the scottish hospital pharmacists’ vocational training scheme : stage 2 fiona mcmillan

Quality Education for a Healthier Scotland

Pharmacy

The Scottish Hospital Pharmacists’Vocational Training Scheme : Stage 2

Fiona McMillanLead Pharmacist Educational Development

NHS Education for Scotland


Pharmacy

What is the Pharmacy Vocational Training Scheme? Stage 2

A structured training scheme for junior pharmacists who are working in secondary care. It equips them with a broad range of skills to enable them to work confidently, consistently systematically and safely, to provide optimal patient care for a variety of different patient groups.

General Level Framework• Modernising Pharmacy Careers


Pharmacy

The ModelLearning by experience and reflection on actions

Kolb’s learning cycle

Active experimentation

Concrete Experience

Reflection

Conceptualising

Source: Kolb, 1984


PharmacyWhy is vocational training important?Standardised and comprehensive experience of all areas within

hospital pharmacy

Links theory to practice

Learning in workplace builds confidence and dealing with unpredictability

Facilitates analysis of situations

Enables observation of role models and team working

Facilitates development of professionalism

Linked to KSF


Pharmacy

Development ProcessThe overall staged development process is:

Stage Accreditation

UG University Undergraduate (Summer Student)

I Pre-Registration Pharmacist

2 General Hospital Pharmacist Practitioner

3 Advanced Hospital Pharmacist Practitioner

4 Hospital Pharmacist Leader


Pharmacy Pharmacist

Stage 2

The necessary skills and experience over the whole range of hospital pharmacy activities

General Hospital Pharmacist Practitioner


Pharmacy

Stage 2Vocational Training Scheme

Commenced ~ 15 years ago

Revised several times - most recently in 2009

Training and assessment aligned to medical and dental models Competencies: Professional focus : 9 competency areas, clinical pharmacy andapplication of pharmacy practice

Evidence: CPD records, case studies, feedback forms

Portfolio assessment: Medical Review in Training Assessments

QA processes

New opportunities for learning [virtual room, presentations on web, induction sessions, peer sessions]


Pharmacy

Pharmacy Vocational Training Scheme What is required for Stage 2 ?

Completion of a competency based framework-9 elements MI, Clinical Gov, Dispensing services, aseptic services

Development of ‘evidence’ [CPD records, clinical case studies,feedback forms]

Development of a personal portfolio or work

Completion of a variety of modules/reading for discussion with tutor


Pharmacy

Pharmacy Vocational Training SchemeSo what did they experience?

Clinical practice ~1 year practice rotated into clinical areas of medicine, surgery +2

specialities - the role of medical gases when caring for patients clinical setting

Application of Pharmacy practice ~1 year practice rotated into variety of areas to enable learning

about

e.g. the role of the pharmacist in preparation of aseptic products for individual patients, legislation relating to preparation of aseptic products.


Pharmacy


Application of Pharmacy Practice

Analysis of prescribing: Audit, MUE undertaken

Patient safety and Clinical Governance - risk assessment, analysis of significant event undertaken.

The pharmacist as a teacher -teaching of several different groups of healthcare professionals -development of training plans for a variety of settings


Pharmacy


Assessment

Assessment of portfolio by panel

Final assessment of trainee - representation from SOPs - confirmation of systematic approach to professional skills - application of problem solving skills - awareness of personal limitations - presentation of aspect from portfolio - 4 practice scenarios - confirmation of portfolio evidence [if required]


Pharmacy

Pharmacy Vocational Training SchemeFacts and Figures

Commenced=Folders issued June - June

June 2007 - 31st May 2008 Number commenced = 24* Number completed = 19

June 2008 - 31st May 2009 Number commenced = 28 Number completed = 15

June 2009 - 31st May 2010 Number commenced = 49 Number completed =19*

~ 70% completion rate* 2 years after starting.


Pharmacy

Trainees started training

by Health Board AreaJune 2009 - June 2010

0 5 10 15 20 25

AA

GG

Gramp

High

Lan

Loth

Tay

Area

Number trainees started

Series1


Pharmacy

Trainees completed trainingby Health Board Area

10 years [Completed to date]

0 5 10 15 20 25 30 35 40 45 50

AA

DG

Fife

FV

GG

Gram

High

Lan

Loth

Tay

Area


Pharmacy

Trainees completed training

Completed May 2007- May 2010

02468

101214

HBoard Area

Num

ber o

f tra

inee

s

Series1

10yr : 2007-10AA 13 7DG 3 3F 1 1GG 46 12Gr 6 2High 3 3Lanark 23 12Loth 15 6Tay 16 4


Pharmacy

Trainees commenced June 2007 – Dec 2007

Commenced

012345678

HB Area

Num

bers

trai

nees


Pharmacy

Trainees completed ~2 years later[Av tome for completion= 2 years]

Trainees completed [~2yrs]

012345678

HB Area

Num

ber o

f tra

inee

s Transferablee.g. Glasgow toLanarkshire


Pharmacy

Qualitative researchn=14

How do Stage 2 trainees like to learn?

‘I like to learn by reading and then .. practical experience’

‘Stage 2 gives you a structured pathway.’

‘It helps me focus where my learning needs to be to observesomeone else.’

‘Working in practice then looking into it myself’

‘It made you reflect..’

‘A doing way of learning.’

‘To have direction…but good to be left up to your own devices..’


Pharmacy

Qualitative researchn=14

What were the main areas of learning?

‘Clinical… nice structured way of going through a patient’ ‘I had to go away and read about the conditions…’

‘I learnt a lot from the specialised cases that I wouldn’t have been exposed to if I didn’t do the training.’

‘Provided some reassurance .. Care plans being seen by someone who was evaluating them.’

‘Gives me confidence…. suitable standard.’

‘I hadn’t had formal MI..’

‘Medical gases quite interesting’


Pharmacy

Qualitative researchn=14,

What was their area of least learning?

‘[Medical gases]…I wouldn’t use gas testing again…’ focus now on clinical application of gases

‘Resource management, procurement.. I am not involved in that area.’ focus now changed due to service redesign

‘Distribution not particularly relevant.’ focus now changed due to service redesign

Conclusions drawn from qualitative research undertaken in 2009 was that trainees learnt more when the experience could be related to their own personal everyday practice or an area of practice that they may wish to explore in a more senior role.


PharmacySummary of experience

‘I have gone into MI. If I hadn’t been doing the rotation I wouldn’t have had the opportunity…’

‘I probably wouldn’t have got a rotation.’

‘Stage 2 gave me confidence. How to deal with things.’

‘Probably the training opportunity it gives you.’

‘Opened my eyes it is a more structured training.’

‘The knowledge of the background activity.’

‘Made me decide what I wanted to do in my career.’

‘It gave me an overview.’Good in giving you a baseline.’


Pharmacy

Qualitative Research n=14

What was their overall experience?

‘Overall a good experience.’‘It develops you all round as a pharmacist.. I don’t think you would get this

without Stage 2.’

‘A lot of late nights.. It has been worthwhile..I have got something to show..’

‘..quite daunting..but when you get into it, it is manageable.’

‘It is good to have that experience behind you.’

‘To begin with I hated it.. but towards the end I could see that it was very beneficial..’


Pharmacy

Pharmacy Vocational TrainingStage 2

Conclusions

Stage 2 of The Scottish Pharmacy Vocational Training Scheme has been revised in light of service redesign in Scotland.

It is a training scheme that aims to develop pharmacists through learning by their everyday experiences and not by underpinning knowledge alone.

Research informs that whilst Stage 2 of the Vocational Training Scheme is challenging, it is viewed by the majority of trainees as;

being a way of receiving a broad structured training and feedback from experienced senior pharmacists

increasing their confidence giving a sense of improved quality of the pharmaceutical care that they are able to provide

helping inform their career choice by providing a well structured grounding in all aspects of hospital pharmacy.


PharmacyPharmacy Vocational Training

Stage 2What’s next?

Development of different formats for traininge - portfolio, Online training, virtual room]

Improving QA processesStrengthening of application criteria – tutorsCalibration of tutors, development of tutor network Development of trainee peer support sessions


PharmacyPharmacy Vocational Training Potential developments

Development of community scheme?

Development of further modules?

Development of specialisation [Stage 3, 4]Underway –Older people, critical care

the scottish hospital pharmacists’ vocational training scheme : stage 2 fiona mcmillan

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