Exploring a collaborative approach to the involvement of patients, carers and the public in the initial education and training of healthcare professionals: A qualitative study of patient experiences.

OBJECTIVE: This study aimed to explore patients' experiences of their involvement in the design and delivery of interprofessional education interventions focussing on mental ill-health for students studying in undergraduate healthcare and healthcare-related programmes. DESIGN: A qualitative methodology using a Grounded Theory approach was used to undertake an iterative series of focus groups with members of a university's Patient, Carer and Public Involvement (PCPI) Group who have a history of mental ill-health and were involved in the development and delivery of educational interventions for students on undergraduate healthcare and healthcare-related programmes. Their experiences of being involved in teaching and learning activities, collaboration with academic staff and integration into the academic faculty were explored. Constant comparative analysis facilitated the identification and prioritisation of salient themes. RESULTS: Five salient inter-related themes emerged from the data: (1) reduced stigma and normalisation of experience of illness; (2) enhanced self-worth; (3) improved well-being; (4) community and connection; and (5) enduring benefits. CONCLUSIONS: A supportive university community and a designated academic PCPI co-ordinator facilitate a supportive environment for patients and carers to develop as educators, contribute to the training of future healthcare professionals and improve their own personal well-being. Appropriately resourced and well-supported initiatives to integrate patients, carers and the public into the functions of an academic faculty can result in tangible benefits to individuals and facilitate meaningful and enduring connections between the university and the wider community within which it is situated. PATIENT AND PUBLIC INVOLVEMENT: Patients have been involved in the design of the teaching and learning initiatives that this study was primarily focused on. Patients were given autonomy in determining how their experiences should be incorporated into teaching and learning experiences.

Evaluating the numeracy skills of pharmacy students in multiple choice questions and free-text answer assessments and their perception of numeracy in clinical practice.

INTRODUCTION: Numerical errors can cause unintentional harm to patients and are a burden to healthcare systems worldwide. There is a paucity of research regarding numerical competence in pharmacists and pharmacy students and how this should be assessed within undergraduate and licensure assessments. METHODS: Two numeracy assessments were given to year three and four pharmacy students at the University of Sunderland, United Kingdom. One paper included ten multiple-choice questions (MCQs) and the second ten free-text answer questions. Participants were then given an evaluation questionnaire to explore their perceptions about the assessments and numeracy in clinical practice. RESULTS: A response rate of 75% (n = 247) was achieved, with 60.9% of students passing the MCQ and 27.9% passing the free-text answer assessments. There were statistically significant differences in pass rates depending on year of study, ethnicity, and previous mathematics qualifications. Participants were asked if numeracy was an important skill for pharmacists in practice; 57.9% thought it were essential and 36.4% quite important. However, only 1.4% felt sufficiently supported in the development of the required numeracy skills, and this has prompted a redesign of teaching and assessment at the university. CONCLUSIONS: Educators need to ensure taught and assessed numeracy is reflective of and transferable to pharmacy practice, whilst ensuring students are supported effectively and engaged. This is likely to be achieved with integrated and clinically focused teaching approaches and appropriately constructed assessments throughout the pharmacy programme.

Community pharmacy as an effective teaching and learning environment: Student perspectives from a UK MPharm programme.

INTRODUCTION: In order to increase new pharmacists' preparedness for clinical practice, pharmacy education in the United Kingdom (UK) is moving towards a five-year integrated degree incorporating the pre-registration year into the undergraduate programme. The purpose of this research is to explore masters of pharmacy (MPharm) student attitudes towards experiential learning and assess community pharmacy as a teaching and learning environment. METHODS: MPharm students (n = 857) at one UK pharmacy school were invited to complete an online questionnaire. Responses were statistically analysed while open comments were thematically analysed. RESULTS: Students were positive about placement organisation, with over 80% agreeing the pharmacist and support staff were enthusiastic and well-prepared. However, 62% of respondents felt they were unable to interact with patients on placements and instead spent time completing pre-determined learning tasks. Seventy-seven percent felt these tasks limited real "hands-on" experiences. Although 78% of respondents believed placements provided a valuable learning experience, only 18% thought placements prepared them for post-graduate employment. CONCLUSIONS: Community pharmacy environments are often busy and unpredictable, and experiential learning should be designed to allow better exposure to clinical practice with less pre-defined learning. Placements should allow for more collaborative working between universities and employers and incorporate the use of learning standards. This would represent a move towards a five-year integrated degree and a better understanding of the associated challenges involved.

Pre-registration pharmacist tutor training: a pilot study.

BACKGROUND: The quality and variability of pre-registration pharmacist training has been questioned in recent years, with many trainees reporting dissatisfaction with their training experiences. A pilot training event aimed at pre-registration tutors from all sectors of practice was developed by Health Education England North East (HEENE) in 2016 to address some of these issues, with the overall aim of developing and preparing new tutors for the role of the tutor. CONTEXT: Quantitative data were collected via questionnaires given to the participants before and after training. The questions focused on participants' perceptions of their competence as a tutor across a range of domains, such as assessing trainee progress in the workplace, providing feedback and reflective practice. Interviews were subsequently held with a subset of participants to help understand the key themes and responses. INNOVATION: Results were overwhelmingly positive, with participants reporting an increased level of confidence in their role, having made positive changes to their practice as a tutor. The only domain that did not show a positive shift after training was 'undertaking of reflective practice'. Participants attributed this to the lack of protected time in the workplace to support reflective practice. The quality and variability of pre-registration pharmacist training has been questioned in recent years IMPLICATIONS: Results from this evaluation imply that this tutor training event was felt to be worthwhile, met the needs that it was developed to address and has the potential to have a positive impact on the standardisation of pharmacist pre-registration tutor training nationally. Areas for improvement centre on external factors relevant to pharmacists' daily practice, such as being allocated time in (or outside of) the workplace to support personal development.

Exploring the utility of the Prescribing Safety Assessment in pharmacy education in England: experiences of pre-registration trainees and undergraduate (MPharm) pharmacy students.

OBJECTIVES: (i) To provide a preliminary indication of the performance of pharmacy undergraduate students and pre-registration pharmacy trainees in the Prescribing Safety Assessment (PSA). (ii) To determine the feasibility of administering and delivering the PSA in schools of pharmacy. (iii) To examine the potential relevance of the PSA and associated training materials to pharmacy education. (iv) To assess the attitudes of the cohort towards the PSA and their readiness to prescribe. METHODS: Four schools of pharmacy in England recruited final year undergraduate pharmacy students and pre-registration pharmacy trainees undertaking training with both hospital and community pharmacy employers in their locality to undertake the PSA. Performance data and feedback from candidates were obtained. KEY FINDINGS: Pre-registration pharmacy trainees in community (n = 27) and hospital (n = 209) settings mean average scores were 86.3% and 85.3%, respectively. There was a significant performance differential between undergraduate pharmacy students (n = 397) and those in pre-registration training, with the mean average score for undergraduate students being 73.0% (t test P < 0.05). Candidates felt their current course did prepare them for the PSA, some highlighted that additional curriculum content would be needed should this become a compulsory high-stakes assessment for pharmacy trainees. The majority of candidates felt that this assessment was useful and applicable to their training. CONCLUSIONS: The PSA process and associated learning tools could be introduced to pre-registration pharmacy education to support trainees in their development towards future prescribing roles.

Evaluation of the anaesthetic effects of combinations of ketamine, medetomidine, romifidine and butorphanol in European badgers (Meles meles).

OBJECTIVE: To evaluate the effects of three anaesthetic combinations in adult European badgers (Meles meles). STUDY DESIGN: Prospective, randomized, blinded, experimental trial. ANIMALS: Sixteen captive adult badgers. METHODS: The badgers were each anaesthetized by intramuscular injection using the three techniques assigned in random order: romifidine 0.18 mg kg(-1), ketamine 10 mg kg(-1) and butorphanol 0.1 mg kg(-1) (RKB); medetomidine 0.1 mg kg(-1), ketamine 9 mg kg(-1) and butorphanol 0.1 mg kg(-1) (MKB); and medetomidine 0.1 mg kg(-1) and ketamine 10 mg kg(-1) (MK). Initial drug doses were calculated based on a body mass of 10 kg. Additional anaesthetic requirements, time to drug effect, duration of action and recovery from anaesthesia were recorded. Heart rate and rhythm, respiratory rate and rhythm, rectal and subcutaneous microchip temperature and oxygen saturation were recorded every 5 minutes. Depth of anaesthesia was assessed using: muscle tone; palpebral and pedal reflexes; and tongue relaxation at these time points. Blood samples and a tracheal aspirate were obtained under anaesthesia. Atipamezole was administered if the badger had not recovered within 60 minutes Parametric data were analysed using anova for repeated measures, and nonparametric data using Friedman's, and Cochran's Q tests: p < 0.05 was considered significant. RESULTS: All combinations produced good or excellent muscle relaxation throughout the anaesthetic period. RKB had the shortest duration of anaesthesia (16.8 minutes compared with MKB 25.9 minutes and MK 25.5 minutes) and antagonism was not required. RKB depressed respiratory rate less than MK and MKB. There was no significant difference between techniques for heart rate and rhythm. CONCLUSIONS AND CLINICAL RELEVANCE: All combinations provided anaesthetic conditions suitable for sampling and identification procedures in adult badgers. The RKB protocol provided a significantly shorter period of anaesthesia when compared with the combinations containing medetomidine.