Stakeholders welcome cross-sector discussion of pharmacist undergraduate education and pre-registration training

Over 100 pharmacy stakeholders gathered in London last month for a lively cross-sector discussion of pharmacist undergraduate education and pre-registration training in England, convened by the Modernising Pharmacy Careers (MPC) programme.

An MPC project team, led by Professor Anthony Smith, Dean of the School of Pharmacy, University of London and Rob Darracott, Chief Executive of the Company Chemists Association, has reviewed current arrangements for pharmacist education and training. The Institute of Education (IoE) at the University of London provided additional support for the team through a review of literature and curricula, engagement with schools of pharmacy and pharmacy professional and regulatory bodies, and by interviewing academics, employers, pre-registration students and pharmacists.

Presentations to stakeholders by Professor Smith, Rob Darracott and Dr David Guile of the Institute of Education on the review were complemented by interactive sessions where groups of delegates considered the strengths and weaknesses of current arrangements and discussed possible options for change.

There was a general agreement on the day that the current education and training process provides registrants with an excellent scientific knowledge base upon which to build their professional practice. However, feedback from students, academics and employers, both in the private sector and NHS settings, identified areas for improvement including: a lack of context for theoretical learning; late exposure to pharmacy practice; the large variation in quality of pre-reg training and tutors, and a need for greater co-operation between HEIs and employers.

Dr David Guile presented methods and proposals for modernising the pharmacy curriculum which were based on three key principles:

  • A continuous period of formation with registration and graduation at the end of year 5
  • Early exposure to practice to support students to make more informed choices about their future careers in pharmacy
  • Close collaboration between HEIs and employers to strengthen their partnerships to support the initial formation of pharmacist and to pave the way for their subsequent professional development

Two approaches were described as starting points for discussions, both of which would accommodate different options for implementation, particularly in relation to practice placements throughout the five years.

Single practice placement (SPP) is a continuous five-year period of qualification with academic and practice-based assessments being undertaken in the fifth year. The single practice placement, possibly a nine-month block, would be in the final year followed by a return to university for three months refresher prior to sitting all remaining examinations in the summer term of the fifth year.

Dispersed practice placement (DPP) is a spiral of opportunities to place the theory in the context of pharmacy practice throughout all five years. The spiral could take one of several forms including the current Bradford model.

Both the SPP and DPP would require additional visits to practice, involvement of patients and simulation of learning and assessment in the early years together with a redesigned of the curriculum to allow theoretical and practice learning to work together more effectively. The DPP approach would involve a more extensive redesign of the curriculum compared with SPP to ensure that theoretical and practice-based elements dovetailed with one another to consolidate the recontextualisation of knowledge and skill.

Although the DPP approach was identified as a superior model from an educational perspective, there were concerns from delegates about the difficulty of implementing such significant change. Discussion points in relation to implementing options which accommodate SPP or particularly DPP, included the logistics of arranging more placements, a risk of clustering of placements round schools of pharmacy, greater costs associated with recruitment, accommodation and travel costs, and standardisation of curricula. Whilst no financial models have been developed, stakeholders highlighted financial implications for students if proposals shifted the current balance between fees/debt and salaried earning, particularly as it could affect the attractiveness of pharmacy as a professional course of study.

Speaking from an educational perspective, Professor Anthony Smith said, “The review work so far has demonstrated to us that change is required if we are to deliver the vision of the Pharmacy White Paper. I do not underestimate the complexity of the process and the logistical difficulties but there is no doubt that we are at the beginning of a long journey and we need to start the planning now.”

Delegates recognised the need for a different way of working between HEIs and employers, in particular the importance of taking co-operation to a different level.

Speaking on behalf of employers Mr Rob Darracott said, “If change is to be delivered then employers and universities will need to work very closely together. The MPC and its Programme Board is an ideal forum to co-ordinate the actions required to work together towards a common goal.”

Chief Pharmaceutical Officer Dr Keith Ridge advised delegates, “In the current public sector financial situation there will be opportunities for innovation in the delivery of education and training. I hope all those with an interest in this programme work collaboratively to deliver the changes required.

A report of the review, incorporating feedback from the stakeholder event and making recommendations for the next phase of the work, will be presented to the MPC Programme Board in February 2010. The Board will consider how best to progress development of the different approaches, addressing issues raised and involving stakeholders in the process.

Click here to view the presentation from Dr Keith Ridge, Chief Pharmaceutical Officer

Click here to view the presentation from Professor Anthony Smith and Mr Rob Darracott

Click here to view the presentation from Dr David Guile, Institute of Education