International Journal of Pharmacy Practice

Hemsworth, A; Gray, N J

doi: 10.1093/ijpp/riag034.020pmid: N/A

IntroductionLegislative and regulatory frameworks governing the practice of community pharmacy public health services (CPPHS)—and the way in which the community pharmacy workforce (CPW) interacts with them—tend to focus on the role of the community pharmacist. This focus influences associated policies, guidance, evaluations and research. Team-based CPPHS activities, however, could optimise skill mix to provide timely and appropriate advice, support and interventions. An initial policy review for England, as part of this PhD research programme, suggested a systemic failure to fully recognise and articulate the potential of involving the wider CPW in CPPHS, and a lack of inclusive policy frameworks and educational strategies for non-pharmacist staff, despite their growing involvement in CPPHS delivery.AimTo examine the CPPHS literature to establish which members of the CPW are participants therein, the nuances of their roles, and reflections on education and training (E&T) required for CPPHS delivery.MethodsJBI methodology[1] guided a scoping review (ScR) including the use of the PRISMA-ScR checklist. The Sample (S), Phenomena of Interest (P of I), Design (D), Evaluation (E) and Research (R) type SPIDER[2] search framework defined the inclusion criteria. Scopus, CINAHL Ultimate and MEDLINE databases were searched with specific keywords to identify articles published in English or French from 1st January 2008 to 14th February 2025 and conducted in the UK, USA, Australia, New Zealand or France. Searches were combined in the sequence of S + (P of I1 + P of I2) + (D or E) + R. The PhD researcher undertook the selection of included studies in three phases (title, abstract and full text). Data were charted into a Microsoft Excel spreadsheet using pre-defined parameters in line with the search strategy. Mixed method data analysis approaches (content and thematic analysis) were used, with study characteristics being analysed quantitatively and extracted data relevant to the ScR objectives being analysed qualitatively.ResultsThirty-four studies were included from a yield of 579 articles, the majority of which came from England (n = 13). All studies referenced pharmacists, but they were only participants in thirty. Sixteen studies included at least one cohort of non-pharmacist participants, such as healthy living champions (HLCs) (n = 7), pharmacy technicians (n = 4) and/or pharmacy assistants (n = 4). Characterisation of non-pharmacist roles was predominantly missing, with studies focusing on overall service delivery as opposed to individual capabilities. In respect of E&T, an important finding in respect of non-pharmacist roles was that other healthcare professionals do not view CP support staff as having the same level of knowledge as their counterparts in GP practices, e.g. healthcare assistants.ConclusionA strength of this ScR is that it has exposed the gap in the literature relating to the PH role of the non-pharmacist CPW, which is consistent with the perpetual cycle of missed opportunities to create whole workforce, evidence-based policy in this field. Addressing this research gap will align well with government-stated need for a new team-based approach to CPPHS delivery. The ScR was limited by predominantly absent definitions for non-pharmacist workforce groups, making it difficult to compare roles across different countries.

Al Hamarneh, Y N; Ramrattan, D; Tsuyuki, R; Sullivan, K; Pan, B; Simpson, S

doi: 10.1093/ijpp/riag034.043pmid: N/A

IntroductionNational surveys estimate that up to 22% of Canadians do not have a regular primary healthcare provider and, of those who have a family physician or nurse practitioner, only about 40% are able to get an appointment on the same/next day. Therefore, many consider primary healthcare in Canada to be in crisis. In the absence of having primary healthcare provided by a family physician or nurse practitioner, many Canadians seek care at emergency departments and walk-in clinics. This displacement of primary care not only places a large burden on acute care systems but also jeopardises continuity of care. In response to this crisis, community pharmacy care clinics were established.AimTo characterise who accesses services offered in a community pharmacy care clinic and the reasons for visiting.MethodsThis cross-sectional descriptive study used information collected from paper-based intake forms that were provided to individuals when they entered the clinic seeking care. Individuals who visited the clinic in Lethbridge, Alberta, Canada between June 24, 2022 and January 31, 2023 were eligible for inclusion. Data were summarised using descriptive statistics. Visit frequency and reasons for visiting the community pharmacy care clinic were stratified according to having a family physician and compared using Chi-squared test.ResultsThere were 3305 people who visited the clinic 4962 times. They submitted 3831 intake forms with 4611 reasons for seeking care. Median age was 32 years (IQR 20 to 51) and 62% were female. Almost one in three (32%) reported not having a family physician and 5% reported usually seeking medical care in an emergency room (ER) or urgent care clinic. Reasons for seeking care were: 79% common ailments (e.g. upper respiratory symptoms, urinary tract infections); 16% chronic disease management (CDM; e.g. diabetes, hypertension); 4% point of care testing or immunisation; or < 2% other. Reasons for seeking care differed whether an individual had a family physician or not (p < 0.01). CDM was more frequently reported as a reason for the visit for people without a family physician (29%) compared to those with one (9%). In contrast, people with a family physician sought care for common ailments more frequently (86%) compared to those without one (63%). Of those who usually seek care in an emergency room or urgent care clinic, 25% of pharmacy clinic visits were for CDM while 69% were for common ailments.ConclusionOur findings indicate that the community pharmacy care clinic has improved access to primary care services to a wide variety of individuals regardless if they had a family physician or not. According to self-reported data, the clinic provided another avenue for continuity of care for CDM, particularly for those who do not have a family physician, as well as assessment and management of common ailments and public health services. The fact that we used information collected from self-reported paper-based intake forms that were not intended for research purposes limited the available data. Using the data for only the first seven months of operations, may have underrepresented the need for the clinic’s services.

Boyce, S; Edgar, H; Adams, V; Bell, K; Booth, N; Daly, O; Turtle, B; Haughey, S

doi: 10.1093/ijpp/riag034.065pmid: N/A

IntroductionHealthcare programmes aim to produce capable and compassionate professionals. An immersive simulation experience allows students to take on the role of the patient to help them to empathise and understand the lived experiences of others.[1] However, this approach is relatively new to the healthcare professions in this study particularly for understanding older and neurodiverse (ND) patients. In 2024/2025, the KN Cheung SK Chin InterSim Centre, a university simulation-based facility in Queen’s University Belfast (QUB), was used to develop interprofessional immersive simulation on the themes of ageing and neurodiversity. Academics, students, practitioners and patients co-designed two scenarios to give students a ‘lived experience’ as ageing and ND individuals navigating healthcare systems. In scenario one, interprofessional groups experienced a dental surgery which was modified to deliver sensory overload whilst completing cognitive challenges. In scenario two, partners donned ageing suits to complete tasks involving collecting and organising medicines. In March 2025, students from pharmacy (QUB), dentistry (QUB) and occupational therapy (Ulster University) were timetabled to complete the final immersive simulations. Each student completed pre-reading, a pre-brief, two scenarios and a supported debrief.AimTo explore the post-event impact of an interprofessional, immersive simulation of ageing and neurodiversity using qualitative methodologies.MethodsA love and breakup letter methodology[2] (a qualitative technique) was employed at the beginning of each debrief session to capture the students’ initial reactions to and reflections on the simulated scenarios. Participants completed their letters using an anonymised letter template on Microsoft Forms. Online focus groups were scheduled two months post-event to explore the longer-term impact. Study participants for the focus groups were recruited at the end of the debrief via an information link. The focus group discussions were transcribed verbatim and anonymised. The focus groups and letters were analysed by three of the researchers and key themes/sub themes identified using thematic analysis.ResultsThe ‘lived experience’ was completed by 96 students (44 pharmacy, 43 dental, 9 occupational therapy)​. Through the facilitated debrief, students explored age-related physical challenges, neurodiversity and healthcare as well as the reasonable adjustments which can be made to reduce health inequalities faced by these patient groups. The anonymised love/breakup letters (n = 96), employed in each debriefing session demonstrated creative reflections from participants. Three main themes were generated including empathy, collaboration and professional development. Two online interprofessional focus groups (n = 3 per group) completed >2 months post-event revealed that participants maintained an empathetic approach and were actively putting into practice what they had learnt including person-centred reasonable adjustments. Analysis of the focus group data generated multiple themes around experiencing patient challenges, empathy, professional insights and collaborative practice.ConclusionThis study provides new insights into how an interprofessional, immersive simulation can provide a valuable experience for students to develop empathy, understanding and the professional insights needed for inclusive practice. The study is strengthened by an interprofessional approach but limited to single centre data collection. Further research is required to ascertain if the results could be replicated with other interprofessional groups and if this impact is maintained beyond registration.

Alageel, N A; Hughes, C M; Alwhaibi, M; Barry, H E

doi: 10.1093/ijpp/riag034.051pmid: N/A

IntroductionDementia is a growing global health challenge, and healthcare professionals’ knowledge and attitudes significantly influence quality of care.[1] Pharmacists, as key members of the healthcare team, play a central role in supporting medication use. Evidence indicates that pharmacist-led interventions can improve caregivers’ understanding, enhance medication adherence, and positively impact health outcomes for people with dementia (PwD).[2] However, little is known about pharmacists’ preparedness to care for PwD in Saudi Arabia.AimThis study sought to evaluate Saudi Arabian hospital pharmacists’ perceived knowledge and attitudes towards PwD, and identify factors associated with these outcomes. Pharmacists’ prior education and training in dementia and their future learning needs were also established.MethodsA self-administered questionnaire (completed on paper or online) was distributed among hospital pharmacists in nine tertiary hospitals in Riyadh between December 2024 and March 2025. A purposive sampling approach was used to invite eligible pharmacists directly involved in dispensing medication for PwD (n = 372). Data were collected on respondents’ demographic characteristics, knowledge of dementia using the validated Alzheimer’s Disease Knowledge Scale (ADKS, which assesses knowledge across seven domains: life impact, risk factors, symptoms, treatment and management, assessment and diagnosis, caregiving, and course of the disease), attitudes towards PwD using the Dementia Attitudes Scale (DAS), and education and training received on dementia. Descriptive and inferential statistics were used to summarise participants’ characteristics and their responses, whilst regression analyses explored factors associated with knowledge and attitudes; p ≤ 0.05 was considered significant. Open-ended responses were analysed using content analysis.ResultsThe response rate was 60.2% (224/372). Most respondents were female (n = 122, 54.5%) with a median age of 32 years. Many respondents were recent graduates, having been qualified for ≤5 years (n = 83, 37.1%). The overall mean knowledge score was 18.9 (SD ±3.6) out of 30, corresponding to 62.9% correct answers. Knowledge scores varied across domains, from 48.3% in ‘risk factors’ to 74.6% in ‘life impact.’ The overall mean attitude score was 93.5 (SD ±13.4) out of 140. Female respondents (β = 0.22, p = 0.001) and those with professional experience of PwD (β = 0.16, p = 0.02) had significantly higher knowledge scores. Having a relative with dementia (β = 0.20, p = 0.004) and holding a postgraduate qualification (β = 0.13, p = 0.06) were associated with more positive attitudes towards PwD. Most respondents (n = 208, 93.0%) had never received dementia-related training, although many expressed interest in attending future training focused on caregiving, communication, and medication use.ConclusionAlthough pharmacists generally expressed positive attitudes towards PwD, their knowledge was moderate, with notable gaps in areas such as the risk factors for dementia. Given the limited prior training reported and respondents’ interest in receiving further training, targeted educational interventions are needed to enhance pharmacists’ knowledge in this area. While these findings contribute to the limited evidence base, they may not be generalisable to other regions or healthcare settings in Saudi Arabia.

Mohammad, F H R; Abuelhana, A; Ammari, W; Ramadon, D; Permana, A D; Iqbal, M; Aisha, S; Mohamed, N; Shah, F; Sabry, N; Courtenay, A J

doi: 10.1093/ijpp/riag034.015pmid: N/A

IntroductionPublic health emergencies, including the COVID-19 pandemic, have highlighted pharmacists’ vital roles in sustaining medicines supply, delivering vaccination programmes, supporting remote care delivery and managing health misinformation within communities.[1] Despite these crisis-response contributions, there is limited synthesis of global evidence examining the extent of pharmacists’ roles across healthcare settings and how these functions are reflected in pharmacy curricula; without crisis training, service gaps may directly affect patient care.[2] A scoping review was conducted to map international contributions by pharmacists during crises and to establish implications for pharmacy education. Embedding this diversity into the review process strengthens inclusivity and the global relevance of findings.AimTo review global evidence on pharmacists’ roles in crisis preparedness and response and identify how evidence informs educational and training needs within pharmacy curricula.MethodsThe review followed PRISMA-ScR guidelines. Five databases (PubMed, Scopus, Embase, CINAHL, Web of Science) were searched for English-language literature published between 2000–2025 using standardised search terms related to pharmacists, pandemics, disaster preparedness, workforce resilience, and education. Ten student reviewers from eight countries participated. Data were extracted independently using a standardised extraction form that captured crisis type, country, healthcare setting (community, hospital/secondary care, primary care or public health administrative settings), pharmacists’ roles, and educational implications. Discrepancies in interpretation were resolved through structured consensus discussions chaired by academic mentors. The collaboration was organised through fortnightly Microsoft Teams meetings where progress was reviewed and agreed tasks assigned. Each fortnight, reviewers examined one of six predefined key focus areas across all represented countries: (1) workforce resilience and medicines supply; (2) pharmacists’ roles in vaccination programmes; (3) public health communication and misinformation management; (4) use of digital health; (5) interprofessional collaboration; and (6) integration of crisis-preparedness content into pharmacy curricula. Findings were cross-checked and synthesised collaboratively during team meetings to ensure methodological rigour and shared interpretation.ResultsThe search returned 684 records; 79 full-text articles were screened, and 28 met the inclusion criteria. Four key points were identified. (1) Workforce resilience and medicine supply: pharmacists in all four settings mitigated shortages, although strategies varied by national supply chain robustness. (2) Vaccination and public health communication: UK and Jordan evidence highlighted pharmacists as trusted vaccinators and educators; Indonesia and Egypt emphasised the impact of community outreach. (3) Digital health and innovation: telepharmacy models were well-reported in the UK; emerging practices noted in Indonesia. (4) Education and training gaps: across all settings, crisis preparedness remains underdeveloped in curricula, although simulation and interprofessional learning pilots were identified in the UK and Indonesia.ConclusionThis review demonstrates that pharmacists contribute essential services during public health crises across multiple healthcare settings; however, evidence indicates an urgent need to integrate crisis-preparedness competencies into undergraduate and postgraduate pharmacy programmes. The international, student-led collaboration strengthened interpretation by incorporating diverse educational and healthcare contexts, although restricting the search to English and variation in reviewers’ experience represent study limitations. Future research should explore how crisis-focused curriculum innovations can be aligned internationally to ensure preparedness competencies are consistently incorporated across pharmacy education and workforce development.

Ibrahim, A Hasan; Almajawleh, M; Abuzaid, H

doi: 10.1093/ijpp/riag034.011pmid: N/A

IntroductionCollaboration between physicians and community pharmacists (CPs) is essential for delivering high-quality patient care.[1] Nevertheless, achieving effective collaborative practice remains challenging.[1] Understanding physicians’ attitudes and barriers to collaboration with CPs is therefore critical to optimising healthcare delivery. However, evidence on physician–CP collaboration in Jordan remains limited, and no studies have examined physicians’ perspectives to date.AimTo investigate physicians’ experiences, views, and attitudes toward collaboration with CPs, and its impact on patient care.MethodsA self-administered questionnaire was distributed to 380 physicians in Amman, Jordan, between January and March 2025 using convenience sampling method. Eligible participants were licensed physicians registered with the Jordan Medical Association and practising in either public or private healthcare facilities in Amman. Participants completed either an online or paper-based questionnaire after providing informed consent. The questionnaire was developed by the research team members following an extensive literature review. The questionnaire comprised four sections: (A) demographic information; (B) extent of collaboration with CPs; (C) physicians’ attitudes toward collaboration with CPs assessed using an adapted version of the Attitudes Towards Collaboration Instrument for general practitioners (ATCI-GP);[2] and (D) physicians’ views on the impact of collaboration on patient care. Descriptive analyses were conducted using SPSS v28 and responses to open-ended questions were analysed thematically.ResultsA total of 209 physicians participated (55.0%). The majority were male (84.2%, n = 176), and over half were under 40 years of age (52.6%, n = 110). Most participants reported some level of collaborative practice, with 47.4% (n = 99) indicating they had sometimes collaborated with CPs and a further 26.3% (n = 55) reporting frequent collaboration. More than half reported sometimes lacking time to return CPs’ calls (51.7%, n = 108), and 54.5% (n = 114) noted that direct communication methods were only sometimes available. Most physicians expressed positive attitudes toward collaboration with CPs, with seven out of 13 statements showing agreement rates above 75%, notably regarding open communication (88.0%, n = 184), mutual respect (87.6%, n = 183), and shared goals in patient care (81.3%, n = 170). However, neutral attitudes were reported regarding trust in CPs’ decisions (42.1%, n = 88), therapeutic expertise (46.9%, n = 98), and meeting professional expectations (33.0%, n = 69). Despite the varying levels of current collaboration with CPs, nearly all physicians agreed/strongly agreed that further collaboration with CPs will have a positive impact on patient outcomes (98.1%, n = 205) and will help to alleviate pressure on the healthcare system (95.7%, n = 200). Thematic analysis of open comments revealed that physicians recommended enhancing collaboration with CPs by increasing mutual role awareness through regular meetings.ConclusionThis study has revealed that the majority of physicians had positive views regarding collaboration with CPs and its impact on care. Positive attitudes were also evident, particularly in areas such as communication, mutual respect, and shared goals with CPs. However, neutral attitudes toward CPs’ expertise and decision-making reflect uncertainty about CPs’ clinical roles, highlighting the need for trust-building and role clarification. While the sample covered diverse healthcare settings, the focus on Amman may limit generalisability to other regions of Jordan. Exploring CPs’ views of collaboration with physicians is required to corroborate study findings.

O’Hare, R; Abuelhana, A; Hughes, F

doi: 10.1093/ijpp/riag034.064pmid: N/A

IntroductionThe General Pharmaceutical Council (GPhC) standards for initial education and training of pharmacists recognise the role of experiential learning (EL) in enhancing preparedness for practice.[1] In Northern Ireland (NI), the Clinical Education Pharmacy Team work with both Schools of Pharmacy to develop Entrustable Professional Activities (EPAs), based on authentic practice tasks, to evaluate student competence in hospital-based practice activities.[2] The retrospective entrustment scale developed for pharmacy undergraduate context in NI has been adapted from the literature, and offers five choices; 2a, 2b, 3a, 3b, and 3c, which offer incrementally increased independence, e.g. if the activity was not completely independently: 2a [Practice Supervisor (PS) had to intervene throughout], completely independently: 3c (PS ready to step in if needed).[2] PSs completed training in 2024 including how to formulate an entrustment decision for a student. All pharmacy undergraduate students in NI in 2024–25 completed hospital-based EL for three days in Year 2, two weeks in Year 3, and three weeks in Year 4. PSs assign an entrustment decision to student performance after observing the activity and discuss areas of improvement during a feedback conversation.AimTo evaluate pharmacy students’ ability to complete authentic pharmacist tasks in secondary care with increasing independence and responsibility, as judged by entrustment decisions by PSs on EPAs.MethodsAn evaluation of entrustment decisions made by PSs in secondary care using the NI Entrustment Scale was undertaken in May 2025.[2] Each entrustment decision for each EPA (2a, 2b, 3a, 3b or 3c) was recorded and counted. All EPAs completed by pharmacy undergraduates attending EL in hospital in 2024–25 were included. Where EPAs were completed in two academic years, the results were compared using descriptive statistics.ResultsA total of 3753 entrustment decisions made on 692 pharmacy students from Year 2 (n = 259), Year 3 (n = 244) and Year 4 (n = 189) were reviewed. Seventeen percent of Year 2 students received an entrustment level of 3c when completing a medication history, compared to 21% of Year 3 students. Thirteen percent of Year 3 students received an entrustment level of 3c when completing medication review compared to 23% of Year 4. Nineteen percent of Year 2 received an entrustment level of 3c when evaluating and managing clinical improvement or worsening compared to 31% of Year 4. Sixty percent of Year 4 students received 3b for their prescribing skills, a further 26% received 3c.ConclusionThis study shows that as NI pharmacy students’ progress through the MPharm, acquiring knowledge, skills and engaging in more EL, they are more likely to achieve a higher entrustment rating from a PS. Limitations include the need to further develop PSs’ understanding of entrustment, and the comparison between academic years may be due to differing academic ability and not solely evolving competence. In future studies, we can compare third year performance in 2024–25 to fourth year performance in 2025–26.

Davison, K; Kaur, J

doi: 10.1093/ijpp/riag034.030pmid: N/A

IntroductionResidents in care homes have been shown to exhibit higher rates of antibiotic resistance compared to community-dwelling individuals.[1] This population also has a high prevalence of asymptomatic bacteriuria, for which urine dipstick testing is not recommended.[2] Age-related changes, including reduced renal function, require careful antibiotic selection; for example, nitrofurantoin is cautioned when estimated glomerular filtration rate (eGFR) is low. Within our Primary Care Network (PCN), prescribing outside local guideline recommendations was observed for suspected urinary tract infection (UTI). Given the elevated risks of antimicrobial resistance and adverse drug effects in this cohort, a multisector initiative was developed to improve antimicrobial stewardship (AMS) and prescribing pathways.AimTo evaluate the impact of a system-wide educational intervention on the management of suspected UTIs in care homes.MethodsA system-wide approach was implemented across one PCN between January and December 2023 involving three GP practices, the admission avoidance nursing team, and six local care homes. Educational materials were co-developed by the PCN clinical pharmacists, regional AMS leads, and care home nursing leads. Resources included: (1) a structured teaching presentation; (2) clinical decision-support posters summarising recognised symptoms for UTI, indications for urine sampling, and first-line antibiotics; and (3) an educational booklet designed to support new staff during turnover. The training was delivered in person by the clinical pharmacy team. Educational domains covered key AMS principles: recognising symptoms consistent with UTI, avoiding unnecessary urine dipstick testing, criteria for appropriate urine samples, assessing renal function before prescribing, and guideline-aligned antibiotic selection. Data collection included: Knowledge assessment at baseline and post-intervention questionnaires for clinicians and care home staff. Prescribing review: retrospective analysis of antibiotic prescriptions for suspected UTIs and clinical documentation of renal function checks. This was analysed through clinical system review over two 3-month periods (March–May 2022 pre-intervention and March–May 2023 post-intervention). Urine sampling assessment: appropriateness of urine samples was evaluated (presence of new urinary symptoms, and adherence to local guidelines).ResultsSeventeen clinical team members and nine care home staff participated in the intervention. Post-intervention questionnaire scores improved across all educational domains, with the most marked improvements in recognising appropriate indications for urine sampling and renal function assessment. Across the two prescribing review periods, documentation of symptoms aligned more consistently with guideline criteria with the proportion of appropriate urine samples increased from 46% (2022) to 100% (2023). Use of renal function calculations (eGFR recording prior to prescribing) increased from 0% (2022) to 100% (2023). Overall antibiotic prescribing for suspected UTI reduced by 52% from 2022 to 2023 with reductions across all antibiotics.ConclusionA system-wide, multisector educational intervention improved staff knowledge and resulted in measurable improvements in UTI-related prescribing behaviours, sampling practices, and use of renal function calculations. Strengths of this study include its multi-sector engagement and replication in real-world practice conditions. Limitations include the single-PCN setting and relatively small sample size, which may affect generalisability. Further rollout and evaluation across wider geographical areas are warranted.

Alzu’bi, G M; Barry, H E; Hughes, C M

doi: 10.1093/ijpp/riag034.074pmid: N/A

IntroductionA core outcome set (COS) represents the minimum set of outcomes that should be reported in all trials related to a specific healthcare area.[1] In 2019, a COS for medicines management interventions for people living with dementia (PLWD) was published.[2] This COS included 21 outcomes with priority given to the seven highest ranking outcomes.[2] However, utilisation of this COS and whether its content requires revision/updating should be evaluated.AimTo assess implementation of the existing COS and its current content using a structured literature review, with a view to updating and refining the included outcomes.[2]MethodsOvid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane CENTRAL, and Web of Science, Research Registry, International Clinical Trials Registry Platform, and ClinicalTrials.gov were searched from 2016 (the cutoff date of the previous review informing the content of the current COS[2]) until April 2025 using search terms to identify outcomes being used in clinical trials since the original COS was developed.[2] Randomised controlled trials (RCTs) or RCT protocols targeting medicines management interventions for PLWD and/or carers, and published in English were included. Information was extracted from included studies encompassing author names, country of study, description of intervention and control groups, and outcomes measured. Extracted outcomes were compared with the content of the COS.[2] Findings were summarised using frequencies and presented in tables.ResultsIn total, 553 articles were retrieved. Following removal of duplicate and non-English records, titles and abstracts of 356 records were screened, leaving 42 articles for full-text screening. Nineteen articles relating to 13 trials and six trial protocols were identified; most (n = 14) were published after publication of the COS. Although some of them used outcomes included in the COS, none of them explicitly cited the COS and several non-COS outcomes were used in the studies. Table 1 presents an overview of outcomes and their use in identified studies.ConclusionThis study highlighted poor implementation of the existing COS in recent clinical trials. The main study limitation was the lack of standardised outcome definitions across studies and how this may have affected comparison with COS outcomes. This study highlights the need to update/revise the COS, explore reasons for poor implementation, and promote its uptake.

Dalton, K; Cullinane, F; Walsh, E; McCarthy, S

doi: 10.1093/ijpp/riag034.017pmid: N/A

IntroductionPeer involvement in objective structured clinical examinations (OSCEs) offers opportunities for peer assessment, teaching, and reflective learning through collaborative feedback.[1] Despite the reported benefits, peer-involved OSCEs are underutilised in health professions education. With limited evidence on peer-involved OSCEs in pharmacy education, a formative peer-involved OSCE was introduced for final year pharmacy students in University College Cork in 2024 to evaluate its potential curricular benefits based on student feedback.AimTo explore final year pharmacy students’ views of a peer-involved OSCE initiative.MethodsFinal year pharmacy students were organised into groups; each were assigned one case with actor briefs and candidate instructions for one OSCE station and had to create this station’s assessment checklist. Students rotated between the OSCE’s four stations to undertake roles as pharmacists, assessors, actors, and observers. Each station comprised one minute of reading time, five minutes of interactive time, followed by eight minutes to provide peer feedback to those in pharmacist roles. A cross-sectional anonymous online survey was administered following OSCE completion, which included questions on the OSCE’s usefulness, impact on future performance, and views on peer-to-peer feedback, as well as open comment sections. Eligible respondents comprised those who had participated in the peer-involved OSCE. Quantitative data were analysed using descriptive statistics, while qualitative responses were narratively synthesised.ResultsOf the 58 final year pharmacy students, 44 participated in the OSCE, all of whom completed the survey. All students found the session valuable, with most finding the session very/extremely valuable (90.9%). Nearly all agreed that the OSCE’s i) peer assessment helped enhanced their understanding of good clinical and communication skills (95.5%), ii) peer feedback received was constructive and helpful for improving performance (97.7%), and iii) opportunity to observe diverse student approaches was very/extremely useful (95.5%). Whilst most felt comfortable or very comfortable in receiving feedback from peers (90.9%), a minority (13%) believed that peer feedback could impact relationships outside the OSCE environment. Nearly all (95.5%) recommended incorporating peer-involved OSCEs into the curriculum. Findings from open comments included that the session allowed students to see OSCEs from a new perspective, with a desire for more structured guidance in OSCE checklist development. Despite a ‘more relaxed environment,’ there was still a ‘pressure to do well’ and not ‘seem incompetent’ in front of peers, whilst some found it challenging to give critical feedback due to peer relationships.ConclusionThis is the first study to explore pharmacy students’ perspectives on peer-involved-OSCEs, which found that peer involvement in a formative OSCE created new viewpoints for students to enhance their skills and inform future performance. While the study’s small sample size, unidisciplinary focus, and single-site nature may limit the findings’ transferability and generalisability to other pharmacy and healthcare programs, the study is strengthened by the survey’s full response—ensuring that the findings reflect the views of all participants and reducing the risk of response bias. This study highlights the value of peer-based learning strategies for optimising OSCE pedagogy and suggests that peer-involved OSCEs could be considered for earlier integration into health professions curricula.