Pharmacy Education
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Pharmacists from community practice, hospitals, industry and academia as well as technicians, independent consultants, administrators and politicians participated in this one-day symposium to help inform the development of a strategy for pharmacy education. The symposium was organised by the Royal Pharmaceutical Society, the Academy of Pharmaceutical Sciences and the Academic Pharmacy Group, and held at the Royal Pharmaceutical Society, London, on 17 November. Dr
Joseph Chamberlain, former editor of The Journal
of Pharmacy and Pharmacology, reports
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Is pharmacy education
in crisis,
or is it simply changing? Professor Bill Dawson (Bionet Ltd), an independent consultant who is
currently working at the interface between academia and industry on educational
policies, thought that pharmacy education was at a crossroads. The profession
needs to see the wider picture in education with more and better communication;
government policy towards education is changing, as typified by the National
Health Service skills escalator, and there is an opportunity for the
profession to be proactive, engaging in the many consultation opportunities
on offer. These consultations include the Higher Education Funding Council
for England review of research funding and of funding methods for teaching,
the Department of Education and Skills review of the future of higher
education and the qualifications for 14- to 19-year-olds, and the Department
of Trade and Industry national skills strategy as well as parliamentary
select committees on research councils. Government funding is spread
across three ministerial groups (DfES, DTI and the Department of Health),
but it is up to the profession to be proactive in improving the situation.
Professor Dawson addressed the question of how pharmacy education will
be provided in the future. Pharmacy education may not be the preserve
of schools of pharmacy, with education being acquired elsewhere, such
as through higher education institutes, by training in the pharmaceutical
sciences or by being a Qualified Person. It should not be assumed that
schools of pharmacy will continue in their present form. The European
dimension may result in procedures being imposed on United Kingdom pharmacy
and Professor Dawson believes strongly that UK pharmacy should inform
Europe on this matter rather than wait for directives to be imposed.
Other stakeholders outside the immediate circles of pharmacy, include
the Learning and Skills Council, the Sector Skills Council, regional
development agencies, education and business partnerships, and employers
and their organisations such as the Association of the British Pharmaceutical
Industry, the National Pharmaceutical Association and the NHS.
There is a range of important questions which need resolution. Should
the Royal Pharmaceutical Society be responsible for this dialogue, and
if so should its role be advisory or regulatory? Should the debate be
wider than that offered by an annual meeting between heads of schools
and the Society? Although educational methods should be systematic in
their application, there must always be room for the individual to push
at the boundaries in an entrepreneurial spirit, Professor Dawson said.
We need to recognise increasing diversity in education
Professor Denyer: research and teaching balance does not need to
be the same in all establishments |
The limit for planning in universities is much shorter than 20 years,
said Professor Stephen Denyer, Cardiff University. By 2010, the government
goal of 50 per cent of young people in higher education would be achieved
by the development of foundation courses. Courses would be more flexible
allowing part-time study and exit and re-entry by students; workplace
experience would be a dominant factor in obtaining qualifications.
The Roberts review of the research assessment exercise clearly recognised
existence of “least research-intensive” institutions which
nevertheless needed funding. Professor Denyer compared the research and
teaching profiles of two schools, both rated five in the research assessment
exercise, and concluded that diversity already exists. Because more funding
is allocated to higher rated institutions, there is a funding drift towards
high-rating organisations so the sustainability of research in other
organisations is lessened. Even so, some institutions that receive only
a few per cent of funding for research are hoping to establish schools
of pharmacy. There is growing competition for good quality students and
staff, and Professor Denyer envisages that schools of pharmacy will need
to recruit students, rather than select them, and individual staff will
become subject to performance rating with local pay agreements also being
introduced.
There are forces that will drive the future size and profile of the pharmacy
workforce, and these must be taken into account now as students are accepted
and courses are designed. Relationships with other health care professionals
will need to be addressed, recruitment and retention policies, perhaps
bearing in mind local requirements, must be established and there needs
to be an appreciation of career development and skills acquisition.
The mission statements of schools of pharmacy need not depend on research.
The research and teaching balance does not need to be the same for all
establishments; there is little evidence that quality is affected by
change in that balance. The Government will look for centres of teaching
excellence. There will be closer links between higher education and the
local economy, with the former often being funded by the latter.
Other notable features of pharmacy education in the future will be a
common core for all health care practitioners, more postgraduate specialisation,
multiprofessional health care learning environments, increasing expectations
for practice placements, increased reliance on teaching technologies
and a changing profile of academic staff.
There will be inevitable consequences for the accreditation criteria.
Curriculum development aimed at broadening access will increase; there
will be a move away from the full-time degree course, and a significant
research project will no longer be required. Autonomous schools or departments
of pharmacy will be replaced by membership of larger institutions and
the teacher-practitioner involvement will increase.
We need to recognise, as a professional body, that there is increasing
diversity in education and we need to decide how we accept and drive
this diversity, Professor Denyer said.
Pharmacy graduates: should they be
practitioners or scientists?
Should the pharmacy graduate be a practitioner or a scientist? Three
short papers were presented giving the views of individuals from different
sectors of pharmacy.
As a community pharmacist, Liam Stapleton, Boots The Chemists, argued
that the pharmacist was a member of the health care team and hence was
primarily a practitioner. Nevertheless there must be a strong scientific
basis underpinning this practitioner role.
Rupi Pannu, AstraZeneca, said that, in theory, all MPharm graduates should
be trained in both attributes regardless of the final specialist area
but, in reality, experience within research and development suggests
new graduates have a poor scientific approach, poor laboratory skills
and minimal specific knowledge required for R&D. Undergraduate degrees
focus predominantly on community and hospital aspects with no real teaching
on scientific principles and methodology. Students are spoon-fed just
to pass examinations. The industrial environment expects excellent verbal
and written communication skills from the graduate, good planning and
organisation skills, the ability to work as part of a team, flexibility,
enthusiasm and initiative. The graduate must bring the scientific attributes
of questioning, challenging, problem-solving, lateral thinking, reasoning
skills, laboratory skills and skills in experimental design and appraisal.
Julie Sowter, Leeds University, gave the view of a hospital pharmacist.
When a new pharmacist joins the health care team, hospitals want a person
with sound scientific knowledge, interpersonal skills and an enquiring
mind, but with an understanding of the roles of other members of the
team and where pharmacy fits in. The new graduate should be clearly aware
of his or her career pathway. The pharmacist is expected to provide in-depth
knowledge of pharmacological principles as applied to the whole body,
and knowledge of pharmacokinetics and pharmaceutics, Ms Sowter said.
The ideal graduate should have early exposure to practice, patients,
practising pharmacists and other health care professionals.
Pharmacy could fall behind other professions if foundation degrees are
not implemented
A foundation degree is an employment-related higher education qualification,
probably with input on the syllabus from employers. It can be a springboard
to career development or further education and employs flexible learning
systems.
The course consists of 240 credits (equivalent to two-thirds of an honours
level degree). Many such courses are available nationally. Dr Joan Taylor,
De Montfort University, described the foundation degree in pharmacy as
implemented by the People’s College, Nottingham and the Leicester
School of Pharmacy.
The degree is designed for two years of full-time study, but more usually
takes three to four years part-time with some study in the workplace.
Employers are likely to support the degree because it is patient-centred
(in line with the NHS pharmacy plan) and it is staff-centred (in line
with the NHS skills escalator).
The degree formalises technician roles, allows specialisation, progression
and evolution, increases professional interaction, and improves patient
care and safety. Dr Taylor suggested that if we do not implement foundation
courses in pharmacy, then formal training will depend on others, in-house
training may not benefit from a spread of best practice updates, and
pharmacy could trail behind other professions in providing stepping stones
to professional goals.
Changing the MPharm course content
Sue Jones described experiences in changing the content and delivery
of the MPharm degree at King’s College London.
The existing MPharm course had a traditional structure of a foundation
course up to Christmas in the first year, followed by four separate streams
(sources and chemistry of drugs, dosage form design and manufacture,
the scientific basis of therapeutics, and pharmacy practice), with a
research project in the fourth year.
Compartmentalisation was thought to result in students not recognising
the full importance of various facets of the education process and a
new course was implemented in September 2002.
The first year involves a pharmacy orientation course, interprofessional
education, essential skills, principals of pharmacy (chemistry of drugs,
physical pharmaceutics, biochemical basis of therapeutics, pharmacy practice
and biopharmacy, law and ethics). The second and third years will include
topic-based teaching, and integration of knowledge and skills. The fourth
year is still being finalised but will concentrate on pharmacy in practice,
a project, electives and preparation for practice, with updates in clinical
and practice pharmacy.
Initial feedback from students has been excellent, particularly in the
appreciation of the importance and interrelation of previously isolated
elements, said Ms Jones.
Workshop sessions
Professional training or science education? Eileen Neilson, Royal Pharmaceutical
Society, reported on the workshop discussions relating to the broad question
of professional training or science education.
Professional training and science education needs to be integrated and
there is a core of knowledge that all pharmacists need. Industry would
not be happy with the idea that specialisation for pharmacists would
not come until after the initial education.
Should the teaching base be research-informed? Dr David Wright, University
of East Anglia, began with an emphatic yes to the question of whether
the teaching base should be research-informed, but required justification
for this view. Literature reports were not clear-cut, with there being
equally persuasive surveys for the positive, negative and neutral effects
of the research background of teaching institutes.
Nevertheless, the group considered that a new school of pharmacy should
not be allowed to open if it did not intend to be research active. There
were tangible benefits to delivering research-informed teaching, such
as the transfer of skills from one generation of teachers to the next,
inculcation of a better understanding of research, experience in problem-solving,
and the positive effect of an enthusiastic teacher. Even with an indicative
syllabus there is a need for imparting knowledge that was not closed
or settled.
Does accreditation stifle innovation? Professor Ian Marshall, Caldarvan
Research, reported that the workshop group gave a firm no to the question
of whether accreditation stifles innovation, and indeed pressed the opposite
view. The process of accreditation enabled non-pharmacy academics to
appreciate the profession of pharmacy and accreditation was helpful in
achieving extremely good scores for the institutes in quality assurance
exercises.
The group emphasised that innovation and diversity can be achieved within
the existing criteria. However, with the number of schools of pharmacy
set to rise to perhaps 30, it was strongly believed that the Royal Pharmaceutical
Society needed to allocate more resources to the accreditation process.
Push for funding
A lively closing discussion emphasised the crucial need for science to
underpin the pharmacy degree, but the two aspects of practice and science
must be taught as an integrated specialty called pharmacy.
Although some thought it was perhaps too much to expect a fully formed
pharmacist at graduation, there are certain expectations that were not
being met and the view was expressed that the lack of funding, particularly
for laboratory experience was not an acceptable excuse; we must push for
the necessary funding — that is our responsibility for the future,
said Professor Bill Dawson. |
