1. 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…..

2. 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?

3. 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

4. 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.

5. 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

6. 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.

7. 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. .

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

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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

16. 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.

17. 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.

18. 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.

19. 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.

20. 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.

21. 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.

22. 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.

23. 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.

24. 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.

25. 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.

26. 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

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

28. 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

29. 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…

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

31. 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…..

32. So how does this fit with the RPS Faculty ?

33. 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.

34. 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.

35. 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

36. 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?