|
Aamer Safdar, Shirley Ip and Angela
Gass are preregistration
tutors at Guy’s and St Thomas’ NHS Foundation Trust,
London
|
A lot has been written about the preregistration training year, the registration
examination, the qualities of trainees and their skills and knowledge,
but relatively little has been written about the preregistration tutor.
The preregistration tutor is the one person who takes responsibility
for the development of trainees and assesses them against the Royal Pharmaceutical
Society’s performance standards. It is the expectation of all tutors
that they will have provided a range of learning opportunities for their
trainees and that they are prepared and ready for the registration examination;
it is in no one’s interests if trainees fail the examination or
are not deemed competent at the end of the training year.
Many pharmacy managers may not always recognise the importance of having
to spend time with the trainees in order for them to grasp new concepts
or to develop their skills to provide new services. For many pharmacists,
the act of dispensing prescriptions accurately is something that comes
naturally to them. This is not always the case for preregistration trainees,
who may only have learnt this skill in the university environment without
the pressure of patients or customers waiting for their medicines. The
extra time needed to support the trainees is an investment for the future
but this is not always seen as important by the managers who are themselves
under pressure to meet targets.
Tutors must set aside time regularly to review trainees’ development
and must arrange formal meetings with them during the year for progress
reviews. This is usually an opportunity to discuss progress and any concerns
with the trainees. These concerns may relate to training opportunities
that have been provided or where further training needs are identified.
For a trainee who is finding it more difficult, this may take up more
time than planned for but is equally important.
Good trainees, who, it must be said, are in the majority, will embrace
the preregistration year and will provide enough evidence for the tutor
to make their assessment decisions fairly easy. There are always going
to be trainees who find it difficult to make the transition from being
a student at university to having to work in a professional environment.
It is often said by trainees that one year of training is not enough
for them to know everything that is required to be a pharmacist. This
is undoubtedly true, but one year should be enough to ensure that the
trainee has enough skills and knowledge to practise safely. Preregistration
tutors can do their trainees a disservice by signing off all the performance
standards too early in the year thus indicating that the trainee has
sufficiently met criteria. This is not only unfair to the hardworking
trainee, it is also unfair to the profession because it indicates that
a trainee is competent to be a pharmacist when he or she may not have
had enough exposure to practise.
Bearing in mind all these difficulties, why does one take on the role
of a preregistration tutor? Surely it must be easier not to bother and
do the work that is required rather than having to think about supporting
and developing someone else. Most preregistration tutors will say they
do this role because they are putting something back into the profession
by developing future practitioners. There is nothing more pleasing than
seeing the trainees that you have tutored become excellent pharmacists.
Even if they no longer keep in touch with colleagues at their preregistration
placement, most people remember their preregistration year. It is pleasing
to see the development of a student who arrives in your workplace with
lots of knowledge gained from university, who has not yet had the opportunity
to apply and develop that knowledge in the workplace, return to the organisation
as a fully fledged pharmacist.
Preregistration trainees are often at the bottom of the ladder in the
workplace hierarchy and often have no one to be their advocates; it is
usually the preregistration tutor who supports them to ensure they have
a fair deal. This is not always the case and there are tutors who see
the preregistration trainee as an extra pair of hands to do the work
that no-one else wants to do. While this work is important and trainees
can gain a lot of useful experiences, this may not always be appropriate
if the trainee is not going to be exposed to a wide enough range of learning
opportunities for them to be able to practise autonomously in the future.
The learning opportunities must be relevant to practice and be beneficial
to the trainee for it to be worthwhile.
Funding is important and trainees do not come cheap. In community pharmacy,
pharmacists can get up to £16,000 for each trainee to cover their
salary costs. This may be a useful incentive to employ a trainee but
the pharmacist must be able and willing to support the trainee to ensure
that they meet the requirements of the Society. In the hospital sector,
where financial difficulties remain, the preregistration trainee may
not be fully funded so will have to contribute to the work. There has
to be a balance between the amount of work that can reasonably expected
from a trainee and how much initial time will be invested to ensure that
the right skills and knowledge are imparted so that they can carry out
the tasks required of them. If this time is not invested then the trainee
may not be skilled enough to do the tasks accurately.
Finally, while managers may not always recognise the intangibility of
preregistration tutoring, most trainees are grateful when they have a
good tutor. The tutor will guide them through what can be a traumatic
year when they lose the comfort zone of being a student and head towards
the wider world. A good tutor will ensure that this transition is as
painless as possible and that the trainee is as prepared as he or she
can be to work as a pharmacist. Every pharmacist only needs to think
back to their first day in practice as a pharmacist to realise how well,
or not as the case may be, they were prepared for a life of being a pharmacist. |
The
Pharmaceutical Journal