A professional development tool for experiential placement students *graduated = stepped, incremental Pharmacy Competencies Graduated* Descriptors :

What is “competency”? Competence is a generic term referring to a person’s overall capacity Competencies are made up of the attributes of knowledge, skills and attitudes. Competency Standards ‘define the competencies required for effective performance in employment’. ’ ‘A competency comprises the specification of knowledge and skill and the application of that knowledge and skill within an occupation or industry level, to the standard of performance required in employment’

Workplace Competency Competence within professions is characterised by a body of knowledge, skills and values. Demonstration and interpretation of these attributes depends on multiple circumstances including the disposition of the individual practitioner, the individual client, the professional role, the professional task & environmental settings & policies. Competence is a relative term dependent on context.

Workplace Competency Miller’s triangle refers to assessment of competency. “Knows” factual exam papers “Knows how” clinical context type test “Shows how” simulated patient, OSCEs etc “Does” in vivo in the workplace

Levels of Competence Novice Student ( Owen & Stupans, 2007, adapted from McAllister 2006) can recall some aspects of theory high supervisory support needed time needed for clinical responsibilities focused on own performance not client problem-solving/planning support needed Intermediate Student recognises aspects of theory in order to problem solve some supervisory support needed in complex situations developing automaticity needs support with prioritising, flexibility Entry-level Student recognises theory to problem solve, is able to integrate theory (knowledge) seeks support for new activities sufficient automaticity for client focus can perform work independently in some areas

Pharmacy Competency Standards (2003) Pharmacy has eight broad competency areas or functional areas (FA). Associated with each of these is more detailed information about the actual competency units, elements and evidence cues which help in the assessing of the competencies. FA1: Practise pharmacy in a professional & ethical manner FA2: Manage work issues and interpersonal relationships in pharmacy practice FA3: Promote & contribute to optimal use of medicines FA4: Dispense medicines FA5: Prepare pharmaceutical products FA6: Provide primary health care FA7: Provide medicines & health information & education FA8: Apply organisational skills in the practice of pharmacy

Assessment of competencies Formal assessment in the competencies mostly happens in the internship process prior to registration. At university and within placements students are learning the skills and knowledge and getting prepared for forthcoming practice. So for example in developing dispensing skills at university and in placements, students will be learning about pharmacology, therapeutics, legislation and practicing a dispensing process

Competency as a journey, (graduated = stepped, incremental) As a student “how well am I progressing?” As a preceptor “how can I provide feedback for my student?” Tool provides a gateway for dialogue Pharmacy students should develop and apply self- assessment skill (this is linked to life-long learning skills, though difficulties of self-assessment are acknowledged.) Preceptors should develop and apply feedback skill (verification supports student self-assessment and increases accuracy )

Using the tool  The tool is easy to use!  Note the layout of the diagram tool on pages 2-5; there are 2 Functional Areas on each page  At the top is the Functional Area (linked to the profession’s competencies) and a brief descriptor  The left side of each diagram gives ‘cues’ about each competency area in terms of early placement, with some additional ‘cues’ for late placement  The right panel relates to internship and the newly- competent professional

Using the tool (cont.)  The four developmental aspects already introduced of Level of Support, Time Taken, Clinical Problem-solving and Degree of Client Focus are shown, with boxes provided to tick relevant categories for each aspect.  A comment box is provided for clarifying remarks or to indicate ‘Not applicable’

Basis of global judgment Developing ability Competency Graduated Descriptors Tool Example Summary of competency descriptors

Summary of Competency Descriptor Cues Pt 1 Functional Area 2: Manage work issues & interpersonal relationships in pharmacy practice Early placement student With assistance & significant additional time Knows and applies key principles of communication………… Applies basic counselling protocol…… Late placement student With guidance & only some additional time..& adjusts; uses a conversational approach...& tailors to individual situations

Applies basic negotiation strategies with preceptor….. Observes & discusses situations of conflict… …& can relate to other staff/health professionals …& uses some effective conflict resolution strategies Summary of Competency Descriptor Cues Pt 2 Functional Area 2: Manage work issues & interpersonal relationships in pharmacy practice Early placement student With assistance & significant additional time Late placement student With guidance & only some additional time

Gives presentations………… Produces accurate written records & reports…… ……………. Summary of Competency Descriptor Cues Pt 3 Functional Area 2: Manage work issues & interpersonal relationships in pharmacy practice Early placement student With assistance & significant additional time Late placement student With guidance & only some additional time

Summary of Competency Descriptor Cues Pt 1 Functional Area 3: Promote and contribute to optimal use of medicines Early placement student With assistance & significant additional time Late placement student With guidance & only some additional time Identifies & accesses relevant information…………… Participates in client interaction using protocols provided………………. …& monitors & reviews drug use …& adapts to client needs in identifying treatment options

Processes records/information & identifies various options…………. Recognises own limitations & seeks advice from preceptor…………… …& makes several recommendations with justification …& identifies appropriate referral pathways Summary of Competency Descriptor Cues Pt 2 Functional Area 3: Promote and contribute to optimal use of medicines Early placement student With assistance & significant additional time Late placement student With guidance & only some additional time

Using the tool: Early placement student Competency Graduated Descriptors cues for dispense medicines Functional area 4: dispense medicines Word picture association Early placement student ‘Product selection. Label errors, focussed purely on getting labelling correct rather than checking appropriateness for patient’ Early placement student ‘with assistance (direction) & significant additional time’: Assesses prescription validity Clarifies medication orders Assesses appropriateness of prescribed medicines Follows predefined systematic dispensing Carries out specific documentation tasks Identifies relevant information

Functional area 4: dispense medicines Word picture association Late placement student : ‘Efficient, accurate checking therapeutics – interactions, correct doses and formulation’ Late placement student Cues are same as early placement but ‘with guidance (prompting) & only some additional time ‘ +..& provides information to patients as appropriate ……. Using the tool: Late placement student Competency Graduated Descriptors cues for dispense medicines