Hospital know-how

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Tomorrow's Pharmacist
2007:24-25
January 2007

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Hospital careers sector

Hospital know-how

Wasim Baqir, David Campbell, Alan Worsley and Rachel Etherington discuss a pilot programme that was set up for undergraduate students to experience hospital pharmacy

Careers in pharmacy

Wasim Baqir is a senior clinical pharmacist and chairman of the pharmacy audit and research group at Northumbria Healthcare NHS Trust, North Shields

David Campbell is chief pharmacist, Northumbria Healthcare NHS Trust

Alan Worsley and Rachel Etherington are senior lecturers at The Sunderland School of Pharmacy, Sunderland

• The programme

• Evaluation of the programme

• Discussion

Some time ago last year, pharmacy staff at Northumbria Healthcare NHS Trust (NHCT) and lecturers from Sunderland University school of pharmacy expressed concerns that many hospital preregistration trainees started their posts without any practical experience of hospital pharmacy. Furthermore, many students do not apply for hospital posts because of possible misconceptions they might have about hospital pharmacy. NHCT pharmacy and Sunderland University school of pharmacy decided to develop a pilot programme for undergraduate students to gain an insight into hospital pharmacy.

The programme

Senior pharmacists from NHCT and lecturers from Sunderland University school of pharmacy met to discuss the programme. It was agreed that the programme should be flexible with minimal structure so that members of the hospital pharmacy staff could adapt the teaching and experience around the needs of the student. It was agreed that the students would spend time with different types of NHCT pharmacy staff (pharmacists, pharmacy technicians and other support staff). Obtaining exposure to the many different staff types who work in pharmacy would help the students appreciate their roles, which is something that is not covered in the undergraduate course.

NHCT pharmacy services are based at three sites (North Tyneside, Wansbeck and Hexham General Hospitals). It was agreed that initially 20 students in two cohorts of 10 students would be shared across the three hospitals — four at North Tyneside, four at Wansbeck and two at Hexham. The programme would involve the student spending a morning a week at his or her chosen hospital for six weeks.

It was planned for the students to receive experience in a broad range of hospital pharmacy services (see Table 1). To ensure that the students got access to as many of these services as possible a timetable was developed for each site.

TABLE 1
Pharmacy Service	Type of experience
Dispensary	The student would gain an understanding of the various types of systems used for dispensing to out- and inpatients (eg, one-stop dispensing)
Medical and surgical wards	The students would shadow clinical pharmacists and pharmacy technicians on the medical and surgical wards to gain experience of the range clinical services provided (eg, taking of medicines history, ward rounds and working with other health professionals)
Emergency care	Experience of the emergency care multidisciplinary ward round and follow-up of patient
Clinical trials	The clinical trials pharmacist shows the student how pharmacy are involved in managing clinical trials (eg, patient dispensing, record-keeping, etc)
Medicines information	The medicines information pharmacist shows the student the type of queries received and how to get the information to answer these queries
Stores	The stores manager and staff show the student how stock is controlled and wards are supplied

Evaluation of the programme

At the end of the six weeks, students and staff were asked to complete a questionnaire exploring their views of the programme.

Eleven of the 20 students returned the questionnaires, with four being from North Tyneside, two from Hexham and five from Wansbeck. Table 2 shows questions and the student responses.

TABLE 2
Question	Responses
How was your hospital pharmacy experience?	9—Better than I expected 2—The same as I expected 0—Worse than I expected
Rate your experience of this six-week programme	7—Very good 4—Good 0—Average 0—Poor or very poor
Did you find the pharmacy staff approachable and helpful?	All 11 students said the found the staff helpful and approachable
Have you had experience in any other sector of pharmacy?	0—Hospital pharmacy 8—Community pharmacy 1—Industry 2—No previous experience of pharmacy
As a result of this experience, would you consider a career in hospital pharmacy?	8—Yes 0—No 3—I was always going to apply for a hospital post

The students were asked to list the best and worst things about their experience. These were categorised.

The best things were:

1. Seeing “real life” hospital pharmacy in a variety of settings
2. Observing the pharmacy team
3. Friendly and helpful staff

The worst points were:

1. Travelling time
2. Not enough time spent in the department

Students were asked if they would make any changes to the programme. The main changes they would make were:

1. More time (many students suggested a whole day)
2. Experience of more specialties (eg, oncology and psychiatry)

There were 24 questionnaires submitted by the staff, with 19 from pharmacists, four from technicians and one from an assistant technical officer.

The staff were asked to list positive and negative points relating to the programme. These were categorised and are shown in Table 3.

TABLE 3
Positive points	Negative points
1. Enthusiastic and interested students	1. Time consuming—especially during busy periods
2. Good opportunity to experience hospital pharmacy	2. Shadowing only—not interactive
3. Polite and professional students	3. Avoid first-year students
4. Careers promotion for hospital pharmacy	4. No written information for students
5. Two-way learning experience

The pharmacy staff stated they would make the following changes to the programme:

1. More structured programme (with aims and objectives)
2. Exclude first-year students
3. Identify an individual to manage students at each site

Discussion

A pragmatic, unstructured programme was used so that individual pharmacy mentors could tailor the experience around the student and the needs of the work-place. However, many of the staff wanted more definition for the programme. The organisers still believe that a rigid programme would be a barrier, however there are plans to introduce clear objectives for students and staff for the next cohort.

Both staff and students enjoyed the programme and provided many positive responses. It was seen as a positive sign that students wanted to spend more time in the department. The main concerns from the staff will be addressed with the next cohort. Specifically, the programme will be limited to third- and fourth-year students.

In summary, this hospital pharmacy experience programme, which has been easy to establish and implement using minimal resources, has proved to be successful, in terms of giving students an idea of how pharmacy operates and its role in the health care team.