Assessing the evidence

1. Assessing the evidence

2. GPhC Guidance: Assessing your trainee’s performance You should: • discuss with your trainee how they will be assessed • discuss what evidence your trainee will need to produce to help you evaluate their performance • consider a range of evidence as part of the assessment process • give your trainee a range of opportunities to demonstrate their competence • consider your trainee’s performance and behaviour against the GPhC’s latest standards for pharmacy professionals • Review your trainee’s progress regularly and adapt their training plan as appropriate.

3. Assessing a baseline level of competence Subconsciouslyincompetent Consciously incompetent Consciously competent Subconsciously competent

4. Assessing competence

5. What is assessment? • Process to decide if competence has been demonstrated against performance standards • Must be evidence based • Need to perform consistently • Usually about 5 occasions, but sometimes difficult to do once

6. Performance Standards • 76 performance outcomes • Divided into three sections • Personal effectiveness • Interpersonal skills • Medicines and health

7. Assessment methods • Written evidence • Testimonials from other staff e.g. locums • Observation by tutor e.g. handing out Rx’s • Setting SMART objectives • Checking prescriptions • Calculation tests • Random questioning • Mock exam • Performance Standards

8. Workplace based Assessments • Case based discussion • Observe clinical skills e.g. health check • Observe practical skills e.g. Dispensing • Multi-source feedback

9. Structuring the evidence S Situation T Task A Action R Result S Standards

10. Examples of Written Evidence • Record of evidence:- Made by individual. Brief notes in diary or note book after activity has happened. (Where possible it should be countersigned) • Testimonial Form;- Written observation or Completed when working (dispensing log). Countersigned by person observing the activity • Copies of prescriptions (Confidentiality !) • Project/Audit write ups • Medicines query or advice

11. Quality of Evidence • Quality not quantity! • Needs to include all relevant facts • Be concise New trainees usually gather too much evidence or are apprehensive about getting it wrong

12. Evidence vs Performance Standards I received a prescription. I found it difficult to read, so I asked the pharmacist to endorse it clearly. It was a reducing dose of prednisolone, I calculated the number of tablets to give as 56. I endorsed the prescription with the number of tablets. I packed the tablets into a correctly labelled box and included a PIL. I signed the prescription. This was checked as correct by a technician. I gave the drug out to the correct patient, checking their address, counselled them clearly with instructions on taking the drug. I asked if they had any questions .They didn’t. What else may you want to help you validate this ??

13. Situation I wanted to know more about medicines use reviews as I will need to complete these once I am qualified. I asked the pharmacist if I could witnessed a medicines use review whilst I was on my community pharmacy placement. The pharmacist first asked for the patient’s consent for me to sit in, luckily the patient agreed. This will prepare me for the medicines use review accreditation and prepare me for when I qualify Task The pharmacist went through all of the patient’s medicines in turn and asked them an open question about each one. ‘Can you tell me about your XXX’ The patient was taking three medicines, two MDI inhalers (SABA and ICS) and a antihistamine tablet. The pharmacist asked the patient to demonstrate how they used their inhaler and it was noted that the patient was pressing the inhaler before inhaling (actuation was too late). The pharmacist highlighted this to the patient and demonstrated the correct technique with a placebo inhaler. The patient was then asked to demonstrate their technique again, which he did correctly. The patient was adherent with his medicines, understood what each one was taken for, experienced no side effects. Upon questioning the pharmacist found out that he purchased paracetamol OTC for the occasional headache and smoked 10 cigarettes each day. Following the consultation the pharmacist went through the completed MUR form with me and we discussed the requirements of the service.

14. Action I witnessed the MUR and how to complete the paperwork. Result The result of the consultation was that the patient will now gain more benefit from their MDI inhalers as they will be using them correctly. I need to revisit the different inhaler types so as I am able to give appropriate advice in practice. I now understand more about the requirements of the service, however I will need to visit the PSNC requirements to understand it further. I also witnessed a consultation and made note of how open and closed questions were used within this to gain the information required from the patient. I plan to look into consultation skills further and complete the CPPE learning for this. The patient was not willing to stop smoking however the pharmacist provided the patient with some leaflets and made the patient aware of the support available to him for when he felt ready to try and reduce his smoking, or quit. This has highlighted the importance of asking about lifestyle during the review, you need to make every contact count. Standards A5.1, A5.2, A5.3, A5.5, B1.1, B1.4, B1.11, C2.2, C2.11

15. A5.1 – Identify and prioritise your own learning needs, based on self-reflection/evaluation or feedback from others. A5.2- Develop your own plans to meet identified learning needs, using smart learning objectives. A5.3- Make full use of learning and development opportunities A5.5 – Identify your further learning needs B1.4 – Elicit all relevant information by the use of appropriate questions B1.11 – Provide information and advice appropriate to the needs of the recipient C2.2 – Proactively assist patients to obtain maximum benefit from their treatment

16. How would you assess ? • C1.3 Assess the prescription for safety and clinical appropriateness • B1.12 Handle conflict appropriately • A1.7 Take responsibility for, and accept outcomes of, your own decisions