Keynote address elearning to improve paediatric prescribing competence

Transcription

1 #NPPG2016 Keynote address elearning to improve paediatric prescribing competence Sarah Pontefract, SCRIPT Editorial Lead & Sam Lissauer, Clinical Research Fellow, University of Birmingham

2 SCRIPT Paediatric elearning to improve paediatric prescribing competence Dr Sam Lissauer Miss Sarah Pontefract

3 Background There is a consistent theme of under-preparedness for prescribing Foundation trainee doctors. [1] The GMC commissioned EQUIP study [2] recommended: Education in practical prescribing should be part of early postgraduate training. Foundation trainee doctors should be given explicit feedback regarding their prescribing practice. [2] Education in prescribing should be a continuing process in postgraduate #safeprescriber

4 Aim Encourage safe, effective, and rational prescribing by developing elearning modules that reflect current prescribing practice in the NHS. Standardise prescribing education for Foundation trainee doctors and encourage self-directed just-in-time learning relating to prescribing and therapeutics. Facilitate monitoring of trainees progress through their learning and monitor #safeprescriber

5 Undergraduate access: 11 medical schools Foundation Doctors Foundation Dentists 47 modules Paediatric Trainee Doctors 7 modules Nursing 25 modules GPs 18 modules 20 modules 2017 launch

6 Dr Sam Lissauer Paediatric Trainee University of

7 Trainees and prescribing

8 Medication Errors 33,000 paediatric safety incidents were reported to the NRLS in Medication errors accounted for 20% of these. The incidence of prescribing errors in paediatric in-patients is around 13%. RCPCH need for a response to critical incidents of gross prescribing error #safeprescriber

9 Medication Errors A West Midland survey 90% of specialist paediatric trainees had been involved in a #safeprescriber

10 RCPCH Curriculum (2016) Good Clinical Care This section describes the generic competencies (knowledge, skills and behaviour) that relate to clinical practice and the importance of the child s needs e.g. APLS, history taking, clinical examination (assessment standards 2-8), promotion of patient safety and therapeutics and prescribing (standards 9-12) and safeguarding children (assessment standard 13).

11 RCPCH Curriculum (2015) Level One Level Two Level Three Knowledge and skills in safe prescribing of common drugs in paediatrics Improving safe prescribing in paediatrics and in advising others appropriately Responsibility for safe prescribing in common and complex situations and for the supervision #safeprescriber

12 START Specialty trainee assessment of readiness for tenure. Assessment taken in ST7. There is a high incidence of developmental needs on prescribing station nationwide, for example: Intravenous aminophylline. Dose adjustment of gentamicin in #safeprescriber

13 Our Vision Provide an elearning programme to improve the prescribing knowledge and skills of ST1 ST8 trainees and non-medical prescribers within paediatrics. Create content for 25 paediatric specific modules. Create a learning environment that will encourage learning and reflective practice. Provide evidence for continuing professional development and linkage to paediatric specific curriculum and e-portfolio. Provide a team of clinical pharmacologists, pharmacists, paediatricians and elearning experts to design, develop and disseminate the results of this #safeprescriber

14 Lets #safeprescriber

15 The Paediatric SCRIPT modules and how they fit #safeprescriber

16 #safeprescriber

17 Sarah Pontefract SCRIPT Editorial Lead University #safeprescriber

18 The elearning Programme Web-based learning Clear learning outcomes Prescribing and therapeutics Background pharmacological knowledge Scenario-based learning Patient safety Pre-test to identify learning needs; post-test to assess knowledge acquisition In-module formative assessment to embed knowledge Certification e-portfolio

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23 Monitoring Progress Dedicated reporting tools. Access to When modules are completed. Pre- and post-test scores. Time spent on the learning. Why? Ensure that trainees are taking steps to develop their prescribing knowledge in postgraduate education. Support feedback for trainees about their prescribing education. Encourage discussion about prescribing in workplace education and #safeprescriber

24 Evaluation Results Behaviour Learning Reaction Figure adapted from Kirkpatrick s (1998) model of #safeprescriber

25 Evaluation Results Behaviour Learning Reaction 75% of respondents agreed it had a positive impact on prescribing skills and knowledge 66% felt more able to challenge decisions 75% had changed prescribing practice

26 Integration into Training

27 Quality Assurance Authored by specialists healthcare professionals Physician; Pharmacist; Nurse. Modules are externally peer reviewed. All modules are reviewed by the author every 2 3 years. Content updated on a daily basis as new guidance is published or patient safety alerts are disseminated. The editorial and technical team respond to feedback from #safeprescriber

28 Quality Assurance #safeprescriber

29 Any #safeprescriber

30 With thanks to Specialist Editorial Board Helen Goodyear Fiona Reynolds Eleanor Hay Liz Evans Rhian Isaac Akila Ahmed Maybelle Wallace Our authors and peer reviewers Health Education England School of Paediatrics Specialist Paediatric Editorial Board University of Birmingham SCRIPT Editorial team OCB Media Ltd Birmingham Children s Hospital

31 References 1. Rothwell, C., Burford, B., Morrison, J., et al. (2012) Junior doctors prescribing: enhancing their learning in practice. British Journal of Clinical Pharmacology, 73 (2): Dornan, T., Ashcroft, D., Heathfield, H., et al. (2009) An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study. [online] Ghaleb MA, Barber N, Franklin BD, Wong ICK. The incidence and nature of prescribing and medication administration errors in paediatric inpatients. Archives of Disease in Childhood. 2010;95(2):113-8.