President advocates shared teaching for health care
The President: do we expect too much? |
The President of the Royal Pharmaceutical Society, Gill Hawksworth, advocated shared education for health professionals when she spoke recently to an audience of pharmacologists and physiologists. She suggested that it was asking too much to teach student health professionals separately and then expect them to work effectively in multiprofessional teams.
Speaking in Manchester on 28 April, Dr Hawksworth said that health care
has become, and will continue to be, complex and no one profession or
professional can be the sole authoritative voice in treating and preventing
illness. “Health care professionals must work as teams in a ways
we have not done before,” she continued. This offered them all
the opportunity to explore and develop shared values and also to harness — and
indeed celebrate — areas of particular knowledge or skill for the
benefit of patients.
“However”, she continued, “the current generation of
medical, pharmacy and pharmacology students are still, in the main, taught
separately,
and yet we expect them go into the workplace and to forge useful multiprofessional
patient-focused teams — are we expecting too much? Evidence suggests
that team-working needs to start early so that students and young professionals
can, through their learning and training, come to respect each other’s
knowledge, skills and abilities, and ensure that teamwork is effectively
embedded into their professional practice. Ongoing experiments in common
learning between professional groups are beginning to explore what does
and does not work in implementing inter-professional learning.”
Dr Hawksworth was speaking as chief guest at a dinner during a joint
meeting of the Committee of Heads of Pharmacology and the Committee of
Heads of Physiology. She had been invited to speak by the chairman of
the former committee, Professor Brenda Costell, who is head of the school
of pharmacy at the University of Bradford. Other guests at the dinner
included the chief executive of the Medical Research Council, Colin Blakemore.
After outlining developments in pharmacy practice, Dr Hawksworth went
on: “The students and young pharmacists we are training today will
be entering into a different world in which a medicines management role
will be a major part of their practice. The extended role of the dispensing
technician,
e-pharmacy and robots will aid the processes of dispensing, enabling
pharmacists to make best use of their extensive knowledge, which in my
opinion has so far been underused for far too long. It is impossible
for a medical student, within the time of their training, to develop
the deep knowledge gained by a pharmacist during four or five years of
education and training focused on medicines and how they are formulated
and used.
“No one professional can hope to know all there is to know about
all medicines as well as diagnostic tests and disease mechanisms and
causes — it
is just asking too much. The speed of developments makes it difficult
to keep up to date in just one of these areas, but we all have to work
smarter, pool knowledge and share responsibility for the quality of care
we deliver. For this to be effective there has to be trust between the
different professionals and confidence in each others knowledge, attitudes
and skills.”
The changes in pharmacy would have a considerable impact on the teaching
of physiology and pharmacology, Dr Hawksworth said. “For a long
time pharmacy has been taught as an amalgam of independent subjects:
of pharmaceutical chemistry, pharmacology, pharmacognosy and pharmaceutical
technology. Pharmacy practice, effectively a new subject just 20 years
ago, continues to develop and grow each year with the increasing emphasis
on clinical skills.”
Extensive research and consultation suggested that pharmacists would
follow increasingly complex career paths into specialised areas of practice
in all sectors of the profession and develop broad management and leadership
roles in the NHS. Community pharmacy offered growing opportunities to
broaden the generalist role to include health development practices and
services as well as to develop specialist clinical services.
An emerging theme was the critical part that the academic workforce would
play in sustaining the profession’s emerging opportunities. Pharmacy
schools were failing to entice pharmacists to take up careers in academia.
Delivering high quality research, teaching and, in the case of clinical
academics, patient care, was a challenging agenda that many recent graduates
simply did not want to pursue. “This”, said the President. “is
a cause of growing concern and could be a real rate limiting step in
delivering the developmental agenda that the profession wants and the
government is demanding.” A key development would be sustained
funding for clinical placement programmes across all the schools.
Dr Hawksworth envisaged a health care system in which different types
of pharmacists would require different levels of input from other health
care professionals. But one thing in common to all aspects of pharmacy
practice was that all would be handling medicines and advising patients
on how to use their medicines properly. However, she added, “they
will be unable to do this without a sound knowledge of the physiology
and pharmacology underpinning the way that medicines work.” Working
together, the health professions could create a health care team with
greater knowledge, greater skills, and greater capability to handle medicines
so that people could be treated with greater safety.
Concluding, Dr Hawksworth said: “The way our students will operate
as graduates will be very different from anything we have experienced,
so there is a big burden on us to ensure that the education we provide
will equip the health care professionals of the future.”
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The
Pharmaceutical Journal