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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
Day
5th
years (SSB block)
23rd September
21st October
11th November
16th 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 mapping
Intended 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 mapping
Intended 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
8f
17b,c,d,f
Anticoagulation Small
group
teaching
UHSM Formative
assessment- case
based
Since
2010
8e,f
17b,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 3
Assessment structure 3
Purpose of the assessment 5
General advice about PSA question writing 6
Writing specific PSA question items 6
Prescribing 6
Prescription Review 9
Planning Management 10
Communicating Information 12
Calculation Skills 13
Adverse Drug Reactions 15
Drug Monitoring 16
Data Interpretation 18
Guidance on good question writing 20
Aims of the questions 20
Structure 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
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11
Meeting with pharmacists 16.11.11

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Meeting with pharmacists 16.11.11

  • 3. 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
  • 4. 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
  • 5. 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
  • 6. Obstacles • Dispersed placements – School based – Hospital based • Funding of resources – Pharmacist time – BNFs • Curriculum – Lacking? – Different?
  • 7. 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?
  • 8. 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)?
  • 9. 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?
  • 10. 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
  • 11.
  • 12. Christie Prescribing Day 5th years (SSB block) 23rd September 21st October 11th November 16th December
  • 13. Getting the students involved…
  • 14. 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
  • 15. 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
  • 16. Curriculum mapping Intended learning outcomes Learning activities Venue(s) Assessment Timeline Alignment
  • 17. Curriculum mapping Intended 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.
  • 18. Curriculum mapping Intended 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.
  • 19. 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 8f 17b,c,d,f Anticoagulation Small group teaching UHSM Formative assessment- case based Since 2010 8e,f 17b,c,d,e,f Etc…
  • 20. 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.
  • 21. ePortfolio • Students complete this online portfolio from year one • Prescribing section • Opportunities to develop this • Potential for uni/multi/inter-professional learning • CPPE
  • 22. 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
  • 23. Development • Prescribing Skills Assessment – Question Item Writing Manual Contents Prescribing Skills Assessment 3 Assessment structure 3 Purpose of the assessment 5 General advice about PSA question writing 6 Writing specific PSA question items 6 Prescribing 6 Prescription Review 9 Planning Management 10 Communicating Information 12 Calculation Skills 13 Adverse Drug Reactions 15 Drug Monitoring 16 Data Interpretation 18 Guidance on good question writing 20 Aims of the questions 20 Structure of the questions 20
  • 24. 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)
  • 25. Phase two: HLB • Multiple cases (main and supplementary) • Recorded lectures • e-learning • e-prescriptions • relevant pharmacology into the module - in an integrated way
  • 26. 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.
  • 27. 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.
  • 28. 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
  • 29. Phase two: HLB • Critically evaluate the roles of the major members of a multidisciplinary health care team and the basis of effective team management

Notas do Editor

  1. This slide to remind me to ask everyone to introduce themselves.
  2. Many examples of obstacles that stand in the way of collaboration and sharing Dispersal of teaching and learning in medication safety is a problem for both our students, some of whom rotate from hospital to hospital, and some who spend the majority of their time at the University campus, and for us as tutors who are also based across the northwest and have different gaps in our timetables to provide teaching. Funding – we have already seen that allocation of SiFT funding is variable across trusts is variable, and unfortunately this is not something that the Medical School has direct control over. However, we can as a group have some indirect control. We can set the learning agenda, some minimum competencies and the medical school can require that training is delivered at each base to ensure that the students have the opportunity to meet these. With the right development, intended learning objectives and associated learning activities can be streamlined to fit in best with for example- pharmacist or medical delivery.
  3. Many examples of obstacles that stand in the way of collaboration and sharing Dispersal of teaching and learning in medication safety is a problem for both our students, some of whom rotate from hospital to hospital, and some who spend the majority of their time at the University campus, and for us as tutors who are also based across the northwest and have different gaps in our timetables to provide teaching. Funding – we have already seen that allocation of SiFT funding is variable across trusts is variable, and unfortunately this is not something that the Medical School has direct control over. However, we can as a group have some indirect control. We can set the learning agenda, some minimum competencies and the medical school can require that training is delivered at each base to ensure that the students have the opportunity to meet these. With the right development, intended learning objectives and associated learning activities can be streamlined to fit in best with for example- pharmacist or medical delivery.
  4. Here is a picture from the University image library. It is called “Student at a lecture”… this is not what we want. As part of this day, we want the students to be involved, not just be passive participants that we feed information to.
  5. Introduction followed by 6 interactive seminars up to 30 minutes each, coffee break.
  6. Introduction followed by 6 interactive seminars up to 30 minutes each, coffee break.
  7. 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.   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.
  8. 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.   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.
  9. 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.   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.
  10. 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.   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.
  11. .
  12. If we delivered this via e.g. CPPE, this could be something that was developed, validated and used by more than one school in the faculty.