Brown Andrew N, Ward-Panckhurst Liane, Cooper Gabrielle
University of Canberra, Canberra, Australian Capital Territory, Australia.
Rural Remote Health. 2013 Apr-Jun;13(2):2327. Epub 2013 Jun 6.
Limited human resources are a major impediment to achieving the UN health-related Millennium Development Goals in a number of Pacific Island Countries (PICs). Lack of education capacity to support competency development in medicine supply management is one of the main issues affecting workforce development in this region, which is characterised by disparate service delivery due to the range of environments in which supply occurs (ie urban, rural and remote), geographical challenges and cultural practices associated with teaching and learning. The supply of medicines, and an adequate pharmacy workforce with appropriate competencies is crucial to ensuring a well-functioning pharmaceutical system. In this region approximately 80% of patients access healthcare in rural areas without a pharmacist, thus local health personnel must be competent in pharmaceutical management relevant to the local context and culture. A new approach involves a partnership between the UN Population Fund Suva Sub-Regional Office, University of Canberra, Ministry of Health officials and the heath personnel within identified PICs, starting with the need to understand local culture and its impact on learning and teaching, and the mapping of competency requirements and an understanding of currently available information and materials. This information will be used to develop and trial new pedagogical approaches to training health personnel involved in essential medicines supply management, to improve medicines availability for patients in their own environment. The focus of this review was to determine what cultural and learning factors need to be considered when developing a curriculum for South Pacific pharmaceutical health personnel who work across a range of practice environments.
A 'realist methodology' consisting of a systematic investigation of the published literature and a targeted review of the 'grey' literature was used. All relevant literature was retrieved and coded manually using broad thematic analysis.
The combined bibliographic and 'grey' literature search strategy resulted in the inclusion of 17 full text articles, 44 documents and 10 books. The five themes identified as key to optimising the cultural and learning approaches for the study population included recognition of: (1) past regional experiences of health related training; (2) the impact of South Pacific culture on learning styles; (3) the impact of external influences on curriculum; (4) the challenges of open and distance education in the Pacific; and (5) a distinct South Pacific student learning approach.
The results of this 'realist methodology' review provide insights into learning approaches and cultural influences on student learning within PICs. The themes generated will be used to develop a set of principles to inform educators and health personnel involved in pharmaceutical training within PICs.
人力资源有限是一些太平洋岛国实现联合国与健康相关的千年发展目标的主要障碍。缺乏支持药品供应管理能力发展的教育能力是影响该地区劳动力发展的主要问题之一，该地区的特点是由于药品供应所处环境多样（即城市、农村和偏远地区）、地理挑战以及与教学相关的文化习俗，导致服务提供存在差异。药品供应以及拥有具备适当能力的充足药学劳动力对于确保药品系统正常运作至关重要。在该地区，约80%的患者在农村地区就医时没有药剂师，因此当地卫生人员必须具备与当地情况和文化相关的药品管理能力。一种新方法涉及联合国人口基金苏瓦次区域办事处、堪培拉大学、卫生部官员以及特定太平洋岛国的卫生人员之间的伙伴关系，首先需要了解当地文化及其对学习和教学的影响，绘制能力要求图谱，并了解当前可用的信息和材料。这些信息将用于开发和试验新的教学方法，以培训参与基本药品供应管理的卫生人员，从而在其自身环境中提高患者的药品可及性。本综述的重点是确定为在多种实践环境中工作的南太平洋药学卫生人员制定课程时需要考虑哪些文化和学习因素。
采用了一种“现实主义方法”，包括对已发表文献进行系统调查以及对“灰色”文献进行有针对性的综述。检索了所有相关文献，并使用广泛的主题分析进行手动编码。
综合书目和“灰色”文献检索策略共纳入17篇全文文章、44份文件和10本书籍。确定为优化研究人群的文化和学习方法的五个关键主题包括认识到：（1）过去与健康相关培训的区域经验；（2）南太平洋文化对学习风格的影响；（3）外部影响对课程的影响；（4）太平洋地区开放和远程教育的挑战；（5）独特的南太平洋学生学习方法。
本次“现实主义方法”综述的结果为太平洋岛国学生学习的学习方法和文化影响提供了见解。所产生的主题将用于制定一套原则，为参与太平洋岛国药学培训的教育工作者和卫生人员提供参考。
