Supervision of undergraduates

Schools of Pharmacy and Medicine

Introductions

Previous meeting

• Minutes from Northwest Medical Education Pharmacist Meeting 26TH May 2011

• Variance in pharmacist time and funding• Standardisation of training for our

undergraduates• Continual learning, and record of continual

learning• Regular meeting of the team to facilitate

collaboration and sharing

Schools agenda

• Prescribing and medication safety relevant to schools across the faculty:– Nursing– Pharmacy– Medicine– Dentistry

• All schools require some uni-, multi-, and inter-professional learning in this arena

National agenda

• National prescribing assessment• Prescribing • Prescription review• Planning management• Data interpretation• Drug monitoring• Communication about medicines• Drug calculations• Adverse drug reactions

• Pilot stage at present• Summative examination from 2013-14

Obstacles

• Dispersed placements– School based– Hospital based

• Funding of resources– Pharmacist time– BNFs

• Curriculum – Lacking?– Different?

Mehvosh

• MRI- Do you send your 5th years prescribing scenarios? Who writes these? Can they be shared?

• Can Kurt tell me more about the national prescribing exam? Question writing/modifying teaching/tutor guidance/existing teaching?

• How involved are other pharmacists with the UPSAs (9&10)? Other examinations?

Paula

• How can I find out what the students already know (or, rather, what they have already been taught) so I can build on this rather than duplicate?

• Who decides what topics pharmacists teach? What do we think the most appropriate topics are (& for other years)?

Layla / Diane

• What teaching do other trusts offer to the medical students and are there ways we could work together to prevent re-inventing the wheel?

• Kurt, can you tell us what other prescribing teaching is offered to students by the medical school?

5th year

• Hospital based prescribing training– SSB block– 1 day training– 3 base hospitals at present

• Community based prescribing– 3 sessions in SSB block– 2 base hospitals + pilot at MRI

• Prescribing case based discussion – 1 session for all students– Teaching hospital block

Christie Prescribing Day5th years (SSB block)23rd September21st October11th November16th December

Getting the students involved…

Christie prescribing day• AM Interactive Sessions 9.00-12.30

• Use turning point technology to allow audience participation and stimulate meaningful learning1. • 9-9.20 Introduction • 09.20-09.50 Seminar 1 ADRs, error reporting, alternative

therapy • 09.50-10.20 Seminar 2 Intravenous and oral fluids • 10.20-10.50 Seminar 3 Controlled drugs

• 10.50-11.10 Coffee break

• 11.10-11.40 Seminar 4 Coagulation & anticoagulation• 11.40-12.10 Seminar 5 Sources of drug information • 12.10-12.40 Seminar 6 Therapeutic drug monitoring

1. Lectures in problem-based learning—Why, when and how? An example of interactive lecturing that stimulates meaningful learning. Medical Teacher, Vol. 27, No. 1, 2005, pp. 61–65

Christie prescribing day• PM Mock OSCE-style stations and closure

13.40-16.00

• 9 stations, 12 minutes per station,  

Station Activity

1 Prescribing

2 Prescription Review

3 Planning Management

4 Communicating Information

5 Calculation skills

6 Prescribing

7 Adverse Drug Reactions

8 Drug Monitoring

9 Data Interpretation

Curriculum mapping

Intended learning outcomes

Learning activities Venue(s) Assessment Timeline Alignment

Curriculum mappingIntended learning

outcomes Learning activities Venue(s) Assessment Timeline Alignment

8. (e) Select appropriate forms of management for common diseases, and ways of preventing common diseases, and explain their modes of action and their risks from first principles.

(f) Demonstrate knowledge of drug actions: therapeutics and pharmacokinetics; drug side effects and interactions, including for multiple treatments, long-term conditions and non-prescribed medication; and also including effects on the population, such as the spread of antibiotic resistance.

Curriculum mappingIntended learning

outcomes Learning activities Venue(s) Assessment Timeline Alignment

17.  Prescribe drugs safely, effectively and economically. (a) Establish an accurate drug history, covering both prescribed and other medication.(b) Plan appropriate drug therapy for common indications, including pain and distress.(c) Provide a safe and legal prescription.(d) Calculate appropriate drug doses and record the outcome accurately.(e) Provide patients with appropriate information about their medicines.(f) Access reliable information about medicines.(g) Detect and report adverse drug reactions.(h) Demonstrate awareness that many patients use complementary and alternative therapies, and awareness of the existence and range of these therapies, why patients use them, and how this might affect other types of treatment that patients are receiving.

Curriculum mapping

Intended learning outcomes Learning activities

Venue(s) Assessment Timeline Alignment

Prescribing in pain Small group teaching

UHSM Formative assessment- case based

Since 2010

8f17b,c,d,f

Anticoagulation Small group teaching

UHSM Formative assessment- case based

Since 2010

8e,f17b,c,d,e,f

Etc…

5th year

• Can we map out learning activities for all years?

• Map to Tomorrow’s doctors, the elements assessed in the Prescribing Skills Assessment and the current Medical School Curriculum.

ePortfolio

• Students complete this online portfolio from year one

• Prescribing section• Opportunities to develop this• Potential for uni/multi/inter-professional

learning• CPPE

ePortfolio

• We could create links to Blackboard learning concerning:

• Prescribing • Prescription review• Planning management• Data interpretation• Drug monitoring• Communication about medicines• Drug calculations• Adverse drug reactions

Development

• Prescribing Skills Assessment– Question Item Writing Manual

Contents  Prescribing Skills Assessment 3Assessment structure 3Purpose of the assessment 5General advice about PSA question writing 6Writing specific PSA question items 6Prescribing 6Prescription Review 9Planning Management 10Communicating Information 12Calculation Skills 13Adverse Drug Reactions 15 Drug Monitoring 16Data Interpretation 18Guidance on good question writing 20Aims of the questions 20Structure of the questions 20

Competencies in phase one

• We would like students to gain competency in, or understanding of:

– Concepts of pharmacodynamics and pharmacokinetics

– Mechanisms of drug delivery

– How drugs are prescribed and regulated

– Basic pharmacology applicable to drug groups in phase 1 PBL cases

– Mechanisms of unwanted drug effects and drug interactions

– Calculation and preparation of drug doses

– Mechanisms for reporting adverse drug reactions

– Complementary and alternative therapy, and purported mechanisms of action of these therapies

– The evidence base for conventional and complementary/alternative therapies

– How to communicate with patients and the health care team regarding medication (basic level skill)

Phase two: HLB

• Multiple cases (main and supplementary)

• Recorded lectures

• e-learning

• e-prescriptions

• relevant pharmacology into the module - in an integrated way

Phase two: HLB

• Demonstrate an understanding of the pharmacology of the common drugs used in relation to each listed disease. Whenever long term drug therapy is warranted the students should be able to discuss the issues related to long term drug therapy: side effects, drug interactions, effects on life style, pregnancy, lactation, teratogenesis etc.

Phase two: HLB

• Discuss the role of non-pharmacological therapies including rehabilitation (in hospital, home and workplace), alternative therapies, management of chronic illness including palliative care and end of life issues.

Phase two: HLB

• Plan appropriate evidence based drug therapy, including the provision of a safe and legal prescription for the common and/or important conditions linked to this module. This will include accessing reliable information about medicines

• Negotiate drug therapy with patients (and their carers) and appreciate the effects of ageing and co-morbidity as well as concomitant therapy on drug safety and safe prescription

Phase two: HLB

• Critically evaluate the roles of the major members of a multidisciplinary health care team and the basis of effective team management