Workplace education and work based learning Dr Catherine Duggan Director Joint Programmes Board Chair of the United Kingdom Clinical Pharmacy Association. Council Member of the Royal Pharmaceutical Society of Great Britain.
The aims of our time here with you... 1. Increase understanding of the use of competency based performance assessment tools as a component of a formalised practitioner development programme 2. Share the learnings from the original development of ALF and GLF in UK and how they "fit" in with above 3. To describe how these can be successfully adopted dto a different healthcare h service and workforce with similar benefits to practitioner performance and patient care delivery 4. To increase educator/ leaders understanding of the workplace assessment and feedback process utilising the Sing GLF to "upskill" 16 "super users" 5. Introduce the use of electronic GLF to assist data capture, entry and review of overall service performance
This presentation 1. Increase understanding of the use of competency basedperformance assessment tools as a component of a formalised practitioner development programme 2. Share the learnings from the original development of ALF and GLF in UK and how they "fit" in with above 3. To start to describe how these can be successfully adopted dto a different healthcare service and workforce with similar benefits to practitioner performance and patient care delivery
Pti Patient tsafety ft Professional Access to medicines Quality and Self care Cost effectiveness challenges? Changing demography Chronic diseases, complexity of therapy Long term disease management New models of delivery New technologies and treatment options Fitness for purpose Knowledge and skills Links between education & practice? Levels of practice related to complexity of patient
What the White Paper says... PGeducation andcpdmustsupport support levels of practice general, advanced and consultant model There must be consistency: Standard, accredited services Standard credentialing processes Consistent approval processes Longer term regulation of advanced d practice
Pharmacist development model Undergraduate & preregistration General postregistration Higher level practice (1) Higher level practice (2) Point of regulation in pharmacy So, what is advanced programmes practice? Professional development
Joint programmes Board www.postgraduatepharmacy.org JPB Drivers for Change Principles for a Pharmacist development strategy: 1. Recognises different level lof practitioner, General, Advanced and Consultant pharmacists. 2. Embracesallfacets all ofpractice. 3. Embraces all sectors of practice. 4. Linked to two recognised competency frameworks that define knowledge and skills (General Level Framework and Advanced to Consultant Level Framework) 5. Underpinned by educational quality assurance structures to provide rigour
Use of frameworks? UK Australia Croatia Slovenia Projects to evaluate use in: EU countries African countries
General Level Framework Delivery of Patient Care Personal Problem Solving Organisation and Management
General Level Framework Delivery of Patient Care Personal Problem Solving Management and Organisation Patient consultation Organisation Gathering information Clinical governance Need for the drug Effective communication Knowledge Service Provision Selection of the drug Teamwork Analysing information Budget setting and reimbursement Drug specific issues Professionalism Providing information Organisations Provision of drug product Follow up Training Medicines information Staff management Monitoring drug therapy Procurement Evaluation of outcomes
Movingfrom knowing (theory) towards doing (performance)
.7 Controlled trial GLF in junior pharmacists Pro obability.6 Intervention = GLF.5 yn Intervention = 30 hospitals.4 Logrank 3 P = 0.00480048.3.2.1 0.0 Non-intervention -.1-2 0 2 4 6 8 Time - months 10 12 14
Community pharmacists Practice pharmacists
GLF evidence baseline and re assessment 320 (70%) pharmacists Qld had baseline 107 have had 1 or more re evaluation Baseline data used to develop training Comparative data of 66 pharmacists Mean 11 months between base and re visit Median scores and ranges for 66 different competencies (activities, behaviours, attributes)
Taking patient s medication history (base) Introduction ti Agenda Questions Consent ADRs Med MdHx Scale :1 = rarely, 2 = sometimes, 3 = usually, 4 = consistently Ian Coombes MSQ November 2009
Taking patient s medication history Sig Introduction ti Agenda Questions Consent ADRs Med MdHx Scale :1 = rarely, 2 = sometimes, 3 = usually, 4 = consistently
Assessing medicine taking behaviour Sig Sig Patient Understands Experience Understand Adherence Manages Background illness of medicines treatment assessment medicines Scale :1 = rarely, 2 = sometimes, 3 = usually, 4 = consistently
Attributes of higher level practitioner? Expert inareaofpractice Able to work in multidisciplinary teams Dissemination and contribution to evidence Training, support and mentorship of staff Managing a team and a caseload Leadership skills
Competency profiles Consultant profile EPP, BR and Leadership at Mastery Management, ETD and RE at Excellence Advanced profile 5 clusters at Excellence RE at Foundation Special Interest Pharmacists profile 4 clusters at Excellence 2 clusters ET&D, RE optional
Pharmacist development model Undergraduate & preregistration General postregistration Advanced Higher Practitioner level r practice (1) Higher level practice (2) Consultant Pharmacist General Level Special PhwSI/Advanced interest & Consultant Level pharmacists Professional Development Frameworks Workplace education; work based learning
Advanced level practitioners 6 4 F HOMALS Quantification Expert PP Leadership Management E & T R & E n = 390 Practice level Specialist in training Experienced practitioner 2 0 F F F F E EE E E MM M M M Leading edgeedge practitioner -2-2 -1 0 1 2
Key performance indicators F1(medical) Low Activity High Activity 200 Saving lives 150 100 50 R-Square = 0.16 0 R-Square = 0.76 70 80 90 100 110 120 Mortality rate Index Borja-Lopetegi, Bates, Webb 2007
Start with the practitioner... Who wants to move on...towards specialism ili & expertise (or revalidation) Who needs access to a practitioner development programme Who wants credentialing as proof of competence (for self, patients, employers, commissioners) Who wants rewards (, career, satisfaction, Awards) Who will needs to be regulated at some point The Practitioner Novice /early career General Level Mid career PhwSI, Advanced or Consultant Generalist revalidation sector independent
Professional Leadership Body Affiliated and/or hosted By PLB General Curriculum Committee General level development c curricula Pre Pre qualification curricula curricula c curricula Specialist group Specialist Curriculum Committee Advanced level Consultant level (incl. PhwSI) Specialist group Inform & represent Specialist group Specialist group Access to A t Community of Practice The Practitioner Novice /early career General Level Mid career PhwSI, Advanced/ Cons Generalist revalidation All sectors
Professional Leadership Body General Curriculum Committee Specialist Curriculum Committee curr ricula curr ricula Pre General level Advanced level Advanced II qualification development curr ricula cu urricula credentialing function (incl. PhwSI) (Experts, Consultants, leading edge, etc.) credentialing function HEIs Local Practice Forum(s) practitioner infrastructure GPhC Outsourcing for revalidation?
3.0 Expert Practice Working relationships 2.5 Leadership Management 2.0 E&T and Development Research & Evaluation Mea an cluste er score 1.5 1.0 0.5 0.0 Specialists in Experienced Leading-edge edge training practitioners practitioners Level 1- Foundation Level 2- Excellence Current level of practice Level 3- Mastery nces skills eviden ge and s ces and owledg perienc Kno Exp
CRITICAL ADJACENCIES
3.0 Expert Practice 2.5 2.0 Working relationships Leadership Management E&T and Development Research & Evaluation Mea an cluste er score 1.5 1.0 0.5 0.0 Specialists in Experienced Leading-edge edge training practitioners practitioners Level 1- Foundation Level 2- Excellence Current level of practice Level 3- Mastery
TRANSFERABLE SKILLS
Academic provision Practice support Various masters we have Study days developed National clinical and specialist groups Consider QA and validation processes National courses Resource pack Link to levels of practice
Advanced Pharmacy Practice Advanced level II Mastery and/or Doctoral level development (APP) Programme Statement of Completion (Advanced Practice) Assessment Assessment Expert Practice & Building Working Relationships E Expert Practice & Building Working Relationships F APP Professional Development Programmes Education, Training & Development E Education, Training & Development F MSc (Advanced Practice) Management & Leadership E Management & Leadership F Research & Evaluation E Research & Evaluation MSc Programme: APP Professional ldevelopment tc Courses ( Core ) F
Credentialing & accreditation Existing UK models Medical Royal Colleges Membership Fellowship US models
Assessments? Testing knowledge, skills, abilities, performance Assessment tools may include: RITA mini CEX mini PAT 360º CBD advanced dosce style tl assessment MCQ examination Aviva voce and portfolio review could assess the practitioner s knowledge and experience across all competencies to Excellence level Against the curriculum and syllabus defined by the SCG
The aims of our time here with you... 1. Increase understanding of the use of competency based performance assessment tools as a component of a formalised practitioner development programme 2. Share the learnings from the original development of ALF and GLF in UK and how they "fit" in with above 3. To describe how these can be successfully adopted dto a different healthcare h service and workforce with similar benefits to practitioner performance and patient care delivery 4. To increase educator/ leaders understanding of the workplace assessment and feedback process utilising the Sing GLF to "upskill" 16 "super users" 5. Introduce the use of electronic GLF to assist data capture, entry and review of overall service performance
Workplace education and work based learning Dr Catherine Duggan Director Joint Programmes Board Chair of the United Kingdom Clinical Pharmacy Association. Council Member of the Royal Pharmaceutical Society of Great Britain.