title: Views of pharmacy graduates and pharmacist tutors on evidence-based practice in relation to over-the-counter consultations: a qualitative study.
abstract: OBJECTIVE
  Health care services offered to the public should be based on the best available evidence. We aimed to explore pharmacy tutors' and trainees' views on the importance of evidence when making decisions about over-the-counter (OTC) medicines and also to investigate whether the tutor influenced the trainee in practice.
  
  
  METHODS
  Following ethical approval and piloting, semi-structured interviews were conducted with pharmacy graduates (trainees) and pharmacist tutors. Transcribed interview data were entered into the NVivo software package (version 10), coded and analysed via thematic analysis.
  
  
  RESULTS
  Twelve trainees (five males, seven females) and 11 tutors (five males, six females) participated. Main themes that emerged were (in)consistency and contradiction, confidence, acculturation, and continuation and perpetuation. Despite having an awareness of the importance and potential benefits, an evidence-based approach did not seem to be routinely or consistently implemented in practice. Confidence in products was largely derived from personal use and patient feedback. A lack of discussion about evidence was justified on the basis of not wanting to lessen patient confidence in requested product(s) or possibly negating the placebo effect. Trainees became acculturated to 'real-life' practice; university teaching and evidence was deemed less relevant than meeting customer expectations. The tutor's actions were mirrored by their trainee resulting in continuation and perpetuation of the same professional attitudes and behaviours.
  
  
  CONCLUSIONS
  Evidence appeared to have limited influence on OTC decision making. The tutor played a key role in the trainee's professional development. More work could be performed to investigate how evidence can be regarded as relevant and something that is consistently implemented in practice.
authors.affiliation: School of Pharmacy, Queen's University Belfast, Belfast, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: McKee
authors.affiliation: School of Pharmacy, Queen's University Belfast, Belfast, UK.
authors.forename: Carmel
authors.initials: C
authors.lastname: Hughes
authors.affiliation: School of Pharmacy, Queen's University Belfast, Belfast, UK.
authors.forename: Lezley-Anne
authors.initials: LA
authors.lastname: Hanna
mesh_terms: D000069:Acculturation; D000328:Adult; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003657:Decision Making; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005178:Faculty; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010595:Pharmacists / Q000523:psychology*; D024382:Professional Role; D036301:Qualitative Research; D012649:Self Concept
chemical_list: D004366:Nonprescription Drugs
keywords: community pharmacy services; decision making; education; evidence-based practice; non-prescription drugs; qualitative research