Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK.
School of Health Sciences, The University of Manchester, Manchester, UK.
Health Soc Care Community. 2022 Nov;30(6):2330-2340. doi: 10.1111/hsc.13783. Epub 2022 Mar 15.
The Pharmacy Integration Fund commissioned 95 cross-sector pre-registration trainee pharmacist placements across England, which incorporated trainees spending 3-6 months in general practice (GP), whilst employed in hospital or community pharmacy. Delivery models varied (blocks or split weeks/days); trainees had pharmacist tutors at the employing/base (hospital/community pharmacy) organisation and in GP. This study aimed to evaluate implementation of cross-sector pre-registration placements, and to identify barriers and enablers of a "successful" placement that achieved its intended outcomes. A qualitative study was undertaken, using semi-structured interviews with triads/dyads of trainee and pharmacist tutors at base and/or GP site. Interviews explored trainees' and tutors' GP placement experiences, and the contribution of GP placements to achieving intended learning outcomes. Data were thematically analysed. Thirty-four interviews (14 trainees, 11 base tutors, 9 GP tutors) were completed in 11 study sites (5 GP/hospital; 6 GP/community pharmacy). GP placements were perceived as valuable and producing well-rounded pre-registration trainees with a good understanding of two settings. Key benefits of GP placements were trainees' ability to work within multidisciplinary teams, and improved clinical and consultation skills. Contingency planning/flexibility was important when setting up cross-sector placements. GP tutor supervision which supported a gradual transition from shadowing to more independent clinical practice with feedback was perceived as valuable. Good collaboration between tutors at the base and GP site ensured joined-up learning across settings. All participants considered 13 weeks in GP an appropriate minimum duration; community trainees preferred longer duration (26 weeks) for more opportunities for clinical and consultation skills learning. Base and GP tutors would welcome clarity on which pre-registration competencies should be achieved in GP placements, which would also aid quality and consistency across providers. Findings from this study identified key attributes of a successful pre-registration cross-sector training experience. These findings can inform policy reforms including changes to initial education and training of pharmacists.
药学整合基金在英格兰委托了 95 个跨部门预注册培训药剂师实习岗位，其中包括培训生在医院或社区药房工作的同时在全科医生（GP）实习 3-6 个月。交付模式各不相同（块状或分周/日）；培训生在受雇的（医院/社区药房）组织和 GP 有药剂师导师。本研究旨在评估跨部门预注册实习的实施情况，并确定实现预期成果的“成功”实习的障碍和促进因素。采用半结构化访谈的定性研究方法，对基地和/或 GP 地点的培训生和药剂师导师进行三人/二人小组访谈。访谈探讨了培训生和导师在 GP 实习的经验，以及 GP 实习对实现预期学习成果的贡献。对数据进行了主题分析。在 11 个研究地点完成了 34 次访谈（14 名培训生、11 名基地导师、9 名 GP 导师）（5 家 GP/医院；6 家 GP/社区药房）。GP 实习被认为是有价值的，可以培养出全面的预注册培训生，使他们对两个环境有很好的了解。GP 实习的主要好处是培训生能够在多学科团队中工作，并提高临床和咨询技能。在设置跨部门实习时，应急计划/灵活性很重要。GP 导师的监督支持从观察到更独立的临床实践的逐步过渡，并提供反馈，这被认为是有价值的。基地和 GP 地点的导师之间的良好合作确保了跨环境的学习衔接。所有参与者都认为在 GP 实习 13 周是一个合适的最短时间；社区培训生更喜欢更长的时间（26 周），以便有更多机会学习临床和咨询技能。基地和 GP 导师将欢迎明确在 GP 实习中应达到哪些预注册能力，这也将有助于提高各个提供者的质量和一致性。本研究的结果确定了成功的预注册跨部门培训经验的关键属性。这些发现可以为政策改革提供信息，包括对药剂师初始教育和培训的改革。
