There is more than just achieving performance standards in your community pharmacy preregistration placement
So you have chosen community pharmacy to complete your preregistration year. How do you make the most of your training year? What should you aim to do in the first 13 weeks before the first appraisal? Kathryn Davison and Kathryn Moffitt explain
It is estimated that over two-thirds of pharmacy graduates enter into a preregistration placement in community pharmacy. Experiences, however, within this sector can vary hugely because the variety of existing community placements is vast. You may have a placement with a large multiple, a small chain or a single independent pharmacy, which all offer different experiences and challenges. There also exists a great diversity between individual pharmacy stores within the same company.
For example, the experience gained from a pharmacy situated near a busy health centre will be different from that gained from a placement in a rural village pharmacy. Whatever or wherever your placement happens to be, you should have had the opportunity by now to find your feet and begin to build a rapport with your tutor and colleagues.
Start planning now
It is important from an early stage to develop a year plan with your tutor. The General Pharmaceutical Council stipulates the performance standards you are required to meet in the preregistration manual, and it is crucial that you are aware of these standards and consider how you are going to meet them. It will become clear that some of them are difficult to achieve in the average community pharmacy.
“Taking a patient history”, for example, is not something you are likely to do every day, so you may want to plan to meet this standard, say, while undertaking your cross-sector hospital placement or during a visit to a local surgery. You are also required to complete an audit at some point during the year and the timing of this may be heavily reliant on avoiding busy periods in the pharmacy. Whatever the circumstances, an initial plan which allows flexibility should help you to prioritise and prepare for the year ahead.
One of your first objectives will undoubtedly be to familiarise yourself with the standard operating procedures of the pharmacy, which will allow you to gain an insight into how the pharmacy operates. Following this, the first few weeks of your training usually involve a process of basic familiarisation. You will be expected to contribute towards many simple tasks, such as checking and putting away drug orders, using the pharmacy labelling system or taking in prescriptions over the counter. These will appear second nature to your co-workers but often feel alien to a trainee with little prior experience.
It is sound advice at this stage and, indeed, throughout the year to set yourself SMART (specific, measureable, achievable, realistic and timely) objectives in order to segment or compartmentalise the many procedures you are required to master. This allows you to achieve your performance standards in a structured manner and can help prevent you from feeling bombarded with information.
For example: “Over the next three weeks I want to become more confident in dealing with patient queries over the counter, including knowing where to find particular products and offering advice on those products.”
This objective is specific and it can be measured by keeping a competence log of patients you have dealt with. It is achievable and realistic within your current area of expertise and you have stipulated a reasonable time to achieve your goal.
By using this approach, particularly at the beginning of the year, you should find that, by the time you reach the first hurdle of the 13-week appraisal, you already have achieved a number of the performance standards that you are required to meet throughout the year. It is not uncommon in the first few months of training to feel a little lost and many trainees feel that they will never reach the standard required of them by the end of the year. You have entered a new environment where you will acquire many new skills and, often, the theory and knowledge you felt confident about as an undergraduate become an unfathomable blur.
Rest assured that, as you progress throughout the year and you become more comfortable with the practical skills you have developed, the clinical theory will take context and you will realise that you are able to counsel patients on how to take their medicines and that you can suggest a more appropriate treatment to a GP without needing to check with your tutor, but this contextualisation takes time to develop so be patient and confident in your own abilities.
“How many standards should I have achieved by my first appraisal?” This is the question that all trainees ask their tutors at an early stage. It is, of course, an unanswerable question because all trainees are different and each one’s experience of the training year is different.
In community pharmacy you should probably expect to spend the first 13 weeks of practice learning procedures and dispensing processes and, often, at this stage, if you have little prior experience you will find that you make errors that other members of staff do not make. This is common and to be expected so, at your first appraisal, it may be that you do not achieve as many performance standards as you had hoped.
. In reality, however, it often happens that considerably less than this is achieved at this first hurdle since you may not have had enough opportunity to exhibit the standards on multiple occasions, meaning your tutor is not confident enough to sign you as competent at this point.
One of the positives of a placement in community pharmacy is the variety of new training tasks that will be available for you in order to exhibit the required competencies. You should have the opportunity to be involved with an array of services, such as minor ailments schemes, head lice treatment patient group directions, chlamydia testing, cardiovascular risk assessments, the provision of compliance aids, to name but a few, all of which will require you to demonstrate excellent communication skills, a professional attitude, responsible behaviour and array of interpersonal skills.
As the year progresses and your capability improves, the complexity of tasks you undertake should grow so that, on any given day, you are faced with a variety of situations such as consultations with local GP practices, multiple prescription queries and the associated counselling required, or even the opportunity to sit in to observe medicines use reviews or anticoagulant clinics. Depending on the training you have undertaken throughout the year, it may be that you are given the responsibility to take ownership of some of these processes within your pharmacy. This should add to your confidence and allow you to exhibit a level of competence that will earn you the respect of your work colleagues.
Although there is a great emphasis throughout your training on achieving the performance standards and studying for the registration assessment at the end of the year, remember that, over the course of the year, you will be improving your clinical knowledge, developing communication and leadership skills, and gaining invaluable experience of how to deal with difficult situations. Community pharmacy offers the opportunity of a varied and rewarding future career, whether it is a clinical focus, a managerial or even a tutoring role, your future at this stage is whatever you choose to make it, so embrace this training year for all that it can offer you.
Kathryn Davison, MRPharmS, and Kathryn Moffitt are preregistration tutors in split community-academia posts
Citation: Tomorrow's Pharmacist URI: 11124421
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