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Group assessment is an important collaborative learning structure for development of graduate teamwork competencies. However, group assessments are often associated with poorer learning outcomes due to highly negative student experiences involving tension and conflict. In this study, an online tool incorporating four strategic ‘GATES’ (Team structure, Communication, Leadership, and Situation monitoring/Mutual support) was designed to support the social processes required for team cohesion. The ‘GATES’ tool was evaluated using mixed methods in an observational, correlational (cross-sectional) study of 693 undergraduate and post-graduate university students and five academics in five Allied Health university courses with a group assessment task. Participants completed two anonymous questionnaires (previous experiences and current experiences) that generated both quantitative and qualitative data. In the first, 95.19% (178/187) of respondents reported a previous group assessment experience, and the experience was negative for 19.1% (34/178) of these students, with 85.3% (29/34) attributing this to group member behaviour. All academics reported issues with previous group assessments they had delivered. Of the students who used the tool (n = 52), there was no statistically significant association between gender, CALD status, or age with group assessment experience. However, 56.9% (29/52) of students and all five academics found the tool useful for getting the group started early, and for managing team issues. The tool appeared most helpful with organisation and planning than in managing team issues, potentially due to the tool negating issues before they arose. Overall, our study’s findings indicate that ‘GATES’ keeps students on track and provides timely support during the team management process.

Objectives NHS England has set itself a target of net zero emissions by 2050. Therefore, to address this gap in the literature, this study aimed to explore engagement with NHS policy on carbon reduction (including awareness of the Sustainable Development Unit [SDU] and the Coalition for Sustainable Pharmaceuticals and Medical Devices [CSPM]) in NHS hospital pharmacists in England. Methods Semi-structured interviews were conducted with 23 pharmacists working in six NHS England hospitals across all hierarchical levels. Four interview questions elicited Yes/No responses and one generated qualitative data which were analysed by two methods – Leximancer and manual coding. Key Findings Only five (5/23; 21.74%) had heard of the SDU and none knew its purpose. Those who did not wish to learn more about the SDU could not see its relevance to their clinical practice. Barriers identified to the inclusion of sustainability considerations in clinical decision-making were lack of knowledge of the environmental risk profiles for treatment options, lack of quality environmental evidence incorporated into clinical guidelines and lack of time to research for themselves. Many participants did not believe that environmental considerations were part of their job. Conclusions For NHS England to successfully deliver on its target of net zero emissions by 2050, immediate action is required from all hospital staff, clinicians included. The challenge for the NHS will be engaging pharmacists and other clinicians with sustainable clinical practice and working with clinicians to reduce identified barriers. As these data were collected in 2016, further research is warranted to determine if pharmacists’ attitudes towards sustainable practice are changing.

Pharmaceuticals and their packaging have a significant negative impact on the environment providing a very strong argument for action on the part of pharmacists and pharmacy technicians to engage with pro-environmental behaviours (PEBs) in their workplaces. The aims of this research were therefore to investigate in hospital pharmacists and pharmacy technicians, 1) factors affecting engagement with workplace PEBs, and 2) determine if legislated carbon reduction targets in the UK influenced workplace PEBs in the UK compared with Australia which does not have legislated carbon reduction targets. The environmentally responsible disposal of pharmaceutical waste was the PEB of interest in this study. A mixed methods research design was utilised and a conceptual model (key variables: Environmental attitude, concern, and knowledge, and organisational factors) was developed to identify factors influencing workplace PEBs. Participants were from five hospitals in Queensland, Australia and five NHS hospitals in England, UK. There was no statistically significant difference in environmental attitude or concern between the two groups-most had a mid-environmental attitude score and low levels of environmental concern. Participants lacked knowledge of the issue and the link between the environment and public health. Both Australian and UK participants reported recycling packaging waste was not a priority in the hospital pharmacy workplace (even in hospitals with recycling capability) as hospitals focused on compliance with clinical (contaminated) and confidential waste streams. Environmental attitude, knowledge, and concern therefore appeared to be weak influences on intention to perform workplace PEBs with workplace social norms (compliance due to audits) appearing to be a significant mediator of action. The key difference between the cohorts was that UK pharmacists felt waste was not in the scope of their role, and therefore not their responsibility. This study identified that

Background: Involving community pharmacists in the provision of care to people living with HIV has the potential to improve health outcomes. Aim: To explore community pharmacists’ perceptions and attitudes regarding the supply of HIV medicines following the Australian Government’s decision to list antiretroviral drugs (ARTs) on the Pharmaceutical Benefits Scheme (PBS) in 2016. Methods: A purposive sample of community pharmacists around Australia was invited to participate in an anonymous, online questionnaire that collected demographic information, and pharmacists’ perceptions and attitudes towards dispensing and counselling HIV antiretroviral medicines. Results: Of the 91 participants, the majority had not dispensed an HIV medicine. Most participants reported feeling comfortable when counselling people living with HIV about their medicines. However, most reported a lack of confidence in knowledge of HIV and HIV medicines, and a lack of confidence in counselling these patients about their medicines and managing the complex issues they experience. There was a statistically significant difference in genders with females reporting less confidence compared with males. Unsurprisingly, confidence in knowledge of HIV and HIV medicines was associated with confidence in counselling people living with HIV. Conclusion: Increased accessibility to HIV antiretroviral medicines through community pharmacies for Australians living with HIV has potentially improved patient health outcomes. However, community pharmacists need to be both confident and comfortable in talking to these patients. This study has identified that Australian community pharmacists would benefit from continuing professional education on this topic. These findings could also be relevant for improving outcomes of patients taking other high-cost drugs.

In the original article, the Royal Hobart Hospital (RHH) data used in the analysis was incorrectly labelled as admissions data. It has been brought to the authors' attention that this is in fact presentations data. This does not impact in any way the analysis and findings. The corrected article has replaced the term "admissions" with "presentations" when referring to the RHH data where necessary. It has also removed the first limitation in the "Limitations of this Study" paragraph in light of these changes. The author apologizes for this error.

Background: Disasters affect health services, health professionals and the health of individuals. During disasters, pharmacists are essential in maintaining the health of their communities. Despite the important roles pharmacists undertake in disasters, little is known about their preparedness to respond to disasters that may affect their communities. Aim: To qualitatively explore the factors that affect Australian pharmacists’ preparedness for disasters. Methods: Semistructured interviews aimed at exploring disaster preparedness were conducted with 13 pharmacists in Australia. Participants were recruited using purposive, snowball, and convenience sampling methods. Interviews were audio recorded and transcribed verbatim. Open and axial coding methods were used to determine the factors associated with preparedness. Ethical approval was obtained from Queensland University of Technology (no. 1700000626). Results: Almost half of the participants (46%) did not feel that they were prepared for a disaster likely to affect their primary place of practice. Two overarching themes contributing to participants’ preparedness were identified: ‘individual factors’ and ‘external factors’. Pharmacists believed that their preparedness was affected by the individual factors of experience, soft skills, knowledge and training. They also noted that external factors such as available resources, administrative support, multisector support and actions by supports were required for them to be prepared. Conclusion: This research is the first of its kind to explore the factors affecting pharmacists’ disaster preparedness. The results indicate that Australian pharmacists feel underprepared for disasters; however, improving this preparedness is complex and will require more than a single intervention. Interventions for improving preparedness need to target individual and environmental factors and involve the whole healthcare team.

Introduction: In a disaster aftermath, pharmacists have the potential to provide essential health services and contribute to the maintenance of the health and well-being of their community. Despite their importance in the health care system, little is known about the factors that affect pharmacists' disaster preparedness and associated behaviors. Study Objective: The goal of this study was to determine the factors that influence disaster preparedness behaviors and disaster preparedness of Australian pharmacists. Methods: A 70-question survey was developed from previous research findings. This survey was released online and registered Australian pharmacists were invited to participate. Multiple linear regression was used to determine the factors that influenced preparedness and preparedness behaviors among pharmacists. Results: The final model of disaster preparedness indicated that 86.0% of variation in preparedness was explained by disaster experience, perceived knowledge and skills, colleague preparedness, perceived self-efficacy, previous preparedness behaviors, perceived potential disaster severity, and trust of external information sources. The final model of preparedness behaviors indicated that 71.1% of variation in previous preparedness behaviors can be explained by disaster experience, perceived institution responsibility, colleague preparedness, perceived likelihood of disaster, perceived professional responsibility, and years of practice as a pharmacist. Conclusion: This research is the first to explore the significant factors affecting preparedness behaviors and preparedness of Australian pharmacists for disasters. It begins to provide insight into potential critical gaps in current disaster preparedness behaviors and preparedness among pharmacists.

The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to ‘rapid, far-reaching and unprecedented changes’ to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet. The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals. This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. ‘Consensus’ implies broad agreement amongst all individuals enga

Objectives: In the aftermath of a disaster, the services provided by pharmacists are essential to ensure the continued health and well-being of the local population. To continue pharmacy services, it is critical that pharmacists are prepared for disasters. A systematic literature review was conducted to explore pharmacists’ and pharmacy students’ preparedness for disasters and the factors that affect preparedness. Methods: This review was conducted in April 2020 through electronic databases CINAHL, MEDLINE, Embase, PubMed, Scopus and PsycINFO, and two disaster journals. Search terms such as ‘pharmacist*’, ‘disaster*’ and ‘prepared*’ were used. The search yielded an initial 1781 titles. Articles were included if they measured pharmacists or pharmacy students’ disaster preparedness. After screening and quality appraisal by two researchers, four articles were included in final analysis and review. Data were extracted using a data collection tool formulated by the researchers. Meta-analysis was not possible; instead, results were compared across key areas including preparedness ratings and factors that influenced preparedness. Key findings: Three articles focused on pharmacy students’ preparedness for disasters, and one on registered pharmacists’ preparedness. Preparedness across both groups was poor to moderate with <18% of registered pharmacists found to be prepared to respond to a disaster. Factors that potentially influenced preparedness included disaster competency, disaster interventions and demographic factors. Conclusion: For pharmacists, the lack of research around their preparedness speaks volumes about their current involvement and expectations within disaster management. Without a prepared pharmacy workforce and pharmacy involvement in disaster management, critical skill and service gaps in disasters may negatively impact patients.

Introduction: Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems’ infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations. Study Objective: The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas. Methods: Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods– manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team. Results: From the manual coding analysis, five key themes emerged – communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis – community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial sup

The recent Australian bushfires and the global COVID-19 pandemic have highlighted the critical need for ensuring health workforce capacity during disasters. National, state and local disaster response plans assume that health professionals are prepared and willing to respond to disasters. However, the literature suggests that, depending on the disaster, health professionals may not be as willing as we may expect. This hesitancy potentially leads to critical gaps in health services delivery during and following disasters.

Background Cyclones can significantly impact on communities and their healthcare services. Community members with chronic diseases, including opioid dependence, who rely on these healthcare services are placed at an increased risk of treatment disruption during a disaster event. Disruptions to the continuity of the opioid replacement therapy (ORT) service can potentially lead to relapse, withdrawal, and risky behaviours in clients with potential repercussions for the community. Objective To explore the effects of Queensland (QLD) cyclones on opioid treatment programs within Queensland community and hospital pharmacies from three perspectives. Method Qualitative research methods were used. Participants comprised five community pharmacists, four Queensland opioid treatment program (QOTP) employees, and five public hospital pharmacists. Participants were identified as they had worked in Townsville, Rockhampton, Mackay, or Yeppoon in a community impacted by a cyclone and involved with ORT supply. Interviews were recorded and data were analysed by two methods - manual coding and the text analytics software Leximancer®. Results The two themes that emerged from the manual coding process were ‘disaster preparedness’ and ‘continuity of service’. The key themes from the Leximancer® analysis aligned with the two manual coding themes with no new themes identified. Primary dosing site closures in disaster-affected areas led to increased pressures on hospitals and other community pharmacy dosing sites to supply ORT doses to clients. However, a lack of dosing information available to pharmacists and strict legislative requirements made continuity of ORT supply during these cyclones difficult. Conclusion Continuation of ORT services during and in the aftermath of a cyclone event is complex. This research highlighted a need for a coordination of efforts and shared dosing information between QOTP employees, community pharmacists, and hospital pharma

Objective: The aim of this study was to explore whether a relationship exists between the number of disasters a jurisdiction has experienced and the presence of disaster-specific pharmacy legislation. Methods: Pharmacy legislation specific to disasters was reviewed for five countries: Australia, Canada, UK, US and New Zealand. A binary logistic regression test using a generalised estimating equation was used to examine the association between the number of disasters experienced by a state, province, territory or country and whether they had disaster-specific pharmacy legislation. Results: Three of six models were statistically significant, suggesting that the odds of a jurisdiction having disaster-specific pharmacy legislation increased as the number of disasters increased for the period 2007-17 and 2013-17. There was an association between the everyday emergency supply legislation and the presence of the extended disaster-specific emergency supply legislation AH19093_IE1.gif. Conclusions: It is evident from this review that there are inconsistencies as to the level of assistance pharmacists can provide during times of crisis depending on their jurisdiction and location of practice. It is not a question of whether pharmacists have the skills and capabilities to assist, but rather what legislative barriers are preventing them from being able to contribute further to the disaster healthcare team. What is known about the topic?: The contributing factors to disaster-specific pharmacy legislation has not previously been explored in Australia. It can be postulated that the number of disasters experienced by a jurisdiction increases the likelihood of governments introducing disaster-specific pharmacy legislation based on other countries. What does this paper add?: This study compared five countries and their pharmacy legislation specific to disasters. It identified that as the number of disasters increases, the odds of a jurisdiction having disaster-specific emergency s

BACKGROUND: Extreme heat (EH) events are increasing in frequency and duration and cause more deaths in Australia than any other extreme weather event. Consequently, EH events lead to an increase in the number of patient presentations to hospitals. METHODS: Climatic observations for Hobart's region and Royal Hobart Hospital (RHH) emergency department admissions data were collected retrospectively for the study period of 2003-2010. A distributed lag non-linear model (DLNM) was fitted using a generalized linear model with quasi-Poisson family to obtain adjusted estimates for the relationship between temperature and the relative risk of being admitted to the RHH. RESULTS: The model demonstrated that relative to the annual mean temperature of 14°C, the relative risk of being admitted to the RHH for the years 2003-2010 was significantly higher for all temperatures above 27°C (P < 0.05 in all cases). The peak effect upon admission was noted on the same day as the EH event, however, the model suggests that a lag effect exists, increasing the likelihood of admission to the RHH for a further 14 days. CONCLUSIONS: To relieve the added burden on emergency departments during these events, adaptation strategies adopted by public health organizations could include preventative health initiatives.

Weather-related natural disasters are increasing in frequency and intensity, severely impacting communities. The patient demographic requiring assistance in a disaster is changing from acute traumas to chronic disease exacerbations. Adequate management requires a multidisciplinary healthcare approach. Pharmacists have been recorded in various disaster roles in literature. However, their roles within these disaster health teams are not well-established and do not fully utilize their skill sets.

The pharmacist’s role in disasters is just as important as in everyday practice. Lack of access to health care services and interruptions to continuity of medication care are the major concerns for chronic disease patients during disasters. Pharmacists’ responsibilities during crises is undefined and their skills and knowledge are underutilized.

Introduction Pharmacists are uniquely placed in the community to be of assistance to disaster-affected patients. However, the roles undertaken by pharmacists in disasters are identified based on their own experiences and networks. There is currently no definition or acknowledgment of pharmacists’ roles in disasters. Objective To acquire consensus from an expert panel of key opinion leaders within the field of disaster health on pharmacists’ roles in disasters throughout the four disaster phases—prevention, preparedness, response, and recovery. Methods A Delphi study consisting of three rounds of online surveys was utilised. Twenty-four key opinion leaders were contacted, with 15 completing all three rounds. The 15 expert panellists were presented with 46 roles identified in the literature and asked to rank their opinions on a 5-point Likert scale. This study used an international, all-hazard, and multijurisdictional approach. Consensus was benchmarked at 80% and any role which did not reach consensus was re-queried in the subsequent round. The third round provided the results of the Delphi study and sought commentary on the acceptance or rejection of the roles. Results Of the 46 roles provided to the expert panel, 43 roles were accepted as roles pharmacists are capable of undertaking in a disaster. There were five roles for the prevention phase, nine for the preparedness phase, 21 for the response phase, and eight for the recovery phase. The experts were asked to prioritise the top five roles for each of the disaster phases. The three roles which did not make consensus were deemed to be specialised roles for disaster pharmacists and not generalisable to the broader pharmacy profession. Conclusion This study identifies pharmacists’ roles in disasters which have been accepted by the international disaster health community. The international key opinion leaders recommended that pharmacists could be undertaking 43 roles in a disaster

I have always been a lover of nature – like many others I am concerned about environmental issues such as pollution, extensive land clearing and development, and destruction of ecosystems . I know I am not the only pharmacist out there who finds images of polar bears clinging to ever - dwindling icebergs seriously disturbing . However, as a practising pharmacist I had never translated this environmental concern into my practice – I had never even given sustainability a thought while providing pharmacy services....

Kermit used to say ‘it’s not that easy being green ’ , and while it can be very difficult for ‘green’ pharmacists or pharmacy technicians to convince colleagues to work with them on sustainability initiatives in hospital pharmacies , I think it’s getting easier . Granted, t h ere are an overwhelming number of factors at play that can influence whether someone will perform a ‘green’ behaviour (i.e. an environmentally responsible or pro - environmental behaviour [ PEB ] ) in the workplace....

Background The number of jurisdictions allowing access to medicinal cannabis has been steadily increasing since the state of California introduced legislation in 1996. Although there is a high degree of legislative heterogeneity across jurisdictions, the involvement of a health professional is common among all. This places health professionals at the forefront of therapy, yet no systematic review of literature has offered insight into the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. Methods Using a predetermined study protocol, PubMed, EMBASE, PsycINFO, CINAHL, and Scopus databases were searched for studies indexed up to the 1st August 2018. Pre-defined inclusion and exclusion criteria were applied uniformly. Screening for relevancy, full-text review, data extraction, and risk of bias were completed by two independent investigators. Risk of bias was assessed using CASP criteria (qualitative) and a modified domain-based risk assessment tool (quantitative). Results Of the 15,775 studies retrieved, 106 underwent full-text review and of these, 26 were included. The overall risk of bias was considered low across all included studies. The general impression was that health professionals supported the use of medicinal cannabis in practice; however, there was a unanimous lack of self-perceived knowledge surrounding all aspects of medicinal cannabis. Health professionals also voiced concern regarding direct patient harms and indirect societal harms. Conclusion This systematic review has offered a lens through which to view the existing literature surrounding the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. These results are limited, however, by the implicit common-sense models of behaviour utilised by the included studies. Before strategies can be developed and implemented to change health professional behaviour, a more thorough understanding of the fact

Background and purpose: Students find clinical pharmacokinetics and pharmacodynamics courses challenging, partly due to their mathematical nature. This study aimed to retrospectively evaluate the impact of “feedback quizzes” on the experiences and academic performance of undergraduate pharmacy students at an Australian university. Educational activity and setting: Formative paper-based quizzes were introduced into tutorials in an intermediate third-year pharmacokinetics course, and summative online quizzes were introduced into a subsequent advanced fourth-year course that included a pharmacokinetics component. Experience data were drawn from institutional student evaluation surveys, and academic performance was obtained from exam results. Student experiences and academic performance were compared pre- and post-intervention using the Test of Equal Proportions and Mann–Whitney–Wilcoxon, respectively. Findings: A greater proportion of students in both quiz cohorts were satisfied with the overall course experience compared to the pre-curricular change cohort (intermediate: 87% vs. 78%; advanced: 63% vs. 50%). Students who received quizzes in both years performed better in the clinical pharmacokinetics component of the advanced course compared to a prior cohort who had no quizzes (85.7% vs. 77.8%). Feedback quizzes, whether formative or summative, administered in-class or outside class, can enhance learning and performance and lead to improvements in student satisfaction with clinical pharmacokinetics courses. Scaffolding of feedback quizzes across year levels can provide students with added confidence when attempting assessment. Collaboration between research-focused and teaching-focused staff can lead to increased scholarship of teaching and learning activities.

Background In addition to the traditional logistics role, pharmacists are undertaking important new roles in disasters. Despite this, little is known about the level of acceptance of these activities by other providers.Problem The aim of this study was to determine the international opinion of disaster and health professionals regarding the emerging roles of pharmacists in disasters.Methods Delegates at the World Association for Disaster and Emergency Medicine's (WADEM; Madison, Wisconsin USA) 20 th Congress in Toronto, Canada (April 2017) were invited to complete an anonymous survey posing eight questions regarding attitudes towards pharmacists' roles in disasters. Quantitative data were analyzed using IBM (IBM Corp.; Armonk, New York USA) SPSS statistical software version 23, and qualitative data were manually coded.Results Of the 222 surveys handed out, 126 surveys were completed yielding a 56.8% response rate. Of the respondents, 96.8% (122/126) believed pharmacists had a role in disasters additional to logistics. Out of 11 potential roles pharmacists could perform in a disaster, provided on a 5-point Likert scale, eight roles were given a rating of Agree or Strongly Agree by 72.4% or more of the participants. Lack of understanding of a pharmacist's roles and capabilities was the highest described barrier to pharmacists' roles in disaster management.Conclusions This multi-disciplinary disaster health community agreed pharmacists have roles in disasters in addition to the established role in supply chain logistics. Participants accepted that pharmacists could possibly undertake numerous clinical roles in a disaster. Several barriers were identified that may be preventing pharmacists from being further included in disaster health management planning and response. WatsonKE, TippettV, SingletonJA, NissenLM.

The requirements of the pharmacy profession are changing globally, moving from a supply function to a more integrated health service delivery model. In line with this global change, the pharmacy education discipline is growing and evolving, and leadership in this area is developing globally. In 2016 FIP held the first global conference on Pharmacy and Pharmaceutical Sciences Education delivering, “a coherent global vision for professional pharmacy education and workforce development” (International Pharmaceutical Federation - FIP, 2016, p.4), aimed to align with the UN Sustainable Development Goals and in particular Goal 3 – Good Health and Well-Being (United Nations (UN), 2015). This chapter discusses the strategic direction that leaders in pharmacy education need to take in light of the challenges of a complex health system, and the evolving of new, expanded roles for pharmacists. This strategic direction aligns with global health workforce development goals. The authors describe some of the advanced scope roles pharmacists are undertaking, the skills required of our graduates to meet employers’ requirements and patients’ needs, and the type of leadership approach required to drive the change in the profession and in academic institutions. The WHO Vancouver Consultancy (International Pharmaceutical Federation (FIP), 2000) highlighted the need for a move away from the traditional, didactic mode of content delivery (with its passive transfer of knowledge) in pharmacy curricula, and for students to actively participate in the learning process. Therefore, the authors argue that leading change in pharmacy education requires leading change in curriculum design and delivery, and the authors describe what this new pharmacy curriculum might look like. Finally, the authors outline the strategic steps required to achieve this change.

Communities are becoming increasingly affected by weather‐related natural disasters. This is due not only to an increase in the frequency and/or intensity of these weather‐related events as a result of climate change,1 but also to the fact that communities themselves are becoming more vulnerable. Chronic disease exacerbations and interruptions to patients’ continuity of medication care are the leading causes of death following disasters – mostly due to the inability to access basic healthcare services...

Objective/s The aim of this study was to explore Queensland hospital pharmacists’ and pharmacy technicians’ knowledge and understanding of the impact of pharmaceuticals on the environment, and the handling of pharmaceutical waste. Methods This study followed a mixed methods research design. Purposive sampling techniques were used to recruit 64 hospital pharmacists and pharmacy technicians working in five public and private hospitals, in metropolitan and regional Queensland, Australia. Both quantitative and qualitative data were collected. Qualitative data were analysed using both text analytics software and manual coding techniques. Descriptive statistics were used to present the quantitative data. Key Findings Lack of environmental knowledge regarding the impact of pharmaceuticals on the environment, and lack of understanding of systems thinking concepts (that all living things are part of the one environment or system, and therefore any negative impacts on the environment will ultimately have negative impacts on human health) were the key findings of this research. Interviewees expressed concern, but most expressed minimal personal concern, about the impact of pharmaceuticals entering the environment. Most interviewees were unsure as to best practice methods for the disposal of pharmaceutical waste, and by complying with hospital policy assumed appropriate disposal occurred. Conclusion Before the pharmacy profession can take up a leadership role in the more sustainable use of pharmaceuticals, pharmacists and pharmacy technicians require environmental information regarding the negative impacts of pharmaceuticals on the environment, and education on systems thinking to enable them to understand that any negative impacts on the environment will ultimately have negative impacts on human health.

Background Interdisciplinary collaboration and communication are vital health graduate capabilities required for future professional pathways. However, students report problems with domineering team members, ‘hitchhikers’, non-cohesive strategies and divergent views,1,2 leading to de-motivation, conflict and poor learning outcomes.3,4 An online Blackboard tool incorporating five strategic ‘gates’ (Team structure, Communication, Leadership, Situation monitoring, and Mutual support was designed to support the social processes required for team cohesion in students doing group assessments. Objectives To determine if the GATES 2.0 tool supported student group work collaborations and improved the group work experience. Methodology GATES was embedded in the Blackboard sites of six QUT health units (courses) which had a group assessment task in 2017. Participants comprised six academics and 721 students. Data collection involved the completion of two online surveys – at the beginning and end of the semester. Both demographic and qualitative data were collected. Results Students believed the tool improved group communication, organisation, and time management through development of action plans. However, GATES did not help resolve conflicts in a few groups, particularly those dealing with ‘hitchhikers’ and members producing poor quality work. Academics reported little need for facilitation of student groups and three reported less student emails regarding group issues. Discussion: There was evidence to support the use of the tool, however more resources need to be added to help students deal with group conflict. The tool would be more effective if the unit coordinators incorporated its use in tutorial activities so that it is not seen simply as an extra activity.

Background: Globally, there is a growing emphasis on appropriate removal of unwanted medicines for safe destruction from community, hospital(1) and other settings. Pharmacists play a vital role in the safe and effective practice of choosing, using and removing medicines in society.(2) Objectives: To explore accredited pharmacists’ (APs’) perspectives on removal of unwanted, unused and expired medicines from patients’ homes as part of Home Medicines Review (HMR) service delivery in Australia. Methodology: An extended exploratory project examining APs’ HMR work processes in Australia utilised 2 focus groups, 15 semi-structured interviews, a national survey (n=255) and non-participatory observation of the patient-pharmacist home consultation (n=5). The data was explored for themes around the return of unwanted medicines (RUM) as part of HMR practice. Results: HMR work practice themes around (RUM) identified across the studies included: barriers such as lack of interest, lack of time, concerns around the medicines remaining in their car for extended periods, perceptions around “the patient can return it themselves to the community pharmacy”, poor relationships with community pharmacists, and lack of use of the Australian RUM project approved plastic bags intended for appropriate removal of medicines from patients’ homes as part of best practice.(3) Discussion: The home visit presents an ideal opportunity for visiting APs to safely and appropriately remove unwanted medicines, to minimise the impact of pharmaceuticals on the environment and to maximise patient safety. Further education and exploration of APs’ work processes for the more sustainable use and disposal of medicines is warranted.

Medicines have a large carbon footprint, and the aim of this research was to identify ways to reduce the carbon footprint of medicines in hospital pharmacy departments. Factors affecting pharmacists' and pharmacy technicians' engagement with pro-environmental behaviours regarding medicines' disposal in Australian and UK hospitals were explored. Environmental attitudes, environmental knowledge, environmental concern, and organisational factors that either help or prevent appropriate disposal of unwanted medicines and their packaging were investigated. Currently, many pharmacists believe medicines' disposal is outside their current scope of practice. Organisation-wide environmental education programs are needed to increase awareness and improve behaviours.

Background: Weather-related natural disasters are increasing in frequency and intensity, severely impacting on communities.1 The patient demographic requiring assistance in a disaster is changing from acute traumas to more chronic disease exacerbations.2,3 This requires a multidisciplinary healthcare approach to adequately manage.2 Pharmacists have been recorded in disaster roles in literature since the 1960’s.4 Their roles within these disaster health management teams are not well-established and does not fully utilise their skillset. Purpose: To identify roles pharmacists can have in the four phases of a disaster – prevention, preparedness, response and recovery. Methods: Semi structured interviews were conducted with 28 international key stakeholders and pharmacists. Interviews were transcribed and analysed using both open and axial manual coding, as well as the text-analytics software Leximancer®. Using these two methods provided triangulation of methods for reliability of results. This research project was covered by QUT ethics approval number 1700000106. Results: The major theme for pharmacists in the preparedness phase was ‘patients’, and in the response phase it was ‘drugs’. To address the barriers of pharmacists being more included in disaster management, the main themes identified were ‘advocacy’ and ‘collaboration’. Conclusion: Pharmacists are identified as a critical piece to the puzzle in the disaster management throughout the four phases. However, there are barriers acknowledged as preventing the integration of pharmacists into the team. The participants suggested collaboration with other health professions and advocating the value of pharmacists. References 1. Sauerborn, R., & Ebi, K. (2012). Climate Change and Natural Disasters-Integrating Science and Practice to Protect Health. Global Health Action, 5. doi: 10.3402/gha.v5i0.19295 2. Chan EYY. 2017. Public health humanitarian responses to natural disasters: Tayl

Background: Communities are becoming more susceptible to the health impacts of disasters due to the ageing population and increasing prevalence of chronic diseases.1 Interruptions in the continuity of medication supply to patients can lead to exacerbations and life-threatening situations.1 Pharmacists have assumed a minor role in disasters in the supply and logistics of medications. Community and hospital pharmacists are unaware of their potential role in assisting their patients during disasters. Objectives: To determine the opinion of the disaster health community on the role of pharmacists in disasters. Methodology: An online survey was emailed to members of the Queensland University of Technology (QUT) Centre for Emergency and Disaster Management (CEDM). Questions were asked on disaster experience and opinions of pharmacists undertaking 11 roles found in literature. Data was analysed using SPSS® version 23 IBM software. Results: There were 97 out of 446 surveys completed, giving a response rate of 21.7%. The majority of the respondents (49.5%) had experience in both disaster management and health professions. Most participants (89.5%) had responded to at least one disaster. The strong consensus was pharmacists do have a role in disasters aside from logistics (89.5%) and these roles are currently within their scope of practice (79.4%). Discussion: Pharmacists have historically in Australia played a minor role in disasters, only using their skills in logistics and medication supply. This survey illustrates the wider disaster health community’s acceptance of further utilisation of pharmacist’s skills and knowledge into other clinical roles (prescribing continuing chronic disease medications, prescribing and administering vaccinations and educating the public). References 1. Chan EYY. Public health humanitarian responses to natural disasters. Taylor & Francis; 2017.

Background: During disasters health services and community health can be compromised. To ensure continuation of services and minimise negative health outcomes it is critical that health professionals are prepared for disasters. Despite the important role that pharmacists play within the healthcare team, little is known about their preparedness to respond to disasters and the factors that affect their preparedness. Aim: Systematic Review of peer reviewed publications that measured pharmacists’ and pharmacy students’ preparedness for disasters. Methods: This review was conducted in January 2018 through databases CINAHL, MEDLINE, Embase, PubMed, Scopus, and PsycInfo using keywords ‘pharmacist’, ‘disaster’, and ‘prepared’. This search yielded an initial 1707 titles. After revision of inclusion criteria and quality appraisal only 3 articles were included in final analysis and review. Due to variations in methodology a meta-analysis of data was not possible. Articles were analysed for key themes and findings. Results: Two articles focused on pharmacy students and one on registered pharmacists. Most students self-rated themselves as ‘negatively’ or ‘neutrally’ prepared for a disaster. For pharmacists 82% were not prepared for a disaster. Factors that influence preparedness include willingness to respond, previous training, and knowledge of disaster event. Conclusion: There is little research available on pharmacists’ preparedness for disasters. From the research available, pharmacist preparedness to respond to disasters appears to be poor. By better understanding pharmacist preparedness, gaps in pharmacy practice can be addressed, leading to a more robust pharmacy workforce able to contribute to health response in disasters and emergencies.

Background: In 2008, the World Health Organisation (WHO) urged health sectors to lead by example in undertaking sustainability initiatives to protect people from the effects of climate change.1 Organisational focus and commitment to sustainability encourages employees’ uptake of environmentally responsible behaviours.2 Purpose: To explore organisational commitment to sustainability in two public healthcare organisations – NHS (UK) and Queensland Health (Australia). Methods: The strategic plans for Queensland Health (released 2016) and NHS (released 2017) were uploaded into Leximancer® text analytic software and a Quadrant Overview map produced. Prominent concepts were compared. Results: The Quadrant Overview did not reveal any concepts in either strategic plan document relating to climate change mitigation, the environment, or sustainable development initiatives. Conclusions: Until sustainability is embedded in public health organisations’ DNA and articulated in strategic plans, sustainability initiatives at hospital level will be slow to occur. Both top-down and bottom-up support for sustainability is required for action. References 1. World Health Organisation. Protecting Health from Climate Change - World Health Day 2008 [cited 2011 27 July]; Available from: http://www.who.int/world-health-day/toolkit/report_web.pdf 2. Gladwin TN, Kennelly JJ, Krause T-S. Shifting Paradigms for Sustainable Development: Implications for Management Theory and Research. The Academy of Management Review 1995.20(4):874-907.

Background: During disasters local communities are the first to respond, often working for days before reinforcements from outside agencies can arrive. Despite pharmacists’ essential role in the everyday healthcare team, they are underutilised in disaster planning and response. Little is known about how prepared pharmacists are for disasters and what factors influence their preparedness. Aim: To explore Australian pharmacists’ current preparedness for disasters that may affect their local communities and the factors that influence their preparedness. Methods: Semi-structured interviews were conducted with 13 Australian pharmacists. Interviews were audio recorded and transcribed verbatim. Transcripts were coded using open and axial coding techniques and analysed for themes. Results: Participants self-rated their preparedness as low. Current preparedness was influenced by a variety of factors including experience, available resources, and current knowledge. Participants identified a variety of interventions that may improve their preparedness including training and the need for support from employers and professional pharmacy organisations. Conclusion: Australian pharmacists’ self-reported preparedness is low and influenced by a variety of factors. Low levels of preparedness may impact willingness to respond to a disaster, resulting in reduced pharmacy workforce and critical healthcare gaps. Understanding of pharmacists’ perceived preparedness is essential to improve education and resources for improving pharmacists’ preparedness for disaster response. This initial exploration of pharmacist preparedness has led to the development and release of a survey that will further assess and explore pharmacist preparedness.

Background: Climate change is a global public health issue and public health organisations have been urged to deliver healthcare more sustainably to reduce their own impacts on public health.1 Purpose: To compare environmental attitudes, knowledge, and concern of hospital pharmacists and pharmacy technicians between a country with legislated carbon reduction strategies (UK), and one without (Australia). Methods: This study employed mixed methods. Participants were pharmacists and pharmacy technicians working in five Queensland hospitals (public and private hospitals in metropolitan and regional centres) (n = 66) and six NHS England hospitals from four regional cities (n = 40). They completed a New Environmental Paradigm (NEP) scale questionnaire to determine their environmental attitude, and answered questions in a semi-structured format. Results: There was no statistically significant difference in environmental attitudes, environmental knowledge, or environmental concern between the two cohorts regarding the impact of pharmaceuticals on the environment. More Australian participants reported environmental concern. Both cohorts lacked understanding of FIP’s ‘One Health’2, p.1 approach. None of the UK pharmacy staff were aware of the Sustainable Development Unit or its purpose. Conclusions: This study suggests failure of sustainability policy dissemination in the NHS to pharmacy staff, and failure of FIP’s Green Pharmacy Practice to be taken up by national pharmacy bodies and disseminated to pharmacist members in the UK and Australia. Further exploration of ways to improve policy dissemination in large public healthcare organisations is warranted. References 1. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. The Lancet 2015.386 (10006):1861 - 914. 2. International Pharmaceutical Federation (FIP). Green pharmacy practice: taking responsibility

Background: The impact of disasters on communities is increasing as a consequence of both weather-related and man-made events.1 In concert with this, exposure and vulnerability of communities is increasing as a function of population change, especially an increasing ageing population and prevalence of chronic disease.2 Exacerbations and interruptions to patient continuity of care are the leading cause of death following disasters.3 When the healthcare system collapses during a disaster,4 individuals are generally in a state of shock and turn to the healthcare professionals they trust and are most easily accessible. Purpose: The aim of this systematic review was to examine the roles pharmacists assume during disasters and their place within the disaster health community. Methods: Four databases were searched - Embase, PubMed, Scopus and Cinahl following the search strategy outlined by the PRISMA statement and flow diagram. MeSH search terms were used and articles were included that were written in English and had applied a method. The exclusion criteria included abstracts for conferences, reviews, articles written in a language other than English and papers that described no methodology or methods. Results: Six articles met the inclusion and exclusion criteria. Recognition of potential roles for pharmacists in disasters appears not to have progressed beyond the ‘traditional role’. Logistics and medication supply remains the prominent role pharmacists undertake during a disaster. Conclusion: Potential new roles for Pharmacist’s in disasters require further exploration and may represent an under-utilised professional clinical resource during disaster events. Better utilisation of pharmacist’s skills and knowledge in a disaster can best be achieved through collaborative and coordinated multi-disciplinary efforts. References 1. Sauerborn, R., & Ebi, K. (2012). Climate Change and Natural Disasters-Integrating Science and Pract

Background: The World Health Organisation and International Pharmaceutical Federation agree that interprofessional education and collaboration leads to a practice-ready workforce and strengthens healthcare systems[1]. While there is a plethora of ways in which educators aim to provide interprofessional education and encourage collaborative practice, creating content that engages students can be challenging. Disaster response requires a robust understanding of health systems, interprofessional collaboration and practice. Utilising a disaster response could improve student engagement, understanding, and perceptions of interprofessional collaborative practice. Purpose: To investigate first-year undergraduate students’ understanding and perceptions of interprofessional collaborative practice following a disaster scenario tabletop exercise. Method: Students enrolled in a first year undergraduate interprofessional subject were invited to participate in pre-post surveys of their participation in a disaster scenario tabletop exercise conducted in workshops. Student participants were from health disciplines of paramedicine, pharmacy, podiatry, and medical radiation sciences. Students were divided into interprofessional teams and presented with a hypothetical disaster scenario for team discussion and response. Results: In the pre-workshop survey, students had a limited understanding of collaborative practice and its importance in everyday practice. In the post-workshop survey, there was an increase in understanding and perceptions of interprofessional collaboration and practice. Conclusion: This novel teaching activity was well received by health students and raised awareness of the heightened need for interprofessional collaborative practice during real world disaster responses. References: [1] International Pharmaceutical Federation, "Interprofessional education in a pharmacy context: global report," International Pharmaceutical Fed

Purpose Climate change has been described as the most significant global health threat of the 21st century. Already, negative effects on human health and well-being can be observed. In 2008, the World Health Organisation urged health sectors to lead by example in undertaking sustainability initiatives to protect people from the effects of climate change. The key finding of the 2015 Lancet Commission on Health and Climate Change was that “tackling climate change could be the greatest global health opportunity of the 21st century”. The time has come for health professionals to rise to the challenge. Objectives This paper presents the sustainability initiatives implemented in the Pharmacy Department at Western Health. Its aim is to serve as an inspiration to others by highlighting what can be achieved. Findings Western Health Pharmacy Department (WHPD) commenced its sustainability initiatives by developing a 5-year Local Sustainability Action Plan (LSAP). The aim of this plan was to reduce the environmental footprint of the department’s activities. Implementation of the LSAP has included: • Embedding sustainability criteria into purchasing contracts • Adding sustainability principles to the Orientation Manual for new staff • Increasing recycling – have added co-mingled (which includes clean paper and packaging waste), toner cartridges and battery recycling • Reducing energy usage – computers have been turned onto energy-efficient mode and increased vigilance with turning off lights • Reducing paper usage - printer settings now default to double-sided print setting • Replacing disposable crockery and cutlery with china, and purchasing keep-cups for staff • Removing bottled water cooler and having filtered water plumbed into kitchen sink • Education sessions for staff.

Introduction. During disasters local communities are the first to respond, often working for days before reinforcements from outside agencies can arrive. Health professionals provide essential roles and services during these events. Despite the important role pharmacists play within the healthcare team, their preparedness to respond to disasters is unknown. Additionally, little is known about what supports pharmacists need to feel more prepared to respond to a disaster. Aims. To determine how prepared Australian pharmacists feel to fulfil roles in local disasters and what supports they require to become more prepared. Methods. A collection of semi-structured interviews led to the development of a mixed-methods survey. This survey will be launched at APSA-ASCEPT 2017 with registered pharmacists invited to participate. Contributors will be asked to self-assess their preparedness for playing a variety of roles that may affect their local community in a disaster. Additionally, this project will explore how pharmacists believe they could improve their preparedness, or how they could be supported in disasters. Results. Results from this survey will feed into a larger research project examining disaster preparedness for pharmacists. The main objective of this research project is to determine how pharmacists can be better prepared to fulfil roles in disasters in Australia. Potential outcomes include competency development, legislative change, and/or short training courses for pharmacists. Discussion. Pharmacists are essential health professionals during disasters. Unfortunately, little is known about how prepared pharmacists feel to assist in disasters and how they can be supported to play a role. The ultimate goal of this research is to improve local preparedness and professional resilience in Australian disasters and emergencies.