Abstract
A computer-based education platform was developed using a theory-based approach to help Canadian pharmacy professionals adopt their full scope of practice. Data from the platform were used to identify factors that impacted user performance and engagement. A de-identified dataset included response data for 21 unique modules, including quiz responses and self-reflection questions. Outcome measures included user performance (mean quiz score) and engagement (completion rate for attempted modules). Analysis of variance (ANOVA), multivariate regression modelling, and machine learning cluster analysis were used to analyze the data. Of the 5290 users, 68% were pharmacists, 11% were technicians, 13% were pharmacy students, and 8% were pharmacy technician students. Four clusters were identified separately for pharmacists and technicians. Clusters with the higher performance and engagement tended to have more users practicing in community pharmacies while the lower performing clusters tended have more internationally trained users. In the regression modelling, pharmacists performed better than technicians and students while students were more engaged (p < 0.0001). Further, internationally trained pharmacists had slightly lower scores but similar engagement compared to domestically trained pharmacists (p < 0.0001). Users demonstrated higher performance on modules related to scope of practice than on clinical topics, and were most engaged with topics directly impacting daily practice such as influenza vaccinations and new and emerging subjects such as cannabis. The cluster analysis suggests that performance and engagement with a computer-based educational platform in pharmacy may be more related to place of practice than to personal demographic factors such as age or gender.
Highlights
The scope of pharmacy practice continues to expand worldwide, especially in areas such as the administration of injections, smoking cessation consulting, medication reviews, and pharmacist prescribing [1]
In this analysis of a national, computer-based education program, the cluster analysis was useful for identifying clear clusters of users based on their performance and engagement, but it identified that demographic factors were not overly predictive of who was in each cluster
Cluster analysis was a useful strategy for analyzing engagement and performance independent of demographics
Summary
The scope of pharmacy practice continues to expand worldwide, especially in areas such as the administration of injections, smoking cessation consulting, medication reviews, and pharmacist prescribing [1]. Research has shown that pharmacists often consider an expanding scope of practice to be a “legitimization” of prior practices and are more likely to offer a new service if they were already doing it in a less formal manner, there can be a tension between a more professional role and the day-to-day need for technical efficiency [2,3,4,5]. The challenge, is that new services associated with an expanding scope can have low uptake, may be delivered in ways that do not align with policy, or may be preferentially offered to less complicated patients [6,7,8,9]. There are significant concerns that computer-based education requires more self-discipline or motivation, which can lead to lower engagement, overall [17]
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