and work based learning - codeg · workplace education and work‐based learning dr catherine...

Workplace educationWorkplace education and work‐based learning

Dr Catherine Duggan

DirectorJoint Programmes Board

Chair of the United Kingdom Clinical Pharmacy Association.

Council Member of the Royal Pharmaceutical Society of Great Britain

Improving the quality of training...improving the quality of patient care

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 programmeprogramme

2. Share the learnings from the original development of ALF and GLF in UK and g g phow they "fit" in with above

3 d ib h h b f ll d d diff h l h3. To describe how these can be successfully adopted to a different healthcare 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"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


p , yoverall service performance

This presentation

1 Increase understanding of the use of competency based performance1. 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 T d ib h h b f ll d d3. To start to describe how these can be successfully adopted to a different healthcare service and workforce with similar benefits to practitioner performance and patient care deliveryp p p y


P ti t f t P f i lPatient safetyAccess to medicinesQuality and Self‐care

Professional challenges?Cost effectiveness challenges?

Changing demographyChronic diseases, complexity of therapyLong term disease managementNew models of delivery New technologies and treatment options

Fitness for purposeKnowledge and skills

k b d ?Links between education & practice? Levels of practice related to complexity of patient


h h hWhat the White Paper says...PG education and CPD must supportPG education and CPD must support

levels of practice

general, advanced and consultant model

There must be consistency:• Standard, accredited services,• Standard credentialing processes• Consistent approval processes

l f d d• Longer term regulation of advanced practice


Pharmacist development modelPharmacist development model

Undergraduate & preregistration

General post‐registration

Higher level practice (2)


Point of regulation in pharmacy So, what is advanced

practice?Professional development

programmes


Joint programmes Boardwww.postgraduatepharmacy.org

JPB Drivers for Change

Principles for a Pharmacist development strategy:1 R i diff t l l f titi1. Recognises different level of practitioner,

General, Advanced and Consultant pharmacists.

2. Embraces all facets of practice.2. Embraces all facets of practice.

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 to5. Underpinned by educational quality assurance structures to provide rigour


Use of frameworks?Use of frameworks?

UKUK

Australia

C tiCroatia

Slovenia

Projects to evaluate use in:

• EU countries

• African countries


General L l F kLevel Framework

Delivery Organisation yof

Patient CarePersonal Problem Solving

gand

Management


General Level FrameworkManagement and

Personal Problem SolvingDelivery of Patient

General Level Frameworkg

OrganisationPersonal Problem SolvingyCare

Patient consultation Organisation Gathering information

Clinical governance

Selection of the drug

Need for the drug Effective communication

Analysing

Knowledge Service Provision

Budget setting and reimbursement

Drug specific issues

Teamwork

Professionalism

information

Providing information

reimbursement

Organisations

Provision of drug product

Medicines information

Follow up

Training

Staff managementinformation

Monitoring drug therapy

Procurement


Evaluation of outcomes

Moving from “knowing” (theory)Moving from “knowing” (theory)Moving from knowing (theory)…

towards

Moving from knowing (theory)…

towards

…“doing” (performance)…“doing” (performance)


Controlled trial GLF in junior pharmacists

.7

6

in junior pharmacists

Intervention = GLFn = 30 hospitalsy

.6

.5 InterventionIntervention

LogrankP = 0 0048ob

abilit

y

.4

3 P = 0.0048

Pro .3

.2

.1

0.0 NonNon--interventionintervention

14121086420-2

0.0

-.1


Time - months

Community pharmacistshPractice pharmacists


GLF evidence baseline and re‐assessmentGLF evidence baseline and re assessment

• 320 (70%) pharmacists Qld had baselinep

• 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)

I t d ti A d Q ti C t ADR M d HIntroduction Agenda Questions Consent ADRs Med Hx

Scale :1 = rarely, 2 = sometimes, 3 = usually, 4 = consistently


Ian Coombes MSQ November 2009

Taking patient’s medication history

Sig

I t d ti A d Q ti C t ADR M d HIntroduction Agenda Questions Consent ADRs Med Hx



Assessing medicine taking behaviour

Sig Sig

Patient Understands Experience Understand Adherence ManagesBackground illness of medicines treatment assessment medicines



Attributes of higher levelAttributes of higher level practitioner?

• Expert in area of practice• Expert in area of practice

• Able to work in multidisciplinary teams

• Dissemination and contribution to evidence• Dissemination and contribution to evidence

• Training, support and mentorship of staff

• Managing a team and a caseload• 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– RE at Foundation

Special Interest Pharmacists profile– 4 clusters at Excellence– 2 clusters ET&D, RE optional


Pharmacist development modelPharmacist development modelAdvanced PractitionerUndergraduate &

preregistrationGeneral post‐registration



Consultant

PractitionerPractitioner

PharmacistPharmacist

General Level PhwSI/Advanced & Consultant LevelSpecial

General Level PhwSI/Advanced & Consultant Level

Professional Development Frameworksinterest

pharmacists

Workplace education; work based learningImproving the quality of training...

improving the quality of patient care

Workplace education; work‐based learning

Advanced level practitioners6Expert PP

Leadership

HOMALS Quantification

4F

LeadershipManagementE & T

F

R & E n = 390

2 F

F MMM

Practice level

Specialist in training Leading edge

0 E ME

M

E

F

EF

E

Specialist in training

Experienced practitioner

Leading‐edgepractitioner

-2


-2 -1 0 1 2

Low ActivityHigh Activity

Key performance indicators F1(medical)

g y

200 Saving lives

150

g

100

R-Square = 0.16

50

0

R-Square = 0.76

Mortality rate Index

70 80 90 100 110 120


yBorja-Lopetegi, Bates, Webb 2007

Start with the practitionerStart with the practitioner...

Wh d i li &

The Practitioner

Who wants to move on...towards specialism & expertise (or revalidation)…

Who needs access to a practitioner Novice /early career

Practitioner

Who needs access to a practitioner development “programme”…

Who wants “credentialing” as proof of

Novice /early career → General Level

Mid‐career→Who wants credentialing as proof of competence (for self, patients, employers, commissioners)…

Mid career → PhwSI, Advancedor Consultant

)

Who wants rewards (£, career, satisfaction, Awards)…

Generalist → revalidation

Who will needs to be regulated at some point… “sector” independent


Affiliated and/or hosted

Professional Leadership Body

By PLB General Curriculum Committee

Specialist Curriculum Committee

c c

Specialist groupcurricula

curricula

curricula

Pre General level Advanced level Consultant

curricula

Specialist groupInform &

Pre‐qualification

General leveldevelopment

Advanced level(incl. PhwSI)

Consultant level

Specialist groupA t

Inform & represent

Specialist group

Access to Community of Practice

Novice /early career→

ThePractitioner

Specialist group Novice /early career→ General Level

Mid‐career → PhwSI, Advanced/ Cons


Generalist → revalidationAll sectors

Professional Leadership Body

General Curriculum Committee

Specialist Curriculum Committee

cu

Committee Committee

curr

curr

curr urricula

ricula

ricula

ricula

Pre General level Advanced level Advanced II

“credentialing” function

Pre‐qualification

General leveldevelopment

Advanced level(incl. PhwSI)

Advanced II(Experts, Consultants,leading edge, etc.)

“credentialing” function

“Local Practice Forum(s)” practitioner infrastructure

HEIs GPhC


Outsourcing for revalidation?

3.0 Expert Practice

2.5

Working relationships

Leadership

Management

2.0

Management

E&T and Development

Research & Evaluation

1.5

er score

nces”

1.0

an cluste

skills

“evide

n

0.5

Mea

ge and

sces and

0.0Specialists in Experienced Leading-edge ow

ledg

perien

c

Improving the quality of training...improving the quality of patient careCurrent level of practice

Specialists intraining

Experiencedpractitioners

Leading edgepractitioners Kn

oExp

Level 1-Foundation

Level 2-Excellence

Level 3-Mastery

CRITICAL ADJACENCIESImproving the quality of training...


CRITICAL ADJACENCIES

3.0 Expert Practice

2.5

Working relationships

Leadership

Management

2.0

Management

E&T and Development


1.5

er score

1.0

an cluste

0.5

Mea

0.0Specialists in Experienced Leading-edge

Improving the quality of training...improving the quality of patient careCurrent level of practice

Specialists intraining

Experiencedpractitioners

Leading edgepractitioners

Level 1-Foundation

Level 2-Excellence

Level 3-Mastery

TRANSFERABLE SKILLSImproving the quality of training...


TRANSFERABLE SKILLS

Academic provision Practice support

• Various masters we have • Study days

pp

developed • National clinical and specialist groups

• Consider QA and validation processes

• National courses

• Resource pack

• Link to levels of practice


Advanced level IIAdvanced Pharmacy

P ti Advanced level II Mastery and/or Doctoral level development

Statement of Completion MSc (Advanced Practice)

Practice(APP) Programme

(Advanced Practice) MSc (Advanced Practice)

Expert Practice & Research &Management &Education, Assessment

Building Working Relationships

E


E

Management & Leadership

E

Training & Development

E

Expert Practice &

EAssessment

E

Research & l

Management & d h

E

Education, &

E

Building Working Relationships

F

Evaluation

F

Leadership

F

Training & Development

FFAPP Professional Development

FFF

MSc Programme:APP P f i l D l t C (“C ”)


Programmes APP Professional Development Courses (“Core”)

Credentialing & accreditationCredentialing & accreditation

• Existing UK models

• Medical Royal Colleges

– Membership

– Fellowship

• US models


Assessments?Assessments?

T ti k l d kill• Testing knowledge, skills, abilities, performance

• A viva voce and portfolio review could assess the practitioner’s kno ledge

• Assessment tools may include:

RITA

practitioner’s knowledge and experience across all competencies to– RITA

– mini‐CEX

mini PAT

competencies to Excellence level

– mini‐PAT

– 360º CBD

d d OSCE t l • Against the curriculum – advanced OSCE style assessment

MCQ examination

gand syllabus defined by the SCG


– MCQ examination

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 programmeprogramme

2. Share the learnings from the original development of ALF and GLF in UK and g g phow they "fit" in with above

3 d ib h h b f ll d d diff h l h3. To describe how these can be successfully adopted to a different healthcare 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"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


p , yoverall service performance

Workplace educationWorkplace education and work‐based learning

Dr Catherine Duggan

DirectorJoint Programmes Board

Chair of the United Kingdom Clinical Pharmacy Association.

Council Member of the Royal Pharmaceutical Society of Great Britain


Pharmaceutical Society of Great Britain.

and work based learning - codeg · workplace education and work‐based learning dr catherine...

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