Medicines Information (MI) Training for Pre-registration Pharmacists

Overview

This document is recommended to provide a consistent and high quality approach to meeting pre-registration pharmacist training requirements in Medicines Information.

Content Page

Objectives1

Management of pre-registration training2

Methods of assessing MI skills3

Learning outcomes framework4-7

Objectives for Pre-reg and Practice Supervisor

This training will deliver core skills in clinical problem-solving which are applicable to pharmacists in a range of professional capacities. Training will ideally be delivered in an MI centre. The following central objectives are mandatory:

To ask appropriate questions when receiving an enquiry or clinical problem (i.e. obtaining background information/ drawing out information from a range of enquirers).

To seek information from specialist resources and colleagues (i.e. identifying appropriate sources; advantages and disadvantages of each).

To collate, synthesise and evaluate the information found (i.e. summarising the information and critically analysing the evidence. Which evidence is most robust?).

To produce a practical and relevant answer (i.e. providing advice specific to the context of the question; an answer that does not require the enquirer to do further work and that anticipates their other needs).

To communicate the answer to the enquirer clearly and in a timely manner, using a range of appropriate means (i.e. in person/ email/ telephone/ letter).

Managing Pre-registration Training

There are a variety of factors that affect the way that pre-registration training should be organised.KSS Pharmacy Education makes the following recommendations to support MI Practice Supervisors:

Experience Required of MI Practice Supervisor

Each named MI Practice Supervisor should be able to demonstrate:

  1. Practice Supervisor or equivalent ‘Train the trainer’ coaching or qualification. Note if the MI Practice Supervisor is new in post then a local education mentor should be assigned to him/her for support and feedback.
  2. Familiarity and complete understanding of the contents of the Medicines Learning Portaland MiCAL.

Requirements of MI Centre

  1. Attainment of the national standards for an MI pharmacist who runs an MI centre.
  2. Subject to audit by regional MI centre every three years in accordance with UKMi national standards.

Duration of Rotation

In order to complete all the training outlined in this document it is recommended that each pre-registration trainee receive 4 weeks full-time experience. However, the precise duration of training should be determined locally as long as the learning outcomes can be met.

Contact Time

It is understood that pre-registration pharmacists working in an MI centre cannot have access to their MI Practice Supervisor all of the time. Sometimes, for example, it is appropriate for the Supervisor to direct the trainee’s research into a particular problem or exercise and then depart, leaving the trainee to undertake this work. When the Supervisor is absent, the pre-registration pharmacist must understand the limits of their responsibilities – e.g. that they cannot answer enquiries unaided, but may take telephone messages.

However, it is expected that the trainee will have immediate access to an appropriately experienced MI practitioner for at least 75% of the time. There should be adequate supervision during non-contact time.

Pre-assessment

If necessary the learning outcomes framework can be used as a pre-assessment tool for trainees who might need a shorter period of training. It can be used to establish a baseline from which a training plan can be developed (e.g. some pre-registration pharmacists may already have good literature searching skills due to their undergraduate experience).

Ratio of Trainees: Practice Supervisor

In practice some MI centres may take two pre-registration pharmacists for training at once. This practice is acceptable, provided the MI Practice Supervisor can ensure sufficient supervision and contact time to meet the needs of both trainees.

[Last updated: 2013]

Methods of Assessing MI Skills of Pre-registration Pharmacists

A number of methods can be used to assess the MI skills of pre-registration pharmacists, including:

Review of the Medicines Learning Portal including the Learning Exercises

Feedback on results of MiCAL exercises

Observation, and response to Practice Supervisor’s feedback

Peer review of answered enquiries

Local tutorials, to test engagement and understanding

Pre-registration pharmacist’s own reflections

Asking for feedback from experienced colleagues and enquirers

Role play (e.g. ethical dilemmas, questioning skills)

Discussion with trainee, and ability to defend own answers or actions

Portfolio of evidence (e.g. enquiries completed, examples of successful problem-solving at ward level)

Contribution to bulletins and other active work

The UKMi telephone skills evaluation tool provides an assessment

Assessing clinical problem solving skills by the pre-reg accompanying the MI pharmacist to his/her designated wards (if applicable).

Ideally, pre-registration pharmacists should be assessed according to the following pattern:

  1. Local training needs analysis informally at induction into MI (e.g. previous experience of MI, familiarity with literature searching techniques). Need not be in writing.
  2. Informal progress review midway through training using the MI Learning Outcomes Framework to determine progress, and then adjustment of future training programme accordingly. The pre-registration Educational Supervisor (pre-reg tutor) should be informed if progress is unsatisfactory.
  3. Formal assessment and feedback at end of training, using the MI Learning Outcomes Framework, and with a copy given to the trainee and to the Educational Supervisor (pre-reg tutor).

[Last updated: 2013]

Medicines Information Learning Outcomes Framework for Pre-registration Pharmacists

These learning outcomes, derived from the GPhC performance standards, identify where MI is well placed to provide good quality evidence of competence. Pre-registration pharmacists should tackle a range of enquiries whilst in MI including those that are urgent and/or higher risk, and participate in other MI activities as appropriate (e.g. publications, formulary). It is recommended trainees answer at least twelve enquiries of at least five distinctly different types.

Trainees should be encouraged to complete self-assessment against the learning outcomes throughout the training, by providing evidence of attainment. They should also work with their Supervisor to identify outcomes that have not yet been met. Supervisors should comment constructively on achievements, and try to ensure that evidence and assessment methods are documented. Both trainee and Supervisor should sign the final assessment and the trainee be given a copy, as well as the Educational Supervisor (Pre reg Tutor).

GPhC Performance Standard / Example Learning Outcomes / Trainee Self-assessment / Assessment by MI Practice Supervisor
  1. Process
A1.6 Makes decisions which demonstrate clear and logical thought / -To demonstrate a systematic and organised approach to information retrieval and problem-solving when completing a range of real clinical enquiries
- To document the enquiry process accurately
  1. Resources
A2.4 Uses resources effectively (includes other workers, equipment, workspace and references) / - To demonstrate an understanding of the resources available in Medicines Information; to select and use them appropriately, appreciating their strengths and weaknesses
- To listen to and seek advice from MI team members
- To obtain information from sources outside the MI centre (e.g. expert colleagues, libraries, pharmaceutical manufacturers)
  1. Problem Identification
A3.1 Recognises and defines actual or potential problems / -To undertake enquiries in the MI centre and:
a) Interpret the enquirer’s needs suitably when searching for information and processing it
b) Identify the potential impact on the eventual answer on other relevant issues
  1. Evaluating Options
A3.2 Identifies workable options to resolve the problem / - To collate the information gathered, and use it to consider the potential answers that might be given
- To evaluate the potential answers by assessing the evidence, and considering the risks and benefits of each approach
  1. Formulating Answer
A3.3 Selects the best solution, based on sound analysis and appropriate evidence
A4.6 Base your actions, advice and decisions on evidence
A4.7 Obtain and process the evidence you need to meet A4.6
C2.1 Provides considered and correct answers to queries, founded on research-based evidence / - To compose answers to MI enquiries that demonstrate an understanding of the quality of evidence.
- To demonstrate that the answer supplied is the best option for the specific scenario by being able to defend it.
- To complete a basic literature evaluation on a published paper (RCT).
- To cite literature references correctly.
  1. Communicating Advice
B1.1 Communicate effectively in English / - To demonstrate effective telephone skills in gathering and delivering information.
- To compose clear, concise and professional written communications (email or letter) with good grammar, spelling and punctuation and language appropriate to the enquirer.
  1. Questioning Skills
B1.4 Elicit all relevant information by the use of appropriate questions / - To identify all of the information required from an enquirer before starting to answer their question.
- To actively seek more information or clarification from enquirers when it is not spontaneously forthcoming.
  1. Tailored Approach
B1.11 Provide information and advice appropriate to the needs of the recipient(s) / - To translate information into practical advice that is relevant to the clinical situation presented by the enquirer.
- To use and adapt suitable language depending on the enquirer, and identify the most appropriate communication method (i.e. oral/written/in person)
- To anticipate enquirers’ future needs and identify additional issues which were not part of the original question but which will impact on the answer (e.g. interactions as part of adverse drug reaction enquiry).
- To understand the purpose of user satisfaction surveys in MI.
  1. Proactive Information
C2.4 Actively provides information and advice to healthcare professionals / - To provide or contribute to information that anticipates healthcare professionals’ needs about medicines
  1. Representing Own Opinions
B2.2 Present your own ideas and opinions appropriately when speaking and in writing / - To be able to defend a professional opinion when answering an enquiry, whilst demonstrating an appropriate awareness of personal limitations.
  1. Meeting Deadlines
B2.3 Meets commitments made to others within agreed deadlines / - To answer enquiries within the agreed timeframe set by MI Practice Supervisor and/or enquirer.
- To demonstrate negotiation of deadlines with enquirers taking into account clinical urgency, departmental workload and enquiry complexity.
- To describe, if appropriate, examples of communication with enquirers where answers to enquiries couldn’t be done within the agreed timeline, with justification.
  1. Adverse Reactions
C2.7 Recognises possible adverse-drug reactions, evaluates risk and takes action accordingly / - To receive enquiries which may involve adverse reactions and to ask appropriate questions (e.g. timing of medication and relevant medical history).
- To identify actual or potential adverse drug reactions and analyse the likelihood, severity, and remedial actions to take.
- To identify when MHRA yellow card reporting is required and demonstrate reporting process.
  1. Signposting
C2.11 Refer, or direct the person, to a more suitable source of help or information when necessary / - To demonstrate appropriate referral of patients or healthcare professionals when a request for advice is outside the competence of the MI team, and be able to justify why this was an appropriate course of action.
General Comments: Trainee / General Comments: Supervisor

Signed and dated…………………………………………………………...... Signed and dated ……………………………………………………………………….

(Pre-registration pharmacist)(MI Practice Supervisor)

[Last updated: 2013]