Identifying the challenges faced by novice community pharmacists and developing a peer support intervention to ease their transitions to independent practitioners

UoM administered thesis: Phd

  • Authors:
  • Esnath Magola-Makina

Abstract

Background: The transition from trainee to newly-registered (novice) practitioner is regarded as the most stressful and challenging of time of a healthcare professional'™s career. Community pharmacists are unusual in that they transition into roles where they commonly work as the sole pharmacist, manage a team of support staff and are accountable from day one of professional registration (without any formal support structure), yet little research exists in this area. This study aimed to identify the transition challenges faced by novice community pharmacists and to develop and feasibility test an evidence-based intervention to ease their transitions to independent practitioners. Methods: Medical Research Council guidance for developing complex interventions was used to frame this programme of work. During development, evidence from existing literature and an exploratory nominal group study identified and prioritised the challenges faced by novice community pharmacists. Findings informed the iterative design process for a peer-coaching intervention with the following components; a social media group, one-to-one coaching, a handbook, group activities and weekly clinical/practice scenarios for group discussion. Twelve novice community pharmacists were recruited purposively to participate in the draft intervention, which was evaluated using semi-structured telephone interviews. Results: Twenty-five participants took part in homogenous group discussions consisting of novice community pharmacists, early career pharmacists, pre-registration tutors and pharmacy colleagues. Similarly to challenges reported by novice doctors and nurses, nominal group discussions identified the following challenges [in order of importance]; relationship management; lack of confidence; decision-making; being in charge and accountable; and adapting to the workplace. Relationship management was attributed to novices' lack of affective skills. There were some differences however in the challenges reported by novice community pharmacists, such as power struggles (with managers or pharmacy colleagues), inverse hierarchy, professional isolation, target culture and full immediate accountability. A number of factors perpetuating these differences were perceived to increase the weight of professional accountability and augment stress; the retail community pharmacy context, the relative lack of support and isolation from peers. Hence, the draft intervention focussed on supporting the novice community pharmacist to develop cognitive and affective skills. All participants viewed the social media forum as the most valuable component because it provided a ‘safe’ confidential space for reassurance, feedback, and sharing or discussing practice experiences. Participants also valued one-to-one discussions with the coach, which supported meaningful reflection and developing self-awareness. Outcomes reported by all participants included increased self-efficacy, increased confidence in decision-making/managing others, an increased sense of preparedness and the ability to cope during transition. Through group components, novice community pharmacists developed ‘a sense of belonging’ and reported feeling less isolated in the workplace. Conclusions: This novel programme of work revealed the challenges faced by novice community pharmacists during transition. Findings suggest that a lack of affective and cognitive skills, the demands of the job and professional isolation caused novices to experience psychosocial stress and high job strain. A group peer-coaching intervention designed to ease the transitions of novice community pharmacists was reported to be acceptable, feasible and beneficial. Study findings led to some recommendations for transition support interventions: incorporate psychosocial support with developmental activities; provide a supportive learning space for developmental discourse that is accessible facilitated and structured; and offer coaching and supported reflection from an experienced pharmacist coach.

Details

Original languageEnglish
Awarding Institution
Supervisors/Advisors
Award date31 Dec 2018