Natalie Medlicott, Jennifer Bruce, Carla Dillon and Megan Anakin Early learning of reflective practice in a re-designed pharmacy programme Adopting e-portfolios for developing reflective practitioners Natalie Medlicott, Jennifer Bruce, Carla Dillon and Megan Anakin

Pharmacists Medication Therapy Experts who Deliver Person-Centred Care

Goal: Graduate ready to go reflective practitioners Pharmacists Goal: Graduate ready to go reflective practitioners

Education Programme (BPharm) Admission To Pharmacy Programme Graduation Registration HSFY Year 2 Year 3 Year 4 ITP “Year 5” BPharm

Curriculum re-design goal: Increase patient care focus of graduates Skills Knowledge Skills Knowledge Product knowledge centred curriculum Patient-centred curriculum

How do reflection and e-portfolios fit into this new curriculum? Introduction reflection as a skill into the programme Shift towards evidence of competence rather than passing tests AND Increasingly, move towards self-directed learning

Implementation Plan Initially small interested group Key staff with positive outlook “champion” Supported initial trials as “one-off” projects Frequently report back to academic staff and students Embed in new curriculum with a genuine purpose !

Bachelor of Pharmacy (Otago) Learning Outcomes Communication, Collaboration and Research BPharm (Otago) Professionalism Pharmaceutical Literacy Population Health Provision of Care

Entrustable Professional Activities (EPAs) Pharmacy Competence Standards EPAs Learning Outcomes Pharmacist Scope of Practice BPharm

Entrustable Professional Activities Units of professional practice that constitute what clinicians (practitioners) do as daily work. Ten Cate (2018) A primer on entrustable professional activities Korean J Med Education, 30, 1 - 10

Observable Foundational EPAs Fulfil professional obligations Communicate effectively Take a patient history Conduct a clinical assessment Create a care plan Clinically validate a prescription Dispense prescriptions Provide medicines information Document activities Observable

EPAs are observable and “e-portfolio – able” !! Evidences can be verified in practice labs and experiential learning sites. Virtual Practice Labs (Actors and simulated patients) Reflection Importantly, these EPAs are observable. Reflection exercises run alongside evidence gathering. We have two main practice environments – virtual practice labs (university) and placements sites (hospitals and community practices). Experiential learning (Real Patients)

Education Programme (BPharm) 2018 Learn reflection 2019 Create and assess evidence 2020 Use portfolio to show competence in EPAs Graduation HSFY Year 2 Year 3 Year 4 ITP “Year 5” 2021 Continue into Internship New curriculum BPharm

Example: Towards the “Communicates Effectively” EPA Tutors and preceptors verify competence Have used the communicates effectively EPA for our second year students. Created assignments through PebblePad for students to learn reflective practice.

Example: Communication in Year 2 Reflection on initial communication skill to identify strengths and limitations

Used evidence (assets) from an earlier activities (1) Pharmacy Skills Labs (2 per week over the Semester 2) Service learning activity (20 hours) People focused Communication focused

Communication – self assessment What am I good at? What do I need to work on? What is my Plan ? Used PebblePad Reflection tutorial material Goal: - Communicate effectively (EPA)

Year 2 papers Uses PebblePad PHCY 210 Introduction to Pharmacy (12 points) PHCY 211 Foundational Pharmaceutical Science (48 points) PHCY 220 Integrated Modules A (60 points) – Pharmacy Practice

Where to now…… E-portfolios are part of our new curriculum for the Bachelor of Pharmacy Steep learning curve for teachers and curriculum designers – encourage innovation Purpose: Reflective Practitioners – ready for Internship challenges! Ready to challenge the profession (armed with evidence base and confidence!

especially post-workshop Acknowledgements Tegan McKegg (Instructional designer) Aynsley Peterson Dr Alesha Smith Student feedback especially post-workshop sticky notes