The Pharmacy Vocational Training Scheme Specialist Training VT3 Module The Pharmaceutical Care of Older People Fiona McMillan Lead Pharmacist Educational Development, NES Garry Todd Specialist Pharmacist, Chair of The Specialist Interest Group for The Pharmaceutical Care of Older People So… this is our topic…..

What are we going to cover? The structure and processes for VT3 specialist training. The types of evidence suitable for specialist training. The assessment processes for specialist training. The VT e portfolio : how can it help me? The GPhc and RPS Faculty: Where do they fit with VT3 training?

The Structure of The Pharmacy Vocational Training Scheme – a continuum of learning Stage 4 Advanced training Education & training, Leadership, Research VT3 (Stage 3) Specialist training – Specialist skills VT2 (Stage 2) General Foundation training – General skills Stage 1 PRPS training

What is the Pharmacy Vocational Training Scheme : Stage 3? It is ....a Specialist Training Programme to support the development of specialist knowledge and skills through the demonstration of competence within a specific area of specialist practice.

Flow chart of VT3 training process Competency framework Learning in practice – development of evidence Evidence types Reflection & learning in practice -refinement of evidence Recording of evidence in e portfolio Portfolio assessment Specialist tutors Resources Underpinning knowledge Final Assessment (face to face) 1.5 hrs Marking schedule mapped to Adv Level Framework. Educational supervisors Reps from SIGs

Why undertake the training? It is a flexible training programme that is based on your practice within your workplace. You can undertake the training at a pace that meets your needs with no need to leave your place of work. It is online and readily available within a secure environment. There are a variety of different resources to help meet different learning styles.

Why undertake the training? Working with a specialist in the field means that you receive a very focused specialist training with senior pharmacists working in your area of practice. The assessment methods are by continuous assessment. The training scheme helps meet the GPhC mandatory requirements for CPD. .

Why undertake the training? The training scheme may help by developing records that you can select to include in your RPS Faculty e portfolio.

VT3 Older People module What is the aim of this module? To meet the learning needs of pharmacists working with (or who wish to work with) older people.

How long does the training take to complete? The training generally takes about 18 months to complete and is generally completed after the Vocational Training Scheme Stage 2 (VT2). However, this depends on the individual and the needs of the service. Some trainees will take longer than this. If the trainee hasn’t undertaken VT2 training, this is fine but there are some requirements to meet before they embark on their specialist training.

Are there pre requisites to do before starting training? Trainees should have knowledge and understanding of the provision of pharmaceutical care to patients using the documentation provided. They should also have the knowledge and understanding of the audit process, the reporting of a Significant Event Analysis, critical appraisal, patient safety, risk management and Adverse Drug Reactions. Furthermore, there are some further prerequisites depending on the specialist module and these can be accessed via the relevant web page.

What does the training entail? The training entails completing a variety of activities to demonstrate competence in the specialist area. There is also underpinning knowledge in a variety of different formats to support the training. Trainees need to complete the activities using a variety of different forms of evidence within their e Portfolio.

What does the VT3 module actually comprise? Pre requisites (PRs) to complete prior to starting training. Induction materials to get you started. Competency framework with Performance Indicators. Resources to support learning. Templates to facilitate the development of evidence. A specific e Portfolio in which to record your evidence.

VT3 Older People - A focus on the module Recognition by Specialist Interest Group that a gap existed in pharmacy education regarding pharmaceutical care of older people. Entry to VT3 training for hospital trainees will usually be after completion of VT2 training. Entry to VT 3 training for community trainees will usually be after a minimum of 3 years experience in community pharmacy. Hospital and community trainees in the same geographical area will be encouraged to meet together for the purposes of practicing case presentations, peer review, avoiding isolation, and addressing different learning styles.

What does the module offer? A structured competency-based approach to learning about pharmaceutical care of older people, using vocational experience to generate evidence to demonstrate competency. A list of 8 general elements and 13 clinical elements chosen to cover some of the more common pharmaceutical care needs in older people. A list of references appropriate to the elements, updated annually. A tailored programme for hospital trainees and for community trainees

What the module does not offer All the answers! There are some pre requisites that are expected to have been completed at VT2 level e.g. audit, significant event analysis, and care planning. The module does not specifically cover generic skills such as consultation skills or clinical assessment skills.

Who can support me with my training? Trainees will be supported in the workplace by a workplace tutor. Tutors will be accredited by NES. An educational supervisor for each region will offer further support to trainees and tutors to ensure standardisation of approach. Trainees are expected to use local peer review sessions to present cases and obtain feedback on these. A Stage 3 trainees and tutors subgroup of the Pharmaceutical Care of Older People shared space on the Knowledge network is available for sharing work and discussions in a closed environment. This is optional but may help increase contact with other trainees.

Who can support me with my training? Educational supervisors are experienced senior pharmacists who are responsible for the trainee within a specific specialist area of pharmacy practice. An Ed Supervisor.......... may be located within a different Health Board area within Scotland. will not be expected to observe the trainees’ practice on a daily basis. should meet with their trainees on a regular basis i.e. once a month. will help the trainees to identify any development needs and provide any support of advice during their training. will also undertake both the formative and summative assessment of the trainee. are expected to attend the regular In Training Reviews (ITRs) for the trainees, the portfolio assessment and the final assessment panel if required.

What are the expectations? Trainees are expected to be proactive in seeking opportunities for workplace-based experience and in generating evidence to demonstrate competence. Reflective practice and identification of further learning needs will be encouraged throughout the training. Tutors are expected to give honest feedback on trainees evidence, and to encourage trainees to seek appropriate learning opportunities. Tutors may be able to support work-shadowing opportunities depending on the resources available to them.

What does this module comprise? Hospital trainees Hospital Trainees will be expected to complete the following tasks: Minimum of 6 months experience in specialist care of the elderly clinical area At least 6 case studies which demonstrate all the general elements (Section A) and at least 9 of the clinical elements (either as a presenting complaint or as a co morbidity). A documented CPD entry on the main learning points for each element included in the case studies At least 3 peer reviewed case study presentations from the 6 case studies above At least 6 documented medication reviews* Work-shadow in community pharmacy for a minimum of 2 days Work- shadow specialist palliative care pharmacist Other opportunities e.g. attendance at specialist stroke or Parkinson’s Disease clinics, attendance at Day Hospitals may arise and can be used as sources of evidence.

What does this module comprise? Community trainees Community trainees will be expected to complete the following tasks: At least 6 case studies A documented CPD entry on the main learning points for each element included in the case studies. At least 3 peer reviewed case study presentations from the 6 case studies above. At least 6 documented medication reviews Further optional experience may be gained where resources allow e.g. Work shadowing *Medication review here is defined as planned review of all medicines for people who are otherwise medically stable. Situations such as care homes, day hospitals, continuing NHS care or community pharmacy are more suitable for this type of review rather than acute in-patient areas.

Focus on The Older People Competency Framework What is the aim of this VT3 module? The aim of this specialist training is to equip practitioners working within a specific area of practice with specialist skills. The objectives are designed to demonstrate the competency of pharmacists wishing to work with older people. The module will be addressed through directed reading, experience in practice and work-shadowing where appropriate.

The Competency framework the elements General Elements 1-8 Provide the background learning - what is different about medicines use in older people compared to other populations? The general elements can (and should be) applied to any clinical case discussion.......... .......a discussion of the care of a person with dementia may cover........ drug handling sensitivity to medicines affecting the central nervous system compliance how can the person be supported to take medicines? professional and legal considerations what is the legal framework supporting medicines use in someone who may lack capacity to consent to treatment?) public health how can the individual be empowered to lead a healthy lifestyle dementia as a long term condition the care of the individual chosen for the case discussion.

The competency framework the elements Clinical Elements 9 to 21 These elements cover the most common long term conditions in older people. Some elements are covered in more detail than others, and for some more evidence is required than for others. This represents the “weight” of each element as assessed by the Specialist Interest Group.

Differences for evidence requirements between the elements..... Element 9 Gastrointestinal disorders A case study and care plan are not required Element 14 Parkinson’s Disease A case study and care plan are required This does not mean that gastro-intestinal disorders are less common in older people, but most of the learning is not specific to older people. Parkinson’s Disease is a condition that is more common in older people, so a case study/ care plan is required.

What are the different types of evidence that I need to collect? CPD records (upload to e portfolio) Feedback forms (variety of healthcare professionals) Reflective reports/essays Mini Clinical Examinations (mini – CEX) Case Based discussions (CbD) Testimonials Action logs Reflection logs (mainly used by VT2) Record of MCQ scores

How do we complete the portfolio? Where do I store my evidence? How do we complete the portfolio? E portfolio

The VT e portfolio is...... Safe, secure, web based area for storing evidence Enables ready access to assessment of evidence from afar…. Enables ready access to specialist resources Enables demonstration of achievement of task at a glance

How do we complete the portfolio? Front page of the e Portfolio How do we complete the portfolio? E portfolio Log in page with links to Audit, SEA pages on NES website This is how trainers and specialist provide feedback… the Ticketed Feedback system… Evidence leads to development of a portfolio and this is the collection of info that demonstrates that learning has been achieved…

Some Programmes that are in e Portfolio.......... List of competency frameworks within e portfolio

There is a drop down tab system at the top of the screen.... Summary over view shows an overview of the work completed, Ticketed Feedback is how specialists give feedback, appraisal/meeting forms, completion of section forms, target timeline (not really used...) E portfolio is easy to use.. Drop down menu from the top tool bar… Messages, quick links, resources, personal library…..

So how does this fit with the RPS Faculty ?

What is the assessment process? Throughout Training – every 3 months In Training Reviews (ITRs) - SIG members- format for sessions - supportive – checking progress – presentation of a case- feedback provided Trainees can attend by VC. Need to attend at least 1 within training period. At completion of training Portfolio assessment – SIG members – pairs- assessment framework. Final assessment – x 1 pa for all specialist areas, SIG members, external on panel + NES, assessment framework mapped to ACLF, lasts about 1 ½ hours.

What the assessors are looking for? Pharmaceutical care for older people is not easy: Multiple long term conditions Multiple medicines Ageing effects on drug handling Assessors will be looking for the identification and management of pharmaceutical care issues in individuals with several concurrent medical conditions. This means that one case study can cover a number of conditions and a number of the elements in the module.

VT4 Advanced VT3 Specialist VT2 Foundation GPhC CPD Revalid’n RPS Faculty Faculty eligibility after 2 years VT2 takes 2 years to complete) VT3 training at regular intervals populate the GPhC site (CPD – revalidation) populate the RPS Faculty site …. May be with different pieces of evidence VT4 Advanced VT3 Specialist VT2 Foundation

What are we going to cover? The structure and processes for VT3 specialist training The types of evidence suitable for specialist training The assessment processes for specialist training The VT e portfolio : how can it help me? The GPhc and RPS Faculty: Where do they fit with VT3 training?