Category: Professional Posters
Purpose: Hospital trainee pharmacists in the UK normally develop their clinical decision making skills via accompanied ward visits. Their learning is mainly shaped by pharmacy-led activities on wards. Ongoing education reform led by Health Education England requires work based educators to promote a multi-professional approach to education where appropriate. Within this education development project we have used clinical case-based scenarios to allow for simulated clinical decision making with different healthcare professionals working together. The aim was to identify the potential benefits of this approach to the different healthcare professionals.
Methods: Trainee pharmacists from East of England hospitals were allocated to small inter-professional learning groups (2-3 members). The groups consisted of medical students (year 5), foundation year 1 doctors (FY1), foundation year 2 doctors (FY2), trainee Advanced Clinical Practitioners (tACP), trainee nurses and trainee pharmacists. Groups were asked to discuss case-based scenarios, prior to making a clinical decision on appropriate treatment choices. The scenarios were written by clinical educators and piloted to ensure validity. Each case was followed by group discussion with a clinical educator, who facilitated discussion and addressed questions raised.
Individual participants were asked to complete a questionnaire at the start of the session (utilising rating of statements on a 1-5 Likert scale) to ascertain the learner groups’ perceptions on the extent of their involvement in clinical decision-making and ability to contribute to evidence-based, safe prescribing.
A post-session questionnaire (utilising rating of statements on a 1-5 Likert scale and several open questions) was used to evaluate perceived benefits for all participants. Trainee pharmacists were invited to a follow-up focus group discussion where they expressed their views regarding the inter-professional learning experience and perceived benefits to their learning. Data analysis was largely descriptive with thematic analysis for responses to open questions and focus group discussions.
Ethical approval was obtained from the UEA Faculty of Medicine and Health Ethics Committee under “Service evaluation”.
Results: Inter-professional learning sessions were conducted at three different hospital sites. Learner groups included; trainee pharmacists [n=28], medical students [n=15], FY1s [n=4], FY2s [n=2], tACPs [n=8] and trainee nurses [n=5]. Clinical educators assigned participants into groups (2-3 members) at the start of each session.
Data from pre-session questionnaires highlighted differences in perceptions between learner groups with regards to the extent of their involvement in clinical decision making. Trainee pharmacists had a higher median rating than medical students, but lower than nurses, tACPs, FY1s and FY2s.
The participants’ perceptions captured in the post session questionnaires indicated that all healthcare disciplines found the session useful and would recommend the learning session to fellow trainees or colleagues. There was variability as to the extent to which the session enhanced clinical decision making skills. Trainee pharmacists reported the maximum benefit.
Focus group discussions with trainee pharmacists identified the following perceived benefits of the sessions: development of inter-professional relationships, making clinical decisions in a secure environment and promoting the strengths of the pharmacy profession.
Suggestions for future improvements included not having FY2s as part of the sessions due to their seniority, having more sessions throughout the training year and on a wider range of topics.
Conclusion: Simulated case-based sessions with multi-professional groups provide a platform for trainee pharmacists to enhance their clinical decision making skills in a secure environment. This learning instils confidence and prepares them better for expanding prescribing and patient-facing roles. Furthermore the opportunity to learn with and from other professions enhances the potential for better integration of trainee pharmacists with multi-professional healthcare teams. This study provides evidence that use of simulated inter-professional learning approaches has multiple benefits for trainee pharmacists. Findings will be used to embed simulated sessions on a wider scale across the East of England.