Does the Scottish pharmacist post-registration foundation programme change self-reported competence? A before and after questionnaire study

Abstract

Abstract Introduction The two-year Post-registration Foundation Programme for pharmacists in Scotland1, is based on an eight-element framework, and supports early career pharmacists to develop core competences relevant to all sectors of practice. Pharmacists have 6 monthly appraisals and are assessed by an online portfolio and a summative OSCE. Aim The aim of this paper is to describe the changes in pharmacists’ self-reported competence at the end-of-programme compared to baseline. Methods Eligible participants were pharmacists from any sector registering for the programme in September 2017/February 2018. They were invited by email to complete an online questionnaire at baseline and exit to assess their self-reported level of competence with 19 statements linked to the framework using a ten-point Likert scale (1 not at all confident ,10 very confident). Additional questions on expectations (baseline only) and experiences (end-of-programme only: resources used, general views on the programme and suggestions for improvement (open text) were included. No reminders were sent. Questionnaires were hosted on a Qualtrics platform. Data was collated in Excel then exported to an SPSS version 27 database. Analyses were based on the sub-sample who completed both questionnaires; frequencies and means/SD are reported and changes from baseline to end-of-programme compared using paired t test. Open-text responses were subjected to content analysis. Ethical approval was not required for this evaluation. Results Ninety-six pharmacists registered for the programme: 14 males; 11 Health Boards. To date 56 have completed the programme (5 community, 34 hospital, 15 hospital/primary-care and 2 primary-care). Baseline and end-of-programme questionnaires were completed by 73/96 pharmacists (76% response) and 54/87 (50 completers and 4 early exiters) (62.1% response) respectively. 37 pharmacists completed both questionnaires. At the end-of-programme there was improvement in self-reported competence across all statements compared to baseline. Based on a paired t-test changes were significant for all competencies at p<0.001, apart from demonstrating a non-discriminatory attitude which was significant at p<0.05 and was the competency at baseline with the highest self-reported competence (9.36, SD 1.16 cf 9.89, SD 0.32). Regular meetings with tutors/NES staff and support from colleagues and healthcare professionals were the resources rated most highly. Around 50% of participants rated the NES resource booklets, guidance documents and the assessment handbook essential/very useful. 15% found NES personnel input essential and 45% rated peer sessions essential/very useful. FPs commented that undertaking the training had; increased confidence, improved clinical skills, increased ability to reflect, furthered their career prospects and enabled progression to independent prescribing. It had also improved: knowledge and skills, patient care, ability to support other health care professionals. Suggestions for improvement related to the online portfolio, support, and the final assessment. Discussion/Conclusion Limitations include small numbers and programme delivery limited to Scotland. Overall, there was a marked improvement in all competency and practice statements at programme exit. Resources provided were generally rated useful and had been utilised. The training programme had also had a positive impact on confidence, reflective practice, and enabled progress to Independent Prescribing courses.