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In some people’s minds the quality of all pharmacy degree courses
was called into question when the Times Higher Education Supplement published
a story on the school of pharmacy at De Montfort University, which revealed
that underperforming students had been allowed
to progress despite concern from staff and external examiners
(PJ, 29 April, p493).
There are, in fact, a number of mechanisms in place to maintain the quality
of pharmacy degree courses provided by universities in the UK. These
mechanisms encompass the universities’ own standards, including
the appointment of various boards and external examiners, accreditation
by the Royal Pharmaceutical Society and review by the Quality Assurance
Agency for Higher Education. Together, these systems aim to secure appropriate
comprehensive standards to ensure pharmacy graduates are prepared for
preregistration training.
The Society’s role
The Society’s accreditation process varies for new and existing
schools. Existing schools are visited by a team of the Society’s
accreditors at least every five years whereas new schools are subject
to a seven-year process (see Panel).
Accreditation of new courses
Accreditation of new courses begins three years
before the school plans to accept students. First an enquiry
is lodged with the Royal
Pharmaceutical Society. This is followed two years before the course
is due to start by an accreditation visit by the Society to assess
the university’s business plan. One year before the course
begins the Society visits to assess the curriculum.
The school is then visited every year for each of the first four
years that the MPharm is delivered so that a cohort of undergraduates
can be followed from enrolment to graduation.
Subsequently the new school is treated as an existing school and
is visited at least every five years. |
Damian Day is head of accreditation at the Royal Pharmaceutical Society
and is responsible for the overall process. “We can, and do, visit
more often if issues come to light or if, for example, we know that something
major is happening, such as the university is moving. So, if there is
anything that we know might impact on the length of accreditation then
we can visit earlier.”
The accreditation team is compiled from a panel of experts and consists of a
team leader (who is a senior pharmacist), at least one pharmacy academic, one
pharmacist from each of the hospital, community and industrial sectors and one
lay member. Accreditation visits take two days and schools are judged against
101 criteria, all of which must be met (see Panel).
101 conditions must be met to gain Society accreditation
There are 50 degree accreditation criteria, which include prerequisite
criteria that are requirements of the EU, a single criterion relating
to degree course entry requirements (that entrants must have achieved
GCSE at grades A to C, or equivalent qualifications, in English
language and mathematics) and criteria organised as required outcomes,
required processes and required structures.
The criteria cover graduate attributes, processes relating to the
student (such as gaining experience of practice) and to the degree
course (such as students being taught alongside other health care
professionals) and structures (such as the school having appropriately
expert academic staff).
The remaining 51 items are in the form of the indicative syllabus
for UK pharmacy degree courses. The syllabus covers the patient,
drug action, the drug substance and the medicinal product, health
care systems and the role of professionals, and how health care
and pharmacy operates in the wider world.
“Accreditation of UK pharmacy degree courses” lists all criteria
in detail and is available via the Royal Pharmaceutical Society’s
website |
Mr Day explains that universities are contacted one year ahead of a
visit so that they have time to prepare. First, the university has to
demonstrate
in documents how it believes it has met each of the assessment criteria.
Then the accreditation team visits the university and talks to a cross
section of staff and students to verify the university’s claims.
“The visiting team talks to every level of staff from vice-chancellor
down to technicians in the laboratories. We also see students,” explains
Mr Day.
A report is then compiled and this is considered at a meeting of the
Society’s education committee, which exercises the Society’s
statutory education powers.
Sanctions
Mr Day says that the committee can recommend one of three courses of
action. It can accredit the course for a maximum of five years — this
is usually subject to conditions that should be met before the next
academic year starts. The committee can place the university on probation — in
order to do that there must be evidence that one or more criteria will
not be met. Or, in extreme circumstances, accreditation can be withdrawn
or denied.
“The strength of the accreditation system is that it is a strictly
criteria-based process. This is what makes it robust,” says Mr Day.
He emphasises that the process is entirely objective. “There are
criteria which are either met or are not met and, if they are not met,
then we step
in.”
Over the past 10 years, the Society has placed three universities on
probation. “One university nearly had its accreditation withdrawn
several years ago because the Society was so concerned about its resource
levels. But in the end the university complied,” says Mr Day. Another
university was placed on probation for one year and one university — De
Montfort — is currently on probation.
If a university is put on probation, the Society specifies certain conditions
that it must meet and by when it must meet them, in order to have its
probation rescinded, explains Mr Day. “There is a process of following
up on what we required [them to do]. We check that they have complied
in the timescale that we required of them.” He adds that the Society
always reserves the right to enquire should any issue arise but that
issue must make one of the criteria vulnerable, ie, it will not be met.
The criteria are wide ranging and cover every aspect of the course, including
what is taught, academic standards, staffing levels and financial issues.
“If you look at it as a process it is equivalent to that of other health
care regulators. We have benchmarked it widely and it is certainly among
the best there is around,” says Mr Day. He stresses that the Society
exercises the full range of sanctions when necessary. “In the past
year we have accredited [some] universities for a full five years, [others]
for less than five years and in one case for only one year.” Examples
of issues that may lead to a university being placed on probation include
a drop in staffing levels, a drop in finance or a complaint from the
external examiners about academic standards. External examiners
Sandy Florence, former dean at the School of Pharmacy, University of
London, explains that it is part of the professional activity of an
academic institution to ensure that the highest standards are achieved. “The
university degree is a science degree regardless of the Society’s
accreditation. So there is an absolute responsibility on the university
to ensure that standards are maintained.” He adds: “What
is often more difficult is to decide what to put in the curriculum.
But once that is decided, and there is uniformity of view on that,
then standards are
maintained.”
All schools of pharmacy appoint external examiners from existing schools
of pharmacy. These examiners offer an independent opinion on the curriculum,
examination papers and individual students. “They are made aware
of the nature of the syllabus and the curriculum, they look at draft
examination papers to see whether they appear to be of the right standard
and check if there are inconsistencies,” says Professor Florence.
The external examiners review the examination papers, check the range
of marks and see if there are difficulties with particular questions
or papers. “A crucial role is in looking at those borderline students,
by conducting a viva or looking again at their papers to confirm whether
they should fail or pass, or pass with a warning,” explains Professor
Florence. Academic boards
Universities also appoint academic boards to monitor the quality of
courses. Gavin Brooks, head of school at the University of Reading, explains
that there is a hierarchical board structure at Reading university.
The structure starts at modular level with each module having a co-ordinator
who is responsible for determining the quality and content of the module.
At a programme level there is a board of studies, which meets once
a term and reviews how well different modules have performed against
prespecified indicators. The next level up is the faculty board for
teaching and learning, which in turn reports to the university board
for teaching and learning.
At Reading the pharmacy board of studies is chaired by the director
of teaching and learning and comprises the head of school, directors
of
each discipline, an academic member of staff from another department
within the university and an external person from Royal Berkshire Hospital.
The school also has an examination board, which meets to review examination
results and decide which students must resit and which must be asked
to leave the course. External examiners attend examination board meetings
and all members of staff are also encouraged to attend.
Professor Florence explains that if there are extenuating circumstances
for particular students then the examination board meeting is where they
would be raised. “There are rules in each university as to the
extent to which the marks of an individual can be moved because of illness
and other problems. Under normal circumstances marks below 35 or 37 per
cent are not considered for compensation,” says Professor Florence.
He explains that compensation can be applied when someone obtains, for
example, 60 per cent in three modules and 38 per cent in one module. “Compensation
is something I was never happy with. I believe that prowess in pharmacology
should not make up for lack of prowess in pharmaceutics,” he says. QAA
The Quality Assurance Agency for Higher Education (QAA) was established
in 1997 to provide an integrated quality assurance service for UK higher
education. It carries out institutional audits of universities and
other establishments every six years. It also publishes a code of practice
for the assurance of academic quality and standards in higher education
(available at www.qaa.ac.uk).
Until this year the agency also conducted subject reviews, which were
similar to accreditation visits. However, since 2001 a slimmer version
of subject reviews, involving a half-day assessment visit, has been in
operation and from the next academic year (2006–07), the agency
will no longer be conducting these reviews. Mr Day comments: “The
crucial difference between the Quality Assurance Agency and the Society
is that the QAA looks at university processes and we look at the course
itself. The Society’s accreditation visits now offer the only sustained
look at the MPharm course.” Holistic approach
Professor Florence believes that an accreditation system, like that
provided by the Society, is needed to ensure that there is some commonality
between courses. However, he believes that the accreditation visits
generally look at systems and he would like to see more debate about
the nature of what is taught and how it is taught. “[Accreditation]
is a system we need but it does not ensure uniformity. In my opinion,
there is not enough comparative data used.”
Professor Florence also believes that there is a tendency not to look
at the school as a whole. “The visits often look at the teaching
element, whereas if the school or department has a high financial turnover
and large research cohorts, then this brings a lot of expertise into
the school, which filters down to the undergraduate curriculum. This
is not really considered.” A more holistic view of institutions
needs to be developed, he adds. He suggests that questions that need
to be asked include: has the school got a good research base? Is the
income base right? Has the head of the school got control over the finances
to the extent that he or she is not dependent on the wider faculty within
which the school sits?
Professor Brooks believes that having the Society’s accreditation
system ensures that the quality of pharmacy courses is as high as it
should be. “It is also a useful mechanism for reminding and aiding
the powers that be that certain things have to be adhered to,” he
adds. Research
Mr Day argues that although universities are mapped against their own
claims and the Society’s criteria, the Society does have an appreciation
of the wider sector: “We survey the universities every year to
look at things like finance and staffing.” He adds that the Society
also conducts research into things like the academic workforce, projected
increases in student numbers and how that might affect preregistration
placements and workforce opportunities, and emerging trends in schools
and research. “I would argue that we do more research into education
than most equivalent health care regulators,” he says.
The Society is currently conducting a full pharmacy education review
programme called “Fit for the future”. It encompasses a review
of the MPharm, preregistration training, postregistration training and
continuing professional development.
The review coincides with the Government’s consultation on the
draft Pharmacists and Pharmaceutical Technicians Order, under Section
60 of the Health Act 1999, which is likely to give extra statutory powers
to the Society relating to CPD. Checks and balances
Professor Florence believes that there are enough checks and balances
within established schools that major problems should not happen. “There
should be enough warning signals from the director of undergraduate
studies, the head of department and the academic board to alert the
dean to a problem before an accreditation visit takes place,” he
concludes. |
The
Pharmaceutical Journal