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Become a teacher-practitioner to help tomorrow’s pharmacists excel

Trainee pharmacists need input from experienced pharmacists to put their learning into practice. If you enjoy helping people learn and develop themselves, the role of teacher-practitioner could be for you.

Teacher-practitioners link pharmacy education to practice

Source: Igor Mojzes l

Teacher-practitioners link pharmacy education to practice

It is Monday morning and you have plans for the education and training lunchtime session in the pharmacy department. You have spent the weekend reading about the need for more patient-centred care and you plan to get your colleagues to think about their counselling skills. You have asked a friend to play the role of a recalcitrant patient with some rather entrenched attitudes about medicines and you want to see how well your colleagues tackle the patient’s concerns. You have carefully scripted the patient’s problems and you have set up your tablet device to record each role play so you can have a group review session afterwards.  

If this sounds like you — if you get professional satisfaction from helping people learn — then perhaps the role of teacher-practitioner is for you.

Teacher-practitioner roles have been developed in pharmacy to encourage greater integration, a “live link”, between the pharmacy undergraduate education and actual practice before and after registration. The role of teacher-practitioner exists in hospital and community settings and it is likely to become more important, in England at least, if Health Education England integrates the preregistration year into the undergraduate degree. So what is involved in being a teacher-practitioner between academia and secondary care and how do you get started?

Dividing your time

The teacher-practitioner model combines regular practice with ring-fenced time for formalised teaching. The role may be shared between an NHS trust and an academic institution (as is the case at Wolverhampton School of Pharmacy: see “Passion for Education”) with the different elements of the role taking up varying proportions of the working week. Some teacher-practitioners will spend half their working week teaching and the rest in practice; others spend four days out of five teaching, with one day in practice designated for delivering a specific task, such as running a clinic.

Alternatively, the teaching may be conducted wholly within a trust periodically, followed by a return to clinical practice until the next teaching episode begins, as Stephen Ward does at Belfast Health and Social Care Trust (see “Safer prescribing”).

The teacher-practitioner model combines regular practice with ring-fenced time for formalised teaching

Posts and payment

Teacher-practitioners who split their time equally between two roles may be employed by a trust, with the associated school of pharmacy contributing financially to the post through a service level agreement. Individuals typically are remunerated at band 7 to 8a level, depending upon the nature of the clinical and teaching roles held.

Teacher-practitioners who are primarily based at the academic institution may be employed by the school of pharmacy and receive remuneration based on a lecturer or teaching fellow scale, typically commanding up to the equivalent of the top end of band 8a level. However, this can vary according to each academic institution. NHS employees can transfer their NHS pension credits via the public sector club scheme. They are also likely to benefit from more annual leave and bank holiday entitlements compared with NHS-employed posts.

Pros and cons

Splitting a job between settings requires a high degree of personal motivation and organisation

Before you embark on a search for a post as a teacher-practitioner take some time to consider what benefits and challenges the post may bring to your career. The teacher-practitioner role suits people who have a passion for education and are willing to learn the skill of teaching. It offers a degree of autonomy and a change of scenery from ward-based practice and can offer flexible working hours. It also supports further career development, including the opportunity to gain a professional teaching qualification (for example, a postgraduate certificate in education).

However, teaching is a skill in its own right and the role can be challenging for those who do not have any experience. Teaching is time and labour intensive: lectures require continual preparation and review and students may not always be receptive to learning. Splitting a job between settings requires a high degree of personal motivation and organisation and the shared nature of the role may limit the development of individual roles or job remits within the separate workplace organisations.

For NHS trusts, having a teacher-practitioner on staff can bring professional teaching skills into the pharmacy department. The post-holder can co-ordinate undergraduate learning to complement and support specific ward-based needs and help to improve the ward-based placement for both students and tutors.

Employing a teacher-practitioner is also a good option for filling specialised, part-time positions. But a loss of staff continuity can impact on areas of care where it is most important, such as in care of the elderly. Teacher-practitioners may be more suitable in roles with a high patient turnover, such as in medical admissions wards.

For the academic institution and students, teacher-practitioners can help shape the curriculum to be up to date and based on real-life scenarios. Work placements, too, can be designed to complement and support the different stages of student learning.

Passion for education

In a recent advertisement for a teacher-practitioner, Wolverhampton School of Pharmacy was seeking a practising hospital pharmacist, ideally with previous experience in training or teaching.  

Leading the recruitment at the university is  Alan Hindle, principal lecturer for accreditation and professional development. He says: “Above all else we are looking for someone with a passion for education — and not someone just looking for a change. The ideal candidate needs to have good communication skills and must be able to face students, which is not always an easy task.” He adds that they want to see some evidence of candidates “having cut their teeth on teaching already”, by providing multidisciplinary education in situ, but emphasises: “We don’t expect to find an ‘oven-ready’ teacher.”

Hindle also notes that many people in teacher-practitioner roles go on to develop a career in academia, rather than returning to clinical practice.

Safer prescribing

Pharmacist Stephen Ward is a teacher-practitioner based at Belfast Health and Social Care Trust and is using his expertise as a pharmacist to teach future doctors. His role centres on the development and delivery of training and assessment of final year medical students as part of an assistantship programme that focuses on improving patient safety in medicines.

The programme, which involves multiple 11-week placements, offers teaching on subjects including: medicines reconciliation; prescribing for hyperkalemia, hypomagnesaemia and warfarin; and safer prescribing of controlled drugs and opioids.  

Ward took the teacher-practitioner role after specialising in palliative care and came to the band 8a post with only informal teaching and knowledge-sharing experience, but believes he is rapidly developing his skills. He says that no two student cohorts are the same and workshops are adapted to suit different student needs.

Ward is currently involved in developing shared core learning objectives for all trusts participating in the assistantship programme. “There is a commitment to quality assurance so we are always seeking feedback and reviewing our content. There is no chance to rest on our laurels,” he says.

Including the time spent preparing and reviewing, each 11-week placement may actually demand Ward’s time over four to five months, which impacts on his ability to provide other clinical pharmacy services within the trust. He tackles this through a high level of personal organisation and task prioritisation, and says the effort is worth it. “If I was teaching 100% of the time, I would lose my practical edge,” he explains.

Ward’s role includes the following teaching-specific responsibilities:

  • Assessing the prescribing skills of medical students and providing feedback on their performance against prescribing standards
  • Developing a system of education and support for junior doctors in a variety of areas, including prescription-writing standards and prescription errors
  • Planning teaching material for medical students to ensure all relevant information is covered and competency is assessed
  • Monitoring and evaluating the teaching sessions and performance of students and provide feedback
  • Training and assessing medical students in their final year to promote accurate drug history taking, medicines reconciliation and prescribing on inpatient drug charts and discharge letters

Happily, the trust recognises the specific demands of the teacher-practitioner role. Ward says: “There is an appreciation of the value and the long-term benefit of providing the trainee medics with real-time and ward-based experience of safer prescribing. We are aiming to minimise the need for corrective practice and support prescribing competency in the months leading up to foundation year 1 induction [of new doctors].”

Seeing medical students develop their prescribing skills is gratifying, Ward says, adding: “As the course goes on you can literally see the ‘light bulbs’ switch on in the trainees’ heads and, when that happens, it is really satisfying.”

Ailsa Colquhoun is a freelance journalist.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2014.20065638

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