Objectives. The purpose of this study was to examine pharmacists' attitudes, behaviors, and preferences towards continuous professional development in Ontario, Canada. Methods. A series of 11 focus group sessions were undertaken with groups of 4 to 5 different pharmacists participating in the Ontario College of Pharmacists' Quality Assurance and Peer Review Process Learning Portfolio session. During these sessions, extensive field notes were compiled and verified with participants. Following all sessions, field notes were transcribed and analyzed thematically using a qualitative data analysis method. Results. Four key themes were identified: (1) definitions and conceptions of continuous professional development (CPD) and continuing education (CE); (2) evolution from a CE to a CPD paradigm; (3) workplace learning as a vehicle for CPD; and (4) the role of peers in enabling CPD. Conclusions. In this study, pharmacists had an opportunity to discuss attitudes, personal behaviors, and preferences regarding CPD and CE. Participants expressed ambivalence towards CPD and were concerned about their lack of skills in self-identification of learning needs and vehicles by which this could be addressed. Participants agreed that workplace learning is a pivotal yet underemphasized component of CPD, and that peer-support is vital in adopting a CPD paradigm.

The use of learning portfolios in health professions has been widely described and discussed as an important tool for promoting reflective practice and continuing professional development. Within pharmacy, there have been reports of the use of the learning portfolio in practice and education. The Ontario College of Pharmacists, as part of its maintenance of competency requirements, requires practicing pharmacists to maintain a learning portfolio as a written record of learning activities, resources used and outcomes. For this study, surveys were distributed to 1415 pharmacists in Ontario, Canada (representing approximately 20% of all pharmacists in the province) and data was collected related to use of the learning portfolio in practice.In addition, anecdotal feedback was collected and analyzed to identify the value of the portfolio in maintenance of competency activities for pharmacists. Results indicate that initially pharmacists may express misunderstanding or misapprehension regarding the role of the learning portfolio and optimal ways of documenting learning in practice. However, with additional support (including the use of facilitated, peer-based discussions), attitudes towards learning portfolios shift towards acceptance and understanding. Quantitative data indicates a wide variation in the number of learning objectives identified per pharmacist per year, the amount of time spent in continuous professional development activities, and the impact of these activities on changing practice.

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Maintenance of competence is integral to health care practitioners' continuing professional development. The adequacy and value of indirect assessment of competence (through, for example, learning portfolios or attendance at educational events) has been questioned. Direct assessment (such as written tests of clinical knowledge or objective structured clinical examinations, OSCEs) has been advocated as a more meaningful indicator of a practitioner's competence. This paper describes the Ontario (Canada) College of Pharmacists' experience with direct assessment through the Peer Review/Quality Assurance process. This process consists of a selfassessment questionnaire, ongoing maintenance of a learning portfolio, a written test of clinical knowledge, and an OSCE. Each year, a randomly selected group of pharmacists in Ontario undertake the Peer Review process. After five years of operation, 992 pharmacists had participated in this program; 86% of participants met or exceeded standards and were encouraged to continue with their own professional development while 14% of participants did not meet standards in identified assessment areas, and were directed to a peer-assisted process to facilitate professional development. Findings suggest individuals who were educated outside Canada or the United States, those in community pharmacy practice, and those who had been in practice 25 years or more demonstrated greatest difficulty in meeting standards. The implications of these results for pharmacy practice and professional development are discussed as are issues related to direct and indirect assessment of clinical skills.

Objectives. To describe development of a Family Practice Simulator (FPS), an interprofessional curricular innovation in which physicians, pharmacists, and other health care professionals work with standardized patients over the course of a simulated 7½-hour "typical" day in a family practice setting. Assessment. Outcomes for the FPS were developed through review of previous literature, standards of practice guidelines, and educational outcomes documents. Simulations were developed, including pharmacist-patient interviews, pharmacist-physician interactions, and pharmacist-nurse interactions. Results. Post-workshop evaluations (n=8) demonstrated the value of the FPS in rapidly orienting and training pharmacists moving into primary care practice and assisting them in developing new collaborative, interprofessional teamwork skills. Conclusions. While clinical simulation has traditionally been focused on patient-practitioner interactions only, the value of simulating a practice style, location (eg, a family practice setting), and multiple types of tasks are beneficial in training pharmacists for more effective, collaborative work with physicians.