Ailsa Power

Scottish pharmacists' perceptions and experiences of a practice-based small group learning pilot: a qualitative study.

INTRODUCTION CPD is an important feature of healthcare professions and regulatory bodies consider it mandatory. Studies of CPD activity of pharmacists showed that 10% were undertaking no CPD. Practice-based small group learning (PBSGL) is a well-received and popular learning resource for GPs in Scotland. From 2011, a pharmacy pilot was undertaken: pharmacists were trained as peer-facilitators and existing PBSGL modules were adapted. Four NHS boards took part and this study aimed to explore the perceptions and experiences of pharmacists. METHODS A qualitative research approach was adopted using focus groups and in-depth interviews. Interviews were audio-recorded and transcriptions made. Transcripts were coded and themes developed using grounded theory methods. RESULTS Participants welcomed PBSGL: it was a feasible learning method, acceptable and had educational impact. They appreciated its interactive nature and discussions founded on their experiences in practice. Participants liked the self-reliance of PBSGL in that they were not dependent on specialist practitioners. There were logistical challenges that impacted on the success of group discussion; some pharmacists were less familiar with small group work. Pharmacists felt isolated during work and appreciated peer discussion. There was a tentative welcome to inter-professional learning but group composition and module topics might impact on the success of this. CONCLUSION Pharmacists were able to change their learning practice in uni-professional PBSGL groups and were able to learn from each other. There may be further learning opportunities if pharmacists participate in inter-professional groups.

Enhancing the Effectiveness of Significant Event Analysis: Exploring Personal Impact and Applying Systems Thinking in Primary Care

Introduction: Significant event analysis (SEA) is well established in many primary care settings but can be poorly implemented. Reasons include the emotional impact on clinicians and limited knowledge of systems thinking in establishing why events happen and formulating improvements. To enhance SEA effectiveness, we developed and tested “guiding tools” based on human factors principles. Methods: Mixed-methods development of guiding tools (Personal Booklet—to help with emotional demands and apply a human factors analysis at the individual level; Desk Pad—to guide a team-based systems analysis; and a written Report Format) by a multiprofessional “expert” group and testing with Scottish primary care practitioners who submitted completed enhanced SEA reports. Evaluation data were collected through questionnaire, telephone interviews, and thematic analysis of SEA reports. Results: Overall, 149/240 care practitioners tested the guiding tools and submitted completed SEA reports (62.1%). Reported understanding of how to undertake SEA improved postintervention (P < .001), while most agreed that the Personal Booklet was practical (88/123, 71.5%) and relevant to dealing with related emotions (93/123, 75.6%). The Desk Pad tool helped focus the SEA on systems issues (85/123, 69.1%), while most found the Report Format clear (94/123, 76.4%) and would recommend it (88/123, 71.5%). Most SEA reports adopted a systems approach to analyses (125/149, 83.9%), care improvement (74/149, 49.7), or planned actions (42/149, 28.2%). Discussion: Applying human factors principles to SEA potentially enables care teams to gain a systems-based understanding of why things go wrong, which may help with related emotional demands and with more effective learning and improvement.

Professional development of pharmaceutical care in type 2 diabetes mellitus: a multidisciplinary conceptual model

Objective To generate a validated model of care providing a framework for continued professional development of the community pharmacist for patients with type 2 diabetes mellitus.

Safer pharmacy practice: a preliminary study of significant event analysis and peer feedback.

Objectives The aim was to investigate the effectiveness of significant event analyses (SEAs) undertaken by pharmacists as judged by a new system of independent peer feedback.

Independent feedback on clinical audit performance: a multi‐professional pilot study

Purpose – The purpose of this paper is to investigate the acceptability and educational impact of independent feedback on the clinical audit performance of different groups of healthcare professionals by trained colleagues.Design/methodology/approach – This is a pilot study involving review of the criterion audit and significant event analysis (SEA) attempts of west of Scotland dentists, pharmacists, physiotherapists, practice managers and nurse practitioners by trained colleagues using validated instruments. Audit, SEA and feedback reports were content‐analysed. Data on pre‐ and post‐study attitudes, experiences and knowledge levels were collected by questionnaire. T‐tests for differences in mean group scores were calculated, along with 95 per cent confidence intervals for mean differences. A difference in mean scores of 1.0 or greater would be indicative of educational gain.Findings – A total of 34 participants submitted 54 audit and SEA reports, with 20 submitting both (58.9 per cent). In total, 14/20 ...

Piloting the United Kingdom '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. HighlightsPharmacist prescribers sat the British Pharmacological Society/UK Medical School Councils Prescribing Safety Assessment, PSA.The PSA consisted of 30 questions to be completed over 60 min.The mean overall PSA scores (±SD) were 87.5% ± 8.7 (range 52–98) compared to a mean score of 88.5% for medical students.Pharmacist prescribers’ performance benchmarked to final year medical students; PSA was considered feasible and acceptable.

Quality improvement of community pharmacy services:a prioritisation exercise

Effective strategies are needed to translate knowledge (evidence) into practice to improve the quality of community pharmacy services. We report the first step of a novel knowledge translation process which involved the systematic identification and prioritisation of community pharmacy services in Scotland which were perceived to require improvement and/or guideline development.

An evaluation of experiences and views of Scottish leadership training opportunities amongst primary care professionals

Abstract Aim: To determine experiences of leadership training of six primary care professions in Scotland and consider future development. Methods: A questionnaire on previous leadership course attendance and future intentions was distributed to community pharmacists, general dental practitioners, general practitioners, practice nurses, practice managers and optometrists. Analysis comprised descriptive statistics for closed questions and management of textual data. Results: Formal leadership training participation was fairly low except for practice managers. Leadership was perceived to facilitate development of staff, problem-solving and team working. Preference for future delivery was similar across the six professions with e-modules and small group learning being preferred. Time and financial pressures to undertake courses were common barriers for professionals. Conclusion: Leadership is key to improve quality, safety and efficiency of care and help deliver innovative services and transformative change. To date, leadership provision for primary care professionals has typically been patchy, uni-disciplinary in focus and undertaken outwith work environments. Future development must reflect needs of busy primary care professionals and the reality of team working to deliver integrated services at local level.

A Scenario-Based Virtual Patient Program to Support Substance Misuse Education

Objective. To evaluate virtual patient (VP) programs for injecting equipment provision (IEP) and opiate substitution therapy (OST) services with respect to confidence and knowledge among preregistration pharmacist trainees. Methods. Preregistration trainee pharmacists pilot-tested the VP programs and were invited to complete pre/post and 6-month assessments of knowledge and perceived confidence. Results. One hundred six trainees participated and completed the pre/postassessments. Forty-six (43.4%) participants repeated the assessments at six months. Scores in perceived confidence increased in all domains at both time points postprogram. Knowledge scores were greater posteducation than preeducation. Knowledge scores were also greater six months after education than preeducation. Knowledge scores at six months were lower than posteducation for both programs. Conclusion. Virtual patients programs increased preregistration pharmacists’ knowledge and confidence with regard to IEP and OST immediately after use and at six months postprogram. There was a loss of clinical knowledge over time but confidence change was sustained.

Scotland: a changing prescription for pharmacy

Abstract Within primary care in Scotland, the community pharmacist is considered the first port of call for advice on minor ailments and public health issues, and providing care for people with long-term conditions. This leading article explores the educational pathway underpinning the training of these pharmacists and pharmacists working in GP practices, as they move from undergraduate through Foundation to undertake significant new patient-focused clinical roles. NHS Education for Scotland (NES) are working with these pharmacists to support these developments. In Scotland pharmacists and their teams are now very much part of the primary care team providing high quality pharmaceutical care to patients on the high street and in GP practices.