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Theory to practice: reflecting on the jump from pharmacy student to preregistration pharmacist

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I felt ready to enter the working world towards the end of my fourth year of my MPharm degree. And after my 50:50 placement in hospital and community, I knew it was going to be a fast-paced year, but I was excited to finally apply my learning to practice.

My first six months are based in hospital, and for the first few weeks I worked in the dispensary, completing my dispensing log and settling in. The dispensary is a central point for all staff and is the best place to get to know the roles in the team and think about where I fitted in.

The biggest shock came when I shadowed the senior pharmacists. I found it difficult to apply the knowledge I gained at university to practice. I achieved a first-class degree and I didn’t struggle with learning, so I knew I needed to re-learn topics I had covered in university in a way more applicable to real-life practice.

I have just completed my 13-week appraisal and am becoming more comfortable with the way in which I review a patient’s medication. My hospital drew up a timetable for my first 13 weeks, in which I shadowed senior pharmacists across the main medical and theatre wards. This gave me insight into what I need to learn. I have created information tables including treatment pathways or causes of electrolyte disturbances. I have also observed multiple methods of medication reconciliation and reviews of patients’ treatments from many pharmacists, with a range of experience, which I can use in my own practice during the upcoming year.

Experience in both community and hospital pharmacy is important. Each of the sectors are far more specialised than I thought they were when I left university. I would have struggled working in hospital if I had taken a placement only in community. And my colleagues working in community have much stronger knowledge of over-the-counter and law aspects.

All preregistration students should complete a minimum of four weeks in each sector of pharmacy; at least 13 weeks is necessary to gather a better insight. I researched Kolb’s experiential learning while writing my final year dissertation at university. A study by Lisko and O’Dell found that Kolb’s experiential learning theory method was well received by nursing students and reported significant learning, but this was not quantified1. Other healthcare courses, including nursing and medicine, incorporate placements and experiential learning. Integration of placements provides opportunities for critical thinking to consolidate classroom-based learning. Community and hospital placements are incorporated into pharmacy courses but are not a requirement. Universities provide placements of different lengths (1–4 weeks in total). Experiential learning provides insight into pharmacist roles that would be difficult to attain in theory1.

The MPharm course is too orientated around exams, and the curriculum needs drastic change. I organised many placements myself, but, with heavy workload and exam requirements, this was extremely difficult during term time. A more placement-orientated course, similar to the nursing and medical degrees, will allow the next generation of pharmacists to develop essential skills and knowledge much earlier on in their careers.

The upcoming integration of the preregistration year into the university courses may begin the move to a more practice-based course and could standardise cross-sector placements.

References
1. Lisko SA and O’Dell V. Integration of theory and practice: experiential learning theory and nursing education. Nurs Educ Perspect 2010;31(2):106–108. PMID: 20455368

Readers' comments (1)

  • Thanks for posting this, Gemma.
    As a first time pre-reg tutor, I was interested in your comments around the transition from theory to practical work place pharmacy.
    Interaction with patients/customers is not easy to simulate in an academic environment and takes time to develop.
    Good luck in your career

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