Transitioning from academic education to professional practice:a national residency program for pharmacy
Presenting author: Andrew Matthews (on behalf of the SHPA Residency Program Project Steering Committee)
ANZAHPE Conference 2017ADELAIDE
Disclosure
www.shpa.org.au
A conflict of interest is any situation in which a speaker or immediate family members have interests, and those may cause a conflict with the current presentation. Conflicts of interest do not preclude the delivery of the talk, but should be explicitly declared. These may include financial interests (eg. owning stocks of a related company, having received honoraria, consultancy fees), research interests (research support by grants or otherwise) or organisational interests
In relation to this presentation, I declare the following, real or perceived conflicts of interest:
Andrew Matthews is a member and employee of the Society of Hospital Pharmacists of Australia (SHPA).
Developing a ‘fit-for-purpose’ workforce“The challenges of development, distribution and responsible use of medicines can only be met with an adaptable pharmaceutical workforce.
One that deploys its knowledge, skills and abilities to the fullest degree in a wide array of environments and in collaboration with other stakeholders in health care”
International Pharmaceutical FederationGlobal Vision for Education and Workforce 2016
www.fip.org/educationreports
www.shpa.org.au
The practitioner journey
www.shpa.org.au
The practitioner journey
www.shpa.org.au
• A formalised practitioner development process defines the pathway from undergraduate through to registration and progression to advanced practice.
• By setting a solid foundation for the practitioner that starts with a generalised base, practitioners are better equipped to progress to more focused and specialised practice.
The profession journey
www.shpa.org.au
The profession journey
www.shpa.org.au
www.shpa.org.au
Galbraith K, Coombes, I, Matthews A, Rowett D, Bader L, Bates I. Advanced pharmacy practice: Aligning national action with global targets. J Pharm Pract Res 2017; 47(2), 131-135. doi: 10.1002/jppr.1333
Pharmacy Practitioner Development Committee. National competency standards framework for pharmacists in Australia 2016. Canberra; 31 May 2017.
PractitionerImpact…
Why residency?•Lack of existing formal or structured experiential training programs Potential barrier to strengthening and expansion of
pharmacists’ roles and scopes of practice Existing programs variable or ad-hoc
•Ever-changing healthcare system pharmacy workforce must evolve need enhanced capacity, capability and flexibility
•Experiential learning with structured feedback is critical for newly registered professionals consolidates formal academic education and applies this
knowledge in real and complex workplace settings www.shpa.org.au
www.shpa.org.au
Why residency?
International Pharmaceutical Federation (FIP). Pharmaceutical workforce development goals. The Hague: International Pharmaceutical Federation; November 2016. Available from www.fip.org/educationreports
SHPA Residency• To facilitate the development of a cohort of competent general
level pharmacists who have completed a structured, formalised, supported and accredited national two-year residency program.
• Residents will demonstrate their advancement through a portfolio of practice based experiential training, that acknowledges that a residency is a practice-based training program.
• Residents skills will be assessed on their impact and experience against the five advanced practice Domains and the associated competencies at an expected performance achievement of Advanced- Stage 1 (Transition Level).
www.shpa.org.au
An unique Australian program……but not a world first.• Pharmacy residency programs commonplace in USA, UK, Canada,
Singapore.
www.shpa.org.au
SHPA Goal: by 2017…
Implementation of the first phase of a structured, formalised, supported and accredited national two-year residency
program for pharmacists in their foundation years.
Accreditation Standards
The Standards cover 4 Domains: Resident- Program relationship Capacity and experience of department and staff Range of pharmacy services and ability to deliver the
residency curriculum Commitment to professional development
www.shpa.org.au
AccreditationSHPA’s accreditation is a quality assurance process that:
ensures the residency site has an appropriate commitment to the resident has the capacity and capability to deliver a residency
program and can offer a broad range of practice based
experiences for the resident; …sufficient to assure the dedicated resident every chance of successful completion of the SHPA residency program.
Accreditation• via a comprehensive accreditation submission from prospective residency program sites (responses to 45 questions aligned with Accreditation Standards).
• 32 applications covering 54 hospitals •SHPA evaluation awarded accreditation to an initial 24 programs. More detail required from remaining 8.
•30 in total achieved accreditation for inaugural program beginning 2017.
•Projected number of residents 120.
www.shpa.org.au
SHPA Residency in Practice• Residents rotate through a diverse program curriculum, ensuring
they gain the skills and knowledge necessary for competent general level pharmacists.
• Evaluation, feedback, and reflection are integral components of the program.
• These requirements are outlined in an Evaluation and Assessment matrix that sets out defined performance evaluation requirements.
• The evaluations contribute to each resident’s own professional practice portfolio, which can again be used in future for formal recognition and credentialing of advanced practice.
www.shpa.org.au
Example curriculum
www.shpa.org.au
Resident # March 2017 - September 2017 September 2017 - March 2018 March 2018 - September 2018 September 2018 - March 20191 A - COLORECTAL/BES A - RESPIRATORY M - INFECTIOUS DISEASES/HIV A - EMERGENCY2 A -NEUROSURGERY A- RENAL A - OUTPATIENT DISPENSARY A - INTENSIVE CARE3 S - SURGERY A - STROKE A - MEDICATION SAFETY C - ACUTE BRAIN INJURY4 A -CARDIOTHORACICS A - GENERAL MEDICINE A - DISPENSARY/ASEPTICS C - AGED CARE5 C - REHAB S - DISPENSARY A - GENERAL MEDICINE A - ORTHOPAEDICS6 C - AGED CARE A - OUTPATIENT DISPENSARY A - RESPIRATORY A - PREADMISSION CLINIC7 A -GASTRO A -DISPENSARY/ASEPTICS A - INFECTIOUS DISEASES?HIV A - PREADMISSION CLINIC8 A -PSYCHIATRY A -ALF CENTRE - DISPENSARY A - CARDIOLOGY A - UPPER GI SURGERY9 A - RESPIRATORY A - COLORECTAL/BES S - DISPENSARY C - REHAB10 A- RENAL A -NEUROSURGERY A - OUTPATIENT DISPENSARY C - AGED CARE11 A - STROKE S - SURGERY A -DISPENSARY/ASEPTICS A -GASTRO12 A - GENERAL MEDICINE A -CARDIOTHORACICS A -ALF CENTRE - DISPENSARY A -PSYCHIATRY13 S - DISPENSARY C - REHAB A - RESPIRATORY A - COLORECTAL/BES14 A - OUTPATIENT DISPENSARY C - AGED CARE A- RENAL A -NEUROSURGERY15 A -DISPENSARY/ASEPTICS A -GASTRO A - STROKE S - SURGERY16 A -ALF CENTRE - DISPENSARY A -PSYCHIATRY A - GENERAL MEDICINE A -CARDIOTHORACICS
Legend
Surgical RotationElective RotationMedical RotationOperational Rotation
2017 INTAKE
Reproduced from The Alfred Hospital Pharmacy Dept. (with permission)
Evaluation and assessment matrix*
www.shpa.org.au
ADVANCED PHARMACY PRACTICE FRAMEWORK: Domains and competencies Cl
inCA
T (s
tart
& e
nd o
f firs
t
rota
tion,
then
onc
e ea
ch
subs
eque
nt ro
tatio
n)
min
i-CEX
(mon
thly
per
clin
ical
rota
tion)
360/
Peer
revi
ew/M
ini-
PAT
(onc
e pe
r rot
atio
n)
Case
-bas
ed d
iscu
ssio
n (m
ulti-
disc
iplin
ary
or
inse
rvic
e)
Case
stud
y or
Pra
ctic
e Ba
sed
disc
ussi
on
(inte
rnal
-id
entif
ied
from
refle
ctiv
e lo
g)
Refle
ctiv
e lo
g (a
t lea
st 3
refle
ctio
ns p
er ro
tatio
n)
Test
imon
ials
(prn
whe
re
rele
vent
)
Dire
ct o
bser
vatio
n of
pr
actic
e (f
or o
pera
tiona
l
rota
tion-
mon
thly
)
Perf
orm
ance
Pla
n (p
er
rota
tion)
CPD
plan
(Ann
ual)
QI p
roje
ct/A
udit-
LO
NG
ITU
DIN
AL(w
ith ri
sk m
anag
emen
t ap
proa
ch)
Com
mitt
ee o
r Wor
king
G
roup
(act
ive
part
icip
atio
n or
pr
esen
tatio
n)
Man
uscr
ipt s
ubm
issi
on
(cas
e/pr
ojec
t/au
dit)
Indu
ctio
n/or
ient
atio
n(f
ocus
on
dept
& h
osp
stra
tegy
)
Teac
hing
of s
tude
nts
(war
d-ba
sed
supe
rvis
ion/
teac
hing
)
DOMAIN 1: Expert professional practice1. Aquire expert knowledge & skills X X X X X X X X2. Use reasoning & judgement X X X X X X X3. Demonstrate accountabilty & responsibility X X X X X4. Use professional autonomy X X X X X X X
DOMAIN 2: Professional and Ethical Practice1. Apply and monitor standards of practice X X2. Contribute to CPD of self & others X X
DOMAIN 3: Communication, Collaboration & Teamwork1. Use appropriate communication skills X X X X X X X
• Defined performance evaluation requirements include familiar tools and assessment methods such as mini-CEX; case-based discussions, 360 feedback (e.g. via mini-PAT), reflective logs, SHPA’s ClinCAT and a research project throughout the residency.
*Extract from Evaluation and Assessment matrix showing only 3 out of total 5 Domains
Competency Framework
www.shpa.org.au
Extract from Domain 1 ‘Expert Professional Practice’
Communication, resources and tools • Via SHPA Residency discussion forum:
www.shpa.org.au
Communication, resources and tools • Via SHPA Residency discussion forum:
www.shpa.org.au
What are residents saying about residency?
www.shpa.org.au
Conclusion• SHPA’s residency program is a two year structured professional
development plan for pharmacists designed to develop their practice towards the Advanced Pharmacy Practice Framework Transition Level (Advanced- Stage 1).
• The International Pharmaceutical Federation (FIP) has emphasised the importance of foundation training infrastructures (Goal 2) in its Pharmaceutical Workforce Development Goals.
• Unlike the USA, UK, Singapore and Canada, Australia had not previously offered a formal program of foundation training in a residency program.
www.shpa.org.au
Conclusion• Residents rotate through a diverse program curriculum, ensuring
they gain the skills and knowledge of competent general level pharmacists.
• Evaluation, feedback, and reflection are integral components of the program.
• Foundation training offered by the SHPA Residency Program adds to the formalised practitioner development framework for pharmacy, and defines the pathway from undergraduate through to advanced practice.
www.shpa.org.au
SHPA Residency Program Project Steering Committee
Peter Fowler (Chair), Cameron J Phillips, Ian Coombes, Christopher Freeman, Daniel Guidone, Arduino A Mangoni, Cathy Martin, Catherine Brown, Matthew Scott. SHPA staff: Andrew Matthews, Sachin Ramnani
Thank you Andrew Matthews
@APharm68
