The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes

Transcription

1 The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes Part I - Responses to National Survey of Pharmacy Technicians and Assistants Part II - Responses to National Survey of Pharmacists (Owners and Managers) March 2007 Prepared for: Moving Forward: Pharmacy Human Resources for the Future Prepared by: Funded by the Government of Canada's Foreign Credential Recognition Program.

2 How to cite this document: Management Committee, Moving Forward: Pharmacy Human Resources for the Future. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes. Ottawa (ON). Canadian Pharmacists Association; (2007)

3 The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes Part I - Responses to National Survey of Pharmacy Technicians and Assistants Part II - Responses to National Survey of Pharmacists (Owners and Managers) Prepared for: Moving Forward: Pharmacy Human Resources for the Future Prepared by: Vision Research March 2007 The Moving Forward initiative is funded by the Government of Canada's Foreign Credential Recognition Program. The opinions expressed in this publication are those of the author and do not necessarily reflect those of the Government of Canada.

4 ACKNOWLEDGEMENTS This report was made possible by the following contributors: Moving Forward Co-Chairs Kevin Hall Winnipeg Regional Health Authority Fred Martin West Prince Pharmacy Management Committee Zubin Austin Association of Faculties of Pharmacy of Canada Patty Brady Human Resources and Social Development Canada Janet Cooper Canadian Pharmacists Association Tim Fleming Canadian Association of Pharmacy Technicians Dennis Gorecki Association of Deans of Pharmacy of Canada Paul Kuras Canadian Pharmacists Association Allan Malek Canadian Association of Chain Drug Stores Linda Suveges The Pharmacy Examining Board of Canada National Advisory Committee Members Pharmacy Technician Working Group Danuta Bertram Winnipeg Regional Health Authority Anne Marie Burns Ottawa Hospital Rock Folkman Canadian Pharmacy Technician Educators Association Susan James Ontario College of Pharmacists Colleen Norris The Glebe Apothecary Allan Samuelson College of Pharmacists of British Columbia Margaret Woodruff Humber College Project Consultants Vision Research Project Manager Heather Mohr Canadian Pharmacists Association Ken Wou Canadian Society of Hospital Pharmacists 2007 Canadian Pharmacists Association

5 TABLE OF CONTENTS Part I - Responses to National Survey of Pharmacy Technicians and Assistants Executive Summary Overview of Moving Forward: Pharmacy Human Resources for the Future...5 A. Introduction Approach and Methodology B. Findings Respondent Profile Gender Age Distribution by Province Where Employed Community Size Hours Worked Years as a Pharmacy Technician Future Plans Technical Training Certification Education When Completed Education Current Job Current Tasks Number of Staff at Pharmacies Job Satisfaction Workload Responsibility Compared to Level of Training Incentives for Upgrading Foreign-Trained Individuals Incidence of Foreign Training Foreign-Trained Pharmacy Technicians Foreign-Trained Pharmacists Working Relationships and Use of Skills Responsibilities Future Technician Training and Responsibilities Likelihood of Taking Future Community College Training Accreditation of Community College Programs Certification of Pharmacy Technicians Regulation of Pharmacy Technicians Summary of Reactions to New Initiatives C. Conclusion Appendix - National Pharmacy Technicians and Assistants Survey Questionnaire The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes

6 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Executive Summary Overview of Moving Forward: Pharmacy Human Resources for the Future..52 A. Introduction Approach and Methodology B. Findings Respondent Profile Gender Distribution by Province Where Employed Community Size Years as Pharmacist Level of Education Role in Primary Workplace Current Job Number of Staff Pharmacists and Technicians Technicians with Community College-Level Training and Certification Satisfaction with Pharmacy Technicians Work Load Level of Responsibility Current HR Practices Sources for Hiring Pharmacy Technicians Job-Specific Training or Education Requirements Hiring Conditions Incentives for Attracting Qualified Technicians Foreign-Trained Individuals Training/Work Outside Canada/USA Technician Training & Responsibilities Accreditation of Technician Training Programs Certification of Pharmacy Technicians Support for Technicians Who Seek Certification Regulation of Pharmacy Technicians Support for Technicians Who Want to Become Regulated Pharmacy Technicians C. Conclusion Appendix National Pharmacist (Owners and Managers) Survey Questionnaire Canadian Pharmacists Association

7 Part I - Responses to National Survey of Pharmacy Technicians and Assistants The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes Executive Summary Part I - Responses to National Survey of Pharmacy Technicians and Assistants The Canadian Pharmacists Association (CPhA), on behalf of Moving Forward: Pharmacy Human Resources for the Future, retained Vision Research to undertake a survey of both pharmacists and pharmacy technicians across Canada. Part 1 of this report presents the results of the survey of pharmacy technicians and assistants. The intent of the survey was both to develop a clear sense of the current profile of pharmacy technicians across Canada (numbers, distribution across jurisdictions and work settings, responsibilities, aspirations), and to measure the interest in and resistance to possible future directions for pharmacy technicians in relation to pharmacists. At its heart, this study explores the question: how might the role of pharmacy technicians evolve to better meet their career goals and to allow pharmacists to make fuller use of their skills and knowledge all in the interest of enhancing patient care? A questionnaire was sent via and mail to a representative sample of 3000 pharmacies across Canada asking recipients to have the senior-most manager or owner (pharmacists) complete the questionnaire and share a second, different questionnaire with the pharmacy technicians on their staff. In addition, participation in the online survey was promoted by CPhA and its partners representing pharmacists and pharmacy technicians to those members for whom addresses were available. In all, 2087 completed questionnaires were received from pharmacy technicians. Since this is the first such study of the pharmacy technician workforce, it is difficult to assess the extent to which the sample of participants in representative of the pharmacy technician population as a whole. There is no baseline profile of the profession against which to compare the respondent profile, nor is there an exact measure of the total number of pharmacy technicians with which to calculate a response rate and commensurate confidence interval. For these reasons, care should be taken in extrapolating the findings to the overall population. Profile of Respondent Technicians This survey provides the first national profile of pharmacy technicians in Canada. The pharmacy technician workforce is mostly female (94% of respondents are women), with an average age of 38.7 years. 43% of responding technicians work in hospitals and other related facilities, 37% in chain or franchise community pharmacies and 16% in independent community pharmacies. Pharmacy technicians come to their jobs with a wide range of education and technical training; some (16%) have only a high school education and no formal pharmacy training, while about two in 10 (20%) report having some university education. A very small The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 1

8 Part I - Responses to National Survey of Pharmacy Technicians and Assistants proportion (2%) have trained and worked abroad as either pharmacists or pharmacy technicians. The vast majority (62%) of respondents report having technician training from a career college or community college. This wide range of technical training and educational attainment reflects in part the variety of training programs for pharmacy technicians currently available in the different provinces and territories of the country. A substantial proportion of pharmacy technicians have been out of school for some time. More than half (55%) completed their education and training at least 10 years ago. Of those with only a high school education, three-quarters (77%) completed it more than 10 years ago. The characteristics of the pharmacy technician respondents in this study were substantially different depending on their work setting. Those working in chain or franchise stores tended to be younger, have fewer years of work experience, were more likely to have graduated from a private career college or been trained by their employer, and were more likely to be in larger cities or metropolitan areas. Those in independent community pharmacies were more likely to have no technical training other than on-thejob, be older, have considerable work experience, and live in small communities. Hospital technicians were more likely to live in larger cities, to have completed a one-year community college program and have the most experience working as pharmacy technicians. Current Jobs To the extent that these functions were permitted in their jurisdictions, pharmacy technicians are now performing a number of functions involving collection of patient information, verification and preparation of prescriptions, and release of products under certain circumstances. Those working in community settings were much more likely to be performing these functions than those in health care institutions. Hospital technicians, however, often prepare automated dispensing equipment, replace ward stocks or have responsibility for narcotics. Many package products in unit dosage packages or prepare sterile preparations. Three-quarters (74%) of hospital technicians participate in a tech-check-tech routine where they verify the accuracy and completeness of products prepared by other technicians; half as many (37%) technicians in community settings do this. About four in 10 technicians in both settings (47% and 44% respectively) were responsible for supervising other technicians. The survey also provided some insight on the question of how many pharmacy technicians are currently working in Canada, and the ratios are somewhat lower than expected. Survey respondents reported an average (mean) of 2.5 full-time technicians and 2.1 part-time technicians per community pharmacy (chain and independent). Assuming the average part-time technician works half a regular workweek, this yields an average of 3.4 technician Full-Time Equivalents (FTEs) per community pharmacy. In contrast, the survey showed an average (mean) of 15 full-time technicians and 7.5 parttime technicians per hospital pharmacy (including long-term care facilities). Assuming the average part-time technician works half a regular workweek, this yields an average of 18.5 technician FTEs per hospital pharmacy Canadian Pharmacists Association

9 Part I - Responses to National Survey of Pharmacy Technicians and Assistants To help develop a ratio of technicians to pharmacists, we also asked respondents how many pharmacists worked in their pharmacies. Technician respondents reported an average of 3 pharmacist FTEs per community pharmacy, for a ratio of 1.13 technician FTEs per pharmacist FTE in community settings. In hospital settings, technicians reported an average of 14 pharmacist FTEs, for a higher ratio of 1.32 technician FTEs per pharmacist FTE in a hospital setting. Job Satisfaction Pharmacy technicians reported being quite satisfied with a number of job-related factors, including their professional relationships both with pharmacists and with other technicians and with opportunities to use their skills. Most technicians (60%) felt that they had the right amount of responsibility given their education, training and experience, although this was less true for technicians who were already certified. However, certain differences emerged between the opinions of hospital- and communitybased technicians. For example, 85% of community technicians were satisfied with the way their technical tasks are shared with pharmacists, while only 69% of hospital technicians are similarly satisfied. One notable contrast to technicians overall satisfaction trends was related to opportunities for job or career growth. Less than half (48%) of technicians were satisfied with this aspect of their job. Workloads may also be an issue, with 45% of technicians indicating they have too much or much too much to do. While many respondents were unaware of the specifics of their employers pay policies, it would appear that they did not currently receive much support from their employers to pursue technical upgrading. Wages generally reflected years of experience rather than type of training or certification. Less than a third of technicians said their employers either provided in-house courses for them (32%) or would pay for technical courses provided by others (31%). Internationally Trained Technicians Just over 2% of technicians responding to the survey had received their training outside North America. More than half of these (60%) had trained and practiced as pharmacists in some other country. These former-pharmacists are more likely to be working in community settings than in health care institutions, and more likely to be working parttime than full-time. Compared to all technicians, those who had been trained abroad were less comfortable with their professional work relationships. Those who had trained as technicians were at least as satisfied with opportunities to use their skills, the amount of responsibility given their skills, and their opportunities for career growth. However, those who had trained as pharmacists in other countries and were now working as technicians were somewhat less satisfied in all these dimensions. Changes to Training and Utilization of Technicians Technicians appear to want national educational standards. 85% of technician respondents expressed support for national accreditation of community college programs. More than 70% of technicians expressed support for possibly requiring all pharmacy technicians to graduate from an accredited program. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 3

10 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Pharmacy technicians are highly interested in moving towards regulation, even though it may require additional training and expanded duties. More than eight in 10 (84%) pharmacy technicians expressed interest in becoming a regulated pharmacy technician, of which an impressive 54% state they would be very interested. Certification of pharmacy technicians, whether voluntary or mandatory, was also positively received. 70% of pharmacy technicians supported voluntary certification, while 62% supported mandatory certification. Overall, technicians were generally supportive of most of the initiatives explored in the survey. Next Steps The findings generated by this research present many opportunities for more in-depth exploration on pharmacy technicians attitudes and intentions regarding their future. Moving Forward will be conducting focus groups to investigate some of these areas in the spring and summer of Visit pharmacyhr.ca for more information Canadian Pharmacists Association

11 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Overview of Moving Forward: Pharmacy Human Resources for the Future One of the most urgent crises facing Canada s health care system today is the appropriate management of health human resources ensuring the right skills in the right place at the right time. Pharmacists are a high priority health human resource at many levels with patients, drug supply management, health institutions, the health system and the population. Pharmacists have a key role to play at all these levels in ensuring pharmaceuticals are used appropriately, safely and provide optimal benefits. Serious challenges are facing the pharmacy sector s efforts to optimize the management of its available human resources. These include the rapid evolution of the pharmacist s role in health care delivery, pharmacist shortages, complexities in integrating international pharmacy graduates, and a complete lack of data on pharmacy technicians. A failure to address pharmacy human resource challenges will compromise the ability of the profession to respond to these new demands and its ability to fully address the safe and appropriate use of drugs in Canada. There is, therefore, an urgent need to understand the factors contributing to these human resources pressures and strategize potential solutions. A collaborative of eight national pharmacy stakeholders has received funding from the Foreign Credential Recognition program of Human Resources and Social Development Canada to undertake a pharmacy human resources study. The collaborative includes the Canadian Pharmacists Association (secretariat for the project), the Association of Deans of Pharmacy of Canada, the Association of Faculties of Pharmacy of Canada, the Canadian Association of Chain Drug Stores, the Canadian Association of Pharmacy Technicians, the Canadian Society of Hospital Pharmacists, the National Association of Pharmacy Regulatory Authorities and the Pharmacy Examining Board of Canada. This study, Moving Forward: Pharmacy Human Resources for the Future, is an in-depth examination of the factors contributing to pharmacy human resources challenges in Canada. It will offer recommendations to ensure a strong pharmacy workforce prepared to meet the current and future health care needs of Canadians. Through a 30-month long series of investigations and consultations, Moving Forward will: Develop a comprehensive understanding of the pharmacy workforce in Canada and the factors that influence its structure and the skills and competencies of its members; Identify and analyze the short- and long-term human resource planning challenges facing the pharmacy sector, including those specific to international pharmacy graduates, and Offer recommendations for and solutions to these challenges. The optimal management of pharmacy human resources requires more than just information; it requires planning. The recommendations developed through this study will be used by stakeholders at local, regional, provincial, territorial and national levels to develop their pharmacy human resources management plans. The findings contained in part 1 of this report represent the results of Moving Forward s landmark National Survey of Pharmacy Technicians and Assistants, and provide a foundation of evidence for further research regarding the changing role of the pharmacy technician. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 5

12 Part I - Responses to National Survey of Pharmacy Technicians and Assistants A. Introduction Approach and Methodology Vision Research was retained by the Canadian Pharmacists Association (CPhA), on behalf of Moving Forward: Pharmacy Human Resources for the Future, to undertake a survey of both pharmacists and pharmacy technicians in Canada. The project had two main objectives: 1) to quantify, for the first time, the pharmacy technician workforce in Canada, and 2) to gain national qualitative knowledge on workforce attitudes and opinions surrounding the current and future role of the pharmacy technician. The project used a two-step methodology, whereby pharmacists were approached directly (using both mail to a representative sample of 3000 pharmacies, provided by Dendrite, and direct to CPhA members whose addresses the association had on file) and indirectly (by issuing invitations to all provincial licensing bodies and national and provincial stakeholders with pharmacist members). In a covering letter sent in early September 2006, pharmacists were asked to both have the most senior manager or owner complete a questionnaire designed for them, and pass a second questionnaire on to the pharmacy technicians on their staff. Though there were some questions repeated between the two questionnaires, the differences in the research instruments and in the populations surveyed called for the findings to be interpreted and reported on separately. Where appropriate, however, we do compare and contrast certain findings. Respondents (both pharmacists and technicians) were given the option of completing a printed questionnaire and submitting it via fax or mail to Vision Research, or visiting a secure website where they could enter their responses online. The survey was in the field for 10 weeks, until mid-november A number of reminder messages were sent directly via fax (again using a Dendrite list) and , and the CPhA and partner organizations (of pharmacists and technicians) promoted participation in the survey to their members. In all, 2087 completed questionnaires were received from pharmacy technicians. Since this is the first such study of the pharmacy technician workforce, it is difficult to assess the extent to which the sample of participants is representative of the pharmacy technician population as a whole. There is no baseline profile of the profession against which to compare the respondent profile, nor is there an exact measure of the total number of pharmacy technicians with which to calculate a response rate and commensurate confidence interval. For these reasons, care should be taken in extrapolating the findings to the overall population. For the charts and graphs presented in the following pages, all percentages have been rounded off to the nearest whole number, reflecting the overall level of accuracy of the survey data. Standard rounding conventions are used; that is, 6.4 or less is rounded down to 6, and 6.5 or more is rounded up to 7. For computed figures (such as the ratio of technicians to pharmacists), the ratio for each individual is calculated, the ratios are summed, and then the sum is rounded. For this reason, the total of two rounded numbers shown in a chart may be slightly different than the actual sum of the unrounded figures. Also for this reason, readers may also find that the totals on certain charts do not add up to Canadian Pharmacists Association

13 Part I - Responses to National Survey of Pharmacy Technicians and Assistants B. Findings 1.0 Respondent Profile 1.1 Gender Of the more than 2000 pharmacy technicians who responded to the survey, nearly all were women (94%); just 6% were men. Male technicians were more common in the large metropolitan areas (8%) than in rural areas (2%). Male respondents were also more common among respondents with some university education (11%), compared to those with only high school (3%), and among those with technical training from a college (7%) or from abroad (22%), compared to those with no formal technical training (4%). 1.2 Age The average age of technicians was 38.7, which is only marginally younger than the average age of the Canadian workforce (39 years) as a whole 1. Nevertheless, a substantial proportion (35%) of technicians was over 40. Technicians working in chain or franchise stores were younger, on average, than those in either independent community pharmacies or health care institutions. Health care institutions had the greatest proportion of older technicians, with 43% being over 40, compared to just 28% of technicians in chain or franchise pharmacies. Age by Employment Setting 100% 80% % 40% 20% 0% All Technicians Chain/Franchise Pharmacy Independent Pharmacy Hospitals/ Long-term Care < 24 years years years years 50+ years 1. Statistics Canada. Labour Force1 Indicators by Age Group, 2001 Counts, for Canada, Provinces and Territories - 20% Sample Data. Available: &Table=1&StartRec=1&Sort=2&B1=Counts01 (accessed April 9, 2007). The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 7

14 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 1.3 Distribution by Province The largest proportion of survey respondents were from Ontario (34%), with another 32% coming from the two most western provinces (16% were from each of British Columbia and Alberta). Manitoba and Saskatchewan together accounted for only 9% of respondents, while another 17% came from the Atlantic provinces. Just 8% of respondents were from Quebec, which is lower than expected, given that some 23% of Canada s pharmacists are licensed in that province. It would appear that technician response rates were higher in provinces (i.e., Ontario, British Columbia) where there has been active discussion of changes in education, certification or roles of pharmacy technicians. NB 7% Provincial Breakdown QC 8% NS 5% PE 1% ON 34% NL 3% BC 16% AB 16% SK 4% MN 5% 1.4 Where Employed Just over half the responding technicians (53%) worked in a community pharmacy while 44% were employed in a hospital or long-term care facility. A few (3%) worked in other settings, such as the Department of National Defence, as a college teacher or in the head office of a pharmacy company. Of those technicians working in community pharmacies, many more were from chain or franchise stores (37%) than from independent community pharmacies (16%). About 12% reported working in more than one location. Employment Setting 3% Hospital/Long-term Care Facility 16% Community Chain/Franchise Pharmacy 53% Community 37% 44% Community Independent Pharmacy Other Canadian Pharmacists Association

15 Part I - Responses to National Survey of Pharmacy Technicians and Assistants The distribution of technicians between community and hospital settings varied considerably by province. At least half the technicians responding to the survey from New Brunswick (57%), Alberta (51%) and British Columbia (51%) were employed in hospitals or long-term care facilities. In contrast, about the largest proportion were from community pharmacies in Newfoundland and Labrador (76%), and Saskatchewan (69%). Provincial Breakdown by Employment Setting 100% 80% % % % % Newfoundland & Labrador NovaScotia PrinceEdwardIsland New Brunswick Quebec Ontario M anitoba Saskatchewan Alberta BritishColumbia Other Hospitals/Long-term Care Independent Pharmacies Chain/Franchise Pharmacies 1.5 Community Size Just over half (55%) of the respondents worked in large urban centres, compared to the 45% who worked in small cities, towns or rural areas. Hospital pharmacy technicians were most likely to be located in large cities (59% versus 55% for technicians as a whole). Those working in independent community pharmacies were more likely to be located in rural areas or small towns (51% versus 45% for technicians as a whole). 21% 34% Community Size 10% Rural & Small Towns Small Cities 35% Larger Cities Tor/Mtl/Van The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 9

16 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Community Size by Employment Setting 100% 80% % % 20% 0% All Technicians Chain/Franchise Stores Independent Stores 35 6 Hospitals/ Longterm Care Rural Small Centres Large Cities Tor/Mtl/Van 1.6 Hours Worked The vast majority of pharmacy technicians (87%) reported that they were working at least 30 hours per week at their primary work place. A substantial 40% reported working 40 or more hours per week at their primary workplace. Only 13% were working part-time (less than 30 hours per week). >40 _ h Hours Worked 40% <14 - h 2% h 11% Technicians in Saskatchewan (55%), Ontario (45%) and Newfoundland and Labrador (44%) were much more likely to report that they were working 40 or more hours per week. 47% h Canadian Pharmacists Association

17 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Hours Worked by Employment Setting 100% 80% 60% % 20% 0% Chain Independent Hospital hours or less 15 to 29 hours 30 to 39 hours 40 or more hours Analysis of the findings shows that respondents in a hospital or long-term care setting were less likely to be working full-time hours (defined as 40 hours or more) than their counterparts in community settings. Indeed, technicians in independent pharmacies were more than twice as likely (59%) to be working more than 40 hours each week. The findings also showed that hours worked per week vary little by the size of the community in which the technician is practising, though respondents in rural settings were somewhat more likely to report working more than 40 hours per week. 100% 80% 60% 46 Hours Worked by Community Size % 20% 0% Rural Small Centres Large Cities Tor/Mtl/Van 14 hours or less 15 to 29 hours 30 to 39 hours 40 or more hours The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 11

18 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 1.7 Years as Pharmacy Technician One-third (32%) of respondents said they had been working as a pharmacy technician for less than five years. Onequarter (26%) had been technicians for between five and nine years, and just over a quarter (27%) had worked for 10 to 19 years in that job. About 15% had been working as pharmacy technicians for more than 20 years. Technicians in hospitals or long-term care facilities had longer tenure than those in community pharmacies, and those in independent community pharmacies had worked longer than Years as a Pharmacy Technician 20 to 29 yrs 13% 10 to 19 yrs 27% 30 + yrs 2% 5to9yrs 26% 0to4yrs 32% those in chain or franchise pharmacies. Five out of 10 respondents (53%) from hospitals and other institutions had worked as technicians for 10 years or more. This compares to only four in 10 (40%) from independent pharmacies and less than three in 10 (28%) from chain or franchise pharmacies. 100% 80% 60% 40% Years as a Pharmacy Technician by Employment Setting % 0% All Technicians Chain/Franchise Pharmacies Independent Pharmacies 23 Hospitals/ Long-term Care 0-4 years 5-9 years years >20 years Canadian Pharmacists Association

19 Part I - Responses to National Survey of Pharmacy Technicians and Assistants There were fewer technicians who recently joined the occupation among respondents in Ontario and Quebec (23% and 28% respectively), compared to those from Manitoba (43%), Prince Edward Island (39%), New Brunswick (37%) and Saskatchewan (37%). 100% 80% 60% 40% Years as a Pharmacy Technician by Provincial Breakdown % % Newfoundland & Labrador NovaScotia Prince Edward Island New Brunswick Quebec Ontario Manitoba S askatchewan Alberta British Columbia 0to4years 5 to 9 years 10 to 19 years >20 years 1.8 Future Plans The majority of pharmacy technicians intended to remain in the occupation for some time. Nearly two-thirds (65%) said they plan to work as a pharmacy technician for 10 or more years, and only 15% said they would leave the job within five years. Male technicians were more likely to say they will leave within five years (26%, versus 14% of women), as were those working in community pharmacies (17%) compared to those in health care facilities (11%). Younger technicians were more likely to say they will leave the occupation (27% of those under 25), as were those who have not worked in the field for very long 27% of those with less than five years in the field say they would leave within five years. Number of Years Planning to be a Pharmacy Technician 10 or more years 65% Less than 1 year 3% 2to4 years 12% 5to9 years 20% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 13

20 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Technicians in the Atlantic provinces were most likely to say they would remain for 10 or more years, while those in the Western provinces were least likely to have plans to stay. Our analysis of the findings showed few significant differences between respondents in different practice settings, though respondents in independent pharmacies were more likely to plan on being a pharmacy technician for 10 or more years than are their counterparts in chain or franchise pharmacies. Number of Years Planning to be a Pharmacy Technician by Employment Setting 100% 80% 60% % 20% 0% Chain Independent Hos p Less than 1 year 5to9years 2to4years 10 or more years ital In terms of differences relating to community size, we noted that rural respondents (72%) were significantly more likely than respondents in large cities (65%) or in Canada s three largest cities (58%) to plan on being a technician for 10 or more years. Number of Years Planning to be a Pharmacy Technician by Community Size 100% 80% 60% % 20% 0% Rural Small Centres Large Cities Tor/Mtl/Van Less than 1 year 2to4years 5to9years 10 or more years Canadian Pharmacists Association

21 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Number of Years Planning to be a Pharmacy Technician by Province 100% 80% 60% 40% 20% 0% Newfoundland & Labrador Nova Scotia Prince Edward Island New Brunswick Quebec Ontario Manitoba S askatchewan Alberta Less than 1 year 2 to 4 years 5 to 9 years 10 or more years British Columbia The percentage of respondents who planned on being technicians for 10 or more years varies considerably by province. Respondents from Saskatchewan (55%) and British Columbia (58%) were least likely to have such long-term intentions, whereas respondents from Prince Edward Island (77%) and Newfoundland and Labrador (75%) were most likely to plan on being a technician for 10 or more years. 1.9 Technical Training When asked to report what statement best described their formal training as a pharmacy technician, almost one in 10 respondents reported they had no formal training as a pharmacy technician (8%), and slightly more than two in 10 had taken courses given by their employers (21%). On the other hand, six in 10 (62%) pharmacy technicians had graduated from a one-year course, either at a private career college (22%) or a community college (40%). Only 7% of respondents had completed a two-year community college program to become a pharmacy technician (reflecting the fact that such programs are relatively new to many provinces). Technical Training Overview Community college 2 yrs 7% Other 2% No formal training 8% Employer training 21% Community college 1 yr 40% Private career college 22% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 15

22 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 1.10 Certification Respondents were asked if they had completed a pharmacy technician certification program, and a variety of types of certification were offered as choices. These ranged from existing, voluntary certification programs offered in certain provinces, to certification in a particular function by one s place of employment. However, it must be noted that the term certification may still have different meanings in certain jurisdictions or workplaces than those choices presented specifically in the survey and, as such, these choices may have been interpreted differently by respondents. It would appear that certified technicians were more likely to respond to the survey, and thus are over-represented in the data. Only about 3000 pharmacy technicians in Ontario (Ontario College of Pharmacists) and another 700 in Alberta (Pharmacy Technician Certification Board of Alberta) have achieved voluntary certification a very small proportion of the total technician workforce. Yet this survey attracted 366 of these certified technicians. Fully 40% of respondents said they had some type of certification. This certification was obtained from a variety of authorities, including the voluntary certification offered by the Ontario College of Pharmacists (18%), the Pharmacy Technician Certification Board of Alberta (10%), by their hospital in a technical function (8%), the US Pharmacy Technician Certification Board (1%), or by some other mechanism (3%). Certification 10% 8% 1% 3% No t Ce r t ifie d Ontario Certified Pharmacy Technician Pharmacy Technician Certification Board of Alberta 40% Certified 18% 60% Certified by Hospital (in a technical function) Pharmacy Technician Certification Board (USA) Other Canadian Pharmacists Association

23 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Closer analysis of the data revealed that the proportion of respondents who reported being certified varies considerably by employment setting. Whereas nearly half (48%) of respondents in hospital pharmacy settings were currently certified in some way (mostly by the institution or a provincial certifying body), only one-third (33%) of technicians in a community pharmacy were certified. Certification by Employment Setting Other Pharmacy Technician Certification Board (USA) Hospital, Technical Function Pharmacy Technician Certification Board of Alberta Ontario Certified Pharmacy Technician Not Certified Community Hospital 0% % 1.11 Education The level of educational attainment among pharmacy technicians is very diverse. On one hand, 16% have completed only high school, while on the other, 10% have some university education and another 10% have completed a university program. Almost twothirds (64%) have completed a community college diploma or certificate in some field, although not necessarily training related to pharmacy. 100% 80% Education Level by Employment Setting % 40% % 0% 16 All Technicians 22 Chain/Franchise Pharmacies 22 Independent Pharmacies 10 Hospitals/ Long-term Care High School College University Technicians working in health care institutions were most likely to have some college education (69%), while those at chain or franchise pharmacies were least likely to have college education (58%). Just 10% of technicians in health care institutions have only high school education, while 22% of technicians working in community pharmacies have high school education. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 17

24 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 1.12 When Completed Education A substantial proportion of pharmacy technicians have been out of school for some time. Three in 10 (30%) completed their education more than 20 years ago, while another 25% last attended school 10 to 20 years ago. Surprisingly, just one-quarter of the respondents to this survey were recent graduates only 9% completed their education in the last two years, and 16% finished two to four years ago. Of technicians with only a high school education, the largest proportion (58%) completed their education 20 or more years ago. Among technicians with some postsecondary education, only about one-quarter had been out of school for 20 years or more. One-third (31%) of technicians with some college had attended less than four years ago, and one-quarter (24%) of those with university education had attended this recently. 100% Number of Years Since Graduation 80% % % 20% 0% All Technicians High School College University 1yrorless 2-4 yrs ago 5-9 yrs ago yrs a g o 20+ yrs a g o There were significant differences in time since graduation, depending on the technicians work location. One-third (32%) of technicians working in chain or franchise community pharmacies had left school within the past five years, compared to just 19% of technicians in health care institutions. No information was collected on the pursuit of continuing education Canadian Pharmacists Association

25 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 2.0 Current Job 2.1 Current Tasks Technicians were asked to indicate which of a list of 21 tasks they did regularly. The tasks performed by technicians working in community settings varied considerably from those in hospitals and other health care settings. Community pharmacy technicians nearly all reported doing the same 10 to 12 core tasks. Virtually all community technicians were handling pharmaceutical products: filling and labelling prescriptions, preparing non-sterile products such as topicals, reconstituting products such as antibiotics, and maintaining inventory by restocking. Nine out of 10 were making compounding or dosage calculations. Nearly all were also working with patient information: collecting patient information such as age and allergies, and entering prescriptions into a database. Eight out of 10 community pharmacy technicians were also verifying the accuracy and completeness of prescription information. In addition, nine out of 10 community technicians were performing clerical duties such as invoicing and dealing with third-party billing. Seven in 10 were also demonstrating equipment such as blood glucose monitoring equipment or ambulatory aids. Nine out of 10 technicians in community pharmacies said they regularly released repeat prescriptions to patients, while 90% reported they released filled prescriptions (new) to the patient with pharmacist counsel, and 29% reported they released filled prescriptions (new) to the patient without pharmacist counsel. The hospital-based respondents reflected the very different work setting in which they practise as they indicated which of the functions they currently carry out. As a whole hospital-based respondents were less likely to be working directly with the pharmaceutical products, and much less likely to be dealing with patient or prescription information. They also had significantly less patient contact. Less than six in 10 hospital technicians said they regularly released repeat prescriptions, and only about four in 10 released new prescriptions (with pharmacist counsel). Selected Current Tasks (1) 100% 80% 60% 40% % 0% Fill Rxs Prep non-sterile prods Reconstitute prods Maintain Inventory Retail Hospital Compoundingcalcs Enter Rxs in database Collect patient info ReleaserepeatRxs Verify Rx info Release new Rxs - wt Pharm Counsel The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 19

26 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Hospital technicians also differed in that they often performed other kinds of tasks rarely done in community settings. Eight out of 10 hospital pharmacy technicians were controlling or distributing narcotics, packaging or pre-packaging medications such as unit doses, and replenishing ward stock, unit dose carts, or drug kits and trays. More than seven in 10 hospital technicians were preparing sterile products such as intravenous mixtures, parenteral nutrition, or chemotherapy tasks rarely done in a community setting. Six in 10 hospital technicians were replenishing automated dispensing equipment, infusion or compounding devices. Three-quarters of hospital pharmacy technicians (74%) were checking the accuracy and completeness of pharmaceutical products prepared by other technicians, almost twice the number of community technicians. About one in four technicians reported that they regularly released new, filled prescriptions to the patient without pharmacist counsel. The proportion doing this was marginally higher in community pharmacies (29%) than in hospital and long-term care settings (23%). Selected Current Tasks (2) 100% 80% 60% 40% 20% % Clerical duties Demo/sell equip Control narcotics Retail Hospital Packagemeds Check other techs Replenish ward stock Useauto dispensing equip Supervise other techs Prep sterile prods Releasenew Rxs-nocounsel 2.2 Number of Staff at Pharmacies Technicians were asked to record the number of full-time and part-time technicians and pharmacists working at their primary workplace. Given the substantial difference between community and hospital staff sizes, we report these numbers separately to avoid presenting a skewed average figure across all employment settings. Survey respondents reported an average (mean) of 2.1 part-time technicians and 2.5 full-time technicians per community pharmacy (chain and independent). Assuming the average part-time technician works half a regular workweek, this yields an average of 3.4 technician Full Time Equivalents (FTEs) per community pharmacy Canadian Pharmacists Association

27 Part I - Responses to National Survey of Pharmacy Technicians and Assistants In contrast, the survey showed an average (mean) of 7.5 part-time technicians and 15 fulltime technicians per hospital pharmacy (including long-term care facilities). Assuming the average part-time technician works half a regular workweek, this yields an average of 18.5 technician FTEs per hospital pharmacy. Technician respondents also reported an average of 3 pharmacists (full- and part-time) per community pharmacy, for a ratio of 1.13 technician FTEs per pharmacist in community settings. In hospital settings, technicians reported an average of 14 pharmacists (full- and part-time), for a slightly higher ratio of 1.32 technician FTEs per pharmacist in a hospital setting. As the following tables summarize, these numbers are quite consistent with those generated through the survey of pharmacists that was also part of this study. According to Technicians According to Technicians Reported Number of Technicians on Staff Chain Indep. Commun. Hosp. n= Part-time Average Full-time Average Combined Average (FTEs) Reported Number of Pharmacists on Staff Chain Indep. Commun. Hosp. n= Part-time Average Full-time Average Combined Average (FTEs) Ratios 1: : 1.32 The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 21

28 Part I - Responses to National Survey of Pharmacy Technicians and Assistants According to Pharmacists Reported Number of Technicians on Staff Chain Indep. Commun. Hosp. n= Part-time Average Full-time Average Combined Average Reported Number of Pharmacists on Staff n= Part-time Average Chain Indep. Commun. Hosp Full-time Average Combined Average Ratios 1: : 1.10 * Pharmacists were asked to report on both current and vacant positions at their primary place of employment. The figures in this table add the two together Canadian Pharmacists Association

29 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Both pharmacists and technicians report a ratio of between 1.00 and 1.10 technician FTEs per pharmacist in community pharmacies and a slightly higher ratio of between 1.10 and 1.32 technician FTEs per pharmacist in hospital settings. 2.3 Job Satisfaction The survey probed a number of aspects of job satisfaction including satisfaction with professional relationships, with division of tasks and with opportunities for professional growth. Overall, pharmacy technicians were quite satisfied with their working relationships: almost nine out of 10 said they were somewhat or very satisfied with their professional relationships with both pharmacists (88%) and other technicians (88%). Relationships with Pharmacists Those working in community pharmacies were more likely to say they were very satisfied with their professional relationships with staff pharmacists, compared to technicians in hospitals or long-term care facilities. Technicians working in rural areas, and those in work locations with three or fewer pharmacists were more likely to be satisfied with technician-pharmacist relationships. It is perhaps not surprising that those who planned to remain as technicians for 10 or more years reported better relationships with pharmacists (90% satisfied) than those expecting to leave the job within five years (82% satisfied). Relationships 100% Relationship with Staff Pharmacists Relationship with Other Technicians 80% 60% % 20% % All Technicians Community Pharmacies Hospitals/ Long-term Care All Technicians Community Pharmacies Hospitals/ Long-term Care Somewhat satisfied Very satisfied Relationships with Other Technicians Once again, technicians in community settings were more likely to be very satisfied about their relationships with other technicians, compared to those working in health care institutions. However, a large proportion in both groups was satisfied. Technicians planning to remain in their jobs were also more likely to be satisfied with their relationships with other technicians, compared to those who did not plan to remain in pharmacy. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 23

30 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Use of Technical Skills Overall, three-quarters (77%) of technicians said they were very or somewhat satisfied with the sharing of technical tasks with pharmacists; however, there were significant differences between the views of technicians in different work settings. Technicians working in community pharmacies were significantly more satisfied (85%) than those in health care institutions (69%) with sharing technical tasks. Technicians working in independent stores were particularly likely to be very satisfied. Overall, 80% of technicians were satisfied with the opportunities to use their skills at work. Technicians in community work environments were also significantly more satisfied (83%) than those in hospitals (77%) with their opportunities to use their technical skills. 100% 80% 77 Use of Skills % 40% % 0% 34 All Technicians 33 Community Pharmacies 36 Hospitals/ Long-term Care Sharing of Tasks with Pharmacists Somewhat satisfied 35 All Technicians Very satisfied 33 Community Pharmacies Opportunities to use Skills 40 Hospitals/ Long-term Care The only aspect of work where most technicians were not satisfied was the opportunity for job or career growth. Less than half (48%) the technicians responding to the survey said they were satisfied with growth opportunities. This was about equally true in both community and institutional settings. 100% 80% 60% Opportunities Opportunities for Job/Career Growth % % 0% All Technicians Retail Pharmacies Hospitals/ Long-term Care 28 Somewhat satisfied Very satisfied Canadian Pharmacists Association

31 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 2.4 Workload Technicians were asked to rate their own workload on an average day, and also that of the pharmacists with whom they worked. About half (48%) of the technicians said their workload was about right. However, almost as many (45%) said they had too much to do, while very few (7%) said they did not have enough to do. Technicians perceptions of their own workload varied significantly according to years of experience. For example, only 29% of technicians with less than two years work experience said they had too much work to do, while 54% of those with more than 20 years as technicians said they were overworked. Similarly, we find that 51% of certified technicians said they had too much to do. 100% Work Experience by Workload 80% 60% 40% 20% 0% < 2 yrs 2-5 yrs 6-10 yrs yrs 20 + yrs Technician Work Experience Abittoomuchwork Much too much work Workload also varies by employment setting, with technicians in independent pharmacies least likely to report having too much work to do (31%), compared to technicians in chain settings (43%) or hospitals (51%). Workload by Employment Setting Hospital Independent 7 24 Chain % 10% 20% 30% 40% Abittoomuchwork Much too much work The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 25

32 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Perhaps owing to the presence of more independent pharmacies in rural areas, we found that the likelihood that a respondent felt they have too much work to do increased with the size of the community, with technicians in rural areas significantly less likely (39%) to report having too much to do that their counterparts in Canada s three largest cities (53%). Workload by Community Size To r/mt l/van Large Cities Small Centres Rural % 10% 20% 30% 40% Abittoomuchwork Much too much work Perhaps it is not surprising that technicians perceived themselves as overworked more than did pharmacists. While 45% of technicians said they had too much to do, only 33% of pharmacists (according to our corresponding survey of pharmacists) said the technicians on their staff were overloaded. Thinking of your average day at your primary workplace, how would you rate the technicians workload? All Technicians (n = 2087) Pharmacists (n = 973) Not nearly enough work to do 1% 1% Not quite enough work to do 6% 12% About right 48% 54% A bit too much work to do 32% 29% Much too much work to do 13% 4% 2.5 Responsibility Compared to Level of Training Technicians were asked whether they felt that the amount of professional responsibility they were given was appropriate, given their current levels of education, training and experience. Many technicians (60%) thought that their current responsibilities matched their training and experience, although about one in four (25%) thought they could take on more responsibilities, and a few (6%) thought they could take on much more responsibility. It is interesting to note that the distribution of responses to this question is not substantially different for certified or uncertified technicians Canadian Pharmacists Association

33 Part I - Responses to National Survey of Pharmacy Technicians and Assistants We note few significant differences in the responses between respondents in hospital or community settings, one of the few questions in the survey upon which respondents from all three settings seem to concur. 100% 80% 60% Level of Responsibility by Employment Setting % 20% 0% Chain Independent Hospital Not nearly enough Not quite enough About right Bit too much Much too much Comparing responses to the same question from technicians and pharmacy owners or managers, there is surprising congruence. About three in 10 in both groups (31% of technicians and 27% of pharmacists) felt that technicians did not have enough responsibility, given their training and experience. Do you feel the level of professional responsibility you/your technicians now have is appropriate, given your/their current education, training and experience? All Technicians (n = 2,087) Certified Technicians (N = 761) All Pharmacists* (N = 973) Not nearly enough responsibility 6% 7% 4% Not quite enough responsibility 25% 28% 23% About right 60% 54% 66% A bit too much responsibility 8% 9% 6% Much too much responsibility 2% 2% 0% *Referring to their technicians 2.6 Incentives for Upgrading Technicians were given a series of questions about salary and other types of incentives for continuing their training. A relatively small number of technicians said their employer paid higher wages to technicians who had specialized training or education (22%), or who were certified (18%). Higher Wages with Specialized Training Higher Wages if Certified Higher Wages with More Years Experience Incentives for Upgrading 0% 10% 20% 30% 40% 50% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 27

34 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Technicians working in rural locations (28%), in independent community pharmacies (30%), or in pharmacies with fewer employees (26%) were more likely to say that pay was linked to training. A substantial proportion of technicians about one-quarter were simply not aware of their employers salary policies for specialized training or certification. Younger employees, and those who had been on the job for a short period of time, were more likely to be unaware of any perks for additional training. According to technicians, twice as many employers (44%) paid higher wages to technicians with more experience, as those who paid additional salary for training (22%). This was more likely in community pharmacies (48%) than in health care institutions (40%). Ironically, younger employees and those with less experience as technicians were more likely to report that salaries increased with experience than those with many years on the job. For example, half of technicians with less than two years experience felt their salaries would increase, while only 40% of those with five to 10 years experience reported this was the case. Note that these findings do not constitute an assessment of salary levels in any way, and there are many widely reported differentials between hospital and community salary levels for pharmacy technicians (e.g., owing to unions and funding). Financial Support for Technician Training According to technicians, about two-thirds of pharmacy employers either offered in-house courses for technicians (32%) or paid for courses given by others (31%). Only about one in six technicians (17%) reported that their employer would pay for a certification exam. Financial Support for Technicians Training 0% 10% 20% 30% 40% 50% Provide In-House Training 32 Pay for Courses Provided by Others 31 Pay for Certification Exam Canadian Pharmacists Association

35 Part I - Responses to National Survey of Pharmacy Technicians and Assistants The situation varied somewhat by work location. Chain or franchise community pharmacies were more likely to offer in-house courses (44%), but less likely to pay for external training (21%). Independent stores were understandably less likely to have in-house courses (26%), but more likely to pay for training done elsewhere (45%). Just 24% of technicians at hospitals and long-term care facilities said their organization offered courses, while just 35% paid for outside training for technicians. Technicians Courses by Employment Setting 100% 80% 60% 40% % 0% All Technicians Chain/Franchise Pharmacies In-house courses 26 Independent Pharmacies Pay for external courses 24 Hospitals/ Long-term Care Financial Support for Certification As noted earlier, only 18% of technicians reported that their employers paid higher salaries to certified technicians. In addition, just 17% of technicians said that their employers would pay the cost of a technician certification examination. 40% and 13% in Ontario and Alberta, respectively, reported that their employers paid higher wages to certified technicians. This finding should be interpreted by bearing in mind that certification examinations are currently only offered in Ontario and Alberta. Only in Ontario, where certification has a higher profile, did slightly more technicians say their exam costs were paid (31%) or higher wages were paid for certification (26%). Provincial Breakdown Paid Higher Wages for Certified Technicians 60% 40% 40 20% 0% 1 1 Newfoundland & Labrador NovaScotia Prince Edward Island New Brunswick Quebec Ontario Manitoba Saskatchewan Alberta British Columbia Even among those technicians who were themselves certified, only about one-quarter said their employer paid the examination cost (26%), or increased salaries for certified technicians (24%). Once again, however, a large percentage (between one-quarter and one-third) did not know what their employer s policy was on financial support for certification. North The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 29

36 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 3.0 Foreign-Trained Individuals 3.1 Incidence of Foreign Training Respondents who indicated that they had completed pharmacy education or training outside Canada and the USA were asked to complete additional questions related to their work experience in countries outside Canada and the USA. Only 45 respondents (2.2%) reported they had completed some pharmacy education or training outside of Canada or the USA. This small number requires that care be exercised in interpreting and extrapolating the findings presented below. Of the 45 respondents, 18 (40%) had worked as pharmacy technicians in another country and 27 (60%) had worked as pharmacists in another country. Nearly all of these foreign-trained individuals working as technicians were women (78%), in keeping with pharmacy technicians as a whole who were 94% female. These foreign-trained respondents were also older than the general body of technicians: 80% were over 30, compared to 64% of all technicians. Foreign-Trained Technicians Practised as a Pharmacist 60% Most of the foreign-trained individuals were working in either British Columbia (28%) or Ontario (22%). A few were in Alberta or Quebec, with only one respondent in each of Manitoba, Saskatchewan and the Atlantic provinces 2. Practised as a Technician 40% Over half (56%) of the foreign-trained were working in large cities, especially in Toronto, Montreal and Vancouver. The education level of these foreign-trained individuals was higher than for all technicians: two-thirds (67%) had a university education. 2 Note that 30% did not give their work location Canadian Pharmacists Association

37 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 3.2 Foreign-Trained Pharmacy Technicians Only 18 (40%) of the 45 foreign-trained technicians had also worked as pharmacy technicians outside of Canada and the USA. These respondents were evenly split between community (50%) and hospital work settings (44%), and more likely to be female (78%) and older than 30 (94%). We also note that 39% of these foreign-trained respondents had more than 10 years of experience working as technicians and 83% of them were working full-time hours. 3.3 Foreign-Trained Pharmacists Of the 45 foreign-trained respondents to the technicians survey, 27 (60%) had previously practised as pharmacists in a country outside of Canada and the USA. These respondents were more likely to be working in a community pharmacy (67%) and more likely to be 30 or older (88%). Just over half of these foreign-trained pharmacists were only working parttime as technicians. More than six in 10 (63%) said they intended to continue working as a pharmacy technician for less than five years. The foreign-trained pharmacists came from a variety of countries, the largest number being from the United Kingdom, but also from Central Asia, Eastern Europe, Central and South America, and Africa. While two-thirds (67%) of the foreign-trained pharmacists had been working as technicians for five years or less, not all were recent immigrants. Eighteen per cent of the foreigntrained pharmacists had been working as technicians for more than 10 years. 3.4 Working Relationships and Use of Skills Foreign-trained individuals were not quite as positive about their work relationships as either technicians or pharmacists as a whole. While roughly nine out of 10 pharmacists (91%) and almost as many technicians (88%) were very satisfied or somewhat satisfied with relationships between technicians and pharmacists, only about three-quarters of foreign-trained pharmacists (74%) and technicians (78%) felt this way. Similarly, only 72% of foreign-trained technicians, compared to 88% of technicians as a whole, felt satisfied with their relationships with other technicians. Those who practiced abroad as pharmacists seemed to be slightly more positive about their relationships with other technicians (81% satisfied). However, when asked about the use of their skills and opportunities for career growth, foreign-trained technicians were somewhat more optimistic than technicians as a whole. Among the small number of foreign-trained technicians, 89% were very or somewhat satisfied with opportunities to use their skills, compared to 80% of technicians as a whole. Similarly, 56% of foreign-trained technicians were satisfied with opportunities for job or career growth, compared to 48% of technicians in general. On the issues of using technical skills and opportunities for growth, foreign-trained pharmacists now working as technicians were understandably less positive. Only 74% were satisfied with the use of their technical skills (compared to 80% of all technicians) and 37% were satisfied with career opportunities (compared to 48% of technicians). The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 31

38 Part I - Responses to National Survey of Pharmacy Technicians and Assistants How satisfied are you with Your professional relationship with staff pharmacists Your professional relationship with other technicians Technicians' sharing of technical tasks with pharmacists Technicians' opportunities to use your skills Technicians' opportunities for job or career growth * Referring to their technicians ** Answering as technicians All Technicians All Pharmacists* Foreign-Trained Foreign-trained Technicians Pharmacists** (% Very/ (% Very/ somewhat somewhat Satisfied) Satisfied) (% Very/ somewhat Satisfied) (% Very/ somewhat Satisfied) NA Responsibilities Technicians with training from outside Canada or the USA were slightly more likely than Canadian-trained technicians to feel that they did not have enough professional responsibility. While the number of foreign-trained individuals was very small, 44% said they did not have enough responsibility, compared to 31% of technicians as a whole. This was true for both those trained abroad as technicians and those trained as pharmacists. All Technicians All Pharmacists* Foreigntrained Technicians Foreigntrained Pharmacists** Responsibility Do you feel the level of professional responsibility you now have is appropriate, given your current education, training and experience Not nearly enough responsibility Not quite enough responsibility About right A bit too much responsibility Much too much responsibility * Referring to their technicians ** Answering as technicians Canadian Pharmacists Association

39 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 4.0 Future Technician Training and Responsibilities The survey explored a number of ways that training and utilization of pharmacy technicians might change in the coming years: accreditation of community college programs, voluntary or mandatory certification of pharmacy technicians, and formal regulation of the pharmacy technician role. 4.1 Likelihood of Taking Future Community College Training All respondents, regardless of their current level of training, were asked how likely they would be to take pharmacy technician training at a community college. Three in 10 respondents ruled themselves out, saying they have this now. Four in 10 said they were very interested (20%) or somewhat interested (20%). Interest in additional training came from all levels: half (49%) of technicians with no community college training said they were interested, but so did 38% of technicians who had already completed a two-year community college program, and 37% of those who were certified. Interest was highest among those working in smaller pharmacies or rural areas. Respondents from hospital settings were less inclined to be very or somewhat likely to complete community college training in the future, possibly owing to the fact that a higher percentage of these are already community college graduates. Interest in future training was higher the longer respondents felt they were likely to stay in the field of pharmacy. There is broad interest among a substantial proportion of technicians in taking additional community college training, irrespective of their current educational attainment and workplace. Likelihood of Taking Future College Training by Employment Setting 100% 80% 60% 40% 20% 0% Chain Independent Hospital Very or somewhat interested Neut ral Not very or not at all interested The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 33

40 Part I - Responses to National Survey of Pharmacy Technicians and Assistants We also find that the likelihood of taking future community college training declines as the size of the community increases. Once again, this may reflect the fact that respondents in large cities are more likely to have already completed community college training. 80% Likelihood of Taking Future College Training by Community Size 60% 40% % % Rural Small Centres Large Cities Tor/Mtl/Van Very or somewhat interested Neut ral Not very or not at all interested 4.2 Accreditation of Community College Programs Technicians voiced very strong support for the concept of national accreditation of community college programs. Overall, 84% of technicians supported establishing a national standard for pharmacy technician programs at community colleges, and only 3% opposed such an idea. Interestingly, the share of respondents who support this idea (84%) is the same as the share of respondents who reported having completed postsecondary education already (20% in university and 64% in community college). Technicians in health care institutions were particularly strong supporters of accrediting community college programs, with nine out of 10 (91%) supporting the statement. Eight in 10 technicians from community pharmacies (79%) were in agreement Canadian Pharmacists Association

41 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Almost three-quarters (73%) of technicians as a whole supported requiring all pharmacy technicians to graduate from a nationally standardized community college program in order to be hired. Once again, technicians working in hospitals and long-term care facilities were stronger supporters of the idea (87%) than were those working in community pharmacies (62%). Accreditation by Employment Setting 100% 80% 60% 40% National Accreditation of Colleges Graduation from Accredited College Requirement for Hiring % 0% 21 All Technicians 23 Community Pharmacies 19 Hospitals/ Long-term Care 18 All Technicians 18 Community Pharmacies 18 Hospitals/ Long-term Care Somewhat support Strongly support 4.3 Certification of Pharmacy Technicians For the purposes of this analysis, certification of pharmacy technicians was presented to respondents as an exam that certifies their level of knowledge and skills once technicians have graduated from a recognized community college program. Currently, only Ontario and Alberta offer such certification. Respondents were then asked how strongly they supported such a certification examination if it were to become available, and if it were either voluntary or mandatory. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 35

42 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Voluntary versus Mandatory Certification Overall, support for certification of pharmacy technicians was fairly strong among technicians themselves. Seven in 10 (70%) supported voluntary certification and just over six in 10 (62%) supported mandatory certification. Furthermore, a substantial proportion about four in 10 respondents expressed strong support for either voluntary or mandatory certification. Certification by Employment Setting 80% 60% 40% Voluntary Certification of Technicians Mandatory Certification of Technicians % % All Technicians Community Pharmacies Hospitals/ Long-term Care All Technicians Community Pharmacies Hospitals/ Long-term Care Somewhat support Strongly support Technicians working in community pharmacies were more likely to support voluntary rather than mandatory certification (74% versus 57%), while those working in health care institutions were equally supportive of either alternative (67% for voluntary, 68% for mandatory). Younger or less experienced technicians were slightly more likely than older or more experienced technicians to support voluntary certification (76% of those under 25, compared to 69% of those over 50). Mandatory certification was also more supported by new technicians than more experienced ones (65% of those with less than two years experience, compared to 56% of those with more than 20 years). Technicians of all educational and training levels were about equally supportive of voluntary certification, but those with no technical training were less supportive of mandatory certification (44% with no formal training supported mandatory certification, compared to 70% of those with a college-level technician course) Canadian Pharmacists Association

43 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Support for voluntary certification was highest among technicians in the Atlantic provinces (77% to 83%) and Quebec (74%), and lowest in Alberta (61%) and Saskatchewan (62%). Support for mandatory certification was strongest in the Atlantic provinces (62% to 69%) and British Columbia (68%), and weakest in Saskatchewan (51%) and Ontario (56%). Certification by Provincial Breakdown 100% 80% 60% % 20% 0% Newfoundland & Labrador Nova Scotia PrinceEdwardIsland NewBrunswick Quebec Ontario Manitoba % Supporting Somewhat or Strongly Saskatchewan Alberta BritishColumbia Voluntary Certification Mandatory Certification Factors Influencing Interest in Certification There are a number of ways that technicians could be encouraged to seek certification of their skills. Respondents reacted favourably to all five factors proposed in the survey. These ranged from providing separate certification exams for hospital and community settings to higher pay after certification. Factors Influencing Interest in Certification 100% 80% 60% 40% % 0% 17 Higher Pay 16 National Recognition 19 Fees Paid 21 Possibility of Promotion 20 Separate Exams Somewhat interested Very interested The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 37

44 Part I - Responses to National Survey of Pharmacy Technicians and Assistants The strongest motivator to become certified, among the factors presented, was the possibility of higher pay. Nine out of 10 (93%) technicians said this was a motivator. Not surprisingly, higher pay was particularly attractive to younger or less experienced technicians, those who had already completed a two-year college program and those living in larger cities. A certification that was nationally recognized, having certification fees paid and having the possibility of promotion were also influential factors for 87% of technicians. National recognition was a slightly stronger motivator than reimbursement or the possibility of advancement, suggesting that many technicians worry about wide acceptance and portability of their credentials (71% were very interested in broad recognition, compared to 68% for fees being paid, and 65% for promotion possibilities). Having separate exams for technicians working in community versus hospital settings was the least influential of the five factors presented; however, it still was an attractive feature to three-quarters (77%) of technicians. Having separate exams depending on work location was more important for those working in health care institutions (80% rated somewhat or very important) and community chain pharmacies (79%), than those in independent stores (64%). Impact of Mandatory Certification Just under one-quarter (23%) of all technicians responding to the survey might not stay in their job if they were required to be certified. About 5% said they were not likely to stay, while 18% were uncertain about whether they would stay. The majority (56%) said they would very likely stay in their job if certification was mandatory. Some sub-groups were more at risk of leaving their jobs: those working in independent community stores (32%), those over the age of 50 (31%), those with only a high school education (36%), and those with no formal training as pharmacy technicians (38%). 23% Impact of Mandatory Certification Not at all Likely 2% Not very likely 3% Uncertain 18% Somewhat likely 21% Very likely 56% Canadian Pharmacists Association

45 Part I - Responses to National Survey of Pharmacy Technicians and Assistants 4.4 Regulation of Pharmacy Technicians The final section of the survey addressed the idea of a regulated pharmacy technician. This was described as someone who would do more tasks and have some responsibilities now held by a pharmacist. Respondents were told that they might need to take additional training and would write a licensing examination in order to become a regulated pharmacy technician. Interest in Becoming a Regulated Pharmacy Technician Not at all interested Not very 2% interested 5% Neutral 9% Somewhat interested 30% Very interested 54% Overall interest in the regulated pharmacy technician position was high. More than half the survey respondents (54%) were very interested, and more than eight in 10 (84%) were at least somewhat interested. Interest was fairly consistent across most sub-groups, although slightly lower among those over the age of 50 (73%), with only a high school education (76%), no technical training (77%), or working in independent community stores (79%). Interest in Becoming a Regulated Pharmacy Technician by Employment Setting 100% 80% 60% 40% % 0% Chain Independent Hospital Very or somewhat interested Neut ral Not very or not at all interested We note that interest in the regulation of pharmacy technicians is quite consistent across all employment settings, with respondents in independent pharmacies only somewhat less interested than their counterparts in chain or hospital pharmacies. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 39

46 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Factors Influencing Interest in Becoming a Regulated Pharmacy Technician The same elements presented in the context of seeking certification were presented again to test their impact on interest in becoming a regulated pharmacy technician. Very similar results were produced. More than nine out of 10 respondents (94%) said that they would be interested in seeking the designation if there was higher pay for a regulated pharmacy technician. Similarly, about nine out of 10 saw the possibility of a promotion (89%), having their employer pay their fee (90%) and national recognition (88%) of the designation as positives. About eight in 10 (81%) saw having separate exams for those in health care institutions versus community pharmacies as a factor that would interest them. Factors Influencing Interest in Becoming a Regulated Pharmacy Technician 100% 80% 60% % 20% 0% 17 Higher Pay 20 Possibility of Promotion 18 Fees Paid 16 National Recognition 22 Separate Exams Somewhat interested Very interested Possible Duties of Regulated Pharmacy Technicians Respondents were asked how they felt about regulated pharmacy technicians being permitted to perform a series of tasks currently performed by pharmacists. These proposed tasks were drawn from numerous sources, such as the 2006 British Columbia College of Pharmacists White Paper on Pharmacy Technicians, and the Report of the Health Professions Advisory Council to the Ontario Minister of Health and Long-Term Care, and included: 1. Receiving new verbal prescriptions from health care providers 2. Receiving repeat verbal prescriptions from health care providers 3. Transferring to or receiving prescriptions from another pharmacy 4. Copying prescriptions for authorized recipients 5. Checking accuracy/completeness of pharmaceutical products prepared for release by unregulated pharmacy technicians Canadian Pharmacists Association

47 Part I - Responses to National Survey of Pharmacy Technicians and Assistants At least seven out of 10 technicians were comfortable with regulated pharmacy technicians performing all of the new duties listed above. Nearly nine out of 10 (87%) felt regulated pharmacy technicians could receive verbal repeat prescriptions from doctors and transfer prescriptions between pharmacies. Eight out of 10 (81%) thought regulated technicians could copy prescriptions for authorized recipients. Three-quarters (75%) were comfortable with the idea that a regulated technician could check the accuracy and completeness of prescriptions prepared for release by other (unregulated) technicians. The lowest level of support, still at a substantial 72%, was for regulated technicians receiving new prescriptions verbally from a prescriber. It should be noted that respondents were given the option of indicating if they currently undertake the duty in question ( Do this now ). Generally speaking, only a very small number (1-2%) of respondents selected this option. The exception is check the accuracy and completeness of pharmaceutical products prepared for release by unregulated pharmacy technicians, where 4% of respondents indicated they currently undertake the duty. Of these, nearly nine in 10 were doing so in a hospital setting. Those who do not currently undertake such a task could then indicate their level of support for regulated pharmacy technicians undertaking the duty in question. The results are presented below. Possible Duties of Regulated Pharmacy Technicians 100% 80% % 40% % 0% 21 Receive repeat verbal Rxs 23 Transfer/receive Rxs from another pharmacy 24 Copy Rxs for authorized recipients 25 Check Rxs prepared by other techs 28 Receive new verbal Rxs Somewhat Support Strongly Support Hospital technicians were likely than those working in community pharmacies to support delegation of additional responsibilities to regulated pharmacy technicians. For example, just 56% of hospital technicians strongly supported allowing regulated technicians to transfer prescriptions between pharmacies, while 69% of technicians in community pharmacies supported delegation of this task. The exception was checking prescriptions prepared by other unregulated technicians; 57% of hospital technicians strongly supported delegation of this task, compared to just 47% of community technicians. This was probably due to hospital technicians familiarity with tech check tech currently used in many hospital pharmacies. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 41

48 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Overall, technicians with more education, more technical training or who were already certified were more likely to support the delegation of duties from pharmacists to regulated pharmacy technicians. Younger or less experienced technicians were often more supportive of delegation of tasks than were older technicians or those who had spent many years in the field. Clearly education as to the implications of delegation and the consequences of errors must be an element of any training for regulated technicians. 4.5 Summary of Reactions to New Initiatives The chart below summarizes technicians reactions to the various initiatives tested in the survey. Clearly, all have a good deal of support from the respondents. Accreditation of community college programs is supported by 85% of technicians, and 73% would make graduation from an accredited program mandatory. The concept of a regulated pharmacy technician position, with additional training but additional responsibilities, was interesting to a large proportion (84%). Perhaps influenced by the current situation of voluntary certification in only some jurisdictions, without commensurate recognition by employers, only seven in 10 (70%) supported voluntary certification of technicians, and just six in 10 (62%), if it is mandatory. 100% Summary of Reactions to New Initiatives 80% % 40% 20% 0% College Accreditation Mandatory Graduation from Accredited College 28 Voluntary Certification Mandatory Certification 30 9 Regulated Pharmacy Technician 5 2 Not at all Interested Not Very Interested Neutral Somewhat Interested Very Interested Canadian Pharmacists Association

49 Part I - Responses to National Survey of Pharmacy Technicians and Assistants C. Conclusion One of the most pressing challenges faced by the pharmacy workforce today is balancing the expansion of the role of the pharmacist with the profession s current overwhelming workload and human resources shortages. Advancing the role of the pharmacy technician is one obvious strategy. However, any work in this direction requires an understanding of the structure and nature of the pharmacy technician workforce in Canada, and the attitudes and intentions of pharmacists and pharmacy technicians relating to technician roles and responsibilities, education and credentialing, and willingness to take on new tasks. This survey represents the first time a national effort has been made to fill some of these information needs. It should be noted that since no baseline profile or exact number of practising pharmacy technicians exist, it is difficult to asses the extent to which the findings are representative of the pharmacy technician population as a whole. On the whole, the findings uncovered by this survey paint a picture of a satisfied and energetic pharmacy technician workforce that is eager to embrace its future. They show high levels of support from technicians for some potential measures that could enhance their qualifications and offer them an expanded rage of tasks and responsibilities. The findings also point to some of the challenges that will need to be addressed in any such process, such as the variability of technicians education and training and the inherent differences between community and hospital practice. The findings generated by this research present many opportunities for more in-depth exploration on pharmacists and pharmacy technicians attitudes and intentions towards the future of pharmacy technicians in Canada. Moving Forward will be conducting further research to investigate some of these areas in the spring and summer of Visit pharmacyhr.ca for more information. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 43

50 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Canadian Pharmacists Association

51 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Appendix - National Pharmacy Technicians and Assistants Survey Questionnaire To submit your questionnaire to Vision Research via fax, dial (613) The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 45

52 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Canadian Pharmacists Association

53 Part I - Responses to National Survey of Pharmacy Technicians and Assistants The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 47

54 Part I - Responses to National Survey of Pharmacy Technicians and Assistants Canadian Pharmacists Association

55 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Executive Summary Part II - Responses to National Survey of Pharmacists (Owners and Managers) The Canadian Pharmacists Association (CPhA), on behalf of Moving Forward: Pharmacy Human Resources for the Future, retained Vision Research to undertake a survey of both pharmacists and pharmacy technicians across Canada. This report presents the results of the survey of pharmacists. The intent of the survey was both to develop a clear sense of the current profile of pharmacy technicians across Canada (numbers, distribution across jurisdictions and work settings, responsibilities, aspirations), and to measure the interest and resistance to possible future directions for pharmacy technicians in relation to pharmacists. At its heart, this study explores the question: how might the role of technicians evolve to better meet their career goals and to allow pharmacists to make fuller use of their skills and knowledge-all in the interest of enhancing patient care? A questionnaire was sent via and mail to a reference sample of 3000 pharmacies across Canada asking recipients to have the senior-most manager or owner (pharmacists) complete the questionnaire and share a second, different questionnaire with the technicians on their staff. In all, 973 completed questionnaires were received from pharmacists. Since this is the first such study of the pharmacy technician workforce, and no baseline profile or exact number of practising pharmacy technicians exist, it is difficult to asses the extent to which the findings are representative of the pharmacy technician population as a whole. For these reasons, care should be taken in extrapolating these results to the overall population. Overall, the survey appeared to reveal that there is a large base of support for new measures that would enhance the qualifications of pharmacy technicians and offer them an expanded range of tasks and responsibilities. The majority of pharmacists (86%) indicated their support for national accreditation of community college pharmacy technician programs. Pharmacists are also prepared to support their technicians in their quest for regulation. 85% of respondents state that they would likely delegate more responsibilities to their regulated pharmacy technicians, and 88% would likely provide mentoring. The concept of certification, as perhaps one of potential steps towards eventual regulation, was also positively received, with more than 65% of pharmacists reporting they supported either voluntary or mandatory certification. The survey provided some insight on the question of how many pharmacy technicians are currently working in Canada, and the reported ratios were lower than expected. Respondents in community pharmacies reported an average of 2.1 full-time technicians and 1.9 part-time technicians per pharmacy per pharmacy. Assuming the average part-time technician works half a regular workweek, we calculate an average of 3 technician Full-Time Equivalents (FTEs) per community pharmacy. Respondents in hospital settings reported much higher numbers of both full-time (12.1 per pharmacy) and part-time (5.9 per pharmacy) technicians for an average of 15 technician FTEs per hospital pharmacy. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 49

56 Part II - Responses to National Survey of Pharmacists (Owners and Managers) To help develop a ratio of technicians to pharmacists, we also asked respondents how many pharmacists worked in their pharmacies. Pharmacist respondents also reported an average of 3 pharmacist FTEs per community pharmacy, for a ratio of 1 technician FTE per pharmacist FTE in community settings. In hospital pharmacies, pharmacists reported an average of 13.6 pharmacist FTEs, for a ratio of 1.1 technician FTEs per pharmacist FTEs in a hospital setting. The results also revealed important differences in attitude between pharmacists practising in a community setting (both chain and independent pharmacies) and those practising in a hospital or long-term care setting. Hospital-based respondents: Recruit pharmacy technicians differently and have higher minimum requirements when they hire; Report significantly larger staff complements of both pharmacists and pharmacy technicians; Are more likely to attract a sufficient number of well qualified applicants, though they also are more likely to feel their technicians have too much to do; Are more likely to support national standards and higher mandatory requirements; and Are more likely to support technicians checking the accuracy and completeness of products but less likely to support technicians receiving new verbal prescriptions. Other influential variables also emerged in this study. The provincial political and regulatory environment influenced opinion on higher mandatory qualifications and an expanded role for technicians. Respondents from provinces such as Ontario, British Columbia and Alberta were generally more supportive of such measures. Others, notably respondents from the province of Quebec, were more reluctant. Gender and years of experience also played a role. Whereas female pharmacist respondents were more likely to perceive that their staff pharmacists and technicians have an excessive workload, they were also less likely to support an expanded role for technicians. Similarly, more experienced pharmacist respondents showed themselves to be more open to new roles for regulated pharmacy technicians. We also noted in many instances that owners/franchisees were more likely to consider supporting their technicians in various ways (e.g., time off, reimbursement for exam costs, higher wages) than were managers, who perhaps are more limited in the decisions they can make on human resource matters. Another important finding from the survey is that the respondents perception of their local labour market for pharmacy technicians varied a great deal across jurisdictions, across rural and urban areas and across work settings. While some respondents (notably those in urban settings, hospitals and in Canada s most populous provinces) reported a surplus of qualified applicants for pharmacy technician positions, others (i.e., rural, in less populous provinces and in independent pharmacies) were much more likely to report a shortage of applicants and lower overall qualifications for the applicants they do Canadian Pharmacists Association

57 Part II - Responses to National Survey of Pharmacists (Owners and Managers) have. This finding is important because the respondent s perception of his or her local labour market for pharmacy technicians emerged as a consistent and important dependent variable. Simply put, the more respondents felt they faced a shortage of qualified applicants for pharmacy technician positions, the more likely they were to be willing to offer support (financial and moral) to pharmacy technicians who want to become certified or regulated (a proposal made in the questionnaire) and the less likely they were to support measures that might be perceived as further restricting the market of talent. Respondents who reported facing a shortage of well-qualified applicants were more likely to not have any minimum requirements for certification, education and experience when they hire technicians. They were more likely to offer incentives to attract technicians who are certified and would be more likely to support technicians on their staff who aspired to become regulated pharmacy technicians. They would also be more likely to support an expanded professional role for such regulated technicians. On the other hand, these same pharmacists who report a shortage of qualified applicants for pharmacy technician positions were less likely to support a mandatory college diploma requirement for pharmacy technicians and less likely to support for successful completion of a certification exam as a requirement for employment as a pharmacy technician. Both measures, while enhancing the qualifications of technicians, could serve to further restrict their numbers and deepen the shortage in certain areas. In the final analysis, pharmacists appear to be cautiously receptive towards measures that will expand the role of pharmacy technicians. In implementing such measures, however, care will have to be taken to consider the impact on tight labour markets and the extent to which such changes fit with the very different organizational cultures and environments in which Canada s pharmacists practise. Next Steps The findings generated by this research raise many opportunities for more in-depth exploration on pharmacists and pharmacy technicians attitudes and intentions towards the future of pharmacy technicians in Canada. Moving Forward will be conducting further research to investigate some of these areas in the spring and summer of Visit pharmacyhr.ca for more information. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 51

58 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Overview of Moving Forward: Pharmacy Human Resources for the Future One of the most urgent crises facing Canada s health care system today is the appropriate management of health human resources ensuring the right skills in the right place at the right time. Pharmacists are a high priority health human resource at many levels with patients, drug supply management, health institutions, the health system and population. Pharmacists have a key role to play at all these levels in ensuring pharmaceuticals are used appropriately, safely and provide optimal benefits. Serious challenges are facing the pharmacy sector s efforts to optimize the management of its available human resources. These include the rapid evolution of the pharmacist s role in health care delivery, pharmacist shortages, complexities in integrating international pharmacy graduates, and a complete lack of data on pharmacy technicians. A failure to address pharmacy human resource challenges will compromise the ability of the profession to respond to these new demands and its ability to fully address the safe and appropriate use of drugs in Canada. There is, therefore, an urgent need to understand the factors contributing to these human resources pressures and strategize potential solutions. A collaborative of eight national pharmacy stakeholders has received funding from the Foreign Credential Recognition program of Human Resources and Social Development Canada to undertake a pharmacy human resources study. The collaborative includes the Canadian Pharmacists Association (secretariat for the project), the Association of Deans of Pharmacy of Canada, the Association of Faculties of Pharmacy of Canada, the Canadian Association of Chain Drug Stores, the Canadian Association of Pharmacy Technicians, the Canadian Society of Hospital Pharmacists, the National Association of Pharmacy Regulatory Authorities and the Pharmacy Examining Board of Canada. This study, Moving Forward: Pharmacy Human Resources for the Future, is an in-depth examination of the factors contributing to pharmacy human resources challenges in Canada. It will offer recommendations to ensure a strong pharmacy workforce prepared to meet the current and future health care needs of Canadians. Through a 30-month long series of investigations and consultations, Moving Forward will: Develop a comprehensive understanding of the pharmacy workforce in Canada and the factors that influence its structure and the skills and competencies of its members; Identify and analyze the short- and long-term human resource planning challenges facing the pharmacy sector, including those specific to international pharmacy graduates, and Offer recommendations for and solutions to these challenges. The optimal management of pharmacy human resources requires more than just information, it requires planning. The recommendations developed through this study will be used by stakeholders at local, regional, provincial, territorial and national levels to develop their pharmacy human resources management plans. The findings contained in Part II of this report represent the results of Moving Forward s landmark National Survey of pharmacists (Owners and Managers), and provide a foundation of evidence for further research regarding the changing role of the pharmacy technician Canadian Pharmacists Association

59 Part II - Responses to National Survey of Pharmacists (Owners and Managers) A. Introduction Approach and Methodology Vision Research was retained by the Canadian Pharmacists Association (CPhA), on behalf of Moving Forward: Pharmacy Human Resources for the Future, to undertake a survey of both pharmacists and pharmacy technicians in Canada. The project had two main objectives: 1) to quantify, for the first time, the pharmacy technician workforce in Canada, and 2) to gain national qualitative knowledge on workforce attitudes and opinions surrounding the current and future role of the pharmacy technician. The project used a two-step methodology, whereby pharmacists were approached directly (using both mail to a representative sample of 3000 pharmacies, provided by Dendrite, and direct to CPhA members whose addresses the association had on file), and indirectly (by issuing invitations to all provincial licensing bodies and national and provincial stakeholders with pharmacist members). In a covering letter sent in early September 2006, pharmacists were asked to both have the senior most manager or owner complete a questionnaire designed for them, and pass a second questionnaire on to the pharmacy technicians on their staff. Though there were some questions repeated between the two questionnaires, the differences in the research instruments and in the populations surveyed called for the findings to be interpreted and reported on separately. Where appropriate, however, we do compare and contrast certain findings. Respondents (both pharmacists and technicians) were given the option of completing a printed questionnaire and submitting it via fax or mail to Vision Research, or visiting a secure website where they could enter their responses online. The survey was in the field for 10 weeks, until mid-november A number of reminder messages were sent directly via fax (again using a Dendrite list) and , and the CPhA and partner organizations (of pharmacists and technicians) promoted participation in the survey to their members. In all, 973 pharmacist questionnaires were completed (73% using the printed questionnaire and 27% online). The National Association of Pharmacy Regulatory Authorities reports (January 2006) that there are 8053 pharmacies in Canada (though the number may be somewhat higher since it only counts hospital pharmacies if they are licensed by a regulatory authority). To the extent that the respondent sample was representative of the overall population of pharmacist owners and managers across Canada, we would expect a confidence interval of +/- 3%, 19 times out of 20. As will be noted below, the survey sample appears representative in terms of primary place of work; however, some provinces are overrepresented in the sample, and others are underrepresented. As well, in the current absence of national demographic data for the pharmacist population as a whole, we cannot verify the extent to which the gender and age balance of the survey sample is representative. Given this, care should be taken in extrapolating the figures reported in this survey to the overall population of pharmacist owners and managers in Canada. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 53

60 Part II - Responses to National Survey of Pharmacists (Owners and Managers) It should also be noted that the total number of responses from some jurisdictions was relatively low. While 225 pharmacists in Ontario responded, for example, only 16 in PEI and 5 from the northern territories did. Because of the wide discrepancy in the number of respondents between jurisdictions, care has to be taken in comparing and contrasting responses by jurisdictions. A 50% level of support in Ontario requires 112 respondents to select the option; the same 50% level of support in PEI requires only 8. That being said, where the variations between jurisdictions are high enough to warrant attention, we will discuss them in the sections ahead. For the charts and graphs presented in the following pages, all percentages have been rounded off to the nearest whole number, reflecting the overall level of accuracy of the survey data. Standard rounding conventions are used, that is, 6.4 or less is rounded down to 6, and 6.5 or more is rounded up to 7. For computed figures (such as the ratio of technicians to pharmacists), the ratio for each individual is calculated, the ratios are summed, and then the sum is rounded. For this reason, the total of two rounded numbers shown in a chart may be slightly different than the actual sum of the unrounded figures. For this same reason, readers may also find that the totals on certain charts do not add up to Canadian Pharmacists Association

61 Part II - Responses to National Survey of Pharmacists (Owners and Managers) B. Findings 1.0 Respondent Profile The scope of this survey did not include providing accurate demographics concerning the profile of pharmacists working in Canada. Nevertheless, we do present the following respondent profile, which does include findings that provide insight on the nature and size of the pharmacist workforce in Canada. 1.1 Gender The survey generated responses from a balanced sample of male (48%) and female (52%) respondents. Unfortunately, national data on the gender distribution of pharmacists is not available for comparison. We note some interesting variations in the demographic profile of the two genders. Male respondents were more likely to be owners and franchisees (63% versus 37%) and less likely to be managers (43% versus 57% for female respondents). Similarly, while 63% of hospital-based respondents were female (versus 37% of male respondents), 54% of independent community pharmacist respondents were male (compared to 46% female). Finally, we note that 57% of the least experienced cohort of respondents is female, while 55% of the most experienced cohort is male. 1.2 Distribution by Province Participants were asked to indicate their postal code. From this information, we were able to determine both the size of the community in which they practice (which has been used to segment the respondents and track significant differences between rural, small urban and large urban centres), and the jurisdiction in which they are licensed. This second measure allowed us to compare the provincial breakdown of the respondent base compared to the overall population of pharmacists in Canada 3. QC 7% Provincial Breakdown NS 7% NB 7% PE 2% ON 26% NL 4% BC 11% MN 8% AB 22% SK 6% Canada s two most populous provinces were underrepresented in the survey sample, with only 7% of respondents practising in the province of Quebec (versus 23% of the nation s pharmacists) and 26% of respondents practicing in Ontario (versus 35%). Alberta, on the other hand, was overrepresented in the survey sample, with 22% of respondents practicing in that province, compared to the 12% share of the country s pharmacists that practise there. 3 Ideally, we would have compared the respondent profile to the profile of pharmacies across Canada and not pharmacists, since we have asked for only one respondent from each pharmacy to answer the questionnaire. Unfortunately, this national data is not available, so we have used the measure of pharmacists by jurisdiction provided by the National Association of Pharmacy Regulatory Authorities (January, 2006) instead. Assuming that the ratio of pharmacists to pharmacy is largely consistent across jurisdictions, the comparison should prove valid. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 55

62 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 1.3 Where Employed The survey generated responses from pharmacists working in a variety of settings. Of those, just over half (52%) worked in community pharmacies that are franchises or pharmacies owned by a chain. Just over one-quarter of respondents (27%) work in independent community pharmacies and just less than one fifth (18%) work in hospitals or long-term care facilities. These findings suggest that the survey sample is largely representative in terms of the primary workplace of respondents. Statistics from the NAPRA website ( indicate that approximately 15% of licensed pharmacist practice in health care settings, while 72% practise in community settings. Employment Setting 3% 27% 18% Hospital/Long-term Care Facility 79% Community 52% Community Chain/ Franchise Pharmacy Community Independent Pharmacy Other 1.4 Community Size Respondents were fairly evenly split between different sizes of cities, with nearly half (45%) practising in large urban centres (>1 million inhabitants) or in Canada s three largest cities (Toronto, Montreal, Vancouver). The remaining respondents practice in smaller urban centres (28%) or in rural areas (16%). Hospital-based respondents were more likely to practice in large urban centres and Canada s three largest cities (53%) and less likely (9.9%) to practice in rural areas. Independent pharmacy-based respondents, on the other hand, were nearly twice as likely to practise in rural areas (53%) than they were to practice in larger centres (23%). Chain and franchise-based respondents are found in all regions of the country, with the highest concentration in small centres and large cities. Other 11% Tor/Mtl/Van 13% Community Size Large Cities 32% Rural 16% Small Centres 28% Canadian Pharmacists Association

63 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 1.5 Years as Pharmacist The survey generated responses from pharmacists with varying levels of professional experience. Generally speaking, we found that less experienced respondents (1-9 years) were more likely to work in large urban centres (24%) than rural areas (16%) compared to respondents with >25 years of experience (25% urban and 31% rural). We also found that less experienced pharmacists were more likely to practice in a community setting (26%) than in a hospital or long-term care facility (10%). The opposite is true for the most seasoned respondents (24% community and 42% hospital). Years of Experience 25+ yrs 29% 20-24yrs 17% 1-9yrs 24% 15-19yrs 15% 10-14yrs 15% 1.6 Level of Education The respondent sample primarily included individuals who had completed a bachelor s degree in pharmacy, with less than 10% having completed a PharmD or any master s or PhD degree. Interestingly, nearly half of those who completed a master s or PhD in pharmacy were practising in Quebec, while none of the respondents from that province had completed a PharmD. Similarly, we found that those with a master s or PhD in pharmacy were more likely to work in a community pharmacy (65%) than a hospital setting (31%) and more like to be male (58%). Level of Education 3% 2% 4% Bachelor's Degree in Pharmacy PharmD Masters or PhD in Pharmacy 91% Other Masters or PhD The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 57

64 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 1.7 Role in Primary Workplace The respondents to the survey were well diversified in terms of their role within the pharmacy that is their principal place of work. Nearly one-third (30%) were owners or franchisees (with these being drawn from community pharmacies), while just over half (54%) were managers (primarily drawn from chain pharmacies and hospitals). The remaining 16% of respondents listed their role as other. As we shall see below, on a number of questions, the owner/franchisees differed significantly from the managers in their responses. Current Role 16% 30% Owner/Franchisee Manager Other 54% 2.0 Current Job 2.1 Number of Staff Pharmacists and Technicians Pharmacists were asked to record the number of full-time and part-time technicians and pharmacists working at their primary workplace. In each case, they were asked to indicate both the number currently employed and the number of vacant positions to arrive at a total number of positions. Given the substantial difference between community and hospital staff sizes, we report these numbers separately to avoid presenting a skewed average figure across all employment settings. The survey revealed an average (mean) of 1.9 part-time technicians and 2.1 full-time technicians per community pharmacy (chain and independent). Assuming the average part-time technician works half a regular workweek, this yields an average of 3.0 technician Full-Time Equivalents (FTEs) per community pharmacy. In contrast, the survey showed an average (mean) of 5.9 part-time technicians and 12.1 full-time technicians per hospital pharmacy (including long-term care facilities). Assuming the average part-time technician works half a regular workweek, this yields an average of 15 technician Full-Time Equivalents (FTEs) per hospital pharmacy. Pharmacist respondents also reported an average of 3 pharmacists (full-time and parttime) per community pharmacy, for a ratio of 1 technician FTE per pharmacist FTE in community settings. In hospital settings, pharmacists reported an average of 13.6 pharmacists (full- and part-time), for a slightly higher ration of 1.1 technician FTEs per pharmacist FTE in a hospital setting Canadian Pharmacists Association

65 Part II - Responses to National Survey of Pharmacists (Owners and Managers) According to Pharmacists* Reported Number of Technicians on Staff Chain Indep. Commun. Hosp n= Part-time Average Full-time Average Combined Average (FTE) Reported Number of Pharmacists on Staff Chain Indep. Commun. Hosp n= Part-time Average Full-time Average (FTE) Combined Average Ratios 1: : 1.10 * Pharmacists were asked to report on both current and vacant positions at their primary place of employment. The figures in this table add the two together. The data above point to a measurable difference in the average staff size of chain and independent pharmacies, with chain pharmacies employing both more technicians and more pharmacists than their independent counterparts. Interestingly, chain pharmacies reported slightly more pharmacists than technicians, the only group to do so. The numbers reported by pharmacist respondents were quite consistent with those generated through the survey of technicians that was also part of this study. Both pharmacists and technicians reported a ratio of between 1.00 and 1.10 technician FTEs per pharmacist in community pharmacies and a slightly higher ratio of between 1.13 and 1.32 technician FTEs per pharmacist in hospital settings. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 59

66 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The table below summarizes the results of the survey of technicians, presented here for comparison purposes. According to Technicians According to Technicians Reported Number of Technicians on Staff Chain Indep. Commun. Hosp n= Part-time Average Full-time Average Combined Average (FTE) Reported Number of Pharmacists on Staff Chain Indep. Commun. Hosp n= Part-time Average Full-time Average Combined Average (FTE) Ratios 1: : 1.32 Unfilled Positions Selecting out the results of the survey of pharmacists related to unfilled positions allows us to get a sense of the differing employment conditions in different sectors and in different parts of the country. Respondents in community settings reported an average 0.19 unfilled technician positions per community pharmacy. The average number of unfilled positions in independent pharmacies (0.20 per pharmacy) was slightly higher than that reported for chain pharmacies (0.18). In contrast, respondents in hospital settings reported a slightly higher 0.35 unfilled technician positions per hospital pharmacy, not surprising given the substantially larger size of the average staff size in hospital settings. In the community setting, the number of unfilled pharmacist positions was quite similar to the number of unfilled technician positions. Respondents in community settings reported an average 0.19 unfilled pharmacist positions per community pharmacy. The average number of unfilled positions in independent pharmacies (0.25 per pharmacy) was slightly higher than that reported for chain pharmacies (0.17). Respondents in hospital settings reported a substantially higher 1.06 unfilled pharmacist positions per hospital pharmacy, nearly three times as high as the average number of unfilled technician positions in hospital pharmacies Canadian Pharmacists Association

67 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 2.2 Technicians with Community College-Level Training and Certification How many technicians at your principal place of work Total % Have community college-level pharmacy training? Part-time Full-time Are certified as pharmacy technicians? Part-time Full-time How many technans at your principal place of work Total % Respondents indicated that 54% of the part-time technicians on their staff had collegelevel pharmacy training, while 60% of full-time staff had similar credentials. These numbers are somewhat in line with the findings from the technician survey, where 47% of technician respondents reported having graduated from a community college program and a further 22% from a career college program of less than one year s duration. Here also, respondents were provided with a number of different mechanisms of certification, and asked to report whether or not they considered their technicians to be certified by any of the available choices. Technicians are generally less likely to be certified (by any mechanism) than they are to have college-level training. At present, only Alberta and Ontario have formal, province-wide certification processes, which is reflected in the high percentage of respondents in these provinces who indicated their technicians were certified by a provincial mechanism. pe of Certification Part-time Technicians Full-time Technicians Type of Certification Part-time Full-time Technicians Technicians Ontario Certified Pharmacy Technician 7.5% 11% Pharmacy Technician Certification Board of Alberta 7.8% 7.3% Canadian hospital certification in technical function 7.8% 10.4% USA Pharmacy Technician Certification Board (PTCB) 0.3% 0.4% Other 2.6% 2.6% TOTAL CERTIFIED 25.8% 31.7% We noted a dramatic difference between the responses of chain, independent and hospital-based respondents. Hospital-based respondents were more than twice as likely as their community counterparts to report having college-educated or certified technicians on their staff. Part of this difference may stem from the fact that many hospitals currently certify technicians who are involved in tech-check-tech activities. The process generally involves audits of the technician s accuracy (e.g., as long as they maintain 99% checking accuracy, they are certified to check the work of other technicians). That is quite different from those who have taken an accepted certification exam from a recognized certification group (e.g., Ontario College of Pharmacists, the USA Pharmacy Technician Certification Board, etc.). The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 61

68 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Technicians with Community College-Level Training and Certification by Workplace 100% 80% 80 60% 40% 20% % Chain Independent Hospital Community College Certification We also noted significant differences between provinces in terms of the percentage of employed technicians with community college training and certification. Technicians with Community College-Level Training and Certification by Province Newfoundland & Labrador 75 80% % % % % Nova Scotia Prince Edward I sland New Brunswick Quebec Ontario M anitoba S askatchewan Alberta British Columbia 44 North 67 Community College Certification Canadian Pharmacists Association

69 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 2.3 Satisfaction with Pharmacy Technicians The survey revealed that the majority of respondents were very or somewhat satisfied with their current professional relationship with the pharmacy technicians on their staff. Indeed, fewer than 10% of respondents rated their level of satisfaction with professional relationships, delegation and opportunities for technicians to use their skills as either very or somewhat dissatisfied. Levels of satisfaction with technicians opportunities for job or career growth rated somewhat lower, however, with only 61% of respondents indicating they were very or somewhat satisfied, and 14% indicating their were very or somewhat dissatisfied. How satisfied are you with Hospitals Community Overall Our analysis revealed few significant differences among the various segments of the total survey population. The only question that elicited some variations was related to technicians opportunities for job or career growth. We found that managers were twice as likely to be somewhat or very dissatisfied with the current opportunities for their technicians (17%) than were the owners and franchisee respondents (8%). We also found that respondents from Canada s three largest cities were also more than twice as likely to be dissatisfied with current opportunities for their technicians job or career growth (20%) than rural respondents. Finally, we found that community pharmacists who operate in chains or franchise pharmacies were twice as likely to be dissatisfied (16%) than their counterparts in independent pharmacies. Though the variations between jurisdictions were limited, we note that respondents from Quebec were consistently less likely to report being very or somewhat satisfied than their counterparts in other jurisdictions. The margins were greatest for satisfaction with the technical tasks than can be delegated (77% versus 84% nationally); technicians opportunities to use their skills (72% versus 82% nationally); and technicians opportunities for job or career growth (51% versus 61% nationally). 2.4 Work Load Very or somewhat satisfied The professional relationship between your staff pharmacists and technicians? The technical tasks that can now be delegated to pharmacy technicians? % % % Technicians opportunities to use their skills? Technicians opportunities for job or career growth? Thinking of an average work day how would you rate Hospitals Community Overall A bit too much or much too much to do % % % The workload of your staff pharmacists The workload of your pharmacy technicians The survey results suggest that few respondents felt their technicians or pharmacists had too little work to do. Indeed, more than half (54%) felt their staff pharmacists had a bit too The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 63

70 Part II - Responses to National Survey of Pharmacists (Owners and Managers) much or much too much work to do on an average day. Fewer respondents (though still one-third) felt their technicians were similarly overburdened. Our closer analysis of the results revealed a few significant differences between various segments of the total survey population. Among them, we found that hospital-based respondents were more likely (47%) to report that their technicians are overburdened than were their counterparts in the community sector (30%). We also found that respondents who felt they face a shortage of qualified applicants for technician positions were more likely (43%) to feel their technicians are overburdened than were respondents who felt they face a surplus of qualified applicants (29%). The findings also show that more experienced pharmacists were more likely to report that their technicians were overburdened (e.g., 41% of respondents with 20 to 24 years of experience) than were their counterparts with less experience (e.g., 25% of respondents with 1 to 9 years of experience). Similarly, female respondents (38%) were more likely to report that their technicians were overburdened than were their male counterparts (28%). We found roughly the same pattern in the respondents assessment of the workload of their staff pharmacists. Excessive workloads were more often reported by hospital-based respondents (76%) than those in the community sector (49%); more often reported by experienced respondents (60%) than less experienced respondents (52%); and more often reported by female respondents (59%) than their male counterparts (50%). The findings from this question were quite consistent between all jurisdictions. 2.5 Level of Responsibility Is the level of responsibility your technicians now have appropriate Not nearly enough or not quite enough responsibility Hospital Community Overall % % % The survey results suggest that a majority (66%) of respondents were satisfied with the level of responsibility of their technicians. Less than one-third (27%) felt their technicians did not have enough or nearly enough responsibility. Only 4% of respondents felt their technicians did not have nearly enough responsibility. We found few significant differences in the response rates of various segments of the respondent population. Of note, respondents who reported they do not have enough qualified applicants for technician positions were somewhat more likely (31%) to feel that technicians did not have enough or nearly enough responsibility than were respondents who reported having too many qualified applicants (26%). We also note that female respondents (25%) were less likely to feel that technicians did not have enough or nearly enough responsibility than were male respondents (30%). The findings from this question were quite consistent between all jurisdictions and between hospital and community-based respondents Canadian Pharmacists Association

71 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 3.0 Current HR Practices 3.1 Sources for Hiring Pharmacy Technicians The respondents reported using a number of different approaches to locating candidates when hiring a pharmacy technician. While some approaches were used by more than half of respondents (e.g., scanning résumés dropped off at the location and promoting existing staff), other approaches were used more scarcely (e.g., online job banks and contacting a technician association). Sources for Hiring Pharmacy Technicians Contact Technicians Associations 5 Online Job Bank Other Head Office/HR does Hiring Newspaper Ad Contact Colleges with Technician Programs Promote Existing Staff Résumé Drop-Off 79 0% 20% 40% 60% 80% 100% Our analysis revealed some important differences in the responses given by pharmacists whose primary place of work is a chain pharmacy, an independent pharmacy or a hospital. Sources for Hiring Pharmacy Technicians by Workplace Contact Technicians Associations Online Job Bank Head Office/HR does Hiring Newspaper Ad Contact Colleges with Technician Programs Promote Existing Staff Résumé Drop-Off % 10% 20% 30% 40% 50% 60% 70% 80% 90% Chain/Franchise Independent Pharmacy Hospital The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 65

72 Part II - Responses to National Survey of Pharmacists (Owners and Managers) We note, for example, that respondents from independent pharmacies were significantly less likely to use online job banks (4% as opposed to 10% overall) and also far less likely to have a head office or human resources department to undertake the hiring on their behalf (5% versus 19% overall). Similarly, we note that respondents in rural areas were significantly more likely (65%) to promote from within than are respondents in large urban areas (i.e., 48% in Montreal, Toronto and Vancouver). These same rural respondents were also less likely to turn to community colleges with technician programs (19% versus 42% in Canada s largest three cities). An expensive option such as newspaper advertising was more likely to be undertaken by respondents who felt there were not enough qualified candidates for pharmacy technician positions (45%) than those respondents who felt there were too many qualified candidates (22%). Provincially, the findings are largely consistent, though we note that respondents from Atlantic Canada were more likely to promote existing staff (63%) and less likely to use newspaper advertising (23%). 3.2 Job-specific Training or Education Requirements The survey revealed that more than half (55%) of all respondents had no minimum requirements in mind when they selected and hired pharmacy technicians. Only onethird required specific educational credentials and less than one-quarter looked specifically for certification. Fewer than one in five (18%) required a minimum number of years of related experience. Requirements for Hiring Technicians Require Min. Years of Experience 18 Require Certification 24 Require Specific Education 33 No Specific Requirements 55 0% 10% 20% 30% 40% 50% 60% Canadian Pharmacists Association

73 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The findings also revealed a significant difference between the responses of hospital pharmacists and those in the community sector. Requirements for Hiring Technicians by Workplace Require Min. Years of Experience Require Certification Require Specific Education No Specific Requirements % 10% 20% 30% 40% 50% 60% 70% 80% All Community Hospitals Hospital pharmacist respondents were significantly more likely to report that they did have minimum requirements for experience, certification and education. Indeed, only 9% of respondents from hospital pharmacies reported they did not have any specific requirements, compared to 66% of respondents from the community sector. Requirements for Hiring Technicians by Community Size Require Min. Years of Experience Require Certification Require Specific Education No Specific Requirements % 10% 20% 30% 40% 50% 60% 70% 80% 90% Rural Small Centres Large Cities Tor/Mtl/Van The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 67

74 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Respondents in rural areas (77%) were significantly more likely to have no specific requirements than were respondents in larger urban centres and in Toronto, Montreal and Vancouver (42%). Similarly, we found that respondents from pharmacies with four or more pharmacists (8%) were significantly less likely to report having no minimum requirements than were respondents from smaller pharmacies (57%). Respondents from larger pharmacies were more likely to have minimum requirements for education (79% versus 31% for smaller pharmacies) and certification (28% versus 23%). Interestingly, respondents from the smaller pharmacies were more likely to have minimum requirements for years of related experience (19%, versus 8% for respondents from larger pharmacies). In terms of jurisdictions, we found that respondents in Atlantic Canada were somewhat more likely to have no specific requirements (63%), especially compared to Alberta (47%) and British Columbia (46%). Manitoba (40%) and Alberta respondents (38%) were more likely to require certification than respondents from other jurisdictions, while Quebec respondents were more likely to require a minimum number of years of related experience (30%). 3.3 Hiring Conditions The survey results showed a wide diversity of responses in terms of the current state of hiring conditions for pharmacy technicians. While one-third of respondents assessed their local market as having a shortage of applicants, nearly one in five assessed their market as having a surplus of applicants. The remaining respondents (49%) assessed their market as having about the right number of applicants. The results revealed important difference between segments in terms of how respondents assessed their local hiring conditions, especially in terms of the workplace setting. Hiring Conditions Too Many Applicants 18% About Right Number of Applicants 49% Not Enough Applicants 33% Hiring Conditions by Workplace Too Many Applicants About Right Number of Applicants Not Enough Applicants % 10% 20% 30% 40% 50% 60% 70% Chain/Franchise Independent Pharmacy Hospital Canadian Pharmacists Association

75 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Closer analysis also revealed that the perceived shortage of applicants was most likely to be reported by respondents from chain pharmacies (39%), less so by respondents from independent pharmacies (30%) and even less by respondents from hospital pharmacies (22%). Hiring Conditions by Community Size Too Many Applicants About Right Number of Applicants Not Enough Applicants % 10% 20% 30% 40% 50% 60% Rural Large Cities Small Centres To r/mt l/van At the same time, we found that respondents from pharmacies with three or fewer pharmacists were significantly more likely (34%) to report a shortage of applicants than were their counterparts in pharmacies with four or more pharmacists (13%). Comparing various provinces, we fond that respondents from Quebec (47%) were most likely to report having a shortage of qualified applicants, especially compared to Manitoba respondents (17%). Conversely, respondents in Manitoba (32%) and British Columbia (29%) were most likely to report a surplus of qualified applicants (a claim only made by 4% of Quebec respondents and 9% of respondents from Saskatchewan). Closer analysis revealed that perceptions of the labour market differed significantly as one moved from major urban centres to rural areas across the country. Consider, for example, the difference in responses from rural respondents and those in Canada s three largest cities. Whereas only 26% of respondents from Canada s three largest cities reported a deficit of applicants, that number climbed to 41% for rural respondents. Similarly, only half as many respondents from rural Canada (12%) were able to report too many applicants compared to respondents from Toronto, Montreal and Vancouver (25%). The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 69

76 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The same question also asked respondents to assess their local labour market in terms of the qualifications of applicants. Here again, responses varied and included those who felt most applicants were well qualified (8%) and those who felt most applicants were not well qualified (40%). The balance of respondents (52%) felt most had adequate qualifications. The results also pointed again to important differences in how respondents from hospitals, chain and independent pharmacies assessed their labour markets for technicians. Qualifications for Hiring Applicants Most applicants well qualified 8% Adequate qualifications 52% Most applicants not well qualified 40% Qualifications for Hiring by Workplace Most Applicants Well Qualified Hospital Independent Pharmacy Chain/Franchise Adequate Qualifications Most Applicants Not Well Qualified % 10% 20% 30% 40% 50% 60% 70% Respondents from hospital pharmacies, for example, were more likely to report that applicants were well qualified (14%) or adequately qualified (59%) than were their counterparts in independent pharmacies (10% and 48%) and chain pharmacies (5% and 49%) Canadian Pharmacists Association

77 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Once again, we found important differences in the assessments of rural and urban respondents. Qualifications for Hiring by Community Size Most Applicants Well Qualified Rural Large Cities Small Centres To r/mt l/van Adequate Qualifications Most Applicants Not Well Qualified % 10% 20% 30% 40% 50% 60% More than half of respondents from rural areas reported that most applicants were not well qualified, compared to only 42% of respondents from Canada s three largest cities. Conversely, the respondents from Toronto, Montreal and Vancouver (50%) were more likely to report that most applicants had adequate qualifications than were their rural counterparts (41%). In terms of qualifications of applicants, no significant differences were found between respondents from various jurisdictions. 3.4 Incentives for Attracting Qualified Technicians The survey results suggest that pharmacies were more likely to reward more qualified technicians through higher pay for more experience (80%) or for more specialized training or education (52%) than they were to pay the costs of technician courses provided by other organizations (40%) or pay the costs of certification exams (25%). Incentives for Qualified Technicians Higher Wages with More Years Experience 80 Higher Wages with Specialized Training Provide In-House Training Higher Wages if Certified Pay for Courses Provided by Others 40 Pay for Certification Exam 25 0% 20% 40% 60% 80% 100% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 71

78 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Closer analysis revealed that owners of pharmacies consistently exercised more latitude in terms of the incentives they used to attract and retain technicians than do their manager counterparts. Incentives for Qualified Technicians Comparing Owners and Managers Pay for Certification Exam Owners Managers Pay for Courses Provided by Others Provide In-House Training Higher Wages with More Years Experience Higher Wages If Certified Higher Wages with Specialized Training % 20% 40% 60% 80% 100% Owners were significantly more likely to report using all of the incentives listed in the questionnaire, sometimes by a considerable margin. For example, owners (41%) were more than twice as likely as managers to report paying for certification exams (19%). The findings also showed repeatedly that the incentives were more likely to be used by respondents who perceived a shortage of applicants for technician positions than by those who felt they had a surplus of applicants. Incentives for Qualified Technicians by Number of Applicants Pay for Certification Exam Pay for Courses Provided by Others Too Many About Right Not Enough Provide In-House Training Higher Wages with More Years Experience Higher Wages if Certified Higher Wages with Specialized Training % 10% 20% 30% 40% 50% 60% 70% 80% 90% Canadian Pharmacists Association

79 Part II - Responses to National Survey of Pharmacists (Owners and Managers) We note that of respondents who felt they did not have enough applicants, 85% would pay higher wages for more experience and 65% would pay higher wages for technicians with specialized training. Of respondents who felt they had too many applicants, the numbers dropped to 72% and 37% respectively. To the extent that these incentives were more likely to be used to attract and retain technicians in tight labour markets, it is not surprising to find that rural respondents were more likely to resort to all of these incentives. Incentives for Qualified Technicians by Community Size Pay for Certification Exam Pay for Courses Provided by Others Tor/Mtl/Van Large Cities Small Centres Rural Provide In-House Training Higher Wages with More Years Experience HigherWagesifCertified Higher Wages with Specialized Training % 10% 20% 30% 40% 50% 60 % 70% 80% 90% Similarly, we found that respondents from hospital pharmacies were also less likely to resort to these incentives (as they report a greater number of more qualified applicants). They were, however, more likely to offer to pay for technician courses offered by other organizations (52%) than were their counterparts in independent pharmacies (51%) and chains (29%). Incentives for Qualified Technicians Hospital versus Community Pay for Certification Exam Community Pay for Courses Provided by Others Hospitals Provide In-House Training Higher Wages with More Years Experience Higher Wages if Certified Higher Wages with Specialized Training % 10% 20% 30% 40% 50% 60% 70% 80% 90% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 73

80 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Similarly, we noted a number of differences between respondents from larger pharmacies (four or more pharmacists) and smaller pharmacies (three or fewer). Whereas larger pharmacies were more likely to pay for courses provided by others, to provide in-house training and to pay higher wages for more years of experience, they were also less likely to pay for certification exams, to pay higher wages if technicians were certified and to pay higher wages if technicians had specialized training. We found few significant differences between jurisdictions with this question. Of note, however, respondents in Atlantic Canada were more likely (64%) to provide in-house courses for technicians, especially compared to those from Saskatchewan (36%). Respondents from Ontario were more likely to pay for courses provided by others (53%), whereas respondents from Manitoba (25%) were less likely than the national average. Finally, we note that respondents from Ontario (49%) were more likely to pay for certification exams than the national average, especially compared to respondents from Atlantic Canada (13%). 4.0 Foreign-Trained Individuals 4.1 Training/Work Outside Canada/USA How many of your current technicians have Total n = 5970 Average years of training/education or practice outside Canada/USA Completed pharmacy technician training/education 0.4% 1.7 outside Canada/USA? Worked as pharmacy technician outside Canada/USA? 0.4% 1.3 Practised as a pharmacist outside Canada/USA? 1% 1.4 Considering that respondents were reporting on nearly 6000 full and part-time pharmacy technicians, we found that the incidence of education or work outside Canada and the USA was remarkably low (0.4% of respondents had technicians on staff who trained and worked as a technician outside Canada and the USA, and only 1% of respondents had technicians on staff who trained and worked as a pharmacist outside Canada and the USA). Respondents in large cities (especially Toronto, Vancouver and Montreal) were most likely to report having these individuals on their staff. Moreover, respondents in smaller pharmacies (i.e., three or fewer pharmacists on staff) and in community settings were more likely to report having technicians with these types of international experience. That being said, the small number of respondents with internationally trained technicians on staff suggests that these findings should not be extrapolated to the broader population Canadian Pharmacists Association

81 Part II - Responses to National Survey of Pharmacists (Owners and Managers) 5.0 Technician Training & Responsibilities 5.1 Accreditation of Technician Training Programs The survey results suggest that the majority of respondents supported or strongly supported both a proposal for a national standard for accreditation of college programs and required graduation from an accredited community college program. Support was particularly strong for the national standard (86%) compared to support for mandatory graduation (65%). The results also showed significant differences in the responses of community-based and hospital-based pharmacists. 100% 80% 60% 40% National accreditation of college programs Support for Accreditation by Workplace Graduation from accredited college requirement for hiring % 0% 29 All Phamacists 32 Community Pharmacies 16 Hospitals/ Long-term Care 26 All Pharmacists 27 Community Pharmacies 18 Hospitals/ Long-term Care Somewhat support Strongly support We found that support for both a national accreditation standard for community college technician programs and for a mandatory diploma from an accredited community college program was significantly higher among hospital respondents than among community (and especially independent) pharmacists. The results also showed that more experienced pharmacists (i.e., >25 years) were less likely to support or strongly support mandatory graduation from an accredited program (58%) than were pharmacists with one to nine years of experience (72%) and that support was stronger among female respondents (68%) than it was among male respondents (60%). Closer analysis revealed that respondents who felt they faced a shortage of qualified applicants were less likely to support the proposal for mandatory graduation from an accredited college (62%) than were those who reported facing a surplus of applicants (71%). The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 75

82 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Similarly, we found that rural respondents were significantly less likely to support or strongly support the proposal for mandatory graduation from an accredited community college program than were their counterparts in large urban centres and, especially, in Canada s three largest cities. Support for Accreditation by Community Size Mandatory College Program To r/mt l/van Large Cities Small Centres Rural National Standard % 20% 40% 60% 80% 100% In terms of variations between jurisdictions, we found a high level of agreement among most provinces and territories. We do note that respondents in British Columbia were more likely to support both the national standard and the mandatory college diploma (92% and 78% respectively). Respondents from Quebec (77% and 54% support) and Manitoba (77% and 57%) were least likely to voice their support for these measures. 5.2 Certification of Pharmacy Technicians The survey asked respondents their opinions on voluntary or mandatory certification exams for pharmacy technicians, with the understanding that any such certification would require technicians to graduate from a recognized community college program and take an exam that certifies their level of knowledge and skills. Support for Certification by Workplace 100% 80% 60% 40% Voluntary certification of technicians Mandatory certification of technicians % 0% 38 All Pharmacists 40 Retail Pharmacies 34 Hospitals/ Long-term Care 27 All Pharmacists 28 Retail Pharmacies 23 Hospitals/ Long-term Care Somewhat support Strongly support Canadian Pharmacists Association

83 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The results suggest high levels of support for either a voluntary or mandatory certification exam. Respondents were more likely to strongly support the mandatory exam (39%) than they were the voluntary exam (27%). Only 6% of respondents were strongly opposed to either the voluntary or mandatory exam. Once again, response rates differed significantly by workplace. Hospital-based respondents were more supportive of the mandatory certification exam than were their counterparts in community pharmacies. Deeper analysis of the data revealed several important differences in response rates between segments, again suggesting that perceived labour market conditions were an influential variable. Consider, for example, that support (strongly and somewhat) for a mandatory certification exam process stood at 71% among respondents who reported having a surplus of qualified applicants for technician positions, compared to 67% among those who felt they did not have enough qualified candidates. Respondents who perceived tight labour markets were somewhat more likely to support a voluntary exam (70%) than were their counterparts who feel they have too many qualified applicants (57%). The pattern is repeated with rural compared to urban respondents. Support for Certification by Community Size Mandatory Exam Voluntary Exam % 10% 20% 30% 40% 50% 60% 70% 80% Rural Small Centres Large Cities Tor/Mtl/Van Support for the mandatory exam was lower among rural respondents (compared to respondents in Toronto, Montreal and Vancouver). These same rural respondents were more likely to support a voluntary exam. Support for Certification Comparing Owners and Managers Mandatory Exam Voluntary Exam % 10% 20% 30% 40% 50% 60% 70% 80% Owners Managers The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 77

84 Part II - Responses to National Survey of Pharmacists (Owners and Managers) We also found that owners, who work principally in independent pharmacies, were somewhat more in favour of a voluntary approach and significantly less in favour of a mandatory exam process. Finally, we note that more experienced respondents were generally less in favour of a mandatory certification exam. While 72% of respondents with 14 or fewer years of experience supported the mandatory certification exam, only 63% of respondents with 15 or more years of experience were similarly in favour. Female respondents were also somewhat more in favour of the mandatory approach (68%) than were their male counterparts (64%). In terms of provincial variances, response rates in support of the voluntary exam differed only slightly between jurisdictions. In terms of the mandatory exam proposal, respondents from British Columbia were most likely to offer support (80%), whereas their counterparts from Quebec (54%) and Manitoba (51%) were least likely. 5.3 Support for Technicians who Seek Certification The survey results showed a strong likelihood that respondents would take steps to support their technicians who seek certification. More than 70% of respondents indicated they were very or somewhat likely to support these technicians by providing mentoring (85%), delegating more responsibility to certified technicians (85%) and paying higher wages to certified technicians (71%). Indeed, more than half of respondents indicated they were very likely to offer mentoring (51%) and more responsibility (50%). Support was somewhat weaker for paying certification fees (63%) and for allowing time off (58%) though each option still garnered the support of more than half of respondents. In the future, how likely would you be to support technicians on your staff who seek certification by Mentoring technicians who are preparing for the certification exam? Allowing time off (with pay) for technicians to take the certification exam? Paying the certification fee for successful technicians? Paying higher wages to certified technicians? Delegating more responsibility to certified technicians? Very or somewhat likely % Uncertain % Not very or notatall likely % We do this now % Closer analysis of the data from this question revealed several significant variances in response rates between different segments of the overall respondent population. To begin with, we found once again that labour market conditions were an important variable in terms of attitudes towards these means of supporting technicians who are seeking certification: the tighter the labour market, the more likely respondents were to offer support Canadian Pharmacists Association

85 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Support for Technicians Seeking Certification by Number of Applicants Mentoring Allowing time off Paying the Exam fee Paying higher wages Delegating more responsibility % 20% 40% 60% 80% 100% Not Enough About Right Too Many In all instances, respondents who reported having too few qualified candidates for technician positions were more likely to support technicians seeking certification than were respondents faced with too many qualified candidates. Where money was considered (paying the exam fee and paying higher wages), the gaps were significant. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 79

86 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Similarly, rural respondents were more likely to offer all types of support than their counterparts in Canada s three largest cities. Support for Technicians Seeking Certification by Community Size Mentoring Allowing time off Paying the exam fee Paying higher wages Delegating more responsibility % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Rural Small Centres Large Cities Tor/Mtl/Van Rural respondents were significantly more likely than those in the largest urban centres to allow for time off to complete the exam (86% versus 55%), more likely to pay the examination fee (75% versus 58%) and more likely to pay higher wages for certified technicians (82% versus 61%). Though the differences are less pronounced, we found a similar pattern when comparing owners/franchisees to managers, with owners/franchisees more likely to offer most of the types of support listed. Support for Technicians Seeking Certification Comparing Owners and Managers Mentoring Allowing time off Paying the exam fee Paying higher wages Delegating more responsibility % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Owners Managers Here again, the margins were greatest when money was involved (paying exam fees and higher wages) Canadian Pharmacists Association

87 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Finally, we note some variances between jurisdictions on this question. Respondents from the Atlantic provinces were more likely to offer mentoring (91%) and time off (70%), especially compared to their counterparts in Quebec (70% and 45% respectively). Respondents from Manitoba were least likely to pay the certification fee (48% versus 70% in the Atlantic provinces and Ontario). Respondents in British Columbia were least likely to pay higher wages for certified technicians (61%) and again contrasted most sharply to their counterparts in Atlantic Canada and Ontario (76% each). 5.4 Regulation of Pharmacy Technicians The survey results revealed strong support for some of the proposed new tasks for regulated pharmacy technicians, and considerable opposition to others. On the one hand, some two-thirds of respondents somewhat or strongly supported having regulated pharmacy technicians receive repeat verbal prescriptions from health care providers, transfer to or receive prescriptions from another pharmacy, or copy prescriptions for authorized recipients. Less than one-quarter of respondents strongly or somewhat opposed these proposals. How would you feel about allowing regulated pharmacy technicians to do some tasks now done by pharmacists, such as Strongly or somewhat support % Neutral % Strongly or somewhat oppose % We do this now % Receive new verbal prescriptions from health care providers? Receive repeat verbal prescriptions from health care providers? Transfer to or receive prescriptions from another pharmacy? Copy prescriptions for authorized recipients? Check accuracy/completeness of pharmaceutical products prepared for release by unregulated pharmacy technicians? On the other hand, support for allowing regulated pharmacy technicians to receive new verbal prescriptions from health care providers or check the accuracy/completeness of products prepared by unregulated pharmacy technicians was significantly lower. The proposal to have technicians receive new verbal prescriptions from health care providers in particular only secured the support of 35% of respondents and drew opposition from 55% of respondents. Indeed, fully 27% of respondents strongly opposed this proposal (the strongest such level of opposition). Despite such strong findings for one of the proposals, we still find interesting variances in how different segments of the respondent population answered these questions, confirming many of the patterns we have seen thus far. Once again, workplace appears as an important independent variable. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 81

88 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Support for Regulated Pharmacy Technician Roles by Workplace Receive new verbal prescriptions Receive repeat verbal prescriptions Transfer/receive prescriptions from other pharmacies Copy prescriptions for authorized recipients Check accuracy/completeness of products % 10% 20% 30% 40% 50% 60% 70% 80% Independent Chain/Franchise Hospital Respondents from independent pharmacies were consistently more likely to support a proposed new role for regulated pharmacy technicians. We found that hospital-based respondents were often more likely than chain-based respondents to support new roles. In the case of checking the accuracy and completeness of work done by an unregulated technician, hospital-based respondents were the most likely of all three groups to express their support. Support for Regulated Pharmacy Technician Roles by Hiring Conditions Receive new verbal prescriptions Receive repeat verbal prescriptions Transfer/receive prescriptions from other pharmacies Copy prescriptions for authorized recipients Check accuracy/completeness of products % 10% 20% 30% 40% 50% 60% 70% 80% 90% Not Enough About right Too Many Respondents who felt they did not have enough qualified candidates for technician positions were more likely to support all but one of the proposals above. The margin was often quite pronounced; for example, support for receiving repeat verbal prescriptions was 18 percent higher among those who felt they faced a shortage of applicants, compared to those with a surplus Canadian Pharmacists Association

89 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Similarly, we found that rural respondents were more likely to support four of the five proposals. Support for Regulated Pharmacy Technician Roles by Community Size Receive new verbal prescriptions Receive repeat verbal prescriptions Transfer/receive prescriptions from other pharmacies Copy prescriptions for authorized recipients Check accuracy/completeness of products % 10% 20% 30% 40% 50% 60% 70% 80% 90% Rural Small Centres Large Cities Tor/Mtl/Van Here again, the margin between the two sets of responses was at times quite significant, even on the question of receiving new verbal prescriptions, where support among rural respondents was 16 percent higher than it was among respondents from Toronto, Vancouver and Montreal. Gender also appears to have played an important role in influencing attitudes toward these possible new roles for regulated pharmacy technicians. Support for Regulated Pharmacy Technician Roles by Gender Receive new verbal prescriptions Male Female Receive repeat verbal prescriptions Transfer/receive prescriptions from other pharmacies Copy prescriptions for authorized recipients Check accuracy/completeness of products % 10% 20% 30% 40% 50% 60% 70% 80% The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 83

90 Part II - Responses to National Survey of Pharmacists (Owners and Managers) With the exception of allowing regulated pharmacy technicians to check the accuracy and completeness of work carried out by unregulated technicians (where no significant difference is apparent), male respondents were consistently more likely to support the possible new roles for regulated pharmacy technicians than were their female counterparts. Support for Regulated Pharmacy Technician Roles by Years of Experience Receive new verbal prescriptions Receive repeat verbal prescriptions Transfer/receive prescriptions from other pharmacies Copy prescriptions for authorized recipients Check accuracy/completeness of products % 10% 20% 30% 40% 50% 60% 70% 80% 1-9 years 25 + years Likewise, years of experience played a role in influencing attitudes on this topic. More experienced pharmacists were significantly more likely to support all of the proposed new roles for regulated pharmacy technicians than were their less experienced counterparts. 5.5 Support for Technicians who Want to Become Regulated Pharmacy Technicians Inthefuture,howlikelywouldyoubeto support the technicians on your staff who want to become regulated pharmacy technicians by Very or somewhat likely % Uncertain % Not very or notatall likely % 13. In the % Mentoring Allowing time off to take exams Paying the exam fee for successful technicians Paying higher wages to regulated technicians Delegating more responsibilities to regulated technicians The survey found that a majority of all respondents were very or somewhat likely to offer various forms of support for their technicians who seek to become regulated. The likelihood was highest for types of support that have no monetary implications e.g., including delegating more responsibilities to regulated technicians (85%) and offering mentoring (88%) Canadian Pharmacists Association

91 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Support was lowest for measures that have some cost (allowing time off and reimbursing the exam fee) though stronger for a measure that would have a much more significant cost to the pharmacy in the long run (paying higher wages to regulated technicians). In a now-familiar pattern, we found that respondents in rural areas are more likely to offer all kinds of support, especially compared to their counterparts in Canada s three largest cities. Support for Technicians who Want to Become Regulated Pharmacy Technicians by Community Size Mentoring Allowing time off Paying the exam fee Paying higher wages Delegating more responsibility % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Rural Small Centres Large Cities Tor/Mtl/Van Similarly, respondents from smaller pharmacies were more likely to offer all kinds of support to technicians who are seeking to become regulated. Support for Technicians who Want to Become Regulated Pharmacy Technicians - Hospital versus Community Mentoring Allowing time off Paying the exam fee Paying higher wages Delegating more responsibility % 10% 20% 30% 40% 50% 60% 70% 80% 90% Hospital Community The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 85

92 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The more a respondent felt they faced a shortage of qualified applicants for pharmacy technician positions, the more likely they were to offer the various kinds of support proposed in the questionnaire. Support for Technicians who Want to Become Regulated Pharmacy Technicians by Hiring Conditions Mentoring Allowing time off Paying the exam fee Paying higher wages Delegating more responsibility % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Not Enough About Right Too Many In terms of variances between jurisdictions, we found some significant differences and one pattern in the data strong support for the measures in Atlantic Canada. In many ways, respondents from Quebec were less likely to support regulated technicians, while respondents from the Atlantic provinces are more likely: Only 74% of respondents in Quebec were very or somewhat likely to offer mentoring (versus 92% in Atlantic Canada and 94% in Saskatchewan); 45% of respondents in Quebec were likely to offer time off (compared to 67% in Atlantic Canada), and Only 82% of respondents in Quebec would delegate more responsibility to regulated technicians (compared to 89% in Atlantic Canada and 91% in Saskatchewan). Respondents in Atlantic Canada were also more likely than the national average to pay the exam fee (69%), as are their counterparts from Ontario (70%). In contrast, only 46% of respondents from Manitoba were similarly inclined on this question. Finally, Atlantic Canadian respondents led the way in terms of their likelihood of paying higher wages for certified technicians (80%), and contrasted sharply with respondents from British Columbia (at 69% who are very or somewhat likely to do so) Canadian Pharmacists Association

93 Part II - Responses to National Survey of Pharmacists (Owners and Managers) C. Conclusion One of the most pressing challenges faced by the pharmacy workforce today is balancing the expansion of the role of the pharmacist with the profession's current overwhelming workload and human resources shortages. Advancing the role of the pharmacy technician is one obvious strategy. However, any work in this direction requires an understanding of the structure and nature of the pharmacy technician workforce in Canada, and the attitudes and intentions of pharmacists and pharmacy technicians relating to technician roles and responsibilities, education and credentialing, and willingness to take on new tasks. This survey represents the first time a national effort has been made to fill some of these information needs. It should be noted that since no baseline profile or exact number of practising pharmacy technicians exist, it is difficult to asses the extent to which the findings are representative of the pharmacy technician population as a whole. In general, these findings illustrate a cautious enthusiasm on the part of pharmacist owners and managers regarding certain proposed measures that would allow pharmacy technicians to better support pharmacists through an expanded role. They also highlight some of the factors that will need to be addressed in any such process, including a thorough understanding of the nature and accountability of tasks which can be appropriately delegated. The findings generated by this research raise many opportunities for more in-depth exploration on pharmacists and pharmacy technicians' attitudes and intentions towards the future of pharmacy technicians in Canada. Moving Forward will be conducting further research to investigate some of these areas in the spring and summer of Visit pharmacyhr.ca for more information. The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 87

94 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Canadian Pharmacists Association

95 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Appendix National Pharmacist (Owners and Managers) Survey Questionnaire To submit your questionnaire to Vision Research via fax, dial (613) The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 89

96 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Canadian Pharmacists Association

97 Part II - Responses to National Survey of Pharmacists (Owners and Managers) The Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes 91

98 Part II - Responses to National Survey of Pharmacists (Owners and Managers) Canadian Pharmacists Association