Exploring the Requisite Skills and Competencies of Pharmacists Needed for Success in an Evolving Health Care Environment

An evidence-led review of the FIP global competency framework for early career pharmacists training and development

BACKGROUND

The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) for early career pharmacists is an evidence-driven guide for pharmacist professional development. First published in 2012, the FIP GbCFv1 contains a structured assembly of competencies for pharmacists in four broad areas: pharmaceutical public health; pharmaceutical care; organisation and management; and professional/personal. FIP is committed to support the advancement of pharmacy around the world, and in light with the expansion of the type of services that pharmacists may provide to their patients and the advances in technology and therapeutics, revising and updating the GbCF is imperative.

OBJECTIVE

The aim of this project was to revise and update the first published iteration of the FIP GbCFv1 (2012) to ensure currency and continued relevance.

METHODS

This is a qualitative study that employed four rounds E-Delphi method. A group of international experts (n = 29) was convened to revise the GbCFv1 through an iterative approach with repeated and synchronised rounds of analysis and revision focusing on the currency of the competency areas and associated behavioural statements. The revision was conducted between January to August 2020.

RESULTS

The number of behavioural statements increased from 100 to 124 behavioural statements, with 23 competency domains, but remain structured within the competency clusters. Three new competencies were added to the GbCF (emergency response, digital literacy, and interprofessional collaboration) and one competency was renamed from self-management to leadership and self-regulation.

CONCLUSIONS

The process undertaken to revise the GbCFv1 are described, resulting in a valid and transnationally relevant GbCFv2. In the GbCFv2, the number of competencies and associated behavioural statements increased due to important additions including emergency response, digital literacy, interprofessional collaboration and an expansion of leadership and self-regulation. This process provides an assurance of relevancy and currency for a 'fit for purpose' early career competency development framework for global implementation.

A pilot study on the use of the nominal group technique to refine core pharmacy roles and to determine what competencies may be missing from pharmacy education

INTRODUCTION

To describe the use of the nominal group technique (NGT) to refine pharmacy core roles and to compare these roles with current pharmacy outcomes and other literature to highlight potential deficiencies.

METHODS

The NGT process was used for this proposal review. The process was conducted in four key stages: silent generation, round-robin, clarification, and voting. A convenience sampling of five pharmacy faculty and administrators that have researched the areas of practice-readiness and pharmacy competencies formed the panel of participants for the NGT process.

RESULTS

Study findings offer seven core roles that define pharmacists' scope of practice: knowledge, patient care skills, professional, scholar, system-based practice/manager, collaborator, and advocate/health promoter. Development of these core roles revealed several missing pharmacy competencies or ones only covered in optional learning objectives: conflict management, professional advocacy, scholarship, empathy, personal health, transitions of care, health outcomes, quality improvement, and health insurance.

CONCLUSIONS

The development of pharmacy roles is one way to ensure students are adequately prepared for pharmacy practice following graduation. Mapping of competencies to core professional roles would allow schools/colleges of pharmacy to have one cohesive document to guide pedagogical and assessment practice. More research and consensus building will be needed before these core roles could be disseminated more broadly.

Lebanese pharmacy core competencies framework: tool validation for self-declared assessment

OBJECTIVES

The Order of Pharmacists of Lebanon, the official pharmacists' association in Lebanon, had suggested a core competencies framework based on global and international frameworks and adapted to the local context. The objective of this study was to validate the structure of this comprehensive set of competencies in the Lebanese context of pharmacy practice.

METHODS

The framework structure was assessed through multiple factor analyses, correlational and reliability measures of self-declared assessment, based on a cross-sectional survey of practising pharmacists.

KEY FINDINGS

The framework had adequate structural validity and reliability: all measured coefficients were of appropriate magnitude. Behaviours adequately loaded on competencies, and competencies adequately loaded on domains and the entire framework. The exploratory factor analysis showed an adequate distribution of competencies in domains. Domains were also inter-correlated, without over-correlation.

CONCLUSIONS

Our results are an essential step towards standardizing pharmacy competencies in Lebanon and show that the Lebanese core competencies framework developed by the Order of Pharmacists of Lebanon is structurally valid and reliable, although not yet applied in the Lebanese educational system. This tool would be helpful to assess the minimum competencies of pharmacists upon and after graduation.

Developing and piloting a self-assessment tool for medication review competence of practicing pharmacists based on nationally set competence criteria

BACKGROUND

New competence requirements have emerged for pharmacists as a result of changing societal needs towards more patient-centred practices. Today, medication review competence can be considered as basic pharmaceutical competence. Medication review specific competence criteria and tools for self-assessing the competence are essential in building competences and a shared understanding of medication reviews as a collaborative practice. The aim of this study was to develop and pilot a self-assessment tool for medication review competence among practicing pharmacists in Finland.

METHODS

The development of the self-assessment tool was based on the national medication review competence criteria for pharmacists established in Finland in 2017 and piloting the tool among practicing pharmacists in a national online survey in October 2018. The pharmacists self-assessed their medication review competence with a five-point Likert scale ranging from 1 for "very poor/not at all" to 5 for "very good".

RESULTS

The internal consistency of the self-assessment tool was high as the range of the competence areas' Cronbach's alpha was 0.953-0.973. The competence areas consisted of prescription review competence (20 items, Cronbach's alpha 0.953), additional statements for medication review competence (11 additional items, Cronbach's alpha 0.963) and medication review as a whole, including both the statements of prescription review and medication review competence (31 items, Cronbach's alpha 0.973). Competence items closely related to routine dispensing were most commonly self-estimated to be mastered by the practicing pharmacists who responded (n = 344), while the more clinical and patient-centred competence items had the lowest self-estimates. This indicates that the self-assessment tool works logically and differentiates pharmacists according to competence. The self-assessed medication review competence was at a very good or good level among more than half (55%) of the respondents (n = 344).

CONCLUSION

A self-assessment tool for medication review competence was developed and validated. The piloted self-assessment tool can be used for regular evaluation of practicing pharmacists' medication review competence which is becoming an increasingly important basis for their contribution to patient care and society.

Preceptor perceptions of contemporary practice skills among new graduates amid community pharmacy transformation

INTRODUCTION

With community pharmacy transitioning from a fee-for-service model to a value-based care focus, the desired skills of pharmacist graduates is an evolving paradigm. As active stakeholders in community practice, pharmacist preceptors are in a unique position to compare the ever-changing dichotomy between pharmacy practice and training. Examining preceptors' assessments of these essential contemporary practice skills may provide useful insights.

METHODS

A survey was emailed to all regional, active college of pharmacy community advanced pharmacy practice experiences preceptors. Participating preceptors were given 30 days to complete the online survey. Weekly reminders were provided.

RESULTS

Of the 168 preceptors invited to participate, 42 (25%) completed the survey. Descriptive analysis compared preceptors' perceptions of transformative services vs. their relative implementation in practice. This revealed service areas such as health screenings that were proportionate in their prevalence of offering and perception as contemporary. In contrast, services such as pharmacogenomic testing were more widely perceived as contemporary compared to their low prevalence as an offering. Participants showed broad consensus in the importance of most skills listed in the survey, predominantly indicating these skills were either "very important" or "extremely important." Only a few specific skills areas were identified that showed less consensus, with a minority of respondents specifying that these skills were of less importance.

CONCLUSIONS

Preceptor surveys may offer insights on the progression of community practice curricula. Continued monitoring of changes in service parameters over time may reveal trends in practice transformation, identifying service areas being more widely adopted.

Development of pharmacy competency framework for the changing demands of Thailand's pharmaceutical and health services

Background

In Thailand, pharmacists are responsible for all activities to ensure access to medicines throughout pharmaceutical supply chain. Competency framework (CF) is an important guidance for professional development and workforce planning.

Objective

This study aimed to explore needs for pharmacy services in pharmaceutical supply chain and competencies of pharmacists to serve those needs. It was the first step for developing evidence-based pharmacy CF within the context of Thailand in 2026.

Methods

A qualitative method using in-depth interviews to gain rich data from practitioners and leaders in all area of practices. 99 key informants from 56 workplaces in Thailand were interviewed during January and March 2016. Data was transcribed verbatim, and thematic analysis was used. Competencies were extracted, followed by several rounds of group discussion among team members to develop an initial framework. The competencies and CF were presented, and recommendations were gained from professional leaders for refining the findings.

Results

The key informants agreed that pharmacist's works and responsibilities have gradually been drifted to support changes in healthcare and pharmaceutical systems. The upcoming pharmaceutical services call for higher standards of practice, larger number of personnel, and skillful pharmacists who have strong foundation in pharmaceutical knowledge as well as an ability to integrate knowledge into practices. Two sets of CFs were established. The general CF comprises five core domains: product focus, patient focus, healthcare system focus, community focus, and personal focus for self-improvement. These general competencies allow practitioners to perform basic professional tasks, including providing information, dispensing, and compounding. The service-specific competency is the integration of general competencies tailored into specific area of practice.

Conclusions

Regarding the professional goal to evolve pharmacists from generalists to specialists for providing higher quality of professional services, the pharmacists are required to demonstrate general competencies and service-specific competencies. The findings serve as the need-based evidence for developing a national CF for pharmacists in Thailand.

Rethinking Competence: A Nexus of Educational Models in the Context of Lifelong Learning

Competency-based education (CBE) “derives a curriculum from an analysis of a prospective or actual role in modern society and attempts to certify students’ progress on the basis of demonstrated performance in some or all aspects of that role”. This paper summarizes pertinent aspects of existing CBE models in health professions education; pharmacy education presented as an example. It presents a synthesis of these models to propose a new diagrammatic representation. A conceptual model for competency-based health professions education with a focus on learning and assessment is discussed. It is argued that various elements of CBE converge to holistically portray competency-based learning and assessment as essential in initial education and relevant to practitioners’ continuing professional development, especially in the context and importance of pursing lifelong learning practices.

Mixed-Method Study of Utilizing Portfolios to Document and Assess Co-Curricular Activities: Student and Advisor Perceptions

Background: Development of professional behaviors must occur in tandem with clinical skills to ensure graduates provide quality care. Portfolios have been widely utilized as a medium to document and reflect on experiences related to professional skills. Methods: Students were required to complete a series of co-curricular activities and document them via paper or electronic portfolios, which were shared with their advisors for feedback and review. To gather perception data, student surveys were administered twice: once for the electronic cohort and once for the paper cohort after their first-year experience with the platform, and focus groups were conducted a year later. Faculty advisors were also asked to complete surveys. Results: Both students and advisors felt that electronic portfolios resulted in a greater understanding of the educational outcomes and was the preferred method for recording co-curricular requirements. Several technical challenges arose with the use of the electronic portfolio and many students and advisors felt they needed more education regarding mapping of activities. Conclusions: The electronic portfolio was found to be more sustainable as compared with paper portfolios, as it helped students adhere to the criteria and self-assessment process. Further research is needed to evaluate long-term benefit of documenting and assessing co-curricular experiences within an electronic platform.

We should pay more attention to student curiosity

INTRODUCTION

Educators sometimes become frustrated when students appear interested only in learning the "right answers for the exam" versus being truly engaged and taking initiative to develop their own questions that add to the learning process. Some have suggested that because information is so readily accessible in today's digital environment that the desire to undertake scholarly inquiry may gradually be lost.

COMMENTARY

Curiosity is a trait that drives people to ask exploratory questions and find creative ways to solve problems. It has been linked with a variety of desired academic and professional outcomes, but is a construct rarely addressed within educational literature. This commentary suggests that curiosity is a characteristic to which pharmacy educators should pay more attention. A series of questions are posed for pharmacy educators to consider with regard to screening for, promoting, and developing curiosity within our student population.

IMPLICATIONS

Pharmacy educators need to be intentional about designing programs and instructional practices in ways that promote and incentivize student curiosity. The questions posed to the Academy are intended to evoke discussion and further study of curiosity within pharmacy education.

Conducting and presenting qualitative research in pharmacy education

SITUATION

The evolution of practices in healthcare and the content and delivery of pharmacy education have generated new challenges for practitioners and academicians. Fittingly, pharmacy education research in the academic setting has grown rapidly to provide innovative solutions to these challenges. One approach for addressing these challenges includes the collection and analysis of qualitative research (QR). Though a useful methodological tool, many pharmacy educators are not trained to appropriately conduct QR and present the findings of their work.

METHODOLOGICAL LITERATURE REVIEW

QR offers many advantages for pharmacy education researchers. However, prior to delving into QR projects it is important to understand the key distinctions of the approach, role of the researcher, and the significance of situating the study so that the research question, data collection techniques, and analysis procedures are aligned.

RECOMMENDATIONS

We provide recommendations for several key components for conducting QR, articulating the process, and presenting and contextualizing the findings.

IMPLICATIONS

This article serves as a primer on QR methods, offering relevant background information, ways to apply this approach in pharmacy education research, and recommendations for presenting qualitative findings. Employing rigorous qualitative approaches in pharmacy education and appropriately presenting the procedures and findings will increase the visibility of QR and provide an opportunity for scholars to become familiar with the approach.

A Systematic Review of Entrepreneurship in Pharmacy Practice and Education

Objective. To review literature pertaining to entrepreneurship in pharmacy practice, education, and the knowledge, skills, and attitudes (KSAs) identified for pharmacist entrepreneurs. Findings. In terms of pharmacy practice, entrepreneurship was most frequently identified with innovation and creativity to develop new opportunities for pharmacists. The most frequent role for entrepreneurship in pharmacy education was related to schools putting a greater emphasis on innovation, creativity, or divergent thinking. Risk-taking and creativity/innovation were the most frequently identified KSAs, with 17 (63.0%) manuscripts mentioning these as important for a pharmacist entrepreneur. Other KSAs pertaining to pharmacy entrepreneurship that were mentioned in the articles included self-starter, management, proactivity, communication, strategic planning, positivity, decision-making, teamwork, versatility, marketing, critical thinking, competitiveness, proposal development, numeracy, technology, self-reflection, persistence, social responsibility, and cultural competence. Summary. No consensus for entrepreneurship in pharmacy practice or education currently exists. In order to improve instructional design and assessment for pharmacy entrepreneurship education, a core set of KSAs for a pharmacist entrepreneur construct must be identified. The most commonly cited KSAs in related literature that are not already part of the Accreditation Council for Pharmacy Education standards include risk-taking, strategic planning, marketing, competitiveness, and social responsibility. These may serve as a starting point for enhancing pharmacy curricula to embrace pharmacist entrepreneurship.

Assessing metacognition in the classroom: Student help-seeking behavior

INTRODUCTION

The study's purpose was to develop an assessment of students' metacognitive monitoring of help-seeking behavior.

METHODS

This study piloted an assessment of help-seeking behavior in first-year student pharmacists to answer two questions: (1) Does help-seeking behavior depend on how familiar students are with the content? and (2) When students ask for help, does their performance and metacognition differ from when they do not seek help? As part of their year-end capstone, students answered drug information questions. The drugs within these questions were chosen based on the level of emphasis during the first-year curriculum (i.e. more familiar or less familiar). For each question, students rated their confidence level for their answer's correctness and marked whether they would ask their preceptor for help. Bias scores were calculated under conditions of familiarity based on level of emphasis (more familiar vs. less familiar) and help-seeking (asked for help and did not ask for help).

RESULTS

Students performed better on more familiar material (d = 1.2), with a small difference in confidence on more familiar material (d = 0.2). When students asked for help, they scored lower (d = -2.2) and reported lower confidence (d = -3.7). Students were more likely to ask for help from their preceptors on more familiar content than less familiar (odds ratio = 1.25) and less likely to ask for help when they were overconfident (odds ratio = 0.18).

CONCLUSIONS

Overall, students were more overconfident for less familiar material and were less likely to ask for help.