In any given year approximately 34% of the 130 million adults in the United States suffer from a mental health condition or disorder. Anxiety and depressive disorders are the most common followed by substance use disorder. Many people who suffer from a mental illness do not seek help. Studies have shown that the stigma of being perceived as having a mental illness prevents many adults from seeking help. Mental Health First Aid ™ (MHFA) is an educational program geared towards educating MHFA responders to assist those who may be experiencing a mental health condition or disorder. Pharmacists are the most accessible healthcare professionals, and many are trained in delivering MHFA. The literature on MHFA suggests that it is an effective educational program for those that take the training course. What is lacking is evidence that MHFA interventions positively affect help-seeking behaviours after an intervention has occurred between a mental health first air responder and an individual requiring MHFA. This paper highlights this issue and provides suggestions for future research.

© 2019, Springer Nature Switzerland AG. Background Pharmacists are increasingly being included as members of general practice primary care teams. To date, there have been few published studies describing the competencies of general practice (GP) pharmacists and establishing their subsequent educational needs. Aim of the review The aim of this literature review is to establish the activities of pharmacists in general practice to inform the development of a comprehensive role description and competency map. Method A systematic literature search of EMBASE, MEDLINE, international pharmaceutical abstracts and the Cochrane database of systematic reviews was conducted from the start of the databases to August 2018. The search focused on studies investigating the roles performed by GP pharmacists. Full text peer-reviewed English language articles were included. A qualitative content analysis of included studies was performed. Two researchers reviewed studies to identify pharmacist roles. Subcategories of roles were then agreed by the research team and used to present the data. GP pharmacist's activities were mapped by two researchers to associated competencies. Any discrepancies between role descriptions and competency maps were resolved in consultation with a third member of the research team. Results The search conducted resulted in 5370 potential articles. Two hundred and twenty-seven full text articles were selected for review resulting in 34 articles that were included for analysis. Seven GP pharmacist role sub-categories and 48 GP pharmacist individual roles were identified. The seven GP pharmacist role sub-categories included medication management, patient examination and screening, chronic disease management, drug information and education, collaboration and liaison, audit and quality assurance and research. All FIP competency domains were included in the GP pharmacist competency map. Competencies related to compounding, dispensing and packaging of medications we...

© 2019 Elsevier Inc. Reflective practice strategies can enable healthcare practitioners to draw on previous experiences to render more effective judgment in clinical situations. The central argument presented in this commentary is that education programs and structures for continuing professional development (CPD) and revalidation of professionals sharpen their focus regarding self-assessment to identify gaps in skills and attitudes rather than merely as a means of on-going monitoring. Pharmacy undergraduate and professional education need to promote reflective practice strategies that foster self-evaluation to promote pharmacists' readiness for practice change and advance patient care within rapidly expanding roles and scope of practice.

© 2019, American Association of Colleges of Pharmacy. All rights reserved. Objective. To assess final-year pharmacy students' performance on and evaluate their experience with a 'flipped examination' vs a traditional examination for an advanced clinical pharmacy course. Methods. Students devised multiple-choice questions for the flipped examination. The Biggs revised 2-factor Study Process Questionnaire was administered before and after the examination to assess any possible changes in the students' perceptions of their level of engagement in the learning process. Focus group discussions also were conducted to further gauge the students' feedback and insights into the flipped examination experience. Results. Changes in mean total study process scores at the deep and surface levels of learning were significant. The flipped examination experience was enjoyable, facilitated a less-stressful learning environment, and improved the students' learning satisfaction, knowledge, and assessment grades. Conclusion. The flipped examination model is an innovative instructional approach that can bring about significant educational gains if designed well pedagogically.

© 2019 Elsevier Inc. Introduction: Reflection is a powerful tool for assisting students to develop the skills to make better informed decisions. As a pharmacy competency standard, reliable and fair assessment strategies are required to measure reflective skills and support students in developing their reflective capacity. The aim of this research was to explore whether we can extend the applicability of a previously tested rubric to a range of educational settings, to account for diversity of pharmacy educators and curricula internationally. Methods: Four raters from three countries applied a reflective rubric to assess a sample (n = 43) of reflective accounts, representing 41% of a cohort of 105 second-year undergraduate pharmacy students. The interrater reliability (IRR) was measured utilizing the intra-class correlation coefficient (ICC), using a two-way random effects model with absolute agreement, to determine the level of agreement between the raters' absolute scores. Generalizability Theory analysis was used to estimate generalizability of raters and stages. Results: Results indicated agreement of raters for (i) each of the seven stages of reflection and (ii) overall score for the reflective account, with moderate to substantial agreement (ICC = 0.55–0.69, p < 0.001); and high agreement for all raters for the overall score (ICC = 0.96, p < 0.001), respectively. The G-Study estimated a relative error coefficient of 0.78. Conclusion: This additional analysis further confirms the reliability and applicability of the rubric to a range of rater academic backgrounds.

© 2019 Elsevier Inc. Background: Simulation is an effective strategy for enhancing interprofessional education (IPE) and collaboration (IPC). Objectives: A novel interprofessional learning model, The RIPE Model (Reflective Interprofessional Education Model) was applied for a pilot study during a simulation laboratory aimed to (i) enhance pharmacy and nursing students' understanding of the roles and responsibilities of professions within the multidisciplinary healthcare team; and (ii) enhance the importance of working collaboratively in team-based care. Methods: The pilot study using a mixed-methods approach, including the administration of a 6-item student survey on a 6-point Likert-type scale as a pre-test (prior to participation in the simulation laboratory) and post-test (after participation in the simulation laboratory), and a debriefing session eliciting a follow up written reflective statement. Results: Sixty-four students (n = 56 pharmacy; n = 8 nursing) participated in the study which resulted n = 52 pharmacy students and n = 8 nursing students matched data to a pre-test and post-test survey, analyzed via paired t-tests. Statistically significant results (p < 0.05) reported a positive increase in pharmacy students' perceptions from the pre-test and post-test survey for all six items indicating the extent of agreement of IPC; and for one item on the nursing student survey. Qualitative analysis of reflective statements (n = 62) was conducted via thematic analysis utilizing Braun and Clarke's 6-phase process. Thematic analysis generated one overarching theme: IPC: Developing appreciation and respect for healthcare team members to improve patient outcomes; and three subthemes: (i) Enhanced decision-making; (ii) Communication and collaboration; (iii) New understandings of roles and responsibilities. Conclusions: Students perceived that utilizing the RIPE Model of learning involving simulation to enhance interprofessional collaboration assisted their understand...

This paper describes a novel model to providing interprofessional education (IPE) and interprofessional collaboration (IPC) within a simulated healthcare environment, in the higher education setting. The RIPE Model (Reflective Interprofessional Education Model) was developed for the purpose of enhancing IPE and IPC, clinical judgement, and decision-making between health professional students (pharmacy and nursing students) at the patient's simulated hospital bedside. A foundation 'unfolding' case utilizing the RIPE model was piloted with first year Master of pharmacy students and postgraduate nursing students at an Australian university and included a pharmacy practitioner acting as a resident medical officer (RMO) for the purpose of the teaching module. The RIPE model rotated students through 10 stations (including 2 reflection stations) to unpack an unfolding case. The development of the RIPE model, processes, and future directions are included in this article. The RIPE Model provides the flexibility to adapt and tailor different cases and scenarios to include other health professional students to enhance educational outcomes, with the feedback of the learning to potentially improve future patient outcomes. Furthermore, the model has the potential to be tailored and utilized for the purpose of upskilling practicing pharmacists for Continuing Professional Development (CPD) and changing scopes of practice.

Reflective practice activities utilizing appropriate tools enhance learning during and after experiential placements. Reflective tools described in the literature, used to support students on traditional placements of a duration of at least two weeks, sit at the unstructured end of a continuum (completely unstructured to just minimal structure). Additionally, non-traditional settings in role-emerging placements are of value as an alternative for experiential education. There were no reflective tools in the literature to provide a means of supporting pharmacy students as novice reflectors in non-traditional settings.To develop one fit-for-purpose tool that students could utilize across their experiences, regardless of type or duration of experiential placement.A multi-phased approach was adopted, including a mix of methodologies: interviews, focus groups, informal feedback from stakeholders, and grading reflective accounts utilizing Mezirow's categories of reflection. A range of stakeholders were involved at each stage to ensure the reflective tool was fit-for-purpose. These included students, placement preceptors, and academic staff acting as graders of student reflective accounts.A total of 24 students participated in focus groups, 13 supervisors/preceptors engaged in interviews and informal feedback, and 853 student reflective accounts were graded, over 3 years. The final tool that has been developed and evaluated in this research supported students to develop to critical reflectors (6% - Phase 2 increased to 62.9% - Phase 3).This novel and innovative approach supports novice reflectors, encourages reflection on action and enhances professional development. It is a structured yet flexible tool, for which there was a gap in the published literature. It can be utilized in varied placements in pharmacy curricula internationally.

Background Team based care has been used internationally to improve the delivery of best practice primary health care. The WentWest General Practice Pharmacist Project, involving the integration of pharmacists within general practice teams, was commissioned to improve medication management of general practice patients. A particular focus of the project was the performance of medication review to allow the detection and resolution of drug related problems (DRPs). Objective The objectives of this 6-month study (October 2016-March 2017) were to: (1) identify and classify the DRPs detected as a result of pharmacist activities within a general practice primary care setting. (2) compare the number of pharmacist recommendations and GP acceptance rates as a result of pharmacist patient consultations across multiple general practice sites. Setting 15 general practice primary care sites in Western Sydney NSW Australia. A multi-centre prospective observational study conducted over a 6-month period from October 2016 to March 2017. Main outcome measure Drug-related problems (DRPs). Results Six pharmacists recorded the results from 493 patient consultations. The pharmacists identified 1124 DRPs and made 984 recommendations, of which 685 (70%) were recorded as accepted by the GP. Conclusion Pharmacists have a valuable role to play in the detection and resolution of DRP as part of the general practice team.

PURPOSE:Reflection is an important skill development for teachers in order for their improvement in teaching style and practice. One of the ways in which teachers can reflect on their teaching is through peer observation and review. DESCRIPTION:The article describes the process of peer observation and review by three academic teachers from three different disciplines at an Australian university. This process was utilized to assist and enhance the teaching practice of a pharmacy educator, whom has been teaching for > 15 years. Using Brookfield's reflective model through the "eyes" of the four "lenses," the pharmacy educator describes what she has learned and wisdom gained through this reflective practice process. ANALYSIS:The peer observation and review process involved elements including (i) a group verbal feedback and (ii) a written report outlining some strategies that could be utilized to improve teaching practice. Both were considered valuable and the method for providing "sandwiched" feedback utilized verbal and non-verbal cues. CONCLUSIONS:Peer observation is a time consuming exercise that requires valuable time. However, the value that generates from such practices and the insights gained through this process far outweighs time spent. Providing feedback in a safe learning environment and "sandwiching" the positive and negative comments can be an effective process. IMPLICATIONS:The value of reflecting on one's teaching practice can allow teachers to develop and improve their teaching style. Universities and colleges that support this type of reflective practice are likely to generate better teachers who will engage students to enhance their learning.

© 2018 Introduction: Appropriate evaluation processes are important in experiential placements. With the growing diversity between placements, consideration for standardization of some of these processes would be beneficial, particularly for those skills that are transferable regardless of the placement type. The objectives of this study was: (1) to explore the experiences, evaluation strategies, and feedback processes of Australian preceptor pharmacists from three primary experiential areas (community, hospital, and industry) in providing student placements; and (2) to inform the future development of the current local experiential program and future extended international experiential programs. Methods: A qualitative, exploratory study with three preceptor focus groups (community, hospital, and industry) were conducted, recorded, and transcribed verbatim. Data were analyzed using Bazeley's 'describe – compare – relate' method for thematic analysis. Results: There were a total of 16 participants. Four themes emerged: (1) motivation and purpose of being a preceptor; (2) expectations of students and the university; (3) organizational planning and conduct of experiential placements; and (4) importance of appropriate evaluation and feedback processes to include evaluation of interpersonal skills, which were considered by all focus group members as highly desirable for future employability. Conclusions: The need for standardized processes across different experiential placements, although difficult given the diversity, is important particularly with respect to evaluation and feedback. As interpersonal attributes are transferable and desirable for all types of experiential settings including rural and international environments, standardizing the evaluation of students to include these could be beneficial and applicable for students on local experiential placements and/or cross globally on international experiential placements.

© 2018 La Trobe University. The Western Sydney Primary Health Network (PHN), WentWest, has been working to improve patient and health system outcomes by commissioning projects that enhance patient-focussed, team-based care. One such project is the WentWest General Practice Pharmacist Project, involving the integration of pharmacists within general practice sites. The aim of this study is to describe, classify and analyse recommendations made by pharmacists to GPs, resulting from patient consultations between pharmacists and patients in a general practice setting. This study was a multi-centre prospective observational study (April 2017-September 2017) investigating recommendations made by pharmacists integrated in a general practice setting. Thirteen general practice sites located in Western Sydney, NSW, Australia were involved in the study. The main outcome measures of this study include the classification of pharmacist recommendations and the percentage of those recommendations accepted by GPs. The pharmacists recorded the results from 618 patient consultations. These consultations resulted in 1601 recommendations of which 1404 (88%) were recorded as accepted. This study demonstrated that the recommendations made by pharmacists in general practice are well accepted by GPs and may lead to improvements in medication management and patient care.

This paper describes a provider-patient communication process, which although not new to health care in general, is new to the pharmacy profession. Health coaching is a technique that empowers patients to make lasting health behavior changes that improve overall well-being. It provides patients with health care implementation options that better suit their lifestyle and abilities. Health coaching programs have the potential to foster better health outcomes, especially with patients who are chronically ill or represent an at risk population for medication non-adherence (e.g. elderly, patients on psychotropic medications). Other health professions (e.g. nursing and medicine) have had success with the implementation of health coaching models. For example, nurse coaching is recognized by the American Nurse Association and recent statistics show 3.1 million nurses in the U.S.A are also trained in nurse coaching. The pharmacy profession has yet to tap the patient-related benefits of health coaching. This commentary will discuss (i) The theoretical foundations of health coaching (ii) Distinctions between health coaching, motivational interviewing and traditional medication therapy counseling (iii) Training necessary for health coaching; and (iv) How pharmacists can use health coaching in practice.

Motivational Interviewing, pharmacist-based health coaching and traditional patient counseling techniques all show merit in improving communication between patients and health care providers. However, in order to effectively utilize these techniques one should have the ability to draw upon internal cognitive and psychological resources. Some patients have difficulty obtaining optimal health outcomes due to an unconscious inability to learn and connect with psychological resources. When this is the case, other methods of communication may need to be considered. With the appropriate training, Eriksonian Hypnosis or the use of techniques such as hypnotic language patterns (HLP) have the potential to be implemented into pharmacy practice settings and assist those patients who have previously failed to make positive behavior changes and act upon their health issues.

Objectives. To investigate whether reflective-writing skills are associated with academic success.
Methods. Two hundred sixty-four students enrolled in a pharmacy practice course completed reflective
statements. Regression procedures were conducted to determine whether reflective-writing skills were
associated with academic success in different assessment formats: written, oral, and video tasks.
Results. Reflective-writing skills were found to be a predictor of academic performance in some
formats of assessment: written examination; oral assessment task and overall score for the Unit of
Study (UoS). Reflective writing skills were not found to predict academic success in the video assessment
task.
Conclusions. Possessing good reflective-writing skills was associated with improved academic performance.
Further research is recommended investigating the impact of reflective skill development on
academic performance measures in other health education.
Keywords: reflective writing, reflection, academic performance, different formats of assessment, pharmacy
education

Objective. To determine the effectiveness of integrating reflective practice activities into a secondyear
undergraduate pharmacy curriculum and their impact on reflective thinking ability.
Design. A cross-over design with repeated measures was employed. Newly developed reflective
modules based on real hospital and community pharmacy cases were integrated into the second-year
pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA),
was introduced to enhance self- and peer reflection.
Assessment. Student responses (n5214) to the adapted Kember et al1 Reflective Thinking Questionnaire
(RTQ) were compared before and after reflective activities were undertaken. Significant improvement
in three indicators of reflective thinking was shown after students engaged in reflective
activities.
Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective
thinking capacity of students. Enhancing reflective thinking ability may help students make better
informed decisions and clinical judgments, thus improving future practice

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

© Springer Nature Switzerland AG 2019. Reflective writing is widely acknowledged to be one of the most effective learning activities for promoting students' self-reflection and critical thinking. However, manually assessing and giving feedback on reflective writing is time consuming, and known to be challenging for educators. There is little work investigating the potential of automated analysis of reflective writing, and even less on machine learning approaches which offer potential advantages over rule-based approaches. This study reports progress in developing a machine learning approach for the binary classification of pharmacy students' reflective statements about their work placements. Four common statistical classifiers were trained on a corpus of 301 statements, using emotional, cognitive and linguistic features from the Linguistic Inquiry and Word Count (LIWC) analysis, in combination with affective and rhetorical features from the Academic Writing Analytics (AWA) platform. The results showed that the Random-forest algorithm performed well (F-score = 0.799) and that AWA features, such as emotional and reflective rhetorical moves, improved performance.

© 2017 Elsevier Inc. Introduction Many health education programs aspire to foster reflective practices to enhance the reflective thinking of students during their study years and throughout their professional careers. Given the increasing attention paid to incorporating reflective practice activities into health education and evidence attributed to rater variability, it is important for educators to carefully consider the assessment criteria and reliability of assessment tools. A reflective rubric was developed to assess pharmacy students' levels of reflection from a reflective writing task. This study investigates the inter-rater reliability (IRR) of a rubric as a tool to assess the levels of reflective thinking apparent in students' written statements. Methods The research involved four raters from different disciplines utilizing a rubric to assess a random sample of the same forty-three reflective statements from a cohort of two hundred and sixty-four students. The IRR was measured using the intra-class correlation coefficient (ICC), using a two-way random effects model (ANOVA) with absolute agreement, to determine reliability of the assessment tool among the raters. Results Results showed measures between the raters for (i) overall reflective statement scores, and (ii) average scores for stages of reflection with an 'almost perfect' agreement, ICC = 0.81 (95% CI 0.61–0.90), (F(42, 126) = 7.83, p < 0.01); and ICC = 0.89 (95% CI 0.83–0.93), (F(42, 840) = 12.49, p < 0.01) respectively. Discussion and conclusions The proposed rubric utilized by four raters showed high agreement with each other's scores, and is a tool for academic assessment of pharmacy students' reflective thinking processes.

© 2017 ACM. Reflective writing can provide a powerful way for students to integrate professional experience and academic learning. However, writing reflectively requires high quality actionable feedback, which is time-consuming to provide at scale. This paper reports progress on the design, implementation, and validation of a Reflective Writing Analytics platform to provide actionable feedback within a tertiary authentic assessment context. The contributions are: (1) a new conceptual framework for reflective writing; (2) a computational approach to modelling reflective writing, deriving analytics, and providing feedback; (3) the pedagogical and user experience rationale for platform design decisions; and (4) a pilot in a student learning context, with preliminary data on educator and student acceptance, and the extent to which we can evidence that the software provided actionable feedback for reflective writing.