A qualitative study of stakeholder perspectives of the current system of assessing pharmacists’ readiness for independent practice in Ireland

Abstract

Abstract Introduction Pharmacy students in Ireland are supervised by an approved tutor pharmacist (preceptor) during placement in the final year of the MPharm programme. Since 2020, students must pass two assessments of their readiness to practise – a Competency Assessment completed by their preceptor and an Objective Structured Clinical Examination (OSCE) referred to as the Professional Registration Examination (PRE), prior to registration and independent practice. The Schools of Pharmacy in Ireland are collectively responsible for the PRE, including design and delivery of the national registration examination. A recent scoping review of the methods and processes used to determine pharmacists’ readiness for independent practice identified that Ireland is the only country globally where the Schools of Pharmacy are responsible for the national registration examination.[1] Aim This study aimed to explore pharmacy graduates’ and pharmacy preceptors’ perspectives of the current system of assessing pharmacist’s readiness for independent practice in Ireland. Methods Online, semi-structured interviews were undertaken with preceptors and recent pharmacy graduates. Purposive sampling was used to invite potential participants for interview. Preceptor participants were invited to take part via newsletter invitation and graduates were recruited via social media (Twitter advertisement). Interviews were recorded and transcribed verbatim. The topic guides were developed based on findings from a linked scoping review and the research team’s experience of the assessments.[1] The topic guides were piloted and refined. Key topics included participants’ awareness and perceptions of current assessments to determine readiness for independent practice and participants’ views regarding the readiness of newly registered pharmacists for independent pharmacy practice. Recruitment continued until thematic saturation was reached. Data were analysed using thematic analysis. Results Fifteen interviews were conducted with preceptors (n=7, female=5, male=2) and recent graduates (n=8, female=5, male=3). The key themes identified were: The Competency Assessment Process, The Professional Registration Examination, Pharmacy Curriculum, Placement Training, Alternative Assessment Methods and Challenges Post-Registration. The most frequently noted issues relating to pharmacy curriculum and training were lack of training and practise in development of soft skills, people management and conflict resolution. Participants expressed concern regarding the fact that legal constraints were preventing students from developing skills required of pharmacists, especially in relation to decision making and prescription checking, and this is considered an impediment to fully preparing students for independent practice. Readiness to practise of graduates is considered context-specific with concerns expressed in relation to locuming practices of newly registered pharmacists. Conclusion This study has highlighted a number of stakeholder concerns regarding the current system of assessment of readiness to practise of pharmacists in Ireland, in particular in relation to the Competency Assessment process. While the interview technique facilitated collection of detailed information, the sample size would prevent generalisation to the target population. The possibility of interviewer bias and/or social desirability bias in participants should be acknowledged. Further research is required to explore the feasibility of the improvements proposed by participants.