Competency-based assessment of practice-based experiential learning in undergraduate pharmacy programmes.

Objective: To obtain feedback from experiential leaning (EL) leads about how competency-based assessments could be undertaken by EL facilitators, and to scope existing EL assessment structures in undergraduate Masters in Pharmacy (MPharm) programmes across the United Kingdom (UK). Methods: A cross-sectional survey was conducted utilizing a nine-item on-line survey, consisting of five open-ended and four closed-ended question. All UK universities with MPharm programmes (n=30) were invited to participate in the survey. Variables of interest were perceptions on activities and competencies that could be assessed by EL facilitators. The survey utilised a 5-point Likert-type response ranging from strongly disagree to strongly agree. Other variables of interest were tools/methods that could be used to assess competency, and perceived advantages and disadvantages of the proposed methods, the latter two captured via open-ended questions. Results: Of the 21 universities that responded (Response rate: 70%), 17 were included in the final analysis. Fourteen of the 17 (82.4%) offered the 4-year programme, while 3 (17.6%) offered both the 4-year and 5-year integrated programme. Assessments were mainly undertaken by university staff (59%), with minimal amounts undertaken during EL (39%). There was unanimous agreement (100%) that facilitators could assess students’ communication skills and professionalism during EL. No consensus, however, was achieved with regard to the tool(s) or method(s) to be used to assess student’s competencies. There were 13 responses to the open-ended comments. An advantage noted was that EL facilitator assessment of students would allow for more accurate evaluation of students in the practice setting, while acknowledging barriers such as the burden of time and the lack of consistency in marking. To address this lack of consistency, the majority highlighted the need for facilitator training. Conclusion: Minimal assessments are currently undertaken during EL, with students predominantly assessed on return to the university. No consensus could be achieved with regard to the tool(s) or method(s) to be used to assess students’ competencies, suggesting that perhaps there is no one-size-fits-all, and that the tools and methods used should be informed by the competencies being assessed

Pharmacy students’ experience of a novel government-funded experiential learning initiative: a mixed-method study (ACTp Study).

Background: In 2018, the Scottish Government made the Pharmacy Additional Cost of Teaching (ACTp) funding available to support the development of Experiential Learning (EL) in undergraduate pharmacy education. To inform the further expansion of EL in the pharmacy degree evaluation of new EL sites was required. Aim and method: A mixed-methods study was undertaken to determine students' perceptions of four new areas included in an EL pilot: primary care, out-of-hours, specialist sites, and remote and rural. Results: There were 43 survey respondents (response rate 72%). Majority agreed the pilot had developed their clinical (n=28, 74%) and communication skills (n=31, 82%), and prepared them for future practice (n=30, 79%). One third felt the EL did not permit them to interact with patients. Focus group and interview participants were positive about their experience and the opportunity to experience new pharmacy roles in non-traditional settings. Many highlighted the lack of hands-on experience and facilitator feedback. Facilitator training and quality assurance of sites are warranted. Conclusions: Future work should focus on assessment of and feedback for students, and interprofessional opportunities within EL

A cross-sectional study examining the nature and extent of interprofessional education in schools of pharmacy in the United Kingdom.

Interprofessional education can prepare the workforce for collaborative practice in complex health and social care systems. The aim of this study was to examine the nature and extent of interprofessional education in schools of pharmacy in the United Kingdom. An online questionnaire was developed using systems theory, published literature and input from an interprofessional expert panel. It included closed and open-ended questions and a demographic section. Following piloting, it was distributed to 31 schools of pharmacy. Descriptive statistics were used for quantitative data, a content analysis approach for qualitative data. Ten schools of pharmacy responded. All reported delivering compulsory interprofessional education. Most (80%) reported an interprofessional steering group overseeing development. Formative and/or summative assessment varied depending on year of study. Mechanism and purpose of evaluation varied, with respondents reporting Kirkpatrick Evaluation Model Levels 1-3 (100%;80%;70%). Two themes were identified: "Variation in Interprofessional Education Approaches and Opportunities" and "Factors Influencing Development and Implementation of Interprofessional Education". Formal teaching was mainly integrated into other modules; various pedagogic approaches and topics were used for campus-based activities. Respondents referred to planned interprofessional education during practice-based placements; some still at pilot stage. Overall, respondents agreed that practice-based placements offered opportunistic interprofessional education, but a more focused approach is needed to maximise student pharmacists' learning potential. Most interprofessional education offered in undergraduate pharmacy curricula in the United Kingdom is campus-based, the nature and extent of which varies between programmes. Very few examples of practice-based activities were reported. Results may inform future interprofessional education curricular developmen

Qualitative study exploring the key determinants of information gathering to inform the management of over-the-counter (OTC) consultations in community pharmacies

Peer reviewedPublisher PD

The development of a marker system for Pharmacists' Behavioural Skills

Objectives: Pharmacists increasingly require complex behavioural skills to fulfil enhanced roles within healthcare teams. Behavioural marker systems are used to assess behavioural (or non-technical) skills during immersive simulation. This study aimed to develop a marker system for pharmacists' behavioural skills in patient-focussed care scenarios, and to investigate its content validity. Methods: Literature describing existing marker systems and the requisite behavioural skills of pharmacists were presented to two expert panels, alongside video examples of pharmacists in patient-focussed care simulations. The expert panels used this information to develop a new behavioural marker system. A third expert panel assessed the content validity, and the item- and scale-content validity indices were calculated. Key findings: The resulting tool contains four categories, each with three or four skill elements: situation awareness (gathering information; recognising and understanding information; anticipating, preparing and planning), decision-making and prioritisation (identifying options; prioritising; dealing with uncertainty; implementing or reviewing decisions), collaborative working (involving the patient; information sharing; leadership or followership), self-awareness (role awareness; speaking up; escalating care; coping with stress). The scale-content validity index was 0.95 (ideal) and the only item below the acceptable cut-off was 'leadership or followership' (0.7). Conclusions: This tool is the first marker system designed to assess the behavioural skills of pharmacists in patient-focussed care scenarios. There is evidence of good content validity. It is hoped that once validated, the Pharmacists' Behavioural Skills marker system will enable pharmacy educators to provide individualised and meaningful feedback on simulation participants' behavioural skills.</p

What capabilities are required for facilitators to support student pharmacists effectively during experiential learning (EL) in Scotland? : Part 1

Experiential Learning (EL) is a requirement of the General Pharmaceutical Council’s Standards for the Initial Education and Training of Pharmacists. Essential to the growth of high-quality EL is the development of the facilitators who supervise the student pharmacists in practice. This research aimed to identify the capabilities required by facilitators to support a student pharmacist effectively during EL. A two-phase mixed methods process was undertaken to reach agreement on the capability descriptors required by EL facilitators. A literature review followed by a modified Delphi process was used to determine consensus on the identified draft capability descriptors. All feedback gained from the Delphi was analysed and used to shape the development of the descriptors. A panel of 48 stakeholders were recruited to take part in the Delphi Process. Response rates for the two Delphi rounds were high (Round 1 – 46 (95.8%), Round 2 – 41 (85.4%)) Following the Delphi the initial list of descriptors was reduced to 92 descriptors across eight overall domains. Through this research, a high level of consensus was reached for the range of descriptors within the framework which can ensure relevant, efficient education and training for EL facilitators to develop quality EL in pharmacy environments

Piloting the United Kingdon 'Prescribing Safety Assessment' with pharmacist prescribers in Scotland.

Background: Prescribing is a complex task requiring considerable knowledge and skills. The Prescribing Safety Assessment (PSA) was developed by the British Pharmacological Society and the United Kingdom (UK) Medical Schools Council. Between February and June 2014, over 7000 final year medical students undertook the PSA, with an overall pass rate of 94%. Independent prescribing for suitably trained pharmacists was introduced in the UK in 2006. To date there has been little focus on any objective measures of prescribing safety. Objective: To determine the PSA performance of a pilot group of pharmacist prescribers in Scotland relative to medical students and to test the feasibility and acceptability of running the PSA. Methods: A group of 59 pharmacist prescribers took part in ten events. The PSA consisted of 30 questions to be completed over 60 min. All questions had been used in the 2014 assessments for final year medical students. The PSA was undertaken online under invigilated conditions, mirroring the medical student assessment. One month later, participants were invited to complete an online evaluation questionnaire. Results: The mean overall PSA scores (±SD) were 87.5% ± 8.7 (range 52–98) compared to a 88.5% for medical students. Based on an Angoff passmark of 76.0%, 53 pharmacists (89.8%) passed compared to an overall pass rate in PSA 2014 of 94%. Pharmacists performed equivalently to medical students in all assessment areas, with a slightly lower performance in the prescribing, drug monitoring and data interpretation questions offset by better performance in prescription review and adverse drug reactions. Feedback was positive in relation to appropriateness, relevance and level of difficulty of the PSA although several commented that they were practicing in very specific clinical areas. Conclusion: These pilot events have benchmarked the PSA performance of pharmacist prescribers with final year medical students, and feedback confirmed feasibility and acceptability

General public awareness and views of community pharmacy services in Scotland: the 'first port of call' study.

Background: The recently published 'Achieving Excellence in Pharmaceutical Care: a Strategy for Scotland' urges community pharmacy (CP) to make itself the 'first port of call' for healthcare advice. Purpose: To explore the Scottish general public's awareness of CP services and their openness to consider CP their 'first port of call' for health care advice. Methods: A Scotland-wide survey was administered up to 20 times in each of 117 CPs by pre-registration pharmacy graduates. It included Likert scales of attitudinal statements with items developed from existing literature. Ethical approval had been gained. Results: To date, the 2260 surveys have been completed from 117 CPs giving a response rate of 96.5%. Varying ages and standards of health are represented. Respondents were aware CPs 'are contracted to the NHS' (87.4%) and that 'pharmacists with an additional qualification can diagnose and prescribe' (53.3%). 87.6% would likely/very likely view CP as their 'First port of Call' for common illnesses. However, 71.4% were unlikely/very unlikely to approach CP with 'more serious symptoms'. Intentions for 'monitor or review of regular medicines' were less clear (unlikely/very unlikely (38.2%) against likely/very likely (35.1%)). 44% lacked an awareness of CP services in general. 75.3% indicated the pharmacist 'should have access to read and update relevant parts of my electronic health record' and pharmacist access to electronic records would make 67.8% more likely to view CP as a 'first port of call' for health issues. Conclusions: This Scotland-wide survey indicated the general public's positivity and openness to access community pharmacy services, however, being recognised as a 'First Port of Call' may require awareness raising

Quality improvement of community pharmacy services:a prioritisation exercise

Funded by NHS Education for ScotlandPeer reviewedPublisher PD

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy