Pharmacology, Toxicology and Pharmaceutics, Pharmacy, General Health Professions
60
Scopus Publications
Scopus Publications
Outcomes, barriers and enablers of post-registration education for Australian registered pharmacists: A qualitative descriptive study Tiernan McDonough, Jo-Aine Hang, Amy Page, Lisa Kalisch Ellett, Christopher Etherton-Beer, Jacinta Johnson Currents in Pharmacy Teaching and Learning, 2026 INTRODUCTION: The experiences of pharmacists undertaking post-registration education in Australia remain unclear. This paper aims to identify the perceived barriers, enablers, and outcomes of post-registration education for pharmacists in Australia to support future program development. METHODS: A qualitative descriptive study design was employed. Australian pharmacists who have completed or nearly completed post-registration education programs were recruited using purposive and convenience sampling. We used semi-structured interviews to collect data that was subsequently analysed using reflexive thematic analysis. Themes were then interpreted using social cognitive theory as a sensitising framework. RESULTS: Interviews were undertaken with 19 pharmacists and lasted a mean of 46 min (SD = 9). Four overarching themes regarding barriers and enablers to education predominated throughout the interviews: learners benefit from experiential education, through authentic examples and practical experience; learners are supported through mentorship and social supports; learners are intrinsically motivated but require extrinsic mechanisms, supports, and clarity of expectations; and learners require flexibility for their diverse needs. One overarching theme related to outcomes for learners, including clinical and non-clinical skills, an evolved professional confidence, and a holistic understanding of health systems and person-centred care. CONCLUSION: Findings indicate that education should be practical and relevant, and involve complex social interactions. Education programs should have clear expectations and structures with inbuilt flexibility for individual needs. This research reflects existing theories of adult learning, most notably social cognitive theory. Prioritising this theory in future programs may enable future education programs in ensuring that pharmacists become, and remain, lifelong learners.
Collaborative pharmacist prescribing models in Australian hospitals: A scoping study Hana Amer, Sally Marotti, Imaina Widagdo, Sharon Goldsworthy, Jacinta Johnson, Lisa Kalisch Ellett Research in Social and Administrative Pharmacy, 2026 BACKGROUND: Collaborative pharmacist prescribing models have been trialled and implemented in Australian hospitals and involve credentialed pharmacists working with doctors and patients to develop patient medicine plans and prescribe medicines. AIM: This study aimed to identify pharmacist prescribing policies and procedures in Australian hospitals and provide a narrative summary of the models and associated training. METHOD: A scoping study was conducted using an exploratory and descriptive approach to identify and map pharmacist prescribing models implemented in Australian hospitals, and their associated training. Hospital pharmacy directors in Australia were contacted through a hospital pharmacy professional organisation in November 2023 and were asked to provide their pharmacist prescribing policies and procedures. Details of the models and training programs were extracted and summarised, with similarities and differences narratively reported. RESULTS: Fifteen different collaborative pharmacist prescribing models were reported to be implemented across more than 35 hospitals. Fourteen models had a formal training program. The models varied in scope of practice, particularly relating to medicine initiation and the timing of prescribing. The training and maintenance of currency of practice differed between models. Only three models recognised credentialing from other hospitals. CONCLUSION: The study reveals variation in scope of practice, training, and credentialing processes between pharmacist prescribing models, with limited recognition and transferability of prescribing skills across jurisdictions in Australia. Efforts to establish national accreditation standards for pharmacist prescriber education programs and the recent introduction of a national credentialing program, could pave the way for the standardisation of the models and training within Australian hospitals.
Evaluating medication discrepancies and harm: a matched cohort study of collaborative pharmacist prescribing in a statewide healthcare system using electronic prescribing Hana Amer, Sally Marotti, Joshua M. Inglis, Imaina Widagdo, Sharon Goldsworthy, Jacinta Johnson, Lisa Kalisch Ellett International Journal of Clinical Pharmacy, 2026 Introduction Collaborative pharmacist prescribing models involve pharmacists working with doctors and patients to develop medication plans and prescribe medications. Limited evidence exists on the impact of these models on medication discrepancies in hospitals using electronic prescribing systems (EPS). Aim This study aimed to evaluate the impact of collaborative pharmacist prescribing on medication discrepancies and potential patient harm within a statewide healthcare system using EPS. Method A multi-site matched cohort study involving 240 patients was conducted. EPS data for 120 patients aged ≥ 18 years who received collaborative pharmacist prescribing was matched 1:1 with 120 patients who received usual care of independent medical prescribing. Matching variables were hospital, clinical unit, sex, age, admission date, triage category and pre-admission medication count. The electronic medical record was reviewed to identify undocumented medication discrepancies, which were defined as any unexplained difference between the pharmacist-led medication history and medications prescribed on admission. The frequency of undocumented discrepancies was calculated. An independent multi-disciplinary clinician panel determined potential harm, using the Harm Associated with Medication Error Classification (HAMEC) tool. Results There were fewer undocumented discrepancies per medication prescribed in the collaborative pharmacist prescribing group compared to usual care (RR 0.04, 95% CI 0.03–0.06) and the relative risk of undocumented discrepancies per patient was lower (RR 0.23, 95% CI 0.13–0.39). The expert clinician panel found that undocumented discrepancies rarely posed serious or severe harm in either group (0 undocumented discrepancies with potential to cause serious or severe harm in the collaborative pharmacist prescribing group compared to 8 in the usual care group). Conclusion The implementation of collaborative pharmacist prescribing within a statewide EPS significantly reduced undocumented discrepancies and lowered the potential for patient harm. As healthcare systems globally shift towards electronic prescribing, this study provides timely and actionable evidence to inform policy and support the adoption of collaborative prescribing models in hospitals using EPS. Such models offer a practical strategy to improve medication safety, reduce patient harm and strengthen interprofessional collaboration at the point of prescribing.
Modes of trust and decision-making processes: A real-world exploration of entrustment decision-making in clinical supervision Tarik Al-Diery, Sally Marotti, Debra Rowett, Jacinta L. Johnson Medical Teacher, 2026 INTRODUCTION: This study aimed to conceptualize how individual clinical supervisors make prospective entrustment decisions when considering trainee and supervisor factors. We sought to explore how supervisors operationalized different modes of trust (presumptive, initial, and grounded) when navigating the complexities of entrustment decision-making. METHODS: Between July and August 2024, experienced pharmacist supervisors across Australia participated in focus group interviews exploring how they make entrustment decisions and enact modes of trust when supervising trainees. The interview guide, informed by prior entrustment literature, explored prospective entrustment decision-making through the lens of individual supervisors. Thematic analysis was conducted using Braun and Clarke's reflexive approach to identify themes and to interpret how supervisors' decision-making processes aligned with different modes of trust. RESULTS: Seven focus group interviews involving 28 supervisors were conducted. Three key themes were evident: (1) Trainee trustworthiness is primarily defined by the ability of the trainee to recognize their limitations, demonstrate self-awareness, and show insight; (2) Supervisors' entrustment decision-making is informed by their trust propensity, risk tolerance, and professional experiences and standards; and (3) The nature of the supervisor-trainee relationship shapes the act of entrustment. Supervisors emphasized the importance of direct observation and evidence accumulation in informing conscious, analytical entrustment decisions, even when prior entrustment decisions had been made by other supervisors. DISCUSSION: Entrustment decisions made by individual supervisors are grounded by accumulated evidence and establishing familiarity with the trainee. Supervisor characteristics and the supervisor-trainee relationship further influence how prospective entrustment decisions are made. Rather than relying on initial trust processes, supervisors described developing grounded trust through direct observation of the trainee and accumulation of multisource evidence to inform conscious, analytical entrustment decisions. This study offers an empirically grounded conceptual framework that deepens our understanding of how trust is enacted and developed in real-world entrustment decision-making.
Healthcare professionals’ perspectives of pharmacist roles in residential aged care: a qualitative systematic review and meta-synthesis Tiernan McDonough, Emily Griffin, Amy Page, Lisa Kalisch Ellett, Christopher Etherton-Beer, Jacinta Johnson International Journal of Clinical Pharmacy, 2026 Introduction Aged care systems are under increasing pressures, demanding optimised interdisciplinary teams. Pharmacist roles are expanding into these teams, and successful integration requires an understanding of team member perspectives. Aim This systematic review and meta-synthesis aimed to identify, analyse and present the published literature pertaining to healthcare professional perspectives of the roles of pharmacists working in residential aged care settings. Method A systematic search of literature published between 2000 and 2025, in English language only, was undertaken across Embase, Medline, CINAHL and Web of Science. Primary studies addressing the research aim were eligible for inclusion. The Mixed Methods Appraisal Tool was used to assess methodological quality of each paper; no papers were excluded based on quality. Two researchers independently reviewed and reached consensus agreement for all studies to include. Both researchers undertook a thematic synthesis of qualitative data to identify analytic themes. Results After removing duplicates, 1874 unique papers were identified through database searching and an additional two papers identified through citation searching. After screening, we included 39 papers for data extraction and analysis. Three overarching themes were identified. Theme 1: ‘Supporting the role’ describes how pharmacist roles in aged care are supported through building trust with the team, education and experience, access to information, specific attributes, organisational buy-in, favourable models of care, and role clarity. Theme 2: ‘Medicines expertise activities’ describes how pharmacists perform three key roles valued by healthcare staff: knowledge and communication brokers, filling existing gaps in care, and optimising quality use of medicines. Theme 3: ‘Helping the team’ illustrates health professionals’ perception of three distinct outcomes of pharmacist input (ie enhanced confidence, improved workforce capacity and capability, and improved person-centred care). Conclusion This meta-synthesis of the evidence regarding the perceptions of healthcare professionals on the role of pharmacists in aged care provides contextual information for individuals, organisations and policy-makers for future implementation. Pharmacists are perceived to improve stakeholder confidence, staff capacity and capability, and overall person-centred care. Embedded roles that foster interdisciplinary collaboration are preferred to irregular visiting roles. These embedded roles are enabled through a range of mechanisms that policymakers, organisations and individuals may leverage for successful implementation in future iterations.
Beyond the Numbers: Exploring Tensions Between Formal Entrustment and Trainee Readiness in Internship Training — A Mixed-Methods Study Tarik Al-Diery, Sally Marotti, Yu Ting Sim, Myriam Jaam, Debra Rowett, Jacinta L. Johnson Perspectives on Medical Education, 2026 Purpose: Entrustment decision-making is shaped by both supervisor and trainee. Existing research has focused largely on supervisor decision-making; however, less is known about how trainees experience and internalize entrustment. This study explores how trainee entrustment develops over a pharmacy internship and examines lived experiences that influence progression toward unsupervised practice. Methods: A convergent mixed-methods design explored the entrustment journey of provisionally registered (intern) pharmacists in Australia. Quantitative data were collected via self-administered questionnaires at three time points (beginning, middle, end of internship), capturing perceptions of entrustable professional activities (EPA) utility and self-perceived readiness for entrustment across ten EPAs. At year-end, focus groups explored pharmacy interns’ perceptions of the EPA framework and how they interpreted and internalized it in relation to their development. Qualitative data were analyzed using reflexive thematic analysis and triangulated with quantitative findings to examine convergence and divergence over time. Results: Seventeen pharmacy interns completed questionnaires; 16 of these participated in focus groups. Self-perceived readiness for entrustment increased significantly across most EPAs, with median entrustment ratings reaching level 3 (independent with reactive supervision) by the end of internship. Pharmacy interns described that being entrusted supported confidence development, particularly when paired with structured feedback and reflective practice. Some noted that an emphasis on meeting numeric benchmarks risked reducing the process to a “numbers game,” overshadowing diverse and complex learning opportunities, and diminishing feedback opportunities once level 3 was achieved. At times, this created asymmetry between being entrusted by a supervisor and the interns’ own sense of readiness for more complex practice. Conclusion: EPAs support trainees’ progression toward autonomy by embedding structure, feedback, and self-reflection that affirms competence and guides development. When entrustment decisions are tied to achieving a predetermined number of EPA observations, there is a risk that entrustment may be conferred prematurely, thereby reducing the depth of feedback and reflection that follows. When framed as assessments for learning, EPAs better support trainees’ transition to confident, autonomous practice.
Analysis of textual responses to explore barriers, enablers, and motivators for cultivating research capacity: a statewide study of hospital pharmacy staff Nadia Izzati Zamri, Nazanin Ghahreman-Falconer, Jacinta L. Johnson, Sally B. Marotti, Elizabeth McCourt, Sidony Miller-Waugh, Laetitia Hattingh International Journal of Clinical Pharmacy, 2026 INTRODUCTION: Studies show that embedding research within healthcare services is associated with improved patient outcomes, enhanced workforce satisfaction, and increases in system performance. However, limited evidence exists regarding the research culture and capacity among hospital pharmacy staff in Australia. AIM: This research aimed to assess the research barriers, enablers, and motivators of a statewide public hospital pharmacy service at the organizational, team, and individual levels in Queensland, Australia. METHOD: This study forms part of a statewide, prospective, cross-sectional survey conducted across 16 public hospitals and health services in Queensland, Australia. Using the validated Research Capacity in Context Tool, data were collected via a survey that included open-ended questions to explore research barriers, enablers, and motivators. Reflexive, inductive thematic analysis was conducted to identify key themes and subthemes in free-text responses, with subthemes mapped against the Capability-Opportunity-Motivation-Behaviour model and the Theoretical Domains Framework. RESULTS: Of the 481 survey participants, 401 provided open-ended responses. Six overarching themes and 14 subthemes were developed that influence research engagement. Themes are time and workload constraints, building research capacity, support from management, career progression and personal satisfaction, altruistic motivators, and navigating research processes. Lack of protected research time, limited access to resources, and variation in leadership support were prominent barriers to research uptake. Enablers of research uptake included availability of mentorship, interdisciplinary collaboration, intrinsic interest, and desire to contribute to patient-centered care. CONCLUSION: This study underscores the multifaceted barriers and enablers that act as motivators to cultivate research capacity within hospital pharmacy departments. Addressing concerns such as protected research time, mentorship, and streamlined governance processes is essential to nurturing a sustainable research culture.
Evaluation of Pharmacy and Nursing Interprofessional Undergraduate Learning in a High-Fidelity Simulated Hospital, Supported with a Virtual Online Environment Adam P. Forrest, Kyung Min Kirsten Lee, Kevin O’Shaughnessy, Jimit Gandhi, Jacinta L. Johnson International Medical Education, 2025 Pharmacy and nursing professions collaborate closely in healthcare settings. Effective interprofessional practice is now widely recognised as essential for achieving optimal patient care outcomes. Little has been published on nursing-pharmacy Interprofessional learning (IPL) in a simulated environment in Australian contexts. This study aimed to evaluate whether an IPL activity improved participants’ communication confidence, role understanding, clinical knowledge, and preparedness for hospital placement, while also assessing student satisfaction and identifying areas for improvement. A pedagogically structured teaching and learning model was developed, involving a high-fidelity on-campus simulated hospital ward, supplemented with a virtual online environment to immerse nursing and pharmacy students in a realistic clinical environment to achieve deep learning in preparation for safe practice. An online anonymous survey was conducted to evaluate participants’ experience and preparedness following the simulation. 280 students participated and 52 completed the evaluation. Most students reported that the experience boosted their confidence in communicating with other healthcare professionals (82%), increased clinical/therapeutic knowledge (86%), gave them a better understanding of the roles of nurses/pharmacists within the hospital setting (88%) and left them feeling better prepared for hospital placement (85%). Student free-text responses from the evaluation survey further supported the expansion of the IPL sessions in the future. IPL involving nursing and pharmacy students in a simulated hospital builds confidence in communicating and increases self-reported preparedness for placement.
Entrustment in Action: Factors that Contribute to Entrustment Decision-Making Through the Lens of the Supervisor and the Intern Tarik Al-Diery, Sally Marotti, Yu Ting Sim, Debra Rowett, Jacinta L. Johnson American Journal of Pharmaceutical Education, 2025 OBJECTIVE: To explore what factors are considered in making an entrustment decision about a provisionally registered (intern) pharmacist from the perspectives of registered and intern pharmacists. METHODS: Registered and intern pharmacists in Australia were invited to participate in an anonymous online survey. The survey included open-ended, free-text questions exploring the factors influencing entrustment decisions for three Entrustable Professional Activities developed by the Australian Pharmacy Council for use in workplace-based assessments of intern pharmacists: dispensing medicines, compounding pharmaceutical products, and providing medication counselling. Qualitative data were analyzed using Braun and Clarke's reflexive thematic analysis approach to identify key themes and subthemes influencing entrustment decisions. RESULTS: Of the 302 respondents (220 registered pharmacists and 82 interns), 215 participants provided qualitative responses. Analysis revealed four major themes: (1) Intern's competency and skill proficiency, with emphasis on technical knowledge, task execution, and interpersonal skills; (2) Intern's self-awareness and metacognition, including receptiveness to feedback and reflective practice; (3) Entrustment process dynamics, highlighting task complexity, contextual risk, and supervisor trust propensity; and (4) Barriers to and opportunities for establishing entrustment practices that guide entrustment decisions. Supervisors reported relying on team-based perspectives to inform entrustment decisions. CONCLUSION: Entrustment decision-making is a multifaceted process shaped by intern characteristics, task complexity, and contextual dynamics. In addition to technical competence, metacognitive capabilities and reflective practice were identified as critical to fostering more autonomy in practice. Variability in supervisors' trust propensity and entrustment practices highlights the need to strengthen entrustment practices to enhance consistency in how decisions are made and to support effective use of Entrustable Professional Activities in workplace-based pharmacy education.
Unlocking Findings of Entrustable Professional Activities for Trainee Development, Entrustment, and Practice Readiness in Pre-registration Pharmacy Training: A Systematic Review Tarik Al-Diery, Sally Marotti, Kyung Min Kirsten Lee, AbdelHakim Bishawi, Debra Rowett, Jacinta L. Johnson American Journal of Pharmaceutical Education, 2025 OBJECTIVE: To explore key findings on the use of entrustable professional activities (EPAs) in preregistration pharmacy training, with a focus on their role in trainee development, entrustment decision-making, and practice readiness. METHODS: A systematic search was conducted across 5 electronic databases (MEDLINE, Embase, Scopus, Emcare, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) to identify studies reporting on the use of EPAs in preregistration pharmacy training. Studies that described how EPAs influenced trainee development, entrustment decision-making, and practice readiness were included. Two independent reviewers screened and extracted data from the included studies. Key findings were synthesized into thematic domains. The Mixed Methods Appraisal Tool 2018 was used to evaluate the quality of the included studies. RESULTS: A total of 581 articles were screened, with 27 meeting the inclusion criteria (17 quantitative descriptive, 7 mixed methods, and 3 qualitative studies). A narrative synthesis of the eligible studies revealed 3 key findings: EPAs support the progressive entrustment of trainees across different time points in training, EPA implementation enhances trainees' self-directed learning and self-awareness skills, and supervisor entrustment decisions are influenced by a range of contextual, personal, and trainee-related factors. Although EPAs were consistently associated with increased trainee autonomy, entrustment practices among supervisors remained relatively variable. Most included studies were assessed as medium to high quality. CONCLUSION: The use of EPAs in pharmacy education fosters trainee autonomy, self-assessment, and professional growth in trainees. However, variability in supervisor decision-making highlights the need for further research to support consistent EPA implementation and supervisor training in authentic practice environments.
Fully Loaded: Digoxin Initiation and Monitoring Jinara Devinuwara, Pany Virdi, Sheryn Tan, Ong Sze Tong, Jeng Swen Ng, Toby Gilbert, Samuel Gluck, Cassandra Potts, Alice Wisdom, Mirjana Culibrk, Jacinta L. Johnson, Lia Bouras, Stephen Bacchi Heart Lung and Circulation, 2025
Pharmacists in aged care: outcomes of a national stakeholders meeting Kate Wang, Nagham Ailabouni, Christopher D. Etherton‐Beer, Jacinta L. Johnson, Deborah Hawthorne, Rhonda Clifford, Liza Seubert, Kylee Hayward, Tiernan Mcdonough, Amy T. Page, Kenneth Lee Journal of Pharmacy Practice and Research, 2025
Management of slow colonic tranit constipation in Parkinson’s disease: Current evidence and a community pharmacy perspective International Journal of Pharmacy and Pharmaceutical Sciences, 2016
