Pharmacy students can deliver services in general practices: a longitudinal work-based learning model for integrated clinical teaching

Abstract

Abstract Introduction Collaboration between healthcare providers and higher education institutions enable service delivery using the student workforce.(1) This is significant as access to an appropriately skilled workforce can broaden the delivery of pharmacy services.(1) Pharmacy students may have knowledge and communication skills to be able to contribute to service delivery.(2) However, models that integrate pharmacy students into pharmacy services in general practice are limited. Aim to explore a new model of work-based learning in general practice for pharmacy students. Methods A qualitative design is appropriate and was used for this exploratory study. Thirty-two students were recruited from third year of an MPharm programme at one University to provide services via a Pharmacy Hub for three general practices in England. Each student attended the Hub for one 3-hour session, each fortnight, for 12 weeks between September 2019 and February 2020. Students completed ‘tasks’ using read-only access to patient records on SystmOne and recorded their activity on clinical worksheets. Students and stakeholders from the Hub were invited to take part in an interview covering what students did and what the long-term impact of the initiative might be via email. A convenience sample of fifteen students, four general practitioners, two pharmacists, two pharmacy technicians, one general practice manager, and two receptionists, completed semi-structured interviews. Data was also extracted from a convenience sample of 51/105 clinical worksheets to identify the types of tasks completed by students. Content analysis of transcribed interview data and extracted clinical data was completed by both authors until theoretical data saturation was reached. Institutional ethics approval was received for this study. Results Four themes were identified which included i) what activities students completed, ii) impact of working in general practice on student learning iii) impact on recruitment to general practice and iv) concerns. Concerns had three sub-themes relating to indemnity cover for students, a lack of face-to-face patient contact and repetition of simple tasks. See Table 1 for extracts of data. Clinical worksheets indicated students reviewed repeat medication requests (76%, n= 39) and acute medication requests (12%, n=6), for a wide range of products, such as analgesia, antifungal treatment, statin therapy and H.pylori eradication. Students also answered medication-related queries (12%, n=6) such as identifying the porcine content of medications and how to switch from insulin glargine to insulin levemir. Conclusion Findings suggest pharmacy students can contribute to service delivery in general practice by providing supporting roles. However, models must ensure students have access to progressively more complex tasks to facilitate learning. These findings should prompt further research evaluating the role of the pharmacy student workforce to establish key activities students can be trusted to complete. A strength of the study is the combination of data from qualitative interviews and clinical worksheets which provide rich, contextual data. A weakness of the study is that participant validation was not used to confirm the study findings.