For Personal Use Only. Any commercial use is strictly prohibited. Results of the 2015 National Certified Pharmacy Technician Workforce Survey

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1 Results of the 2015 Ntionl Certified Phrmcy Technicin Workforce Survey Shne P. Desselle, B.S.Phrm., Ph.D., FAPhA, College of Phrmcy, Touro University Cliforni, Vllejo, CA. Erin R. Holmes, Ph.D., School of Phrmcy, University of Mississippi, University, MS. Purpose. The results of the 2015 Ntionl Certified Phrmcy Technicin Workforce Survey re described. Methods. A survey ws e-miled to rndomized smple of 5,000 certified phrmcy technicins (CPhTs) throughout the United Sttes, with response reminders employed. Survey items eliciting demogrphic nd work chrcteristics nd work life ttitudes were generted from the literture nd qulittive interviews. This study imed to describe job stisfction, sources of stress, profession nd employer commitment, eduction nd trining, nd resons for entry into the profession mong CPhTs nd determine reltionships between those vribles nd CPhTs level of involvement in vrious work ctivities, with prticulr ttention pid to differences in prctice setting. Frequency sttistics, correltion nlysis, nd mens testing were used to meet study objectives nd identify significnt differences. Results. A totl of 516 CPhTs currently working s phrmcy technicin responded to the survey. The CPhTs reported high levels of involvement in more trditionl ctivities but less involvement in those tht involve greter cognitive lod. Respondents reported moderte levels of job stisfction nd commitment nd somewht high levels of stress overll. Most CPhTs chose to be phrmcy technicin becuse they desired to enter helthcre field nd help people nd were recruited. CPhTs derived benefit from ll spects of eduction nd trining evluted nd most from on-the-job trining. Perceived vlue of eduction nd trining ws ssocited with higher stisfction nd commitment nd with lower stress. There were number of differences in these work life ttitudes cross prctice settings nd by involvement in vrious job functions. Conclusion. The results of the survey indicted tht job stisfction nd commitment were moderte nd tht stress levels were somewht high mong CPhTs. There were number of differences in work life ttitudes cross prctice settings nd by involvement in vrious job ctivities. Keywords: eduction, professionl; job stisfction; phrmcy dministrtion; phrmcy technicins; technicin trining Am J Helth-Syst Phrm. 2017; 74:e Address correspondence to Dr. Desselle This rticle will pper in the July 1, 2017, issue of AJHP. Copyright 2017, Americn Society of Helth-System Phrmcists, Inc. All rights reserved /17/0000-e295. DOI /jhp The phrmcy profession hs been evolving, with incresing prticiption of support stff in providing cre to ptients. There hs been considerble investigtion of phrmcists roles in the work force in order to move the profession forwrd nd dvnce ptient cre. These studies hve exmined, mong mny other fctors, phrmcists rediness to provide cre, 1 innovtion, 2 orgniztionl culture issues, 3-5 phrmcists roles in ddressing helthcre disprities, 6-12 finncil considertions (e.g., lck of economic incentive for phrmcists to dedicte time to delivering cognitive services), 13 nd scope of prctice regultions t federl nd stte levels tht constrin or encourge dvnced prctice. 14 However, little such tten- AM J HEALTH-SYST PHARM VOLUME e295

2 tion hs been focused on phrmcy technicins. Phrmcists prctice is more likely to evolve when phrmcists cn delegte certin tsks with greter confidence. For those responsibilities lredy hndled by support personnel, there is growing recognition tht it tkes the proper mix of high-level ttitudes, skills, nd behviors for optiml performnce. 15 Numerous reports from hospitl nd community phrmcy settings hve described technicins tking on greter roles, including but not limited to mediction reconcilition, ssistnce with dischrge plnning, nd heightened involvement in ptient nd customer service ctivities Phrmcists hve been wrming up to the professionliztion of support personnel. Wilson et l. 27 found good fit for model of professionl expertise for phrmcy technicins tht included knowledge, ptient ssessment nd eduction, resoning nd judgment, nd virtues. Desselle nd Schmitt 28 found support mong phrmcists for mndtory certifiction of phrmcy technicins nd for ctivities for which technicins cn ssume greter responsibility. Further delinetion nd development of phrmcy support personnel roles hve been sought Myers 32 offered specific opportunities where phrmcy technicins could mke the most impct on effective ptient cre nd opertions for helth-system phrmcies. Wick 33 posited tht phrmcy s optimiztion of technicin use could enhnce not only opertionl but lso clinicl cpbilities of phrmcy orgniztions. The Council on Credentiling in Phrmcy weighed in to imprt more synchronous model of phrmcy cre tht considered the issues fcing phrmcy, lbor nd work-force needs, nd how the work of ll phrmcy personnel cn be orgnized for phrmcy to rech its full potentil. 34 Still, there hs been little study on issues relted to technicin professionliztion. Evidence suggests tht phrmcy technicins experience KEY POINTS Reltionships were found between the involvement of certified phrmcy technicins (CPhTs) in vrious work ctivities nd work ttitudes, including their commitment to their employer nd the phrmcy profession. Eduction modlities of technicins were found to be very useful, even though incorportion of dditionl soft skills into their trining could be beneficil. The results of the survey indicted tht job stisfction nd commitment were moderte nd tht stress levels were somewht high mong CPhTs. reltively low job stisfction nd high levels of turnover. 35,36 Phrmcy technicins hve reported future uncertinty bout their creers, which hs deleterious effect on their job stisfction nd qulity of work life. 37 Given their reltively low rtes of py compred with those of phrmcists, phrmcy technicins could potentilly be lured wy from their jobs, even while reltively smll py increses could foster greter loylty nd commitment. 35 It ws suggested over decde go tht technicins might require more theoreticl nd hnds-on eduction nd trining. 38 It lso hs been severl yers since technicins reported on their generl preferences for further trining. 35 The previously stted preferences were not prsed by prctice setting, where eduction nd trining needs my differ. While there hs been modicum of reserch on technicins work lives, no study hs linked their level of trining, type of trining, nd prepredness for the current job with ny spect of their work life. There lso is little informtion bout the fctors tht ttrct technicins to the field of phrmcy. As phrmcy continues its move towrd more ptient-centered prctice, closer exmintions of technicin prctice re required. The purpose of this study ws to further explore technicins qulity of work life nd the eduction nd trining received by phrmcy technicins in the United Sttes. The specific objectives of this study were to (1) describe the current stte of work stisfction, sources of stress, nd profession nd employer commitment mong certified phrmcy technicins (CPhTs), (2) describe CPhTs level of involvement in vrious prctice settings in rnge of current nd prospective job responsibilities, (3) identify the resons tht CPhTs entered their field of work, (4) describe the prevlence nd perceived helpfulness of vrious trining methods to prepre CPhTs for their current jobs, nd (5) determine the reltionships mong prctice setting, level of involvement in job responsibilities, eduction nd trining received, nd perceived usefulness of trining with levels of stisfction, stress, nd commitment of CPhTs to their employer nd the profession. Methods Design nd smple. Institutionl review bord exemption for study procedures ws grnted by Touro University nd University of Mississippi. In this cross-sectionl study, questionnire ws used to survey ntionwide rndomized smple of CPhTs. Using smple-size clcultion recommended by Dillmn et l., 39 n estimted 384 respondents were deemed required to meet the study objectives. Assuming response rte of pproximtely 10%, we sought contct informtion from the Phrmcy Technicin Certifiction Bord (PTCB) for 5,000 CPhTs to whom the questionnire would be disseminted. Responses only from CPhTs working s technicin (prttime or full-time) were desired. Thus, e296 AM J HEALTH-SYST PHARM VOLUME

3 the survey ws designed to utomticlly terminte for ny respondent who ws younger thn 18 yers, retired, not working s technicin, or full-time student in doctor of phrmcy degree progrm. Survey construction nd implementtion. This study s sponsors the Phrmcy Workforce Center, ASHP, nd PTCB provided list of desired topics for investigtion, including primry plce of employment, experience s phrmcy technicin, vrious demogrphics, creer commitment, job stisfction, nd job stress. A multistge process ws used to refine the survey, including dditionl literture review; collecting dt from in-depth, semi-structured interviews; nd survey piloting. Respondents used liner numeric scles to chrcterize their involvement in vrious job responsibilities, commitment to their employer nd the phrmcy profession, job stisfction, nd job stress. The survey contined questions regrding prctice setting, demogrphic chrcteristics, resons for entering the profession, type of eduction nd trining received for the current phrmcy technicin job, nd the usefulness of the eduction nd trining received. Respondents geogrphic loction ws lso collected. 40 The survey ws built using Qultrics softwre (Qultrics, Provo, UT). Investigtors sent the CPhTs notice vi e-mil regrding the impending survey during the first week of October A URL with copy of the survey nd cover letter informing the 5,000 CPhTs of their rights ws distributed during the second week of October Reminder e-mils were sent pproximtely 1, 2, nd 3 weeks fter the survey ws e-miled. The survey ws closed on November 9, Dt nlysis. The dt were prepred for nlysis using IBM SPSS Sttistics for Windows, version 21.0 (IBM, Armonk, NY). Frequency distributions were tbulted for ll relevnt questions. Survey scles were subjected to principl components nlysis with vrimx rottion, item nlysis, nd internl consistency relibility nlysis to determine construct vlidity, internl consistency relibility, nd ppropriteness of ech item. Correltion nlysis (Person s correltion coefficient) ws used to determine reltionships between two or more continuous vribles. The liner numeric scles of stress nd job stisfction were summed, nd the sums were used s dependent vribles in onewy nlyses of vrince (ANOVAs) nd F tests or with independent smple t tests, with prctice setting nd demogrphic chrcteristics serving s independent vribles. Reltionships between level of involvement in ctivities with geogrphic loction nd rurlity nd between method of trining nd qulity of work life vribles were ssessed using similr onewy ANOVAs. Results Respondent chrcteristics. A totl of 702 CPhTs completed the survey. Of those, 516 (73.5%) were currently employed s technicin, 73 (10.4%) were employed in nother phrmcy- or helth-relted field, 8 (1.1%) were retired, 39 (5.6%) were unemployed nd looking for work, nd 20 (2.8%) were unemployed nd not seeking work. The results detiled further in this report re from responses tllied from the respondents working currently s phrmcy technicin (full- or prt-time) nd not enrolled in doctor of phrmcy degree progrm (n = 516). Respondents demogrphic chrcteristics re shown in Tble 1. Most respondents were femle. The men ± S.D. ge of respondents ws ± yers, their men ± S.D. yers of experience s technicin ws ± 9.76 yers, nd their men ± S.D. number of yers with the current employer ws 7.90 ± 7.89 yers. Responses were gthered from ll prts of the country nd representtive of vrious prctice settings. For the purposes of further nlysis, respondents from lrge nd smll chin, mss merchndiser, independent community, nd supermrket settings were chrcterized s respondents from the community setting; respondents from hospitl nd helth-system inptient nd outptient settings were chrcterized s respondents from the hospitl setting. Respondents from the community nd hospitl settings plus ll other respondents represented the totl number of respondents. Tble 2 provides dt regrding community phrmcy technicins level of involvement in vrious job ctivities nd the importnce they plce on those ctivities nd their perceptions of the degree of importnce their employers plce on those ctivities. Levels of involvement were rther similr cross ctivities, mostly quite high. Respondents were lest involved in verifying the work of other technicins nd mintining utomted technology. Respondents rted collecting nd communicting ptient informtion, filling prescriptions, nd ssessing prescriptions s their most importnt ctivities, though they indicted tht their employer s perceived these ctivities s lower in importnce. The biggest differences in those perceptions were for collecting ptient informtion, filling prescription, nd communicting with insurnce compnies. Dt regrding hospitl phrmcy technicins level of involvement in vrious job ctivities re shown in Tble 3. Respondents reported being highly involved in mintining floor stock nd dispensing cbinets, unit inspections, nd repckging ctivities, with less involvement in dispensing medictions with remote video supervision, ssisting with mediction ssistnce progrms, nd criterion-bsed screening of medicl records. The lrgest gps between selfscribed importnce nd perceived importnce by the employer were relted to compounding nonsterile products (excluding chemotherpy), repckging ctivities, supervising other technicins, nd replenishing unit dose crts. AM J HEALTH-SYST PHARM VOLUME e297

4 Tble 1. Chrcteristics of Respondents Chrcteristic Respondents from home helthcre, long-term cre, nd phrmcy benefits mngement compnies selfreported ctivities in which they were involved. The most frequently cited ctivities were compounding, inventory mngement, ptient sfety inititives, customer nd ptient service, mediction reconcilition, nd benefits nd pln reviews. Impetus for becoming phrmcy technicin. Tble 4 provides informtion on the resons reported by survey respondents for choosing to become phrmcy technicin. Generl interest in helth creer nd the desire to help people were the resons most commonly cited. It should be noted tht recommendtions, support, nd recruitment by others plyed prominent role, with nerly 40% of respondents citing recommendtion of friend, recruit- No. (%) Respondents Femle (n = 507) 433 (85.4) Employment b (n = 670) Full-time technicin 412 (61.5) Prt-time technicin ( 20 hr/wk) 67 (10.0) Prt-time technicin (<20 hr/wk) 37 (5.5) Employed but not s technicin 84 (12.5) Unemployed nd seeking work 39 (5.8) Unemployed nd not seeking work 20 (3.0) Retired 8 (1.2) Actively enrolled Phrm.D. student 3 (0.4) Geogrphic loction (n = 511) West 121 (23.7) South 181 (35.4) Northest 59 (11.5) Midwest 150 (29.4) Rurlity (n = 511) Rurl 61 (11.9) Smll city 133 (26.0) Suburb of lrger city 150 (29.4) Medium-sized or lrge city urbn core 167 (32.7) Clculted only from those currently working s technicin nd nswering the survey question. b Percentges clculted from vlid responses nlyzed. ment by phrmcist, or both s their reson for pursuing their creer s phrmcy technicin. Approximtely 1 in 6 respondents indicted tht they were ttrcted by slry or fulfilling creer. Technicin trining nd eduction. Over 75% of the respondents indicted tht on-the-job trining (OJT) ws included in their trining, nd n even higher percentge of technicins from community phrmcy reported the sme. While over 25% of respondents completed n ccredited progrm through their employer or voctionl school, pproximtely 1 out of 6 respondents completed progrm of which they were unsure of its ccredittion sttus. Tble 5 provides respondents rtings of the helpfulness of vrious eduction nd trining modlities in prepring them for their current work responsibilities. Forml OJT with the current employer ws rted most highly, followed by previous technicin work experience nd guidnce nd mentorship from supervisors nd peer technicins. PTCB certifiction ws rted higher thn voctionl trining, but both were rted rther highly. Community CPhTs reported higher levels of helpfulness for most trining methods thn did hospitl CPhTs. Qulity of work life: Stisfction, stress, nd commitment. The principl components nd item nlyses of the summted scles of job stisfction nd stress demonstrted solid construct vlidity nd internl consistency relibility, with Cronbch s lphs of 0.88 nd 0.79, respectively. The men ± S.D. score on the 10-item, ggregted work stisfction scle, with possible rnge of 10 60, ws ± The men ± S.D. score on the 9-item, ggregted stress scle, with possible rnge of scores from 9 to 45, ws ± Tble 6 provides respondents levels of stisfction with vrious spects of their job, broken down by prctice setting. CPhTs reported the highest levels of stisfction with their phrmcist coworkers, work schedule, nd opportunity to use their knowledge. They reported being lest stisfied with their level of stress, opportunity for dvncement, nd py. Nerly 30% of respondents were highly disstisfied ( response of 1 or 2 on the 6-point scle) with the opportunity for dvncement, level of stress, nd py. CPhTs reported tht their highest levels of stress were relted to being short-stffed, their volume of work, nd other employees not doing their fir shre of work (Tble 7). Community CPhTs reported high levels of stress relted to ptients who re rude or imptient nd from lck of rest breks. Hospitl CPhTs reported being highly stressed due to poorly designed workflow nd disgreements with peers. CPhTs commitment ws evluted in severl wys, including the e298 AM J HEALTH-SYST PHARM VOLUME

5 Tble 2. Level of Involvement, Importnce, nd Perceived Importnce of Technicin Activities in Community Phrmcies Activity Involvement Men ± S.D. Score Importnce b Perceived Importnce to Employers b Receive prescriptions 2.85 ± ± ± 0.63 Collect or communicte ptient informtion 2.87 ± ± ± 0.61 Assess prescription for completeness, ccurcy, uthenticity, leglity, or reimbursement eligibility 2.80 ± ± ± 0.51 Input prescription 2.84 ± ± ± 0.65 Provide prescription to ptient or cregiver 2.66 ± ± ± 0.83 Direct ptient to phrmcist for counseling 2.72 ± ± ± 0.67 Identilty medictions nd supplies to be ordered or mnge inventory 2.70 ± ± ± 0.74 Use nd mintin utomted technology 2.59 ± ± ± 0.93 Communicte with insurnce compnies to determine coverge for prescriptions nd services 2.72 ± ± ± 0.80 Fill/lbel prescription 2.89 ± ± ± 0.66 Verify the work of other technicins 2.26 ± ± ± 0.96 Mesured on 3-point scle where 1 = not t ll involved nd 3 = involved very frequently. b Mesured on 4-point scle where 1 = very little to no importnce nd 4 = very importnt. durtion they expected to remin with the current employer. More thn hlf of respondents indicted plns to remin with their employer for t lest 5 yers; in fct, 140 (33.7%) of 415 respondents plnned to sty t lest 10 yers. Still, 1 in 5 respondents reported either looking to leve or plnning to keep options open. The mode response to seprte question indicted tht mny respondents were susceptible to shocks, such s being lured wy to n lterntive creer. 41 Mny respondents who did intend to remin or might hve been contemplting creer chnge indicted tht they would like to remin in helthcre field, nd fewer thn 10% indicted considering leving for nonhelthcre-relted field. Overll, stisfction ws highly correlted with commitment to the employer (r = 0.53, p < 0.01) nd commitment to the profession (r = 0.29, p < 0.01). Stress levels were inversely correlted with employer commitment (r = 0.20, p < 0.01) nd profession commitment (r = 0.13, p < 0.05), which reinforces the ide tht while stress (or lck thereof) my influence stisfction nd commitment, stress is its own unique construct. Respondent ge ws correlted with profession commitment (r = 0.11, p < 0.05) but not with commitment to the employer. Yers with the current employer ws relted to commitment to the employer (r = 0.28, p < 0.01) nd commitment to the profession (r = 0.17, p < 0.01). Tble 8 provides mtrix of correltions mong stisfction, commitment, work stress, nd perceived usefulness of vrious eduction nd trining modlities. Stisfction ws highly correlted with employer commitment nd inversely correlted with stress. Stisfction ws highly correlted with profession commitment. Stress levels were inversely correlted with stisfction but lso with commitments to the employer nd profession. Work stress ws not ssocited with perceived usefulness of trining. There ws strong reltionship between employer nd profession commitments. Perceived usefulness of OJT, supervisor mentoring, nd peer mentoring were relted to work life mesures (i.e., if technicin perceived usefulness of ny of these trining methods, then he or she ws more likely be stisfied, more committed, nd less stressed on the job). Perceived usefulness of PTCB certifiction ws ssocited with higher levels of profession commitment, stisfction, nd commitment to the employer but not with job stress. Qulity of work life nd entry into the profession. Profession commitment ws higher mong those who cme into the profession becuse they were recruited by phrmcist (t = 3.12, p < 0.01) or due to the desire to seek fulfilling creer (t = 2.97, p < 0.01). Technicins who reported hving completed n ccredited stndlone trining progrm from voctionl school reported higher levels of stress thn did other respondents (t = 2.15, p < 0.01), yet there were no other sttisticlly significnt reltionships between method of trining nd qulity of work life. Additionl nlyses by prctice setting, geogrphic region, nd ru- AM J HEALTH-SYST PHARM VOLUME e299

6 Tble 3. Level of Involvement, Importnce, nd Perceived Importnce of Job Activities of Phrmcy Technicins in Helth Systems Activity Involvement Men ± S.D. Score Importnce b Perceived Importnce to Employers b Replenish unit dose crts 2.34 ± ± ± 0.98 Restock floor stock nd/or utomted dispensing cbinets 2.80 ± ± ± 0.88 Compound sterile preprtions (excluding chemotherpy) 2.57 ± ± ± 0.94 Compound chemotherpy preprtions 1.62 ± ± ± 1.06 Order-entry ctivities 1.71 ± ± ± 1.21 Purchsing/inventory mngement 1.98 ± ± ± 0.97 Informtion technology system mngement 1.73 ± ± ± 1.11 Controlled substnce system mngement 2.12 ± ± ± 0.95 Supervision of other technicins 1.96 ± ± ± 1.08 Checking dispensing of other technicins 1.78 ± ± ± 1.24 Billing 1.71 ± ± ± 1.20 Criteri-bsed screening of medicl records to identify mediction-relted problems 1.49 ± ± ± 1.20 Preprtion of clinicl monitoring informtion for phrmcist review 1.39 ± ± ± 1.18 Dispensing meds with remote video supervision 1.20 ± ± ± 1.24 Mediction ssistnce progrm mngement 1.28 ± ± ± 1.22 Initition of mediction reconcilition 1.43 ± ± ± 1.17 Qulity ssurnce ctivities/unit inspections 2.48 ± ± ± 0.93 Pckging/repckging ctivities 2.43 ± ± ± 1.00 Fcilitting trnsitions of cre 1.61 ± ± ± 1.18 Mesured on 3-point scle where 1 = not t ll involved nd 3 = involved very frequently. b Mesured on 4-point scle where 1 = very little to no importnce nd 4 = very importnt. rlity. For CPhTs in community phrmcy, those who were more involved in ptient counseling lso reported being more stressed (r = 0.17, p < 0.01). Also, those involved in the use of technology reported higher profession commitment (r = 0.14, p < 0.01). With respect to CPhTs in hospitls, higher stress levels were reported by those technicins more involved in compounding chemotherpeutic gents (r = 0.22, p < 0.01) nd in criteribsed screening of mediction records (r = 0.28, p < 0.01). Technicins more involved in purchsing ctivities reported lower stress levels (r = 0.21). Technicins who reported greter involvement in floor stock mintennce (r = 0.25, p < 0.01), inventory mngement (r = 0.25, p < 0.01), controlled substnce mngement (r = 0.21, p < 0.05), billing ctivities (r = 0.19, p < 0.01), nd repckging ctivities (r = 0.22, p < 0.01) reported higher levels of commitment to the profession. There were severl ssocitions between geogrphic region nd the likelihood of involvement in vrious ctivities, such s helping with mediction ssistnce progrms, supervising other technicins, nd ssisting with controlled substnce system mngement. There were no ssocitions between rurlity (size of city in which they worked) nd ny of the other vribles. Discussion This study exmined, mong other things, CPhTs involvement in vrious ctivities nd the reltionship between tht involvement with qulity of work life components. While this study did not undertke forml tsk nlysis, it provided n updte on comprehensive nlysis undertken by PTCB nerly 2 decdes go. 26 While there re plentiful ccounts of technicins tking on new roles in single orgniztions, the current study found tht wholesle chnge in technicins responsibilities since PTCB s tsk nlysis hs not been very rpid. Both community nd hospitl technicins reported high levels of importnce for e300 AM J HEALTH-SYST PHARM VOLUME

7 Tble 4. Resons Cited by Respondents for Becoming Phrmcy Technicin Reson Community (n = 286) No. (%) Respondents Hospitl (n = 144) Totl b (n = 516) Generl interest in phrmcy or helthcre creer 188 (65.7) 97 (67.4) 333 (64.5) Recommendtion of friend, collegue, or fmily member 71 (24.8) 35 (24.3) 127 (24.6) Recruitment or encourgement by phrmcist 49 (17.1) 21 (14.6) 77 (14.9) Work schedule/flexibility 40 (14.0) 15 (10.4) 63 (12.2) Slry 41 (14.3) 19 (13.2) 83 (16.1) Benefits 19 (6.6) 22 (15.3) 51 (9.9) Fulfilling creer 41 (14.3) 20 (13.9) 75 (14.6) Exposure by working t different job in phrmcy orgniztion 39 (13.6) 25 (17.4) 76 (14.8) Work t previous employer, technicin-relted 17 (5.9) 9 (6.3) 35 (6.8) An opportunity to serve the public 45 (15.7) 19 (13.2) 72 (14.0) A desire to help people 121 (42.3) 46 (31.9) 196 (38.0) Respondents were llowed to select up to 3 choices. b Community, hospitl, nd ll other respondents. Tble 5. Helpfulness of Eduction nd Trining Modlity in Prepring Respondents for Their Current Work Responsibilities Trining/Eduction Modlity Men ± S.D. Score Community Hospitl Totl Forml trining or eduction progrm t college or voctionl school 3.30 ± ± ± 1.03 PTCB or similr certifiction 3.36 ± ± ± 0.85 Work t previous employer, technicin-relted 3.55 ± ± ± 0.09 Work t previous employer, not s technicin 2.48 ± ± ± 1.14 Forml OJT from employer 3.55 ± ± ± 0.78 Guidnce nd mentorship from supervisor(s) 3.52 ± ± ± 0.85 Guidnce nd mentorship from peer technicins 3.49 ± ± ± 0.84 Responses bsed on 4-point scle where 1 = not helpful t ll nd 4 = very helpful. The results lso ccount for not pplicble option on the scle, which did not figure into the men clcultion. PTCB = Phrmcy Technicin Certifiction Bord, OJT = on-the-job trining. nerly ll ctivities exmined in this study. Coupled with the finding tht certin ctivities were ssocited with higher commitment levels, employers should note tht technicins might be menble to tking on greter responsibility. Employing orgniztions might tke note of other results in this study relted to CPhTs qulity of work life. While job stisfction ws reltively high overll, it ws lower in regrd to stress environment nd perceived fir tretment from mngement. This corrobortes previous reserch findings tht technicins hve micble reltionships with most of their peers nd with their supervising phrmcists but believe tht employers sometimes view them s replceble. 37 CPhTs indicted high levels of stress due to being short-stffed, other employees not doing their fir shre, nd the totl volume of work. CPhTs might hold employers more ccountble for these things s opposed to their supervisors nd peers. Some of the differences in reported stress levels cross job settings cn be nticipted. For exmple, disgreements with peers might occur more frequently in hospitls thn in community settings due to the number of peers with whom technicins interct in the hospitl. CPhTs in the community setting re more likely to come AM J HEALTH-SYST PHARM VOLUME e301

8 Tble 6. Respondents Levels of Stisfction With Vrious Aspects of Their Job Men ± S.D. Score Job Aspect Community Hospitl Totl Work schedule 4.60 ± ± ± 1.26 Phrmcist coworkers 4.84 ± ± ± 1.91 Phrmcist technicin coworkers 4.62 ± ± ± 1.20 Worklod 4.17 ± ± ± 1.37 Py 3.40 ± ± ± 1.48 Opportunity to use your knowledge 4.79 ± ± ± 1.23 Opportunity for dvncement 3.54 ± ± ± 1.54 Employee benefits 3.86 ± ± ± 1.49 Level of stress 3.30 ± ± ± 1.49 Fir tretment from mngement 4.10 ± ± ± 1.48 Responses bsed on 6-point scle where 1 = very disstisfied nd 6 = very stisfied. Tble 7. Amount of Stress Reported by Respondents, by Stress Source Source Men ± S.D. Score Community Hospitl Totl The mount or volume of work 3.40 ± ± ± 1.02 Being short-stffed 3.73 ± ± ± 1.09 Other employees not doing their fir shre of work 3.36 ± ± ± 1.18 Disgreements with technicin peers t my job 2.24 ± ± ± 1.15 Ptients/customers/fmilies who re rude or imptient 3.05 ± ± ± 1.20 Deling with stff from other helthcre providers 2.32 ± ± ± 0.95 Indequte technology, hrdwre, or other resources 2.59 ± ± ± 1.22 Poorly designed workflow nd division of lbor 2.59 ± ± ± 1.22 Lck of rest breks, or time to tke scheduled rest breks 2.70 ± ± ± 1.29 Responses bsed on 5-point scle where 1 = little or no stress nd 5 = tremendous mount of stress. into direct contct with ptients nd their cregivers, so it is only nturl tht interctions with them re greter source of stress, even though these interctions lso contribute to job stisfction. Employers might wnt to exmine policies nd procedures ssocited with undue stress nd invest in processes tht leverge technicins positive interctions with ptients. This study likely represented the most comprehensive evlution of CPhTs commitment to their employer nd the phrmcy profession. Approximtely hlf of respondents reported tht they intended to remin with their current employer for t lest 5 10 yers. Nerly 2 in 5 respondents indicted possibility of leving should something unexpected hppen, but nerly the sme number expressed hope to mke their job long creer. As such, respondents expressed desire for stbility but might be quite susceptible to forementioned shocks due to disstisfction with stress nd levels of py. 41 The findings from this study re not dissimilr from similr surveys of nursing ssistnts, who, like phrmcy technicins, re mking strides towrd professionliztion but hve less time nd money invested into their creers nd lso re pid less thn most other helthcre professionls. 42 In this study, lrge proportion of CPhTs climed tht they were mndted to become certified, more by employers thn by stte governments. In ddition, pproximtely one third of respondents indicted tht they hd completed voctionl trining progrm, with mny of those progrms e302 AM J HEALTH-SYST PHARM VOLUME

9 Tble 8. Correltion Mtrix of Perceived Usefulness of Eduction nd Trining, Commitment, Stisfction, nd Stress Usefulness of Voctionl Trining Usefulness of PTCB Certifiction Usefulness of Previous Technicin Work Usefulness of Previous Nontechnicin Work Usefulness of OJT Usefulness of Supervisor Mentoring Usefulness of Peer Technicin Mentoring Commitment to the Employer Commitment to the Profession Totl Stisfction With Job Totl Stress From Job Vrible Usefulness of voctionl trining b b b b b b Usefulness of PTCB certifiction b b b b b b c b b Usefulness of previous technicin work b b b b b b Usefulness of previous nontechnicin work b b b b b b Usefulness of OJT b b b b b b b b c Usefulness of supervisor mentoring b b b b b b b b Usefulness of peer mentoring b b b b b b b Commitment to employer c b b b b Commitment to profession b b b b Totl stisfction with job b b c c b b b b b b Totl stress from job c b b... PTCB = Phrmcy Technicin Certifiction Bord, OJT = on-the-job trining. b p < c p < AM J HEALTH-SYST PHARM VOLUME e303

10 being ccredited by ASHP. However, some respondents completed n unccredited progrm or were not wre if their progrm ws ccredited, which is cuse for concern. Eductionl institutions should tke the opportunity to inform the technicins nd other stkeholders on the importnce of ccredittion. To our knowledge, this is the first study to exmine CPhT eduction nd trining longside work life issues, which could be importnt in promoting greter commitment, less burnout, more stbility, nd incresed ttrctiveness of technicin work s creer. It lso could point out issues to be djudicted in eduction nd trining design. While respondents scribed reltively high vlue to nerly ll types of eduction nd trining, it is not surprising tht they would scribe the highest vlue to OJT. This reinforces the need for employers to tke n ctive role in creting n environment for self-evlution, skill ssessment, nd ptient centeredness. The fct tht perceived vlue of eduction nd trining ws ssocited with qulity of work life requires further exmintion. The finding tht technicins experience high levels of stress from deling with ptients nd sometimes peers might prompt voctionl institutions nd PTCB to dd elements to eduction nd trining tht provide more exposure to time mngement, ptient communiction, conflict resolution, nd other so-clled soft skills. 43 This study is lso the first to exmine technicins primry resons for entering the profession. Nerly two thirds of respondents indicted preference for creer in helthcre field. Mny lso expressed desire to help people nd to serve the public nd lso indicted being recruited by friend, collegue, or phrmcist. Moreover, CPhTs who were recruited by phrmcist or otherwise entered the profession to seek fulfilling creer reported higher levels of commitment to the profession. These findings suggest tht technicins my be effective in recruiting future technicins nd tht phrmcists should be involved in the recruitment process. The geogrphic regionl differences found mong CPhTs in this study wrrnt further investigtion. In the hospitl setting, greter number of CPhTs from the West were involved in ctivities relted to the mngement of systems; it might not be coincidentl tht those respondents lso reported higher levels of profession commitment. The results of this study should be considered within the context of vrious strengths nd limittions. The low response rte limits generlizbility of the results to the entire CPhT popultion. The survey ws dministered only to technicins certified through PTCB. Some sttes (nd employers) do not require certifiction; s such, work ttitudes from technicins who voluntrily become certified my differ from those who were mndted to cquire certifiction or those not certified t ll. The use of e-mil versus postl or hybrid mechnisms of survey delivery hs been ssocited with lower response rtes nd could lso introduce bis. 44 It is lso possible tht responses cme more redily from those feeling either very fvorble or very unfvorble towrd their jobs. However, the use of rndomized smpling procedure cross n entire ntion of CPhTs provided foundtion of representtiveness in the survey responses. The proportions of respondents cross prctice setting, sex, ge, nd geogrphic loction were commensurte with expecttions. Responses to the qulity of work life questions ligned with expecttions, nd psychometric evlution of responses demonstrted very good internl consistency relibility. Even so, their being crfted specificlly for the study versus using commonly reported instruments mkes comprisons cross different studies more difficult. While vrious mechnisms were used to scertin commitment ttitudes, these ttitudes do not necessrily trnslte directly into ctul turnover behvior. The list of potentil resons for entering the profession ws not necessrily n exhustive one. This study further explored CPhTs work life situtions nd updted previous tsk nlyses. It lso ws the first to link work ttitudes with CPhTs level of involvement in vrious work ctivities. There re number of findings on which phrmcy leders, eductors, nd employers cn tke ction to strengthen the phrmcy technicin work force nd leverge their involvement to enhnce opertions nd to better prepre phrmcy support personnel to enhnce ptient cre. Conclusion The results of the survey indicted tht job stisfction nd commitment were moderte nd tht stress levels were somewht high mong CPhTs. There were number of differences in work life ttitudes cross prctice settings nd by involvement in vrious job ctivities. Acknowledgments The uthors thnk the phrmcy technicins who prticipted in the pilot survey nd those who responded to the survey. Disclosures Funding for this study ws received from the Phrmcy Workforce Center, Americn Society of Helth-System Phrmcists, nd Phrmcy Technicin Certifiction Bord. The uthors hve declred no potentil conflicts of interest. References 1. Berger BA, Grimley D. Phrmcists rediness for rendering phrmceuticl cre. J Am Phrm Assoc. 1997; 37: Jmbulingm T, Doucette WR. Phrmcy entrepreneuril orienttion: ntecedents nd its effect on the provision of innovtive phrmcy services. J Soc Adm Phrm. 1999; 16: Holidy-Goodmn M. Entrepreneurship, resource mngement, orgniztionl culture, nd other business fctors influencing phrmcy prctice chnge. Res Socil Adm Phrm. 2012; 8: Clrk BE, Mount JK. Phrmcy service orienttion: mesure of orgniztionl culture in phrmcy e304 AM J HEALTH-SYST PHARM VOLUME

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