There was no significant bias in respondents' backgrounds in terms of age, undergraduate course, or region of residence. However, differences were found in terms of sex and highest educational background.

The results of multivariate logistic regression analysis of hospital pharmacists revealed significant associations between “experience presenting at academic conferences” and “age 30 s,” “presence of pharmacists to consult,” “experience in supervising interns,” and “number of types of self-improvement.”

In a report on clinical research by hospital pharmacists, 94.6% of the participants indicated that they were anxious when planning and conducting clinical research. They cited “statistical analysis,” “preparation of research protocol,” and “how to formulate clinical questions” as points of anxiety (or uncertainty) [6]. Therefore, the results of this study highlight the importance of having a pharmacist available at your facility for research consultations, enabling the presentation of your research findings at academic conferences. Additionally, according to the Learning Pyramid published by the US National Institute for Training and Research, teaching others is a learning method with the highest knowledge retention rate [8]. Muroi reported that all pharmacists in a hospital have developed a roof-tile educational system in which they can learn and grow together with interns, thereby deepening their own understanding of diseases and drug therapy [9]. Therefore, we believe that the experience of supervising interns stimulates motivation and reflection on one's own knowledge, which may be related to academic conference presentations. Among hospital pharmacists, support from the human environment of the facility and motivation for self-improvement may be important factors in their commitment to presenting at academic conferences.

However, the items that showed significant associations with the results for community pharmacists were “over 70 s,” “highest educational background (doctoral or master's degree),” and “number of types of self-improvement.” No significant associations were found between physical or human environmental factors in the facility to which they belonged. Thus, among community pharmacists, physical and human environmental factors did not differ significantly among pharmacies, suggesting that individual motivation influenced their commitment to present at academic conferences. In a survey of Canadian pharmacists working in emergency medicine, there was a relationship between current research and the experience of obtaining a master's or doctoral degree [10], and it is thought that their original motivation for research, such as the experience of attending a master's or doctoral program, influenced their commitment to presenting at academic conferences after employment. However, the small number of community pharmacists with experience presenting at academic conferences suggests that this factor may not have been accurately captured.

Regarding the results of the stratified analysis, significant associations were found for “sex (male)” and the “number of types of self-improvement” among pharmacists affiliated with large hospitals. Ueki et al. reported that the greater the number of hospital beds, the lower the levels of job satisfaction [11]. Women are less satisfied with their jobs than men are in items such as relationships with other healthcare professionals and patients. Furthermore, they may take leaves of absence or resign from their jobs owing to life events such as childbirth or maternity leave. Therefore, it is possible that men work more persistently at large hospitals and, consequently, have more opportunities to present at academic conferences. Additionally, since environmental factors, such as guidance and education systems, are generally considered better in large hospitals, it is possible that individual motivation for self-improvement influences one’s efforts to present at academic conferences. Significant associations were found among pharmacists belonging to “ 30 s,” “40 s,” “50 s,” “meeting a role model,” “more than 16 full-time pharmacists,” and “presence of a pharmacist to consult” among pharmacists belonging to small- and medium-sized hospitals. However, no significant association was found for “number of types of self-improvement.” Therefore, it was considered that in small- and medium-sized hospitals, the physical and human environmental factors of their institutions, such as stimulating experiences as students, consultation systems, and personnel, influenced pharmacists’ commitment to presenting at academic conferences rather than their motivation to conduct self-improvement.

A survey on clinical research support efforts reported that the number of oral presentations at academic conferences and the number of papers written by hospital pharmacists improved when universities and civil hospitals collaborated and university faculties provided research guidance to hospital pharmacists [12]. Since small- and medium-sized hospitals do not have the same physical and human environment as large hospitals, it is conceivable that the establishment of such support may increase opportunities to make presentations at academic conferences.

Accordingly, pharmacists in small- and medium-sized hospitals may be constrained from taking part in conference presentation efforts because of a lack of a specific number of years of experience or a sufficient number of pharmacists. It is possible that those in their 20 s may not have had many opportunities to experience academic conference presentations, as the focus of their work is on daily duties. However, the “presence of a pharmacist to consult” and “meeting a role model” may have positive impacts.

It was interesting that “meeting a role model” was related to the experience of presenting at academic conferences in an environment with insufficient physical and human resources at one's facility.

In the stratified analysis of community pharmacists, only the highest educational background (“doctoral or master 's degree”) was significantly associated with pharmacists affiliated with a pharmacy chains or DS. Regarding motivation for self-improvement, it is possible that pharmacists affiliated with pharmacy chains and DS have a better environment for self-improvement, such as training, than small- and medium-sized community pharmacies, and that no difference was found. Therefore, it is conceivable that only past research experience may have led to their commitment to academic conference presentations. However, the small number of community pharmacists who had　presented at academic conferences may not have accurately captured these factors.

A significant association was found between number of types of self-improvement among pharmacists belonging to small- and medium-sized community pharmacies. Therefore, it is possible that pharmacists belonging to small- and medium-sized community pharmacies have greater differences in motivation for self-improvement, which may affect their commitment to academic conference presentations.

Additionally, a comparison of hospital pharmacists and community pharmacists showed a significant difference in the background of the respondents, with only 41 (13.7%) of the community pharmacists having “experience presenting at academic conferences” compared to 152 (50.7%) of the hospital pharmacists. Compared to the latter, the former are expected to face multiple physical environmental and human environmental factors at your facility when presenting at academic conferences. Hospital pharmacists can obtain detailed patient information, such as background, medical history, and laboratory values from medical records. However, community pharmacists will only be able to access limited information from prescriptions and medication records.

Additionally, according to a survey [13] by the Ministry of Health, Labour and Welfare, the average number of pharmacists in one pharmacy was 2.3 (median 2.0); there may be insufficient pharmacists to guide on research owing to fewer pharmacists in the facility compared to hospitals. In the present results, there was a significant association between “experience presenting at academic conferences” and “presence of pharmacists to consult” among hospital pharmacists, but not among community pharmacists. Therefore, it is possible that the presence of mentors was low among community pharmacists. These differences in human environmental factors may be responsible for differences in academic conference presentation experiences between hospital and community pharmacists.

Sato et al. conducted a clinical study as a community pharmacists, in collaboration with hospital pharmacy departments and universities and reported the results [14, 15]. In the United States, the Governmental Agency for Healthcare Research and Quality has taken the lead in establishing practice-based studies. Since 1999, a practice-based research network has been established in each region, led by primary care physicians. Pharmacists' awareness, interest, and motivation in clinical research have reportedly increased over time, owing to the existence of such networks [16]. To address the strain in conducting research in affiliated institutions' current state of affairs, we suggest forming networks and collaborating with other facilities and institutions, as in the case of small- and medium-sized hospitals. We believe that this strategy can be adopted in Japan.

In the sensitivity analysis, there was no significant variation in items other than respondent attributes (age, last educational background, etc.) for hospital and community pharmacists. Therefore, the results of this analysis were considered robust. The percentage of hospital pharmacists who had presented at academic conferences was similar to that in previous studies [6].

Since this study was a nationwide, Internet-based survey, a limitation was the inclusion of only pharmacists registered as monitors with an Internet research firm and of those able to use a PC or other electronic devices. However, the use of electronic devices is currently mandatory in pharmacist practices. As there was no bias in respondent age, we were able to collect results that were close to the current situations of pharmacists. Based on the results of a survey of hospital pharmacists regarding the surrogate outcomes of this study [6], we considered that the absolute number of hospital and community pharmacists with experience in writing papers is currently small.

Therefore, in order to emphasize the feasibility of the study, we set the experience of presenting at academic conferences, which is considered the first step in evidence generation, as an outcome in this study, although it is a lower hurdle compared to writing a paper. Therefore, factors other than the experience of writing may exist.

In addition, we did not confirm the affiliations and number of presentations for the surrogate outcome in this study, which was the presence or absence of experience presenting at academic conferences after employment. Therefore, it is possible that employment history influenced the results or that the presentation was a one-time event. Therefore, it is unclear whether the problem was continuously identified and resolved. And we did not investigate the quality of evidence for the content of past conference presentations.

The number of pharmacists who had presented at academic conferences was extremely small among community pharmacists, and the sample size was not large enough to accommodate the number of factors in the multivariate analysis. This limitation reduced the reliability of the analysis.