Pre-registration Year Research Articles

Measuring moral development in the pharmacy profession from undergraduate to established practitioner: a decadal longitudinal study.

The aim of this study is to measure and evaluate the moral reasoning of undergraduate pharmacy students as they progress through a British university, and onward through the early years of their professional practice. This study utilizes version 2 of Rest's Defining Issues Test in a longitudinal design, evaluating a single cohort of future pharmacists, which started a 4-year Master of Pharmacy degree program in 2008-09, completed their preregistration training, and progressed through their early careers. The final dataset was collected in 2019. Both descriptive and inferential statistical analysis was subsequently carried out. The cohort experienced significant moral growth during the 4 years of their undergraduate degree, where they were exposed to an ethical education designed to engage students at the "plus one" level of moral reasoning. There is also evidence for work-based augmentation of moral development between graduation from university and qualification as pharmacists. The subjects underwent a marked increase in moral development as they progressed through their undergraduate studies, followed by another sizeable, though not statistically significant developmental progression during the preregistration year. The retrograde step in moral development observed between newly qualified level and established practitioner level requires further investigation: structured interviews with participants, which focus on changes to their experiences in practice and how these affected their moral agency are already underway.

We audited our vancomycin patients, with some surprising results

As I started my pharmacist foundation training year (formerly known as the preregistration year) at Bradford Royal Infirmary, Yorkshire, I was involved in managing the care for a large number of patients on antimicrobial treatment. I actively took part in antibiotic audits as part of my role, where I reviewed the appropriateness of treatment in […]

Professional Dilemmas Experienced by Pharmacy Graduates in the United Kingdom When Transitioning to Practice

Objective. For many pharmacy students in the United Kingdom there are few opportunities during undergraduate education to learn, or be exposed to, different ways of dealing with ethical and professional dilemmas in real life practice. This study aimed to explore the experiences of graduates during their pre-registration year and early practice (up to two years post-qualification) on their perceived preparedness to make professional decisions when faced with problems or dilemmas once in practice.Method. Semi-structured interviews were undertaken with preregistration trainees and early careers pharmacists (up to two years qualified). Interviews were transcribed verbatim and analyzed thematically using the Framework Approach.Results. Eighteen interviews (nine preregistration trainees and nine qualified pharmacists) were conducted. Four key themes emerged: continued learning in practice, exposure to role-modelling, moral courage, and stress and moral distress.Conclusion. This study found that preregistration trainees and early career pharmacists perceive a need to be challenged and to receive further support and positive role-modelling to help them continue to develop their ethical and professional decision-making skills in the practice setting. The level and quality of support reported was variable, and there was a reliance on informal networks of peer support in many cases. This study suggests a need to raise awareness among preregistration tutors (preceptors) and line managers (supervisors) to improve and increase support in this area.

Exploring pre-registration tutors’ views on professionalism and leadership skills shown by pre-registration tutees

Abstract Introduction The GPhC introduced new standards on the initial education and training of pharmacists which requires leadership and professionalism to be demonstrated (1). It was reported previously that pre-registration tutees did not possess the professional and leadership skills expected of them when starting the pre-registration year (2). It is important to see if current tutees are meeting the new standards. If they are not, this would suggest that more should be done in undergraduate training to address this gap. Aim This study aimed to explore the views of pre-registration tutors on the professionalism and leadership skills of current pre-registration tutees and to identify what more could be done to develop these skills during the undergraduate and pre-registration years. Methods A semi-structured interview schedule was developed based on the aim of the study and relevant literature. It addressed attitudes and behaviours thought to demonstrate leadership and professionalism, tutors’ views on tutee’s skills, and the roles of tutors, tutees and undergraduate education in developing these skills. Regional Managers working for Well Pharmacy were informed of the study. Those interested in participating provided contact details of the pre-registration tutors within their area. In October 2020, individual tutors were invited by email to participate, with a participant information sheet and consent form attached. Potential participants were followed-up by telephone and a convenient time for interview arranged. Telephone interviews were digitally recorded, transcribed verbatim and thematically analysed using the Framework Approach. Interviews were continued until no new broad themes emerged. Results Twelve tutors based across England and Wales were interviewed, seven were male, and experience ranged from newly qualified to 20 years in practice. Five main themes emerged: role of undergraduate education; role of the tutor and tutee; professional behaviours of tutees; leadership skills of tutees; challenges and barriers. The role of undergraduate education was perceived to be that of instilling basic knowledge and providing work experience through placements. Interviewees suggested that more undergraduate multi-sector placements could be offered, with a greater focus on leadership skills. The tutors’ role was reportedly to coach, support learning and be a role model whilst tutees needed to understand their limitations and learn from their tutor and pharmacy team. Communication skills, confidence and teamwork were cited as the most desired skills with tutees not always excelling in these. Limited knowledge, individual characteristics and lack of experience were reported as barriers for tutees, with time constraints, paperwork, and staffing issues for tutors. Interviews were conducted across a wide geographical area with tutees likely to have attended various universities. However, the study focused on community pharmacy only, and interviews were conducted three months into the pre-registration year, whilst leadership skills develop over time. Conclusion This study highlights the need for increased placement hours in undergraduate education; the advent of HEE funding to support further placement activity is welcome. A greater focus on communication, teamwork and leadership in the MPharm may benefit future tutees. In addition, pharmacy organisations could introduce more protected tutor/tutee time for tutors to support tutees in developing their skills. References (1) General Pharmaceutical Council, 2020. Initial education and training for pharmacists. Available at: <https://www.pharmacyregulation.org/initial-training> [Accessed 14 October 2021]. (2) Christou, M. and Wright, D., Engendering and appraising professionalism within the UK pharmacy pre-registration year: Identifying the current barriers. Pharm Educ, 2011:11(1):107-14. Available at: https://pharmacyeducation.fip.org/pharmacyeducation/article/view/338/307 [Accessed 14 October 2021].

Why I have changed my approach to see the patient, not the disease

Along with many other pharmacists, I found my university education always diverted my focus towards the question: how does a drug treat the disease? It was not until my preregistration year that I realised I often described patients by their disease state or drug history, rather than using their name, when discussing cases with my […]

Gul Root (1950–2022)

Having completed her preregistration year at the Westminster Hospital in London, Gulanar (Gul) Root joined the Royal Pharmaceutical Society (RPS) in 1974 after graduating from the University of Brighton with a BSc (Hons) in pharmacy. She spent the first 20 years of her career in paediatric pharmacy, before going on to join East Surrey Health […]

Pharmacy foundation training: how has the first year gone?

In June 2022, the first ever cohort of foundation pharmacy trainees took the registration exam. And, despite technical problems causing delays for some students, they made history as the first group to undertake this training at this stage of their careers. In many ways, foundation training is very similar to the previous preregistration year, requiring […]

Pharmacy graduates' perceived impact of long-term undergraduate use of an ethical decision-support tool on their early practice

IntroductionValues-based practice is an important concept within healthcare decision-making that sits alongside evidence-based practice. Values Exchange (Vx) (http://www.vxcommunity.com) is an online tool that supports the development of ethical and professional decision-making skills through values transparency. The aim of this research was to explore the perceived impact of long-term use of the tool during undergraduate study on pharmacy graduates' early practice. MethodsAlumni in their pre-registration year or up to two years qualified were invited to participate via a question at the end of a survey, with additional students invited prospectively during an undergraduate lecture. All had completed three cases per year on Vx during the four-year master of pharmacy course. Semi-structured interviews were audio-recorded and transcribed verbatim, and framework analysis was applied. Ethical approval was obtained. ResultsA total of 18 interviews (nine pharmacists and nine pre-registration tutees) were conducted between May 2015 and March 2016. Thirteen participants were female, 13 were based in community pharmacy, and 10 were Caucasian. Interviews ranged from 50 min to 2 hours. Three themes emerged from the data: (1) the Vx learning environment, (2) learning and reflection, and (3) potential enhancements for learning. Participants perceived Vx to be an effective teaching tool supporting the development of skills necessary to exercise professional judgement in pharmacy practice. ConclusionsVx appears to be a worthy addition to the armoury of teaching methods necessary to support future pharmacists in their preparedness to deal with ethical and professional dilemmas in practice.

Structured experiential learning placement for pharmacy undergraduate students – a pilot study

Integration of a pharmacist role into the United Kingdom core healthcare services became better recognized in recent years. The General Pharmacy Council is modernizing pharmacy education through the introduction of the foundation year, replacing the pre-registration year, moving to five-year from a four-year degree, and proposed hands-on undergraduate placements across the five years. Experiential learning placements (ELP) are not a component of the current pharmacy education. ELP was designed a

Experiential Education in the Time of COVID-19: An Australian Experience

The pharmacy degree at Monash University is a four year undergraduate Bachelor of Pharmacy with Honours (BPharm(Hons)), followed by a one year Master of Pharmacy incorporating a preregistration year of supervised practice, known in Australia as internship. The first cohort of the BPharm(Hons) will graduate in 2020. A key principle of the new curriculum was that clinical experiential placements should commence early in the curriculum, be fully integrated with the didactic curriculum, and prepare students for internship by developing their competence in performing useful and relevant tasks in the workplace. Entrustable Professional Activities (EPA) are used as the framework for their experiences.

Experiential Education in the Time of COVID-19: An Australian Experience.

The pharmacy degree at Monash University is a four year undergraduate Bachelor of Pharmacy with Honours (BPharm(Hons)), followed by a one year Master of Pharmacy incorporating a preregistration year of supervised practice, known in Australia as internship. The first cohort of the BPharm(Hons) will graduate in 2020. A key principle of the new curriculum was that clinical experiential placements should commence early in the curriculum, be fully integrated with the didactic curriculum, and prepare students for internship by developing their competence in performing useful and relevant tasks in the workplace. Entrustable Professional Activities (EPA) are used as the framework for their experiences.

Views and experiences of community pharmacy team members on antimicrobial stewardship activities in Scotland: a qualitative study

Background It has been acknowledged and recognised internationally that the community pharmacy team has a major role to play in antimicrobial stewardship programmes, particularly regarding patient engagement. However, there is a paucity of published research on community pharmacy-based activities in antimicrobial stewardship, and views and perceptions of the community pharmacy team on their role in antimicrobial stewardship. Objective To explore views and experiences of community pharmacy teams across Scotland on antimicrobial stewardship, activities related to European Antibiotic Awareness Day, and a self-help guide to treating infection. Setting Community pharmacy, Scotland. Methods Qualitative, semi-structured in-depth telephone interviews were undertaken with a purposive sample of community pharmacy team members over a six week period between November and December in 2016. Interviews were audio-recorded, transcribed verbatim and data analysed thematically using the framework approach. Main outcome measure Views and perceptions of antimicrobial stewardship and European Antibiotic Awareness Day activities and role of the pharmacy team. Results Twenty-seven participants were interviewed—20 pharmacists, five pharmacy graduates completing their pre-registration year, and members of the pharmacy support team including two pharmacy technicians and one medicines counter assistant. They were working mainly in urban areas and across five regions of Scotland. Most were aware of antimicrobial stewardship but some were not familiar with the term. Participants identified roles for the community pharmacy team in antimicrobial stewardship including the importance of the pharmacy as a first port of call for self-care advice. Some participants, including pharmacists, showed lack of awareness of European Antibiotic Awareness Day; those who were aware thought it may not have the desired impact on educating the public. Most participants, irrespective of role within the team, were not familiar with the self-help guide but they perceived this as a useful resource for the pharmacy team. Conclusion The participants recognised and identified roles for the community pharmacist within antimicrobial stewardship. However, the lack of awareness of European Antibiotic Awareness Day shows a need for European Antibiotic Awareness Day tools and other materials to be more effectively disseminated and for more training to be provided.

John Stuart Whittaker

After studying at Victoria University Manchester, John Stuart Whittaker obtained a first class degree in anatomy before qualifying as a doctor in 1957. He did his preregistration year in Manchester and a rotating senior registrar post in various Manchester hospitals. He was appointed as a …

Foundation training programme could replace preregistration year from the summer of 2021

Foundation training programme could replace preregistration year from the summer of 2021

Everything you need to know about pharmacy foundation training

Universal foundation training for pharmacists is being introduced sooner than expected, with an interim foundation programme launched this autumn and a one-year foundation scheme set to replace the current preregistration year from July 2021.

Replacing the preregistration year could prove transformative

Replacing the preregistration year could prove transformative

Ian James Burns

Ian James Burns was born in Glasgow to parents James Aloysius Burns and Mabel Thomson Dick of Rutherglen. He attended Burnside Primary School and St Aloysius College, Glasgow, before gaining...

Community pharmacy as an effective teaching and learning environment: Student perspectives from a UK MPharm programme

IntroductionIn order to increase new pharmacists' preparedness for clinical practice, pharmacy education in the United Kingdom (UK) is moving towards a five-year integrated degree incorporating the pre-registration year into the undergraduate programme. The purpose of this research is to explore masters of pharmacy (MPharm) student attitudes towards experiential learning and assess community pharmacy as a teaching and learning environment. MethodsMPharm students (n = 857) at one UK pharmacy school were invited to complete an online questionnaire. Responses were statistically analysed while open comments were thematically analysed. ResultsStudents were positive about placement organisation, with over 80% agreeing the pharmacist and support staff were enthusiastic and well-prepared. However, 62% of respondents felt they were unable to interact with patients on placements and instead spent time completing pre-determined learning tasks. Seventy-seven percent felt these tasks limited real “hands-on” experiences. Although 78% of respondents believed placements provided a valuable learning experience, only 18% thought placements prepared them for post-graduate employment. ConclusionsCommunity pharmacy environments are often busy and unpredictable, and experiential learning should be designed to allow better exposure to clinical practice with less pre-defined learning. Placements should allow for more collaborative working between universities and employers and incorporate the use of learning standards. This would represent a move towards a five-year integrated degree and a better understanding of the associated challenges involved.

Design and Evaluation of a New National Pharmacy Internship Program in Ireland

Objective. To design, deliver, and evaluate a National Pharmacy Internship Program that met the educational requirements of pharmacy graduates to register as competent pharmacists and earned graduates a master's level degree. Methods. The National Pharmacy Internship Program was designed as a 12-month, full-time, blended-learning, competency-based program leading to a master's degree. Intern performance was assessed academically and by pharmacy preceptor (tutor) appraisals. Interns who demonstrated competency were invited to sit for the Professional Registration Examination (PRE). Feasibility and performance were evaluated and a longitudinal approach allowed intern and preceptor views to be compared to the former preregistration year. Results. Overall performance in the PRE was good and relatively consistent with almost all interns proceeding to register as pharmacists. Interns believed that the program had enabled them to develop the knowledge, skills, and overall competencies required for future independent practice as a pharmacist. Preceptors considered the program to have built on prior learning and provided a sufficiently rounded experience for professional practice. Preceptors also stated that the program was an improved educational experience over the former, less structured, preregistration training. Conclusion. The National Pharmacy Internship Program was perceived to be an improvement on the previous preregistration year. The program quality assured pharmacy education outcomes at the entry-to-practice level on a national basis, and uniquely recognized the students' accomplishment by awarding them a master's degree.

Pharmacy OSCEs and Competency-Based Assessments by Sharon Haughey and Roisin O'Hare Book review

Over the past decade, the pharmacists’ role has been revolutionised utilising and incorporating expert clinical skills and knowledge. In doing so, a pharmacist’s performance is underpinned by competence and must be assessed in a valid and reliable manner throughout the undergraduate degree and preregistration year prior to becoming a responsible practitioner. The Observed Structured Clinical Examination (OSCE) is a practical assessment method evaluating student application of knowledge and understanding of the content in a simulated real-life environment. ‘Pharmacy OSCEs and competency-based assessments’ by Haughey and O’Hare is a novel book which endeavours to enhance the use of this method of assessment in pharmacy education.