Descriptive assessment of graduates' perceptions of pharmacy-related competencies based on the Lebanese pharmacy core competencies framework
Background: Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. In 2017, the Official Pharmacists’ Association in Lebanon [OPL - Order of Pharmacists of Lebanon] took the initiative to develop a pharmacy core competency framework.
Objective: The primary objective of this survey was to evaluate graduates' perceptions of pharmacy-related competencies “taught” across Lebanese pharmacy schools/faculties, based on the suggested Lebanese Pharmacy Competencies Framework. This study also explored the association between graduates' demographics, university attributes, and self-assessed competency performance.
Methods: A cross-sectional study involving pharmacists who graduated from Lebanese universities was performed through a 40-minute online questionnaire distributed over social media platforms and groups of pharmacists.
Results: Pharmacists perceived their competence as moderate upon graduation, the lowest scores being in fundamental knowledge and medicine supply; the highest reported scores were in personal skills and safe/rational use of medicines. Moreover, females, younger graduates, PharmD holders, and pharmacists working in hospitals/clinical settings and academia had the highest perception of their competencies. Pharmacists in the public sector and medical laboratory directors had the lowest perception of competence.
Conclusions: When comparing the taught curriculum to the suggested Lebanese Pharmacy Competency Framework, all domains need to be improved to optimize the perception, education, and practice of pharmacists. It is essential to emphasize fundamental knowledge, medicines supply, and public health competencies in undergraduate curricula and improve continuing professional education.
Saseen JJ, Ripley TL, Bondi D, et al. ACCP Clinical Pharmacist Competencies. Pharmacotherapy. 2017;37(5):630-636. https://doi.org/10.1002/phar.1923
Guerreiro MP, Cantrill JA, Martins AP. Preventable drug-related morbidity: determining valid indicators for primary care in Portugal. Acta Med Port. 2007;20(2):107-129.
Sacre H, Hallit S, Hajj A, Zeenny RM, Sili G, Salameh P. Developing core competencies for pharmacy graduates: The Lebanese Experience. https://www.researchsquare.com/article/rs-11850/v1 (accessed Feb 8, 2021).
Hilmer SN, McLachlan AJ, Le Couteur DG. Clinical pharmacology in the geriatric patient. Fundam Clin Pharmacol. 2007;21(3):217-230. https://doi.org/10.1111/j.1472-8206.2007.00473.x
Hanlon JT, Schmader KE, Samsa GP, et al. A method for assessing drug therapy appropriateness. J Clin Epidemiol. 1992;45(10):1045-1051. https://doi.org/10.1016/0895-4356(92)90144-c
Samsa GP, Hanlon JT, Schmader KE, et al. A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity. J Clin Epidemiol. 1994;47(8):891-896. https://doi.org/10.1016/0895-4356(94)90192-9
Hanlon JT, Schmader KE. The medication appropriateness index at 20: where it started, where it has been, and where it may be going. Drugs Aging. 2013;30(11):893-900. https://doi.org/10.1007/s40266-013-0118-4
Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med. 1991;151(9):1825-1832.
National Association of Pharmacy Regulatory Authorities. Professional competencies for Canadian at entry to practice pharmacists. 2014; https://napra.ca/sites/default/files/2017-08/Comp_for_Cdn_PHARMACISTS_at_EntrytoPractice_March2014_b.pdf (accessed Jul 24, 2020).
Conférence Internationale des Doyens des facultés de PHARMacie d'Expression Française. [Evaluations of CIDPHARMEF]. https://cidpharmef.org/article/detail/7 (accessed Jul 31, 2020).
High Council for Evaluation of Research and Higher Education. Evaluation and Accreditation. https://www.hceres.fr/en/evaluation-and-accreditation (accessed Jul 31, 2020).
Université Saint-Joseph, [Acquin Self-Assessment Report 2017-2018 (Abridged Version)]. https://www.usj.edu.lb/qualite/pdf/Rapport2018-VersionAbregee.pdf (accessed Jul 31, 2020).
National Competency Standards Framework for Pharmacists in Australia. Pharmaceutical Society of Australia Ltd. 2016; https://www.psa.org.au/wp-content/uploads/2018/06/National-Competency-Standards-Framework-for-Pharmacists-in-Australia-2016-PDF-2mb.pdf (accessed Jul 29, 2020).
ASHP-ACPE Joint Task Force. Entry-level competencies needed for pharmacy practice in hospitals and health-systems. https://www.ashp.org/-/media/BB3E0831027D43328D1FFB6515E636F7.ashx (accessed Jul 29, 2020).
Meštrović M. Are we competent in pharmacy practice? what are pharmacist competencies and how can they be measured and developed? Adv Pharmacoepidemiol Drug Saf. 2012;1:(e116). https://doi.org/10.4172/2167-1052.1000116
World Health Organization. Adherence to long-term therapies - Evidence for action. Geneva: WHO; 2003.
George J, Phun YT, Bailey MJ, Kong DC, Stewart K. Development and validation of the medication regimen complexity index. Ann Pharmacother. 2004;38(9):1369-1376. https://doi.org/10.1345/aph.1d479
Horne R, Weinman J, Barber N, Elliott R, Morgan M. Concordance, adherence and compliance in medicine taking. London: NCCSDO; 2005.
Medina MS, Plaza CM, Stowe CD, et al. Center for the Advancement of Pharmacy Education 2013 educational outcomes. Am J Pharm Educ. 2013;77(8):162. https://doi.org/10.5688/ajpe778162
Dobesh PP, Bosso J, Wortman S, et al. Critical pathways: the role of pharmacy today and tomorrow. Pharmacotherapy. 2006;26(9):1358-1368. https://doi.org/10.1592/phco.26.9.1358
Paradis E, Zhao R, Kellar J, Thompson A. How are competency frameworks perceived and taught? : An exploratory study in the context of pharmacy education. Perspect Med Educ. 2018;7(3):200-206. https://doi.org/10.1007/s40037-018-0432-y
Bruno A, Bates I, Brock T, Anderson C. Towards a global competency framework. Am J Pharm Educ. 2010;74(3):56. https://doi.org/10.5688/aj740356
FIP Education Initiatives. A global competency framework for services provided by pharmacy workforce. https://www.fip.org/files/fip/PharmacyEducation/GbCF_v1.pdf (accessed Jul 29, 2020).
Coombes I, Avent M, Cardiff L, et al. Improvement in pharmacist’s performance facilitated by an adapted competency-based general level framework. J Pharm Pract Res. 2010;40(2):111-118. https://doi.org/10.1002/j.2055-2335.2010.tb00517.x
Rutter V, Wong C, Coombes I, et al. Use of a general level framework to facilitate performance improvement in hospital pharmacists in Singapore. Am J Pharm Educ. 2012;76(6):107. https://doi.org/10.5688/ajpe766107
Ihekoronye MR, Osemene KP. Evaluation of the participation of community pharmacists in primary healthcare services in nigeria: a mixed-method survey. Int J Health Policy Manag. 2020;[Ahead of Print]. https://doi.org/10.34172/ijhpm.2020.224
Meštrović A, Staničić Z, Hadžiabdić MO, et al. Evaluation of Croatian community pharmacists' patient care competencies using the general level framework. Am J Pharm Educ. 2011;75(2):36. https://doi.org/10.5688/ajpe75236
Mills E, Bates I, Farmer D, Davies G, Webb D. The general level framework: use in primary care and community pharmacy to support professional development. Int J Pharm Pract. 2008;16(5):325-331. https://doi.org/10.1211/ijpp.16.5.0008
Bruno A. The feasibility, development and validation of a global competency framework for pharmacy education. London: University of London; 2011.
Sacre H, Hallit S, Hajj A, et al. Developing Core Competencies for Pharmacy Graduates: The Lebanese Experience. J Pharm Pract. 2020;897190020966195. https://doi.org/10.1177/0897190020966195
Sacre H, Hallit S, Hajj A, et al. Upgrading pharmacy education to produce practice-ready pharmacists in Lebanon. Pharm Educ 2020;20:985.
Abou-Mrad F, Tarabey L. Healthcare quality in a fragmented society: the Lebanese model. Neurol Sci. 2014;35(2):179-183. https://doi.org/10.1007/s10072-013-1473-y
Order of Pharmacists of Lebanon. Directory. https://opl.org.lb/Pharmacist.php (accessed Jul 31, 2020).
Kaliyaperumal K. Guideline for conducting a knowledge, attitude and practice (KAP) study. Commun Ophthalmol. 2004;4:8-9.
Bajis D, Chaar B, Penm J, Moles R. Competency-based pharmacy education in the Eastern Mediterranean Region-A scoping review. Curr Pharm Teach Learn. 2016;8(3):401-428. https://doi.org/10.1016/j.cptl.2016.02.003
Nasser SC, Saad AH, Karaoui LR. Mapping of the biomedical literature evaluation competencies based on pharmacy students' feedback. BMC Med Educ. 2016;16:59. https://doi.org/10.1186/s12909-016-0583-7
Ramia E, Salameh P, Btaiche IF, Saad AH. Mapping and assessment of personal and professional development skills in a pharmacy curriculum. BMC Med Educ. 2016;16:19. https://doi.org/10.1186/s12909-016-0533-4
Ramadan B, Metni M, Hamadeh G, Kurdi M, Karam R. Requirements for a Successful Drug Launch in Small Markets: A Pilot Study in Lebanon. Value Health Reg Issues. 2019;19:59-64. https://doi.org/10.1016/j.vhri.2019.01.006
Strand MA, Miller DR. Pharmacy and public health: a pathway forward. J Am Pharm Assoc (2003). 2014;54(2):193-197. https://doi.org/10.1331/japha.2014.13145
US Department of Health and Human Services. Healthy People 2020. https://www.healthypeople.gov (accessed May 1, 2020).
United Nations. About the sustainable development goals. https://www.un.org/sustainabledevelopment/sustainabledevelopment-goals/ (accessed May 1, 2020).
Hallit S, Selwan CA, Salameh P. Primary health care policy and vision for community pharmacy and pharmacists in Lebanon. Pharm Pract (Granada). 2020;18(2):2003. https://doi.org/10.18549/pharmpract.2020.2.2003
Udoh A, Bruno A, Bates I. A survey of pharmacists' perception of foundation level competencies in African countries. Hum Resour Health. 2018;16(1):16. https://doi.org/10.1186/s12960-018-0280-1
Echeverri M, Unni E, Harpe SE, et al. A Multi-School Validation of a Revised Scale for Assessing Cultural Competence in Pharmacy Students. Am J Pharm Educ. 2019;83(3):6602. https://doi.org/10.5688/ajpe6602
Steeb DR, Miller ML, Schellhase EM, et al. Global Health Learning Outcomes by Country Location and Duration for International Experiences. Am J Pharm Educ. 2020;84(5):7682. https://doi.org/10.5688/ajpe7682
Crawford SY, Awé C, Tawk RH, Simon Pickard A. A Cross Sectional and Longitudinal Study of Pharmacy Student Perceptions of Readiness to Serve Diverse Populations. Am J Pharm Educ. 2016;80(4):62. https://doi.org/10.5688/ajpe80462
Mills E, Laaksonen R, Bates I, Davies G, Duggan C. Self-assessment of competence in a community pharmacy setting. Pharm Educ. 2005;5(3):1-11.
Detlor B, Julien H, Serenko A, Booker L. Factors Affecting Student Learning Outcomes of Information Literacy Instruction. https://asistdl.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/meet.14504701309 (accessed May 1, 2020).
Magaziner J. Education in France. https://wenr.wes.org/2015/09/education-france (accessed Jul 31, 2020).
Boyle M, Myford C. Pharmacists' expectations for entry-level practitioner competency. Am J Pharm Educ. 2013;77(1):5. https://doi.org/10.5688/ajpe7715
Chanakit T, Low BY, Wongpoowarak P, Moolasarn S, Anderson C. Hospital pharmacists' perceptions of the suitability of doctor of pharmacy graduates in hospital settings in Thailand. BMC Med Educ. 2015;15:181. Published 2015 Oct 24. https://doi.org/10.1186/s12909-015-0471-6
Accreditation standards and guidelines for the professional program in pharmacy leading to doctor of pharmacy degree: Draft Standards 2016. https://www.acpe-accredit.org/pdf/Standards2016DRAFTv60FIRSTRELEASEVERSION.pdf (accessed Mar 23, 2016).
Držaić M, Kummer I, Mucalo I, Bruno A, Ortner Hadžiabdić M. Identifying self-assessed competencies and areas for improvement within community pharmacist-preceptors support during pre-registration training. BMC Med Educ. 2018;18(1):303. https://doi.org/10.1186/s12909-018-1413-x
Katoue MG, Awad AI, Schwinghammer TL, Kombian SB. Pharmaceutical care education in Kuwait: pharmacy students' perspectives. Pharm Pract (Granada). 2014;12(3):411. https://doi.org/10.4321/s1886-36552014000300002
Kennie-Kaulbach N, Farrell B, Ward N, et al. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies. BMC Fam Pract. 2012;13:27. https://doi.org/10.1186/1471-2296-13-27
Sarriff A, Gillani W, Babiker G. Pharmacist perception to importance and self-competence in pharmacy practice. Int J Pharm Stud Res. 2010;I(II):1-21.
Vyas D, Bhutada NS, Feng X. Patient simulation to demonstrate students' competency in core domain abilities prior to beginning advanced pharmacy practice experiences. Am J Pharm Educ. 2012;76(9):176. https://doi.org/10.5688/ajpe769176
Schussel KE, Forbes S, Taylor AM, Cooley JH. Implementation of an Interprofessional Medication Therapy Management Experience. Am J Pharm Educ. 2019;83(3):6584. https://doi.org/10.5688/ajpe6584
Hallit S, Sacre H, Hajj A, Sili G, Zeenny RM, Salameh P. Projecting the future size of the Lebanese pharmacy workforce: forecasts until the year 2050. Int J Pharm Pract. 2019;27(6):582-588. https://doi.org/10.1111/ijpp.12564
Sacre H, Hallit S, Hajj A, Zeenny RM, Sili G, Salameh P. The Pharmacy Profession in a Developing Country: Challenges and Suggested Governance Solutions in Lebanon. J Res Pharm Pract. 2019;8(2):39-44. https://doi.org/10.4103/jrpp.jrpp_19_5
Sacre H, Tawil S, Hallit S, Sili G, Salameh P. Mandatory continuing education for pharmacists in a developing country: assessment of a three-year cycle. Pharm Pract (Granada). 2019;17(3):1545. https://doi.org/10.18549/pharmpract.2019.3.1545
Caputo EL, Feter N, Rombaldi AJ, da Silva MC, Reichert FF. What are the challenges of epidemiological research during the COVID-19 pandemic? Motriz. 2021;27:e10200200. https://doi.org/10.1590/S1980-657420210000200
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