Using a Secret Shopper to Evaluate Pharmacist Provision of Emergency Contraception
Bibliographic record
Abstract
Introduction: Commonly known as “the morning-after pill,” hormonal emergency contraception or the emergency contraceptive pill (ECP) is most effective if used within 72 hours of unprotected sex. In this paper we review a pilot project in Toronto, Ontario, that aimed to increase accessibility by allowing pharmacists to dispense ECP through a pharmacist-physician collaborative agreement, using a predefined protocol. Participating pharmacists received training in the pilot protocol and about ECP. To evaluate whether participating pharmacists were following the project protocol (i.e., giving accurate information to women requesting ECP and dispensing ECP appropriately), and to determine the quality of the pharmacist-patient encounter, we sent “secret shoppers” to participating pharmacies. Method: Five trained “secret shoppers,” using one of two predefined scripts (Script One, where ECP was clearly appropriate, and Script Two, where ECP was not appropriate) visited 34 participating pharmacies to request ECP. At the end of the visit, the secret shopper filled in a questionnaire about the encounter and provided comments. Percentages were calculated for all variables. Results: For Script One encounters (n=17), most pharmacists followed the protocol correctly to dispense ECP. For Script Two encounters (n=17), 71.4% provided alternatives to ECP, but three pharmacists did not follow protocol and provided ECP. For Script One, 52.9% of pharmacists and for Script Two, 71.4%, provided a community referral for follow-up care. The majority of pharmacists (97%) treated the shopper with respect and 85% communicated clearly. Most of the shoppers' comments were positive and the main negative comment about the encounter was lack of privacy. Conclusions: The use of a secret shopper allowed the examination of the pharmacist-customer interaction to delineate issues of importance to the pilot project and provide feedback on areas that may require improvement in the pharmacy provision of emergency contraception, namely, dealing with women who do not qualify for ECP and providing women with community referrals for sexually transmitted infections or ongoing contraception.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".