Shaping practice behaviour: novel training methodology

Context — Some studies that have used “pseudo‐patron” methods have provided the basis for criticism of pharmacists' performance and have stigmatised these methods in pharmacy research. Objective — To test and refine the use of pseudo‐patron methodology, with feedback to practitioners, as a means of implementing behaviour change. Method — In the studies reported in this paper practice behaviour was shaped by conducting a workshop and then providing ongoing training in the form of feedback and coaching immediately after a pseudo‐patron visit. The involvement of pseudo‐patrons was negotiated with pharmacists and their staff and embedded within their professional development. Results — An initial study showed that, compared with controls, pseudo‐patron trained pharmacists were significantly more likely to identify off‐label (not in accordance with label specifications) analgesic use ( P <0.01) and were more likely to discuss the use of alternatives ( P <0.02). The methodology was refined and in a subsequent study pharmacists were even more likely to identify misuse ( P <0.001), assess readiness to change ( P <0.001) and deliver an appropriate intervention ( P <0.001). Conclusions — The results of the studies presented in this paper demonstrate that the inclusion of pseudo‐patron visits in pharmacist training is feasible and that a combination of workshops and performance feedback, including positive and corrective elements, can produce substantial protocol adherence in the natural setting. The use of pseudo‐patron methods as part of a training programme is effective in shaping behaviour of pharmacists and pharmacy assistants.