Purpose:Entrustment decision-making is shaped by both supervisor and trainee. Existing research has focused largely on supervisor decision-making; however, less is known about how trainees experience and internalize entrustment. This study explores how trainee entrustment develops over a pharmacy internship and examines lived experiences that influence progression toward unsupervised practice.Methods:A convergent mixed-methods design explored the entrustment journey of provisionally registered (intern) pharmacists in Australia. Quantitative data were collected via self-administered questionnaires at three time points (beginning, middle, end of internship), capturing perceptions of entrustable professional activities (EPA) utility and self-perceived readiness for entrustment across ten EPAs. At year-end, focus groups explored pharmacy interns’ perceptions of the EPA framework and how they interpreted and internalized it in relation to their development. Qualitative data were analyzed using reflexive thematic analysis and triangulated with quantitative findings to examine convergence and divergence over time.Results:Seventeen pharmacy interns completed questionnaires; 16 of these participated in focus groups. Self-perceived readiness for entrustment increased significantly across most EPAs, with median entrustment ratings reaching level 3 (independent with reactive supervision) by the end of internship. Pharmacy interns described that being entrusted supported confidence development, particularly when paired with structured feedback and reflective practice. Some noted that an emphasis on meeting numeric benchmarks risked reducing the process to a “numbers game,” overshadowing diverse and complex learning opportunities, and diminishing feedback opportunities once level 3 was achieved. At times, this created asymmetry between being entrusted by a supervisor and the interns’ own sense of readiness for more complex practice.Conclusion:EPAs support trainees’ progression toward autonomy by embedding structure, feedback, and self-reflection that affirms competence and guides development. When entrustment decisions are tied to achieving a predetermined number of EPA observations, there is a risk that entrustment may be conferred prematurely, thereby reducing the depth of feedback and reflection that follows. When framed as assessments for learning, EPAs better support trainees’ transition to confident, autonomous practice.

Emergency hormonal contraceptive pills (ECP), a safe and effective way to reduce the risk of unwanted pregnancy, are available without a prescription in community pharmacies in Australia, and >90 countries globally. Supply is informed by practice guidelines for pharmacists in several countries; however, use remains limited. This study aimed to explore the perspectives and practices of community pharmacists in Australia when providing ECP, to identify challenges and facilitators encountered when using ECP practice guidelines. Semi-structured interviews were undertaken with purposively sampled Australian community pharmacists who actively supplied ECP, from across a diversity of locations and years of practice. Interview questions were informed by the Theoretical Domains Framework. The interviews were audio-recorded, transcribed verbatim, thematically analysed inductively, then deductively mapped against the Theoretical Domains Framework and double coded. Seventeen interviews were conducted. The four overarching themes - decision-making in ECP provision, geographic variation in practice, guideline use, and knowledge gaps and training needs - could be mapped against seven of the 10 relevant Theoretical Domains Framework domains. A lack of confidence and up-to-date knowledge among pharmacists was a challenge to optimal provision of ECP. Practice guidelines were acknowledged to contain valuable information, but were difficult to interpret, and use was limited. Australian pharmacists' perspective of their practice in providing ECP has highlighted the challenges and facilitators to the use of the ECP practice guidelines. Guidelines were seen as inaccessible, ambiguous and impractical, indicating the need for future research to optimise their use. Findings can inform targeted interventions to enhance ECP guideline uptake and improve patient outcomes.

Common ailment and non-prescription medication-related problems faced by people with intellectual disability: Findings from medication reviews provided by pharmacists.

Scope and factors associated with dietary and vitamin and mineral supplement (VMS) counselling by pharmacists in Australia

To explore what factors are considered in making an entrustment decision about a provisionally registered (intern) pharmacist from the perspectives of registered and intern pharmacists. Registered and intern pharmacists in Australia were invited to participate in an anonymous online survey. The survey included open-ended, free-text questions exploring the factors influencing entrustment decisions for three Entrustable Professional Activities developed by the Australian Pharmacy Council for use in workplace-based assessments of intern pharmacists: dispensing medicines, compounding pharmaceutical products, and providing medication counselling. Qualitative data were analyzed using Braun and Clarke's reflexive thematic analysis approach to identify key themes and subthemes influencing entrustment decisions. Of the 302 respondents (220 registered pharmacists and 82 interns), 215 participants provided qualitative responses. Analysis revealed four major themes: (1) Intern's competency and skill proficiency, with emphasis on technical knowledge, task execution, and interpersonal skills; (2) Intern's self-awareness and metacognition, including receptiveness to feedback and reflective practice; (3) Entrustment process dynamics, highlighting task complexity, contextual risk, and supervisor trust propensity; and (4) Barriers to and opportunities for establishing entrustment practices that guide entrustment decisions. Supervisors reported relying on team-based perspectives to inform entrustment decisions. Entrustment decision-making is a multifaceted process shaped by intern characteristics, task complexity, and contextual dynamics. In addition to technical competence, metacognitive capabilities and reflective practice were identified as critical to fostering more autonomy in practice. Variability in supervisors' trust propensity and entrustment practices highlights the need to strengthen entrustment practices to enhance consistency in how decisions are made and to support effective use of Entrustable Professional Activities in workplace-based pharmacy education.

To explore the expected level of entrustment and the corresponding degree of supervision for trainees at designated milestones during their pharmacy internship. Registered and provisionally registered (intern) pharmacists in Australia were invited to participate in an anonymous online questionnaire. Participants articulated the level of supervision they expect an intern pharmacist to achieve for the three Entrustable Professional Activities (EPAs) included in the Australian Pharmacy Council workplace-based assessment tools using the 5-level entrustment scale. These three EPAs are dispensing medicines, compounding pharmaceutical products, and providing medication counseling. A total of 302 responses were received (82 intern pharmacists and 220 registered pharmacists). Intern pharmacists' self-perceived level of entrustment was higher than the level expected by registered pharmacists at the midpoint and conclusion of intern training for the dispensing and compounding EPAs. Pharmacists in community pharmacy and hospital dispensary settings expected intern pharmacists to practice with more autonomy compared to hospital clinical pharmacists at the conclusion of intern training for the compounding and counseling EPAs. A medium level of consensus (50%-74.9% overall agreement at any one entrustment level) was reached by all pharmacists regarding the expected level of entrustment of intern pharmacists at different time points in training for all three EPAs. There is a lack of consensus among registered pharmacists regarding the level of supervision expected of intern pharmacists at defined time points in training. Entrustment decisions by registered pharmacists may vary depending on the practice setting. Intern pharmacists' self-perceived entrustment of their performance was higher than that of registered pharmacists, highlighting the need for further research to explore the existing gap between supervisor and trainee perceptions of supervision requirements.

Identifying public health competencies for Australian pharmacists: A modified Delphi study.

Community pharmacists in Australia are increasingly at the forefront of public healthcare, expanding their scope of practice since first providing immunisation services in 2014. This article examines the evolving role of pharmacists, highlighting their significant contributions to vaccination efforts. Despite their growing impact, pharmacists face complexities due to varying regulatory frameworks and scope of practice across Australian jurisdictions. These challenges affect service consistency and consumer experience. Opportunities for community pharmacies to enhance and strengthen their care of communities remain, including initiatives like the National Immunisation Program Vaccinations in Pharmacy (NIPVIP), which enhances vaccine accessibility and affordability and travel advice and vaccination. Community pharmacists also play a critical role in public health promotion, opportunistic immunisation and support when disease outbreaks occur. To maximise their value, the healthcare system must address regulatory inconsistencies and promote multidisciplinary collaboration. By overcoming these barriers, community pharmacies can continue to provide accessible, high-quality care, reinforcing their essential role in public health and vaccination services.

Medicine shortages are increasingly common and disruptive to the optimal delivery of health care. They are caused by a variety of factors, including manufacturing and supply-chain issues, regulatory and trade issues, and fluctuations in demand. Prescribers and pharmacists in Australia can manage a shortage by switching to another brand, strength or dosage form of the same medicine, switching to a different registered medicine, or accessing an unregistered medicine that has been made available via section 19A of the Therapeutic Goods Act 1989 or through the Special Access Scheme. There are a range of resources and tools that can assist clinicians with identifying and managing medicine shortages in Australia. Shortages are managed most effectively when prescribers, pharmacists and nurses work together, in collaboration with patients, to develop, implement and monitor strategies to manage the shortage.

Development and validation of measures of pharmacists’ acceptability and willingness to screen for perinatal depression

IntroductionA Community of Practice is briefly defined as a group of people with a shared interest in a given area of practice who work collaboratively to grow collective knowledge. Communities...

The authors acknowledge the Traditional Custodians of the lands on which our members meet, work, and live, including the Wurundjeri people of the Kulin Nation, Traditional Custodians of Naarm where the Society of Hospital Pharmacists of Australia (SHPA) is based. We thank Elders past and present, and celebrate Aboriginal and Torres Strait Islander Peoples as the first pharmacists, bush medicine practitioners, and doctors who practised on these lands. In Australia, everyone shares a fundamental right to safe and high-quality health care. This is defined in the Australian Charter of Healthcare Rights,1 which all healthcare systems must strive to uphold. The Australian Charter of Healthcare Rights summarises the basic rights of patients and consumers when accessing healthcare services, including access, safety, respect, partnership, information, privacy, and the ability to give feedback.1 This Standard references and relies on SHPA Standards of Practice for Clinical Pharmacy Services2 as the foremost Standard. This Standard supersedes the previous SHPA Standards of practice for the provision of palliative care pharmacy services3 and may overlap with others. Depending on the area of specialty practice it may be advisable to refer to additional Standards of Practice. The use of the word ‘specialisation’ in this Standard is in line with the National Competency Standards Framework for Pharmacists in Australia,4 where ‘specialisation’ refers to the scope of practice rather than the level of performance. ‘Specialisation’ in and of itself does not confer additional expertise. The National Competency Standards Framework for Pharmacists in Australia4 complements the underpinnings of the Australian Charter of Healthcare Rights1 across five domains of competency for the pharmacy profession: (1) professionalism and ethics, (2) communication and collaboration, (3) medicines management and patient care, (4) leadership and management, and (5) education and research. This Standard is for professional practice and is not prepared or endorsed by Standards Australia. It is not legally binding. Palliative care has traditionally been equated to end-of-life care, but it can be and is provided in conjunction with disease-modifying therapies aimed at prolonging life in many conditions.5 Many people live with life-limiting conditions for many years.6 Palliative care can therefore be equally beneficial for patients first diagnosed with a life-limiting condition and for patients with active, progressive, advanced disease with little to no prospect of cure.7 Although not intended to prolong or hasten death, provision of palliative care has been associated with increased survival and less intensive care at end-of-life.8, 9 The World Health Organization recognises that access to palliative care, to relieve health-related suffering, is a human right.10 The purpose of this Standard is to describe current best practice for the provision of palliative care pharmacy services (Box 1) and is intended for palliative care pharmacists. For this Standard, all pharmacists who provide palliative care pharmacy services will be referred to as palliative care pharmacists. Palliative care pharmacy services include:

Abstract BackgroundThe expanding scope of practice for pharmacists in Australia now includes the provision of vaccination services. Therefore, it is crucial to understand the perceptions of pharmacists regarding vaccination services and the impact of providing this service on their job satisfaction and well‐being.AimThis study aims to evaluate the job satisfaction and well‐being of pharmacists in Australia regarding the provision of vaccination services. Additionally, it aims to determine the barriers to administering vaccines by pharmacists.MethodA mixed‐methods study was conducted among pharmacists in Australia. An anonymous survey was distributed to pharmacies via email and advertised on social media sites. Ethics approval was granted by the RMIT Research Ethics Committee (Reference no: 24747) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained for all participants via a project information sheet and voluntary completion of an anonymous survey.ResultsThe study found that community pharmacists experienced moderate job satisfaction levels, with mean job satisfaction and well‐being scores of 17.6 (±6.2) and 17.0 (±6.50) respectively. A correlation was identified between job satisfaction and well‐being, indicating that lower job satisfaction corresponded to lower well‐being. Factors such as years of experience (p = 0.001), work‐related stress (p = 0.001), willingness to vaccinate (p = 0.001), workload (p = 0.001) and lack of support and reimbursement for vaccinating pharmacists influenced job satisfaction and well‐being levels.ConclusionThe study highlights the median to minimal job satisfaction levels among pharmacists in Australia and the correlation between pharmacists' willingness to administer vaccines and their job satisfaction and well‐being. Additionally, the study underscores the need for additional support and reimbursement for vaccinating pharmacists. To enhance the pharmacy profession's role in the healthcare system, new strategies are required to support pharmacists in providing vaccination services.

Trans and gender-diverse people visiting pharmacies may not always receive optimum care due to pharmacists' lack of knowledge and confidence to provide such care. This situation prompts a need for training. This paper aimed to describe a guide to the design, implementation, and evaluation of a training program on transgender healthcare for pharmacists in Australia. The Implementation Mapping Framework provided a foundation for the design, implementation, and evaluation of this training program. Through active involvement in the program development, trans and gender diverse people and pharmacists guided the program design, ensuring alignment with the cultural, social, and healthcare contexts. The needs analysis highlighted the necessity for training for pharmacists to improve their cultural awareness and pharmacotherapeutic knowledge about transgender healthcare. Applying a novel Gender Inclusivity in Pharmacy Framework, online modules-(1) Transgender healthcare-language, terminology, and key healthcare issues, (2) Gender-affirming therapies, and (3) Case studies in transgender healthcare-were developed to enable the implementation of a training program. The Implementation Mapping Framework and the Gender Inclusivity in Pharmacy Framework proved effective tools for providing an education program for pharmacists.

ABSTRACT The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists’ participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists’ participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke’s techniques. Five themes were constructed: “Clinical pharmacy service structure”, “Ward round structure”, “Pharmacist’s capabilities”, “Culture” and “Value”. A culture supportive of pharmacist’s contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists’ participation in WR. Being physically “absent” from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual’s role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.

To explore the roles of early adopters of Australia's embedded on-site pharmacist model in supporting quality use of medications in residential aged care facilities (RACFs). Qualitative semistructured interviews were conducted with 15 pharmacists working as embedded on-site pharmacists, or beyond the scope of traditional consultant pharmacist roles in Australian RACFs. Interviews were audio-recorded, transcribed and thematically analysed independently by two investigators using an inductive approach. Deductive analysis was also undertaken using a knowledge broker framework: knowledge manager, linkage agent and capacity builder. Dominant themes were roles and benefits of embedded pharmacists, factors associated with success and challenges. Roles and benefits included (1) resident-level interventions and an enhanced ability to provide collaborative outcome-focussed resident-centred care, including timely input and follow-up, and improved relationships with residents, family and interdisciplinary team; and (2) system-level interventions such as contributing to clinical governance and quality improvement. Factors associated with success included personal capabilities and approach of the pharmacist, and organisational culture and sector-wide support. Challenges included pharmacist workforce shortages, perceived lack of pharmacist readiness and difficulty determining an appropriate service model. Deductive coding demonstrated roles of embedded pharmacists were consistent with all three activities of a knowledge broker. This study highlights the resident- and system-level roles and benefits of embedded on-site pharmacists, and provides a framework for defining this emerging workforce model in Australian RACFs.

Adverse drug reactions (ADRs) are unintended and harmful events associated with medication use. Despite their significance in postmarketing surveillance, quality improvement, and drug safety research, ADRs are vastly underreported. Enhanced digital-based communication of ADR information to regulators and among care providers could significantly improve patient safety. This paper presents a usability evaluation of the commercially available GuildCare Adverse Event Recording system, a web-based ADR reporting system widely used by community pharmacists (CPs) in Australia. We developed a structured interview protocol encompassing remote observation, think-aloud moderating techniques, and retrospective questioning to gauge the overall user experience, complemented by the System Usability Scale (SUS) assessment. Thematic analysis was used to analyze field notes from the interviews. A total of 7 CPs participated in the study, who perceived the system to have above-average usability (SUS score of 68.57). Nonetheless, the structured approach to usability testing unveiled specific functional and user interpretation issues, such as unnecessary information, lack of system clarity, and redundant data fields-critical insights not captured by the SUS results. Design elements like drop-down menus, free-text entry, checkboxes, and prefilled or auto-populated data fields were perceived as useful for enhancing system navigation and facilitating ADR reporting. The user-centric design of technology solutions, like the one discussed herein, is crucial to meeting CPs' information needs and ensuring effective ADR reporting. Developers should adopt a structured approach to usability testing during the developmental phase to address identified issues comprehensively. Such a methodological approach may promote the adoption of ADR reporting systems by CPs and ultimately enhance patient safety.

The inclusion of clinical pharmacists in ward rounds (WRs) can reduce adverse drug events, improve communication and enable collaborative decision-making. The aim of this study is to investigate the level of and factors that influence WR participation by clinical pharmacists in Australia. An online administered, anonymous survey of clinical pharmacists in Australia was conducted. The survey was open to pharmacists aged ≥18 years, who had worked in an Australian hospital in a clinical role in the previous two weeks. It was distributed via The Society of Hospital Pharmacists of Australia and on pharmacist-specific social media threads. Survey questions related to the extent of WR participation and factors that influence WR participation. Cross-tabulation analysis was conducted to determine whether there was an association between WR participation and factors that influence WR participation. Ninety-nine responses were included. The level of WR participation by clinical pharmacists in Australian hospitals was low, with only 26/67 (39%) pharmacists who had a WR in their clinical unit actually attending the WR in the previous 2 weeks. Factors that influenced WR participation included having recognition of the role of the clinical pharmacist within the WR team, support from pharmacy management and the broader interprofessional team, and having adequate time and expectation from pharmacy management and colleagues to participate in WRs. This study highlights the need for ongoing interventions such as restructuring workflows and increasing the awareness of the role of a clinical pharmacist in WR to increase participation of pharmacists in this interprofessional activity.

Abstract BackgroundThe implementation of digital healthcare systems in hospitals globally and in Australia has led to the introduction of the informatics pharmacist as a career in the healthcare system. However, informatics pharmacists are not yet part of routine clinical services in Australia, so their perspective and roles are not well understood.AimTo explore pharmacists' and other health professionals' perspectives of the roles of informatics pharmacists within interprofessional teams in Australian health care.MethodThis study used semi‐structured interviews with experts in pharmacy and/or informatics. They were recruited using convenience sampling and snowballing. The interviews were audio‐recorded and transcribed and analysed using inductive thematic techniques to identify major themes. Ethical approval was received from the local institutional Human Research Ethics Committee (Approval No: 2020000069).ResultsThe process of inductive thematic analysis was used to analyse the interview transcriptions of 11 participants. Six themes were identified: (1) a promising future for the informatics pharmacists, (2) education, (3) specific skills, (4) scope of informatics role, (5) impacts, and (6) barriers. Participants described the career of informatics pharmacists as an emerging specialty in today's healthcare systems. The roles of informatics pharmacists in Australian health care are described together with the skills and knowledge required for these roles.ConclusionA key role of informatics pharmacists is to facilitate the appropriate use of digital systems to prevent medication errors and improve patients' safety. While international experience has shown the potential scope for an informatics pharmacist, this research shows the use of informatics pharmacists in Australia is in its infancy.

Development and Validation of Entrustable Professional Activities for Provisionally Registered (Intern) Pharmacists in Australia