Recommendations for Planning and Managing International Short-term Pharmacy Service Trips

Learning Through Experience: Analyzing the Impact of Short Study Abroad Programs from the Students' Own Words

OBJECTIVE

The purpose of this study was to determine what students participating in short study abroad program (SSAP) elective courses learned during their experiences and if they satisfied the course learning objectives.

METHODS

University of Florida College of Pharmacy students who participated in an SSAP to Scandinavia in the years 2014, 2016, 2017, and 2018 wrote digital journals describing their experiences. This study used inductive and deductive thematic analysis to analyze the journals and identify codes and themes.

RESULTS

Four cohorts with a total of 39 student journals were analyzed leading to 11 themes being identified. Example themes included Differences in Pharmacy Practice, Differences in Pharmacy Law/Processes, Differences in Pharmacy Education/Training, and History/Culture. These themes were then mapped to the course objectives, and all course objectives were deemed to be fulfilled.

CONCLUSION

Students participating in one College's SSAPs over 4 years through their own words demonstrated a better understanding of health care, pharmacy, and culture as it exists in one or more foreign countries and were able to meet the course objectives.

Characteristics of Successful International Pharmacy Partnerships

Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other's programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.

Some People are Different from You: A Case Study of a Cultural and Ethical Problem in Global Health

Pharmacists, student pharmacists, and other healthcare providers are frequent participants on short-term medical service trips (MSTs) to medically underserved areas. Many such MSTs take place in areas like sub-Saharan Africa where cultural beliefs about healthcare and society may be very different from what volunteers from the Global North believe. These cultural divergences may then give rise to ethical problems MST volunteers need to navigate. This case study provides an example of such an ethical problem developing from a difference in cultures - the case of female genital cutting. Often, the ethical training that most MST volunteers receive during their clinical education is inadequate to help them address these kinds of cultural differences and the problems that result. A six-step process to provide MST volunteers with the tools to address such cultural-ethical problems is included. Medical, Public Health, and Microfinance Teams with local interpreters in Nana Kenieba, Cercle of Kati, Koulikoro Region, Southwest Mali.

Implementing electronic health records on a medical service trip improves the patient care process

Background

The efficiency of the patient care process of short-term medical service trips is often not assessed. The Gregory School of Pharmacy has organized annual medical camps in rural Uganda, however, the paper health records used for documentation and communication between stations have shown several limitations that hinder an optimal patient care process. Therefore, our objective was to implement an electronic health record system in these medical camps to improve the workflow and optimize the patient care process.

Methods

An electronic health record system that functioned over a battery-operated local area network was developed and implemented. Patient health information was entered and reviewed at the different stations using mobile devices. The impact of electronic health records (used in 2019) on the patient care process was assessed using the number of patients served per physician per hour and the number of prescriptions filled per hour and comparing these to paper records (used in 2017).

Results

Electronic health records were successfully implemented and communication across stations was fluid, thus improving transitions. Importantly, 45% more patients were served per physician per hour and 38% more prescriptions were dispensed per hour when using electronic (2019) compared to paper records (2017), despite having a smaller team in 2019.

Conclusion

Implementation of electronic health records in rural Uganda improved the patient care process and the efficiency of the medical camp.

Long-Term Impact of Interprofessional Medical Mission Service Trips in Sierra Leone

Objective: The purpose of this study was to evaluate the impact of capacity-building short-term mission service trips to Sierra Leone on local health education and perspectives. Methods: This was a prospective, mixed-methods study. During three mission trips between June 2017 and December 2019, health professional students taught multiple locally selected patient care-related topics. Local staff completed knowledge questionnaires and were surveyed or interviewed on mission service impact along with the cultural competence of missionaries. Mission team members completed the Intercultural Effectiveness Scale (IES) and surveys to determine their cultural competence. Results: After initial education, 90% passed the knowledge questionnaire with at least a 50% and the correct response rate was 57.9 vs. 66.7% after 6 months and 2.5 years, respectively (p = 0.40). Local staff ranked education/training as most valuable (84%) and highly desired (53%). Mean IES score and survey responses of both missionaries and local staff rated mission team cultural competence as average. Conclusions: Education-focused mission trips in Sierra Leone seem to have long-lasting benefits and a positive impact on local staff, though improved intercultural competence is needed.

Fulfilling Educational Competencies through Global Pharmacy Experiences

Many Colleges of Pharmacy in the United States offer international education and practice experiences to their students. Multiple publications have described these offerings and related them back to the CAPE 2013 Outcomes. This article describes the multiple international programs offered by one College of Pharmacy, including international Advanced Pharmacy Practice Experiences, Short Study Abroad Programs, and International Health Outreach Trips. The article also details the relevant competencies associated with these international experiences.

A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis

BACKGROUND

The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medications. This is critical for settings with poor access to health care. Rural and remote Australia is one example of a setting where the pharmacy profession, schools of pharmacy, and regulatory agencies require pharmacists to assure medication access. Studies of drug distribution systems in such settings are uncommon. This study describes a model for a drug distribution system in an Aboriginal Health Service in remote Australia. The results may be useful for policy setting, pharmacy system design, health professions education, benchmarking, or quality assurance efforts for health system managers in similarly remote locations. The results also suggest that pharmacists can promote access to medications as a social determinant of health. The primary objective of this study was to propose a model for a drug procurement, storage, and distribution system in a remote region of Australia. The secondary objective was to learn the opinions and experiences of healthcare workers under the model.

METHODS

Qualitative research methods were used. Semi-structured interviews were performed with a convenience sample of 11 individuals employed by an Aboriginal health service. Transcripts were analyzed using Event Structure Analysis (ESA) to develop the model. Transcripts were also analyzed to determine the opinions and experiences of health care workers.

RESULTS

The model was comprised of 24 unique steps with seven distinct components: choosing a supplier; creating a list of preferred medications; budgeting and ordering; supply and shipping; receipt and storage in the clinic; prescribing process; dispensing and patient counseling. Interviewees described opportunities for quality improvement in choosing suppliers, legal issues and staffing, cold chain integrity, medication shortages and wastage, and adherence to policies.

CONCLUSION

The model illustrates how pharmacists address medication access as a social determinant of health, and may be helpful for policy setting, system design, benchmarking, and quality assurance by health system designers. ESA is an effective and novel method of developing such models.