Perceived importance of emotional intelligence for clinical pharmacy practice and directions for its improvement: a focus group study

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Providing pharmacists’ perceptions may support the integration of EI development approaches into their professional development continuum. Objective This research aimed to analyse pharmacists’ perceptions of the characteristics of emotionally intelligent clinical pharmacists, the importance of EI in clinical practice, and educational models and approaches to enhancing EI. Method A qualitative study with a focus group methodology was conducted with pharmacy practitioners using a semistructured guide grounded in the EI competency framework and existing qualitative research methodology practices. Purposive sampling was conducted until information and meaning saturation had occurred. The focus group recordings were transcribed and independently coded by two researchers. Pharmacists' attitudes were categorized and examined through descriptive statistics. The conventional content analysis of qualitative data was applied. Results According to the 17 focus group participants, emotionally intelligent clinical pharmacists are perceived as self-confident communicators who control and manage emotions, work well under pressure, and handle every situation effectively. Emotional self-control, self-awareness and awareness of others, and demonstration of tolerance, understanding, and empathy have emerged as key EI competencies required for challenges in clinical practice. EI lectures with clinical application reflections, behavior modelling, and behavior-changing methods were perceived to be of particular importance for pharmacist education and development programs. Conclusions Clinical pharmacists and other practitioners perceived EI competencies as necessary for their professional success and high-quality patient-centered care. They suggested that they be a focal point in pharmacy professional development programs. Figures Figure 1 Figure 2 Impact statements • Emotional intelligence may positively impact pharmacists' well-being and improve patient-centered care and related outcomes. • Limited evidence exists on the importance of emotional intelligence for clinical pharmacy practice and its role in developing successful coping strategies in challenging situations. • The findings of this research could serve all relevant stakeholders in pharmacy education and professional development to expedite changes in teaching and learning methodologies to better suit pharmacists’ EI development and ultimately lead to better provision of patient-centered care. Introduction Emotional intelligence (EI) has been identified as a critical concept in shaping a pharmacist’s professional identity by contributing to pharmacy education, patient-centered care, and leadership [ 1 ]. The definition of clinical pharmacy (CP) practice highlights the pharmacist’s responsibility “to attain person-centered goals for individual patients within a multidisciplinary team” [ 2 ]. This encompasses a range of pharmacist cognitive, managerial, and interpersonal activities in various settings, all of which are strongly influenced by EI [ 2 ]. Numerous studies on preregistered pharmacy students have suggested that EI-related content should be included in pharmacy curricula [ 3 – 6 ]. The International Pharmaceutical Federation, in cluster four of its Global Competency Framework (GbCF) for the development of early career pharmacists, explicitly outlined the EI behaviors required to be demonstrated within the specified competencies [ 7 ]. Incorporating EI-related content into continuing pharmaceutical development (CPD) programs may enhance CP practice competencies and pharmacists' stress-handling abilities [ 1 , 8 – 10 ]. However, some authors have questioned the lasting impact of EI development programs and how they translate into clinical practice, thus potentially improving patient-related outcomes (PROs) [ 6 ]. Encouragingly, research in other medical professions seems to have addressed this concern, revealing positive outcomes in longitudinal studies with physicians and nurses engaged in ongoing EI development programs, leading to improved PROs [ 11 – 13 ]. Further investigations are warranted to confirm the applicability of these findings to CP practitioners (CPPs) [ 6 , 14 ]. The integration of EI-related curricular and extracurricular content and activities at universities and within CPD appears to be correlated with the inter- and intraprofessional relationships, leadership skills, and interpersonal relationships of CPPs with patients and their families. This advancement in clinical practice can potentially enhance patient outcomes [ 8 , 15 – 17 ]. In our research on local pharmacy study practices across all levels of CPD, it became evident that the lack of EI-related and EI-development-stimulating content and methods contributed to a lack of difference in EI levels among pharmacists delivering and not delivering a new service to a vulnerable group of patients with diabetes [ 10 ]. We observed no difference in EI levels between pre- and postspecialization graduates [ 18 ]. Qualitative research on clinical pharmacists' perceptions of the role of EI in practice does not exist. To address this gap, a focus group study was conducted. Aim The study had three primary objectives: (1) to define the characteristics of emotionally intelligent clinical pharmacists, (2) to understand pharmacists' perceptions of the importance of EI and relevant subdomains for clinical practice, and (3) to generate ideas and solicit suggestions regarding models and approaches for enhancing EI among clinical pharmacists. Ethics approval The ethics committee of the Pharmaceutical Chamber of Serbia approved the study protocol (No. 316/6-4-2, dated December 28th, 2022). Method Study type, design, and tools This qualitative study used a focus group methodology in March 2023. The study followed the COREQ and SRQR guidelines [ 19 , 20 ]. A focus group semistructured guide with questions and prompts was developed and pretested with three study-independent pharmacists and experts. The guide was constructed based on the existing EI research and concepts and was grounded in qualitative research theory and practice [ 10 , 18 , 21 – 25 ]. Several suggestions for adaptation emerged during the pretest. The final version, containing 14 questions (Supplementary File 1), was consolidated in a consensus meeting involving the research team and two independent experts, one of whom was a trained psychologist. An interactive two-hour session was conducted for all study participants, focusing on the concept of EI, including its models, competencies, instruments, research results, and the study's objectives. The Genos EI instrument, validated and pretested for the Serbian pharmacist population, was introduced to the participants [ 10 ]. The Genos instrument comprises subdomains related to emotional self-awareness (ESA), emotional awareness of others (EAO), emotional expression (EE), emotional reasoning (ER), emotional self-control (ESC), emotional self-management (ESM), and emotional management of others (EMO) [ 23 , 26 ]. Sampling strategy Purposive sampling was utilized to include participants with diverse experience and practice areas. This study specifically targeted CPP postgraduates specializing in the Faculty of Pharmacy, University of Belgrade (Serbia). Inclusion criteria and enrolment The participants expressed their interest in participating in the study electronically. The inclusion criteria were participation in all study steps, signing the informed consent form, and completing the demographic questionnaire. Data collection The research team led focus group sessions of one-and-a-half hours, following a semistructured guide. All sessions were audio-recorded. Details about the recording and data anonymity were explicitly outlined in the Informed Consent. Essential insights were summarized, and participants’ final feedback was requested, along with encouragement to contact either the DS or VM for additional input. Observers and note-takers documented the focus group structure and flow, nonverbal cues, and other observations, including participants’ group behaviors. Research team and setting Four researchers composed the research team: two moderators, two observers, and note-takers. The researchers had experience in qualitative research and were trained to conduct focus group studies. Only the research team members and study participants were in the rooms where the focus group discussions were held. Reflexivity and rigor VM has had previous contact with the participating CPPs. To avoid potential feelings of unease and reluctance to speak up openly and express their opinions, it was decided that the focus groups with CPPs should be moderated by DS, who had no prior knowledge of the participants and their experiences. Coding DS conducted verbatim transcriptions of the audio recordings. The transcripts were verified by comparison with the original recordings and corrected by VM wherever needed. Final reconciliation was performed after a check by a study-independent expert. Coding was independently performed by two experts using two different instruments, MaxQDA software and an Excel sheet. A codebook was built to ensure consistent methodology and test for code saturation [ 27 ]. MaxQDA software was also used in the code frequency analysis. To enhance coding reliability, independently coded documents were compared, and evaluators reached greater than 80% agreement through consensus, as suggested by other qualitative researchers [ 28 ]. Saturation was defined as the point when no new information could be gathered about the central themes or as “meaning saturation” when no new meanings of issues determined by the codes could be found [ 27 ]. Analyses All participants were coded as S1 to S17, and the participants’ demographic data were analysed using descriptive statistics. As the qualitative research literature suggested, inductive thematic analysis was applied to the focus group data [ 29 , 30 ]. Categories for the themes and subthemes were deductively constructed from the semistructured guide questions. The notes compiled during the study were also analysed to extract additional data and to discern potential sources of bias by reflecting on the behaviours of both moderators and participants. Results The focus groups A total of 17 participants out of the 20 invited participants took part in the study. No new ideas or additional meanings to the issues were introduced after the second focus group session. Hence, the research team agreed at a consensus meeting that information saturation had occurred, including meaning saturation. Given the structure of the invitees, it was decided to stratify them into groups containing those in the CP roles (n = 8/10, all working in community pharmacies) and other specializing pharmacists (n = 9/10), who were asked to put themselves “in the shoes” of a clinical pharmacist and give their own perspectives. The age range in the total study population was 24–50, and the CP experience ranged from just below 1 to 18 years, with an overall group’s experience of 7.3 ± 6.5 years. Female participants made up the majority in both groups. The demographic characteristics of the study participants are presented in Table 1 . Table 1 Demographic characteristics of the study participants Characteristic Number Frequency (%) Gender Male 4 24 Female 13 76 Age (years) 20–24 2 12 25–29 6 35 30–34 2 12 35–40 5 29 > 40 2 12 CP Experience (years) <1 1 6 1–5 2 12 6–10 3 18 11–15 1 6 16–20 1 6 CP Experience (years) - Mean (SD) 8.1 (5.5) Abbreviations used: CP – clinical pharmacy, SD – standard deviation. Insert Table 1 here. Coding A total of 50 codes were assigned to the transcripts across the nine categories, which were deductively derived from the focus group guide. The top 10 codes had a frequency above 50% (Table 2 ). Table 2 Top 10 codes ranked in descending frequency order Code Effective Communication Emotional Awareness of Others Emotional Self-Awareness Emotional Self-Control Trust Respect Patient-centricity and focus Emotional Self-Management Work under pressure and effective stress management Self-confidence and knowledge Insert Table 2 here. Coding reliability testing Greater than 80% agreement was reached for codes in 7 out of 9 categories, while the code assignments in the two remaining categories were settled at the consensus meeting. Thematic analysis Given the specifics of the EI topic, numerous code repetitions emerged across categories. Therefore, inductive thematic analysis was employed in three steps: (1) identifying the characteristics of emotionally intelligent clinical pharmacists, (2) identifying issues and challenges in everyday CP practice (as themes) and defining EI strategies to address these challenges (as subthemes), and (3) identifying EI development strategies in the education and professional development of clinical pharmacists. Definition of an emotionally intelligent clinical pharmacist Participants recognized, fully reflected, and related the desired EI behaviors to their everyday practice. They identified several key characteristics of emotionally intelligent CPPs (Fig. 1 ). The codes representing characteristics in the first step in the latter analysis emerged into more developed themes, issues and challenges, and respective EI strategies (Table 3 ). Table 3 Themes and subthemes by category Category Issue/Challenge (Theme) Emotionally Intelligent Strategy (Subtheme) EI importance for CP practice managing stressful situations (drug addicts, aggressive, dissatisfied patients) emotional self-awareness (ESA) communication in challenging situations (taboos, e.g., emergency birth control) emotional awareness of others (EAO) - understanding needs staying patient-focussed with person-centered approach demonstrating empathy understanding patient needs/vulnerable groups self-control and management of our own emotions (not to get provoked and stay calm/composed) interprofessional relationships EAO, emotional expression (EE) EI and professional error avoidance work under pressure and stress management building resilience through ESA and emotional self-management (ESM) building and maintaining focus ESA and intention-to-be-focussed practices effective communication (poor communication as an error) demonstrating tolerance, understanding, and empathy building trust EAO, emotional management of others (EMO) and EE seeking solutions/fast decision-making ESA and emotional reasoning (ER) EI and prevention of inadequate behaviors towards pharmacists (secondary victims) building trust effective, competent, patient-centered, assertive communication built on ESA, EAO, EMO, and EE effectively building the capacity to adapt to different people creating a positive work environment ESA, EAO, EE, demonstrating empathy, fostering team and self-development, being tenacious staying composed ESA, EAO, EMO, demonstrating patience in work with people/emotional self-control (ESC) work under pressure and stress management building resilience through ESA, ESC, and ESM EI and good communication within CP teams successful management and leadership clear, precise, positive, and open communication to embrace change building a feedback culture ESA, EAO, EE, ER, ESC, ESM, EMO creating a positive work environment EAO, showing understanding and demonstrating empathy building teamwork and interpersonal relations demonstrating respect, EAO, EE, ESC, ESM, ESA and EMO EI and conflict prevention and resolution recognize the moment and understand the needs EAO respecting diversity person-centered care patient complaints ESC, EAO, EMO the inadequate reaction of the employee leadership support, building team spirit EAO, demonstrating understanding and empathy conflict prevention EAO, ESA, building resilience, ESC building leadership capabilities developing ESA, EAO, EE, ER, ESC, ESM, EMO EI and interprofessional collaboration mutual respect good, open communication step in other's shoes flexibility/openness ESA, EAO Vanity EAO - being aware of how the others feel interprofessional understanding and knowledge - the higher the knowledge, the lower the vanity ESA pharmacist's proactivity in a communication cycle: patient‒physician-pharmacist ESA, EAO building trust ESA, EAO, EE building and maintaining focus ESA and intention-to-be-focussed practices EI and loyalty of users of pharmaceutical services building trust understanding needs demonstrating empathy EAO - showing that you care high-level, patient-centered care EAO EMO - being pleasant, kind, polite, with a positive attitude, making people feel well ESC building and maintaining focus ESA and intention-to-be-focussed practices ER, EE Abbreviations used: EI – emotional intelligence, CP – clinical pharmacy. Insert Fig. 1 here. In the participant's opinion, an emotionally intelligent CPP is a competent and self-confident professional who stays calm in every situation, manages situations well, and remains focused on the patient through person-centered interaction. CPPs are aware of their own emotions and the emotions of others and manage them well through effective communication with patients and colleagues, build trust, and work well under pressure while adequately managing stress. Participants in the second focus group put more emphasis on “balance in communication” (S9) and “emotional self-control” (S14) as prerequisites for effective patient-centered care. Importance of EI for CP practice Participants in both groups acknowledged that effectively communicating and maintaining focus proved particularly challenging with aggressive, dissatisfied patients due to financial constraints, longer time-to-service, or patients with alcohol or drug abuse problems prone to conflicts. In such circumstances, high EI skills are required to help individuals perceive, understand, and manage their emotions and those of others; stay composed and calm; and act with self-confidence. Communication is also challenging for vulnerable patient groups, patients with malignancies, elderly patients, or patients in situations where “taboo” topics are discussed, such as patients requiring emergency birth control. It was emphasized that CPP’s understanding of patient needs, being emotionally aware of others, and demonstrating empathy, as well as “well balancing” the expression of one’s own emotions to create bonds and trust, are essential EI strategies in such instances. “With some oncology or other difficult patients, controlling emotions is so important, so we can protect them and show more empathy. We used to have in our pharmacy a patient support program for oncology patients… Therefore, all kinds of things happened, all kinds of situations and some outpourings of emotions on their part… It affected us personally; emotional balance, control, and empathy were vital…” (S14) Participants stressed the importance of EI for intra- and interprofessional collaboration, which was later discussed in detail under a separate category. EI and professional error avoidance Research has identified numerous EI-related factors contributing to dispensing errors in community pharmacy settings [ 31 ]. The example is working under pressure due to CPP work complexity, which, together with other distracting factors, induces stress and hampers focus. “Sometimes the mistake is not in dispensing the medicine. Sometimes, the mistake is having a wrong attitude towards the patient, a wrong attitude towards a colleague, or wrong communication. … You may not have a chance to correct it. However, how much is it possible to control ourselves, manage our emotions and behavior to be fair to others?” (S2) The groups suggested that the answer might be in further ESA development, which would support building resilience, better ESM, and enhanced tolerance, demonstrating understanding and empathy so the pressure would ease on either side: the CPP, the patient, and the physician. With enhanced ER, decision-making processes improve and create less pressure. Intention-to-be-focused practices may lead to decreased error frequency and overall outcome improvements. “The pharmacist's thoughts of the day should be positive, with a clear intention: ‘Today, I will try to be 200% myself, to devote myself to the patients and to do my job with maximum quality’." (S5) In the event of dispensing errors, participants felt that they could be handled well if support in the organization was in place and if trust had been established with patients and colleagues through practical demonstrations of EAO and EE. EI and prevention of inadequate behaviors towards pharmacists (secondary victims) Participants observed that patients' behaviors depend on the CPP’s behavior. Investing in development to lead effective patient-centered communications might build trust and ultimately prevent inadequate behaviors toward pharmacists. Creating a positive work environment through team EI development may cultivate satisfaction on both ends and alleviate tensions even with the most aggressive patients, such as those with drug addiction problems. Furthermore, such an environment fosters teamwork, self-development, and changes in behaviors, with more empathy, patience, and tenacity being demonstrated. “I think satisfaction is quite important. Satisfaction with the work environment, satisfaction with the job, satisfaction with yourself… with such an attitude, you feel well, happy, satisfied. Then, you pass it on to others, both to the patients and colleagues.” (S8) Participants felt that ESA, EAO, EMO, and EE competencies were essential for further development, together with ESC, which was more frequently emphasized in the second focus group. Insert Table 3 here. EI and communication within CP teams Building further on the importance of a positive work environment, participants stressed the significance of emotionally intelligent leadership, which stimulates transparent, open, and positive communication and supports embracing change and feedback culture developments. “Our communication should be an open type communication to have feedback from colleagues… they should feel and have complete freedom to turn to leaders for anything… should feel support and respect… We cannot change people, but we can help them be better here with us, in our organization.” (S1) To show more understanding, empathy, and respect, participants felt that all EI competencies are equally essential for development. EI and conflict prevention and resolution Effective, emotionally intelligent leadership was recognized to be vitally important in preventing conflicts within CP teams. If disputes occur with patients or interprofessionally, “the leader should stand by his team and provide support… that is where his role is…” (S10). The participants stressed that the building of emotionally intelligent workplaces was equally important. “A colleague started arguing with me in a team meeting... I could have reacted in several ways, but I chose clear and concrete communication, prevented conflict, and primarily thought about the rest of the team.” (S4) Participants felt that recognizing the moment and understanding needs are critical in conflict prevention and found enhanced EAO and respecting diversity to be EI strategies to foster those needs. EI and interprofessional collaboration A lower level of mutual respect was found to be challenging within interprofessional teams, and some participants felt that “these situations with physicians often occur out of vanity” (S1), as well as due to CPP’s lack of proactive communication. They found ESA, EAO, openness, flexibility in communication, interprofessional knowledge, and experience exchange to be promising strategies for addressing these challenges. “We solved the prescribing-dispensing-reimbursement issue… It was a collaboration between the pharmacy, the doctor, and the patient's family... In addition, when we achieve that circle, it makes it easier for everyone, for all the participants... if we have open communication with the physician so that we can easily get in touch with him, it becomes much easier for the patient and us…” (S2) EI and the loyalty of users of pharmaceutical services Loyalty was recognized by the participants as positively correlated with the quality of patient-centered care. The quality of care was defined as “professionalism, focus on the patient and his health, …, understanding person’s needs, … and building trust” (S1). Therefore, EAO, showing that one cares, demonstrating empathy, and EMO through a positive attitude, kindness, and making people feel well, seems to be a good EI strategy for fostering behavioural change to further increase loyalty. EI development programs The third step in the inductive thematic analysis required a specific approach to best structure themes and subthemes for EI development in CP practice emerging from defined codes. Donabedian’s framework was applied (Fig. 1 ) [ 32 ]. Insert Fig. 2 here. The focus group participants achieved a profound understanding of EI concepts. They demonstrated the ability to identify issues and challenges where EI competencies are essential for fostering effective behaviors (“embracing change in CP practice” – S9, for example”). Participants emphasized their sense of being ill-prepared for CP practice after graduation. They stressed the importance of implementing EI content in curricula at all stages of CP development, including undergraduate and specialization programs. “Education about EI should be included from the early days of studies because I think that the earlier we develop the skills, the better we will manage everything later, …, both privately and at work. … it all seemed fabulous to me at university - and then, you face a conflicting patient, and you just need to manage... You do not know what hit you or how to react, and you are expected to be professional. ...whatever work we do, we work with people, most often, and everything, again, depends on your EI.” (S1) The groups identified training with interactive EI sessions combined with behavior modelling (“watching videos of best practice behaviors” – S3) and behavior changing workshops (“role plays in groups of three with rotating roles” – S4, S9) as the best EI development approaches. Learnings are easily implemented in CP practice, and “the follow-up, reflection, and experience exchange sessions should be organized” (S1, S3, S17). Therefore, several participants emphasized the methodology applied in this research as the most suitable for their professional development. Many have found online programs to be good EI development platform options. They stressed the importance of ongoing efforts in the education of faculty members, emphasizing the need for a shift in teaching and practicing methodologies. Participants stated that EI development programs would enhance all EI competencies and improve CPPs’ stress management, self-confidence, and overall well-being. They foster team spirit, CPP self-dedication, and commitment to their development. They may improve inter- and intraprofessional collaboration, leadership, focus, person-centered communication, and ultimately patient-related outcomes. Discussion Statement of key findings Our qualitative research results demonstrated high levels of EI importance and EI competency relevance for the quality of CP practice and CPPs’ professional development. The study participants suggested incorporating EI-related content and methodologies from the beginning of pharmacy undergraduate programs and throughout the CPD continuum. The specifics of the programs’ components and approaches correlate with integrative review findings published in mid-2023 [ 1 ]. Strengths and weaknesses To the best of our knowledge, this is the first qualitative study with CPPs aiming to determine the importance of EI for CP practices and the ways to develop it. This study provides new knowledge about the impact of the study, teaching, and learning approaches on EI development in CPPs and may further clarify the results of our previous research [ 10 , 18 ]. This study has several limitations. Given the purposive sampling methodology, selection bias cannot be ruled out. As with other qualitative studies, it is possible that recall, nonresponse, or socially desirable response biases were present. A single-nation design makes the study results less transferable to other healthcare systems and work environments. Interpretation The CP group’s characteristics generally represent those working in community pharmacies in Serbia [ 33 ]. Participants’ age and experience did not affect their ability to perceive, understand, or manage emotions in different CP practice situations or to articulate and relate adequate EI coping strategies. This is in line with our quantitative research results, where no significant impact of age on pharmacists’ EI levels could be found, but it also aligns with studies in other professions [ 10 , 18 , 23 ]. However, this finding contradicts the findings of some researchers [ 13 , 34 ]. The characteristics of emotionally intelligent CPP that were defined in the study could be well set within the cognitive, emotional, relational, and behavioral (CERB) framework and correlate with the results of studies investigating the personal characteristics of successful pharmacists [ 8 , 17 ]. The focus group participants identified several issues and challenges in CP practice, including working under pressure and stress management, together with effective management of stressful situations. They identified ESA, EAO, ESC, ESM, and EMO competencies as necessary for applying adequate coping strategies. This may explain the stress-protective effects of the latter four EI subdomains (competencies) found in our previous research with different pharmacy practitioners [ 10 , 18 ]. However, the self-awareness EI subdomain has been identified as less stress protective, although the participants in the present study highly praised it. This might be explained by the lack of EI education and application of the required competencies set within the GbCF and the lack of contemporary standards in pharmacy education, such as the standards of the Accreditation Council for Pharmacy Education in the US, where self-awareness is a core competency [ 7 , 35 ]. Furthermore, local issues where the feedback culture was not sufficiently cultivated may play a role. The study results highlighted the necessity for a multitude of EI development programs to be integrated into curricular, extracurricular, and CPD initiatives. This is entirely in line with the findings of other researchers [ 1 , 36 , 37 ]. Didactic, experiential, reflection, feedback, behavior-modelling, and behavior-changing approaches were found to be most beneficial for EI development within different pharmacy education and development programs. Other authors presented similar findings in the pharmacy and other education domains [ 1 , 38 , 39 ]. Further research Further mixed-method studies with pre- and postpharmacy development programs’ EI measurements and qualitative research with the same study groups may add value to support EI inclusion in CPD programs and test possible approaches to education quality assurance. Conclusion Our study results indicate that CPPs and other pharmacy practitioners can fully understand the importance of EI in CP practice to develop effective coping strategies for emerging challenges and potentially improve patient-centered care and its outcomes. They strongly support EI content inclusion in all relevant CPD programs. The study results may serve as valuable insights for academia, regulatory bodies, and professional pharmacy organizations to incorporate EI development programs in pharmacy education and professional development programs. The notion of “teaching and developing” professionalism is no longer adequate for the evolving demands of the modern pharmacy profession. Declarations Acknowledgements The authors would like to thank all the study participants for their time and contribution to this research and Prof. Dušanka Krajnović and Ass. Ivana Stević for their support. Funding The work of the VM was funded by the Ministry of Education, Science and Technological Development, Republic of Serbia, through a Grant Agreement with the University of Belgrade-Faculty of Pharmacy No: 451-03-47/2023-01/200161. This research received no external funding. Conflicts of interest The authors have no conflicts of interest to declare. CRediT authorship contribution statement Dejan Senćanski contributed to the study's conception and design, study execution, data analysis and interpretation, and wrote the original draft and revisions. Ivana Tadić contributed to the conception and design of the study, data analysis and interpretation, and manuscript revisions. Dragana Jocić contributed to the conception and design of the study, its execution, and manuscript revision. 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ISBN: 978-0387883694 Hennink MM, Kaiser BN, Weber MB. What Influences Saturation? Estimating Sample Sizes in Focus Group Research. Qual Health Res. 2019;29(10):1483–96. Burla L, Knierim B, Barth J, et al. From Text to Codings. Nurs Res. 2008;57(2):113–7. Braun V, Clarke V. Conceptual and design thinking for thematic analysis. Qualitative Psychology. 2022;9(1):3-26. Cooper R, Chenail R, Fleming S. A Grounded Theory of Inductive Qualitative Research Education: Results of a Meta-Data-Analysis. Qual Rep. 2015;17:1–26. Ashour A, Phipps DL, Ashcroft M. Predicting dispensing errors in community pharmacies: An application of the Systematic Human Error Reduction and Prediction Approach (SHERPA). PLoS One. 2022;17:1–17. Donabedian A. The quality of care. How can it be assessed? JAMA J Am Med Assoc. 1988;260(12):1743–8. The Pharmaceutical Chamber of Serbia. Section “Database - Membership”. Available at: https://www.farmkom.rs/baze-podataka.php. Accessed 09.01.2024 Ahmad Hassali MA, Hussain R, Saleem F, et al. Perceived Emotional Intelligence and Its Association with the Demographic Characteristics among Pharmacy Students: A Cross-Sectional Study. J Pharm Pract Community Med. 2017;3(3):108–13. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (“Standards 2016”). Accreditation Council for Pharmacy Education. Published February 2, 2015. Available at: https://www.acpe-accredit.org/pdf/Standards2016FINAL2022.pdf Accessed 28.12.2023 Holden MD, Buck E, Luk J, et al. Professional Identity Formation. Acad Med. 2015;90(6):761–7. Lu WH, Iuli R, Strano-Paul L, et al. Renaissance School of Medicine at Stony Brook University. Academic Medicine. 2020;95(9S):S362-6. Nelson MH, Fierke KK, Sucher BJ, et al. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes. Am J Pharm Educ. 2015;79(4):48. Cherniss C, Goleman D. Training for emotional intelligence: A model. In: Cherniss, C and Goleman D, editor. The emotionally intelligent workplace. San Francisco: Jossey-Bass – A Wiley Company; 2001:209–33. ISBN: 978-1118308790 Supplementary Files SupplementaryFile1EN.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 20 Feb, 2024 Reviewers invited by journal 20 Feb, 2024 First submitted to journal 19 Feb, 2024 Editor assigned by journal 13 Feb, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3952262","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":273894324,"identity":"a2396e19-f1b7-48f4-98e5-01042ab147b7","order_by":0,"name":"Dejan Senćanski","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIie2QsWrCQBiA/yAkyxHXP5zoK5wE1OLLXAgki4VOkimNS7r4AD5Gps6RQLNc9wMHk8VZKJRAO3ijCp5163Df9t/x8X93AAbDf6QEfj7h0H1Y8e0/KJdTkN8z3Dprv14gHU6d6tB2Yhbn9K3pJb+3FU+UId1A5T+to6lPJD7nA8GsT80uJjmnBMqgkDChcFQKLsBaZRpl34Q/BNLXQjrfXnfE2Ma4sTJNGJMQqS09ziSZoArjNnJmZZp/8wSP5oRV40IslpQIHKswtl1p3uLWItyRJB2xun73uo901Me4bXVhAISrvKuzUicAOHfuDQaDwXACXNBQWDxNf+sAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-0869-6124","institution":"Univerzitet u Beogradu Farmaceutski fakultet","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Dejan","middleName":"","lastName":"Senćanski","suffix":""},{"id":273894325,"identity":"8fe325a1-d3a1-4725-8620-61fcd6049baf","order_by":1,"name":"Ivana Tadić","email":"","orcid":"","institution":"Universitat Innsbruck","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ivana","middleName":"","lastName":"Tadić","suffix":""},{"id":273894326,"identity":"a6f647a7-bd8a-4344-9591-3b3efb1701fc","order_by":2,"name":"Dragana Jocić","email":"","orcid":"","institution":"University Business Academy in Novi Sad: Univerzitet Privredna akademija u Novom Sadu","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dragana","middleName":"","lastName":"Jocić","suffix":""},{"id":273894327,"identity":"7cb2ae09-8e0c-48ed-9885-34b45e5323ef","order_by":3,"name":"Valentina Marinković","email":"","orcid":"","institution":"University of Belgrade Faculty of Pharmacy: Univerzitet u Beogradu Farmaceutski fakultet","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Valentina","middleName":"","lastName":"Marinković","suffix":""}],"badges":[],"createdAt":"2024-02-13 00:20:49","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3952262/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3952262/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51512988,"identity":"583cf8a4-c074-4cc2-a340-fe26a2a184ef","added_by":"auto","created_at":"2024-02-22 21:25:11","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":31967,"visible":true,"origin":"","legend":"\u003cp\u003eCharacteristics of an emotionally intelligent clinical pharmacist. The relative frequency of a code is indicated by its size.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3952262/v1/ee2e0575691a56ca2d19d5d1.png"},{"id":51512990,"identity":"0d2a6a66-14c0-4e96-b7ab-ad5a69a6d955","added_by":"auto","created_at":"2024-02-22 21:25:12","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":43751,"visible":true,"origin":"","legend":"\u003cp\u003eEmerging themes and subthemes for EI development in CP practice\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations used:\u003c/em\u003e PCS – Pharmaceutical Chamber of Serbia, MOH – Ministry of Health, CPE – continuing pharmaceutical education, CP – clinical pharmacy, EI – emotional intelligence, ESA – emotional self-awareness, EAO – emotional awareness of others, EE – emotional expression, ER – emotional reasoning, ESC – emotional self-control, ESM – emotional self-management, EMO – emotional management of others.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3952262/v1/2f3f729d1a5542b033155a14.png"},{"id":51512994,"identity":"5c0ec20b-8ce5-4272-8dc1-9196eeafe892","added_by":"auto","created_at":"2024-02-22 21:25:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":587576,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3952262/v1/1232babd-ee22-4065-9823-9600c4684a48.pdf"},{"id":51512991,"identity":"e1148d10-982e-4963-9b72-ce752406bc02","added_by":"auto","created_at":"2024-02-22 21:25:12","extension":"docx","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":19258,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFile1EN.docx","url":"https://assets-eu.researchsquare.com/files/rs-3952262/v1/5294226e3d20bc7b08cf6ffe.docx"}],"financialInterests":"","formattedTitle":"Perceived importance of emotional intelligence for clinical pharmacy practice and directions for its improvement: a focus group study","fulltext":[{"header":"Impact statements","content":"\u003cp\u003e\u0026bull;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Emotional intelligence may positively impact pharmacists\u0026apos; well-being and improve patient-centered care and related outcomes.\u003c/p\u003e\n\u003cp\u003e\u0026bull;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Limited evidence exists on the importance of emotional intelligence for clinical pharmacy practice and its role in developing successful coping strategies in challenging situations.\u003c/p\u003e\n\u003cp\u003e\u0026bull;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;The findings of this research could serve all relevant stakeholders in pharmacy education and professional development to expedite changes in teaching and learning methodologies to better suit pharmacists\u0026rsquo; EI development and ultimately lead to better provision of patient-centered care.\u0026nbsp;\u003c/p\u003e\n"},{"header":"Introduction","content":"\u003cp\u003eEmotional intelligence (EI) has been identified as a critical concept in shaping a pharmacist\u0026rsquo;s professional identity by contributing to pharmacy education, patient-centered care, and leadership [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The definition of clinical pharmacy (CP) practice highlights the pharmacist\u0026rsquo;s responsibility \u0026ldquo;to attain person-centered goals for individual patients within a multidisciplinary team\u0026rdquo; [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This encompasses a range of pharmacist cognitive, managerial, and interpersonal activities in various settings, all of which are strongly influenced by EI [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNumerous studies on preregistered pharmacy students have suggested that EI-related content should be included in pharmacy curricula [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The International Pharmaceutical Federation, in cluster four of its Global Competency Framework (GbCF) for the development of early career pharmacists, explicitly outlined the EI behaviors required to be demonstrated within the specified competencies [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIncorporating EI-related content into continuing pharmaceutical development (CPD) programs may enhance CP practice competencies and pharmacists' stress-handling abilities [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, some authors have questioned the lasting impact of EI development programs and how they translate into clinical practice, thus potentially improving patient-related outcomes (PROs) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Encouragingly, research in other medical professions seems to have addressed this concern, revealing positive outcomes in longitudinal studies with physicians and nurses engaged in ongoing EI development programs, leading to improved PROs [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Further investigations are warranted to confirm the applicability of these findings to CP practitioners (CPPs) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe integration of EI-related curricular and extracurricular content and activities at universities and within CPD appears to be correlated with the inter- and intraprofessional relationships, leadership skills, and interpersonal relationships of CPPs with patients and their families. This advancement in clinical practice can potentially enhance patient outcomes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our research on local pharmacy study practices across all levels of CPD, it became evident that the lack of EI-related and EI-development-stimulating content and methods contributed to a lack of difference in EI levels among pharmacists delivering and not delivering a new service to a vulnerable group of patients with diabetes [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. We observed no difference in EI levels between pre- and postspecialization graduates [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Qualitative research on clinical pharmacists' perceptions of the role of EI in practice does not exist. To address this gap, a focus group study was conducted.\u003c/p\u003e\n\u003ch3\u003eAim\u003c/h3\u003e\n\u003cp\u003eThe study had three primary objectives: (1) to define the characteristics of emotionally intelligent clinical pharmacists, (2) to understand pharmacists' perceptions of the importance of EI and relevant subdomains for clinical practice, and (3) to generate ideas and solicit suggestions regarding models and approaches for enhancing EI among clinical pharmacists.\u003c/p\u003e\n\u003ch3\u003eEthics approval\u003c/h3\u003e\n\u003cp\u003eThe ethics committee of the Pharmaceutical Chamber of Serbia approved the study protocol (No. 316/6-4-2, dated December 28th, 2022).\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy type, design, and tools\u003c/h2\u003e \u003cp\u003eThis qualitative study used a focus group methodology in March 2023. The study followed the COREQ and SRQR guidelines [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA focus group semistructured guide with questions and prompts was developed and pretested with three study-independent pharmacists and experts. The guide was constructed based on the existing EI research and concepts and was grounded in qualitative research theory and practice [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan additionalcitationids=\"CR22 CR23 CR24\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Several suggestions for adaptation emerged during the pretest. The final version, containing 14 questions (Supplementary File 1), was consolidated in a consensus meeting involving the research team and two independent experts, one of whom was a trained psychologist.\u003c/p\u003e \u003cp\u003eAn interactive two-hour session was conducted for all study participants, focusing on the concept of EI, including its models, competencies, instruments, research results, and the study's objectives. The Genos EI instrument, validated and pretested for the Serbian pharmacist population, was introduced to the participants [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The Genos instrument comprises subdomains related to emotional self-awareness (ESA), emotional awareness of others (EAO), emotional expression (EE), emotional reasoning (ER), emotional self-control (ESC), emotional self-management (ESM), and emotional management of others (EMO) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling strategy\u003c/h2\u003e \u003cp\u003ePurposive sampling was utilized to include participants with diverse experience and practice areas. This study specifically targeted CPP postgraduates specializing in the Faculty of Pharmacy, University of Belgrade (Serbia).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eInclusion criteria and enrolment\u003c/h2\u003e \u003cp\u003eThe participants expressed their interest in participating in the study electronically. The inclusion criteria were participation in all study steps, signing the informed consent form, and completing the demographic questionnaire.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eThe research team led focus group sessions of one-and-a-half hours, following a semistructured guide. All sessions were audio-recorded. Details about the recording and data anonymity were explicitly outlined in the Informed Consent. Essential insights were summarized, and participants\u0026rsquo; final feedback was requested, along with encouragement to contact either the DS or VM for additional input. Observers and note-takers documented the focus group structure and flow, nonverbal cues, and other observations, including participants\u0026rsquo; group behaviors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eResearch team and setting\u003c/h2\u003e \u003cp\u003eFour researchers composed the research team: two moderators, two observers, and note-takers. The researchers had experience in qualitative research and were trained to conduct focus group studies. Only the research team members and study participants were in the rooms where the focus group discussions were held.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eReflexivity and rigor\u003c/h2\u003e \u003cp\u003eVM has had previous contact with the participating CPPs. To avoid potential feelings of unease and reluctance to speak up openly and express their opinions, it was decided that the focus groups with CPPs should be moderated by DS, who had no prior knowledge of the participants and their experiences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eCoding\u003c/h2\u003e \u003cp\u003eDS conducted verbatim transcriptions of the audio recordings. The transcripts were verified by comparison with the original recordings and corrected by VM wherever needed. Final reconciliation was performed after a check by a study-independent expert.\u003c/p\u003e \u003cp\u003eCoding was independently performed by two experts using two different instruments, MaxQDA software and an Excel sheet. A codebook was built to ensure consistent methodology and test for code saturation [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. MaxQDA software was also used in the code frequency analysis.\u003c/p\u003e \u003cp\u003eTo enhance coding reliability, independently coded documents were compared, and evaluators reached greater than 80% agreement through consensus, as suggested by other qualitative researchers [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Saturation was defined as the point when no new information could be gathered about the central themes or as \u0026ldquo;meaning saturation\u0026rdquo; when no new meanings of issues determined by the codes could be found [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eAnalyses\u003c/h2\u003e \u003cp\u003eAll participants were coded as S1 to S17, and the participants\u0026rsquo; demographic data were analysed using descriptive statistics. As the qualitative research literature suggested, inductive thematic analysis was applied to the focus group data [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Categories for the themes and subthemes were deductively constructed from the semistructured guide questions.\u003c/p\u003e \u003cp\u003eThe notes compiled during the study were also analysed to extract additional data and to discern potential sources of bias by reflecting on the behaviours of both moderators and participants.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\"\u003e\n \u003ch2\u003eThe focus groups\u003c/h2\u003e\n \u003cp\u003eA total of 17 participants out of the 20 invited participants took part in the study. No new ideas or additional meanings to the issues were introduced after the second focus group session. Hence, the research team agreed at a consensus meeting that information saturation had occurred, including meaning saturation.\u003c/p\u003e\n \u003cp\u003eGiven the structure of the invitees, it was decided to stratify them into groups containing those in the CP roles (n\u0026thinsp;=\u0026thinsp;8/10, all working in community pharmacies) and other specializing pharmacists (n\u0026thinsp;=\u0026thinsp;9/10), who were asked to put themselves \u0026ldquo;in the shoes\u0026rdquo; of a clinical pharmacist and give their own perspectives. The age range in the total study population was 24\u0026ndash;50, and the CP experience ranged from just below 1 to 18 years, with an overall group\u0026rsquo;s experience of 7.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.5 years. Female participants made up the majority in both groups. The demographic characteristics of the study participants are presented in Table \u003cspan\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eDemographic characteristics of the study participants\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u0026ndash;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35\u0026ndash;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCP Experience (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u0026ndash;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u0026ndash;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u0026ndash;15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u0026ndash;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCP Experience (years) - Mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.1 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cem\u003eAbbreviations used:\u003c/em\u003e CP \u0026ndash; clinical pharmacy, SD \u0026ndash; standard deviation.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eInsert\u003c/strong\u003e Table \u003cspan\u003e1\u003c/span\u003e \u003cstrong\u003ehere.\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\"\u003e\n \u003ch2\u003eCoding\u003c/h2\u003e\n \u003cp\u003eA total of 50 codes were assigned to the transcripts across the nine categories, which were deductively derived from the focus group guide. The top 10 codes had a frequency above 50% (Table \u003cspan\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eTop 10 codes ranked in descending frequency order\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"1\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCode\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEffective Communication\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmotional Awareness of Others\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmotional Self-Awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmotional Self-Control\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTrust\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRespect\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePatient-centricity and focus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmotional Self-Management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWork under pressure and effective stress management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-confidence and knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cstrong\u003eInsert\u003c/strong\u003e Table \u003cspan\u003e2\u003c/span\u003e \u003cstrong\u003ehere.\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\"\u003e\n \u003ch2\u003eCoding reliability testing\u003c/h2\u003e\n \u003cp\u003eGreater than 80% agreement was reached for codes in 7 out of 9 categories, while the code assignments in the two remaining categories were settled at the consensus meeting.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\"\u003e\n \u003ch2\u003eThematic analysis\u003c/h2\u003e\n \u003cp\u003eGiven the specifics of the EI topic, numerous code repetitions emerged across categories. Therefore, inductive thematic analysis was employed in three steps: (1) identifying the characteristics of emotionally intelligent clinical pharmacists, (2) identifying issues and challenges in everyday CP practice (as themes) and defining EI strategies to address these challenges (as subthemes), and (3) identifying EI development strategies in the education and professional development of clinical pharmacists.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\"\u003e\n \u003ch2\u003eDefinition of an emotionally intelligent clinical pharmacist\u003c/h2\u003e\n \u003cp\u003eParticipants recognized, fully reflected, and related the desired EI behaviors to their everyday practice. They identified several key characteristics of emotionally intelligent CPPs (Fig.\u0026nbsp;\u003cspan\u003e1\u003c/span\u003e). The codes representing characteristics in the first step in the latter analysis emerged into more developed themes, issues and challenges, and respective EI strategies (Table\u0026nbsp;\u003cspan\u003e3\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 3\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eThemes and subthemes by category\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eIssue/Challenge (Theme)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEmotionally Intelligent Strategy (Subtheme)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI importance for CP practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emanaging stressful situations (drug addicts, aggressive, dissatisfied patients)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eemotional self-awareness (ESA)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecommunication in challenging situations (taboos, e.g., emergency birth control)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eemotional awareness of others (EAO) - understanding needs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003estaying patient-focussed with person-centered approach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edemonstrating empathy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eunderstanding patient needs/vulnerable groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eself-control and management of our own emotions (not to get provoked and stay calm/composed)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003einterprofessional relationships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO, emotional expression (EE)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and professional error avoidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ework under pressure and stress management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding resilience through ESA and emotional self-management (ESM)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding and maintaining focus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA and intention-to-be-focussed practices\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eeffective communication (poor communication as an error)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edemonstrating tolerance, understanding, and empathy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding trust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO, emotional management of others (EMO) and EE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eseeking solutions/fast decision-making\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA and emotional reasoning (ER)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and prevention of inadequate behaviors towards pharmacists (secondary victims)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding trust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eeffective, competent, patient-centered, assertive communication built on ESA, EAO, EMO, and EE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eeffectively building the capacity to adapt to different people\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecreating a positive work environment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO, EE, demonstrating empathy, fostering team and self-development, being tenacious\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003estaying composed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO, EMO, demonstrating patience in work with people/emotional self-control (ESC)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ework under pressure and stress management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding resilience through ESA, ESC, and ESM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and good communication within CP teams\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003esuccessful management and leadership\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eclear, precise, positive, and open communication to embrace change\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding a feedback culture\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO, EE, ER, ESC, ESM, EMO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecreating a positive work environment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO, showing understanding and demonstrating empathy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding teamwork and interpersonal relations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edemonstrating respect, EAO, EE, ESC, ESM, ESA and EMO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and conflict prevention and resolution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003erecognize the moment and understand the needs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003erespecting diversity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eperson-centered care\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003epatient complaints\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESC, EAO, EMO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ethe inadequate reaction of the employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eleadership support, building team spirit\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO, demonstrating understanding and empathy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003econflict prevention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO, ESA, building resilience, ESC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding leadership capabilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edeveloping ESA, EAO, EE, ER, ESC, ESM, EMO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and interprofessional collaboration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emutual respect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003egood, open communication\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003estep in other\u0026apos;s shoes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eflexibility/openness\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVanity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO - being aware of how the others feel\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003einterprofessional understanding and knowledge - the higher the knowledge, the lower the vanity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003epharmacist\u0026apos;s proactivity in a communication cycle: patient‒physician-pharmacist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding trust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA, EAO, EE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding and maintaining focus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA and intention-to-be-focussed practices\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEI and loyalty of users of pharmaceutical services\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding trust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eunderstanding needs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edemonstrating empathy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO - showing that you care\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ehigh-level, patient-centered care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEAO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEMO - being pleasant, kind, polite, with a positive attitude, making people feel well\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebuilding and maintaining focus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eESA and intention-to-be-focussed practices\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eER, EE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cem\u003eAbbreviations used:\u003c/em\u003e EI \u0026ndash; emotional intelligence, CP \u0026ndash; clinical pharmacy.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eInsert\u003c/strong\u003e Fig.\u0026nbsp;\u003cspan\u003e1\u003c/span\u003e \u003cstrong\u003ehere.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eIn the participant\u0026apos;s opinion, an emotionally intelligent CPP is a competent and self-confident professional who stays calm in every situation, manages situations well, and remains focused on the patient through person-centered interaction. CPPs are aware of their own emotions and the emotions of others and manage them well through effective communication with patients and colleagues, build trust, and work well under pressure while adequately managing stress. Participants in the second focus group put more emphasis on \u003cem\u003e\u0026ldquo;balance in communication\u0026rdquo;\u003c/em\u003e (S9) and \u003cem\u003e\u0026ldquo;emotional self-control\u0026rdquo;\u003c/em\u003e (S14) as prerequisites for effective patient-centered care.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\"\u003e\n \u003ch2\u003eImportance of EI for CP practice\u003c/h2\u003e\n \u003cp\u003eParticipants in both groups acknowledged that effectively communicating and maintaining focus proved particularly challenging with aggressive, dissatisfied patients due to financial constraints, longer time-to-service, or patients with alcohol or drug abuse problems prone to conflicts. In such circumstances, high EI skills are required to help individuals perceive, understand, and manage their emotions and those of others; stay composed and calm; and act with self-confidence.\u003c/p\u003e\n \u003cp\u003eCommunication is also challenging for vulnerable patient groups, patients with malignancies, elderly patients, or patients in situations where \u0026ldquo;taboo\u0026rdquo; topics are discussed, such as patients requiring emergency birth control. It was emphasized that CPP\u0026rsquo;s understanding of patient needs, being emotionally aware of others, and demonstrating empathy, as well as \u0026ldquo;well balancing\u0026rdquo; the expression of one\u0026rsquo;s own emotions to create bonds and trust, are essential EI strategies in such instances.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;With some oncology or other difficult patients, controlling emotions is so important, so we can protect them and show more empathy. We used to have in our pharmacy a patient support program for oncology patients\u0026hellip; Therefore, all kinds of things happened, all kinds of situations and some outpourings of emotions on their part\u0026hellip; It affected us personally; emotional balance, control, and empathy were vital\u0026hellip;\u0026rdquo;\u003c/em\u003e (S14)\u003c/p\u003e\n \u003cp\u003eParticipants stressed the importance of EI for intra- and interprofessional collaboration, which was later discussed in detail under a separate category.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\"\u003e\n \u003ch2\u003eEI and professional error avoidance\u003c/h2\u003e\n \u003cp\u003eResearch has identified numerous EI-related factors contributing to dispensing errors in community pharmacy settings [\u003cspan\u003e31\u003c/span\u003e]. The example is working under pressure due to CPP work complexity, which, together with other distracting factors, induces stress and hampers focus.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes the mistake is not in dispensing the medicine. Sometimes, the mistake is having a wrong attitude towards the patient, a wrong attitude towards a colleague, or wrong communication. \u0026hellip; You may not have a chance to correct it. However, how much is it possible to control ourselves, manage our emotions and behavior to be fair to others?\u0026rdquo;\u003c/em\u003e (S2)\u003c/p\u003e\n \u003cp\u003eThe groups suggested that the answer might be in further ESA development, which would support building resilience, better ESM, and enhanced tolerance, demonstrating understanding and empathy so the pressure would ease on either side: the CPP, the patient, and the physician. With enhanced ER, decision-making processes improve and create less pressure. Intention-to-be-focused practices may lead to decreased error frequency and overall outcome improvements.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;The pharmacist\u0026apos;s thoughts of the day should be positive, with a clear intention: \u0026lsquo;Today, I will try to be 200% myself, to devote myself to the patients and to do my job with maximum quality\u0026rsquo;.\u0026quot;\u003c/em\u003e (S5)\u003c/p\u003e\n \u003cp\u003eIn the event of dispensing errors, participants felt that they could be handled well if support in the organization was in place and if trust had been established with patients and colleagues through practical demonstrations of EAO and EE.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\"\u003e\n \u003ch2\u003eEI and prevention of inadequate behaviors towards pharmacists (secondary victims)\u003c/h2\u003e\n \u003cp\u003eParticipants observed that patients\u0026apos; behaviors depend on the CPP\u0026rsquo;s behavior. Investing in development to lead effective patient-centered communications might build trust and ultimately prevent inadequate behaviors toward pharmacists. Creating a positive work environment through team EI development may cultivate satisfaction on both ends and alleviate tensions even with the most aggressive patients, such as those with drug addiction problems. Furthermore, such an environment fosters teamwork, self-development, and changes in behaviors, with more empathy, patience, and tenacity being demonstrated.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think satisfaction is quite important. Satisfaction with the work environment, satisfaction with the job, satisfaction with yourself\u0026hellip; with such an attitude, you feel well, happy, satisfied. Then, you pass it on to others, both to the patients and colleagues.\u0026rdquo;\u003c/em\u003e (S8)\u003c/p\u003e\n \u003cp\u003eParticipants felt that ESA, EAO, EMO, and EE competencies were essential for further development, together with ESC, which was more frequently emphasized in the second focus group.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eInsert\u003c/strong\u003e Table\u0026nbsp;\u003cspan\u003e3\u003c/span\u003e \u003cstrong\u003ehere.\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\"\u003e\n \u003ch2\u003eEI and communication within CP teams\u003c/h2\u003e\n \u003cp\u003eBuilding further on the importance of a positive work environment, participants stressed the significance of emotionally intelligent leadership, which stimulates transparent, open, and positive communication and supports embracing change and feedback culture developments.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Our communication should be an open type communication to have feedback from colleagues\u0026hellip; they should feel and have complete freedom to turn to leaders for anything\u0026hellip; should feel support and respect\u0026hellip; We cannot change people, but we can help them be better here with us, in our organization.\u0026rdquo;\u003c/em\u003e (S1)\u003c/p\u003e\n \u003cp\u003eTo show more understanding, empathy, and respect, participants felt that all EI competencies are equally essential for development.\u003c/p\u003e\n \u003cdiv id=\"Sec23\"\u003e\n \u003ch2\u003eEI and conflict prevention and resolution\u003c/h2\u003e\n \u003cp\u003eEffective, emotionally intelligent leadership was recognized to be vitally important in preventing conflicts within CP teams. If disputes occur with patients or interprofessionally, \u003cem\u003e\u0026ldquo;the leader should stand by his team and provide support\u0026hellip; that is where his role is\u0026hellip;\u0026rdquo;\u003c/em\u003e (S10).\u003c/p\u003e\n \u003cp\u003eThe participants stressed that the building of emotionally intelligent workplaces was equally important.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;A colleague started arguing with me in a team meeting... I could have reacted in several ways, but I chose clear and concrete communication, prevented conflict, and primarily thought about the rest of the team.\u0026rdquo;\u003c/em\u003e (S4)\u003c/p\u003e\n \u003cp\u003eParticipants felt that recognizing the moment and understanding needs are critical in conflict prevention and found enhanced EAO and respecting diversity to be EI strategies to foster those needs.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec24\"\u003e\n \u003ch2\u003eEI and interprofessional collaboration\u003c/h2\u003e\n \u003cp\u003eA lower level of mutual respect was found to be challenging within interprofessional teams, and some participants felt that \u003cem\u003e\u0026ldquo;these situations with physicians often occur out of vanity\u0026rdquo;\u003c/em\u003e (S1), as well as due to CPP\u0026rsquo;s lack of proactive communication. They found ESA, EAO, openness, flexibility in communication, interprofessional knowledge, and experience exchange to be promising strategies for addressing these challenges.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;We solved the prescribing-dispensing-reimbursement issue\u0026hellip; It was a collaboration between the pharmacy, the doctor, and the patient\u0026apos;s family... In addition, when we achieve that circle, it makes it easier for everyone, for all the participants... if we have open communication with the physician so that we can easily get in touch with him, it becomes much easier for the patient and us\u0026hellip;\u0026rdquo;\u003c/em\u003e (S2)\u003c/p\u003e\n \u003cdiv id=\"Sec25\"\u003e\n \u003ch2\u003eEI and the loyalty of users of pharmaceutical services\u003c/h2\u003e\n \u003cp\u003eLoyalty was recognized by the participants as positively correlated with the quality of patient-centered care. The quality of care was defined as \u003cem\u003e\u0026ldquo;professionalism, focus on the patient and his health, \u0026hellip;, understanding person\u0026rsquo;s needs, \u0026hellip; and building trust\u0026rdquo;\u003c/em\u003e (S1). Therefore, EAO, showing that one cares, demonstrating empathy, and EMO through a positive attitude, kindness, and making people feel well, seems to be a good EI strategy for fostering behavioural change to further increase loyalty.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec26\"\u003e\n \u003ch2\u003eEI development programs\u003c/h2\u003e\n \u003cp\u003eThe third step in the inductive thematic analysis required a specific approach to best structure themes and subthemes for EI development in CP practice emerging from defined codes. Donabedian\u0026rsquo;s framework was applied (Fig.\u0026nbsp;\u003cspan\u003e1\u003c/span\u003e) [\u003cspan\u003e32\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eInsert\u003c/strong\u003e Fig.\u0026nbsp;\u003cspan\u003e2\u003c/span\u003e \u003cstrong\u003ehere.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe focus group participants achieved a profound understanding of EI concepts. They demonstrated the ability to identify issues and challenges where EI competencies are essential for fostering effective behaviors \u003cem\u003e(\u0026ldquo;embracing change in CP practice\u0026rdquo;\u003c/em\u003e \u0026ndash; S9, for example\u0026rdquo;). Participants emphasized their sense of being ill-prepared for CP practice after graduation. They stressed the importance of implementing EI content in curricula at all stages of CP development, including undergraduate and specialization programs.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Education about EI should be included from the early days of studies because I think that the earlier we develop the skills, the better we will manage everything later, \u0026hellip;, both privately and at work. \u0026hellip; it all seemed fabulous to me at university - and then, you face a conflicting patient, and you just need to manage... You do not know what hit you or how to react, and you are expected to be professional. ...whatever work we do, we work with people, most often, and everything, again, depends on your EI.\u0026rdquo;\u003c/em\u003e (S1)\u003c/p\u003e\n \u003cp\u003eThe groups identified training with interactive EI sessions combined with behavior modelling \u003cem\u003e(\u0026ldquo;watching videos of best practice behaviors\u0026rdquo;\u003c/em\u003e \u0026ndash; S3) and behavior changing workshops \u003cem\u003e(\u0026ldquo;role plays in groups of three with rotating roles\u0026rdquo;\u003c/em\u003e \u0026ndash; S4, S9) as the best EI development approaches. Learnings are easily implemented in CP practice, and \u003cem\u003e\u0026ldquo;the follow-up, reflection, and experience exchange sessions should be organized\u0026rdquo;\u003c/em\u003e (S1, S3, S17). Therefore, several participants emphasized the methodology applied in this research as the most suitable for their professional development. Many have found online programs to be good EI development platform options. They stressed the importance of ongoing efforts in the education of faculty members, emphasizing the need for a shift in teaching and practicing methodologies.\u003c/p\u003e\n \u003cp\u003eParticipants stated that EI development programs would enhance all EI competencies and improve CPPs\u0026rsquo; stress management, self-confidence, and overall well-being. They foster team spirit, CPP self-dedication, and commitment to their development. They may improve inter- and intraprofessional collaboration, leadership, focus, person-centered communication, and ultimately patient-related outcomes.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eStatement of key findings\u003c/h2\u003e \u003cp\u003eOur qualitative research results demonstrated high levels of EI importance and EI competency relevance for the quality of CP practice and CPPs\u0026rsquo; professional development. The study participants suggested incorporating EI-related content and methodologies from the beginning of pharmacy undergraduate programs and throughout the CPD continuum. The specifics of the programs\u0026rsquo; components and approaches correlate with integrative review findings published in mid-2023 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and weaknesses\u003c/h2\u003e \u003cp\u003eTo the best of our knowledge, this is the first qualitative study with CPPs aiming to determine the importance of EI for CP practices and the ways to develop it. This study provides new knowledge about the impact of the study, teaching, and learning approaches on EI development in CPPs and may further clarify the results of our previous research [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study has several limitations. Given the purposive sampling methodology, selection bias cannot be ruled out. As with other qualitative studies, it is possible that recall, nonresponse, or socially desirable response biases were present. A single-nation design makes the study results less transferable to other healthcare systems and work environments.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInterpretation\u003c/h3\u003e\n\u003cp\u003eThe CP group\u0026rsquo;s characteristics generally represent those working in community pharmacies in Serbia [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Participants\u0026rsquo; age and experience did not affect their ability to perceive, understand, or manage emotions in different CP practice situations or to articulate and relate adequate EI coping strategies. This is in line with our quantitative research results, where no significant impact of age on pharmacists\u0026rsquo; EI levels could be found, but it also aligns with studies in other professions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. However, this finding contradicts the findings of some researchers [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe characteristics of emotionally intelligent CPP that were defined in the study could be well set within the cognitive, emotional, relational, and behavioral (CERB) framework and correlate with the results of studies investigating the personal characteristics of successful pharmacists [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e The focus group participants identified several issues and challenges in CP practice, including working under pressure and stress management, together with effective management of stressful situations. They identified ESA, EAO, ESC, ESM, and EMO competencies as necessary for applying adequate coping strategies. This may explain the stress-protective effects of the latter four EI subdomains (competencies) found in our previous research with different pharmacy practitioners [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, the self-awareness EI subdomain has been identified as less stress protective, although the participants in the present study highly praised it. This might be explained by the lack of EI education and application of the required competencies set within the GbCF and the lack of contemporary standards in pharmacy education, such as the standards of the Accreditation Council for Pharmacy Education in the US, where self-awareness is a core competency [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Furthermore, local issues where the feedback culture was not sufficiently cultivated may play a role.\u003c/p\u003e \u003cp\u003eThe study results highlighted the necessity for a multitude of EI development programs to be integrated into curricular, extracurricular, and CPD initiatives. This is entirely in line with the findings of other researchers [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Didactic, experiential, reflection, feedback, behavior-modelling, and behavior-changing approaches were found to be most beneficial for EI development within different pharmacy education and development programs. Other authors presented similar findings in the pharmacy and other education domains [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003eFurther research\u003c/h2\u003e \u003cp\u003eFurther mixed-method studies with pre- and postpharmacy development programs\u0026rsquo; EI measurements and qualitative research with the same study groups may add value to support EI inclusion in CPD programs and test possible approaches to education quality assurance.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur study results indicate that CPPs and other pharmacy practitioners can fully understand the importance of EI in CP practice to develop effective coping strategies for emerging challenges and potentially improve patient-centered care and its outcomes. They strongly support EI content inclusion in all relevant CPD programs. The study results may serve as valuable insights for academia, regulatory bodies, and professional pharmacy organizations to incorporate EI development programs in pharmacy education and professional development programs. The notion of \u0026ldquo;teaching and developing\u0026rdquo; professionalism is no longer adequate for the evolving demands of the modern pharmacy profession.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank all the study participants for their time and contribution to this research and Prof. Du\u0026scaron;anka Krajnović and Ass. Ivana Stević for their support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe work of the VM was funded by the Ministry of Education, Science and Technological Development, Republic of Serbia, through a Grant Agreement with the University of Belgrade-Faculty of Pharmacy No: 451-03-47/2023-01/200161. This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCRediT authorship contribution statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDejan Senćanski\u003c/strong\u003e contributed to the study\u0026apos;s conception and design, study execution, data analysis and interpretation, and wrote the original draft and revisions. \u003cstrong\u003eIvana Tadić\u003c/strong\u003e contributed to the conception and design of the study, data analysis and interpretation, and manuscript revisions. \u003cstrong\u003eDragana Jocić\u003c/strong\u003e contributed to the conception and design of the study, its execution, and manuscript revision. \u003cstrong\u003eValentina Marinković\u003c/strong\u003e contributed to the study\u0026apos;s conception and design, study execution, data analysis and interpretation, and manuscript revisions. All authors approved the final manuscript for submission.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLarose-Pierre M, Cleven AJ, Renaud A, et al. Reevaluating Core Elements of Emotional Intelligence in Professional Identity Formation for Inclusion in Pharmacy Education. Am J Pharm Educ. 2023;87(6)\u003c/li\u003e\n\u003cli\u003eDreischulte T, van den Bemt B, Steurbaut S. European Society of Clinical Pharmacy definition of the term clinical pharmacy and its relationship to pharmaceutical care: a position paper. Int J Clin Pharm. 2022;44(4):837\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eFoster K, Fethney J, Kozlowski D, et al. Emotional intelligence and perceived stress of Australian pre-registration healthcare students: A multi-disciplinary cross-sectional study. Nurse Educ Today. 2018;66:51\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eMcCloughen A, Foster K. 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How can it be assessed? JAMA J Am Med Assoc. 1988;260(12):1743\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eThe Pharmaceutical Chamber of Serbia. Section \u0026ldquo;Database - Membership\u0026rdquo;. Available at: https://www.farmkom.rs/baze-podataka.php. Accessed 09.01.2024\u003c/li\u003e\n\u003cli\u003eAhmad Hassali MA, Hussain R, Saleem F, et al. Perceived Emotional Intelligence and Its Association with the Demographic Characteristics among Pharmacy Students: A Cross-Sectional Study. J Pharm Pract Community Med. 2017;3(3):108\u0026ndash;13.\u003c/li\u003e\n\u003cli\u003eAccreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (\u0026ldquo;Standards 2016\u0026rdquo;). Accreditation Council for Pharmacy Education. Published February 2, 2015. Available at: https://www.acpe-accredit.org/pdf/Standards2016FINAL2022.pdf Accessed 28.12.2023\u003c/li\u003e\n\u003cli\u003eHolden MD, Buck E, Luk J, et al. Professional Identity Formation. Acad Med. 2015;90(6):761\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eLu WH, Iuli R, Strano-Paul L, et al. Renaissance School of Medicine at Stony Brook University. Academic Medicine. 2020;95(9S):S362-6.\u003c/li\u003e\n\u003cli\u003eNelson MH, Fierke KK, Sucher BJ, et al. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes. Am J Pharm Educ. 2015;79(4):48.\u003c/li\u003e\n\u003cli\u003eCherniss C, Goleman D. Training for emotional intelligence: A model. In: Cherniss, C and Goleman D, editor. The emotionally intelligent workplace. San Francisco: Jossey-Bass \u0026ndash; A Wiley Company; 2001:209\u0026ndash;33. ISBN: 978-1118308790\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3952262/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3952262/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e Emotional intelligence (EI) is a critical set of skills that impacts clinical pharmacists’ well-being and positively influences high-level patient-centered care. Providing pharmacists’ perceptions may support the integration of EI development approaches into their professional development continuum.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e This research aimed to analyse pharmacists’ perceptions of the characteristics of emotionally intelligent clinical pharmacists, the importance of EI in clinical practice, and educational models and approaches to enhancing EI.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e A qualitative study with a focus group methodology was conducted with pharmacy practitioners using a semistructured guide grounded in the EI competency framework and existing qualitative research methodology practices. Purposive sampling was conducted until information and meaning saturation had occurred. The focus group recordings were transcribed and independently coded by two researchers. Pharmacists' attitudes were categorized and examined through descriptive statistics. The conventional content analysis of qualitative data was applied.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e According to the 17 focus group participants, emotionally intelligent clinical pharmacists are perceived as self-confident communicators who control and manage emotions, work well under pressure, and handle every situation effectively. Emotional self-control, self-awareness and awareness of others, and demonstration of tolerance, understanding, and empathy have emerged as key EI competencies required for challenges in clinical practice. EI lectures with clinical application reflections, behavior modelling, and behavior-changing methods were perceived to be of particular importance for pharmacist education and development programs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e Clinical pharmacists and other practitioners perceived EI competencies as necessary for their professional success and high-quality patient-centered care. They suggested that they be a focal point in pharmacy professional development programs.\u003c/p\u003e","manuscriptTitle":"Perceived importance of emotional intelligence for clinical pharmacy practice and directions for its improvement: a focus group study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-22 21:25:05","doi":"10.21203/rs.3.rs-3952262/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2024-02-20T19:34:34+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-20T08:34:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Clinical Pharmacy","date":"2024-02-19T10:10:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-13T12:45:33+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"91cd2dca-96ed-4f90-b92f-b57a3d97d75c","owner":[],"postedDate":"February 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-05-02T02:40:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-22 21:25:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3952262","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3952262","identity":"rs-3952262","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}