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2021/22 Taught Postgraduate Module Catalogue

HECS5323M Independent Prescribing for Pharmacists

30 creditsClass Size: 50

If you are applying for a stand-alone Masters level module please note you must meet either the general University entry criteria or the specific module pre-requisite for this level of study.

Module manager: Dr Mary-Claire Kennedy
Email: m.c.kennedy@leeds.ac.uk

Taught: 1 Jan to 30 Sep, 1 Sep to 30 Jun (adv year), Semesters 1 & 2 (Sep to Jun) View Timetable

Year running 2021/22

Pre-requisite qualifications

This module (HECS5323M) will be offered at 30 credits and replaces HECS5146M which is currently offered at 45 credits.

The pharmacy regulator, the General Pharmaceutical Council (GPhC), published a revised set of learning outcomes in Jan 2019 for providers of the Independent Prescribing module for pharmacists. The Independent Prescribing module has been revised to meet these new learning outcomes and changes have also been made to the assessment for the module.

HECS5146M will continue to be offered for the Sept 2019 intake of the module and HECS5323M will come into effect in Jan 2020. HECS5146M will continue to be in place for students who were enrolled on this module and have assessments/resubmissions to complete.

This module is mutually exclusive with

HECS5321MIndependent and Supplementary Prescribing for Allied Health
HECS5322MIndependent and Supplementary Prescribing for Nurses and Mid

Module replaces

HECS5146M

This module is not approved as an Elective

Module summary

This module results in registered pharmacists being able to apply to the GPhC or the PSNI for annotation on the professional register as Independent (non-medical prescribers). There are 26 days of structured learning activities (8 days face-to-face and 18 days distance learning), and 90 hours of learning in practice. The education programme aims to prepare pharmacists to prescribe safely, appropriately and cost-effectively as an independent prescriber. The module has been developed based on the GPhC (regulator for pharmacists and accrediting organisation) 'Standards for the education and training of pharmacist independent prescribers, January 2019'.

Objectives

This module is designed for registered pharmacists (i.e. with the GPhC or PSNI) to obtain the necessary knowledge and skills to become independent prescribers.

The module includes taught compulsory days along with blended learning and practice hours supervised by a Designated Prescribing Practitioner (DPP). On successful completion of the module, pharmacists must apply to be annotated on the GPhC or PSNI registers as independent prescribers, in order to prescribe in their area of clinical practice. The module aims to develop the competence of the individual as an independent prescriber by focusing on the stipulated learning outcomes presented under four core domains of: person centred care, professionalism, professional knowledge and skills and collaboration. These learning outcomes are expanded upon in the next section.

Learning outcomes
The accrediting organisation dictates the learning outcomes (n=32) that pharmacist independent prescribers should have met at the point of annotation (at differing levels according to Miller's knowledge and competence hierarchy triangle), within four core domains. Therefore, the module learning outcomes must mirror these. The four core domains are person-centred care (Domain 1), professionalism (Domain 2), professional knowledge and skills (Domain 3), and collaboration (Domain 4). Following completion of this module, the individual will be able to demonstrate the following learning outcomes:

- Learning outcome 1 (LO1): Synthesises knowledge and skills from a wide range of appropriate sources (e.g. bio-psycho- social theories of human biology and development, pharmacology and applied therapeutics, pharmacy calculation, social influences, academic reviews, national and local policies and guidelines), to enable an in depth consultation with a patient in a structured, systematic manner. The consultation includes evidence based history-taking techniques, effective communication with patients/carers as well as implementing a plan for assessment and review of the patient where appropriate (Domains 1, 2 & 3)

- Learning Outcome 2 (LO2): Demonstrates a critical appraisal of the roles and responsibilities of an independent and supplementary prescriber with knowledge of the legal, ethical and professional framework for accountability and responsibility in relation to prescribing (Domain 2)

- Learning Outcome 3 (LO3): Demonstrates ability to question and interpret evidence to enable appropriate, safe and cost-effective prescribing decisions taking into account evidence-based practice and national/local guidelines where they exist (Domains 2 & 3)

- Learning Outcome 4 (LO4): Communicates and collaborates effectively with healthcare professionals to ensure the safe and effective management of the patient (LO4- Domain 4)

Skills outcomes
Skills and knowledge introduced/strengthened and assessed during the module build on the professional skills and knowledge of a qualified pharmacist and include: physical assessment skills, effective history taking and consultation skills, rational clinical decision making, critical appraisal of the evidence base, theory and legislation underpinning safe and cost-effective independent prescribing including deprescribing.


Syllabus

To satisfy each of these learning outcomes, the module will focus on a range of topics of importance to prescribers including consultation, decision-making, assessment and review, prescribing in a team context, applied therapeutics, evidence-based practice and clinical governance, legal, policy, professional and ethical aspects and prescribing in the public health context. The standards (Part 1, learning outcomes) defined by the GPhC have been mapped to these core subject matters. The GPhC's learning outcomes (n=32) are grouped under 4 domains (Appendix 1):
1. Person centred care (Domain 1: GPhC Learning outcomes: 1.1-1.6)
2. Professionalism (Domain 2: GPhC Learning outcomes: 2.1-2.9)
3. Professional knowledge and skills (Domain 3: Learning outcomes: GPhC 3.1-3.11)
4. Collaboration (Domain 4: GPhC Learning outcomes: 4.1-4.6)

Consultation
- History-taking techniques through effective consultation skills (GPhC Learning outcomes 1.4, 4.5)

Decision-Making
- Psychological and physical impact of prescribing decisions on people and patient centred care (GPhC Learning outcome 1.1)
- Support individuals to make informed choices that respect people’s preferences (GPhC Learning outcomes: 1.3; 1.6, 4.4)
- Role of the prescriber in working in partnership with people who may not be able to make fully informed decisions about their health needs (GPhC Learning outcomes 1.5, 4.4, 4.5 )
- Factors that influence prescribing decisions (GPhC Learning outcomes 2.4, 2.6)
- Health economics when making prescribing decisions (GPhC Learning outcome 2.7)
- Risks and benefits associated with prescribing decisions (GPhC Learning outcome 3.2)

Assessment and Review
- Investigations and interpretation of their results and data (GPhC Learning outcome 3.6)
- Effective monitoring and management to improve patient outcomes (GPhC Learning outcome 3.9)

Prescribing in a Team Context
- The role of the independent prescriber and the role of others in multi-professional teams (GPhC Learning outcomes 2.1)
- Work collaboratively with others to optimise individuals' care, understanding their roles in the prescribing process (GPhC Learning outcome 4.1)

Therapeutics
- Application of pharmacology as it applies prescribing practice (GPhC Learning outcomes 3.3, 3.4)
Evidence-based Practice and Clinical Governance
- Clinical governance of the prescriber, who may also supply medicines to patient (GPhC Learning outcome 2.8)
- How to raise concerns related to inappropriate or unsafe prescribing by other prescribers (GPhC Learning outcome 2.9)
- Evidence-based decision-making for prescribing (GPhC Learning outcome 3.1)
- Recognising and managing prescribing and medication errors (GPhC Learning outcome 3.10)
Legal, Policy, Professional and Ethical Aspects
-
Legal responsibilities under equality and human rights legislation and respect diversity and cultural differences (GPhC Learning outcome
1.2)
- Legal and ethical implications of prescribing, remote prescribing and the handling and sharing of confidential information (GPhC Learning outcomes 2.2 and 2.3)
- Local, regional and national guidelines, policies and legislation related to healthcare (GPhC Learning outcome 2.5)
- Record keeping to ensure safe and effective care and align with relevant legislation (GPhC Learning outcome 3.5)
- Current and emerging systems and technologies in safe prescribing (GPhC Learning outcome 3.7)
- People's need when prescribing remotely (GPhC Learning outcome 3.8)
- Role and responsibilities, and those of others, in safeguarding children and vulnerable adults (GPhC Learning outcome 4.2)
- When and where to refer people appropriately and when to seek guidance from another member of the healthcare team or an appropriate authority (GPhC Learning outcomes 4.3 and 4.6)

Prescribing in the Public Health Context
- Public health issues in promoting health in prescribing (GPhC Learning outcome 3.11)

Teaching methods

Due to COVID-19, teaching and assessment activities are being kept under review - see module enrolment pages for information

Delivery typeNumberLength hoursStudent hours
Supervised Practice901.0090.00
Class tests, exams and assessment21.503.00
Lecture133.0039.00
Practical23.006.00
Tutorial22.004.00
Independent online learning hours108.00
Private study hours150.00
Total Contact hours142.00
Total hours (100hr per 10 credits)400.00

Private study

An important aspect of this course is the independent and private study undertaken by students. The GPhC requires pharmacists to attend for 8 days of face-to-face teaching and 18 days of distance learning. As noted above, students are required to attend lectures, practicals and tutorials during the face-to-face days. The 18 days of distance learning are captured within the independent study hours detailed above. Students are required to engage with audio-recorded lectures delivered by the module team, review the powerpoint slides or other resources or reading supporting teaching sessions as well as undertake learning through interactive slides or MCQs. Online discussion fora, accessed through Minerva, are also used to support group discussions about specific topics (e.g. autonomy and consent) outside of teaching sessions.

There is a minimum of 150 hours at Level M included for private study. Students are expected to spend private study time in preparation for lectures, tutorials, practicals, the portfolio and assessment. Students are also required to spend 90 hours with the designated prescribing practitioner. While it is acknowledged that the total number of study hours is not in keeping with the University's expectations for a 30 credit module, this is due to the requirements imposed by the regulator in relation to the amount of contact time that students should have with course providers.

Opportunities for Formative Feedback

Formative assessment is provided throughout the module. Formative OSCEs are provided during a 3 hour(split into 2 x 1.5 hours) session which takes place two weeks prior to summative assessment. The marking schemes for each of these formative OSCE stations are provided to students during these sessions to compare their answers to the correct/appropriate answers for the station. This gives students the opportunity to identify any outstanding knowledge or competency gaps prior to undertaking to the summative assessment. In addition, case-based scenarios and questions are used within the lectures and seminars for students to work on. There are also workbooks and online learning opportunities available for students to complete which have formative assessments within them.

Feedback is also provided by the DPP via observation of practice, discussions about patient cases and achievement of competencies throughout preparation of the portfolio. We are also introducing a requirement for students to meet with the DPP at the outset of the course; during this meeting the student drafts a learning plan in conjunction with the DPP. The DPP will also meet with the student midway through the module to review the learning plan and discuss progress. This midway point meeting is an opportunity to receive written and verbal formative feedback. This initial and midway point meeting to establish a learning agreement and receive formative feedback have been introduced in response to the GPhC standard 3.6: Each pharmacist independent prescriber in training must be supported as a learner in a learning and practice environments. There must be a mechanism in place for designated prescribing practitioners to liaise with course providers regularly about progress of a pharmacist independent prescriber in training in learning and practice environments and standard 8.2, there are mechanisms in place within the module for pharmacist independent prescribers in training to meet regularly with their DPP and others to discuss and document their progress as learners.

When preparing the portfolio, students are encouraged to send in samples of their work in the portfolio, these are reviewed by a member of the module team and returned to the student. There is a timetabled session on preparing the portfolio and students can bring samples of their work to this session and receive feedback from the tutor. There are also three additional tutorial sessions scheduled in the months following completion of the OSCE, when the students are undertaking their practice placement hours. Students are encouraged to attend one of these three tutorial sessions to receive feedback from one of the module team on drafts relating to their portfolio work. We are also happy to meet with students throughout the module to discuss any aspect of teaching or assessment as appropriate.

A detailed academic supervision document has been developed for the module which draws on the School's Academic Supervision Policy. This is shared with the students during the induction session so that they have a clear idea of the nature and extent of academic supervision and opportunities for feedback throughout completion of the module.

Methods of assessment

Due to COVID-19, teaching and assessment activities are being kept under review - see module enrolment pages for information


Coursework
Assessment typeNotes% of formal assessment
EssayReflective 3000 word essay (also known as a reflective Practice Evidence Record). This essay is one of the prescribing focused case-studies presented by students in their prescribing portfolio. Further information about the portfolio is provided later.70.00
PortfolioPass/Fail. The portfolio forms the main framework for recording supervised learning in practice and independent study. Information about the essay component of this has been outlined above, since it is assessed differently to the other aspects of the portfolio. It includes a prescribing log, supervised practice time log and evidence of prescribing competency in various forms such as: case studies; reflective accounts; witness testimonies; recording of meetings, visits, discussion; protocol or guideline development and use (EBP)0.00
In-course AssessmentFORMATIVE: OSCE (Objective Structured Clinical Examination)0.00
Total percentage (Assessment Coursework)70.00

The format of this assessment in 2020/21 may be subject to change as a result of restrictions imposed as a result of the Covid-19 epidemic but the learning outcomes will remain unchanged and approval of the appropriate PSRB (Professional, Statutory and Regulatory Bodies) will be obtained The portfolio is marked as a pass or fail by the DPP who signs to verify the student’s achievement of each competency indicator. This relates to GPhC Standard 6.5, which states "The DPP is responsible for signing off a pharmacist independent prescriber as being competent as a pharmacist independent prescriber." The portfolio is the marked by a member of the module team to assess it from a clinical and academic viewpoint. Students must demonstrate all specified competencies based on the single competency framework for prescribers. The portfolio is a robust assessment tool as it allows the module team to consider the development of the student as a competent and reflective non-medical prescriber. Academically the portfolio is assessed as a pass or fail with one graded element which will give 70% of the overall mark for the module. For this graded aspect, students are required to write a 3000 word reflective case study linked to the development of competence evidenced in the portfolio. Students are instructed to select a consultation episode and critically examine the consultation. Additionally the portfolio must include a numerical assessment. This will take the form of a drug calculation constructed by the student's DPP related to the context of the student's practice. A prescription linked to this calculation is necessary to demonstrate competence in this area. Students must achieve 100% in both the calculation and the prescription to pass, which is assessed and verified by the DPP and by the academic marker. This means that the calculation has to be entirely correct (i.e. all workings are included and are correct) and that the prescription satisfies all legal requirements. The calculation and prescription are requirement components of the portfolio, therefore if either of these components are awarded <100%, the overall portfolio fails. All elements (demonstration of competencies, supervised practice time, numerical assessment, prescription assessment, 'sign-off' from DPP, graded element [pass mark 50]) of the portfolio have to be satisfactory, otherwise the portfolio will be deemed a fail. Review and approval of the portfolio and associated components by the DPP has been included to meet the GPhC learning standard 6.5, which states "The DPP is responsible for signing off a pharmacist independent prescriber as being competent as a pharmacist independent prescriber." Students have two attempts at the portfolio. If the student fails, the student is permitted a 2nd attempt and if successful at the second attempt they will be awarded a pass but the overall course mark will be reduced to the minimum allowed for a pass (30%). There is no compensation allowed between assessment elements. The summative coursework assessments and examinations associated with the module (i.e. the OSCE, graded and non-graded elements of portfolio, and other coursework) all need to be a passed independently for the student to pass the module.


Exams
Exam typeExam duration% of formal assessment
OSCE (Objective Structured Clinical Exam)0 hr 90 mins30.00
Total percentage (Assessment Exams)30.00

OSCE stations will assess performance and competence in a range of skills, knowledge and behaviours covered within the teaching sessions of the module. Stations will examine several topics including clinical assessment skills, knowledge of legislation related to prescribing, pharmacology and therapeutics, and communication skills. The OSCE will last for no longer than 90 minutes with each station lasting 8-10 minutes. Compensation is permitted between OSCE stations. Each OSCE station will be standard set individually and then the total score or the equivalent total percentage based on the modified Angoff method will be calculated. All scores of the standard set stations are added together to get a final pass mark. We will then model the addition of a standard error of measurement (SEM) which is approximately 2-3% addition to the pass mark. This is to ensure that false positive decisions are not made and that we are confident that all who 'pass' should have done. However, a major failure to identify a serious problem or an answer which would cause the patient harm (moderate, severe or death outcomes as defined by WHO 2018 guidance) will result in overall failure of the OSCE (Cooper et al., 2018). The student will be required to complete a second attempt at the OSCE. Currently the summative OSCEs are recorded for internal moderation and are uploaded to Grademark for external examining purposes and deleted after the appeals process deadline has expired

Reading list

The reading list is available from the Library website

Last updated: 30/06/2021 16:22:17

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