FIP Congress 2006
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Roger Tredree reports from a session organised by
the Hospital Pharmacy Section and the Academic Pharmacy Section
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 The World Congress of Pharmacy and Pharmaceutical Sciences,
the 66th International FIP Congress, was organised by the International
Pharmaceutical Federation in association with the Federal
Council of Pharmacy of Brazil.
It took place in Salvador da Bahia from August 26 to 31, 2006
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How hospital pharmacists are trained for future practice
across the world
Jennifer Marriott, senior lecturer in clinical pharmacy
at Monash University, Melbourne, Australia reviewed the skills needed
by pharmacists in hospital
practice, such as communication, patient assessment and problem solving,
and discussed how these can be developed in undergraduates.
Students
practise these skills in experiential placements, where they also gain
workplace knowledge and see clinical activities first hand. In addition,
they can be exposed to a range of specialist activities, such as manufacturing,
clinical trials, research activity and distribution services.
Dr Marriott said that experiential learning, where learning is contextualised
in a
variety of practice settings, is one of the
major innovations in pharmacy teaching. Professionals can act as teachers
or preceptors providing support for these novice professionals. They
act as role models who demonstrate proper attitudes and behaviours.
Within their placements students can interact with individual patients,
and this is considered to be particularly valuable because it develops
students’ abilities to work with patients to ensure that they understand
their medicines, said Dr Marriott. Residency training in the US
Marianne Ivey, corporate director of Health Alliance Pharmacy Services,
Cincinnati, Ohio, described the US experience in residency training
and its importance in the development of hospital pharmacists. Residency
programmes are conducted to meet high quality training standards set
by hospital pharmacy practitioners. The American Society of Health-System
Pharmacists audits the residency programme and compares it with the
published standard.
A resident is mentored under the guidance of an experienced preceptor
in an organised, directed postgraduate training programme. The student
focuses on direct patient care and practice management over a one-year
period, which can be followed by a second year. The first year builds
knowledge, skills and abilities to enhance competencies in managing medication
use systems and providing optimal medication therapy outcomes for patients
with a broad range of disease states.
To be eligible the student must
have PharmD or BS with experience. They are paid $30,000 to $45,000.
The second year provides advanced training in a focused area of pharmacy
practice building on skills acquired in the first year.
Core outcome competencies are developed for each student and they are
given weekly evaluation and feedback. They are encouraged to self evaluate
and reflect on their actions. During this time the preceptor acts as
a model and mentor and can give particular training to accelerate learning.
Interactions with other disciplines and with real patients are key components.
Residents become self-motivated and open-minded — characteristics
necessary for leaders for tomorrow. They learn to function as team members,
can implement change, can evaluate and improve systems, and are patient-
centred. Residencies create practitioners for the future who are confident,
motivated and who will continue to develop professionally. In-house training in Ghana
Rebecca Nordor, from Ghana, tackled the in-house training
needs from a developing country perspective. Mrs Nordor emphasised the
need for
hospital pharmacists to update their knowledge and skills to match
changing trends in health care delivery.
However, this can be hampered
by limited resources to provide training outside the institution, so
structured in-house training must be provided. In developing countries
there is usually an inadequate health budget so it is difficult to
provide the minimum care for patients and medicines budgets are under
pressure. In Ghana there is a four-year bachelor of pharmacy degree,
during which undergraduates gain experience in work placements.
A two-year master of science in clinical pharmacy degree by distance
learning has been introduced and hospital pharmacists can be sponsored
for this programme. The West African Postgraduate College of Pharmacists
supports a programme for practitioners with at least five years’ experience,
for a duration of three to five years, leading to an award of fellowship
of the college.
Mrs Nordor said that with the introduction of these initiatives there
has been a dramatic paradigm shift from traditional roles to patient-centred
delivery of care. These courses are provided as internships, the goals
are to provide future pharmacists who can deliver quality pharmaceutical
care and espouse good ethical behaviour. Mrs Nordor described a sophisticated
in-house training curriculum which is similar to that provided in developed
countries.
Continuing education for pharmacy staff is provided at a half-day weekly
meeting. Update lectures are targeted at pharmaceutical sciences and
disease conditions. There is no funding for outside speakers so members
of the department make a financial contribution to provide honoraria
for them.
Adherence counselling is important in developing countries, especially
where there is a high incidence of HIV/AIDS. So FHI — a non-profit
international public health organisation — has started training
key health personnel, including pharmacists, on voluntary counselling. Specialisation in Europe
Jacqueline Surugue, from France, and president of
the European Association of Hospital Pharmacists, spoke on the new directive
relating to hospital
pharmacy specialisation in Europe — Directive 2005/36/EC on the
recognition of professional qualifications. This consolidates and modernises
the rules currently regulating the recognition of professional qualifications
and replaces the 15 existing directives in this field.
Its aim is to
harmonise training and give automatic recognition of professional titles
throughout the European Union. A basic diploma is required with a minimum
duration of studies (five years). The directive defines the acquired
knowledge and skills, the activities the basic diploma gives access
to, the course of training for pharmacists and the evidence of formal
qualifications.
Previous proposals for specialisation in hospital pharmacy have been
dropped because consensus could not be achieved. There are two ways forward,
said Mrs Surugue. The first is to use the concept of a “common
platform”, defined as “a collection of criteria on professional
qualifications able to bridge the substantial differences between the
training conditions in the different member states.” Secondly,
there may be “the possibility to present proposals for recognition
based on minimum common training in view of a future directive”.
Mrs Surugue explained the various stages involved in taking these ideas
forward, including an overview of current training for specialisation
in hospital pharmacy across Europe. The apparent disparities indicate
the complexity of the task ahead in finding common ground when the working
groups begin next year. |
The
Pharmaceutical Journal