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The Pharmaceutical Journal Vol 265 No 7114 September 16, 2000
Pharmacy Practice Research
Papers presented at the British Pharmaceutical Conference, Birmingham, September 10 to 13, 2000 pR75

Integration of pharmacy audit participation within continuing education: a national initiative

By F. MacRae, R. M. Parr* and M. Bennie&134;

Introduction The Royal Pharmaceutical Society in Scotland has issued guidance to pharmacists which recognises that clinical audit and continuing professional development (CPD) are essential components of clinical governance.1 CPD is a cyclical process of reflection, planning, action and evaluation, requiring motivation for both service and self improvement through continuing education (CE).2,3 Pharmacists have a personal commitment to undertake at least 30 hours of CE per annum and community pharmacists in Scotland have a contractual requirement to undertake clinical audit.
However, data suggest that levels of pharmacy participation in audit and structured CE have scope for improvement. Annual pharmacy participation in CE accredited by the Scottish Centre for Post-Qualification Pharmaceutical Education (SCPPE) lies at 69 per cent (SCPPE in-house database, 2000), while a 1998 survey of Scottish community pharmacists reported an overall audit participation rate of 57 per cent (11 per cent participation in multi-professional audit).4 Previous work has also identified that pharmacists may view audit in isolation from other professional activities and perceive a lack of incentives to stimulate audit participation.5
This paper describes a scheme that has been established to link CE and audit activity within CPD. The scheme, designed by a project group which includes members of the SCPPE and the Scottish Pharmaceutical Audit Facilitator (SPAF) Group, was launched in April, 2000.

Method The scheme required the introduction of an accreditation process to award CE time credits for participation in audit activity. The process included: definition of audit projects eligible for inclusion within the scheme; standardisation of CE time credit to be awarded for baseline audit and re-audit activities; documentation to support pharmacist self-reflection and verification of audit participation; and a system for monitoring uptake of the scheme and evaluating outcomes. The structured self-reflection documentation (CPD form) was piloted in a purposive sample of 10 community pharmacists.

Focal points

  • Continuing professional development requires integration of clinical audit and continuing education
  • Pharmacist participation in audit and, clinical (multiprofessional) audit in particular, leave scope for improvement
  • A national scheme endorsed by the Scottish Centre for Post-Qualification Pharmaceutical Education has introduced an accreditation process to recognise audit within the range of continuing education activities
  • Continuing education credits for audit activities now form part of an integrated system to support pharmacist participation in audit

Results The criteria for audit eligibility include: a methodology approved by an audit facilitator; an audit already endorsed by the Society; and one of the six audit templates designed by the project group specifically to support multiprofessional audit. CE time credits of 5 hours for undertaking a baseline audit and 2.5 hours for a re-audit have been assigned. The CPD forms record what pharmacists set out to achieve, the outcomes of audit participation and evaluate personal learning experiences. The rate of return of CPD forms will provide a quantitative measure of uptake of the scheme, with success having been internally defined as receipt of 100 completed CPD forms within the first 12 months. Qualitative review of documented CPD outcomes will further enable monitoring and review of the scheme by the SPAF group and SCPPE.
Copies of the CPD forms are accessible to community pharmacists via the SPAF network, and via the SCPPE and Society websites.

Discussion The Government has made a clear link between professional self-regulation, CPD and clinical governance. The health care professions are given the challenge of implementing methods for improving clinical effectiveness through increasing the quantity and quality of participation in CPD. This scheme, introduced in Scotland, aims to overcome the tendency for pharmacists to view audit in isolation from service provision and CE.
The ultimate goal is to improve participation in multidisciplinary audit. In view of this goal, the evaluation of the success of the scheme will require further quantitative and qualitative research after a period of implementation and development.

Acknowledgment: The authors wish to acknowledge national project funding (1998-2000) from the Clinical Resource and Audit Group, Scottish Executive.

Scottish Department, Royal Pharmaceutical Society of Great Britain; *Scottish Centre for Post-Qualification Pharmaceutical Education, University of Strathclyde, Glasgow; &134;Lothian Education, Research and Development Service, Edinburgh, and the Department of Pharmaceutical Sciences, University of Strathclyde, Glasgow

References

1. Achieving excellence in pharmacy through clinical governance: Royal Pharmaceutical Society in Scotland's policy on clinical governance. Edinburgh: the Society; Jan 2000.
2. Continuing professional development: pilot scheme documentation. London: Royal Pharmaceutical Society education division; 1999.
3. Lucas M. Continuing professional development: improving yourself and your service. Pharm J 2000;264:16-417.
4. MacRae F, Bennie M. Development of an action plan to support the integration of pharmacists into the primary care clinical audit team within Scotland. Pharm J 1999;263:R52.
5. Clinical Resource and Audit Group. Establishing pharmacist participation in multiprofessional audit. Six-month report of CRAG National Project CA97/15. Edinburgh: Scottish Executive; 2000.