- Title
- Simulated professional pharmacy techniques for training and assessment of professional competence in the review and supply of prescribed medicines in community pharmacy
- Creator
- Croft, Hayley Alison
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Safe and effective patient-centred medicine dispensing is central to the role of community pharmacists. There is increasing demands for graduate pharmacists to be competent across all areas of professional practice, a requirement given momentum by health regulators, public interest and educational institutions. Consequently, it is necessary for student assessment models to evolve to track progress towards competence and ensure preparedness of entry level pharmacists for practice. The research in this thesis is underpinned by current trends identified in a thorough review of the literature related to competency-based entry level pharmacy education and assessment. This review highlighted key opportunities that have become the focus of this research including; 1) integrated assessment models which evaluate multiple competencies simultaneously and provide a suitable focus to expand the range of practice-based assessment of pharmacists in medicine dispensing and; 2) entrustment decisions about learners using Entrustable Professional Activity (EPA) descriptions that provide an opportunity to reframe our approach to assessment of pharmacy practice skills. Aspects of the community pharmacy work system that are vulnerable to medication-related errors were identified using a comprehensive literature review and structured using a human factors framework. Analysed according to the dimensions of the human factors SHELL model, the findings of this review identified key areas of focus for competency-based interventions and assessment in simulation-based training activities. This research is focused on the assessment of pharmacist’s clinical reasoning processes in the supply of prescribed medicines in a community pharmacy. These processes are not routinely captured in simulation-based assessments, despite being crucial elements of the dispensing process and given their potential to impact patient safety. Undertaking a qualitative think-aloud study with community pharmacists revealed seven core cognitive processes used by pharmacists when making decisions about the appropriateness and safety of a prescribed medicine before supplying to a patient. These findings were used to inform the development of an assessment model focused on the evaluation of competency in medicine dispensing, and identifying the complex and dynamic cognitive skills required in this area of practice. The resulting Model of Entrustment in Dispensing Skills (MEDS) assessment framework utilises seven domains representing key competency areas in medicine dispensing; complimented by a global rating using an entrustment scale. Evidence for validity of the assessment framework was ensured through both the collection and interpretation of evidence. The framework was used in a pilot study conducted with expert assessors (n=10) who provided assessment ratings of final year undergraduate pharmacy students (n=21) in two simulated medicine dispensing tasks. The study demonstrated that entrustment decisions can be incorporated successfully to evaluate student performance and provide feedback on performance, with psychometric analysis of the framework producing high reliability coefficients and good correlation between total score and EPA ratings. This thesis contributes valuable knowledge to current developments in health professional assessment. In particular, this work furthers the discussion concerning the challenging nature of evaluating competence by demonstrating a framework that creates evidence to support the validity of assessment decisions. The developed EPA-based assessment evaluates medicine dispensing skills in an integrated manner, informing reliable decisions about the level of supervision required for students when supplying medicines. The framework represents promising progress towards development of a validated holistic assessment of competency in medicine dispensing, and may be adopted into entry level training programs nationally and internationally.
- Subject
- pharmacy; assessment; entrustable professional activities; simulation
- Identifier
- http://hdl.handle.net/1959.13/1412971
- Identifier
- uon:36557
- Rights
- Copyright 2020 Hayley Alison Croft
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 8 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 447 KB | Adobe Acrobat PDF | View Details Download |