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Education PlanAdvanced Community Pharmacist

Education Programme

Royal Dutch Pharmacists Association

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EDUCATION PLAN – ADVANCED COMMUNITY PHARMACIST EDUCATION PROGRAMME

Table of Contents

I Introduction 2

II Cohesion of the education plan 4

III Profile of the community pharmacy specialisation 6

IV Competences of a specialist community pharmacist 8

IV.1 Four sub-competences in the seven competence areas of the specialist

community pharmacist specialist 9

IV.2 Description of the competence areas and sub-competences 10

V Task areas and application of the competences of the specialist community

pharmacist 16

VI Assessment 31

VI.1 Assessment and assessment instruments 32

VI.2 EPAs per area of activity, applicable assessment instruments and frequency

of assessment 35

VI.3 Programme assessment schedule 43

VI.4 Linking task areas, EPAs and competences 44

VI.5 Linking EPAs and assessment forms with review dates and proficiency levels 47

VII Education methods and activities 52

VIII Education material 52

IX Quality assurance 53

Appendices

A. Knowledge and skills checklist 55

B. Overview of centrally organised courses within the specialist community

pharmacist advanced education programme 58

C. Pharmacist Supervisor (ApOP) competence profile 63

Version of April 2012

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I IntroductionThe education programme for the profession of community pharmacist was introduced as an advanced specialisation within the field of community pharmacy in 1995. This document will hereinafter use the term ‘advanced community pharmacist education programme’ or simply ‘advanced education programme’.

In October 2004, the general assembly of the KNMP approved the professional association’s ambition to develop a specialisation in community pharmacy registered under the Dutch Individual Healthcare Professions Act (Wet beroepen in de individuele gezondheidszorg, BIG). This decision was based in part on the 2002 report published by the Committee on the Pharmacy Education Continuum (Commissie Opleidingscontinuüm Farmaci, COF), titled De apotheker als zorgverlener1 (‘The pharmacist as health-care provider’).

In 2005, the Subsequent Committee on the Pharmacy Education Continuum (Vervolgcommissie Opleidingscontinuüm Farmacie) followed up with another report titled De openbaarapotheker: specialist (‘The community pharmacist as a specialist’), setting out an education model comprised of a bachelor’s phase in pharmacy or pharmaceutical sciences, a master’s phase in pharmacy, and a concluding specialisation in community pharmacy, hospital pharmacy or industrial pharmacy2.

A ‘high level’ advanced (i.e. post-graduate) education programme continues to be regarded as a key requisite for an accepted specialisation in community pharmacy. Initial steps to modernise the existing programme were taken with the publication of two reports in 2007: Structuurplan specialisme openbare farmacie3 (‘Master plan for the community pharmacy specialisation’ and Opleidingsplan specialisme openbare farmacie4 (‘Education plan for the community pharmacy specialisation’).

Implementation of the modernisations themselves commenced in the course of 2008 with the appointment of a part-time education director. The incentive for these modernisations also came from a number of other factors. There had been indications from the professional field, including from the Young Pharmacists Society (Vereniging van Jonge Apothekers, VJA) that the education programme was due for a thorough evaluation and overhaul. As well, today’s dynamic pace of development makes it vital to periodically examine education programmes to ensure they continue to align with practice. With the changing times it had also become clear that the old ‘master/apprentice’ system for workplace learning was outdated. This view was also expressed in the reports on renewal of the intramural medical specialist advanced education programmes, which proposed a radically different training structure.

The Central Board for Pharmacy Specialists (Centraal College Specialisten Farmacie, CC) decided to establish a register for specialist community pharmacists with effect from 1 January 2012, at the same time amending the education requirements for the specialist community pharmacist education programme. This resulted in an education plan, drawn up on the basis of the guiding principles set out in the Central Board’s decision on education requirements that was issued in September 2011. The education plan furnishes supervisors, trainees and lecturers with handholds for teaching and assessing the knowledge, skills and attitudes needed to be a specialist community pharmacist.

Coordination between all the various education tracks, from undergraduate through post-graduate programmes, has had a decisive impact on the quality of specialist community pharmacists. Education providers, and even more so those responsible within these forums, must remain in constant dialogue to ensure a continuing high standard of coordination between and quality in their respective programme tracks. Figure 1 provides a schematic overview of how the different programmes fit together. Universities are responsible for the basic training of pharmacists, while advanced education and the subsequent process of re-registration and ‘lifelong learning’ falls under the remit of the specialist societies. After completing their training as specialist community pharmacists, graduates are registered in the specialists register of community pharmacists. Specialists in the register are subsequently evaluated every five years to assess if they have met the continuing

1 CommissieOpleidingscontinuümFarmacie.Deapothekeralszorgverlener.TheHague:KNMP;2002.2 VervolgcommissieOpleidingscontinuümFarmacie.De openbaar apotheker: specialist.TheHague:KNMP;2005.3 LeufkensHGM,DaemenBJG.Structuurplan specialisme openbare farmacie.TheHague:KNMP;2007.4 SchobbenAFAM,DeGierJJ,SchalekampT,DaemenBJG.Opleidingsplan specialisme openbare farmacie.TheHague:KNMP;2007.

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education requirements for re-registration. The attitude of a trained specialist is expected to be such that he5 is always actively engaged in seeking out training opportunities to fill gaps in his knowledge and skills; this process is referred to as Continuing Professional Development (CPD). As figure 1 shows, various proposals have also been put forward for the future. Among them is to enable a select group of specialist community pharmacist trainees (Apothekers in Opleiding tot Openbaar Apotheker Specialist, ApIOS) to pursue a PhD degree in addition to their advanced education programme. Another possibility under consideration is to introduce education programmes leading to registration in specific sub-domains as part of the continuing education and re-registration process.

Figure 1 The pharmacy education continuum

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University

Advanced education programme

Specialty society

Continuing education/ re-registration

Bachelor’s phase

Master’s phase

Training as specialist community pharmacist

Training as specialist community pharmacist in conjunction with a PhD track

Special registration (e.g. pharmacist supervisor)

Continuing education; Lifelong learning;Specialist re-registration

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Kerncompetenties van de openbaar apotheker specialist

The pharmacy education continuum

Quality assuranceEducation process

Assessment framework decreeProfessionalisation of supervisor &

trainee doctors (AIOs) Research on education

Educationactivities

Educationalmaterial

Educationmethods

Operationalisedcompetences AssessmentThemes

Profile of the advancededucation programme

Competencesof specialists

Basis of support

Framework decreesSpecific decrees

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University

Advanced education programme

Specialty society

Continuing education/ re-registration

Bachelor’s phase

Master’s phase

Training as specialist community pharmacist

Training as specialist community pharmacist in conjunction with a PhD track

Special registration (e.g. pharmacist supervisor)

Continuing education; Lifelong learning;Specialist re-registration

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Kerncompetenties van de openbaar apotheker specialist

The pharmacy education continuum

Quality assuranceEducation process

Assessment framework decreeProfessionalisation of supervisor &

trainee doctors (AIOs) Research on education

Educationactivities

Educationalmaterial

Educationmethods

Operationalisedcompetences AssessmentThemes

Profile of the advancededucation programme

Competencesof specialists

Basis of support

Framework decreesSpecific decrees

II Cohesion of the education planThis education plan follows along the general lines set out by the medical specialty societies in modernising their education programmes since 2002, including in the use of the practical tool designed by the Supervisory Group for the Development of Continuing Education Plans (Begeleidingsgroep Beschrijving Opleidingsplannen Vervolgopleidingen, BBOV), generally referred to as the BBOV ‘house’ or ‘Heineman’s house’ (Figure 2).

This instrument specifies basic components needed in an education plan, which it envisions as ‘filling’ the rooms of a house with ‘furniture’. The present education plan discusses different rooms in turn. Section III outlines the core profile of the community pharmacy specialisation, followed in Section IV by the competence profile of a specialist community pharmacist. This profile sets out the relevant core competences in conformity with the model developed by the Canadian Medical Education Directives for Specialists (CanMEDS) in 20006. The CanMEDS competences are a key element in the CCSF’s education requirements.

Figure 2 Heineman’s ‘house’

Section V gives as detailed as possible a description of the activities in which a specialist community pharmacist engages. These activities are broken down into themes based on shared features and as such form recognisable elements in the education programme. These recognisable elements are here designated as ‘task areas’. There are ten task areas in total, classified as follows:

1. Patient communication and counselling2. Health-care questions from patients and the general public3. Medication surveillance4. Periodic medication review5. Consultation with colleagues6. Preventive care and screening7. Collection and management of patient data8. Product care9. Quality assurance in the pharmacy10. Knowledge, education and scientific understanding

6 The CanMEDS 2005 Physician Competency Framework. Better standards. Better physicians. Better Care http://meds.queensu.ca/medicine/obgyn/pdf/CanMEDS2005.booklet.pdf

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The links between competences and task areas correspond with the transfer from theory to practice. Section V discusses these links in terms of the operationalisation of competences. Assessment is a fundamental instrument in education and a critical component of this advanced education programme. Incorporated throughout the education programme, assessment should form an integral part thereof. Section VI describes the assessment plan, including the application of Entrustable Professional Activities (EPAs), different forms of assessment and how these link into general competences. The structure of the advanced education programme and in particular the assessment plan are clarified in sections V and VI (see also figure 3 for a schematic diagram). Descriptions of the content of the specialisation and of the advanced education programme are broken down in line with the ten task areas. Within each of these task areas (in conjunction with their operationalised competences; see Section V), a number of EPAs have been selected for inclusion in the assessment plan. Specialist community pharmacist trainees (ApIOS) are assessed on these EPAs using suitable assessment instruments, in some cases on multiple occasions during the education programme. Linking the EPAs with the assessment instrument makes it possible to assess one or more of the CanMEDS core competences. With a sufficient number of EPAs and suitable assessment instruments and a sufficient frequency of assessment, we can ensure that the full set of competences is adequately assessed over the course of the programme. Core competences are assessed by indirect means, which is an approach to practical training substantiated in literature (see Section VI.4).

Figure 3 Schematic diagram of the structure of the advanced education programme, showing how general competences are embedded in the programme.

Sections VII through IX discuss, in order: education methods and education activities, education material, and quality assurance. The end of the report contains a brief bibliography and a number of integral appendices.

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opleiding. De combinatie van EPA en toetsingsinstrument zorgt voor toetsing van één of meer van de CanMeds kerncompetenties. Met voldoende EPA’s, daarbij geschikte toetsingsinstrumenten en voldoende vaak toetsen zorgen we ervoor dat alle competenties in de loop van de opleiding in voldoende mate worden getoetst. Er vindt dus een indirecte toetsing plaats van de kerncompetenties, wat een in de literatuur onderbouwde wijze van werken is bij opleiden in de praktijk. (Zie hoofdstuk VI.4). Figuur 3 Schematische weergave van de opbouw van de vervolgopleiding die de inbedding van de

algemene competenties in de opleiding weergeeft In hoofdstuk VII tot en met IX komen achtereenvolgens aan de orde: opleidingsmethodiek en opleidingsactiviteiten, opleidingsmateriaal en kwaliteitszorg. Het rapport wordt gecompleteerd met enige literatuurverwijzingen en enkele – niet onbelangrijke ‐ bijlagen. III Profiel specialisme openbare farmacie In het “Witboek Farmacie”, dat in 2011 door de KNMP werd gepubliceerd8, wordt de context waarin de openbare farmacie zich beweegt omschreven. Wij citeren:

“De Nederlandse bevolking zal tot 2050 sterk vergrijzen. Het geneesmiddelgebruik zal daarbij blijven stijgen. De intrinsieke effectiviteit en veiligheid van geneesmiddelen is de afgelopen decennia flink verbeterd. Indien deze geneesmiddelen op de juiste wijze worden voorgeschreven en gebruikt dan kunnen deze flinke gezondheidswinst bieden. Bij verkeerd voorschrijven en gebruik kan de balans tussen positieve en negatieve effecten van deze geneesmiddelen echter naar de verkeerde kant doorslaan. Recent werd in het HARM onderzoek becijferd dat meer dan 5% van de acute ziekenhuisopnamen in Nederland het gevolg is van het verkeerd voorschrijven, monitoren en gebruik van medicijnen. In verschillende onderzoeken is daarnaast vastgesteld dat het dramatisch is gesteld met de therapietrouw van patiënten. Afhankelijk van het type geneesmiddel stopt tot 80% van de mensen voortijdig met behandelingen voor chronische aandoeningen als hoge bloeddruk, glaucoom en osteoporose. De theoretische gezondheidswinst van deze geneesmiddelen wordt daardoor ernstig beperkt. Behalve effectiviteit en veiligheid is doelmatigheid een belangrijk issue binnen de gezondheidszorg. Geneesmiddelen zijn soms duur, maar kunnen, mits optimaal gebruikt en begeleid, ook leiden tot aanzienlijke gezondheidswinst en zelf kostenbesparing elders in de zorg. Het bestuderen van geneesmiddelgebonden problemen bij ouderen (gepubliceerd in een grote (buitenlandse) studie)

8 http://www.knmp.nl/downloads/over‐de‐knmp/knmp‐vereniging/KNMPWitboekFarmacie.pdf; laatst geraadpleegd 05072011.

Vervolgopleiding openbaar apotheker specialist

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III Profile of the specialisation in community pharmacy The KNMP’s 2011 publication Witboek Farmacie (‘Pharmacy White Paper’)7 describes the operational context of community pharmacy as follows:

‘The Dutch population will show a strong ageing trend until 2050. The use of medicines will continue to rise accordingly. Medicines’ intrinsic efficacy and safety has improved considerably in recent decades and, provided they are prescribed and used correctly, can yield considerable health gains. However, if incorrectly prescribed and used, the balance between medicines’ positive and negative effects will tip in the wrong direction. The recent HARM study calculated that more than 5% of acute hospital admissions in the Netherlands are due to the incorrect prescription, monitoring and/or use of medicines. Various studies have further established deplorable adherence to medication among patients. Depending on the type of medicine, up to 80% of people prematurely stop their treatments for chronic conditions such as high blood pressure, glaucoma and osteoporosis. The theoretical health gain of these medicines is therefore severely undermined. Another major issue in health care, in addition to efficacy and safety, is efficiency. Medicines may at times be expensive, but provided they are optimally used and supervised, can also lead to considerable health gains and even save on costs in other areas of care. Research into drug-related problems among the elderly (published in a major foreign study) indicates that at least ten euros are saved for every euro invested in pharmaceutical care. In view of the stated problems, promoting the effective, safe and efficient use of medicines poses a major challenge, demanding the best efforts of care providers (both individually and collaboratively) working in the health care sector. Over the next few years, difficulties are anticipated in maintaining a large enough workforce of highly qualified care providers to facilitate optimum supervision of medicine users. This makes it especially important that pharmacies fulfil their health care role to the fullest extent possible. This white paper describes specific areas in which this role can be further developed and the resources needed to support pharmacists in their new role.’

The field of community pharmacy is rapidly evolving. Although practitioners’ knowledge about the product – mainly medicines – is substantial, there is a growing urgent need for a broader and more thoroughgoing application of pharmacotherapeutic knowledge to ensure patients’ medication safety and the effective use of medicines. In other words, community pharmacists need to be able to prevent, detect and resolve (potential) pharmacotherapy-related problems so as to optimise patients’ quality of life, provide them the best possible treatment for their conditions and minimise the chance of adverse effects. Pharmacists carry out this task in various contexts, such as when dispensing medicines, in situational circumstances (such as at the start of an individualised method of distribution) and periodically when carrying out medication reviews, for example.

As will be explained in the descriptions of the specialist community pharmacist task areas (Section V), caring for individual patients has become a central focus of the community pharmacist’s work. Accordingly, the first seven task areas are directly related to the pharmacist’s role as carer. This change in the profession is also evident internationally and remarked by, among others, the International Pharmaceutical Federation (FIP), which has as its motto: ‘patient-focused, medicine-centred’. Today, pharmacists’ patient care role is being widely promoted by both the KNMP and the Scientific Community Pharmacists Section (Wetenschappelijke Sectie Openbare Farmacie, WSO. However, this is not to detract from the duty of product care that is a key niche of the community pharmacist’s expertise. Community pharmacists must possess extensive knowledge not only of ready-to-use medicines but also of compounded medicines and preparations, and product care remains the province of the pharmacist. Further, this role extends not only to medicines, but also to related product groups collectively known as medical and assistive devices, responsibility for which also falls to the community pharmacist. As small to medium enterprises, pharmacies are strongly focused on the organisation of pharmaceutical care. To fulfil these various tasks, pharmacists must have an effective system of quality assurance in place for their business, as well as to be able to provide an adequate demonstration of their quality.

7 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPWitboekFarmacie.pdf;lastconsultedon05July2011.

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Where feasible, community pharmacists work according to the ‘evidence-based’ guidelines, drawing in part on their own area of specialisation and in part on related domains such as general medicine. Both individually and as an occupational group, community pharmacists are continually engaged in activities to improve the pharmaceutical care provided to patients. Development and application of specific pharmaceutical care guidelines is one of those activities, as is the provision and maintenance of continuing and targeted education programmes as part of CPD.

Community pharmacists work in close consultation with general practitioners and others who prescribe medicines. In the current system of integrated care, there is also a call for collaboration with parties other than prescribers, for example with nurse practitioners, medical assistants, homecare assistants, nursing home staff and others.

The profession shares common ground with transmural pharmacy as practised at hospital outpatient pharmacies and at pharmacy service points (Apotheek Service Punt, ASP), as well as with the specialised field of hospital pharmacy, which has its own advanced education programme.

Community pharmacists are generalists who have to contend with new developments on an ongoing basis. These include developments in the field of pharmacotherapy and product care as well as in the broad domain of the health care system. As an example, for several years now community pharmacists have been responsible for the distribution and product care of specialised medicines such as oral oncolytics. Increasing concerns about medication safety are also necessitating changes at community pharmacies. At the same time, they must take account of current or imminent changes in other areas such as health care reimbursement and the organisation of integrated care. These changes will have a defining impact on the position of pharmacies and how they are organised.

This education plan forms part of the KNMP’s broadly supported ambition as an expert in the field of community pharmacy to make a significant contribution to the effective, safe and efficient use of medicines, as set out in the Witboek Farmacie, mentioned above, and in the Nationaal Routeplan Farmacie8 (‘National Pharmacy Roadmap’).

8 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPNationaalRouteplanFarmacie.pdf;lastconsultedon6July2011.

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IV Competences of the specialist community pharmacistA competence is defined as the ability to carry out complex tasks in an effective manner through the integration and application of a specific combination of knowledge, skills and attitude. General competences have been defined in line with the model developed by the Canadian Medical Education Directives for Specialists 2000 (CanMEDS 2000). These core competences are divided into seven areas of competence. The CanMEDS model refers to seven overlapping roles, in which the role of the ‘medical expert’ (in the case of the pharmacist, ‘the pharmaceutical expert’) represents the core integrating role. We refer to ‘pharmaceutical expertise as being the core role of the specialist community pharmacist. The other six roles are: communicator, collaborator, scholar, health advocate, manager and professional. The considerable and necessary overlap between these various roles and the core integrating role of the pharmaceutical expert are clearly visualised in the CanMEDS diagram (see figure 4). Each of the seven areas of competence is further broken down into four sub-competences. These have been formulated along the lines of the medical specialist advanced education programmes as translated to the domain of community pharmacy. Section IV.1 provides a summary of these sub-competences, followed by a detailed description in Section IV.2.

Figure 4 The CanMEDS diagram

Core competences of the specialist community pharmacist

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IV.1 Four sub-competences in the seven competence areas of the specialist community pharmacist

1. Pharmaceutical Expertise1.1. The specialist possesses up-to-date knowledge of and skills in the field. 1.2. The specialist correctly applies the full arsenal of his or her field of expertise, demonstrating efficacy, safety and efficiency in the pharmacotherapy of individual patients.1.3. The specialist provides effective and ethically responsible patient care.1.4. The specialist swiftly finds the requisite information and correctly applies it to patient care and education.

2. Communication2.1. The specialist builds effective treatment relationships with patients.2.2. The specialist listens closely and attentively to patients and efficiently obtains relevant patient information.2.3. The specialist discusses pharmaceutical and other medical information thoroughly with patients and any family members.2.4. The specialist provides proper verbal and written reports on patient cases.

3. Collaboration3.1. The specialist consults with the pharmacy team and its members, colleagues, prescribers and other care providers in an efficient manner.3.2. The specialist provides proper referrals to the medical sector.3.3. The specialist is an effective discussion partner for colleagues, including within the pharmacy team. 3.4. The specialist contributes to effective interdisciplinary collaboration and integrated care.

4. Scholarship4.1. The specialist considers medical and pharmaceutical information from a critical perspective, has knowledge of basic research methods and practises pharmacy in accordance with evidence-based guidelines as far as possible.4.2. The specialist promotes the expansion and development of scientific expertise.4.3. The specialist develops and pursues a personal continuing education plan.4.4. The specialist promotes the expertise of students, specialist community pharmacist trainees (ApIOS), colleagues, patients and others involved in health care.

5. Health Advocacy5.1. The specialist knows and recognises the most important determinants of disease and of medicine use in particular.5.2. The specialist promotes the health and correct use of medicine by patients and the community as a whole.5.3. The specialist acts in accordance with the relevant statutory provisions.5.4. The specialist responds appropriately to care-related incidents.

6. Management6.1. The specialist organises work so as to balance patient care and personal development.6.2. The specialist works effectively and efficiently within a health care organisation.6.3. The specialist spends the resources available for patient care in a responsible manner.6.4. The specialist uses information technology to optimise patient care and for refresher training and continuing education.

7. Professional7.1. The specialist provides a high standard of patient care with integrity and in a sincere and engaged manner.7.2. The specialist demonstrates proper personal and interpersonal professional conduct.7.3. The specialist knows the limits of his or her own competence and acts within these limits.7.4. The specialist practises pharmacy in conformity with the customary ethical standards of the profession.

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IV.2 Description of the competence areas and sub-competences1. PHARMACEUTICAL EXPERTISE

Pharmaceutical expertise is the core competence and draws on all the other competences. Narrowly defined, pharmaceutical expertise centres on professional expertise.

Description of the competence area

The specialist has oversight of the knowledge domain relevant to his or her own sphere of knowledge and action and is capable of finding scientific pharmaceutical information swiftly and efficiently. He or she systematically and continuously monitors the risks of medicine use using various methods and taking account of all relevant clinical and pharmacotherapeutic data, and on the basis of these formulates reasoned hypotheses for improved medicine use by individual patients. He or she monitors the quality of products intended for individual patients. He or she possesses the manual skills required to apply specific medication, compound medication and ensure product care. He or she is respectful of the wishes of patients and their families. He or she adheres to standard working methods, proceeding from a reasoned and scientifically founded approach to pharmacy/pharmacotherapy. The specialist makes appropriate use of medical pharma ceutical technology as needed and is aware of the benefits and drawbacks associated with specific interventions.

General sub-competences of Pharmaceutical Expertise

1:1. The specialist possesses up-to-date knowledge of and skills in the field

This is the fundamental basis of all pharmaceutical expertise. This does not require ready encyclopaedic knowledge, but sufficient knowledge, insight and the skills to provide efficient, high-quality patient care.

1:2. The specialist correctly applies the full arsenal of his or her field of expertise, demonstrating efficacy, safety and efficiency in the medicine use of individual patients

This includes the ability to define a request for assistance, hear/record a relevant, concise and accurate case history pursuant to such a request or in connection with an analysis of medicine use, following relevant procedures for the collection, analysis and interpretation of data, compiling a targeted risk management profile and determining the correct pharmacotherapeutic treatment needed to help resolve a patient’s problem. It also includes monitoring the quality of products intended for individual patients.

1:3. The specialist provides effective and ethically responsible patient care

This entails the ability to take correct decisions based on an evaluation of pharmacotherapeutic options and their limitations in terms of the burden to the patient and other constraints.

1:4. The specialist swiftly finds and correctly applies the requisite information

This includes knowing how to ask the right patient-related questions, systematically researching the literature for validation and critically evaluating medical and pharmaceutical literature and other evidence, all with a view to optimising pharmacotherapeutic or pharmaceutical decision-making.

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2. COMMUNICATION


The specialist provides patients (or the patient’s representative) with the required and desired (and occasionally unwelcome) information in correct, comprehensible and empathetic wording and observes the time and has the patience needed to do so. He or she has the ability to give a concise verbal or written case report concerning a disease, medicine use or compounding medication, formulating final or provisional conclusions and remaining questions.

General sub-competences of Communication

2:1. The specialist builds effective treatment relationships with patients

This includes developing and maintaining good relations with patients (and their families) and cultivating an environment characterised by understanding, trust, empathy and confidentiality.

2:2. The specialist is patient-focused, listens closely and attentively to patients and efficiently obtains relevant patient information

This includes demonstrating interest in the patient’s ideas, concerns and expectations regarding the origins, nature and treatment of their disease or pharmacotherapeutic problem. Specialists are able to accurately assess the influence of factors such as age, gender, ethnic and cultural background, social network and emotions.

2:3. The specialist discusses pharmaceutical information thoroughly with patients and any family members

This entails the capacity to inform and advise patients in a sympathetic and respectful manner whilst simultaneously promoting patients’ understanding of, and encouraging them to discuss and actively participate in decisions relating to their treatment and particularly their medicine use. This involves the ability to listen to patients with a view to assuring both them, their families of an optimum and consistent level of patient care. It also requires verifying patients’ comprehension. Equally, it demands the skills to maintain clear and accurate records. All of the above must be carried out in accordance with the applicable statutory rules.

2:4. The specialist provides proper verbal and written reports on patient cases

During consultations, transfers and meetings about patients the specialist provides concise but accurate summaries of patients’ pharmacotherapeutic and other pharmacotherapy-related problems, for example as regards correct preparation methods, and explains and as necessary defends the proposed or implemented strategy, and formulates clear questions for productive discussion with colleagues.

3. COLLABORATION


The specialist acknowledges limits in his or her knowledge, skills and experience, demonstrating in ways including a willingness to consult with colleagues and through proper consultations or referrals provided with a sense of personal engagement and the acceptance of responsibility. He or she has insight into the consequences of his or her actions on other professionals involved in the care of the patient concerned and furthermore works well as part of a team.

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General sub-competences of Collaboration

3:1 The specialist consults with the pharmacy team and its members, colleagues, prescribers and other care providers in an efficient manner

This entails the capacity to develop pharmacotherapeutic analysis and treatment strategies as well as follow-up strategies in conjunction with patients and other care providers. It requires knowledge of the roles and specialisms of the other involved parties, informing patients and their family members and including them in decision-making, and explicitly accounting for the opinions of patients and care providers in treatment plans.

3:2. The specialist provides proper referrals

This presupposes insight into the limits of the specialist’s own expertise and capacities and familiarity with the resources of other medical care disciplines and areas of expertise within the field of patient care.

3:3. The specialist is an effective discussion partner for colleagues, including within the pharmacy team

This includes the ability to present thoroughly substantiated verbal and written evaluations and recommendations following meetings with colleagues in the pharmacy team, colleagues or other care providers.

3:4. The specialist contributes to effective interdisciplinary collaboration and integrated care

This includes insight into the integrated care of individual patients, effective communication with other care providers and familiarity with activities carried out at hospitals, doctor’s surgeries, in committees, and at research, teaching and knowledge institutions, among others. It also implies an ability to distinguish the specialisms of other team members, a respectful attitude towards the opinions and roles of individual team members, contributing to healthy team development and conflict resolution and contributing individual expertise to help fulfil team tasks. This general competence also includes taking all necessary steps to ensure the safe transfer of patient information and taking responsibility for patient care continuity.

4. SCHOLARSHIP


The specialist has the ability to distinguish the numerous scientific aspects as intermeshed with the medical pharmaceutical practice, to view these from a critical perspective and possibly develop scientific research questions on the basis of personal observation and experience, and actively pursues and organises refresher and continuing education in accordance with current views on education, quality assurance and continuous professional development.

General sub-competences of Scholarship

4:1. The specialist considers information from a critical perspective

This competence is about working in conformity with the spirit of scientific research and using rational grounds to make medical pharmaceutical decisions. Similar to pharmaceutical expertise, this competence includes the ability to ask the right questions, to efficiently research the literature for and assess the quality of validating evidence and to keep abreast of validated care standards for the most common disorders encountered at his or her practice.

4:2. The specialist promotes the expansion and development of scientific expertise

Though not every specialist conducts independent scientific research, they must nevertheless possess the skills needed to take part in collaborative research projects, quality assurance and in developing guidelines that are relevant to medical and pharmaceutical practice.

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4:3. The specialist develops and pursues a personal continuing education plan

This entails taking charge of determining personal learning needs and includes setting personal learning objectives, choosing suitable learning methods and evaluating personal learning outcomes with a view to optimising personal practice.

4:4. The specialist promotes the expertise of students, specialist community pharmacist trainees (ApIOS), colleagues, patients and others involved in health care

This includes educational and other activities designed to train younger generations in the pharmaceutical profession. It entails helping others determine their learning needs and development pathways, giving constructive feedback and applying the principles of adult knowledge acquisition when interacting both with students and specialist community pharmacist trainees (ApIOS) as well as with patients, colleagues and others involved in health care.

5. HEALTH ADVOCACY


Specialists are members of society and must remain conscious of their role as public health advocates, and in doing so respond to the challenges of the social, environmental and biological factors which affect the health of patients and society overall. The specialist understands that advocacy plays a key part in promoting health at the patient, practice and community level. Specialists promote health through their individual and collective actions to influence policy and public health.

General sub-competences of Health Advocacy

5:1. The specialist knows and recognises the most important determinants of disease and medicine use in particular

This includes the ability to recognise, assess and respond to key psychosocial, economic and biological factors affecting patient health and particularly medicine use (efficacy and safety). The specialist assimilates information about health determinants in individual and community patient care. At the level of the pharmacist/patient relationship, this involves (1) the ability to adapt patient treatments and information with a view to promoting patients’ overall health and their use of medicines in particular, and to increase their understanding of proper procedures, particularly as these relate to the use of medicines and (2) helping patients to learn to cope with illness and in particular to promote the use of medicines to this end and to foster active participation in the pharmacotherapeutic decision-making process. At the societal level this involves (1) identifying risk groups and recognising societal developments that can influence public health and medicine use in particular, (2) identifying relevant government policies and (3) where appropriate, contributing to policies beneficial to public health and to medicine use in particular.

5:2. The specialist promotes the health and correct use of medicine by patients and the community as a whole

This includes the application of pharmaceutical expertise in situations not directly related to patient care, such as when issuing statements as a pharmaceutical expert or holding presentations.

5:3. The specialist acts in accordance with the relevant statutory rules

The specialist keeps abreast of the relevant prevailing statutory rules and practises in conformity with his or her own legal position and that of patients, also as regards the duty of professional confidentiality, and understands the consequences for his or her provision of pharmaceutical expertise.

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5:4. The specialist responds appropriately to care-related incidents

The specialist correctly identifies incidents in patient care and product care, detects personal errors and the errors of others and has learned to discuss and manage these with a view to implementing an effective policy in the given situation, to learning from the incident, to preventing its recurrence and to the interests of the patient. The specialist is familiar with the standard medical pharmaceutical procedures for reporting incidents and knows how to respond to complaints relating to patient care.

6. MANAGEMENT


In their daily decisions about tasks, policy, staff and resources, specialists must also be effective managers. Such decisions are made in connection with individual patient care, professional organisations and in the broader context of the health-care system as a whole. The specialist must therefore have the ability to set priorities, work efficiently as part of a team of colleagues and make rational decisions about the deployment of limited resources. Specialists may also take a position at the head of a health-care organisation. In that case, the specialist has oversight of the myriad of associated interests and aspects that factor into patient care (such as administrative, financial/economic and management-related) and manages these in an ethically, legally and economically responsible manner.

General sub-competences of Management

6:1. The specialist organises work so as to balance patient care and personal development

This includes effectively using time-management and self-evaluation skills to formulate realistic expectations and develop a balanced lifestyle.

6:2. The specialist works effectively and efficiently within a health-care organisation

This refers to insight into the roles and responsibilities of specialists and organisations involved in and mechanisms driving the health-care system and societal relationships. It includes the ability to work efficiently in a team of colleagues, to lead a practice, and to work as part of a broader organisational management structure or as a representative within the national health-care system.

6:3. The specialist spends the resources available for patient care in a responsible manner

Though the patient’s interests always come first, the specialist must be able to fully weigh the pros and cons of allocating medicines in terms of the benefit to individual patients and the population at large.

6:4. The specialist uses information technology to optimise patient care and for refresher training and continuing education

This includes the ability to use patient-related databases and electronic information and understanding the fundamentals of medical pharmaceutical information technology so as to provide the best possible patient care and maintain personal professional expertise.

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7. PROFESSIONAL


Specialists have a unique social role as professionals whose specific expert knowledge, skills and conduct are aimed at improving the health and well-being of others. Specialists strive to meet the highest possible standards in pharmaceutical care and ethical conduct and also continually engage in perfecting their expertise. The specialist uses moral and ethical considerations to decide whether or not to commence or continue pharmaceutical interventions, and is able to substantiate these decisions. The specialist has the ability to empathise with the patient’s questions, culture and living conditions to enable him or her to gain a good understanding of the patient, but can still discern and distinguish his or her own feelings. He or she understands the complexity of supervising patients who are at the end of life and acts accordingly. The specialist is able to reflect critically on his or her own competence and professionalism.

General sub-competences of Professionalism

7:1. The specialist provides a high standard of patient care with integrity and in a sincere and engaged manner

This includes the awareness that the patient is of central importance. Also, the ability to discern and adapt to diversity in ethnic and cultural backgrounds and social issues that can impact the provision of patient care, and to maintain and expand relevant knowledge, skills and professional conduct.

7:2. The specialist demonstrates proper personal and interpersonal professional conduct

This includes taking responsibility for personal actions, self-awareness, maintaining a proper balance between personal and professional roles and addressing interpersonal differences in professional relations.

7:3. The specialist knows the limits of his or her own competence and acts within these limits

This includes determining if and when other experts need to be called in to contribute to the provision of care to a patient.

7:4. The specialist practises pharmacy in conformity with the customary ethical standards of the profession

This includes an understanding of and adherence to the ethical and medical pharmaceutical code of conduct, the ability to recognise ethical dilemmas and when to call in assistance to resolve these, and the ability to recognise and respond to unprofessional conduct at other health-care providers, with due regard for local and national rules and regulations.

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V Task areas and operationalisation of the specialist community pharmacist competencesThe activities performed by a specialist community pharmacist are broken down into components based on shared features, and as such form recognisable elements in the education programme. These recognisable elements are designated as ‘task areas’. The education programme has, as it were, been broken down on the basis of task areas corresponding to the specialist’s duties. The task areas provide an overall rather than a detailed educational plan. They do, in fact provide the concrete building blocks for the education programme, and provide specialist community pharmacist trainees (Apothekers in Opleiding tot Openbaar Apotheker Specialist, or ApIOS), clarity on the areas of the education programme they should focus on. These task areas help to structure the development of competences by linking competences to task areas. The ten task areas are described below. The description of each task area is followed by a text linking the task area to the CanMEDS competence areas and is referred to as the operationalisation of the competence area.

Task area 1. Patient communication and counselling

Description of task area 1Providing verbal information to a patient takes centre stage when dispensing medicines and medical aids. The provision of information and counselling should be based on the expectations and needs of the patient. When dispensing medicines and medical aids to patients for the first time, it is key to actively assist the pa-tient in using the prescribed medicine. In any event this includes explaining the effect of the medicine, the main side effects and how the medicine should be taken. The user's experience should be discussed particu-larly when dispensing the medicine for the second time, and on subsequent occasions, including adherence to medication (proper use), the side effects, difficulty in swallowing and the use of medicine combined with daily activities. The pharmacist evaluates use together with the patient. There are specific issues that only come to light when talking to the patient, such as the incorrect use of the medication as a result of failure to understand the medication or aversion to, or fear of a specific medicine. In communicating with and coun-selling the medicine user, the pharmacist should always bear in mind that many people have difficulty in ac-cepting the use of medication, which over time may lead to non-adherence to medication if inadequate com-munication is provided. For specific groups of patients, specific consequential aspects are attached to patient counselling. Examples of such groups are children, care home residents, patients with psychiatric or cogni-tive problems, home care and palliative care patients. One particular form of information provision involves giving instructions concerning the use of dosage forms that require special patient skills, e.g. inhalation aids, insulin and eye drops. Consequently, the instructions may also be directed to carers or the home care nurse. The provision of written information supports and complements verbal information. Although the provision of written information is laid down by law in the form of government-approved instruction leaflets issued by the manufacturer, pharmacists provide supplementary non-conflicting written information. During patient communication the pharmacist takes account of the aspect of privacy. In addition to providing information when dispensing medicines or medical aids, information concerning the organisation of pharmaceutical care, including the procedure, the services offered and the pharmacy’s privacy policy should also be given.

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Competence area Operationalisation of the competence area: Specialist community pharmacist trainee (ApIOS)

Pharmaceutical expertise

• When dispensing medicine for the first time, has sufficient knowledge to be able to explain its effect, the main side effects and how the medicine is used.

• When dispensing the medicine a second time and on subsequent occasions, has sufficient knowledge to be able to interpret and explain the patient’s experi-ence with the use of the medicine (adherence to medication, any side effects, difficulty in swallowing the medicine, and using the medicine in combination with 18 daily activities).

• Has sufficient knowledge to be able to advise and assist specific patients, such as children, care home residents, patients with psychiatric or cognitive prob-lems, and home care and palliative care patients.

• Has sufficient knowledge and skills to be able to provide instructions concern-ing special dosage forms (e.g. inhalation aids, insulin and eye drops).

Communication • Builds an effective treatment relationship with patients keeping their social, psychological and cultural backgrounds in mind.

• Is patient-focused, listens closely and attentively to the patient and obtains and interprets relevant patient health information, which is important when com-municating about the medicine the first time it is dispensed.

• Is patient-focused, listens closely and attentively to the patient and obtains and interprets relevant patient health information, which is important when com-municating about the medicine the second time it is dispensed or on subse-quent occasions (evaluates use of the medicine).

• Discusses the pharmaceutical information, including information about the risks involved, in a comprehensible manner with the patient or the patient’s carer.

• Makes available written information to support the verbal information.• Communicates how pharmaceutical care is organised, such as the procedure,

the services offered and the pharmacy’s privacy policy.• During communication with the patient or the patient’s carer always verifies

whether the information has been understood and asks whether they have any further questions.

Collaboration • When communicating with and counselling the patient, works with pharmacy staff, prescribers and other care providers, such as home care nurses.

Scholarship • Has knowledge of communication skills and discussion techniques and applies these in practice.

• Is familiar with and follows specific guidelines for dealing with the drug inter-actions as well as contraindication monitoring.

• Is familiar with and employs general medical and pharmaceutical resources, such as instructional leaflet texts, Farmacotherapeutisch Kompas (a Dutch ref-erence book on the appropriate use of medicines for health care professionals), Informatorium Medicamentorum (a Dutch reference book of all medicines in the Netherlands, for both registered and unregistered use), and Recep-teerkunde (a Dutch book dealing with product care and the compounding of medication).

• Has knowledge of and follows professional guidelines and standards containing sections devoted to the use of pharmacotherapy in treating disease/disorders, e.g. the standards issued by the Dutch College of General Practitioners (NHG), consensus texts issued by the Quality Institute for the Health Care Sector in the Netherlands (CBO) and Farmacotherapeutisch Kompas.

• Continuously monitors advances in scientific knowledge in the field of phar-macy and pharmacotherapy.

Health advocacy • Knows and recognises the main determinants of disease and the incorrect or problematic use of medicine, including difficulty in accepting the use of medi-cation (non-adherence to medication).

• Knows the legal requirements concerning the provision of written information.• Duly observes the relevant laws, such as the Medical Treatment Contracts Act

(Wet op de Geneeskundige Behandelingsovereenkomst, WGBO) and the Per-sonal Data Protection Act, (Wet Bescherming Persoonsgegevens, WBP).

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Management • Instructs and manages pharmacy staff to ensure effective patient communica-tion and counselling.

• Makes agreements with prescribers and other care providers concerning patient communication and counselling, and acts accordingly.

• Uses information technology to enhance patient communication.• Records patient communication in the patient’s record.

Professional • Communicates with integrity in an engaged and sincere manner with the patient or the patient’s carer.

• Knows the limits of his or her own level of competence and acts within these limits.

• Demonstrates appropriate professional conduct towards the patient or the patient’s carer.

Task area 2. Health-care questions from patients and the general public

Description of task area 2In this task area the patient - who often does not have a prescription - seeks to communicate with the pharmacist or pharmacy team. The pharmacy may have to deal with a wide range of health-care questions, including those relating to medicines supplied under the supplementary health insurance scheme, phar-macy and chemist-only drugs, pharmacy-only drugs, or patient self-care in general. Other queries relate to prescription-only medicines (insulin and oral contraceptive medicine), incontinence products, a side effect, possible poisoning, pharmaceutical care, the use of medicine or medical aids prior to, during or after admis-sion to hospital, travel vaccination, a request to fill in a travel passport or a Schengen declaration for medi-cines, or a request for a second opinion. The pharmacist assesses the problem or the health-care question in the context of the information available on the patient (in the electronic patient record (EPR) and/or the patient’s current symptoms, complaints, disorders and current forms of treatment, including pharmaco-therapy. The pharmacist communicates with the patient to obtain a clear understanding of the health-care question, such as asking self-care patients the ‘WHAM’ questions. In general the basic format for conducting a consultation is as follows (six phases): analyse the patient’s problem, set a treatment goal, determine the relevant treatment options, and use this as a basis to determine a choice of treatment tailored to the patient providing supporting arguments, perform the treatment (medical or non-medical), and lastly perform fol-low up. The outcome of the pharmaceutical or pharmacy consultation may involve referral to a doctor, who usually also is the prescriber, or another care provider. Documentation should be provided for non-regular clients to ensure that their medical records or patient record remains updated.



• Has a broad knowledge of the field of pharmacotherapy and non-pharmaco-therapy, such as the domain of self-care, medical aids and travel vaccination.

• Has the skill to respond to health-care questions in a process-oriented manner.• Has the ability to locate the required information swiftly in order to respond to

the health-care question.

Communication • Is patient-focused and listens closely and attentively to the person asking the question to ensure that he clearly understands the health-care question.

• Discusses the outcome of the health-care question thoroughly with the person asking the question properly and with the patient in mind.

Collaboration • Works with pharmacy staff when responding to health-care questions.• When responding to health-care questions refers to other care providers, where

necessary.• Works with The Netherlands Pharmacovigilence Centre Lareb when dealing

with and reporting a side effect. • Works with the Area Health Authority (GGD), general practitioner (GP) or hospi-

tal concerning travel vaccination information.

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Scholarship • Knows the evidence-based guidelines for diseases and the relevant pharmaco-therapy for these diseases, including the guidelines for self-care patients.

• Knows the specific evidence-based guidelines relevant to the provision of phar-macy-only drugs. Has knowledge of how to deal with and report possible side effects (including Lareb) and medication errors.

• Is familiar with and employs the resources relevant to travel vaccination, poisoning and the care and treatment of drug addicts.

• Develops the required academic expertise and skills in order to respond appro-priately to health-care questions, including the less familiar clinical features, off-label use and orphan drugs.

Health advocacy • Knows and recognises the most important determinants of disease and the incorrect or problematic use of medicine.

• Understands the potential risks involved for patients using medicine.• Takes appropriate action in the event of the risk of a potential health hazard

for the patient.• Duly observes the relevant laws, such as the Medical Treatment Contracts Act

(Wet op de Geneeskundige Behandelingsovereenkomst, WGBO) and the Per-sonal Data Protection Act, (Wet Bescherming Persoonsgegevens, WBP).

Management • Instructs and supervises pharmacy staff to ensure they can respond optimally to health-care questions, particularly those concerning self-care. Makes agree-ments about responding to health-care questions, including self-care, with prescribers and other care providers and acts accordingly.

• Uses the medication surveillance module in the pharmacy information system to identify pharmacotherapy-related problems relevant to self-care products, in any event for the pharmacy-only type.

• Records the health-care question, the care process and results thereof in the patient’s record.

Professional • Responds to the health-care question with integrity, in an engaged and sincere manner,


• Demonstrates appropriate professional conduct towards the person asking the question.

Task area 3. Medication surveillance910

Description of task area 3The pharmacist can identify any pharmacotherapy-related problems the patient may have at various stages in the care process. For instance, when issuing a prescription, supplying a self-care medicine, while talking to a patient or when checking the prescription and checking the medication surveillance alerts, which is referred to as the final check. For the purpose of medication surveillance the pharmacist uses tools such as the medication surveillance module on the pharmacist’s computer, which detects a pharmacotherapy-relat-ed problem by generating a computerised alert. Examples are dosage-related problems, drug interactions, contraindications9, intolerance, double medication, medicines prescribed on incorrect or irrational phar-macotherapeutic grounds, off-label use, medication prescribed for the wrong patient, omitted medicines10, medication adherence problems, overuse, underuse, use for too long a time, use for too short a time and technical issues with the use of the medicine. The problem may arise with the prescriber of the medicine or the user. The pharmacist is conversant with the checking options provided in the pharmacy information system and incorporates his or her own appropriate checks, as required. The pharmacist interprets - and pri-oritises, if required – the problems identified in line with the guidelines set out for correctly responding to medication surveillance alerts using clinical and laboratory data. The pharmacist reaches a decision on how to respond to the problem and discusses his or her proposal, stating reasons as appropriate, with the general practitioner and/or the patient. The pharmacist records his or her ultimate response in the patient’s record.

9 Includes:disorders,reducedkidneyfunction,pharmacogeneticparameters,pregnancyandbreastfeeding.10Wheretheword‘medicine’appearsinthetext,insomecasesitalsomeans‘medicalaid’.

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• Responds to pharmacotherapy-related problems systematically, including those found via ICT (medication surveillance alerts): dosage-related problems, drug interactions, contraindications, intolerance, double medication, medicines pre-scribed on incorrect or irrational pharmacotherapeutic grounds, off-label use, medication prescribed for the wrong patient, omitted medicines, medication adherence problems, overuse, underuse, use for too long a time and use for too short a time.

• In responding to pharmacotherapy-related problems, takes account of the potential risk factors, such as comorbidity, clinical-chemical parameters, pharmacokinetic and pharmacogenetic data sets and suchlike.

• Checks prescriptions and the corresponding medication surveillance alerts upon completion of the prescription process.

• Performs medication surveillance when compounding medication based on a prescription using pharma raw materials or adapting a commercial product.

Communication • Consults with the patient or the patient’s carer in a clear and comprehensible manner (and provides reassurance as appropriate) in the event of pharmaco-therapy-related problems arising from a prescription or the outcome of an intervention.

Collaboration • Works with pharmacy staff when performing medication surveillance.• When performing medication surveillance collaborates with prescribers,

on a one-off basis, and where possible on a regular basis.• Intervenes as appropriate in response to medication surveillance alerts and has

the ability to determine an alternative pharmacotherapy policy in consultation with the prescriber.

• When performing medication surveillance works with care providers other than prescribers, such as the Thrombosis Service.

Scholarship • Is familiar with and follows specific guidelines in dealing with drug interac-tions and contraindication monitoring.

• Is familiar with and employs general resources in order to respond to medica-tion surveillance issues, such as instructional leaflet texts, Farmacotherapeu-tisch Kompas and Informatorium Medicamentorum.

• Is familiar with and follows professional guidelines and standards providing sections devoted to the use of pharmacotherapy in treating disease, e.g. the standards issued by the Dutch College of General Practitioners (NHG), consen-sus texts issued by the Quality Institute for the Health Care Sector in the Neth-erlands (CBO) and Farmacotherapeutisch Kompas.

• Continuously monitors developments concerning scientific expertise in the field of pharmacotherapy-related problems and how to respond to these problems.

Health advocacy • Understands the potential risks involved for patients using medicine.• Takes appropriate action in the event of the risk of a potential health hazard

for the patient.• Duly observes the relevant laws, such as the Medical Treatment Contracts Act

(WGBO) and the Personal Data Protection Act, (WBP).

Management • Complies with the rules and procedures for responding to problems identified, including delegation to assistants (levels of response and consultation with prescribers and the Thrombosis Service).

• Instructs and manages pharmacy staff to ensure good medication surveil-lance practice.

• Makes agreements with prescribers and other care providers concerning medication surveillance and acts accordingly.

• Uses the medication surveillance module in the pharmacy information system in order to identify pharmacotherapy-related problems.

• Records the outcome of the response to pharmacotherapy-related problems in the patient’s record in the correct manner.

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Professional • Performs medication surveillance with integrity, in an engaged and sincere manner,


• Demonstrates appropriate professional conduct towards the doctor and the patient.

Task area 4. Periodic medication review

Description of task area 4A proactive and periodic review of pharmacotherapy is essential, particularly for at-risk patients, such as elderly and polypharmacy patients and of at-risk points in time, e.g. admission to or discharge from hospi-tal. Patients eligible for a medication review are recommended by their general practitioner, the home care provider, the carer, and other prescribers or are selected by the pharmacist when processing the prescription or by performing searches on the computer. The patient may also take the initiative to have a medication re-view performed. There are a range of sources for gathering data for the purpose of ultimately formulating a treatment plan: the patient’s record available at the pharmacy (containing details of medication and clinical data), the patient’s details which are available to the prescriber (their medical history and clinical data), and by talking directly to the patient. Information can be obtained when the pharmacist and, in turn, the patient contacts the doctor. One way of collecting information in order to gain an idea of potential problems is to perform searches. A medication review can be performed on the basis of the above information. The identi-fied drug-therapy related problems are prioritised and incorporated in the treatment plan, in collaboration with the responsible prescriber. The patient’s record should be updated accordingly. The periodic medication review takes place on the basis of a Continuum of Care for the individual patient, and therefore includes ad-equate follow-up. (A special type of periodic medication review is the prescribing and protocol-led processing of repeat medicines by the pharmacist).



• Selects at-risk patients and at-risk points in time for the purpose of conducting a periodic medication review.

• Has the ability to collect and assess information about the patient from the patient’s record as part of a periodic medication review.

• Has the ability to collect and assess information about the patient recorded by the doctor in the patient’s record as part of a periodic medication review.

• Has the ability to collect and assess information about the patient by talking to the patient or the patient’s carer as part of a periodic medication review.

• Assesses the information collected as part of a periodic medication review.• Prioritises the identified pharmacotherapy-related problems.• Translates pharmacotherapy-related problems into recommendations for the

purpose of formulating a pharmaceutical treatment plan.• Records the treatment plan in the patient’s record in the appropriate manner.

Communication • Communicates the intent and outcomes of the periodic medication review in a clear and comprehensible manner to the patient and/or the patient’s carer.

• Is patient-focused, listens closely and attentively to the patient and effectively obtains information relevant to the patient.

Collaboration • Works with the prescriber to obtain the information required for the medica-tion review.

• Discusses the identified pharmacotherapy-related problems and the corre-sponding recommendations in the appropriate manner with the prescriber/doctor as part of a pharmaceutical treatment plan.

• Makes clear agreements with the doctor about the action to be taken.• Makes referrals in a timely manner as appropriate, if required during the

review process.• Works with pharmacy staff to obtain the information required for the medica-

tion review.

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Scholarship • Knows the evidence-based guidelines specific to the pharmacotherapy of dis-eases.

• Develops the required scientific knowledge and skills in order to competently perform the periodic medication review.

Health advocacy • Knows and recognises the most important determinants of disease and the incorrect or problematic use of medicine.

• Promotes the health of a specific group of patients by performing a periodic medication review, in which the balance between effectiveness and harmful-ness could be at issue due to the nature of the disease and/or the use of medi-cine.

• Acts in accordance with the relevant statutory provisions, such as those under the Medical Treatment Contracts Act (WGBO).

Management • Guarantees that the medication review and the treatment plan form part of the regular care provided to the patients referred to.

• Ensures that this activity is organised such that is performed effectively and efficiently within the pharmacy organisation.

Professional • Performs the periodic medication review with integrity, in an engaged and sin-cere manner.

• Demonstrates appropriate professional conduct towards the patient and the doctor.


Task area 5. Consultation with colleagues11

Description of task area 5The pharmacist consults regularly with a pharmacy staff member about individual patients. Consultations are held regularly with prescribers, such as the general practitioner, but occasionally with another doctor or the Thrombosis Service as well. The reason for a consultation usually is a problem with a prescription. The pharmacist also consults with other care providers, such as the medical assistant, the general practitioner’s support staff, the prescribing nurse, the clinical chemist or the hospital pharmacist. It may also be neces-sary to consult with other parties, such as the home care provider. Topics that might be discussed during the consultation are: the course of the disease, the therapeutic effect or side effects of a medicine, drug interac-tions, user problems11, biomarkers , the medication review and agreements made in the treatment plan. The pharmacist also holds regular consultations with doctors (pharmacotherapy consultation, FTO) and possibly other care providers (pharmaco integrated care consultation, FKO). The key themes include the development of formularies, including implementation in ICT, the application of medical and pharmaceutical standards and efficiency. Joint activities in the area of pharmaceutical patient care, the development of integrated health care and care groups, including implementation therefore, could also come up for discussion both during and outside the pharmacotherapy consultation. The aim of the latter consultation is to make agree-ments with colleagues, provide feedback on prescriber data and monitor agreements.


11Anewterm,whichincludesclinical-chemicalvalues,plasmalevelsinmedicinesandclinicalvalues,suchasbloodpressureandgeneticdata.

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• Analyses pharmacotherapy-related problems and transcribes these into recom-mendations for the purpose of consultation with colleagues.

• Includes in the analysis and the recommendation the appropriate information about the course of a disease, the therapeutic effect or side effects of a medi-cine, drug interactions, user problems, biomarkers, the medication review and agreements made in the treatment plan.

• Has the ability to prepare and present a topic during regular consultation meetings.

• Contributes to the adoption of agreements made with colleagues and records these in documents, such a formulary.

• Generates, analyses and ensures that feedback is provided on prescription data.• Monitors agreements made with colleagues in the course of time and provides

feedback.

Communication • Has the ability to communicate the outcome of consultations with other care providers to the patient or the patient’s carer.

Collaboration • Consults effectively about care for individual patients with other care provid-ers, such as the GP, the medical assistant, the GP’s support staff, the prescrib-ing nurse, the clinical chemist, the hospital pharmacist and the home care pro-vider.

• Provides effective input during consultations with doctors – and occasionally with other care providers – on pharmacotherapy policy, including during the pharmacotherapy consultation (FTO).

• Works with pharmacy staff to ensure the effective transfer of patient health information during individual clinical consultation on a patient with another practitioner.

Scholarship • Uses evidence-based information during one-off and regular consultations with other care providers.

• Promotes the expertise of other care providers as well as his or her own exper-tise during regular consultations.

• Monitors relevant developments in the area of medical and pharmaceutical sci-ences, guidelines, etc.

Health advocacy • Acts appropriately in compliance with the provisions laid down by law, includ-ing privacy laws and the Medical Treatment Contracts Act (WGBO).

• Allows the efficiency factor (the lowest possible costs for the highest possible quality) to play a part during consultations with other care providers in line with responsible business practice.

Management • Appropriately implements in the pharmacy organisation the agreements made during the consultations with other care providers.

• Uses supporting information technology, such as searches.• Understands the role and expertise required of pharmacy staff, and makes

agreements concerning individual clinical consultations conducted by phar-macy staff members with another practitioner (delegation of duties).

Professional • Holds consultations with colleagues with integrity, in an engaged and sincere manner.

• Demonstrates appropriate professional conduct towards the doctor (and the patient).


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Task area 6. Preventive care and screening

Description of task area 6Pharmacists provide general information to specific groups of patients, such as those suffering from mi-graine or diabetes, the elderly, or in general to schools. Pharmacists may do so in conjunction with other care providers or on an individual basis. The general information could relate to medicine, self-care, travel or other types of vaccinations as well as medical aids or lifestyle. General information focusing specifically on the primary prevention of disease is also given, i.e. how to stop smoking (cardiovascular diseases) or how to deal with obesity (diabetes). Pharmacists can be deployed to screen the state of health of specific at-risk groups. This involves measuring risk factors, such as blood pressure, cholesterol, glucose levels, etc. which is performed in consultation with general practitioners as far as possible.



• Has sufficient knowledge of the areas on which general information is pro-vided.

• Has sufficient knowledge of the prevention of the diseases on which informa-tion is provided.

• Is familiar with and the skills required to screen risk factors.

Communication • Communicates general information in the appropriate manner to the selected target groups.

• Communicates the limits of the screening methods to the client.• Communicates the meaning of the screening outcomes to the client.

Collaboration • Consults and where possible collaborates with other care providers or patient organisations on the provision of general information, the prevention of dis-ease and the use of screening methods.

• Works with pharmacy staff in the area of preventive care and screening.• Makes referrals to other care providers following the provision of general infor-

mation, preventive care and screening.

Scholarship • Knows the evidence-based guidelines for diseases and the pharmacotherapy for these diseases as set out in the relevant guidelines.

• Knows the evidence-based guidelines concerning the use of screening.• Knows the limits of diagnostic screening methods.

Health advocacy • Knows and recognises the determinants of disease and the incorrect or prob-lematic use of medicine.

• Promotes the health of patients and the community in general.• Acts in accordance with the relevant statutory provisions, such as those under

the Medical Treatment Contracts Act (WGBO).

Management • Ensures that the activities are organised such that they are performed effec-tively and efficiently within the pharmacy organisation.

• Ensures that the activities referred to are organised as effectively and effi-ciently as possible in collaboration with other care providers or with patient organisations.

• Records patient screening and the results thereof in the patient’s record.

Professional • Provides general information, information concerning the prevention of dis-ease and the use of screening methods with integrity, in an engaged and sin-cere manner.

• Demonstrates appropriate professional conduct towards the patient and doctor.• Knows the limits of his or her own level of competence and acts within these

limits.

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Task area 7. Collection and management of patient data

Description of task area 7The pharmacist collects and manages patient data in the pharmacy information system to ensure effective medication surveillance and patient counselling, as well as for administrative purposes. The data collected comprises personal data (address and insurance details) and specific information, such as medication in-formation, clinical information (conditions, diagnoses, symptoms and clinical-chemical data), cultural and psychosocial information, and care activities performed by the pharmacy. Information is collected with the patient's assistance and/or by other care providers by exchanging or transferring the relevant information (via the Open Care Information System - OZIS, and the national centre that offers access to patient health information - LSP), with due observance of the privacy rules and having regard to the guideline concerning the safe transfer of medication information. The pharmacist builds up a patient record in which the relevant information has been incorporated and can be used effectively. The pharmacist is familiar with the holder-ship/ownership principle of patient records – with the launch of the national electronic patient record (EPD) – and informs the patient thereof as required. Patients may be given access to their patient record. The pharmacist has documented what information should or should not be included in the patient record. Care activities are also coded as far as possible for the purpose of retroactive analysis.



• Is familiar with keeping patient records.• Collects, documents and manages relevant and current patient health informa-

tion.• Has the ability to exchange patient health information with other care provid-

ers to ensure the continuity of the pharmacotherapy.• Uses the health information in the patient’s record effectively for the purpose

of medication surveillance and patient counselling.• Is familiar with the coding of care activities.

Communication • Effectively communicates and discusses medical and pharmaceutical informa-tion with the patient or the patient’s carer.

• Effectively acquires the relevant patient health information.• Explains to the patient or the patient’s carer that information has been

recorded in the patient’s record, including the duty of confidentiality, and has the ability to deal with the patient’s objections to having the information placed on record.

• Explains the exchange of health information among care providers to the patient or the patient’s carer, including the duty of confidentiality.

• Makes clear to the patient or the patient’s carer that they have the right to access the patient’s health information.

Collaboration • Consults with other care providers, including pharmacist colleagues, concern-ing the exchange of patient health information.

• Works well with pharmacy staff in performing these activities.

Scholarship • Is familiar with the guideline for the safe transfer of medication information.• Is familiar with the ICT parameters binding the pharmacy’s own information

system and the exchange of information.• Has the ability to analyse coded care activities.

Health advocacy • Is familiar and acts in accordance with the regional and national formats and standards applicable to patient records.

• Is familiar and acts in accordance with the privacy laws applicable to patient records.

• Is familiar and acts in accordance with the statutory provisions laid down in the Medical Treatment Contracts Act (WGBO).

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Management • Instructs and supervises pharmacy staff in collecting and managing patient health information, including treating privacy-sensitive information as confi-dential.

• Uses the pharmacy information system to optimise management of patient health information.

• Shares patients’ health information electronically to optimise patient care.

Professional • Acts with integrity, is engaged and sincere in collecting, recording and transferring patient health information.

Task area 8. Product care

Description of task area 8Product care entails ensuring the availability of the proper medicine until such time as it is dispensed. In other words, the pharmacist ensures that the required medicine is available in the correct form, for the cor-rect patient and that it complies with the required quality standards. The pharmacist should judge whether the prescribed medicine is easy to administer and sufficiently user-friendly. Storing medicines in the phar-macy and delivering medicines to the patient form part of regular product care. It also means providing instructions on storage conditions and handling products outside the pharmacy, at the patient’s home or care institution. Special activities may occasionally need to be performed in order to make available medi-cines and medical aids, such as locating medicine suppliers, for orphan drugs for instance, which cannot be obtained through the usual distribution channel. The medicine may need to be compounded using pharma raw materials. Prior to compounding the pharmacist weighs the rationality and quality in terms of pharma-cotherapy, and the pharmaceutical quality and the feasibility of the request. He or she will propose an al-ternative in consultation with the prescriber. To create an easy-to-administer medicine, the pharmacist may need to adapt a commercial product, such as turning tablets into capsules. Product care also involves com-pounding medication for administration. This activity is performed both inside and outside the pharmacy, at the patient's home or in the care institution and, for example, involves working with parenterals, enteral feeding tubes, grinding tablets or measuring the correct dosage with a dose syringe. The information and instructions relate not only to the methods used for the activities but also acquiring mathematical skills and knowledge of hygiene. Pharmacists must ultimately be able to perform a recall procedure for all products. Product care covers the whole of the integrated care spectrum. In performing product care the pharmacist works with other care providers, patients or carers, suppliers of pharma raw materials, medicines and medi-cal aids and with compounding pharmacies.



• Makes medicines and medical aids available in a timely manner.• Weighs rationality and quality in terms of pharmacotherapy before compound-

ing medication.• Assesses the pharmaceutical quality before compounding medication.• Assesses the feasibility of the request concerning the compounding of medica-

tion prior to doing so.• Has the ability to draw up a protocol and/or work instruction for compounding

medication based on pharma raw materials.• Compounds medicine based on pharma raw materials.• Makes available a medicine by adapting a commercial product.• Compounds medication that is to be administered to a patient both at the

pharmacy and outside the pharmacy.• Assesses whether the prescribed medicine is sufficiently user-friendly or suit-

able for administering to a patient.• Ensures that medicines are stored safely in the pharmacy and during delivery

to the patient, and advises the patient on how to store the medicine.• Performs recall procedures.

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Communication • Communicates effectively about the aspects of product care with the patient or the patient’s carer, for instance on how to order the medicine, compound the medication and a possible change in the prescribed product.

• Ensures that instructions are provided about the product dispensed to ensure that it is used effectively.

• Ensures that instructions are provided about the storage conditions of the product dispensed and how the product should be handled at the patient’s home or care institution.

• Records the aspects of product care in the patient’s record.

Collaboration • Consults effectively with the prescriber about the product care aspects, propos-ing an alternative medicine if necessary, stating reasons.

• Consults effectively with suppliers of pharma raw materials, medicines and medical aids.

• Consults effectively with nurses or carers about the specific aspects of product care, such as compounding medication for administration to the patient, stor-age, etc.

• Respects the expertise of pharmacy staff concerning product care and delegates tasks effectively.

• Has the ability to assess and respond to an authorisation letter and a doctor’s statement.

Scholarship • Ensures that he or she maintains and advances his or her scientific knowledge in the area of product care.

• Is familiar with and uses resources, specific guidelines and protocols concern-ing product care, as described in Recepteerkunde (a Dutch book dealing with product care and the compounding of medication), for instance.

Health advocacy • Is receptive to and responds effectively to any queries and complaints the patient or the patient’s carer may have about the product.

• Acts in compliance with the provisions laid down by law, including those under the Medical Treatment Contracts Act (WGBO), the health insurance scheme and in compliance with the Dutch Pharmacy Quality Standard (NAN).

Management • Is familiar with and contributes to agreements made within the pharmacy concerning the quality of the products that is to be provided.

• Has the ability to organise the availability of medicines, and medical and assis-tive devices efficiently in a timely manner at the required quality level.

• Uses computer systems and information technology to deliver a high-quality product.

Professional • Performs product care with integrity, in an engaged and sincere manner,• Has the ability to reflect on his or her own actions in the appropriate manner.• Knows the limits of his or her own qualities and areas in which he or she lacks

the required expertise or skills.

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Task area 9. Quality assurance in the pharmacy

Description of task area 9Quality assurance is a broad concept and covers the intrinsic care aspects of the pharmacy, on the one hand, and business matters, on the other. Aside from being a specialist in his or her field, the pharmacist also functions as an entrepreneur and manager - a person who delegates part of his or her tasks. The aspects of this task area are as follows: • ·Quality assurance policy. The pharmacist pursues a quality assurance policy based on the Deming Quality

Circle, which is also referred to as the ‘Plan, Do, Check, Act’ or PDCA cycle. In performing quality assurance, the pharmacist employs a quality manual, certification and recertification, an annual quality report, quality indicators and other formats to reflect quality, including patient consultation, quality surveys involving mystery guests and quality circle surveys, and a complaints procedure and error registration to guarantee and help improve the quality of the care provided.

• Stock management and logistics. The logistics to and inside the pharmacy as well as stock management play a key role in ensuring that medicines and other products that are of good quality are available on a timely basis (see also task area 8). Account should also be taken of the economic aspects, i.e. the stock management system (design, management, economics), distribution system inside the pharmacy (traditional system, robots, medicine cabinets and analysis of the distribution system), the distribution channels to the pharmacy (reliable suppliers, central filling and automated distribution systems [ADS], the organisation of distribution to and inside nursing and care homes, etc. The pharmacy complies with the specific record-keeping formats laid down by law, such as those for opiates.

• Human resource management. The pharmacy is an organisation in which people increasingly work at a wider range of levels. Different educational and continued education requirements and salaries apply to the different positions. Human resource policy in the pharmacy covers task areas, such as terms of employment, working conditions, education and training, individual and group consultation, recruitment and selection, the distribution of duties, etc.

• Administration. The pharmacy is also a business involving economic, fiscal and legal aspects, whereby factors such as relations with debtors, creditors, the tax authorities, the industrial board, professional association, health insurers and other organisations come into play. The primary care pharmacy is required to comply with numerous legal and statutory aspects, including privacy guidelines, the rules laid down under the Medicines Act and the Medical Treatment Contracts Act (WGBO) and third-party liability. The pharmacist is required to monitor current issues and implement the relevant aspects as appropriate, including insurer guidelines concerning the reimbursement of health care costs and authorisations, for instance).

• The pharmacy business. The pharmacist carries joint responsibility for business continuity. The aspects described above play a role in ‘conducting business’. Other matters that come into play are a locality scan, recognising and responding to the needs of the client population, the relationship with the municipality, dealing with key financial figures and the auditor-client relationship.



• Is responsible for the following quality assurance aspects at the pharmacy: quality assurance policy, stock management and logistics, human resource management, administration and the pharmacy business.

Communication • Demonstrates the quality of the pharmacy, based on indicators for instance, to his or her patients/clients by presenting an annual report.

• Provides information on quality assurance in the pharmacy, if asked by the patient.

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Collaboration • Consults regularly with all or a group of pharmacy staff on quality assurance policy, stock management and logistics, staff matters and, if required, on aspects of the pharmacy business.

• Consults regularly with each member of pharmacy staff individually about the personal aspects of the sub-areas of quality assurance described.

• Works with a range of external parties in the area of quality assurance, such as wholesalers, the professional association, the inspectorate, educational bodies, the accountant/auditor, health insurers, patients, etc.

• Works on quality assurance with other care providers involved in providing integrated care.

Scholarship • Is familiar with the standards and guidelines and key developments in quality assurance.

Health advocacy • Acts appropriately in the event of care-related incidents.• Seeks certification and exposure for quality assurance.• Complies with the standards and guidelines concerning human resource man-

agement, such as terms of employment, education and training, etc.• Complies with the privacy guidelines, the rules laid down under the Medicines

Act and the Medical Treatment Contracts Act (WGBO), third-party liability, and health insurance guidelines.

• Complies with the statutory rules concerning the pharmacy business.

Management • Organises and implements the various aspects of quality assurance in the phar-macy ensuring a proper balance between day-to-day patient care.

• Uses information technology to support the implementation and development of quality assurance policy.

• Organises improvement programmes on the basis of quality surveys.

Professional • Performs quality assurance, including the human resource management aspects, with integrity, in an engaged and sincere manner.

Task area 10. Knowledge, education and scientific understanding

Description of task area 10The scientific mindset the pharmacist has acquired whilst studying at university, should never diminish during professional practice. Health care in general and the individual patient's often complex state of health demand that the pharmacist embraces a scientific mindset. The medical pharmaceutical sciences are advancing continuously. Advances are published in both primary and secondary literature and incorporated in professional multidisciplinary guidelines, nationwide collaboration agreements and standards. Pharma-cists are required to be conversant with developments and have the ability to implement these in peripheral areas, such as nutrition and homeopathy. Societal developments also occur, such as the changing care needs of patients, developments in the organisation of care (in integrated care, for instance, which requires more knowledge of the peripheral care areas), legislation amendments (in part on the basis of policy changes and/or due to political developments), advancements in ICT and communication or changed quality stand-ards. Pharmacists will need to adapt their care accordingly. Continuing education is key, which means that pharmacists should upgrade their knowledge and skills, develop and maintain a personal development plan (PDP), reflect on their own development (preferably allowing others to do so too), disseminate and demon-strate their knowledge and skills (to pharmacy assistants and trainee pharmacists), and apply what they have learned in practising care. Research too plays a key role, i.e. generating knowledge and effectively translating it into day-to-day care (enhancing standards and guidelines, for instance).



Communication • Has the ability to communicate research and research results, both in writing and verbally, to both experts and non-experts.

• Has the ability to communicate effectively as part of teaching.

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Collaboration • Works with other parties, such as care providers, educators and researchers in the area of research and education.

Scholarship • Upgrades one’s knowledge and skills by constantly and critically keeping abreast of advances in scientific knowledge in the area of pharmacotherapy, as published in professional and scientific Dutch and international journals.

• Upgrades knowledge and skills by constantly and critically keeping abreast of developments concerning professional guidelines and standards providing sec-tions devoted to the use of pharmacotherapy in treating diseases, e.g. the stan-dards issued by the Dutch College of Practitioners (NHG), consensus texts issued by the Quality Institute for the Health Care Sector in the Netherlands (CBO) and Farmacotherapeutisch Kompas, Receptuurkunde and other profes-sional or multidisciplinary guidelines, nationwide collaboration agreements and standards

• Upgrades knowledge and skills by constantly and critically keeping abreast of developments in other areas, such as technological developments (e.g. dosage forms) and peripheral areas, such as homeopathy.

• Develops and maintains an individual development plan (PDP), a key aspect of which entails reflecting continuously on one’s own development.

• Disseminates knowledge and skills to pharmacy staff, trainees and trainee pharmacists.

• Promotes the expansion and advancement of scientific knowledge by being involved in research activities.

Health advocacy • Keeps constantly but critically abreast of societal developments, such as changes in patients’ care needs, developments in the organisation of care, legislation amendments, developments in the area of ICT and communication or changes in quality standards.

Management • Adapts the organisational structure of the pharmacy and the care provided by the pharmacy in response to scientific and societal developments.

• Applies the knowledge acquired during training and continued education programmes in the pharmacy organisation and the care provided by the pharmacy.

Professional • Demonstrates appropriate personal professional conduct in pursuit of knowledge, education and science.

• Practices pharmacy, in pursuit of knowledge, education and science, in compliance with the Code of Ethics governing the pharmacy profession.

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VI Assessment

Assessment forms the core of each education programme. The education programme would in fact be ineffective if an assessment would not be incorporated. Assessment drives learning by the specialist community pharmacist trainee (ApIOS) and enables the supervisor to determine the trainee’s progress during the programme and identify any gaps in knowledge, where further work is required.

The quality of the education programme will improve as a result of assessment. The nature of the assessment is primarily development-oriented, educational and formative. Assessment definitely is an aspect that trainees themselves must carry out. Self-reflection or self-assessment is key to their development throughout the two-year programme. Assessment moreover encourages the pharmacist supervisor (apotheekopleider, ApOP) and any others who are in some way involved in the education programme to provide feedback. In addition two selective assessments are conducted during the two-year programme.

Assessments are held at certain points in time – at the end of the first and second years of the programme – to determine whether the trainee is making sufficient progress. These assessments could have implications for the continuation of the education programme, for the trainee’s further individual education plan and whether or not the trainee will ultimately qualify for registration as a specialist community pharmacist.

In addition to the education programme in the pharmacy, education is also provided centrally. Specific assessment instruments are used in centrally organised courses, such as knowledge assessment and participation in education. The primary aim of assessment is to assist the specialist community pharmacist trainee in becoming fully proficient during the programme. This means that he or she should acquire the right combination of knowledge, skills and attitude and has the ability to apply these in day-to-day practice. This education plan uses a range of assessment instruments, also referred to as forms of assessment, for conducting assessments, a description of which is provided in Section VI.1. Assessments are required in order to assess the competences of and day-to-day activities performed by the specialist community pharmacist trainee. This means that further factors can be assessed, aside from solely knowledge or practical skills. A range of activities have therefore been selected which are performed by community pharmacists within the various task areas and which typify the activities performed in professional practice, or Entrustable Professional Activities’ (EPAs), as referred to in the education programme. There are 40 EPAs in total, a description of which is given in Section VI.2 for each task area. The assessment of one or several EPAs in each task area – using specific assessment instruments – involves assessing a number of competencies in the relevant task area each time.

Section V1.2 describes the specific assessment instruments that are to be employed for assessing the various EPAs as well as the frequency of assessment during each year of the education programme. Section VI.3 provides a summary of the frequency of assessment applicable to the various assessment instruments. The specialist community pharmacist trainee is ultimately required to have undergone and passed the – indirect - assessment of all key competence areas based on all EPAs using the applicable instruments. Section VI.4 clearly demonstrates that this education plan enables trainees to successfully undergo assessment. Lastly, Section VI.5 links EPAs and the various forms of assessment to review dates and levels of proficiency.

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VI.1 Assessment and assessment instrumentsA range of instruments are available for the purpose of conducting assessments, a description of which is provided in table 1. These instruments are simply tools designed primarily for the purpose of providing or obtaining feedback. Not every instrument is suitable for assessing every Entrustable Professional Activity (EPA) and the various competences. The knowledge assessment, for example, does not measure communication with patients. Moreover, not one single instrument will help to adequately assess all of the community pharmacist’s competences at once. Assessment of 40 EPAs with the aid of the applicable assessment instruments once or on multiple occasions during the two-year education programme will help obtain a good idea of the competences of the specialist community pharmacist trainee (ApIOS). The progress reviews conducted between the specialist community pharmacist trainee and the pharmacist supervisor (ApOP) during the course of the education programme are vital. The results of the assessments performed to date are discussed during the review sessions. All of the results are retained in the portfolio, which has a key and valuable role. The portfolio may also contain other information, such a written account of the trainee’s experience of the education programme (including the number of activities), a strengths and weaknesses analysis and the tasks set as a result thereof. The constantly updated Personal Development Plan (PDP) forms an integral part of the above. Feedback is vital in the specialist community pharmacist trainee’s education programme. The pharmacist supervisor is required to provide feedback during the assessment periods and assessment reviews as well as on a regular basis at work and during the short, scheduled reviews that should take place preferably each fortnight. The trainee is responsible for scheduling the consultation periods! Forms or manuals for the various assessment instruments are or will be made available.

Table 1 Assessment and assessment instruments

a. Assessment instruments applicable to the pharmacy providing hands-on training

Discussing critical incidentsThis form of assessment discusses a situation in which the specialist community pharmacist trainee has learned or could learn a lot. Both the trainee and the pharmacist supervisor may take the initiative to discuss a critical incident. The trainee should first write a short report or perform an analysis. The trainee’s role is discussed, i.e. what went well, what could have gone better and what lessons were learned from the situation. Examples of critical incidents are aggressive parents, a difficult patient, an error made by the pharmacy or the trainee, a side effect or problems in coaching a staff member or trainee/work placement student.

Case-based discussionThis form of assessment is devoted to the pharmacotherapy used in treating a patient and potential drug-related problems. A case is analysed and the various pharmacotherapy treatment options are substantiated and discussed.

Directly observed preparation skills (DOPS)This feedback instrument has been developed for the purpose of the observation and assessment of product care inside the pharmacy. The whole process of compounding medication for administration is systematically assessed.

Assessment of the patient recordThis instrument focuses on a patient’s electronic patient record. The documentation of an activity and/or a patient consultation is discussed with the pharmacist supervisor. The discussion might relate to the intake of a new patient or a medicine consultation in connection with admission to hospital. A patient record assessment may also involve assessing a completed protocol, for instance when first dispensing a medicine. The knowledge and skills checklist has a role in the assessment of patient records, see Appendix A. Regular emphasis is placed on the key aspects of creating a patient record, working on a protocol-led basis, disseminating information, transferring a patient and the continuity of care as a result of conducting patient record assessments. The competences assessed depend on the EPA.

360° feedbackFeedback is usually provided by the pharmacist supervisor. Feedback based on assessments by various immediate colleagues and staff, such as the supervisor, the pharmacist’s peers, pharmacy assistants, other pharmacy staff, administrative staff, patients and other care providers, such as doctors, is referred to as multi-

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source or 360° feedback. A unique aspect of this type of feedback is that different perspectives underlie the opinions given. The 360° feedback method reflects the overall opinion of a range of different parties. This assessment instrument gauges the competences of professionalism, communication and collaboration.

Self-assessmentThe self-assessment’ and strengths and weaknesses analysis performed by the specialist community pharmacist trainee are correlated. Comparison of the results thereof with the results of the 360° feedback is an excellent way to identify the trainee’s strengths and weaknesses. The trainee also performs a self-assessment of his or her behavioural competences. The information could prove beneficial for the continuation and further scope of the education programme

Short practical assessment During a short practical assessment the supervisor observes the trainee performing an activity in day-to-day practice, which includes a patient consultation. This might, for instance, be a consultation concerning patient counselling when dispensing a medicine for the first time, a pharmaceutical case history relevant to a care question or responding to a medication surveillance alert. Two competence areas are usually assessed, i.e. pharmaceutical expertise and communication.

Model letterThe model letter represents all types of written material prepared by the trainee, such as written information material or a report regarding the collection and analysis of quality indicators. The material forms the basis of the review with the supervisor. The purpose of the review is to improve the quality of correspondence and knowledge dissemination. The competences assessed depend on the EPA.

Reflective reportThe trainee submits a self-reflection report on an EPA. The trainee should include the following in the self-reflection report: what were my learning objectives for the activity, what went well, what did not go so well and what would I like to improve. The self-reflection report serves as the starting point for the review with the supervisor.

b. Assessment instruments applicable to centrally organised courses

Knowledge assessmentA written assessment of progress is a reliable method for assessing knowledge, as incorporated in the education plan (task areas). Knowledge assessment aligns with the mix of assessment instruments used to form a reliable and valid opinion. The knowledge assessment is administered centrally.

Participation in educationParticipation in or assessment of centrally organised individual courses, such as presenting an assignment.

c. Review instruments

Knowledge and skills checklistThe knowledge and skills checklist has been designed as an instrument for monitoring the trainee’s learning process in acquiring knowledge and skills. The trainee fills in the checklist while performing activities. The checklist is discussed during the progress reviews with the supervisor. The checklist forms part of the trainee’s portfolio, an example of which is included in Appendix A.

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Job suitability assessmentTwo reviews are held during the education programme relating to the suitability of the trainee for the role of specialist community pharmacist, which, in fact, also serve as a progress review. The assessment takes place at the end of the first and second years of the education programme.

Orientation interviewDuring the orientation interview, on the basis of the trainee and pharmacist supervisor’s mutual expectations agreements are made on what the trainee should learn. A key component is the preliminary discussion of the Personal Development Plan (PDP) to be drawn up by the trainee.

Personal Development PlanAs part of his or her portfolio each trainee is required to prepare a PDP that serves as a guideline for the education programme activities. The document is dynamic and should be updated regularly following each progress review. The PDP contains the planned activities relating to patient and product care, self-study, individual courses, and agreements concerning supervision and assessment. The PDP is determined in consultation with the supervisor.

PortfolioThe trainee’s portfolio forms a key component of the education programme. It contains a collection of documents that reflect the trainee’s progress. In any event the documents include the results of the progress and job suitability assessment reviews that are required to be conducted at certain points in time between the supervisor and the trainee, including the PDP, the trainee’s self-assessment and the results of courses and other educational activities. The trainee is responsible for maintaining and updating his or her portfolio, which is checked for completeness by the pharmacist supervisor. The portfolio is made available to the trainee electronically.

Progress reviewThe development of the trainee’s skills and competences are discussing during a progress review. Evidence as submitted and included in the portfolio forms a key component thereof. During the review the pharmacist supervisor and the trainee examine a possible lag in the development of competences and establish improvement areas. A key starting point for the review, however, is to bolster the trainee’s self-confidence, support the trainee’s learning process and to provide positive feedback. A progress review is scheduled every three months.

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VI.2 EPAs broken down by task area, the applicable assessment instruments and frequency of assessment

Assessments are required in order to assess the competences of and the day-to-day activities performed by the specialist community pharmacist trainee (ApIOS) at the pharmacy providing the hands-on training. A range of activities have therefore been selected which are performed by community pharmacists within the various task areas and which typify the activities performed in professional practice, or the ‘Entrustable Professional Activities’ (EPAs), as referred to in the education programme. There are 40 EPAs in total, a description of which is given below for each task area. The description is followed by the applicable assessment instruments and the frequency of assessment each year, broken down by task area and EPA.

Task area 1. Patient communication and counselling

EPAs

1 Patient counselling when dispensing a medicine for the first time

Cover all ‘major diseases’: diabetes, asthma/ COPD, cardiovascular disease, psychiatric disorders (particularly depression), rheumatic diseases and cancer. This includes providing technical instructions, e.g. for inhalation devices, blood glucose meters, etc. Keep the patient’s social, psychological and cultural background in mind, e.g. in respect of a psychiatric patient, elderly dementia patients, etc. NB: Language barrier/communication problems, Ramadan, a child suffering from a chronic disease, disabilities, the desire to have children, pregnancy and breast feeding (see knowledge and skills checklist in Appendix A).

2 Patient counselling when dispensing a medicine on a second or subsequent occasion

In any event dispense the medicine a second time. Cover all ‘major diseases’. See also the explanation under EPA 1 and the knowledge and skills checklist in Appendix A.

3 Counselling a palliative care patient

A prescription for an opiate may signify the time to begin counselling. Termination of Life on request may sometimes signify the termination of care for a palliative care patient. Although this is not considered as palliative care, this particular aspect of care has been included here.

4 Counselling a patient or the patient’s carer in using care and/or medical aids

• Incontinence products• Surgical dressings• Liquid foods• Injection systems, drips, cartridges (see knowledge and skills

checklist in Appendix A).

Form of assessment Subject Frequency

Short PracticalAssessment

EPA 1: Patient counselling when dispensing a medicine for the first time (with different aspects, where possible).

1x in first year1x in second year


EPA 2: Patient counselling when dispensing a medicine a second time (with different aspects, where possible).



EPA 4: Counselling a patient or the patient’s carer in using care and/or medical aids.


Assessment of patient record

EPA 1: Copy of an anonymised EPR or a completed protocol concerning dispensing medicine for the first time to patients suffering from diseases, in accordance with the knowledge and skills checklist in Appendix A.


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EPA 2: Copy of an anonymised patient’s EPR or a completed protocol concerning dispensing medicine for a second time/on subsequent occasions to patients suffering from diseases, in accordance with the knowledge and skills checklist in Appendix A.


Case-based discussion EPA 3: Counselling a palliative care patient. 1x in second year

Task area 2. Health-care questions from patients and the general public

EPAs

5 Dealing with a self-care patient Use WHAM questions as an aid; pharmacy-only drugs. Keep the social, psychological and cultural background of the person requesting self-care in mind.

6 Responding to a patient’s health-care question, non-self-care

Including the health-care questions asked by the patient’s carers. The questions may relate to any side effects experienced, complaints, travel vaccination advice, and possible poisoning. Keep the social, psychological and cultural background of the person requesting self-care in mind. (see knowledge and skills checklist in Appendix A).



EPA 5: Dealing with a self-care patient. 1x in first year1x in second year

Discussion of critical incidents

EPA 6: Responding to a patient’s health-care question, non-self-care.

4x in first year

Task area 3. Medication surveillance

EPAs

7 Responding to an ‘alert’ indicating a pharmacotherapy-related problem, generated by a computerised adverse drug event alerting system or otherwise.

Aspects that should be covered include: phased assessment, the relationship between the pharmacy assistant and the pharmacist, consultation with the prescriber as well as the patient. Responding to a range of problems: See knowledge and skills checklist in Appendix A. Take account of the potential risk factors, such as comorbidity, clinical-chemical parameters, pharmacokinetic and pharmacogenetic data sets and suchlike.

8 Checking prescriptions and the corresponding medication surveillance alerts upon completion of the prescription process.

Responding to a range of problems: See knowledge and skills checklist in Appendix A. Take account of the potential risk factors, such as comorbidity, clinical-chemical parameters, pharmacokinetic and pharmacogenetic data sets and suchlike.

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EPA 7: Responding to an ‘alert’ indicating a pharmacotherapy-related problem, generated by a computerised adverse drug event alerting system, or otherwise.



EPA 7: Copy of an anonymised EPR concerning medication surveillance alerts that have been dealt with as referred to in the knowledge and skills checklist.



EPA 8: Checking the list of medication surveillance alerts.


Knowledge assessment The pharmaceutical care needs of certain patient groups and pharmacotherapy-related problems.

1x in second year

Task area 4. Periodic medication review

EPAs

9 Performing a technical medication review for an at-risk patient, including preparing a pharmacotherapy treatment plan (PTP).

The medication review concerns a polypharmacy patient and/or geriatric patient, usually suffering from multimorbidity (for a number of major diseases, see EPA 4). Patient selection may also relate to the at-risk timing, such as discharge from hospital. Performing a review and preparing a PTP in consultation with the doctor.

10 Patient pharmacotherapy consultation in connection with a medication review, including preparing a PTP.

Possible visit to a patient’s home.See also EPA 9.

11 Carrying out a PTP and ensuring the continuity of care

Further activities resulting from EPA 9 and/or 10,all of which after having consulted with the doctor or the doctor’s support staff. Consultation with the patient. Determine the timing of checks. Repeat the medication review.

12 Patient pharmacotherapy consultation in connection with admission to hospital or another care institution.

Possible visit to a patient’s home.See also EPA 9.Key components: what medicine is the patient currently taking and what problems is the patient experiencing.

13 Patient pharmacotherapy consultation in connection with discharge from hospital or another care institution

Possible visit to a patient’s home.See also EPA 9.Key components: what medicine is the patient currently taking, differences in medicine use history, and ensuring patient understanding.Includes monitoring following the consultation.

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EPA 10: Patient pharmacotherapy consultation in connection with a medication review, including preparing a pharmacotherapy treatment plan (PTP).



EPA 13: Patient pharmacotherapy consultation in connection with discharge from hospital or another care institution

1x in first year

Case-based discussion EPA 9: Performing first technical medication review for an at-risk patient, including preparing a PTP.



EPA 11: Carrying out a treatment plan and ensure continuity thereof.

2x in first year 10x in second year


EPA 12: Assessing a patient pharmacotherapy consultation in connection with admission to hospital or another care institution.

1x in first year

Knowledge assessment Medication review 1x in second year

Task area 5. Consultation with colleagues

EPAs

14 Consultation with the prescriber concerning a prescription, or as a result of a different problem

It may also be necessary to consult/communicate with the Thrombosis Service. What agreements have been made on the delegation of this task to assistants?

15 Involvement in and/or preparation of a pharmacotherapy consultation (FTO)

Including presentation during the FTO.Including determining the location of new medicines.

16 Participation in and/or consultation concerning integrated care

Including consultation with care groups. In relation to the pharmacy itself, e.g. in connection with a health-care centre. In addition: developing a regional formulary, care consultation with a care or nursing home, etc.


360º feedback and self-assessment

This form of assessment involves various EPAs, such as EPA 14 (consultation with the prescriber), EPA 15 (involvement in and/or preparation and implementation of an FTO), and EPA 16 (involvement in integrated care).



EPA 14: Consultation with the prescriber concerning a prescription, or as a result of a different problem.


Reflective report EPA 15: Participation in, and/or preparation of and holding a pharmacotherapy consultation (FTO).


Reflective report EPA 16: Participation in and/or consultation concerning integrated care.

1x in second year

39


Task area 6. Preventive care and screening

EPAs

17 Providing general information – either in writing or verbally – to a group of patients and/or non-experts

Including presentations to groups, and preparing written information material. Including information for website publication.

18 Offering screening and performing screening activities

In conjunction with general practitioners, where possible.This may include performing a search in order to select a specific group of patients.This may include obtaining, analysing and describing screening results, as well as reporting thereof in the annual quality report.


Model letter EPA 17: Providing general information in writing to a group of patients and/or non-experts.

1x in first year

Reflective report EPA 17: Providing general information verbally to a group of patients and/or non-experts.


Reflective report EPA 18: Reporting on a screening activity performed. 1x in first year2x in second year

Task area 7. Collection and management of patient data

EPAs

19 Conducting an intake interview Includes:• New patient• Passer-by• Passer-by with an official prescriptionIncluding updating the patient record, exchanging information (passer-by after-care) and taking measures to ensure the protection of privacy.



EPA 19: Conducting an intake interview. 1x in first year1x in second year


EPA 19: Copy of an anonymised EPR for a patient or passer-by, with whom an intake interview has been conducted.


40


Task area 8. Product care

EPAs

20 Making available medicines that are difficult to obtain

Including imported orphan drugs.

21 Compounding based on a prescription using pharma raw materials

As part of total product care, which therefore includes assessing quality (analysis) and performing medication surveillance.

22 Compounding a medication for administration, including• product care for special medi-

cation administration sys-tems

• product care for special medi-cines

This is carried out at the pharmacy and/or at the patient’s home.• Medication administration systems: Drip and injection systems,

cartridges• Special medicines: Suspensions, cytostatic drugs, protein medi-

cines, sterile medicines, etc. This also involves storage inside the pharmacy, transportation/delivery, storage at the patient’s home, providing the patient information and instructions on how to store and administer the medicine at home and explaining the weekend emergency protocol.

23 Performing a recall procedure Traceability through to the patient.



EPA 20: Making available medicines that are difficult to obtain.

2x in first year

Directly observed preparation skills (DOPS)

EPA 21: Compounding based on a prescription using pharma raw materials.



EPA 22: Compounding a medication for administration.



EPA 23: Performing a recall procedure. 2x in first year

Task area 9. Quality assurance in the pharmacy

EPAs

24 Using an individualised form of distribution

Including analysing why this is necessary, and providing information.

25 Preparing, implementing and evaluating:• a pharmaceutical patient care

project (PPC)• an annual or project plan• the annual report

Including consultation with other care providers and/or the health insurer.

26 Maintaining a quality assurance system

Including a quality assurance manual, quality assurance documents, certification and re-certification.

27 Collecting and analysing quality indicators

Applying the Deming Quality Circle.

28 Collecting and analysing errors or near errors

Including working with the Central Medication Incidents Registry (CMR), the national registration centre that records medication incidents.

29 Collecting, reporting and analysing side effects

Including liaising with the Netherlands Pharmacovigilence Centre LAREB; and advising the patient to report side effects directly to LAREB, where applicable.

41


30 Performing the relevant activities and analysing:• the stock control system• the distribution system• working conditions

• Stock control system: timely availability, economics and user data. Including opium legislation. Pertaining to the outcome: possibly changing the way stock control is organised. Including understanding purchasing efficiencies, substitute medicines and parallel imports of medicines.

• Distribution system: including any special aspects, such as the use of robots, lockable medicine cabinets, patient online orders, at nursing and care homes.

• Working conditions: various aspects, including sickness reports, monitoring absenteeism due to illness, working conditions, stat-utory OHS requirements (also applicable to the compounding of medication), etc.; employee satisfaction survey (concerning the pharmacy organisation and working conditions).

NB: OHS during home care and at care institutions should also be taken into account.

31 Relationship with suppliers, the industry and the software supplier

Including selection on the basis of aspects such as the continuity of delivery/supplies, delivery times, the quality of order processing and certification.

32 Preparing an employee job description

Including salary, and the recruitment and selection of new employees.

33 Conducting an employee performance and appraisal review

Including preparing and evaluating employee Personal Development Plans (PDPs).

34 Work meeting/progress meeting Group work meeting. Including education and training, and implementation. Involves participating in, holding a presentation at and chairing the meeting.

35 Implementing a change on the shop floor or introducing a procedure or a work regulation

Including providing instructions, stating reasons and checking (quality circle). Targeted at a specific group, and individuals.

36 Relationship with insurers Entering into contracts. Including collecting and analysing management information in preparation of the contract negotiations. Specific guidelines. Authorisations.



EPA 24: Using an individualised form of distribution (providing information to a new patient).

1x in first year

Model letter EPA 25: Report on the Implementation and Innovation project as part of centrally organised courses: Management & Quality Activity I.

1x in first year

Model letter EPA 26: Work out assignment about maintaining a quality assurance system.


Model letter EPA 27: Report on collecting and analysing quality indicators.

1x in second year

Model letter EPA 30: Work out assignment concerning an analysis of the stock control or distribution system or the working conditions.


Model letter EPA 31: Work out assignment concerning the pharmacist’s relationship with suppliers, the industry and the software supplier.

1x in second year

Model letter EPA 32: Employee job description. 1x in second year

Model letter EPA 36: Work out assignment concerning the pharmacist-insurer relationship.

1x in second year

42



EPA 28: Collecting and analysing errors or near errors. 2x in first year1x in second year


EPA 29: Collecting, reporting and analysing side effects.

1x in first year

Reflective report EPA 33: Conducting an employee performance and appraisal review.


Reflective report EPA 34: Work meeting/progress meeting. 2x in first year1x in second year

Reflective report EPA 35: Implementing a change on the shop floor or introducing a procedure or a work regulation.


360° feedback and self-assessment

This form of assessment relates to several EPAs and involves third-party assessment of the quality of performance within the pharmacy organisation. It covers various EPAs described in task area 9, as well as other task area EPAs. You may choose to combine this form of assessment and the same form of assessment described in task area 5 to enable other parties to assess both internal and external performance simultaneously.

1x in the first year1x in the second year

Task area 10. Knowledge, education and scientific understanding

EPAs

37 Analysis of major external influences

Preferred supplier policy, modifying the medicine reimbursement method, price adjustments, etc. Identifying potential ethical problems associated with external influences. Discuss internally, where required.

38 Processing new information on medicines

From the Medicines Evaluation Board (MEB) (changes in the information provided in medicine leaflets and risk management plans), the manufacturer (product information), Gebu Medicines Bulletin (new medicines), Pharma Selecta (a Professional Information Bulletin on Medicines), etc.

39 Initiating, performing and/or taking part in practice research

40 Supervising a trainee/work placement student in certain areas of care and/or coaching a staff member

Including providing feedback.


Model letter EPA 37: Work out assignment concerning an analysis of major external influences.

1x in second year

Model letter EPA 38: Work out assignment concerning processing new information on medicines.

1x in first year

Model letter EPA 39: Paper (taking part in a research project) as part of centrally organised courses: Pharmaceutical practice – Research Activity I

1x in second year

Reflective report EPA 40: Supervising a trainee/work placement student in certain areas of care and/or coaching a staff member

2x in the first year2x in second year

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VI.3 Education programme assessment schedule

The frequency of assessment applicable to the various assessment instruments is shown in the table below.

Assessment instruments Three months

Six months

Nine months

First year

Three months

Six months

Nine months

Second year

Education requirements decree√ Progress reviewX Job suitability review

√ √ X √ √ √ √ X

Orientation interview √

Personal Development Plan (PDP)

ongoing

Portfolio ongoing


21 x a year 7 x a year

Case-based discussion 2 x a year 11 x a year





360o feedback and self-assessment

√ √ √

Short practical assessment


Model letter 5 x a year 8 x a year

Reflective report 12 x a year 11 x a year

Knowledge assessment 1 x a year

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VI.4 Linking task areas, EPAs and competences

The specialist community pharmacist trainee (APIOS) is ultimately required to have undergone adequate assessment in all key competence areas based on all EPAs using the applicable assessment instruments. The table below clearly demonstrates that this education plan enables trainees to successfully undergo assessment.

EPAs Assessed competences

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Task area 1: Patient communication and counselling

1. Patient counselling when dispensing a medicine for the first time

SPA+PRA SPA KA (SPA) PRA

2. Patient counselling when dispensing a medicine on a second or subsequent occasion

SPA+PRA SPA KA (SPA) PRA

3. Counselling a palliative care patient CBD CBD + KA)

4. Counselling a patient or the patient’s carer in using care and/or medical aids.

SPA SPA KA

Task area 2: Health-care questions from patients and the general public

5. Dealing with a self-care patient. SPA SPA KA (SPA)

6. Responding to a patient’s health-care question, non-self care.

CI CI (CI) CI CI CI

Task area 3: Medication surveillance

7. Responding to an ‘alert’ indicating a pharmacotherapy-related problem, generated by a computerised adverse drug event alerting system or otherwise.

SPA+PRA SPA (SPA) KA PRA (SPA)

8. Checking prescriptions and the corresponding medication surveillance alerts upon completion of the prescription process.

CI (CI) CI CI + KA

CI CI (CI)

Task area 4: Periodic medication review

9. Performing a technical medication review for an at-risk patient, including preparing a pharmacotherapy treatment plan (PTP).

CBD (CBD) CBD + KA

(CBD)

10. Patient pharmacotherapy consultation in connection with a medication review, including preparing a PTP.

SPA SPA KA

11. Carrying out a PTP and ensuring the continuity of care.

PRA PRA KA PRA

12. Patient pharmacotherapy consultation in connection with admission to hospital or another care institution.

PRA PRA KA PRA

13. Patient pharmacotherapy consultation in connection with discharge from hospital or another care institution.

SPA SPA KA

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Phar

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Task area 5: Consultation with colleagues

14. Consultation with the prescriber concerning a prescription, or as a result of a different problem.

CI CI KA CI CI

15. Participation in, and/or preparation of and holding a pharmacotherapy consultation (FTO).

RR RR RR RR (RR)

16. Participation in and/or consultation concerning integrated care.

RR RR RR RR (RR)

Task area 6: Preventive care and screening

17. Providing general information – either in writing or verbally – to a group of patients and/or non-experts

ML ML ML ML

18. Offering screening and performing screening activities.

RR RR (RR) RR RR

Task area 7: Collection and management of patient data

19. Conducting an intake interview. SPA+PRA SPA PRA

Task area 8: Product care

20. Making available medicines that are difficult to obtain.

CI CI CI

21. Compounding based on a prescription using pharma raw materials.

DOPS DOPS

22. Compounding a medication for administration, including:• product care for special medication adminis-

tration systems • product care for special medicines

PRA PRA

Task area 9: Quality assurance in the pharmacy

23. Performing a recall procedure. CI CI CI

24. Using an individualised form of distribution.

SPA+ SPA

25. Preparing, implementing and evaluating:• a pharmaceutical patient care project (PPC)• an annual or project plan• the annual report

ML ML ML

26. Maintaining a quality system. ML ML ML ML

27. Collecting and analysing quality indicators. ML ML ML ML

28. Collecting and analysing errors or near errors.

CI CI CI CI CI

29. Collecting, reporting and analysing side effects.

CI (CI) (CI) (KA) CI CI

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Phar

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30. Performing the relevant activities and analysing:• the stock control system• the distribution system• working conditions

ML ML

31. Relationship with suppliers, the industry and the software supplier.

ML ML

32. Preparing an employee job description. ML ML

33. Conducting an employee performance and appraisal review.

RR RR RR

34. Work meeting/progress meeting. RR RR

35. Implementing a change on the shop floor or introducing a procedure or a work regulation.

RR RR

36. Relationship with insurers. ML ML

Task area 10: Knowledge, education and scientific understanding

37. Analysis of major external influences. ML ML ML

38. Processing new information on medicines. ML ML

39. Initiating, performing and/or taking part in practical research.

ML ML ML ML ML

40. Supervising a trainee/work placement student in certain areas of care and/or coaching a staff member.

RR RR RR

Abbreviations used for the forms of assessmentCBD = Case-based discussionCI = Discussion of critical incidentsPRA = Assessment of patient recordDOPS = Directly observed preparation skills (DOPS)SPA = Short Practical AssessmentKA = Knowledge assessmentML = Model letterRR = Reflective report(..) = Assessment is not always possible

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VI.5 Linking EPAs and assessment forms with review dates and proficiency levels

A review date refers to a point in time for evaluating what the specialist community pharmacist trainee (ApIOS) has learned and how he or she has developed. Four review dates have been defined in the new education plan as follows:

Review datesReview date I after six monthsReview date II after one yearReview date III after 18 monthsReview date IV after two years, at the end of the education programme

All EPAs are linked to a review date on which the required level of proficiency should be achieved. There are four proficiency levels:

Proficiency levelLevel 1 has knowledge of/is familiar withLevel 2 acts under strict supervisionLevel 3 acts under limited supervisionLevel 4 acts without supervision

At present, the degree to which the levels of proficiency are realistic is not quite clear. The requirements established are minimum requirements. They are deemed realistic. However, the goals may need to be adjusted in some areas. The table below describes how often the assessment instrument should be deployed in the first and second year of the education programme. It also indicates at what point in time, in other words on what review date, the required level of proficiency should be achieved. In some cases a proficiency level may be achieved at an earlier stage. Please bear in mind that the requirements are minimum requirements.

Short practical assessment

Proficiency level

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EPA 1: Patient counselling when dispensing a medicine for the first time (with different aspects, where possible).


IIII

EPA 2: Patient counselling when dispensing a medicine a second time (with different aspects, where possible).


IIII

EPA 4: Counseling a patient or the patient’s carer in using care and/or medical aids.


IIII

EPA 5: Dealing with a self-care patient. 1x in first year1x in second year

IIII

EPA 7: Responding to an ‘alert’ indicating a pharmacotherapy-related problem, generated by a computerised adverse drug event alerting system, or otherwise.


IIIII

48


EPA 10: Patient pharmacotherapy consultation in connection with a medication review, including preparing a PTP.

1x in first year2x in second year I III IV

EPA 13: Patient pharmacotherapy consultation in connection with discharge from hospital or another care institution

1x in first year I

EPA 19: Conducting an intake interview. 1x in first year 1x in second year

IIIII

EPA 24: Using an individualised distribution form (providing information to a new patient).

1x in first year II


Proficiency level 1 2 3 4

EPA 1: Copy of an anonymised patient’s EPR or a completed protocol concerning dispensing medicine for the first time to patients suffering from diseases, in accordance with the knowledge and skills checklist.


IIII

EPA 2: Copy of an anonymised patient’s EPR or a completed protocol concerning dispensing medicine for a second time/on subsequent occasions to patients suffering from diseases, in accordance with the knowledge and skills checklist.


IIII

EPA 7: Copy of an anonymised EPR concerning medication surveillance alerts that have been dealt with as referred to in the knowledge and skills checklist.


I IIIII

EPA 12: Assessing a patient pharmacotherapy consultation in connection with admission to hospital or another care institution.

1x in first year I

EPA 11: Carrying out a pharmacotherapy treatment plan (PTP) and ensuring the continuity of care.


I IIIII IV

EPA 19: Copy of an anonymised EPR for a new patient or passer-by, with whom an intake interview has been conducted.


IIII

Case-based discussion


EPA 3: Counselling a palliative care patient. 1x in second yearIV

EPA 9: Performing a technical medication review for an at-risk patient, including preparing a pharmacotherapy treatment plan (PTP).


IIV

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Model letter


EPA 17: Providing general information in writing to a group of patients and/or non-experts.

1x in first year II

EPA 25: Report on the Implementation and Innovation project as part of centrally organised courses: Management and Quality Activity I.

1x in second year IV

EPA 26: Work out assignment about maintaining a quality system.


IIIV

EPA 27: Report on collecting and analysing quality indicators.


EPA 30: Work out assignment concerning an analysis of the stock control or distribution system or the working conditions.


I IV

EPA 31: Work out assignment concerning the pharmacist’s relationship with suppliers, the industry and the software supplier.


EPA 32: Employee job description. 1x in second year IV

EPA 36: Work out assignment concerning the pharmacist-insurer relationship.


EPA 37: Work out assignment concerning an analysis of major external influences.


EPA 38: Work out assignment concerning processing new information on medicines.

1x in first year II

EPA 39: Paper (participation in a research project) as part of centrally organised courses: Pharmaceutical practical research Activity I.




EPA 21: Compounding based on a prescription using pharma raw materials.


I II III

EPA 22: Compounding a medicine for administration.


II IV

Reflective report


EPA 15: Participation in, and/or preparation of and holding a pharmacotherapy consultation (FTO).


I II III

EPA 16: Participation in and/or consultation concerning integrated care.


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EPA 17: Providing general information verbally to a group of patients and/or non-experts. Reflective report based, in part, on a participant survey.


I III

EPA 18: Report on a screening activity performed. 1x in first year1x in second year

I III

EPA 33: Conducting an employee performance and appraisal review.


I II III IV

EPA 34: Work meeting/progress meeting. 2x in first year1x in second year

I II III

EPA 35: Implementing a change on the shop floor or introducing a procedure or a work regulation.


I II III

EPA 40: Supervising a trainee/work placement student in certain areas of care and/or coaching a staff member.


I II III IV



EPA 6: Responding to a patient’s health-care question, non-self care.

4x in first year I II

EPA 8: Checking the list of medication surveillance alerts.


I IIIV



I IIIII

EPA 20: Making available medicines that are difficult to obtain.

2x in first year I II

EPA 23: Performing a recall procedure. 2x in first year I II

EPA 28: Collecting and analysing errors or near errors.


I IIIII

EPA 29: Collecting, reporting and analysing side effects.

1x in first year I

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360° Feedback and self-assessment


This form of assessment involves various EPAs, such as EPA 14 (consultation with the prescriber), EPA 15 (involvement in and/or preparation and implementation of an FTO), EPA 16 (involvement in integrated care) as well as task area 9 EPAs (quality assurance). A self-assessment of behavioural competences commences in the first year.

2x in first year

1x in second year

I II

IV


I II III

EPA 15: Participation in, and/or preparation of and holding a pharmacotherapy consultation (FTO).

I II III

EPA 16: Participation in integrated care. I II III IV

Knowledge assessment


This refers to the pharmaceutical care needs of certain patient groups, pharmacotherapy-related problems and a medication review.


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VII Education methods and activitiesThe main education method used is the performance of professional activities by the specialist community pharmacist trainee (ApIOS) under the supervision of the pharmacy providing the hands-on training. The hands-on training is supplemented with a relatively limited number of individual courses. The trainee carries joint responsibility for his or her learning process. The pharmacist supervisor’s key role is to supervise the learning process. He or she acts as a role model for the trainee, gives instructions, observes the activities performed by the trainee and provides feedback. The pharmacist supervisor also is also responsible for providing an optimum learning and working environment.

Performing activities in the pharmacy, such as patient and product careThe day-to-day activities in the pharmacy and the discussions that may be linked to the activities form the basis of the education programme. Agreements concerning the nature, intensity and the way in which supervision is organised are made between the trainee and the supervisor. These agreements are incorporated in the trainee’s personal development plan and are regularly updated as the education programme progresses. Explicit attention should be paid to the education programme, and this takes place when conducting assessments.

Individual coursesIn addition to the hands-on training in the workplace, dedicated classes are held during the education programme. Individual courses cover the main topics in the domain of community pharmacy, such as pharmacotherapy, patient communication, product care and management of the pharmacy organisation. Appendix C describes the components of the individual courses. A central assessment is a component of the individual courses.

VIII Education materialWhile part of the education material is available, some of the education material still needs to be developed. The material does not form an integral part of this education plan but is described in the appendices. Examples of material that has already been developed are as follows: this education plan for the community pharmacy specialisation, the prevailing KNMP guidelines or the guidelines that are to be drawn up by the KNMP in association with the Scientific Community Pharmacy Section (Wetenschappelijke Sectie Openbare Farmacie, WSO) and a range of assessment instruments, such as the short practical assessment, the patient record assessment, the 360° feedback questionnaire and the progress review form.

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IX Quality assuranceThe Specialist Community Pharmacist education programme embraces several quality assurance components as follows:

1. Education and training process2. Review of decrees issued by the Central Board for Pharmacy Specialists (Centraal College Specialisten

Farmacie, CC)3. The pharmacist supervisor4. The professionalisation of the specialist community pharmacist trainee (ApIOS)5. Education survey6. The lecturer involved in centrally organised courses.

Re 1. Education and training processThe education method described should primarily align with developments in day-to-day practice. The changing views on pharmacotherapy and the changing roles in the health-care sector are deemed to have implications for the content of the curriculum. It is vital that this be constantly taken into account and that the education programme undergoes regular evaluation. The director of the advanced education programme, the Central Board for Pharmacy Specialists (WSO), the Community Pharmacy Council (Consilium Openbare Farmacie) to be established and possibly other institutions, such as an ‘Education Special Interest Group (SIG ‘Onderwijs’), all have a role in the above.

Re 2. Review of decrees issued by the Central Board for Pharmacy SpecialistsThe decrees issued by the Central Board for Pharmacy Specialists (CC) set out the requirements the specialist community pharmacist trainee must meet and the required quality of the pharmacist supervisors in the pharmacy providing the hands-on training. The Specialists Registration Committee (Specialisten Registratie Commissie, SRC) is responsible for monitoring compliance with the established requirements. SRC assesses pharmacies providing hands-on training, pharmacist supervisors and the individual courses taken by specialist community pharmacist trainees, (e.g. the trainee’s portfolio). The SRC assessment is a key instrument for monitoring compliance with the required standards.

Re 3. The pharmacist supervisor (ApOP)In the first place, the quality of the supervisor is guaranteed by the pharmacist supervisor education programme. The description of the principles of competence-based education and training, the competences themselves as well as the relevant quality indicators, which form the basis of the pharmacist supervisor education programme, are incorporated in Appendix D of this education plan. The education programme commences with the basic pharmacist supervisor education programme. Upon registration in the pharmacist supervisor register, pharmacist supervisors are required to pursue selected refresher courses to strengthen their pharmacist supervisor competences. The refresher courses still need to be developed. Information on the pharmacist supervisor’s performance is obtained during assessments (see re 2 above) and by means of feedback received from specialist community pharmacist trainees. The above information is obtained on a regular basis, and covers the level of the hands-on training provided in the workplace, the education and training environment and the atmosphere at work.

Re 4. Professionalisation of the specialist community pharmacist trainee (ApIOS)Specialist community pharmacist trainees should be trained in accordance with the modern competence-based education methods, as described in this education plan. They are required to learn to direct and maintain the development of their own competences. This requires specific skills in order to derive maximum benefit from the learning periods in the workplace. This also means actively creating sufficient knowledge acquisition periods and dealing with feedback. In addition this specifically implies deploying the assessment instruments appropriately or using the portfolio. Explicit attention is placed on the professionalisation of the specialist community pharmacist trainee during the centrally organised courses.

Re 5. Education surveyTraditionally education and training surveys are rarely conducted in the field of Pharmacy. This contrasts with Medicine, where surveys are conducted on the basic education offered at university level as well as on advanced programmes and post-graduate continuing university education. These surveys generally focus on the academic validation of the selected content of the curricula, as well as on the effectiveness of the programmes. Consequently the modernisation of advanced education programmes is a valued theme. Education and

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training surveys will need to be developed in the field of pharmacy following the example of Medicine. Pharmacy may be able to utilise the experience and expertise gained in the field of Medicine. Themes that may be worthwhile surveying in the field of Pharmacy are: the alignment between basic university education and the advanced education programme, and the quality of the specialist community pharmacist trainee’s learning environment in day-to-day practice.

Re 6. Lecturers in centrally organised coursesVarious lecturers teach the central curriculum. Emphasis will be placed on developing a programme aimed at raising the level of lecturer professionalism. Lecturers will need to be familiar with the principles, format and content of the advanced education programme and will need to work on developing didactic, assessment and feedback competences. Lecturer quality can be monitored on the basis of feedback forms concerning the teaching provided.

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AppendicesAppendix A Knowledge and skills checklistAppendix B Overview of centrally organised courses within the Advanced Specialist Community Pharmacist

education programmeAppendix C C. Pharmacist Supervisor (ApOP) competence profile

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Appendix A. Knowledge and skills checklist

The knowledge and skills checklist has been designed as an instrument for monitoring the trainee’s learning process in acquiring knowledge and skills. The specialist community pharmacist trainee (ApIOS) fills in the checklist while performing activities. The checklist is discussed during the progress reviews with the supervisor and forms part of the trainee’s portfolio.

When responding to a pharmacotherapy-related problem, detected through a computer-generated alert or otherwise, during and upon completion of the prescription procedure, including checking, you will have responded to the alerts or situations listed below.

Quarter

1 2 3 4 5 6 7 8

Pharmacotherapy-related problems (see also EPAs 7 and 8)

Dosage-related problems

Drug interactions

Contraindications

Intolerance

Double medication

Incorrectly/irrationally prescribed pharmacotherapy medicines

Off-label use

Medication prescribed for the incorrect patient

Omitted medicines

Medication-adherence problems

Overuse

Underuse

Use for too long a time

Use for too short a time

When counselling patients about medication, you have assisted patients suffering from the following diseases, conditions, or using the following care and/or medical aids or have responded to their questions.

Quarter

1 2 3 4 5 6 7 8

Diseases/conditions (see also EPAs 1 and 2)

Diabetes

Asthma/COPD

Cardiovascular disease

Depression

Rheumatic disease

Cancer

Desire to have children

Pregnancy

Breast feeding

Language barrier / communication problems

Ramadan

Children suffering from a chronic disease

Disabilities

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Care/medical aid (see also EPA 4)

Eye drops

Inhalation medication

Insulin and blood glucose meter

Incontinence products

Surgical dressings

Liquid foods

Injection systems, drips, cartridges

Health-care question (see also EPA 6).

Side effects

Complaints

Travel advice

Possible poisoning

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Appendix B. Overview of centrally organised courses within the Specialist Community Pharmacist advanced education programme

Outline of centrally organised courses

Seven clusters:

• Pharmacotherapy• Product Care• Communication• Active Learner• Professionalism and Pharmaceutical Ethics• Management and Quality• Pharmaceutical Practical Research

Centrally organised study sessionsSome of the study sessions will be organised in conjunction with components from other clusters, where possible.

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Cluster Name Subtitle Duration OrderCombined with

Pharmacotherapy Pharmacotherapy I Cluster orientation and Cardiovascular diseases I

1 half-day session: 3.5 hours

Day 1

Pharmacotherapy II Interpreting laboratory values


Day 1

Pharmacotherapy III Cardiovascular diseases 2


Day 2 Combined with another cluster: P & E II

Pharmacotherapy IV Medication review training


Day 3

Pharmacotherapy V Diabetes 1 half-day session: 3.5 hours

Day 3

Pharmacotherapy VI Cardiovascular diseases III


Day 4

Pharmacotherapy VII

Pain and pain control 1 half-day session: 3.5 hours

Day 4

Pharmacotherapy VIII

Geriatrics 2 half-day sessions: 7 hours

Day 5

Pharmacotherapy IX Palliative care 1 half-day session: 3.5 hours

Day 6 Combined with another cluster: P & E IV

Pharmacotherapy X Psychiatry 1 half-day session: 3.5 hours

Day 7 Combined with another cluster: Com-munication III


Product Care Product Care I: Dispensing medicine 1 half-day session: 3.5 hours

Day 1 Double group

Product Care II: Compounding medication for administration (incl. high-risk substances)


Day 1

Product Care III: Compounding 1 half-day session: 3.5 hours

Day 2 Double group

Product Care IV: Suppliers, purchasing and outsourcing


Day 2

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Communication Communication I Transferring information to a patient


Day 1 Both sessions are combined on one day

Communication II Questioning patients about problems concerning the use of medication


Day 1

Communication III More serious patient issues, pharmaceutical case history


Day 2 Combined with another cluster: Pharmaco- therapy X

Communication IV GP collaboration 1 half-day session: 3.5 hours



Active Learner Active Learner I Kick-off meeting 2 half-day sessions: 8.5 hours

Day 1

Active Learner II Conclusion 1 half-day session: 3.5 hours

Day 2


Professionalism and Pharmaceutical Ethics

P & E I The role of the pharmacist who carries ultimate responsibility


Day 1 Combined with another cluster: M & Q III

P & E II Professionalism in the pharmacy: What is a good leader?


Day 2 Combined with another cluster: Pharmaco-therapy III

P & E III Professionalism in integrated care: the issue owner


Day 3 Combined with another clus-ter: Communi-cation IV

P & E IV Professionalism in society: How do you represent your profession?


Day 4 Combined with another cluster: Pharmaco- therapy IX

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Management and Quality (M & Q)

Management and Quality I

Leadership I ‘Management’

2 half-day sessions: 7 hours

Dag 1

Management and Quality II

Leadership II ‘Change Management’


Day 2

Management and Quality III

Management and Quality: The Link



Management and Quality IV

Management and Quality: The Quality System


Day 4

Management and Quality V

Strategy and Policy: Innovation and Implementation


Day 5

Management and Quality VI

Employees I ‘Collaboration’


Day 6

Management and Quality VII

Values I Care indicators


Day 7

Management and Quality VIII

Strategy and Policy: Business Administration I: Financial Indicators


Day 7

Management and Quality IX

Personnel II Employment Matters


Day 8

Management and Quality X

Strategy and Policy: Business Administration II: Financial Indicators


Day 8

Management and Quality XI

Personnel III ‘Individual Coaching’


Day 9

Management and Quality XII

Values II Care indicators


Day 9

Management and Quality XIII

Strategy and Policy: Privacy issues and complaints


Day 10

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Activities

Pharmacotherapy Pharmacotherapy Activity I

9 x Pharmacotherapy knowledge assessment

During Pharmacotherapy case-based discussion I-X, except for IV.

Pharmacotherapy Activity II

Case presentation During Pharmacotherapy case-based discussion I-X, except for II and V.

Pharmacotherapy Activity III

10 medication reviews Commences after Pharmacotherapy case-based discussion IV.

Pharmacotherapy Activity IV

Feedback on 2 x 10 medication reviews

Peer review of two trainee peers by the specialist community pharmacist trainee (ApIOS); commences after Pharmacotherapy Activity III (or earlier, to be mutually agreed).

Pharmacotherapy Activity V

2 medication reviews Assessment by experts.

Pharmacotherapy Activity VI

Written abstract

Product Care Product Care Activity I

Product Care knowledge assessment

During Product Care I & II & III & IV.

Active Learner Active Learner Activity I

PDP (first version) Assignment during Active Learner I: Kick-off meeting.

Active Learner Activity II

PDP (subsequent version)

Active Learner Activity III

National knowledge assessment

Communication No activities

Professionalism and Pharmaceutical Ethics

P & E Activity I Essay on a current moral theme

Commences after P & E IV Central Seminar.

Management and Quality

M & Q Activity I Report on the Implementation and Innovation project

Commences after M & Q V Central Seminar.

Pharmaceutical practical research

Pharmaceutical practical research Activity I

Paper (Participation in conducting research)

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Appendix C. Pharmacist Supervisor (ApOP) Competence Profile

Pharmacist Supervisor (APOP)

Commissioned to, compiled and developed in association with HPC the Human Perspective in Consulting

The Hague 2010

Didactic Competences

Individual Competences

Knowledge Competences

APOP

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1. Introduction

Competence-based learning takes centre stage in the curriculum designed for the Community Pharmacist Specialisation. The robustness of the education programme will be determined primarily by the qualities of the Pharmacist Supervisor (ApothekerOpleider, ApOP), responsible for training the specialist community pharmacist trainee (Apotheker in Opleiding tot Specialist, ApIOS) in the pharmacy. The qualities of the Pharmacist Supervisor will similarly be expressed in competences. This document incorporates these competences in the form of a Pharmacist Supervisor Competence Profile, a compact and comprehensive version of which is provided.

2. The route to the Pharmacist Supervisor competence profile: principles and procedure

Three areas of competence, i.e. Didactics, Individual competences and Knowledge, have ultimately been defined together with the relevant sub-competences. Each competence includes performance indicators formulated in terms of the Pharmacist Supervisor’s observable behaviour.

The principles underlying these profiles are derived from various sources:A. The CanMEDS-model with its core competence areas, which KNMG used as a model when recently

modernising its advanced medical programmes.B. The competences and component principles applied in the Renewed Dutch Education Programme for

General Practitioners as implemented in recent years.C. The doctoral research conducted by Dr Peter Boendermaker, which included the traits of a good

general practitioner supervisor and the instruments he developed for the Department responsible for the Education Programme for General Practitioners in Groningen.

D. The Manual detailing the Appraisal System for Pharmacists in Salaried Employment (KNMP, February 2005), which incorporates the competences required for various community pharmacy roles.

E. ‘The pharmacist supervisor should be proficient in what the specialist community pharmacist trainee should ultimately be able to do’, according to the adage. Drawing on the adage, the competence diagrams as currently used in the KNMP Community Pharmacist Registration Programme were consulted for reference.

F. The Primary Pharmacy Task Areas and the Entrustable Professional Activities (EPAs) also serve as the basis of the profile.

G. The principles as used in the Assessment Centre Method, which is also a competence-based method, observable behaviour and assessment thereof.

The Pharmacist Supervisor competence profile was submitted to ‘The Quality of the Pharmacist Supervisor’ Focus Group (Klankbordgroep Kwaliteit van de ApOP), and was assessed during workshops held on 14 May 2009, the date on which the Community Pharmacy Section was established, and during a Teach-the-Teacher Symposium on 25 June 2009.

3. Purpose of the Pharmacist Supervisor Competence Profile

The Pharmacist Supervisor Competence Profile serves several purposes:

1) The competences describe the exit qualifications relating to the pharmacist supervisor education and training programme: What criteria should the Pharmacist Supervisor meet after having acquired the required knowledge, skills and behavioural competences after two years of education and training?

2) The profile is the standard against which the aspiring Pharmacist Supervisor measures himself or herself on a number of occasions through Self-Assessment, and serves as the basis of assessment as part of the 360° feedback provided by other parties included in the Pharmacist Supervisor’s feedback circle. The profile thus serves as the basis of the assessments carried out at various stages in the education programme.

3) The profile offers vital input for the aspiring Pharmacist Supervisor’s Personal Development Plan (PDP). After all, individual action points are linked to the scores on the profile.

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4) The competence profile serves as a crucial guideline in structuring the curriculum and providing content to the ‘Teach-the-Teacher for Pharmacist Supervisors education programme. All teaching methods (exercises, simulations, analyses, DVD, etc.) are required to contribute to developing the Pharmacist Supervisor’s competences.

4. What is a competence?

The term ‘competence’ has multiple definitions. In the context of the Pharmacist Supervisor education programme, the following definition applies: a combination of pharmacotherapy and care-based knowledge and insight, individual attitude and didactic skills are observable in the behaviour of the Pharmacist Supervisor, the aim of which is to train and supervise the specialist community pharmacist trainee (ApIOS) in the pharmacy.

The objectives of the specialist community pharmacist trainee are described in the exit qualifications which the trainee is required to have achieved at the end of the registration period, and in the future at the end of the Specialist Community Pharmacist education programme.

In the compact profile in Section 5 and comprehensive profile in Section 6, three clusters of competences have been distinguished.

A. Didactic competences describing whether the Pharmacist Supervisor possesses a didactic attitude and didactic skills to enable him or her to transfer (or ‘teach’) knowledge and experience of pharmacotherapy, leadership and management of the pharmacy business to the specialist community pharmacist trainee.

B. Individual competences A Pharmacist Supervisor who achieves a good score for didactics, may nonetheless not have the ability to withstand stress, or may be inflexible. And, a Pharmacist Supervisor who is indeed able to withstand stress and is flexible does not necessarily profess to be good teacher. He or she should possess more competences rather than solely ‘educator’ competences. These competences are referred to as individual competences and are not relevant to the presence of a specialist community pharmacist trainee in the pharmacy. They are competences the pharmacist requires in situations other than in training situations.

C. Knowledge or specialist competences ‘The pharmacist supervisor should be proficient in what the specialist community pharmacist trainee should ultimately be able to do’, is a key adage. This means that the Pharmacist Supervisor or the aspiring Pharmacist Supervisor must be fully proficient in pharmacotherapy and should possess up-to-date knowledge of areas, such as pharmaceutical patient care, medicines, and the management and administration of the pharmacy. The Pharmacist Supervisor or aspiring Pharmacist Supervisor is viewed by the specialist community pharmacist trainee as a role model. Or, to quote Peter Boendermaker “… which is part of the master-assistant situation, and the supervisor should be aware that his actions, to a greater degree than his words, will be observed and emulated by the trainee very carefully.” (Meesterschap 2003; p.42). This holds true particularly for the knowledge or specialist competences.

5. The Compact Pharmacist Supervisor (ApOP) Profile

To view the Pharmacist Supervisor’s competences at a glance, the Pharmacist Supervisor competence profile is set out in a compact format below. For the underlying definitions and performance indicators, please refer to the Comprehensive Competence Profile in Section 6.

Cluster 1 Didactic competences

1.1 The Pharmacist Supervisor has the ability to empathise with the specialist community pharmacist trainee (ApIOS).1.2 The Pharmacist Supervisor offers the specialist community pharmacist trainee room for personal development.1.3 The Pharmacist Supervisor has the ability to adapt and act according to the situation in his or her working relationship with the specialist community pharmacist trainee. 1.4 The Pharmacist Supervisor is not afraid to delegate patients to the trainee.1.5 The Pharmacist Supervisor has the ability to deal with criticism.

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1.6 The Pharmacist Supervisor has the ability to provide individual supervision to the specialist community pharmacist trainee.1.7 The Pharmacist Supervisor continuously works on life-long learning and peer feedback.1.8 The Pharmacist Supervisor makes available time to train and supervise the specialist community pharmacist trainee.1.9 The Pharmacist Supervisor motivates the specialist community pharmacist trainee.1.10 The Pharmacist Supervisor is not afraid to give feedback.1.11 The Pharmacist Supervisor has the ability to observe, record, classify, appraise and evaluate competences. 1.12 The Pharmacist Supervisor gives the specialist community pharmacist trainee responsibility for his or her own development.1.13 The Pharmacist Supervisor structures and divides the two years of the education programme in the pharmacy into phases.1.14 The Pharmacist Supervisor has the ability to avoid or manage any conflicts according to the situation.1.15 The Pharmacist Supervisor has the ability to communicate well with the specialist community pharmacist trainee.1.16 The Pharmacist Supervisor has the ability to analyse any problems thoroughly during the education programme before taking a decision.1.17 The Pharmacist Supervisor involves the members of the pharmacy team in the trainee’s education programme.1.18 The Pharmacist Supervisor maintains contact with the lecturers involved in the education programme concerning the trainee’s progress.

Cluster 2 Individual competences

2.1 The Pharmacist Supervisor demonstrates vision concerning the direction to be pursued by his or her own pharmacy in the years ahead.2.2 The Pharmacist Supervisor is flexible.2.3 The Pharmacist Supervisor is able to withstand stress.2.4 The Pharmacist Supervisor is highly motivated to deliver excellent performance.2.5 The Pharmacist Supervisor is enthusiastic about the profession and teamwork.2.6 The Pharmacist Supervisor acts with integrity.2.7 The Pharmacist Supervisor creates an educational climate where trust and security take centre stage.

Cluster 3 Knowledge competences

3.1 The Pharmacist Supervisor possesses up-to-date knowledge and understands all aspects of the community pharmacist role.

3.2 The Pharmacist Supervisor serves as a community pharmacist role model for the specialist community pharmacist trainee.

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6. The Comprehensive Pharmacist Supervisor (ApOP) Competence Profile and Performance Indicators

The competences that the Pharmacist Supervisor is required to meet are shown by category. However, the profile has been specified in further detail to reflect the definition of each competence as well as the performance indicators. Performance indicators provide a detailed description of the observable behaviour of the Pharmacist Supervisor in day-to-day practice, which serve as a basis for assessing the Pharmacist Supervisor’s competence scores.

6.1 Cluster 1 Didactic competences

1.1 The Pharmacist Supervisor has the ability to empathise with the specialist community pharmacist trainee

The Pharmacist Supervisor demonstrates that he or she has the ability to empathise with the professional standards, motivation, personal and educational situation, the views and opinions of the specialist community pharmacist trainee and bears this in mind when taking decisions or action.

Performance indicators:1 The Pharmacist Supervisor is a good listener, (maintains eye contact, utters words

of encouragement, nods, does not interrupt, and summarises).2. The Pharmacist Supervisor asks the specialist community pharmacist trainee open

questions, and continues to ask questions. 3. The Pharmacist Supervisor gives the specialist community pharmacist trainee the

opportunity to speak. 4. The Pharmacist Supervisor provides an explanation if a certain view offered by the

specialist community pharmacist trainee cannot be incorporated in decisions.

1.2 The Pharmacist Supervisor offers the specialist community pharmacist trainee room for personal development

The Pharmacist Supervisor offers the specialist community pharmacist trainee the room to develop into a pharmacist with his or her own style of working and accepts that that particular style may differ from the supervisor’s own style.

Performance indicators:1. The Pharmacist Supervisor encourages the specialist community pharmacist

trainee to take initiative.2. The Pharmacist Supervisor delegates responsibilities to the specialist community

pharmacist trainee.3. The Pharmacist Supervisor encourages the specialist community pharmacist

trainee to be creative.4. The Pharmacist Supervisor allows the arguments put forward by the specialist

community pharmacist trainee to convince him or her.5. Shows that he or she appreciates another view and a different opinion.

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1.3 The Pharmacist Supervisor has the ability to adapt and act according to the situation in his or her working relationship with the specialist community pharmacist trainee

Depending on the situation in the pharmacy, the Pharmacist Supervisor has the ability to alternate between the role of educator, coach, peer pharmacist and manager of the specialist community pharmacist trainee.

Performance indicators:1. The Pharmacist Supervisor schedules in evaluations.2. The Pharmacist Supervisor schedules in progress reviews.3. The Pharmacist Supervisor schedules in meetings with colleagues.4. The Pharmacist Supervisor demonstrates different behavioural styles and has the

ability to switch from content to emotion, from expert to equal partner, from giving approval to giving rewards, etc.

1.4 The Pharmacist Supervisor is not afraid to delegate patients to the trainee

The Pharmacist Supervisor has the ability to delegate patients entrusted exclusively to his or her care to the specialist community pharmacist trainee for the purpose of broadening the trainee’s personal development.

Performance indicators:1. The Pharmacist Supervisor delegates patient contacts to the specialist community

pharmacist trainee.2. The Pharmacist Supervisor discusses patient contacts afterwards with the

specialist community pharmacist trainee.3. The Pharmacist Supervisor accepts that the specialist community pharmacist

trainee may opt for a different approach towards the patient than the approach he or she would choose, provided that the same goal is achieved.

1.5 The Pharmacist Supervisor has the ability to deal with criticism

The Pharmacist Supervisor is open to criticism or negative feedback from the specialist community pharmacist trainee, adopts a vulnerable attitude, shows that he or she is eager to learn, allows himself or herself to be observed by the other person and allows discussion of his or her own errors.

Performance indicators:1. The Pharmacist Supervisor is a good listener, (maintains eye contact, utters words

of encouragement, nods, does not interrupt, and summarises).2. The Pharmacist Supervisor asks questions and asks for examples.3. The Pharmacist Supervisor does not get defensive (does not revert to ‘yes, but’) and

is actually eager to hear the arguments put forward by the specialist community pharmacist trainee.

4. The Pharmacist Supervisor places his own performance on the agenda, for example by scheduling in a performance review.

5. The Pharmacist Supervisor also learns from the specialist community pharmacist trainee.

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1.6 The Pharmacist Supervisor has the ability to provide individual supervision to the specialist community pharmacist trainee

The Pharmacist Supervisor has the ability to guide and direct the development of, and tasks performed by the specialist community pharmacist trainee and has the ability to view each specialist community pharmacist trainee as an individual, in other words he or she recognises and acknowledges that each trainee is different and that they often require a different approach.

Performance indicators:

1. See the performance indicators under 1.1 concerning empathy.2. Prepares the trainee’s Personal Development Plan together with the specialist

community pharmacist trainee based on the trainee’s current competences. 3. Discusses the specialist community pharmacist trainee’s work and study load. 4. Enables discussion of the specialist community pharmacist trainee’s PDP.5. Seeks activities that are in line with the specialist community pharmacist

trainee’s current level of competence.

1.7 The Pharmacist Supervisor continuously works on life-long learning and peer feedback

The Pharmacist Supervisor desires to undergo continuous training in the supervisor role, progresses from aspiring Pharmacist Supervisor to fully fledged Pharmacist Supervisor and is open to receiving peer feedback as an instrument for remaining alert and for learning from other Pharmacist Supervisors, for instance.

Performance indicators:1. The Pharmacist Supervisor is fully proficient in pharmacotherapy and business

administration (see Cluster 3 ‘Knowledge’).

2. The Pharmacist Supervisor also has a Personal Development Plan (PD) and ensures that it is regularly updated.

3. The Pharmacist Supervisor takes regular refresher courses.4. The Pharmacist Supervisor is a member of a peer feedback group and regularly

participates in peer group meetings.

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1.8 The Pharmacist Supervisor makes time available to train and supervise the specialist community pharmacist trainee

The Pharmacist Supervisor makes time available for the education programme and for consultation with the specialist community pharmacist trainee on the programme, does not consider the trainee’s questions as ‘disruptive’ but understands that the trainee is eager to learn and is engaged, and is prepared to answer a question or seek a solution to a problem in collaboration with the trainee.

Performance indicators:1. A regular progress review will be held at least twice each month between the

Pharmacist Supervisor and the specialist community pharmacist trainee and will be scheduled in advance.

2. The review will rarely be cancelled by the Pharmacist Supervisor.3. The Pharmacist Supervisor will assess progress made by the trainee on the basis of

the trainee’s Personal Development plan.4. After a specialist community pharmacist trainee has taken part in a course in the

KNMP Registration Programme, the Pharmacist Supervisor will take the initiative to enquire how the trainee has found the course.

5. The Pharmacist Supervisor is prepared to adapt his or her own schedule if requested by the specialist community pharmacist trainee.

1.9 The Pharmacist Supervisor motivates the specialist community pharmacist trainee

The Pharmacist Supervisor provides encouragement and motivation by helping to raise the specialist community pharmacist trainee’s self-confidence, making the trainee feel competent and by delegating tasks previously allocated to the Pharmacist Supervisor.

Performance indicators:1. The Pharmacist Supervisor gives compliments, as appropriate.2. The Pharmacist Supervisor ensures an equal measure of positive and negative

feedback.3. The Pharmacist Supervisor expands the authority, responsibilities and duties of the

specialist community pharmacist trainee on the basis of the progress made by the trainee.

4. The Pharmacist Supervisor delegates not only the execution of duties to the specialist community pharmacist trainee, if possible and desired, but also the authority to take decisions.

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1.10 The Pharmacist Supervisor is not afraid to give feedback

The Pharmacist Supervisor recognises and acknowledges that providing positive and negative feedback to the specialist community pharmacist trainee is a key component of the training situation and makes a significant contribution to maintaining good behaviour on the one hand, and behavioural change, on the other.

Performance indicators:1. The Pharmacist Supervisor ensures an equal measure of positive and negative

feedback, where possible.2. A specific example of a situation confronting the specialist community pharmacist

trainee will always be included in the feedback given.3. Feedback will be provided by the Pharmacist Supervisor as soon as possible after

the situation and behaviour of the specialist community pharmacist trainee has occurred.

4. The Pharmacist Supervisor speaks for himself or herself and not on behalf of the team.

5. The specialist community pharmacist trainee will be given the time to change his or her attitude and behaviour.

6. The Pharmacist Supervisor remains critical, even if a training situation proceeds smoothly.

1.11 The Pharmacist Supervisor has the ability to observe, record, classify, appraise and evaluate competences

The Pharmacist Supervisor has the skills to perform ORCAE: i.e. to Observe the specialist community pharmacist trainee in day-to-day practice, Record and Classify observations based on the competences in the ‘Registered Pharmacist’ profile, perform an Appraisal and to Evaluate the scores on a regular basis during the two years of registration jointly with the specialist community pharmacist trainee.

Performance indicators:1. The Pharmacist Supervisor will be present in the pharmacy at least three days a

week.2. The Pharmacist Supervisor will maintain a log book.3. The Pharmacist Supervisor schedules in progress reviews.4. The Pharmacist Supervisor schedules in evaluations.5. The Pharmacist Supervisor employs the appropriate assessment instruments as

used in his or her own education programme and that of the trainee.

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1.12 The Pharmacist Supervisor gives the specialist community pharmacist trainee responsibility for his or her own development

The Pharmacist Supervisor does not explain everything in minute detail but allows the specialist community pharmacist trainee to come up with ideas and draw conclusions about his or her own learning process, areas on which to focus and the action that needs to be undertaken, for the purpose of corrective adjustment, for example.

Performance indicators:1. The Pharmacist Supervisor delegates responsibility to the specialist community

pharmacist trainee for preparing, implementing and updating his or her own Personal Development plan.

2. The Pharmacist Supervisor asks a range of open questions.3. The Pharmacist Supervisor allows the specialist community pharmacist trainee

to score himself or herself against the competences in the Registered Pharmacist Profile on several occasions during the two years of registration.

4. The Pharmacist Supervisor offers the specialist community pharmacist trainee the opportunity to incorporate action points in his or her PDP on the basis of these scores.

5. The Pharmacist Supervisor encourages the specialist community pharmacist trainee to take initiative and challenges the trainee in this regard.

6. The Pharmacist Supervisor assesses the progress made by the trainee on the delegated responsibilities.

1.13 The Pharmacist Supervisor structures and divides the two years of the education and training programme at the pharmacy into phases

In allocating responsibilities, authority, duties, projects and pharmacy-related activities outside the pharmacy the Pharmacist Supervisor has the ability to divide appropriately the two years of the education and training programme at the pharmacy into logical, chronological phases as the specialist community pharmacist trainee becomes fully proficient in performing tasks.

Performance indicators:1. The Pharmacist Supervisor provides structure on the basis of the trainee’s Personal

Development plan.2. The Pharmacist Supervisor adapts his style of management in line with the

progress made by the specialist community pharmacist trainee in becoming fully proficient in performing tasks.

3. The Pharmacist Supervisor has the ability to formulate education programme objectives.

4. The Pharmacist Supervisor has the ability to set priorities.

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1.14 The Pharmacist Supervisor has the ability to avoid or manage conflict according to the situation

The Pharmacist Supervisor has the ability to recognise conflicts or potential conflicts, has the ability to apply different styles for managing conflict depending on the situation and has the skill to determine the position of the specialist community pharmacist trainee and his or her own position in the conflict.

Performance indicators:1. The Pharmacist Supervisor has the ability to be assertive/forceful in the event of a

conflict.2. The Pharmacist Supervisor is not afraid to sit down and analyse the problem, have

his or her say and let people have their say, and reach a compromise.3. The Pharmacist Supervisor demonstrates that he knows whether and when third-

party mediation is called for.

1.15 The Pharmacist Supervisor has the ability to communicate well with the specialist community pharmacist trainee

The Pharmacist Supervisor has the ability to clearly communicate his or her ideas, opinions, plans, feedback, tips and advice in understandable language to the specialist community pharmacist trainee.

Performance indicators:1. See the performance indicators under 1.1 concerning empathy.2. The Pharmacist Supervisor has the ability to structure discussions with the

specialist community pharmacist trainee (in other words a discussion has a beginning, middle and end).

3. The Pharmacist Supervisor demonstrates that he or she is aware of his or her non-verbal behaviour during discussions (facial expression, eye contact, nodding, loudness of speech, intonation, etc.) and what effect it has on the specialist community pharmacist trainee.

4. The Pharmacist Supervisor adapts the level of communication to the trainee’s level of knowledge and experience.

5. The Pharmacist Supervisor picks up on signals expressed by the trainee both verbally and non-verbally.

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1.16 The Pharmacist Supervisor has the ability to analyse any problems thoroughly during the education programme before taking a decision

The Pharmacist Supervisor first obtains an idea of the situation in which the trainee performs activities in the pharmacy (forms an Idea), subsequently analyses any problems that have arisen and identifies what is going well (forms an Opinion) and then takes decisions in order to improve the situation, where necessary (takes a Decision).

Performance indicators:1. See the performance indicators under 1.12 ORCAE.2. The Pharmacist Supervisor has the ability to distinguish between key issues and

side issues.3. He or she has the ability to recognise and examine problems.4. He or she sees the connection between the education plan and the specialist

community pharmacist trainee’s current phase of development and problem situations in day-to-day practice.

5. The Pharmacist Supervisor does not adopt a wait-and-see attitude but takes action.6. The Pharmacist Supervisor discusses viewpoints thoroughly and is not afraid to

take final decisions.7. The Pharmacist Supervisor has the ability to determine when he or she should

take a decision or whether he or she can leave this up to the trainee.

1.17 The Pharmacist Supervisor involves the members of the pharmacy team in the training situation

The Pharmacist Supervisor has the ability to gain the interest of, and involve other pharmacists, pharmacy assistants and other pharmacy staff in the training situation.

Performance indicators:1. The Pharmacist Supervisor explains to the team why the pharmacy is being used

for education and training.2. The Pharmacist Supervisor explains the authority, responsibilities and duties of

the specialist community pharmacist trainee.3. The Pharmacist Supervisor clearly explains the content of and time that is to be

spent on the Registration Programme to the team jointly with the trainee.4. The Pharmacist Supervisor clearly outlines the phases and duration of the

education plan to the team jointly with the trainee.5. The Pharmacist Supervisor allocates one or several assistants an active role in

assisting/supervising the trainee in the initial phase.6. The Pharmacist Supervisor ensures the continuity of the education programme

during his absence.

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1.18 The Pharmacist Supervisor maintains contact with the lecturers involved in the education programme concerning the trainee’s progress

The Pharmacist Supervisor actively liaises with the lecturers involved in the education programme on the trainee’s progress, and asks them, where necessary, to focus on specific competences or on specific aspects of the trainee’s performance.

Performance indicators:1. The Pharmacist Supervisor schedules in evaluations.2. The Pharmacist Supervisor assesses the trainee’s progress on the basis of the

trainee’s Personal Development plan.3. On the basis of points 1 and 2, the Pharmacist Supervisor should have spoken to

each lecturer involved in the KNMP Registration Programme on one occasion at least concerning the acquisition of competences by the trainee.

6. 2 Cluster 2 Individual competences

2.1 The Pharmacist Supervisor demonstrates vision on the direction to be pursued by his or her own pharmacy in the years ahead

The Pharmacist Supervisor operates actively in the relevant environment (pharmaceutical market, patient preferences, politics, legislation, health insurer and local developments) and translates the main aspects into long-term policy for his or her own pharmacy, components of which he or she will discuss with the pharmacy staff.

Performance indicators:1. The Pharmacist Supervisor monitors developments in the field by reading

professional literature, through his or her own network and by taking part in departmental or quality circle meetings.

2. The Pharmacist Supervisor regularly performs a SWOT analysis of his or her own pharmacy and its environment.

3. The Pharmacy Supervisor involves the pharmacy team in the analysis and discusses future aspects with them.

4. The Pharmacist Supervisor not only prepares an Annual Plan at operational level but substantiates the plan with a strategic and tactical vision for the pharmacy and the pharmacy environment for the next three years.

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2.2 The Pharmacist Supervisor is flexible

The Pharmacist Supervisor has the ability to adapt his behaviour should problems, obstruction or opportunities arise in the training situation without losing sight of the predefined goal.

Performance indicators:1. In the event of obstruction or problems, the Pharmacist Supervisor has the ability

to adopt a different behavioural style, switching from:

- content to emotion- vague to firm- task-oriented to human-oriented- nuanced to direct and challenging - a wait-and-see attitude to taking initiative - expert to equal discussion partner - giving approval to giving rewards/motivating - providing information, to asking for information - exploring a problem to problem-solving

2.3 The Pharmacist Supervisor is able to withstand stress

The Pharmacist Supervisor will continue to demonstrate effective performance in a self-confident manner under time pressure and when facing setbacks, disappointment or opposition.

Performance indicators:1. Opposition and resistance on the part of the specialist community pharmacist

trainee, or arising during discussions with other parties will in no way deter the Pharmacist Supervisor. Instead, he or she will examine the root cause of resistance and endeavour to remove it.

2. The Pharmacist Supervisor will not deviate from predefined goals, plans and procedures until the goal has been achieved, or the plan has been implemented or can no longer be reasonably carried out.

2.4 The Pharmacist Supervisor is highly motivated to deliver excellent performance

The Pharmacist Supervisor sets high standards for his or her own work and the work performed by others, is not satisfied with average performance and acts accordingly.

Performance indicators:1. The Pharmacist Supervisor maintains at least the prevailing quality standards.2. The Pharmacist Supervisor points out whether members of the pharmacy team

and the specialist community pharmacist trainee deviate from the quality standards and allows this to be discussed.

3. The Pharmacist Supervisor implements changes in order to improve the quality of care provided to patients.

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2.5 The Pharmacist Supervisor shows enthusiasm for the profession and teamwork

The Pharmacist Supervisor shows enthusiasm for the profession as well as working in and with the pharmacy team, and is able to kindle similar enthusiasm in the specialist community pharmacist trainee as well as others.

Performance indicators:1. The Pharmacist Supervisor is aware that he or she should act as a role model.2. The Pharmacist Supervisor usually communicates in terms of what is possible

rather than what is not possible.3. The Pharmacist Supervisor thinks more in terms of opportunities rather than

threats.4. The Pharmacist Supervisor also gives positive feedback (compliments).

2.6 The Pharmacist Supervisor acts with integrity

The Pharmacist Supervisor observes generally accepted social, ethical, professional and legal standards in all activities relating to his role as a pharmacist and Pharmacist Supervisor.

Performance indicators:1. The Pharmacist Supervisor is aware that he or she should act as a role model.2. The Pharmacist Supervisor observes the agreements made and the established

standards. 3. The Pharmacist Supervisor treats confidential information that she or she has

received from the specialist community pharmacist trainee as confidential.4. The Pharmacist Supervisor safeguards the balance between trainee commitment on the one hand, and distance, on the other.

2.7 The Pharmacist Supervisor creates an educational climate where trust and security take centre stage

The Pharmacist Supervisor creates a work and educational climate within the pharmacy team for the specialist community pharmacist trainee in which trust, respect for each other’s personality traits, collaboration and to a certain extent tolerance for error take centre stage.

Performance indicators:1. See the performance indicators under competence 1.18.2. The Pharmacist Supervisor enables discussion of any strengths and weaknesses in

the team.3. The Pharmacist Supervisor enables immediate discussion of any collaboration

problems. 4. Any errors made will be dealt with by means of a case by the Pharmacist

Supervisor jointly with the team.

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6.3 Cluster 3 Knowledge competences

3.1 The Pharmacist Supervisor possesses up-to-date knowledge and understands all aspects of the community pharmacist role

The Pharmacist Supervisor possess demonstrable and up-to-date knowledge and understands pharmaceutical patient care, medicines, the compounding of medicine, the management and administration of the pharmacy, and communication with patients, doctors and other external parties.

Performance indicators:1. The Pharmacist Supervisor complies with the Re-Registration requirements.2. The Pharmacist Supervisor possesses up-to-date knowledge as set out in the

Primary Care Pharmacist Requirements.

3.2 The Pharmacist Supervisor serves as a community pharmacist role model for the specialist community pharmacist trainee

As a community pharmacist, the Pharmacist Supervisor serves as a role model for the specialist community pharmacist trainee in terms of the various competences set out in the ‘Community Pharmacist Position Description and Competence Profile’ (see the ‘Manual detailing the Appraisal System for Salaried Pharmacists’, published by KNMP in February 2005).

Performance indicators:1. The Pharmacist Supervisor achieves a good score for Competence 3.1 (see above).2. The Pharmacist Supervisor achieves a good score for the competences described in

the Community Pharmacist Competence Profile’.3. The Pharmacist Supervisor is aware that he or she should act as a role model.4. The Pharmacist Supervisor clearly explains his or her own actions stating reasons

to the specialist community pharmacist trainee.

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Credits

This education plan was written by Dr Henk Buurma, Director of the Specialist Community

Pharmacist advanced education programme at KNMP, who was responsible for modernising the

programme. We wish to extend our appreciation in particular to Annemieke Floor-Schreudering,

pharmacist, for her significant contribution.

Various components of the plan were submitted to numerous colleagues – practitioners, our

colleagues at the KNMP office and at educational institutions. The Young Pharmacists Society (VJA)

has also made a significant contribution as have countless external experts, including the experts at

HPC the Human Perspective in Consulting and the University of Utrecht Faculty of Medicine.

KNMP

Alexanderstraat 11

2514 JL The Hague

The Netherlands

+ 31 (0)70-37 37 373

[email protected]

www.knmp.nl/opleiding-registratie

While this publication has been formulated with all due care, KNMP is not in any way liable for any

information that may nonetheless not be free from errors or omissions.

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