health service managers, nurses, health interpreters, allied health professionals, and community-based ethnic welfare organization personnel working in or with select metropolitan health services in Victoria, Australia. Analysis of the data revealed that workplace cultural diversity education in healthcare is a significant site of resistance and struggle. 'Resistance' was expressed in several forms including: the problematization of resources and staff availability to attend cultural diversity education forums; indifferent failure to recognize cultural imperatives in healthcare; deliberate refusal to recognize cultural imperatives in healthcare; selective recognition of cultural imperatives in healthcare ('facts sheets' only); and the angry rejection of cultural imperatives in healthcare. 'Struggle', in turn, largely involved cultural diversity educators having to constantly 'cajole and convince' (and even manipulate) staff to attend cultural diversity education forums and using a 'velvet glove and iron fist' approach to teaching staff who remained resolute in their resistance when participating in educational forums. An important implication of this study is that the politics of workplace cultural diversity education - and the 'politics of resistance' to such programs - need to be better recognized and understood if the status quo is to be successfully challenged and changed. The need for critical debate and further comparative research on the subject are also highlighted.