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The Pharmacy Vocational Training Scheme

Learning from experience, learning in practice.

VT2 General and VT3 Specialist training

July 2015

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ContentsBackground and introduction 3

Requirements prior to starting the different stages of Vocational 4Training

Vocational Training : VT2 training – Generalist training 6

VT2 training : Generalist training guidance for completion of the VT2 framework (V7 Sept 2015) 12Professional and Personal practice 13

The Clinical Pharmaceutical Care of patients 13

Ensuring the Safety of Patient 15

Cost Effective Use of Resources 16

Dispensing of Prescriptions 16

Education and training and Development 17

Dispensing of Aseptic products 18

Information about Medicines 19

VT2 : FAQs by tutors and trainees 19

VT2 : Guidance on activities 26

VT3 : Specialist training 29

VT3: FAQs about VT3 training 32

VT2 and VT3 : FAQs about mini – CEX and CbDs 38

VT2 and VT3: FAQs about how to complete the VT 47ePortfolio

VT3: FAQs about the Infection and Antimicrobial Stewardship 54module

References, Appendices (Formats of evidence, VT2/VT3 assessment processes) 65

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Background

The Pharmacy Vocational Training Scheme[1,2,3] originated in 1995 and is supported by the NHS Scotland Directors of Pharmacy, both Schools of Pharmacy in Scotland and The Royal Pharmaceutical Society.

The Training Scheme was originally introduced for junior pharmacists within secondary care, with the view to provide them with a comprehensive structured training programme over a two year period. Over the past five years, the training scheme has been redesigned and redeveloped to meet the changing needs of the service. Developments have also included the introduction of Specialist Training Frameworks.

Introduction

The Pharmacy Vocational Training Scheme is a structured, work-based training experience for hospital pharmacists to enable them to deliver safe and effective pharmaceutical care. It is available for pharmacists working within secondary care within NHS Scotland. Currently available at Stage 2 (Generalist Level), it is being developed at two further levels;

Stage 2 [general/foundation training] Stage 3 [specialist clinical training] Stage 4 [education, leadership and research modules].

Pharmacists should have completed Stage 2 prior to embarking on Stage 3 training. However, it is envisaged that whilst undertaking Stage 3 training they may start a module within Stage 4. There will be instances where the previous level of training has not been achieved and there are pre requisites to help where previous stages of training have not been achieved.

What is the aim of the Vocational Training scheme?

The aim of the Pharmacy Vocational Training Scheme (VTS) is to facilitate the acquisition of knowledge and skills necessary for pharmacists to participate fully in their post as a general (hospital) pharmacist. The emphasis is on developing competence (the ability to perform tasks consistently to the required standard) using activities in the workplace and a structured training rotation. The training is based on gaining experience by undertaking a task, demonstration of competence and reflection on learning from undertaking the task. This may require the task to be undertaken on a specified number of occasions.

Stage 1 (Pre registration training) training is undertaken in either community or hospital pharmacy.

Stage 2 (General/Foundation training) is for junior pharmacists (Band 6 or equivalent), who need to develop general skills and gain a broad experience in pharmacy practice prior to specialising in a clinical area of practice.

Stage 3 (Specialist training) is for more senior pharmacists (Band7 or equivalent) who need to develop more specialist skills, in particular clinical skills.

How do I register to start training or to become a VT tutor?

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There is registration information on the NES Pharmacy website. Each year there is the opportunity to register for training, three times per annum, in September, January and May. Registration is online. After registering trainees are expected to undertake the relevant induction training prior to starting completing their competency framework. Details of the induction materials are on the NES Pharmacy website.

New tutors should also register online, three times per annum, in September, January and May each year. New tutors are required to register at the registration date in advance of them tutoring a trainee. e.g. a tutor starting with a trainee on 1st September should register the previous May and have completed the induction resources prior to tutoring a trainee. The tutor needs to also attend an induction session in Sept., January or May and needs to inform NES of the completion of the various induction resources.

After registration trainees and tutors receive a ‘Welcome e mail’ that details how to get started and induction activities that need completed prior to attending the induction training which is generally help ~3 weeks after the training start date. i.e. late January, May and September.

Requirements prior to starting the different stages of Vocational Training

There are some requirements that trainees need to undertake prior to starting their training To undertake Vocational Training Stage 2 (VT2 training ), currently, the trainee needs to be employed in secondary care within the NHS in Scotland and they ideally should have undertaken their Pre Registration training (PRPS) within secondary care. However, this is not mandatory.

Prior to embarking on VT2 training trainees need to understand the fundamentals of aseptic dispensing, dispensing and the provision of pharmaceutical care. They need to have completed the following :

aseptic training - aseptic dispensing and checking processes, the aseptic environment , formulation and stability of aseptic products, the preparation of intrathecal injections (simulation for preparation of 3 products required.

dispensing training -the in- patient and out - patient dispensing processes the provision of pharmaceutical care to patients using standard care plans and case study

documentation provided (webinar available) the Adverse Drug Reaction reporting modules (available on NES website)

In each instance they need to develop as a piece of evidence which is included in their ePortfolio after they have had a discussion with their tutor.

Prior to embarking on any module of VT3 Training, trainees need to have completed the following resources:

the provision of pharmaceutical care to patients using the documentation provided (webinar available)

the audit process (completed an audit, see NES CPD web pages) the reporting of an analysis of a Significant Event (completed and SEA, see CPD web pages) the process of Critical appraisal (completion of Critical appraisal modules 1 and 2, plus MCQs) patient safety (webinar available) risk management (webinar available required) leadership theory (webinar or attendance at a course introducing leadership theory) the Adverse Drug Reaction reporting modules (available on NES website)

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In each instance they need to develop as a piece of evidence which is included in their ePortfolio, after discussion with their tutor / supervisor or Educational Supervisor.

Prior to starting a specific VT3 module, there are some further pre requisites depending on the specialist module.

All pre requisites should be demonstrated by having a discussion with the tutor after completing the relevant resource to ensure that the pre requisite is met. Where there is no resource, guidance should be sought from their Educational Supervisor

Frameworks for training

What is the framework for each of stage of training?

For each stage of the Vocational Training Scheme, the trainee completes a competency framework and provides evidence in the form of an ePortfolio.

Within VT2 training there are 8 Elements. All Elements are required to be completed.

Within VT3 training each framework comprises specialist clinical areas with the more generic aspects of training being covered in modules of Education and training, Leadership and Research.

What type of evidence can be collected?

A wide variety of different types of evidence can be collected within the VT ePortfolio. Examples of which are:

audit case based discussions (CbDs) feedback forms mini – clinical evaluations (mini – CEX) presentations reflective reports SEA short reports training plans.

Completion of Section forms (COS) are not required post 1st September 2015. Feedback forms have replaced the COS forms and therefore there should be at least ONE Feedback form within each Element within the ePortfolio.

What does the ePortfolio comprise of?

The ePortfolio is a resource to help trainees collect and organise their evidence online. The format of the ePortfolio has been designed to enable tutors and assessors to view the evidence in a systematic fashion. There are areas for:

forms - appraisal, rotation details, meeting with tutor, declaration of work and templates for; aseptic dispensing, dispensing services and medicines information

logs - care plans, case studies and reflective and action based logs

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compilation of references (personal library)

resources (underpinning knowledge modules).

Vocational Training: VT2 training – Generalist training

Completing VT2 training ensures that pharmacists achieve a ‘well rounded’ ‘general’, structured training within their first two years of starting within the hospital setting. It also enables trainees to gain experience in some areas that they may not have been able to experience had they not been part of the training scheme.[4,5] VT2 training has been mapped to the Knowledge and Skills Framework.

The training is recognised by the Directors of Pharmacy and the Schools of Pharmacy (SOPs) in Scotland as well as Queens University, Belfast. For details of any Approved Prior Learning (APL) trainees should contact the relebant School of Pharmacy (SOP).

The training takes approximately 18 months to 2 years to complete during which trainees complete tasks and develops a variety of different forms of evidence to demonstrate that they are competent and meet a particular performance standard consistently. The evidence is collated into a ePortfolio which is then submitted as part of the assessment process.

Trainees who are unable to complete within the 2 years period should indicate an estimated date for final assessment unless due to exceptional circumstances this is not possible.

The training achieved whilst working in practice, provides the pharmacists with the opportunity to gain knowledge, and to develop skills relating to

Professional and Personal practice

The Clinical Pharmaceutical Care of Patients

The Quality and Safety of Patient

The Cost Effective Use of Resource

Dispensing Prescriptions Education, Training and Development The Dispensing of Aseptic Products Medicines Information

For each rotation there are a specified set of competencies which are used to plan, conduct and evaluate the trainee’s performance.

There are also rotational practice activities which the trainee must complete, to help them achieve the competencies.

The rotation is also supported by ‘resources’ that help the trainee develop underpinning knowledge.

The workplace rotations are intended to be flexible to accommodate individual learning needs and service requirements. For example, experienced trainees moving into hospital practice from another area of pharmacy, such as community pharmacy, may be able to demonstrate their competence in some rotations in a shorter time than a newly qualified pharmacist. In such instances the previous experience should be recorded in the paperwork with ‘gaps’ identified and targeted as part of their rotation. All information relating to this should be included in their ePortfolio

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Support for training

There is a variety of support available for VT2 and VT3 trainees when they are undertaking training namely:

locality tutors (LT) (VT2 trainees) educational supervisors (Ed Sup) (VT3 trainees) specialist tutors (ST) (VT2 trainees) pharmacy Practice Education Coordinators (PECs) (VT2 and VT3 trainees) vocational training tutors (VT tutor VT2 and VT3) local site based trainers (VT2 and VT3 trainees).

The role of the Locality Tutor, Educational Supervisor and the Specialist Tutor are similar in nature with both roles having a remit for trainees within a designated Health Board area. However, the remit of the ES is wider than that of the LT in that they may have responsibility for trainees out with their Health Board area but within their area of specialist practice. The ST role describes senior pharmacists who have a remit for a number of trainees within a single smaller Health Board area. The ST relates to the LT or the ES with the LTs and ESs provide guidance and support to STs and tutors.

The LT/ ES also; delivers training sessions, attends National meetings as required, ensures that the VT curriculum is in line with service redesign and is involved in portfolio and final assessments where they may be required to be the Chair a panel.

The ST Specialist Tutors is expected to support other pharmacists locally during training towards Stage 2 of The Pharmacy Vocational Training Scheme within their sector of practice within their Health Board Area. This will involve acting as a role model in practice and supporting pharmacists with achievement of the competency framework, hosting local peer review sessions for trainees and guiding and advising the tutors of trainees. Support with this role will be available from your Regional Practice Education Coordinator (PEC).

Pharmacy Practice Education Coordinators, employed by NES, are responsible for different regions within Scotland and will meet with trainees shortly after registration to ensure that they are informed prior to starting training. They may also run local induction and peer sessions to ensure that trainees progress with their training throughout the 18month to 2 year period.

Vocational Training Tutors are experienced pharmacists. They are required to register with NHS Education for Scotland as part of the Vocational Training Scheme and are expected to keep themselves abreast of developments by attending at least every 3 years a Vocational Training Peer session at least every 3 years. They are expected to facilitate training but will not observe practice on a daily basis.

It is anticipated that tutors will meet with trainees on a monthly basis to;

review progress sign off/discuss completed evidence develop objectives complete appraisal forms.

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The tutor has a supportive role, and is involved in facilitating the trainee’s learning and assessing their development.

They do this by: helping the trainee to identify their development needs supporting, advising and encouraging the trainee during their training undertaking formative assessments (to monitor and review the trainee’s progress) summative assessments (to check that the trainee has met the required standards).

At the end of each rotation, the workplace tutor will use the competency framework to carry out a summative assessment, which will check that the trainee has met the required standard. Evidence should be reviewed, competencies signed off and any ‘gaps’ for further training identified.

The criteria for tutors, is under development. However, within their application to register as a tutor they are required to detail their; professional journey/experience to date, training/mentoring experience and their commitment to CPD (for which they may submit a Significant Event Analysis).

Trainers are experienced technicians and pharmacists who may sign off activities whilst the trainee is within their section. Trainers are not currently registered with NHS Education for Scotland, nor do they routinely attend training however, any trainers are welcome to attend any of the training days

Mentors are pharmacists who have recently completed the training scheme. They may informally advise new trainees and may share their experiences of completing the training scheme.

Are there resources for training?

Once registered for training, trainees will receive/be able to access a copy of the competency framework and modules which they will need to refer to whilst undertaking training. There are induction materials for trainees and tutors as well as a series of webinars available via the NES website.

Assessment processes

What is the format of the assessment processes?

Formative Assessment

VT2 and VT3 trainees are assessed throughout their training on a regular basis. For VT2 trainees this tends to be by their tutor at their base and also comprises of regular appraisals at 6, 9 and 15months of training. A satisfactory 15month appraisal showing completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment.

For VT3 trainees there are In Training Reviews (ITRs) that are peer review sessions that are held on a regular basis. In Training Reviews are designed to be supportive and to enhance learning whilst providing feedback on progress. The sessions are attended by 3 or 4 members of the Specialist Group, NES and the specialist trainees. Each trainee needs to attend at least ONE ITR throughout their training and to have received satisfactory feedback (uploaded to ePortfolio), prior to be invited to come forward for final assessment.

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For an ITR, the format comprises – presentation from each trainee (case study), training completed to date and objectives for the next 3 months. All trainees are present at the session and are expected to contribute. Written feedback is provided. Vc is available where possible. Each trainee needs to attend at least ONE ITR throughout their training and to have received satisfactory feedback (uploaded to ePortfolio), prior to be invited to come forward for final assessment.

Final assessment

For VT2 trainees, a satisfactory 15month appraisal showing completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment.

Portfolios are assessed by trained assessors using a standard scoring framework.

Trainees receive written feedback and are advised what they need to prepare for discussion at their final assessment. Should the trainee require to prepare only minor items (< 5 items) for discussion at the final assessment then they will be invited to attend the final assessment. Should they require to prepare more than a few minor items (>5 items) for discussion at final assessment then they will be deferred to the next set of assessments.

Where the portfolio meets the required standard the trainee will be invited for a final face - to - face assessment.

Should the portfolio not meet the required standard, the training will be advised to defer to the next set of assessments.

At the final assessment trainees present on as aspect of their portfolio and undertake practice based scenarios. Trainees who have not been deferred from a previous set of assessments) ,will be awarded a; Pass, Pass with merit or Pass with distinction. To achieve a Pass with merit, trainees need to have had no items requiring remediation at the portfolio assessment stage and have achieved a good pass in both the ‘core areas’ of their portfolio the final face to face assessment.

Should a trainee not have a satisfactory final assessment, they will be advised to spend further time in practice and to come forward for reassessment at the next set of final assessments.

For VT3 trainees, satisfactory feedback from In Training Reviews, indicating continued progress and completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment. Trainees need to also have attended at least ONE In Training Review (ITR) throughout their training for which they have received favourable feedback.

Portfolios are assessed by trained assessors using a standard scoring framework. Where the portfolio meets the required standard the trainee will be invited for a final face - to - face assessment.

Should the portfolio not meet the required standard, the training will be advised to defer to the next set of assessments.

At the final assessment there is a panel discussion around aspects of the trainee’s portfolio.

Trainees (who have not been deferred from a previous set of assessments), will be awarded a; Pass, Pass with merit or Pass with distinction. To achieve a Pass with merit, trainees need to have had no items requiring remediation at the portfolio assessment stage and have achieved a good pass in both the ‘core areas’ of their portfolio the final face to face assessment.

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General points for completion of the VT2 / VT3 competency framework.

Identification of training needs prior to starting a section of the competency framework

Identify training needs for each section prior to starting in the section and plan with the ‘trainer’ for the section how some identified training needs and therefore competencies will be achieved.

Draft a CPD plan to cover identified training needs. This can be in the form of a word document and uploaded to your ePortfolio and linked to the start of the Element or, it can take the form of GPhC CPD record or it can be the template using the PDP function within ePortfolio.

Timelines for undertaking activities

Planning of activities - When planning activities that are going to be completed, identify if the final CPD record that will form the evidence will be in the form of a reflective or action page. For VT2 trainees their is a document that provides timelines for when activities should be completed.

Evidence formats

Evidence takes a variety of different formats. In the curriculum a form of evidence is specified. However, so long as you prepare a suitable form of evidence, other forms of evidence are normally accepted so long as they meet the basic criteria.

Examples as specified - where specific examples are specified , trainees are expected to demonstrate achievement of the competency against all of the examples.

VT training is undertaken in the workplace and it is imperative that personal examples from a trainee’s workplace are detailed within their evidence.

Reflection and highlighting learning from undertaking a task to achieve a competency, is key to the development of evidence. Trainees should detail personal examples throughout their portfolio.

Anonymise all pieces of evidence. There should be no patient details, CHI numbers, hospital numbers, bar codes, doctor’s names within your portfolio. Anything that could trace back the evidence to the patient should not be included. Hospital logos on headed notepaper do not need to be deleted. Use the templates provided and do not upload any original prescriptions or documents to your ePortfolio.

Cross reference items throughout your portfolio wherever possible. Ensure that assessors will understand why each piece of evidence meets the competency.

Personal Library within ePortfolio

Organise your ePortfolio Personal Library so that it, is organised as per the headings within the competency framework. Make sure that you link all evidence within your Personal Library to a competency within the curriculum.

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Receiving Feedback on evidence

Share evidence for feedback with your tutor on a monthly basis and your Locality tutor / Educational Supervisor on regular basis so that they are aware of your progress.At least ONE ‘Feedback Form’ is required for each section of the Competency Framework

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The Pharmacy Vocational Training Scheme VT2 training Generalist training

Guidance for completion of Version 7 (September 2015) of the Competency Framework

July 2015

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General points for completion of the VT2 - Version 7 September 2015 competency framework.

Please check the information relating to the resources that are available to help you with your training.

Section A

Element A

Professional and Personal practice

Learning outcomes for this Element are:

an awareness of personal behaviour and the impact of personal behaviour on others

the ability to accept responsibility for own actions the ability to communicate in a variety of different formats the ability to organise workload the ability to work collaboratively the ability to review a service and propose developments for a service the ability to relate work undertaken to national priorities to

Within this Element, trainees are expected to demonstrate personal awareness and the development of basic leadership skills. Evidence should be provided for each competency and should where possibly not be cross referenced to the Clinical section. This is a change from previous guidance for previous frameworks.

The Clinical Care of Patients

Learning outcomes for this Element are the :

ability to document a patient assessment ability to document identified pharmaceutical care issues for specific patients ability to document pharmaceutical care outcomes for specific patients ability to document the pharmaceutical care provided for a specific patient in line

with the evidence base. ability to provide seamless care through the resolution of actions to prevent primary

care / secondary care interface issues ability to provide healthcare information to patients / carers in clinical practice

Within this Element, trainees are expected to provide evidence as care plans and case studies and where appropriate mini Clinical Examinations (mini - CEX) and Case Based discussions (CbDs).Trainees are also expected to demonstrate within one of their care plans/ case studies knowledge and understanding of the storage and the use of medical gases.

Word documents should be developed and uploaded to your Personal Library. Do not use the ePortfolio care plans as they have been problematic.

Care plans should follow the format as described on the NES Pharmacy website. A short summary (paragraph) [~200 words] as a front page should describe the case and highlight; reasons for choice of

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case, learning from developing the care plan and reflections for future practice from the learning undertaken. Pharmaceutical inputs and outcomes should be detailed within the care plan making reference to evidence base where possible. Include pharmacy care issues identified, the actions that you undertook to address the issue and the output from your action. Did the care reflect current guidelines? Within e portfolio there is a template for a care plan and a case study.

Case studies should be 2,000 words in length, use single spacing, Vancouver style referencing with numbered pages and should follow the guidance on the NES Pharmacy website. The actual number of words is not critical, just ensure that the cases are ‘full’ enough and that they include a discussion that that describes the disease state and your input to the case. A summary sheet [~200 words] should form the front page and should describe the case and highlight; reasons for choice of case, learning from developing the care plan and reflections for future practice from the learning undertaken. References should be used throughout the case study and should be listed at the end of the case study in Vancouver style. Reflections and your input to the care of the patient are important.

The evidence required to support the competencies takes the form of a set number of care plans using the standard documentation provided, some of which should be accompanied by a more detailed case study. Where you are undertaking mini - CEX and Case based Discussions (CbD) as part of your clinical rotation the number of care plans and case studies required to be developed are reduced in number.

The care plans and case studies should encompass medicine, surgery and a further two specialist area. The specialist areas can be from within Medicine e.g. respiratory, The requirement is to experience and provide evidence for a mix of clinical experience. There is a requirement to develop a case study or a care plan that demonstrates knowledge about medical gases in the clinical setting. You should ensure that one of your case studies or care plans include detail about oxygen saturation levels. This can be cross referenced to the Medical gases section.

The training is progressive and we wish to see the progress. All case studies will not be perfect unless they are completed at the end of training. The clinical specialist within the relevant area should sign off the case studies. When the clinical specialist provides feedback on the case studies, the learning from the feedback should be incorporated in a summary at the front of the case study.

All references should be anonymised. ‘Local guidelines’ should be referred to as opposed to ‘NHS [Health Board name] guidelines’.

Current medication needs to include everything that the patient was taking on admission.When detailing the drug and the medical history the whole medical and drug history should be covered at the start and then aspects that are relevant to the case focussed upon.

The templates are available within e portfolio and the NES website. www.nes.scot.nhs.uk/pharmacists

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http://www.nes.scot.nhs.uk/pharmacists

Ensuring the Safety of Patients

Learning outcomes for this Element are the :

ability to personally contribute to the local clinical governance agenda ability to apply procedures relating to information governance, financial and

corporate governance ability of to analyse a significant event to a satisfactory standard ability to undertake an audit and a PDSA cycle to a satisfactory standard ability to apply local procedures for the management of risk ability to contribute to the Scottish Patient Safety Programme ability to report an adverse drug reaction

Within this section trainees are required to demonstrate competence in various Clinical Governance tasks that they undertake within their practice. There is analysis of a Significant Event and the undertaking of one cycle of an audit.

Significant Event Analysis (SEA)

The SEA submitted will be put out for peer review. The proforma on the NES website should be completed and e mailed to [email protected] Feedback normally takes about 4 weeks from receipt of the submission.

Look at samples of SEA on NES website. This shows the level of detail required. This is an analysis of an event that was significant to you, that you were involved in. Give the reviewers detail as to the situation. Was the ward busy? What type of ward was it? Why do you think the event happened? Remember the reviewers are national peer reviewers and may be based in community pharmacy as opposed to hospital pharmacy. Detail any changes made to prevent the event happening again. What was the impact? The event doesn’t have to be negative and doesn’t need to be a Critical Incident/medication error. Submitting an SEA doesn’t take away from submitting a Yellow Card or a local Critical Incident report. Submitting an SEA is all about personal reflection and learning. The idea of getting feedback from others is to highlight any issues that you may not have considered to ensure that the event has been analysed fully and therefore will not happen again.

If submitting an SEA for an incident this may be cross referenced.

Audit

The audit received will be put out for peer review. The proforma on the NES website should be completed and e mailed to [email protected] Feedback normally takes about 4 weeks from receipt of the submission.

Topics for audit can be varied. If a trainee has undertaken an audit within their pre registration year they may undertake a further audit of the same work. The pre registration audit should not be submitted. All training is required to be current and not from a previous training programme. The pre registration audit should not be submitted. An audit undertaken as part of another course e.g. Clinical Pharmacy course, within the past 6 months, may be submitted. It is advisable to transfer the information to the proforma to enable as constructive feedback as possible to be provided. There are examples on the website.

Where the work of another pharmacists is used e.g. design of the audit, the individual should be recognised. The audit must include criteria [specific, not a general over arching aim] and specific standards [with percentages]. Where possible, undertake a 2nd cycle and re audit. One cycle is sufficient for VT2 training but two cycles are better and if you keep it simple, two cycles and effecting a change is achievable.

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mailto:[email protected]


Cost Effective Use of Resources


awareness of the procedures for the introduction of new medicines to NHS Scotland ability to manage the procedures for the prescribing of a non formulary medicine awareness of the local mechanisms for pharmaceutical homecare services

Within this section you are expected to demonstrate an understanding of the cost effective use of resources. The section involves reading through the Standing Financial Instructions (SFIs) and relating the instructions briefly to pharmacy practice. This could be quite a tedious task but when you have reviewed the SFIs discuss with your tutor or Locality tutor and think about how in a future role you may be affected by the SFIs.

Dispensing of Prescriptions

Learning outcomes for this Element are the:

ability to consistently and systematically professionally check a variety of different types of prescriptions to the required standard being sensitive to patient needs

ability to apply local procedures for the supply of medicines where there are various problems with the supply chain

ability to dispense clinical trial medication and a medicine without a product licence

This section involves the demonstration of competence when dispensing medicines. Professional aspects should be signed off by a pharmacist. So you may wish to organise a pharmacist trainer or your tutor to supervise you undertaking a task.

Prior experience e.g. when a trainee transfers from community to hospital practice will be taken into account and as in Aseptic services the individual will be required to undertake a series of simulations to demonstrate competence, rather than spend a specified time within the dispensary.

The section specifies preparation of extemporaneous medication. However, if no opportunity to make an extemporaneous product then the requirement of development of evidence demonstrating acquisition of knowledge of processes for dispensing of extemporaneous products is required.

Also within this section the trainee is required to demonstrate practice with an unlicensed medication and clinical trial medication. N.B. Unlicensed medication is a medicine without a product licence as opposed to a licensed product being prescribed out with the product licence.

Keep information anonymous! No actual prescriptions or any patient details should be included in your portfolio. There are templates on which you should transcribe the relevant information from the original prescriptions.


Education, Training and Development

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the ability to provide education for a variety of healthcare professionals the ability to provide education for students the ability to provide feedback to others

Within this section trainees are required to demonstrate competence in different teaching sessions. The teaching needs to be of staff and not patients. Personal learning from undertaking each of the events needs to be demonstrated with reflections on how the session would be handled in future via development of CPD records (short reflective report) and training plans.

The evidence needs to include information pertaining to the background, prep for session, audience, reflections on; personal learning from delivery of the session, what went well, areas for improvement and actions for future delivery of similar session.

Work by other members of staff needs to be recognised. e.g. use of power point slides.

Developing a brief training plan is an important part of the learning and teaching process. Plans should include the:

aim, learning outcomes and programme handout (where available) feedback/evaluation form (completed formal evaluation and/or VT Feedback form)

Feedback forms may be given to one or more participants of the training. If a formal evaluation form of the training episode is available this should also be included.

There is a sample of a training plan on the NES website within the Vocational training section about developing your portfolio.

www.nes.scot.nhs.uk/pharmacists

Section B

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Dispensing of Aseptic products


knowledge and understanding of aseptic technique knowledge and understanding of aseptic products knowledge and understanding of the need for personal hygiene and clean room

clothing the ability to professionally finally check a variety of aseptic products knowledge and understanding of the various aspects of good aseptic dispensing

practice

Pharmacists are expected to have undertaken the technical role of preparation of aseptic products within their pre –registration year. Where this has not occurred, the pharmacist and their tutor, needs to review the competencies undertaken as part of pre reg training. Trainees who are required to undertake a specified number of products due to not having prepared products in their pre registration year, often prepare products in a simulated environment with confirmation of competency from their trainer. If you can gain technical experience and can complete pre reg competencies then this would be ideal.

B22: Intrathecal injections. Complete local training programme. If intrathecal injections are not made at your site and you do not receive actual preparation experience, state this up front. If you have no opportunity to make intrathecal products then you need to complete a CPD record (n=1]) starting at ‘action’ demonstrating knowledge of processes involved in the dispensing of intrathecal products.

B23 & B24: Include a mix of prescriptions for your templates. Link aseptic theory with your own personal experience and include short examples of the products that you have checked to show that you are competent. Include your reflections. What have you done? How would you do it differently next time? B24: The report may be done individually for each type that is covered for this competency. e.g. short report for TPN, short report for Chemotherapy and a short report for CIVAS if there are examples of CIVAs included or one longer report covering the different types of examples included may be developed.

Where ONE report(s) is the route of choice, it should highlight relevant aspects about the example as specified in the competency to show understanding of differences in practice due to e.g. differences in formulation, legislation, processes, environment and QA processes.Include reflections.

Focus on the professional role of the pharmacist.


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Information about Medicines


knowledge and understanding of Medicine Information processes and procedures the ability to answer Medicine Information enquiries

This section requires the completion of a variety of medicine information enquires of a varying degree of complexity and also tasks within the MiCal workbook.

Enquiries may include ward based clinical enquiries from your practice but some enquiries need to be more complex than others and need to demonstrate the ability to undertake a literature review.

There is also a peer review sheet to complete and include in your portfolio.

The enquiries should not be those that you may have undertaken within your pre registration year.

No patient detail should be included. This includes patient name, DOB, Hospital number, Hospital name and address, Doctor’s name and address.

There are templates on which you should transcribe the relevant information from your original enquiry including any relevant information from the UKMi database.

A range of complex/simple satisfactory enquiries (using different categories as listed in the MI workbook and within e portfolio) should be transcribed onto the relevant template as evidence in support of the different competencies within this section. A description of the enquiry answered, self reflection learning points and a statement about which competency (ies) the enquiry relates to, should be included.

For sections requesting completion of the relevant MiCAL/workbook sections, ONE feedback Form signed by the trainee and their tutor/trainer is sufficient as evidence that the various sections have been completed.

It is not necessary to copy sections of the workbook for submission within your portfolio.

N.B. workbook sections completed during pre-registration should be read again as a refresher but need not be done again.

Only ONE Feedback form is required to be signed off for this section.

Templates are available on the NES website within the Vocational training section about developing your portfolio.

www.nes.scot.nhs.uk/pharmacists

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October 2014

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The Pharmacy Vocational Training Scheme VT2 training

Frequently Asked Questions by Trainees and Tutors

Q1.What is the pharmacy vocational training scheme stage 2 (VT2)?

Vocational training is training that is developed to help with the development of skills for a particular role/function. Within Pharmacy, the aim of VT2 training of is to enable the development of foundation skills within a specific area of pharmacy practice.

Currently there is Vocational Training at a Foundation level (VT2) and also at a Specialist level (VT3).

VT2 training has been developed to equip junior pharmacists to acquire the knowledge and skills necessary for them to participate fully in their post as a ‘general’ pharmacist. The emphasis is on developing competence (the ability to perform consistently to the required standard) using activities in the workplace, a structured training rotation and the reflections on the training experience by the trainee.

Trainees complete a series of tasks that assess performance in the workplace and record evidence from undertaking the task in a variety of different formats e.g. GPhC CPD records, Feedback forms, Witness testimonials, Evidence logs, Action logs and Reflection Logs. All evidence is stored in the NHS ePortfolio which is a safe and secure area in which to store information. No patient information/details should be stored within the NHS ePortfolio.

Q2.What is the purpose of VT2 training ?

The purpose of this level of training is to provide a structured, work-based training experience for junior pharmacists, enabling them to deliver safe and effective pharmaceutical care within their area of practice.

Q3.What are the benefits of the training scheme for individual pharmacist?

The training ensures that pharmacists achieve a well-rounded, ‘general’ structured training. Some trainees have indicated that due to the rotational nature of the training they have been able to gain experience in some areas that they may not have been able to visit had they not been part of the training scheme.

Undertaking training and development of CPD records as evidence also helps to meet the GPhC Continuing Professional Development (CPD) requirements. It is compatible with the CPD process with reflective practice being encouraged. Since 2009, trainees have been completing CPD records as evidence instead of lengthy reports.

The training also provides:

an opportunity to achieve competence in a variety of areas of pharmacy practice

an opportunity to reflect and decide on future areas in which to specialise

trainees’ with increased confidence and enhanced organisational skills.

Some universities give Approved Prior Learning (APL) towards further Postgraduate study.

e.g. the first year of the Queens’ Diploma and Masters Programme in Clinical Pharmacy; for Strathclyde University, the case studies will be assessed upon completion of Stage 2 and successful trainees will gain exemption from the first 2 weeks of the MSc in Clinical Pharmacy; for RGU there is a template to complete when registering for the MSc course

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Q4.What are the benefits of undertaking the training?

The training provides a framework which can be used to structure and target work-based training and experience for junior hospital pharmacists efficiently and effectively. It has also been shown to increase confidence, make trainees aware of their limitations and to allow future specialist areas for training to be explored.

Q5.How long will it take to complete the training scheme?

VT2 training is intended to take two academic years (approximately 20 months) to complete. This will depend on the individual and the needs of the service. Some trainees will take longer than this.

There may also be some trainees coming from other areas of pharmacy, such as community pharmacy, who already have experience and evidence of competence in some aspects who may complete the programme in a much shorter time. This will be dealt with on an individual basis.

Q6.Who can register for the training?

The training scheme is open to all junior pharmacists who are working as a hospital pharmacist within NHS Scotland. The pharmacist must have the support of their designated line manager prior to application. In addition, trainees must have a tutor who is registered as a tutor with the scheme, i.e. those who have registered as a tutor with NHS Education for Scotland (NES) from 2005 onwards.

To register as a trainee for the scheme by completing the online form. See NES website for the link.

Q7.What will the training entail?

The training is focussed on the professional role of the pharmacist with technical aspects having been completed in previous Stage 1/ PRPS training. The training provides trainees with the opportunity to gain knowledge, skills and experience in the following key areas of pharmacy practice.

For each rotation, there is a specified set of competencies and behavioural statements which are used to plan, conduct and evaluate the trainee’s performance. There are also rotational practice activities which the trainee needs to complete to help them develop and demonstrate their competence. The training is supported by resources that help the trainee develop underpinning knowledge to support their rotation.

Competence is also required to be demonstrated in some ‘wider’ areas e.g. medical gases, procurement and formulary management. This helps the trainees to gain an insight into the ‘broader’ practice of pharmacy to complement their practice as they progress.

Q8.How long will the trainee spend in each rotational area?

The workplace rotations are intended to be flexible to accommodate individual learning needs and service requirements. For example, experienced trainees moving into hospital practice from another area of pharmacy, such as community pharmacy, may be able to demonstrate their competence in some rotations in a shorter time than a newly qualified pharmacist. In such instances, the previous experience should be recorded with any learning needs identified and targeted as part of their rotation.

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Q9.There are locality tutors, tutors, mentors and trainers. What are the differences?

Locality tutors are experienced senior pharmacists who are responsible for the trainees within a defined area within Scotland. They may host an event where trainees meet to discuss their evidence or they may visit trainees and their tutor at some stage throughout their training. Should a trainee be unsure of what to do, they can contact their locality tutors or PEC in the first instance.

Tutors are experienced pharmacists who facilitate the trainee’s training and assess their development overall within the organisation. They do not observe the trainee’s practice on a daily basis; they are aided by local trainers with this. The trainees should meet with their tutor on a regular basis (once a month) and record the meetings within their ePortfolio.

The role of the tutor is to;

meet with the trainee on a monthly basis

help the trainee to identify their development needs and develop learning objectives as required

adapt the training rotation as required to ensure that the trainee receives a structured training within the 2 year period

provide guidance, support or advice

‘sign’ off evidence as appropriate (specialists will sign off evidence where specific expertise is required)

provide written feedback for evidence from their trainee

complete ‘Completion of section’ forms for each section of training

organise specific placements for the VT2 rotation

Tutors are required to register with NES as part of the training scheme. Tutors are required to be qualified for a minimum of 2 years (post Pre registration training) and demonstrate:

completion of VT2 training (where possible)

an ongoing commitment to their CPD

specific skills (e.g. giving feedback, listening skills)

involvement in the provision of education to other healthcare professionals.

On successful application to become a VT2 tutor the tutor will receive induction information.

Trainers are not registered as part of the training scheme.

Trainers are experienced pharmacists or technicians who work within specific area of practice and who are therefore responsible for the training of the VT2 trainee when they are within their specific area of practice.

The trainers will help identify the trainee’s training needs for a specific section of their training rotation and

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will plan, conduct and evaluate their training experience. They are also responsible for signing off their rotational practice activities whilst the trainee is within their section. However, trainers are not currently registered with NHS Education for Scotland, nor do they routinely attend training sessions. However, any trainers are welcome to attend any of the training days. Details of which can be located at NES Pharmacy website.

Mentors are pharmacists who have recently completed the training scheme. They informally advise new trainees and share their experiences on completing the training.

Q10.What do trainees need to do once they have registered to start their training?

Once registered, within 2 weeks, both the trainee and tutor will each receive a username and password to access the ePortfolio. If they have previously accessed the e Portfolio they will retain their original username and password but they will both be registered onto the specific training scheme. They will still be able to view the previous training that they have undertaken. To get started with the ePortfolio, the trainees should review the various forms that are available and make use of the resources section for guidance. For more information on how to develop an ePortfolio, please refer to the Hints and Tips on Completion of a Trainee Portfolio. In addition, the trainee should meet with the tutor to develop a structured rotation in order to meet the competencies specified in the competency framework.

Q11.What type of evidence will trainees need to collect and where is the evidence stored?

Trainees are expected to collect evidence as they progress. It may be in the form of a care plan, a case study, a prescription, a training plan or a CPD record etc. For more information on each type of evidence, please refer to the Hints and Tips on Completion of a Trainee Portfolio.

Trainees should verify their evidence by obtaining feedback from pharmacy staff and other healthcare professionals. Please note that they should not be completed by a peer who is undertaking the same training scheme.

Evidence should also be cross-referenced where possible with the reason for the cross-reference into this new section of the competency framework, being clearly stated in the introductory information for the piece of evidence.

The VT scheme is a progression over a two-year period. As such, there is an expectation that there will be regular progress.

The basis of the training is about learning from experience and reflecting on your practice. It is important to have reflections as part of each piece of evidence. [What did you learn? What would you do differently next time and why?]

If you started training after January 2013 all evidence should be stored within an NHS ePortfolio.

Portfolios that are paper based are only accepted if training started before January 2013.

There are some FAQs to help you with the VT ePortfolio. See further section in this document.

Q12.If I have completed a hospital pre-registration year, what evidence can I transfer to the VT scheme?

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Trainees who have completed their pre-registration training in the hospital sector will have completed some evidence that you may wish to reflect on and develop further for the vocational training. This will be at the discretion of your VT and locality tutor. In general, VT2 training is at a more advanced level than PRPS training and hence evidence used within PRPS training is not generally accepted as part of VT2 training.

Q13.What assessments will there be?

There are two types of assessment associated with the VT programme:

Formative assessment (to aid the trainee’s development, generally this type of assessment is occurring when the trainee meets with their tutor).

Summative assessment (to check that the trainee has met the required standard, this is the portfolio assessment and the face-to-face panel assessment).

At the start of each rotation, the tutor should utilise the rotational competencies and behavioural statements to help the trainee identify their learning needs and develop a CPD plan for that specific area. The tutor and trainee should meet regularly to monitor progress. The trainers, who are the staff leading the specific area of practice, should also be involved in this discussion or they should in fact facilitate this discussion when the trainee starts within their area.

At the end of each rotation, the tutor or trainer/specialist will use the rotational competencies and behavioural statements to carry out an assessment, which will check that the trainee has met the required standard. Evidence should be reviewed, competencies should be signed off and any gaps for further training should be identified.

Deadlines for submission of portfolio for review are generally undertaken every SIX months (currently 31 st

January and 31st July) while final assessments are generally held every SIX months (currently in May and November). Portfolio needs to be submitted to NES in April and October in order to qualify for the May and November assessment respectively. Once the trainee has successfully completed the portfolio, they will be invited for their final assessment. The final assessment lasts approximately ONE hour and is generally held at NES, Glasgow.

For this final assessment, the trainee should prepare a short presentation on a topic from their portfolio with the learning points and reasons for the choice of topic explained as part of the presentation. The topic may be stipulated in the feedback from the portfolio assessment. Ten minutes is allocated to the presentation, plus 5 minutes for questions. Trainees who run over their allocated time may be penalised and will be asked to summarise the final slides.

The trainees’ approach to the development of the presentation, their communication skills and their approach to answering questions by the panel is assessed at this stage. The trainee then has to detail their approach to FOUR workplace scenarios. The approach of the trainee is assessed based on their response to questions from the panel. The outcome from the assessments is communicated to the trainees verbally when they are given feedback and then confirmed via an e-mail. The trainees will also receive a certificate of completion.

Q14. What paperwork do I need to complete prior to my final assessment?

You need to complete the following :

a Completion of Section form (for each section of the framework (This is linked to the first competency within the framework for each section)

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a Declaration of Own Work form a 15 month appraisal

Q15.What happens on successful completion of the training?

On successful completion of both parts of the external assessment process (portfolio and panel interview), the pharmacist will be issued with a Certificate of Completion. This certificate will enable them to gain exemption from the first year of certain university Diploma/Masters programmes e.g. the Queen’s University Diploma/Masters programme in Clinical Pharmacy.

Q16.What happens if I am not successful at assessment?

The assessment process for the scheme is generally split into two parts. In some cases when portfolios are reviewed, trainees are requested to submit a small amount of further information/clarify information. The trainee is expected to bring this to the final assessment and may be asked to discuss aspects of their work to ensure that the competency has been met. At portfolio assessment, if the information that is required for clarification is deemed to be too much to prepare prior to the final assessment, the trainee will be asked to defer and resubmit at the following set of assessment.

Should a trainee be unsuccessful at the panel assessment, then the trainee will be given feedback, support from the Locality Tutor and the opportunity to re present at the next set of assessments.

Q17 I undertook my PRPS training in community pharmacy. Is there any baseline training that I need to undertake prior to starting VT2 training?

Trainees who have undertaken their PRPS training within community pharmacy will not have had experience of aseptic dispensing or Medicines Information training. Trainees should undertake some shadowing of technical staff within aseptic services and should complete some simulation exercises to demonstrate an understanding of the aseptic processes where possible. There are also aseptic modules that should be completed prior to undertaking the aseptic dispensing competencies. The trainee should develop an Evidence log’ after discussion with their tutor that demonstrates their understanding. For MI training, the tutor should organise a copy of the MiCal workbook and the trainee should spend an agreed time within a Medicines Information Centre to ensure that they have a basic understanding of the work within this area. Such training is dependent on local services. For clinical pharmacy training the trainee should enrol for a local clinical pharmacy course where possible.

Q18 Is there a timetable of what needs to be covered? What evidence needs to be logged and when?

There is a guidance about the timelines for activities. See the NES website and within this document for details.

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The Pharmacy Vocational Training SchemeVT2 training

Guidance on activities

November 2014

Suggested Training month (using 1st September as Month 1)

Activity Activity type Section of framework

Month 1 Access NES website and familiarise with the Vocational Training pages

Web pages and e portfolio

General

Month 2 Care planning Webinar C: Clinical pharmacy

Month 3 Good practice guidance; Writing in Patients’ Clinical Case Notes within NHS Scotland

Interactive PDF C: Clinical pharmacy

Month 3 Clinical Governance/Patient Safety – Module 1 Module D: Clinical governance / patient safety

Month 3 Clinical Governance/Patient Safety – Module 2 Module D: Clinical governance / patient safety

By month 4 Attend Induction event/meet with PEC or LT for induction Tutorial General

Month 5 Medical gases recording Recording H: Medical gases

Month 5 Medical gases MCQs Assessment H: Medical gases

Month 5 or month 17 A Taste of Leadership Course /webinar A: Personal Competencies

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Month 6. Look at samples of SEA on NES website e.g. Lithium SEA.

Submit to NES within a month of analysis. At start of Year 2 at the latest. Year 1 into Year 2 of training.

Appraisal

Task D: Clinical governance / patient safety

Month 9 Appraisal

Month 13. Patient SafetyMay have been done as a PRPS trainee.

Modules D: Clinical governance / patient safety

Month 14 Patient Safety Webinar D: Clinical governance / patient safety

Month 14 Operating Procedure: Need to actually write or review a SOP

Webinar D: Clinical governance / patient safety

Month 15 Risk Management

Appraisal


Month 17 Risk assessment or complaint/incident.


Month 18 Cost effective use of medicines.Application of theory of procurement and introduction of new medicines, SMC website, Evidence base – that’s what we do recording.

Familiarise with assessment info on VT pages of NES website.

Task E: Cost effective use of medicines

Month 20 Introduction to leadership Webinar A: Personal Competencies

Aseptic services

Aseptic Services Aseptic modules: Unit 16 Module Before/during aseptic rotation

Aseptic Services Aseptic modules: Unit 17 Module Before/during aseptic rotation

Aseptic Services Local training programme for intrathecal chemotherapy

Task Before/during aseptic rotation

Medicines information

Medicines Information

Completion of MiCal workbook

Workbook Completed as a PRPS trainee.

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Medicines Information Reads local and national guidance for MI

Task During MI rotation or during Year 2 of training

Medicines Information Peer review of at least one MI enquiry using UKMi methodology

Task During MI rotation or during Year 2 of training

Medicines Information NES Critical appraisal packages level 1

Webinar During MI rotation or during Year 2. May have been completed as PRPS trainee.

Medicines Information NES Critical appraisal packages level 2

Webinar During MI rotation or during Year 2 of training

Medicines Information Critical appraisal package level 1 –and level 2 Assessments

Assessment After viewing the webinars for Critical appraisal Year 2 of training

The Pharmacy Vocational Training Scheme VT3 Specialist training

July 2015

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The VT3 Specialist modules comprise of a competency framework, a set of resources and a specific ePortfolio. These modules should ideally be completed after VT2 Generalist training. Registration for each VT3 module is online at the same time of year as VT2 training. Trainees should only register for ONE Specialist Framework at a time. Some frameworks may take longer to complete than others.

During registration process, applications will be submitted to the relevant Specialist Interest Group (SIG). Trainees are then allocated a Supervisor who may be located elsewhere in Scotland.

Trainees and Supervisors are required to discuss progress either face to face or over the telephone once per month. The discussions should be recorded within the “Record of Meetings” form within the ePortfolio.

Trainees are required to attend ONE “In Training Review” (ITR) throughout their training and to have received satisfactory feedback prior to completing and submitting the “Own Declaration” form for assessment. The feedback from the ITR should be included within their ePortfolio.

Assessment in VT3 follows the same model as for a VT2: a portfolio assessment followed by a face to face assessment.

There are currently 3 VT3 frameworks available:

Infection and antimicrobial stewardshipThe pharmaceutical care of older peoplePublic health

For further information about each of the Specialist modules please contact [email protected] or look at the Vocational Training web pages on the NES website.

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The Pharmacy

Vocational Training Scheme

VT3 Training

Frequently Asked Questions for Trainees and Tutors

Version 4.0 August 2015

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Q1 What is the pharmacy vocational training scheme Stage 3 (VT3)? 33Q2 What is the purpose of Vocational Training (VT)? 33Q3 What are the benefits of the training scheme for individual pharmacists?

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Q4 How long will it take to complete the training? 33Q5 Who can register for the training? 34Q6 What are the pre-requisites (PRs) for the training scheme? 35Q7 What will the training entail? 35Q8 There are educational supervisors, tutors and mentors. What are the differences?

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Q9 How do trainees get started with the training? 36Q10 What type of evidence do trainees need to collect? 36Q11 If I have completed a Stage 2 of The Pharmacy Vocational Training Scheme (VT2), what evidence can I transfer to the Stage 3 of The Pharmacy Vocational Training Scheme (VT3 )?

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Q12 What assessment will there be? 36Q13 What happens on successful completion of the training? 37Q14 What happens if I am not successful in assessment? 37

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Q1 What is the pharmacy vocational training scheme Stage 3 (VT3)?

VT3 is a structured, work-based training experience for hospital pharmacists with more than 2 years experience who wish to specialise within an area of pharmacy practice. The emphasis is on developing a portfolio which demonstrates competence of the various tasks detailed within the specialist competency framework. The training is addressed through directed learning, experience in practice and work-shadowing where appropriate.

Q2 What is the purpose of Vocational Training (VT)?

The purpose of the training scheme is to facilitate the acquisition of knowledge and skills necessary for pharmacists who wish to develop more specialist skills and in particular clinical skills within a specific area of practice e.g. infection and antimicrobial stewardship, older people, cancer, clinical trials, critical care, rheumatology and public health.

Q3 What are the benefits of the training scheme for individual pharmacists? How does the training

fit with other training e.g. MSc courses, RPS Faculty?

Completing the training scheme ensures that the pharmacists achieve a well-structured specialist clinical training within a specific clinical area. Being structured according to the Continuing Professional Development (CPD) cycle, the training scheme will also help the pharmacist to meet the GPhC mandatory requirements for CPD.

The training is designed to be undertaken in the workplace and is very much based on reflection and learning from experience. Aspects of the training may be used as part of further Post Graduate study. It is envisaged that the evidence gathered will also be able to be used to populate specific parts of the RPS Faculty portfolio should you choose to join the Faculty. This training is very much core training to ensure that appropriate skills and knowledge for a specific role are achieved.

Working with a specialist (tutor and educational supervisor) in the field the pharmacists will receive a very focused specialist training with senior pharmacists working in the area of practice.

Q4 How long will it take to complete the training?

The training generally takes about 18 months to complete and is generally completed after the vocational training scheme Stage 2 (VT2). However, this depends on the individual and the needs of the service. Some trainees will take longer than this. If the trainee hasn’t undertaken VT2 training, this is fine but there are some requirements to meet before they embark on their specialist training.

Q5 Who can register for the training?

The training scheme is open to all pharmacists with more than 2 years experience who wish to specialise or who are working in a specialist area of practice within NHS Scotland. The trainees ideally should have completed VT2, however this is not mandatory. Prior to application, the trainee must have the support of their designated line manager. Also, trainees must have a tutor and/or an educational supervisor who is registered as part of the scheme.

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To register as a trainee for the scheme, please complete and submit an application that is available here.

Q6 What are the pre-requisites ) for the training scheme?

Trainees should have knowledge and understanding of the provision of pharmaceutical care to patients using the documentation provided. They should also have the knowledge and understanding of the audit process, the reporting of a Significant Event Analysis, critical appraisal, patient safety and risk management. Furthermore, there are some further pre-requisites depending on the specialist module. The requirements vary depending on the specialist module. See the NES website for more information.

Q7 What will the training entail?

The training entails completing a variety of activities to demonstrate competence in the specialist area. There is also underpinning knowledge in a variety of different formats to support the training. Trainees need to complete the activities using a variety of different forms of evidence within their e Portfolio.

Q8 There are educational supervisors, tutors and mentors. What are the differences?

Educational supervisors are experienced senior pharmacists who are responsible for the trainee within a specific specialist area of pharmacy practice. They may be located within a different Health Board area within Scotland. They will not be expected to observe the trainees’ practice on a daily basis, but they should meet with their trainees on a regular basis i.e. once a month, and record the meetings within the ePortfolio. They will help the trainees to identify any development needs and provide any support of advice during their training. In addition, they will also undertake both the formative and summative assessment of the trainee. They are expected to attend the regular In Training Reviews (ITRs) for the trainees, the portfolio assessment and the final assessment panel if required. Meetings should be held virtually where possible.

To become an Educational Supervisor for a Specialist VT3 Module, the applicant should have a minimum number of 2years experience working as a pharmacist within the specialist area within the NHS in Scotland. For more information, please refer to NES website .

Tutors are experienced pharmacists within a specialist area of pharmacy practice that help facilitating the trainees’ training and assessing their development. Not all specialist training modules have tutors some only operate with educational supervisors. Tutors are not expected to observe the trainees’ practice on a daily basis, but they should meet with their trainees on a regular basis i.e. once a month, and record the meetings within the ePortfolio. They will help the trainees to identify any development needs and provide any support or advice during their training. Tutors are not expected to attend portfolio assessments or the final assessments but may be asked to attend the ITRs if required. The ITRs are generally hosted by the educational supervisors of the Specialist Interest Group (SIG).Meetings should be held virtually where possible.

The criteria for tutors are still under development. However, they are required to register with NES as part of the training scheme, detailing their professional journey/experience to date, their training/mentoring experience and their commitment to CPD within their application. Tutors are retrained approximately every 3 years when they come together to receive an update about the scheme and review evidence to ensure that they ‘calibrated’ with other tutors. For more information, please refer to NES website for more information.

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http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/the-pharmacy-vocational-training-scheme/stage-3-(vt3).aspx

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/the-pharmacy-vocational-training-scheme/stage-3-(vt3)/fast-track-educational-supervisor-information.aspx


Mentors are pharmacists who have recently completed the training scheme. They may informally advise new trainees and may share their experiences on completing the training. However, due to the novelty of VT3, there are only a few mentors currently within the one specialist area.

Q9 How do trainees get started with the training?

To get started, trainees should first familiarise themselves with the NES Pharmacy website (VT pages) and the personnel who are there to assist their training. Trainees should also access Portal the online booking system and update their details if required. This will ensure that they are eligible to attend a variety of events that are open to the VT3 trainees.

Once the trainees receive a username and password to access the ePortfolio, usually within one to two weeks following the closing date of registration, trainees should start setting up their ePortfolio. To learn more about how to set up the ePortfolio, please refer to FAQs about the VT ePortfolio. There is also a recording of an introductory webinar about how to use the VT ePortfolio available within the NES Pharmacy website (VT pages). While VT2 ePortfolio was used as a demonstration, the VT3 ePortfolio is very similar and it will be very helpful for you to watch this webinar. Similarly, a sample VT2 ePortfolio is available here for you to view.

Username mcmillan4984 and password = olivermac!

As Oliver also has a VT2 ePportfolio, you should select the VT3 training plan so that you can view the VT3 competencies that are available to Oliver.Furthermore, trainees should also complete the induction information that is on the NES website.

Q10 .What type of evidence do trainees need to collect?

Trainees need to collect a variety of different forms of evidence. There are Logs and Forms within e Portfolio.

GPhC CPD records are also to be collected as a form of evidence. Within the Logs section of ePortfolio there are action and reflection logs as well as activity logs. Within the forms section there are feedback forms and testimonial forms. There are also mini – CEX, Case based Discussion (CbD), case study and care plan templates.

Within VT training pharmacists are required to develop a care plan and then often a full case study using the basic information from the care plan. For information re developing a care plan please see the VT web pages Resources section where you will be able to listen to a webinar that describes the care planning process. There are templates and guidance also available.

If you currently don’t work in the specialist area you may need to shadow specialists for a specific amount of time to ensure that you can collect evidence for your portfolio.

Q11 If I have completed a Stage 2 of The Pharmacy Vocational Training Scheme (VT2), what

evidence can I transfer to the Stage 3 of The Pharmacy Vocational Training Scheme (VT3 )?

The aim of VT2 training is to develop ‘generalist’ broad skills. The aim of VT3 training is to develop specialist skills within a specific area of practice. For VT3 training you will be attached to a new programme and hence a new competency framework and so you should develop new evidence at this more specialist level for inclusion in your VT3 ePortfolio.

Q12 What resources are available to help me?

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LeonZ, 05/08/15,

Are we expecting the VT3 trainees to complete all of these

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/the-pharmacy-vocational-training-scheme/induction-information-for-trainees.aspx

https://www.nhseportfolios.org/Anon/Login/Login.aspx?ReturnUrl=%2FAuth%2FSitePages%2FTrainee%2FDefault.aspx

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/about-nes-pharmacy/educational-resources/resources-by-topic/personal-development/e-portfolio-webinar-for-vt2-trainees.aspx

http://www.nes.scot.nhs.uk/media/2340917/frequently_asked_questions_about_the_vt_e_portfolio_trainees_7th_october_2013.docx

https://www.portal.scot.nhs.uk/


There are a variety of resources available for each specific VT3 module. The induction resources are ‘core’ for all VT3 modules. Should you wish to include a further resource for your specific area of practice please e mail [email protected] with details of the reference/resource and it will be considered for inclusion. Likewise, if you feel that there is a more up to date version of a resource available please advise us and we will update our resources accordingly.

Q13 What assessment will there be?

There are informal formative assessments that are held on a regular basis with the educational supervisors for the specific area. These are In Training Reviews (ITRs). Your tutor or educational supervisor should also be providing feedback on your evidence as you progress through training. This in itself is a formative assessment. There is a portfolio assessment which is a final summative assessment. Pairs of assessors assess portfolios using a marking schedule. If the trainee successfully passes the portfolio assessment, they are invited to attend the final face to face assessment. The final assessment lasts approximately 1.5 hours and is when the trainee’s portfolio is discussed in depth with an assessment panel. There is a specific marking schedule that has been mapped to a variety of advanced level frameworks Q14 What happens on successful completion of the training?On successful completion of the training you will be awarded a certificate of completion of the specific module.

Q15 What happens if I am not successful in assessment?

If you are not successful at the portfolio assessment then you will be invited to resubmit your portfolio at the next diet of assessments. If you are successful at the portfolio assessment but not successful at the final assessment, then, you will be invited to attend the next set of final assessments using your current portfolio. The final assessments are generally every 12 months (annually).

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The Pharmacy Vocational Training Scheme

VT2 and VT3 training

Frequently Asked Questions about mini-Clinical Evaluation (mini-CEX) and Case-based Discussion (CbD) Exercises

Version 1.9 March 2014

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Mini-Clinical Evaluation Exercise (mini-CEX)

Q1. What is mini-CEX?

Mini-CEX originated in the UK and has been used within medicine for years. It was adapted for use within pharmacy in 2006 and was introduced into the Pharmacy Vocational Training Scheme to enhance learning, in 2011?. A mini-CEX is a 15 – 20 minutes, observed, real-life, interaction between a trainee and a patient and/or doctor. The observer provides the trainee with immediate feedback on this interaction, focussing on the clinical skills, attitudes and behaviours of expected of the trainee. mini-CEX are suitable for use in a variety of situations normally expected of the trainee such as medicine reconciliation, discussing a TPN prescription with a doctor, receiving an MI enquiry on the ward or carrying out medication counselling with a patient e.g. counselling a patient about their warfarin

Q2.Why use the mini-CEX?

MiniCEX is time efficient way of assessing trainees in real practice setting and it presents a complete and realistic challenge to trainees. It allows trainees to get feedback on their performance from an experienced pharmacist about a real patient, in real time.

Q3. Who is involved in the mini-CEX?

It is the trainee’s responsibility to indentify and approach the appropriate pharmacist to be an assessor: e.g. the senior pharmacist specialising in the clinical area. Trainees are advised to arrange a time and date for the assessment in advance, and it is suggested that this is organised at the start of the trainee’s rotation. The trainee should not expect the assessment to be done immediately upon request.

Q4. Where does the mini-CEX happen?

The mini-CEX must be conducted in the clinical setting.

Q5. How long will it last?

The observation will take approximately 15 – 20 minutes, followed by immediate feedback. This may take approximately 30 – 60 minutes in total to complete.

Q6. How many mini-CEX assessments need to be included in the ePortfolio?

In total, trainees are expected to have at least 8 mini-CEXs in their portfolio. A minimum of one mini-CEX should be completed for each clinical rotation and should represent a range of different clinical problems and realistic challenges encountered throughout the training period.

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Q7. What happens during the mini-CEX?

Time and date arrangement. The mini-CEX is driven by the trainee. Prior to the assessment, it is the trainee’s responsibility to approach the appropriate pharmacist and arrange a time for the assessment to be carried out. It is suggested that a date should be organised at the start of the trainee’s rotation. However, this is dependent on the rotation and workload of each senior pharmacist and sometimes trainees just need to grab an opportunity. However, this should not be the norm and trainees must appreciate the workload of assessors.

Patient selection. The assessor will accompany the trainee to their ward. The trainee will identify 3 previously unseen patients on the ward and the assessor will select one of these patients for the assessment. Understanding that patients might be in theatre or asleep at the time of assessment, a realistic approach should be undertaken.

Trainee-patient interaction. In situations where pharmacist-patient interaction is being assessed (e.g. taking of drug history) the assessor should stand at a distance so that they can observe and hear the interaction (e.g. at the end of the patient’s bed). They should not interrupt the interaction with the patient unless they feel that the information being given is detrimental to patient care. Normal ward procedures should be followed by the pharmacist being assessed. The assessor will observe the trainee’s ability to deliver pharmaceutical care to the patient in real time.

Trainee-assessor discussion. A discussion between trainee and assessor can be undertaken following a trainee-patient interaction. The trainee will briefly present the clinical scenario to the assessor, highlighting key pharmaceutical issues and suggesting appropriate action plan. The discussion should be led by the trainee. The assessor, on the other hand, should practise a passive role in the discussion. The assessor can prompt the trainee using relevant questions to the clinical scenario to assess trainee’s understanding of the clinical scenario. However, the assessor should not dictate how the trainee should deliver the pharmaceutical care unless the action is detrimental to patient care.

Trainee-doctor interaction. Similar to trainee-patient interaction, in situations where trainee’s interaction with other members of the multidisplinary team is involved, the assessor will observe the trainee’s ability to interact with other healthcare professionals to delivery pharmaceutical care to the patient in real time.

Marking of the CEX form. Following the assessment, it is good to give the feedback as soon after the session as possible. Prior to the CEX a paper version of the form should be printed off and taken to the clinical area for scoring throughout the session. This way the feedback can be given straight after the session and then the assessor can either give the form to the trainee to upload into their Personal Library within their e Portfolio or the assessor can transfer the scores onto a mini CEX form that can be sent by the trainee using the ticketed feedback system.

To use the ticketed feedback system the trainee needs to generate a new ticket after which the ‘Generate a New Ticket’ page will appear .The trainee should select the ‘Mini-CEX assessment form’ and fill in the assessor’s details. An email will then be sent to the assessor providing the login code for the assessor to use to ‘log into’ the ePortfolio and complete the ticketed mini-CEX assessment form.

The assessment form should be filled in based on the trainee’s performance within each competency area using the rating scale.

Feedback to the trainee. This should be done as soon as possible after the session. The assessor will provide feedback on skills essential to the provision of good pharmaceutical care. In keeping with the quality improvement assessment model, the assessor will highlight the trainee’s strengths, identify areas for development and together, the trainee and assessor will agree action points. Approximately two weeks after the mini-CEX, the trainee should meeting with their tutor or the assessor to briefly discuss learning outcomes from the agreed action points.

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Feedback to the trainee. The assessor will provide feedback on skills essential to the provision of good pharmaceutical care. In keeping with the quality improvement assessment model, the assessor will highlight the trainee’s strengths, identify areas for development and together, the trainee and assessor will agree action points. Approximately two weeks after the mini-CEX, the trainee should meet with their tutor or the assessor to briefly discuss learning outcomes from the agreed action points.

Q8. What competency areas will be assessed?

The following competency areas will be assessed and the explanation for each competency area is as follows:

Delivery of Patient Care

1. Patient consultation Introduction to patient, conducting a patient-centred consultation, exploring the medical/surgical condition with the patient, considering the patient’s own health beliefs, being aware of personal limitations and making appropriate referrals

2. Need for drug Establishing the patient’s background, taking a drug history and gaining the necessary information from a range of sources in order to decide on the appropriateness of drug therapy

3. Selection of the drug Appropriate consideration of evidence-based medicine and drug interactions (drug-drug, drug-disease, drug-patient)

4. Drug specific issues Checking that the drug is prescribed correctly (route, formulation, dose, frequency, course length) and considering available results and what effect they have on drug therapy e.g. U&Es, LFTs

5. Provision of drug product Implementing an effective system for the supply of medicines

6. Medicines information and patient education

Provision of medicines and health advice to patients, carers, other pharmacystaff medical and nursing staff, and other healthcare professionals

7. Professionalism Identification and prioritisation of medicines management issues, time management, patient confidentiality, appropriate application of guidelines such as formulary, therapeutic switching policies etc

Problem solving

8. Gathering information Accessing and summarising the information required and ensuring the information used is up-to-date

9. Knowledge Knowledge of pathophysiology of common medical/surgical conditions encountered, pharmacology, side effects and drug interactions

10. Analysing information Demonstrating the ability to evaluate information gathered (reliability or source, relevant to patient care), correctly identifying the problem, appraising options, making appropriate decisions and demonstrating a logical approach

11. Overall clinical care An assessment that summarises all of the above in terms of outcome for the patient

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Q9. What rating scale will be used to access the trainee?

The full range of the rating scale should be used and comparison made with what would be expected of any pharmacist at that stage of their vocational training. Trainees should aim for “meets expectations” although it is expected that some ratings will be below this. The key part of mini-CEX is effective feedback and identifying learning needs.

Rating Scale

Significantly below Performs poorly; very rarely meets the standard expected

Below Performs poorly; meets the standard required occasionally

Borderline Performs satisfactorily; with appropriate support and direction should meet expectations

Meets expectations Performs well and to the standard expected of a pharmacist at that stage in their training

Above Performs to a standard higher than what you would expect from a pharmacist at that stage in their training

Significantly above Performs to an excellent standard; trainee is ahead of his/her peer group

Unable to comment Unable to comment as performance not observed whilst s/he was there

Q10. How can trainees and assessors learn to use the mini-CEX?

Trainees and assessors can learn more about how to use the mini-CEX by viewing the JPB Assessment Tools . Please request the link from NES Pharmacy

Case – based Discussion (CbD)

Q1. What is CbD?

CbD originated in the UK and has been used within medicine for years. It was adapted for use within pharmacy in 2006 by CoDEG (Competency Development & Evaluation Group) and was introduced into the Pharmacy Vocational Training Scheme to enhance learning, in 2012.CbD is a 20-30 minute discussion between the trainee and their tutor or assessor on a previous case. As with the mini-CEX this is designed to provide feedback clinical skills, problem solving skills and knowledge of trainees in relation to a real life situation. CbD is an assessesment of a trainee in relation to a retrospective patient case, which differentiates this from the miniCEX . CbD can be suitable for a wide range of cases such as discussing the pharmacokinetic or pharmacodynamics of a new drug for a patient, evidence base use of a drug in a particular patient, the legal or ethical issues around patient care, or even based on a patient that has been utilised for a mini-CEX.

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Q2. Why use the CbD?

The CbD allows trainees and their tutor / assessor to discuss previous patient cases in a retrospective view. The assessor can observe how the trainee utilises their problem solving skills and enhance learning by encouraging reflection. It is not the assessor’s role to interrogate the trainee about the case but to ask questions related to the competencies expected and to assess the trainee’s strengths and weaknesses.

Q3. Who is involved in the CbD?

It is the trainee’s responsibility to indentify and approach the appropriate pharmacist to be an assessor: e.g. the senior pharmacist specialising in the clinical area. Trainees are advised to arrange a time and date for the assessment in advance, and it is suggested that this is organised at the start of the trainee’s rotation. The trainee should not expect the assessment to be done immediately upon request.

Q4. Where does the CbD happen?

The CbD can be conducted in the ward or at a suitable location. The most appropriate place would be somewhere quiet where there will be minimal disruption.

Q5. How long will the CbD last?

The CbD may take approximately 20 minutes but this will depend on the case being discussed. It should not take any longer than an hour.

Q6. How many CbD assessments need to be included in the e Portfolio?

A minimum of one CbD should be completed for each clinical rotation and should represent a range of different clinical problems and realistic challenges encountered throughout the training period. Throughout the training period trainees are expected to complete at least 8 CbDs

Q7. What happens during the CbD?

Time and date arrangement: The CbD is driven by the trainee. Prior to the assessment, it is the trainee’s responsibility to approach the appropriate pharmacist and arrange a time for the assessment to be carried out. It is suggested that a date should be organised at the start of the trainee’s rotation. However, this is dependent on the rotation and workload of each senior pharmacist.Patient selection: The trainee should choose and share three cases which they have prepared in advance and the assessor should select one of these case for the CbD assessment. A previous miniCEX can be used for a CbD.Trainee-assessor discussion: The trainee may bring patient notes, drug charts and other details to help them to discuss their case. The trainee should start the discussion by outlining the key points of the case to the assessor. They should then also highlight the key pharmaceutical care issues and the rationale for the treatment and the care that they provided. After this the assessor should take over

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the discussion and question the trainee to check if they have fulfilled the assessment criteria. Details of the criteria are on the CbD Form. After this the assessor should give verbal feedback and formal written feedback (using the CbD Form) after the meeting.The most vital part of the CbD is the feedback given by the assessor to the trainee. The assessor should provide feedback on skills essential to the provision of good pharmaceutical care. In keeping with the quality improvement assessment model, the assessor should highlight the trainee’s strengths, identify areas for development and together, the trainee and assessor should agree action points. Approximately two weeks after the CbD, the trainee should meet with their tutor or the assessor to briefly discuss learning outcomes from the agreed action points.Marking of the CbD: Following the assessment, the trainee should send a CbD assessment form to the assessor from their ePortfolio. To do this, the trainee should log into the ePortfolio, select ‘Learning and Reflection Logs’ from the dropdown menu under ‘Logs’. In the ‘Learning and Reflection Logs’ page, they should then click on the ‘Request Ticket’ tab on the top right corner as depicted below.

Subsequently, a ‘Generate a New Ticket’ page will appear and the trainee should select ‘CbD assessment form’ and fill in the information of the assessor. An email will then be sent to the assessor providing the login code for the assessor to log into the ePortfolio to fill up the ticketed mini-CEX assessment form.

The assessment form should be filled in based on the trainee’s performance within each competency area using the rating scale.

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Q8. What competency areas will be assessed?

The following competency areas will be assessed and the explanation for each competency area is as follows:

Pharmaceutical Needs Assessment/ Identification and prioritisation of care issues.

Pharmacist has identified correctly the pharmaceutical care issues for patient. The trainee is able to prioritise the pharmaceutical care issues appropriately.

Treatment Recommendations Can discuss the treatment of the main medical problem – evidence-based treatment guidelines, drug therapy (mechanism of action of drugs, dosage range, key pharmacokinetic data, cautions, contra-indications, common side effects, major drug interactions, patient counselling points).

Patient Monitoring and follow up Can discuss the rationale for the monitoring of the patient’s pharmaceutical care.Can demonstrate practical ongoing and appropriate monitoring of therapy (including kardexes as well as biochemistry, haematology)Can discuss and demonstrate how the care of this patient was managed in conjunction with the wider healthcare team

Professionalism Demonstrates ability to prioritise; and was timely and succinct. Can show an ethical approach, and awareness of any relevant legal frameworks. Has insight into own limitations. Considers interface issues.

Overall Clinical Judgement Can discuss own judgement , synthesis, caring and effectiveness for this patient

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Q9. What rating scale will be used to assess the trainee?

The full range of the rating scale should be used and comparison made with what would be expected of a pharmacist at that stage of their vocational training. Trainees should aim for “meets expectations” although it is expected that some ratings will be below this. The key part of CbD is effective feedback and identifying learning needs.

Rating Scale

Significantly below Performs poorly; very rarely meets the standard expected

Below Performs poorly; meets the standard required occasionally

Borderline Performs satisfactorily; with appropriate support and direction should meet expectations

Meets expectations Performs well and to the standard expected of a pharmacist at that stage in their training

Above Performs to a standard higher than what you would expect from a pharmacist at that stage in their training

Significantly above Performs to an excellent standard; trainee is ahead of his/her peer group

Unable to comment Unable to comment as performance not observed whilst s/he was there

Q10. How can trainees and assessors learn to use the CbD?

Trainees and assessors can learn more about how to use the CbD by viewing the JPB Assessment Tools. Ask NES for details.

Q11. Is there a pass or fail mark issued for the mini-CEX and CbD assessments?

There is no pass or fail grade associated with these tools but they are rated instead. These assessments are utilised to portray to the trainee how their current performance is and then improving through the feedback given by the tutor/assessor.

Q12. What are the main differences between the miniCEX and CbD?

Though they are both orientated around feedback from the tutor/assessor and then developing an action plan to improve the performance as a trainee, there are differences in the format of the assessment process and the criteria for assessment.In a mini-CEX, the assessor is able to assess the trainee’s practice in the clinical area where as in a CbD the assessor can only assess the trainee’s current knowledge and decision making and facilitate their further learning. In the miniCEX the assessor observes the trainee’s performance in the ward area in real time. The assessor observes the trainee’s interaction with the patient or other health care staff. In a CbD, the trainee and assessor a previously prepared clinical case in a quiet, private area. The CbD assessor may

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be different to the assessor for the mini--CEX and so they may not have assessed the trainee’s attitude or interpersonal skills. The assessor will ask probing questions which will require a more detailed explanation of the care issues compared to the questions asked in a miniCEX.

The Pharmacy Vocational Training Scheme VT2 and VT3 training

Frequently Asked Questions about how to complete the VT ePortfolio

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Key functions within the ePortfolio are the ability to ‘download your portfolio to e mail evidence to your tutor and trainers and the ticketed feedback system which enables them to provide written feedback after reviewing the pieces of evidence. Trainees should ensure that they are familiar with these two functions at the start of their training. View the ePortfolio presentation on the NES website to supplement your learning about how to use the ePortfolio.

Q1. Who is the VT e Portfolio intended for?

The VT e Portfolio is intended for those VT trainees who started the Pharmacy Vocational Training Scheme, from 1st January 2013 onwards. Vocational training is training that emphasises skills and knowledge required for a particular role. It applies to a current rather than a previous training role.

Q2. How will this change affect the trainee who started before January 2013?

We are not expecting people who started before January 2013 to use the e Portfolio because this would mean that they would need to transfer too much evidence from paper to an electronic format. They would need to ensure that their evidence was in line with the version of the competency framework that is within the e Portfolio. This may mean a lot of work for the trainee.

Q3. What does the development of an e Portfolio mean to both tutors and trainees?

The e Portfolio is a safe and secure system in which trainees will develop and store all of their evidence for a particular training programme. Tutors will be able to access the e Portfolio to review the evidence and provide feedback prior to meetings. This will hopefully improve the effectiveness of regular meetings between tutors and trainees.

Q4. How do tutors and trainees get started with the e Portfolio?

Once registered, both tutors and trainees will each receive a username and password within 1 week after the closing date for registration. To get started with the e Portfolio, trainees should review the various forms that are available within the e Portfolio and the resources section where there is guidance to help get them started. Within the Personal Library section, trainees should set up the folders as per the various sections outlined in the competency framework and ensure that the folders are configured correctly. Please note that once any of the folders contains an item, it cannot be deleted or reconfigured unless the folder is emptied first. It is advisable for the tutor to access the e Portfolio and help the trainee if required.

Q5. If the trainee has used the e Portfolio previously (e.g. pre-registration year), will it be necessary to change the username and password?

The same username and password should be used. Only those who haven’t used the e Portfolio will be sent a new username and password. To view the next aspect of training, the trainee will need to be registered onto the relevant training programme by NES Pharmacy staff. Once access has been granted they should on entering the e Portfolio remember to select the training available for a ‘registered pharmacist’ in order to see the relevant VT curriculum. The trainee will also be able to

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access any previous e Portfolio and as they progress through training any further training undertaken using e Portfolio.

Q6. What is available within the e Portfolio?

All current forms and templates are available within the VT e Portfolio either under the ‘Logs’ or the ‘Forms’ section. There are also Care Plans that can be developed over time, saved and then emailed to the specialist trainer for feedback. Furthermore, various resources e.g. the Competency Framework that the trainee needs to access are available as are links to the NES website and documents in the resources section.

Q7. What forms are available within the e Portfolio and which forms can be saved for editing prior to finally being saved?

There are a variety of different forms to capture evidence e.g. Action logs, Reflection logs, Feedback forms, Witness testimony forms, mini – CEX and Case based Discussion forms as well as Evidence forms, Reflective report forms; Dispensing services, Aseptic dispensing and Medicines information templates . The majority of forms are editable. Some forms have the ability to be saved as a ‘draft’ prior to sharing e.g. aseptic services activity and reflection log, dispensing services activity and reflection log, medicines information activity and reflection log.

Some forms are editable even after placed within the ‘shared area’ e.g. personal development plan, record of completion form, VT2 rotation record, VT action log and reflection log. This function allows trainees to share their personal development plan with their tutor prior to meeting and make any necessary changes following the meeting.

Some forms are non-editable and cannot be deleted e.g. VT record of meeting. Therefore, it is necessary for trainees to ensure that this completed form is submitted (shared) within their e Portfolio.

Q8. What information should be omitted from the e Portfolio?

All original prescriptions and worksheets and any information that has patient details included e.g. CHI numbers, any healthcare professional’s names, any names of NHS organisations that could enable the information to be traced back to a patient. Templates have been developed and are available within the ePortfolio to capture information from prescriptions and worksheets where there is patient identifiable information. Using the template should negate the use of patient identifiable information.

Q9. How do the ‘action logs’ and the ‘reflection logs’ differ from CPD records?

The action and reflection logs are standard templates that have been developed to be stored within the e Portfolio. CPD records, in contrast, are hosted externally by the GPhC and need to be uploaded into the Personal Library section of the e Portfolio. The formats of each type of log are quite similar with the action log being a record of an action/activity that has been completed while the reflection log and CPD records are a record of proposed learning i.e. learning needs.

Q10. Are action and reflection logs (in e Portfolio) interchangeable with CPD records?

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Action and reflection logs are just a much shorter version of a CPD record. It is fine to complete a CPD record instead of an action log but not vice versa as we prefer a much more detailed reflection as depicted in the CPD record.

Q11. How are CPD records imported from the GPhC website into the e Portfolio?

There are various ways in which the CPD records can be imported from the GPhC website into the e Portfolio. There is a presentation that covers this. One way is to copy and paste the CPD record into a word document, save it in a folder and subsequently upload it into the e Portfolio Personal Library. Alternatively, you can save the CPD record as a PDF, save it in a folder and then upload it into the Personal Library. However, this can only be done if a PDF creator is installed within the computer. On the other hand, the CPD record can be saved as a webpage and uploaded directly into the Personal Library. However, please note that the e Portfolio only support the webpage as the format of a single file Web Archive (*mht) that is only supported by the Internet Explorer.

Q12.Where are completed pieces of evidence stored?

The various forms will be stored within the relevant section within the e Portfolio. The competency can be linked to the piece of evidence and displayed as a list. This will help the tutor and trainee to identify any learning needs and help develop a personal development plan to cover the competency.

Most of your evidence will be saved in a standard format within the main part of your e Portfolio (Logs and forms section of e Portfolio, where there are a variety of forms but also action and reflection logs). There will be pieces of evidence that you wish to include that may not be in a standard format and available as a word document that you have created. This evidence should be uploaded into the Personal Library of your e Portfolio. We suggest that the Personal Library needs to be formatted carefully and outlined as per the competency framework prior to any evidence being uploaded. This is because once a folder contains even just one item; the folder cannot be deleted or reformatted unless it is emptied first. There is a presentation - Development of your e portfolio and a Guidance document that details how to do this effectively.

Q13. How can tutors and trainees learn to develop an online portfolio?

In addition to the presentation and VT e Portfolio Guidance document , there is a recording of a webinar with a specialist demonstrating the various aspect of e Portfolio. It is important for both the tutors and trainees to watch the recording before starting to develop an e Portfolio.

There is also a sample VT2 e Portfolio available for you to view.

Username: mcmillan4984 Password: olivermac! Please note that the competency framework within this presentation is not the most up to date version.

Q14. If the trainee has used the e Portfolio during their pre-registration training, is it necessary to view the webinar and read the Guidance?

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http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/the-pharmacy-vocational-training-scheme/stage-2-(vt2)/developing-your-vt2-portfolio.aspx


Whilst there are some similarities between both the PRPS and the VT e Portfolio there are some differences. Therefore, it will be beneficial if the trainee can view the webinar and get up to speed with the VT e Portfolio.

Q15. Can trainees download pieces of evidence from the e Portfolio to share with others?

Yes, there is a function to download the evidence as a PDF within the e Portfolio. This function would be particularly useful if trainees wish to receive feedback on a piece of evidence e.g. care plan/case study from their trainers or other healthcare professionals that would like to see the evidence before providing any feedback through the ticketed feedback system.

Q16. a) How do trainees receive feedback from the tutor or specialist trainer signing off the evidence?

The trainee’s tutor is linked to their e Portfolio and can view any ‘shared evidence’ and provide comment. For other specialists and trainers there is a ‘ticketed feedback system’ within the e Portfolio. Without having to receive paper copies of the evidence, the tutor will be able to provide feedback easily within the e Portfolio by adding signature or comment for each Log or Form that has been shared. Please note that this can be done by clicking on the ‘add link’ button below each Log or Form.

For other specialists and trainers there is a ‘ticketed feedback system’ within the e Portfolio. This enables the trainee to send the specialist/trainer a ‘ticket’ (an online feedback form or witness testimony) from the e Portfolio on which they provide comments. The individual will be sent a specific code via their email address and asked to provide feedback to a task that the trainee has undertaken. With the specific code, they can access the NHS e Portfolio to view the specific piece of evidence – they cannot view any other pieces of evidence.

Please note that once a ‘ticket’ is issued it is only available for feedback for 28 days from the date of issue.

Q16. b) How do I select the items from my e Portfolio to attach to the e mail for my tutor/specialist to provide feedback?

To select the pieces of evidence from your e Portfolio for the specialist/trainer to view, use the ‘Profile’ tab at the top of the screen. Select the ‘Down load portfolio ‘ button and then the link entitled ‘ items from my e Portfolio to make into a PDF...’

To create a PDF, select the items from your e Portfolio in the left box and click the >> arrow to move them to the box on the right hand side of the screen. Select the "Make PDF" button. The items will then appear as a PDF that can be saved as a file and then e mailed to the specialist/ tutor.

The tutor can then provide feedback on the form that they access via the ticketed feedback system.

Q16. c) How are the various forms and logs ‘signed’ by the specialist/tutor?

The various forms and logs are ‘signed’ by the tutor using the Links button at the bottom of the page. This provides the opportunity to provide either a comment or a signature by selecting the appropriate ‘Comments’ or ‘Signature button’. The piece of evidence should be shared with the specialist for

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feedback using the ticketed feedback system as described above. The feedback from the specialist can then be linked by the trainee to the relevant competency and this will then be able to be viewed as part of the evidence for the competency. The tutor can then ‘comment’ or ‘sign’ this piece of and this would all be viewed as part of the piece of evidence.

Q17. How do trainees receive feedback on a care plan/case study? (See also Q16).


The process that is used to get feedback from a specialist is the Ticketed Feedback Form process as mentioned above. Any comments received by the tutor/specialist may then be detailed in the reflective element of the care plan/case study or the piece of evidence edited and re saved and shared. However, it may be good practice to also send them a Witness Testimonial form to complete when you finalise the care plan/case study so that you get their final sign off.

Q18. Is there a care plan document that trainees can populate on the ward prior to populating in the e Portfolio?

Yes, there is a word document within the resources section of the e Portfolio and available on the VT pages of the NES website that trainees can print off and use on the ward after which they should copy the information into the e Portfolio.

Within the e Portfolio the various sections of the Care Plan can be edited several times prior to completion. Once complete they should be amalgamated using the software within e Portfolio and saved as a PDF document.

As an alternative to populating the different sections of the care plan and then amalgamating, a word version of the care plan can also be completed electronically and uploaded into Personal Library.

Q19. What evidence is required for each competency?

This detail is in the competency framework which is available within the resources section within the e Portfolio.

Q20. How do I link the evidence to a specific competency?

Trainees can link their evidence e.g. action or reflection logs, feedback forms, witness testimony, files that have uploaded into personal library, to the competency framework within the ePortfolio. Within each ‘logs’ or ‘forms’, there is a ‘links’ button. By clicking the ‘links’ button, trainees will be asked what would they like to link to that particular piece of evidence. To link to the competency framework, trainees should click ‘link with a curriculum item’ and select the curriculum e.g. VT2. A list of performance indicators that has incorporated within the competency framework will appear and trainees can add links to the performance indicators that they have achieved within the particular evidence.

Q21. How can Locality tutors or Educational Supervisors ‘sign’ off sections of evidence as the trainee progresses?

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The Completion of section form can be used by the Locality tutor /Educational Supervisor to indicate that the section of the e Portfolio is finished and in effect ‘signed off’ and ready for submission for assessment.

Q22. How should I navigate around the ePortfolio website?

It is recommended that you use the bar at the top of ePortfolio for navigation rather than the back arrow. Some people have encountered problems when using the back arrow.

Q23. What is the best way to request a Ticketed Feedback from a trainer, tutor or educational supervisor?

Once you have clicked on to the Ticketed Feedback ePortfolio webpage via the Forms section you should click on the "Request Ticket" option and the click on "Request New Assessment". You should then follow the instructions to send a request to your tutor, trainer or educational supervisor as appropriate. If you have evidence to submit at the same time you should send this by email at the same time.

Q24. Once a Log Entry has been signed off, can it be altered?

It depends of the entry however many cannot be edited once they have been signed by the trainee and the trainer or educational supervisor so be careful not to sign them off until they are fully completed

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The Pharmacy

Vocational Training Scheme

VT3 Training

Frequently Asked Questions about the Infection and Antimicrobial Stewardship module

Version 3.0 July 2014

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Acknowledgements

Grateful thanks is extended to Osman Saleem (Pre registration Pharmacist) and the various Project Managers and Leads for the various Specialist Groups for facilitating development of this document.

About this document

Within this document there are general questions with answers about Stage 3 Vocational Training (VT3 Training) and also more specific questions with answers about the various Specialist modules.

Contents

Section 1 General questions about VT3 training...............................................................................50

Q1.1.What is the pharmacy vocational training scheme Stage 3 (VT3)?......................................50

Q1.2.What is the purpose of Vocational Training (VT)?...............................................................50

Q1.3.What are the benefits of the training scheme for individual pharmacist?..........................50

Q1.4.How long will it take to complete the training?..................................................................50

Q1.5.Who can register for the training?......................................................................................50

Q1.6.What are the pre-requisites (PRs) for the training scheme?...............................................51

Q1.7.What will the training entail?..............................................................................................51

Q1.8.There are educational supervisors, tutors and mentors. What are the differences?..........51

Q1.9.How do trainees get started with the training?...................................................................52

Q1.10.What type of evidence do trainees need to collect?.........................................................52

Q11.1.If I have completed a Stage 2 of The Pharmacy Vocational Training Scheme (VT2), what

evidence can I transfer to the Stage 3 of The Pharmacy Vocational Training Scheme (VT3 )?.....52

Q1.12.What assessment will there be?........................................................................................53

Q1.13.What happens on successful completion of the training?.................................................53

Q14.1.What happens if I am not successful in assessment?........................................................53

Section 2 Questions about the VT3 Infection and AMS competency framework and ePortfolio......55

Q2.1.How many elements do I need to cover in this module?....................................................55

Q2.2.Which elements should I tackle first?..................................................................................55

2.3.How many electronic documents do I need to produce for ePortfolio?................................55

Q2.5.If I am e.g. working in a remote and rural setting or otherwise do not have access to all the

patient groups in the elements which I have chosen, how do I provide evidence of

pharmaceutical care performance indicators?............................................................................56

Q2.6.What do I do if I need to use the CPD/Reflective Essay option for several elements to

document my understanding of pharmaceutical care issues and thus I do not have enough

patient groups to allow me to have 6 Care Plans covering 9 specialist/clinical elements and an

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additional 4 patient groups to use for Mini - CEX as an alternative option for demonstrating the

provision of pharmaceutical care?...............................................................................................56

Q2.7.Do my Case based Discussions (CbDs) have to be linked with the same Care Plans as my

Case Studies?...............................................................................................................................57

Q2.8.Why is it suggested that the 6 Care Plans and Case Studies should cover at least 9

specialist/clinical elements within the module?..........................................................................57

Q2.9. What should I do if I want to complete the OPAT element but there is not yet a service

available within the area where I work?......................................................................................57

Q2.10.When should I produce a CPD record and when should I produce a Reflective Essay or

Action Plan?.................................................................................................................................57

Q2.11 How long should each CPD or Reflective Essay be?...........................................................57

Section 3 Questions about the resources listed on the NES website for the VT3 Infection and

Antimicrobial Stewardship module..................................................................................................58

Q3.1. If resources are listed in the "Core resources" list do I need to read, watch or complete

them all, even if I have a good knowledge and understanding of the subject already?...............58

Q3.2.Do I need to access all the Supplementary resources listed?..............................................58

Q3.3.Is the Core and Supplementary Resource List on the NES website automatically updated?

.....................................................................................................................................................58

Q3.4.If a resource is on YouTube and I cannot access this from work due to NHS restrictions,

what should I do?........................................................................................................................58

Q3.5.If I am experiencing problems accessing resources, if I wish to give urgent feedback about

resources or have any feedback on how this module is working in practice, whom should I

contact?.......................................................................................................................................59

Section 4 Further Questions.............................................................................................................59

Q4.1.If I am not yet practising as an Antimicrobial Pharmacist but would like to do so in the

future, can I apply to do the course?...........................................................................................59

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Section 1 General questions about VT3 training

Q1.1.What is the pharmacy vocational training scheme Stage 3 (VT3)?

VT3 is a structured, work-based training experience for hospital pharmacists with more than 2 years experience who wish to specialise within an area of pharmacy practice. The emphasis is on developing a portfolio which demonstrates competence of the various tasks detailed within the specialist competency framework. The training is addressed through directed learning, experience in practice and work-shadowing where appropriate.

Q1.2.What is the purpose of Vocational Training (VT)?

The purpose of the training scheme is to facilitate the acquisition of knowledge and skills necessary for pharmacists who wish to develop more specialist skills and in particular clinical skills within a specific area of practice e.g. infection and antimicrobial stewardship, older people, cancer, clinical trials, critical care, rheumatology and public health.

Q1.3.What are the benefits of the training scheme for individual pharmacist? How does the training

fit with other training e.g. MSc courses, RPS Faculty?

Completing the training scheme ensures that the pharmacists achieve a well-structured specialist clinical training within a specific clinical area. Being structured according to the Continuing Professional Development (CPD) cycle, the training scheme will also help the pharmacist to meet the GPhC mandatory requirements for CPD.

The training is designed to be undertaken in the workplace and is very much based on reflection and learning from experience. Aspects of the training may be used as part of further Post Graduate study. It is envisaged that the evidence gathered will also be able to be used to populate specific parts of the RPS Faculty portfolio should you choose to join the Faculty. This training is very much core training to ensure that appropriate skills and knowledge fora specific role are achieved.

Working with a specialist in the field (tutor and educational supervisor) the pharmacists will receive a very focused specialist training with senior pharmacists working in the area of practice.

Q1.4.How long will it take to complete the training?

The training generally takes about 18 months to complete and is generally completed after the vocational training scheme Stage 2 (VT2). However, this depends on the individual and the needs of the service. Some trainees will take longer than this. If the trainee hasn’t undertaken VT2 training, this is fine but there are some requirements to meet before they embark on their specialist training.

Q1.5.Who can register for the training?

The training scheme is open to all pharmacists with more than 2 years experience who wish to specialise or who are working in a specialist area of practice within NHS Scotland. The trainees ideally should have completed VT2, however this is not mandatory. Prior to application, the trainee must have the support of their designated line manager. Also, trainees must have a tutor and/or an educational supervisor who is registered as part of the scheme.

To register as a trainee for the scheme, please complete and submit an application that is available here.

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Q1.6.What are the pre-requisites (PRs) for the training scheme?

Trainees should have knowledge and understanding of the provision of pharmaceutical care to patients using the documentation provided. They should also have the knowledge and understanding of the audit process, the reporting of a Significant Event Analysis, critical appraisal, patient safety and risk management. Furthermore, there are some further prerequisites depending on the specialist module. The requirements vary depending on the specialist module. See the NES website for more information.

Q1.7.What will the training entail?

The training entails completing a variety of activities to demonstrate competence in the specialist area. There is also underpinning knowledge in a variety of different formats to support the training. Trainees need to complete the activities using a variety of different forms of evidence within their e Portfolio.

Q1.8.There are educational supervisors, tutors and mentors. What are the differences?

Educational supervisors are experienced senior pharmacists who are responsible for the trainee within a specific specialist area of pharmacy practice. They may be located within a different Health Board area within Scotland. They will not be expected to observe the trainees’ practice on a daily basis, but they should meet with their trainees on a regular basis i.e. once a month, and record the meetings within the ePortfolio. They will help the trainees to identify any development needs and provide any support of advice during their training. In addition, they will also undertake both the formative and summative assessment of the trainee. They are expected to attend the regular In Training Reviews (ITRs) for the trainees, the portfolio assessment and the final assessment panel if required. Meetings should be held virtually where possible.

To become an Educational Supervisor for a Specialist VT3 Module, the applicant should have a minimum number of years experience working as a pharmacist within the specialist area. For more information, please refer to NES website .

Tutors are experienced pharmacists within a specialist area of pharmacy practice that help facilitating the trainees’ training and assessing their development. Not all specialist training modules have tutors some only operate with educational supervisors. Tutors are not expected to observe the trainees’ practice on a daily basis, but they should meet with their trainees on a regular basis i.e. once a month, and record the meetings within the ePortfolio. They will help the trainees to identify any development needs and provide any support or advice during their training. Tutors are not expected to attend portfolio assessments or the final assessments but may be asked to attend the ITRs if required. The ITRs are generally hosted by the educational supervisors of the Specialist Interest Group (SIG).Meetings should be held virtually where possible.

The criteria for tutors are still under development. However, they are required to register with NES as part of the training scheme, detailing their professional journey/experience to date, their training/mentoring experience and their commitment to CPD within their application. Tutors are retrained approximately every 3 years when they come together to receive an update about the scheme and review evidence to ensure that they ‘calibrated’ with other tutors. For more information, please refer to NES website for more information.

Mentors are pharmacists who have recently completed the training scheme. They may informally advise new trainees and may share their experiences on completing the training. However, due to the novelty of VT3, there are only a few mentors currently within the one specialist area.

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http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/the-pharmacy-vocational-training-scheme/stage-3-(vt3)/fast-track-educational-supervisor-information.aspx

Q1.9.How do trainees get started with the training?

To get started, trainees should first familiarise themselves with the NES Pharmacy website (VT pages) and the personnel who are there to assist their training. Trainees should also access Portal the online booking system and update their details if required. This will ensure that they are eligible to attend a variety of events that are open to the VT3 trainees.

Once the trainees receive a username and password to access the ePortfolio, usually within one to two weeks following the closing date of registration, trainees should start setting up their ePortfolio. To learn more about how to set up the ePortfolio, please refer to FAQs about the VT ePortfolio. There is also a recording of an introductory webinar about how to use the VT ePortfolio available within the NES Pharmacy website (VT pages). While VT2 ePortfolio was used as a demonstration, the VT3 ePortfolio is very similar and it will be very helpful for you to watch this webinar. Similarly, a sample VT2 ePortfolio is available here for you to view.

Username mcmillan4984 and password = olivermac!

As Oliver also has a VT2 e portfolio, you should select the VT3 training plan so that you can view the VT3 competencies that are available to Oliver.Furthermore, trainees should also complete the induction information that is on the NES website.

Q1.10.What type of evidence do trainees need to collect?

Trainees need to collect a variety of different forms of evidence. There are Logs and Forms within e Portfolio.

GPhC CPD records are also to be collected as a form of evidence. Within the Logs section of e Portfolio there are action and reflection logs as well as activity logs. Within the forms section there are feedback forms and testimonial forms. There are also mini – CEX, Case based Discussion (CbD), case study and care plan templates.


If you currently don’t work in the specialist area you may need to shadow specialists for a specific amount of time to ensure that you can collect evidence for your portfolio.

Q1.11 .If I have completed a Stage 2 of The Pharmacy Vocational Training Scheme (VT2), what

evidence can I transfer to the Stage 3 of The Pharmacy Vocational Training Scheme (VT3 )?

The aim of VT2 training is to develop ‘generalist’ broad skills. The aim of VT3 training is to develop specialist skills within a specific area of practice. For VT3 training you will be attached to a new programme and hence a new competency framework and so you should develop new evidence at this more specialist level for inclusion in your VT3 e Portfolio.

Q1.12 What resources are available to help me?

There are a variety of resources available for each specific VT3 module. The induction resources are ‘core’ for all VT3 modules. Should you wish to include a further resource for your specific area of practice please e mail [email protected] with details of the reference/resource and it will be considered for inclusion. Likewise, if you feel that there is a more up to date version of a resource available please advise us and we will update our resources accordingly.

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https://www.nhseportfolios.org/Anon/Login/Login.aspx?ReturnUrl=%2FAuth%2FSitePages%2FTrainee%2FDefault.aspx

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/about-nes-pharmacy/educational-resources/resources-by-topic/personal-development/e-portfolio-webinar-for-vt2-trainees.aspx

http://www.nes.scot.nhs.uk/media/2340917/frequently_asked_questions_about_the_vt_e_portfolio_trainees_7th_october_2013.docx

https://www.portal.scot.nhs.uk/


Q1.13.What assessment will there be?

There are informal formative assessments that are held on a regular basis with the educational supervisors for the specific area. These are In Training Reviews (ITRs). Your tutor or educational supervisor should also be providing feedback on your evidence as you progress through training. This in itself is a formative assessment. There is a portfolio assessment which is a final summative assessment. Pairs of assessors assess portfolios using a marking schedule. If the trainee successfully passes the portfolio assessment, they are invited to attend the final face – to – face assessment. The final assessment lasts approximately 1.5 hours and is when the trainee’s portfolio is discussed in depth with an assessment panel. There is a specific marking schedule that has been mapped to the various advanced level frameworks. Please see the NES Pharmacy website and the Guidance document for further details.

Q1.14.What happens on successful completion of the training?

On successful completion of the training you will be awarded a certificate of completion of the specific module.

Q1.15.What happens if I am not successful in assessment?

If you are not successful at the portfolio assessment then you will be invited to resubmit your portfolio at the next diet of assessments. If you are successful at the portfolio assessment but not successful at the final assessment, then, you will be invited to attend the next set of final assessments using your current portfolio. The final assessments are generally every 12 months (annually).

Section 2 Questions about the competency framework and ePortfolio

Q2.1.How many elements do I need to cover in this module?

You need to cover a total of 15 elements: the 11 core elements plus a choice of 4 from the 10 elective elements.

Q2.2.Which elements should I tackle first?

It is recommended that you start by covering Elements 1-4 initially: Introduction to antimicrobial stewardship; Essential pharmaceutical microbiology incorporating resistance and immune function; Antimicrobial agents by therapeutic class; and Healthcare associated infection. This will ensure that you have robust background knowledge of the subject.You can document the pharmaceutical care performance indicators from these elements at any time throughout the training period as you come across appropriate patients.

Once you have covered the main points of Elements 1-4 you can then approach the rest in any order you prefer.

Q2.3.How many electronic documents do I need to produce for ePortfolio? (Please also see the VT

ePortfolio FAQs document)

You require:

15 x Feedback forms - one for each element covering all the competencies included in the element.

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A mixture of 15 pieces of evidence including: GPhC CPD entries, Reflective Essays and Action Plans. The individual element will offer a choice of these as appropriate. Element 2 requires 2 different CPD/Reflective Essay submissions while none of these are required for Element 11. GPhC CPD records can be uploaded to your personal library.

A minimum of 6 Care Plans including at least 9 of the clinical/specialist elements being covered by the trainee.

6 Case Studies including at least 9 of the clinical/specialist elements being covered by the trainee and based upon 6 Care Plans identified above. 4 Case based Discussions (CbDs) which either can be associated with the Care Plans already being used with the Case Studies or can be associated with a separate Care Plan and then submitted in place of a Case Study as evidence of the provision of pharmaceutical care if you already have your full quota of 6 Case Studies.

NB Each Case Study and CbD must be linked with a Care Plan

4 Mini Clinical Examinations (Mini - CEX) which should be conducted on a patient for whom the trainee has not previously developed a Care Plan. The Mini - CEX can be used as an alternative to a Care Plan with Case Study and/or CbD to demonstrate the provision of pharmaceutical care to patients within an element. The Mini - CEX can be performed under the supervision of a senior/specialist member of the pharmacy staff or e.g. an infectious diseases consultant as appropriate.

1 or 2 Testimonials for Element 1, Performance indicators 1.4 and 1.5 can be covered in one Testimonial from one senior member of the healthcare team, or if appropriate from two different senior healthcare professionals.

4 Records of Completion ( MCQ Scores) Logs for Elements 2 and 10. Even if the trainee is fully conversant with the content of the e-learning package and does not require to go through the package itself, they should complete the MCQs as evidence and document their score and a brief summary of learning points using the ePortfolio log.

2 Presentations with Training Plans covering Elements 4 and 11 (These are not e portfolio documents and should be uploaded to your personal library).The relevant number of completion forms for the individual elements within your competency framework.

Q4 How do I record evidence of submitting a Yellow Card if I have completed one?

When you are completing the Yellow Card, either on paper or online, make sure you do not include any patient identifier material such as CHI numbers or dates of birth. You will have to include the patient's initials for the MHRA. As any saved copy of a Yellow Card will contain the patient's initials, this cannot be uploaded as evidence to ePortfolio. To record evidence of submitting a Yellow Card simply record brief details of the suspected drug(s) and adverse reaction(s) in your CPD record, Reflective Essay or Case Study as appropriate indicating that a Yellow Card was submitted.

Q2.5.If I am e.g. working in a remote and rural setting or otherwise do not have access to all the

patient groups in the elements which I have chosen, how do I provide evidence of pharmaceutical

care performance indicators?

For Elements 2 and 9 in the core section and Elements 12 to 14 and 16 to 21 of the elective section where it may not be possible for all antimicrobial pharmacists to access a patient with these particular pharmaceutical care requirements within the time allocated to complete the module, you do not

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need to complete a Care Plan, Case Study, CbD or Mini - CEX. As an alternative you should discuss the specific pharmaceutical care needs for this group of patients in your CPD or Reflective Essay explaining how you would expect to address such needs in practice.

If you have trouble accessing a group of patients where this alternative option is not listed then please discuss this with your Educational Supervisor and the Lead Pharmacist for Educational Development at NES.

Q2.6.What do I do if I need to use the CPD/Reflective Essay option for several elements to

document my understanding of pharmaceutical care issues and thus I do not have enough patient

groups to allow me to have 6 Care Plans covering 9 specialist/clinical elements and an additional 4

patient groups to use for Mini - CEX as an alternative option for demonstrating the provision of

pharmaceutical care?

If you do not have access to enough different patient groups to use the Mini - CEX option as an alternative to developing a Care Plan/Case Study/CbD then you will need to identify a different patient within one of the elements for which you have already developed a Care Plan. This second patient can be used to demonstrate your patient centred communication and problem solving skills employing the Mini - CEX.

If you are practising in a remote and rural setting you may wish to try to choose your elective elements to maximise your ability to meet the basic requirements for Care Plans and Case Studies i.e. to try to make sure that you can cover at least 9 elements in your Care Plans and Case studies.

Q2.7.Do my Case based Discussions (CbDs) have to be linked with the same Care Plans as my Case

Studies?

No, within a specific element, if you have a Care Plan for a patient you can either use this with a Case Study alone, a CbD alone or you can link a Case Study and CbD to the same Care Plan. So long as you produce 6 Case Studies and 4 CbDs for the module, you may mix and match as you wish. This gives you the option to demonstrate the provision of pharmaceutical care as a Case Study, CbD or Mini - CEX.

Q2.8.Why is it suggested that the 6 Care Plans and Case Studies should cover at least 9

specialist/clinical elements within the module?

It is expected that there will be considerable overlap between the elements within the module e.g.: if you have a patient with sepsis, there could also be pharmacokinetic considerations for that patient; if you have a patient with a skin and soft tissue infection, there could also be HAI issues; if you have a patient with a urinary tract infection this may also include the application of pharmaceutical stewardship in practice etc.

Q2.9. What should I do if I want to complete the OPAT element but there is not yet a service

available within the area where I work?

You should speak with your line manager or Director of Pharmacy (DoP) to make sure that it will be possible for you to be released for at least one day to either work-shadow within an OPAT team or attend an OPAT clinic to gain some experience of an OPAT service first hand. You will NOT however be required to identify a patient for whom to develop a care plan during that time.

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Q2.10.When should I produce a CPD record and when should I produce a Reflective Essay or Action

Plan?

We have given you the option to provide evidence as GPhC CPD records so that you do not need to do any more work than necessary to meet the GPhC requirements while completing the module. You should follow the GPhC guidance regarding how many CPD records should start from reflection.If you are completing the module as a full-time antimicrobial pharmacist over about 18 months then you would be expected to produce between 13 and 15 CPD records within that time to meet GPhC requirements. This is why we have suggested that you could provide your evidence for most of the elements as a CPD record. For some more in-depth pieces of evidence you may however wish to use the Reflective Essay on e portfolio as an alternative.If you are working as an antimicrobial pharmacist part-time along with other pharmacy duties then you would not expect all your GPhC CPD records to involve antimicrobials and stewardship. In this case you could, for example produce 8 CPDs for the module and cover the other elements with Reflective Essays.

In some elements there is the option to document your evidence as an Action Plan if it is anticipated that a slightly shorter report may be adequate.

We have aimed to make the choices for recording evidence as flexible as possible so you can pick and choose as you prefer in most cases while giving you the option to minimise duplication of work to fulfil GPhC requirements.

Q2.11 How long should each CPD or Reflective Essay be?

Try to keep each CPD or Reflective Essay as succinct as possible. These reports do not need to be long, so long as they provide enough evidence to meet the performance indicators. We do not stipulate specific word counts however, as a rough guide, most CPDs and Reflective Essays should be equivalent to not more than a couple of sides of A4 if possible. For some reports such as those in 2.3, 2.7 and Elements 3, 16 and 17 where there is a lot to cover, or if you need to include pharmaceutical care considerations within your CPD/Reflective Essay, then the report may need to be longer to include all the necessary details. In such cases try not to exceed a maximum of 2000 words.

SECTION 3 Questions about the resources listed on the NES website for the VT3 Infection and

Antimicrobial Stewardship module

Q3.1. If resources are listed in the "Core resources" list do I need to read, watch or complete them

all, even if I have a good knowledge and understanding of the subject already?

No, if you feel that you are up to date on the subject already, e.g. you helped to develop the SIGN guideline in question or use it on a regular basis then you are not obliged to read it again. You should however be able to demonstrate an understanding of the subjects in the core resources in the evidence you produce as your performance indicator.

If there is a requirement for evidence as a record of completing an MCQ for an eLearning resource then you can complete the MCQ without working your way through the whole programme so long as you are confident that you know the subject well.

Q3.2.Do I need to access all the Supplementary resources listed?

No, the supplementary resources are available in case you wish to investigate a subject in more depth either while you are completing the Infection and Antimicrobial Stewardship Module or at some time

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in the future. These supplementary resources have been identified by ASAP members as useful additional information which you can access as you wish.

Q3.3.Is the Core and Supplementary Resource List on the NES website automatically updated?

No. The ASAP Education Sub-committee will review the Core resource list every 2 years on a rolling programme however it will be your responsibility as a professional pharmacist to ensure that you are sourcing the most up to date evidence e.g. if a new NICE guideline is published and the previous version is still listed on the resource list, you will be expected to work with the latest version.

There is a column on the far right of the resource list where you can comment about any of the resources and highlight any that have been superseded.

Q3.4.If a resource is on YouTube and I cannot access this from work due to NHS restrictions, what

should I do?

Currently there are only a few resources which are accessed via YouTube and not all are core resources. If your NHS site does not allow access to these either via the NHS computer or a personal electronic device then it would be recommended that you should access then from your home PC or laptop. We apologise for any inconvenience this may cause.

Q3.5.If I am experiencing problems accessing resources, if I wish to give urgent feedback about

resources or have any feedback on how this module is working in practice, whom should I contact?

You can contact either the Chair of the ASAP Education Sub-committee or the Lead Pharmacist for Educational Development at NES ([email protected] ).

Section 4 Further Questions

Q4.1.If I am not yet practising as an Antimicrobial Pharmacist but would like to do so in the future,

can I apply to do the course?

Yes, if your DoP is willing to put you forward for the course with a view to developing your career as an antimicrobial pharmacist in the future, then this would be possible. It may however be necessary to arrange more work-shadowing to enable you to complete the course successfully. This should be discussed with your DoP and the Lead Pharmacist for Educational Development at NES.

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References

1. NHS Education for Scotland. Pharmacy, Vocational Training www.nes.scot.nhs.uk/Pharmacy/Vocational training (accessed December 2014).

2. The Scottish Executive Health Department. The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. Edinburgh: The Scottish Executive, 2004.

3. Relaunch of national training scheme for hospital pharmacist in Scotland. The Pharmaceutical Journal.Forum:2000;264:381.

4.McMillan F. Is this Examination Fit for Purpose? [assignment]. Edinburgh:Univ. Edinburgh.2006.

5. McMillan F., What were the learning experiences of Pharmacists who have completed Stage 2 of the Scottish Hospital Pharmacists’ Vocational Training Scheme? [Dissertation] Edinburgh :Univ Edinburgh. 2009.

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http://www.nes.scot.nhs.uk/Pharmacy/Vocational

Appendix A (1)

Forms within the VT e Portfolio

Forms Ticketed? SectionFeedback Form Y Forms > Ticketed FeedbackWitness Testimony Y Forms > Ticketed FeedbackAdditional Action Plan N Forms > Appraisal / Meeting FormsVT Appraisal Y Forms > Appraisal / Meeting FormsWeekly Review Meeting Record N Forms > Appraisal / Meeting FormsVT Record of Meeting N FormsRecord of Completion of Section N Forms > CompletionVT Rotation Record N Logs > Learning and Reflection Case-based Discussion (CbD) Y Logs > Learning and Reflection Mini-Clinical Evaluation Exercise (Mini-CEX) Y Logs > Learning and Reflection Action Record N Logs > Learning and Reflection Scribble N Logs > Learning and Reflection Case study log N Logs > Learning and Reflection Medicines Information Activity and Reflection N Logs > Learning and Reflection Dispensing Services activity and reflections log N Logs > Learning and Reflection Aseptic services reflection log N Logs > Learning and Reflection Aseptic services activity log N Logs > Learning and Reflection Declaration of own work N Logs > Learning and Reflection CMS Care Plan N Logs > Learning and Reflection Reflection Log N Logs > Learning and Reflection Record of Completion (MCQ Scores) N Logs > Learning and Reflection Personal development form N Logs > Personal Development PlanCare Plan: Clinical Management N Profile > Care Plan Do not useCare Plan: Continuity Of Care N Profile > Care Plan Do not useCare Plan: Current Medication N Profile > Care Plan Do not useCare Plan: Factors Affecting N Profile > Care Plan Do not useCare Plan: Investigations N Profile > Care Plan Do not useCare Plan: Medical and Drug History N Profile > Care Plan Do not use Care Plan: Patient Details N Profile > Care Plan Do not useCare Plan: Pharmaceutical Care Plan N Profile > Care Plan Do not useCare Plan: Reviews N Profile > Care Plan Do not useCare Plan: TDM N Profile > Care Plan Do not useCare Plan: Summary N Profile > Care Plan Do not useCare Plan: Reflection and learning N Profile > Care Plan Do not useCare Plan: Feedback Form N Profile > Care Plan Do not use

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Appendix A (2)

Different forms for different forms of evidence

Form/ evidence

typeUse when? Used by

whom?

Completed by whom?Comments

CPD record To evidence reflective practice VT Trainee VT trainee CPD/PDP plan

Completion of resources

Record completed resources

VT TraineeVT trainee

Completion of Resources Form

Feedback form

Obtain feedback from healthcare

professionalsVT Trainee

Other healthcare professionalsPharmacists

TrainersTutor

Feedback form(Each section pf the CF should have a min of 1

Feedback form).

Witness testimonial

Obtain feedback on performance of undertaking a

specific task

VT Trainee

Other healthcare professionalsTrainers

Tutor Witness testimonial

Clinical care plan and

case study guidance

To evidence pharmaceutical

care issuesVT Trainee VT trainee

TrainersTutor

Clinical care plan guidanceClinical case study guidance

Medicines information

template

To record MI enquiries + reflections

VT2 Trainee

VT traineeTrainersTutors

( Sign off by trainer using Ticketed Feedback process and witness

testimony)

Enquiry Answer Assessment FormTemplate for MI enquiry

Clinical governance and patient

safety

To record analysis of a significant

eventTo record an

audit

VT2 Trainee VT2 Trainee SEA template Audit template

Aseptic template(s)

To record aseptic products checked

+ reflectionsVT2 Trainee

VT2 Trainee( Sign off by trainer using Ticketed

Feedback process and witness testimony)

Products checked Reflections

Dispensing template

To record prescriptions

checked + reflections

VT2 TraineeVT2 Trainee

( Sign off by trainer using Ticketed Feedback process and witness

testimony)

Products checked and reflections

Education and training

To record a training plan for an educational

session

VT2 Trainee VT2 Trainee Training plan

Evidence scoring tool

A tool to help tutors provide feedback on

specific pieces of evidence

TutorTrainer

TutorTrainer Evidence scoring tool

Completion of activities

guidance

To check which activities should be done when

VT2 trainee VT2 trainee Guidance for completion of activities

Appraisal 6, 9 and 15 mths VT2 Tutor Appraisal form

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http://www.nes.scot.nhs.uk/media/3308/1-stage2-appraisal-form-july-2009.doc

http://www.nes.scot.nhs.uk/media/2040531/stage_2_activities_1st_may_2013_v3.doc

http://www.nes.scot.nhs.uk/media/2967230/evidence_scoring_tool__1st_sept_2014_final_for_circulation2.doc

http://www.nes.scot.nhs.uk/media/1682984/teaching_plan_for_teaching_5th_year_medical_students_on_preparation_for_practice.doc

http://www.nes.scot.nhs.uk/media/1666379/discharge_script_template_4.doc

http://www.nes.scot.nhs.uk/media/1666274/aseptic_services__template_3.doc

http://www.nes.scot.nhs.uk/media/1666277/aseptic_services__template_2.doc

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/cpd-audit,sea/audit.aspx

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/pharmacists/cpd-audit,sea/significant-event-analysis-for-pharmacy-staff.aspx

http://www.nes.scot.nhs.uk/media/1715766/mi_stage_2_template_jan_2013_final_for_release_1.doc

http://www.nes.scot.nhs.uk/media/1599234/i_medicines_information_enquiry_answer_form_document_aug_2012.doc

http://www.nes.scot.nhs.uk/media/3311/4-casestudy-proforma-1.pdf

http://www.nes.scot.nhs.uk/media/3312/5-care-plan-proforma-june-2011.doc

http://www.nes.scot.nhs.uk/media/2838928/witness_testimony_sept_2014.docx

http://www.nes.scot.nhs.uk/media/3318/stage2-testimonial-feedback-form-july-2009.doc

http://www.nes.scot.nhs.uk/media/2551094/20-02-14_vt2_and_vt3_completion_of_resources_form-1.rtf

http://www.nes.scot.nhs.uk/media/3310/3-cpd-plan-for-stage-2-vocationaltrainings-scheme.doc

form trainee (e mail [email protected] when completed)

Record of meetings form

Monthly when meet with tutor/trainer

VT2 trainee Tutor

Record of meetings

(meet with tutor 1/mth)

Record of rotation form

Monthly to record your rotation

VT2 trainee VT2 trainee

Record of rotational experience

Completion of section form

On completion of each section

VT2 trainee

VT2 traineeTutor

(Specialist should provide feedback via Ticketed Feed

back process using a witness testimonial then

tutor should complete Completion of Section

form)

Completion form

Declaration of own work form

On submission for assessment

VT2 trainee

Prior to submission for assessment +15mth appraisal

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http://www.nes.scot.nhs.uk/media/1700588/record_of_completion_of_section_form_feb_2013.doc

http://www.nes.scot.nhs.uk/media/3317/rotation-record.doc


Appendix B

Format of VT2 and VT3 final assessmentTrainees may be awarded Pass, Pass with merit or Pass with distinction. To achieve a Pass with merit, trainees need to have a good pass in the ‘core areas’ of their portfolio plus their face to face assessment.

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IntroductionsDescription of the assessment forms

Presentation of case (10 mins)

VT2 Generalist (1 hour)Questions from panel members about the presentation

VT3 Specialist (1.5 hours)Questions from panel members based on question proformaquestion proforma

VT3Discussion of evidence from ePortfolio

Assessment of application of specialist knowledge in practice

Assessment of problem solving skills from 4 practice based scenarios.

Question using proforma

Discussion of items from ePortfolio

VT3Discussion of VT3 journey, reflections and close

Assessment of presentation skills, response to questioning, systematic approach, awareness of own limitations, generalist knowledge and understanding.

VT2Discussion of VT2 journey, reflections and close

Discussion of items from ePortfolio

Appendix C

Format of portfolio assessment for VT2 and VT3 trainees

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Trainee indicates to LT that they wish to submit their portfolio for the final assessment

Portfolio submitted to NES assessment by specified deadline

Portfolio assessed by pair of assessors using standard framework

Feedback provided. Trainee advised of items for final assessment

Trainee receives information about final assessment

Trainee submits any requested items to NES + presentation

Final face to face assessment by panel

VT2 – NES, PEC/LT + University representative)

VT3 – NES, 2 members of SIG + external SIG representative

Trainee asked to defer to next set of final assessments.

Successful trainee receives certificate of completion of VT2 or Specialist module

competence - web viewthis can be in the form of a word document and ... of the competency against...

Documents