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The Pharmacy Vocational Training Scheme Learning from experience, learning in practice. VT2 General and VT3 Specialist training March 2016 1 | Page

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The Pharmacy Vocational Training Scheme

Learning from experience, learning in practice.

VT2 General and VT3 Specialist training

March 2016

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ContentsBackground and introduction 3

Requirements prior to starting the different stages of Vocational 4Training

Vocational Training : VT2 training – Generalist training 6

VT2 training : Generalist training guidance for completion of the VT2 framework (V7 Sept 2015) 12Professional and Personal practice 13

The Clinical Pharmaceutical Care of patients 13

Ensuring the Safety of Patient 15

Cost Effective Use of Resources 16

Dispensing of Prescriptions 16

Education and training and Development 17

Dispensing of Aseptic products 18

Information about Medicines 19

For FAQs please see the VT2, VT3 FAQs document

References, Appendices (Formats of evidence, VT2/VT3 assessment processes) 65

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Background

The Pharmacy Vocational Training Scheme[1,2,3] originated in 1995 and is supported by the NHS Scotland Directors of Pharmacy, both Schools of Pharmacy in Scotland and The Royal Pharmaceutical Society.

The Training Scheme was originally introduced for junior pharmacists within secondary care, with the view to provide them with a comprehensive structured training programme over a two year period. Over the past five years, the training scheme has been redesigned and redeveloped to meet the changing needs of the service. Developments have also included the introduction of Specialist Training Frameworks.

Introduction

The Pharmacy Vocational Training Scheme is a structured, work-based training experience for hospital pharmacists to enable them to deliver safe and effective pharmaceutical care. It is available for pharmacists working within secondary care within NHS Scotland. Currently available at VT2 (Generalist Level), it is being developed at two further levels;

VT2 [general/foundation training] VT 3 [specialist clinical training] VT 4 [education, leadership and research modules].

Pharmacists should have completed VT2 prior to embarking on VT3 training. However, it is envisaged that whilst undertaking VT3 training they may start a module within Stage 4. There will be instances where the previous level of training has not been achieved and there are pre requisites to help where previous stages of training have not been achieved.

What is the aim of the Vocational Training scheme?

The aim of the Pharmacy Vocational Training Scheme (VTS) is to facilitate the acquisition of knowledge and skills necessary for pharmacists to participate fully in their post as a general (hospital) pharmacist. The emphasis is on developing competence (the ability to perform tasks consistently to the required standard) using activities in the workplace and a structured training rotation. The training is based on gaining experience by undertaking a task, demonstration of competence and reflection on learning from undertaking the task. This may require the task to be undertaken on a specified number of occasions.

Stage 1 (Pre registration training) training is undertaken in either community or hospital pharmacy.

VT2 (General/Foundation training) is for junior pharmacists (Band 6 or equivalent), who need to develop general skills and gain a broad experience in pharmacy practice prior to specialising in a clinical area of practice.

VT3 (Specialist training) is for more senior pharmacists (Band7 or equivalent) who need to develop more specialist skills, in particular clinical skills.

How do I register to start training or to become a VT tutor?

There is registration information on the NES Pharmacy website. Each year there is the opportunity to register for training, three times per annum, in September, January and May. Registration is online. After registering trainees are expected to undertake the relevant induction training prior to starting

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completing their competency framework. Details of the induction materials are on the NES Pharmacy website.

New tutors should also register online, three times per annum, in September, January and May each year. New tutors are required to register at the registration date in advance of them tutoring a trainee. e.g. a tutor starting with a trainee on 1st September should register the previous May and have completed the induction resources prior to tutoring a trainee. The tutor needs to also attend an induction session in Sept., January or May and needs to inform NES of the completion of the various induction resources.

After registration trainees and tutors receive a ‘Welcome e mail’ that details how to get started and induction activities that need completed prior to attending the induction training which is generally help ~3 weeks after the training start date. i.e. late January, May and September.

Requirements prior to starting the different stages of Vocational Training

There are some requirements that trainees need to undertake prior to starting their training To undertake Vocational Training VT2 (VT2 training ), currently, the trainee needs to be employed in secondary care within the NHS in Scotland and they ideally should have undertaken their Pre Registration training (PRPS) within secondary care. However, this is not mandatory.

Prior to embarking on VT2 training trainees need to understand the fundamentals of aseptic dispensing, dispensing and the provision of pharmaceutical care. They need to have completed the following :

aseptic training - aseptic dispensing and checking processes, the aseptic environment , formulation and stability of aseptic products, the preparation of intrathecal injections (simulation for preparation of 3 products required.

dispensing training -the in- patient and out - patient dispensing processes the provision of pharmaceutical care to patients using standard care plans and case study

documentation provided (webinar available) the Adverse Drug Reaction reporting modules (available on NES website)

In each instance they need to develop as a piece of evidence which is included in their eportfolio after they have had a discussion with their tutor.

Prior to embarking on any module of VT3 Training, trainees need to have completed the following resources:

the provision of pharmaceutical care to patients using the documentation provided (webinar available)

the audit process (completed an audit, see NES CPD web pages) the reporting of an analysis of a Significant Event (completed and SEA, see CPD web pages) the process of Critical appraisal (completion of Critical appraisal modules 1 and 2, plus MCQs) patient safety (webinar available) risk management (webinar available required) leadership theory (webinar or attendance at a course introducing leadership theory) the Adverse Drug Reaction reporting modules (available on NES website)

In each instance they need to develop as a piece of evidence which is included in their eportfolio, after discussion with their tutor / supervisor or Educational Supervisor.

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Prior to starting a specific VT3 module, there are some further pre requisites depending on the specialist module.

All pre requisites should be demonstrated by having a discussion with the tutor after completing the relevant resource to ensure that the pre requisite is met. Where there is no resource, guidance should be sought from their Educational Supervisor

Frameworks for training

What is the framework for each of stage of training?

For each stage of the Vocational Training Scheme, the trainee completes a competency framework and provides evidence in the form of an eportfolio.

Within VT2 training there are 8 Elements. All Elements are required to be completed.

Within VT3 training each framework comprises specialist clinical areas with the more generic aspects of training being covered in modules of Education and training, Leadership and Research.

What type of evidence can be collected?

A wide variety of different types of evidence can be collected within the VT eportfolio. Examples of which are:

audit case based discussions (CbDs) feedback forms mini – clinical evaluations (mini – CEX) presentations reflective reports SEA short reports training plans.

Completion of Section forms (COS) are not required post 1st September 2015. Feedback forms have replaced the COS forms and therefore there should be at least ONE Feedback form within each Element within the eportfolio.

What does the eportfolio comprise of?

The ePortfolio is a resource to help trainees collect and organise their evidence online. The format of the ePortfolio has been designed to enable tutors and assessors to view the evidence in a systematic fashion. There are areas for:

forms - appraisal, rotation details, meeting with tutor, declaration of work and templates for; aseptic dispensing, dispensing services and medicines information

logs - care plans, case studies and reflective and action based logs

compilation of references (personal library)

resources (underpinning knowledge modules).

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Vocational Training: VT2 training – Generalist training

Completing VT2 training ensures that pharmacists achieve a ‘well rounded’ ‘general’, structured training within their first two years of starting within the hospital setting. It also enables trainees to gain experience in some areas that they may not have been able to experience had they not been part of the training scheme.[4,5] VT2 training has been mapped to the Knowledge and Skills Framework.

The training is recognised by the Directors of Pharmacy and the Schools of Pharmacy (SOPs) in Scotland as well as Queens University, Belfast. For details of any Approved Prior Learning (APL) trainees should contact the relebant School of Pharmacy (SOP).

The training takes approximately 18 months to 2 years to complete during which trainees complete tasks and develops a variety of different forms of evidence to demonstrate that they are competent and meet a particular performance standard consistently. The evidence is collated into a eportfolio which is then submitted as part of the assessment process.

Trainees who are unable to complete within the 2 years period should indicate an estimated date for final assessment unless due to exceptional circumstances this is not possible.

The training achieved whilst working in practice, provides the pharmacists with the opportunity to gain knowledge, and to develop skills relating to

Professional and Personal practice

The Clinical Pharmaceutical Care of Patients

The Quality and Safety of Patient

The Cost Effective Use of Resource

Dispensing Prescriptions Education, Training and Development The Dispensing of Aseptic Products Medicines Information

For each rotation there are a specified set of competencies which are used to plan, conduct and evaluate the trainee’s performance.

There are also rotational practice activities which the trainee must complete, to help them achieve the competencies.

The rotation is also supported by ‘resources’ that help the trainee develop underpinning knowledge.

The workplace rotations are intended to be flexible to accommodate individual learning needs and service requirements. For example, experienced trainees moving into hospital practice from another area of pharmacy, such as community pharmacy, may be able to demonstrate their competence in some rotations in a shorter time than a newly qualified pharmacist. In such instances the previous experience should be recorded in the paperwork with ‘gaps’ identified and targeted as part of their rotation. All information relating to this should be included in their eportfolio

Support for training

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There is a variety of support available for VT2 and VT3 trainees when they are undertaking training namely:

locality tutors (LT) (VT2 trainees) educational supervisors (Ed Sup) (VT3 trainees) specialist tutors (ST) (VT2 trainees) pharmacy Practice Education Coordinators (PECs) (VT2 and VT3 trainees) vocational training tutors (VT tutor VT2 and VT3) local site based trainers (VT2 and VT3 trainees).

The role of the Locality Tutor, Educational Supervisor and the Specialist Tutor are similar in nature with both roles having a remit for trainees within a designated Health Board area. However, the remit of the ES is wider than that of the LT in that they may have responsibility for trainees out with their Health Board area but within their area of specialist practice. The ST role describes senior pharmacists who have a remit for a number of trainees within a single smaller Health Board area. The ST relates to the LT or the ES with the LTs and ESs provide guidance and support to STs and tutors.

The LT/ ES also; delivers training sessions, attends National meetings as required, ensures that the VT curriculum is in line with service redesign and is involved in portfolio and final assessments where they may be required to be the Chair a panel.

The ST Specialist Tutors is expected to support other pharmacists locally during training towards VT2 of The Pharmacy Vocational Training Scheme within their sector of practice within their Health Board Area. This will involve acting as a role model in practice and supporting pharmacists with achievement of the competency framework, hosting local peer review sessions for trainees and guiding and advising the tutors of trainees. Support with this role will be available from your Regional Practice Education Coordinator (PEC).

Pharmacy Practice Education Coordinators, employed by NES, are responsible for different regions within Scotland and will meet with trainees shortly after registration to ensure that they are informed prior to starting training. They may also run local induction and peer sessions to ensure that trainees progress with their training throughout the 18month to 2 year period.

Vocational Training Tutors are experienced pharmacists. They are required to register with NHS Education for Scotland as part of the Vocational Training Scheme and are expected to keep themselves abreast of developments by attending at least every 3 years a Vocational Training Peer session at least every 3 years. They are expected to facilitate training but will not observe practice on a daily basis.

It is anticipated that tutors will meet with trainees on a monthly basis to;

review progress sign off/discuss completed evidence develop objectives complete appraisal forms.

The tutor has a supportive role, and is involved in facilitating the trainee’s learning and assessing their development.

They do this by:

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helping the trainee to identify their development needs supporting, advising and encouraging the trainee during their training undertaking formative assessments (to monitor and review the trainee’s progress) summative assessments (to check that the trainee has met the required standards).

At the end of each rotation, the workplace tutor will use the competency framework to carry out a summative assessment, which will check that the trainee has met the required standard. Evidence should be reviewed, competencies signed off and any ‘gaps’ for further training identified.

The criteria for tutors, is under development. However, within their application to register as a tutor they are required to detail their; professional journey/experience to date, training/mentoring experience and their commitment to CPD (for which they may submit a Significant Event Analysis).

Trainers are experienced technicians and pharmacists who may sign off activities whilst the trainee is within their section. Trainers are not currently registered with NHS Education for Scotland, nor do they routinely attend training however, any trainers are welcome to attend any of the training days

Mentors are pharmacists who have recently completed the training scheme. They may informally advise new trainees and may share their experiences of completing the training scheme.

Are there resources for training?

Once registered for training, trainees will receive/be able to access a copy of the competency framework and modules which they will need to refer to whilst undertaking training. There are induction materials for trainees and tutors as well as a series of webinars available via the NES website.

Assessment processes

What is the format of the assessment processes?

Formative Assessment

VT2 and VT3 trainees are assessed throughout their training on a regular basis. For VT2 trainees this tends to be by their tutor at their base and also comprises of regular appraisals at 6, 9 and 15months of training.

A satisfactory 15month appraisal showing completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment.

For VT3 trainees there are In Training Reviews (ITRs) that are peer review sessions that are held on a regular basis. They are organised by members of the SIG and are supported by NES.

In Training Reviews are designed to be supportive and to enhance learning whilst providing feedback on progress. The sessions are attended by 3 or 4 members of the Specialist Group, NES and the specialist trainees. Each trainee needs to attend at least ONE ITR throughout their training and to have received satisfactory feedback (uploaded to eportfolio), prior to be invited to come forward for final assessment.

For an ITR, the format comprises – presentation from each trainee (e.g. a piece of evidence), training completed to date and objectives for the next 3 months. All trainees are present at the session and are expected to contribute. Written feedback is provided. VC is available where possible. Each trainee

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needs to attend at least ONE ITR throughout their training and to have received satisfactory feedback (uploaded to eportfolio), prior to be invited to come forward for final assessment.

Final assessment

For VT2 trainees, a satisfactory 15month appraisal showing completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment.

Portfolios are assessed by trained assessors using a standard scoring framework.

Trainees receive written feedback and are advised what they need to prepare for discussion at their final assessment. Should the trainee require to prepare only minor items (< 5 items) for discussion at the final assessment then they will be invited to attend the final assessment. Should they require to prepare more than a few minor items (>5 items) for discussion at final assessment then they will be deferred to the next set of assessments.

Where the portfolio meets the required standard the trainee will be invited for a final face - to - face assessment.

Should the portfolio not meet the required standard, the training will be advised to defer to the next set of assessments.

At the final assessment the VT pharmacists undertake practice based scenarios.

The assessment scores from the portfolio assessments and the final assessments are reviewed by the VT Assessment Group. The VT Assessment Group is a multidisciplinary group which has the responsibility for ensuring that the assessments are fair and are undertaken in an equitable manner.

Should a trainee wish to appeal their final assessment outcome then they should write to the Lead Pharmacy for Vocational Training, NES Pharmacy indicating the grounds on which they wish to appeal.

For VT3 trainees, satisfactory feedback from In Training Reviews, indicating continued progress and completion of the majority of the Competency Framework is a requirement to be eligible to submit for the final assessment. Trainees need to also have attended at least ONE In Training Review (ITR) throughout their training for which they have received favourable feedback.

Portfolios are assessed by trained assessors using a standard scoring framework. Where the portfolio meets the required standard the trainee will be invited for a final face - to - face assessment.

Should the portfolio not meet the required standard, the training will be advised to defer to the next set of assessments.

At the final assessment there is a panel discussion around aspects of the VT3 pharmacist’s portfolio.

Trainees (who have not been deferred from a previous set of assessments), will be awarded a; Pass, Pass with merit or Pass with distinction. To achieve a Pass with merit, trainees need to have had no items requiring remediation at the portfolio assessment stage and have achieved a good pass in both the ‘core areas’ of their portfolio the final face to face assessment.

The VT Assessment Group

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The VT Assessment Group is committed to providing a high level of service to the participants undertaking the NES Vocational Training Programme. In particular, the Group is committed to excellence, fairness and equality, and continuous improvement of quality while working in partnership with participants.

Resit Assessments

Resit assessments are offered to VT pharmacists who do not pass the final face – to – face assessment. They are not offered for those who are not successful at the portfolio assessments as they required more time in practice and automatically defer to the next set of assessments.

Those who are not successful at the final assessment will be automatically offered a resit assessment.The resit assessments are generally 4-6 weeks after the final assessment date. If the VT pharmacist wishes to defer to the next set of assessments and not take up the offer of the resit assessment this decision will be respected.

VT pharmacists will have 3 opportunities at the final assessment (final assessment, resit assessment / defer assessment, further assessment at next diet of assessment), after which the appropriate Director of Pharmacy will be contacted.

Appeal process

The NES VT Assessment Group recognises grounds to appeal against a decision made from time of application until completion or withdrawal. An indication that an appeal will be made should be after communication of the final assessment outcomes but within 5 working days of the outcome being communicated by NES.

The grounds for appeal are:

Additional information is available that was not, and could not, reasonably have been

made available to the Assessment Group at the time it made its original decision and

which had it been available could have led the Board to making a different decision

There was a material irregularity in the procedures of the VT Assessment Group or in

the conduct of the assessment.

Participants’ appeals are underpinned by the principles of clarity, confidentiality, fairness and adherence to processes and academic standards, timeliness and early resolution, and accessibility. An appeal is where a VT Pharmacist in training, seeks review of a decision made by NES with regard to a participant’s:

o Admission

o Assessment

o Programme award

o Progression

o Termination of studies on academic grounds

o Outcome of disciplinary proceedings in regard to plagiarism

There are stages in the process:

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o Informal early resolution: Participants who wish to appeal should, in the first instance,

make every effort to resolve the matter through informal discussion with the

appropriate person (e.g. education supervisor, course leader). Participants should

expect a formal response normally within 10 working days from the Programme Leader.

If the issue is not satisfactorily resolved then this will be taken to the next stage.

o VT Assessment Group: If the issue has not been resolved informally and the participant

wishes to take it further, they should write a letter of Appeal detailing their issue, along

with all relevant evidence, to the NES VT Assessment Group Chairperson who will

investigate further and arrange a formal meeting. If the issue is not satisfactorily

resolved then this will be taken to the next stage.

o Pharmacy Directorate Investigation: If the participant feels that the matter has still not

been satisfactorily dealt with they may request a further investigation. This is the last

opportunity to submit supporting evidence. An Appeal Panel will be convened to hear

the matter.

Matters of a professional nature such as fitness to practice is the general practice employer‘s responsibility.

General points for completion of the VT2 / VT3 competency frameworks.

Identification of training needs prior to starting a section of the competency framework

Identify training needs for each section prior to starting in the section and plan with the ‘trainer’ for the section how some identified training needs and therefore competencies will be achieved.

Draft a CPD plan to cover identified training needs. This can be in the form of a word document and uploaded to your eportfolio and linked to the start of the Element or, it can take the form of GPhC CPD record or it can be the template using the PDP function within eportfolio.

Timelines for undertaking activities

Planning of activities - When planning activities that are going to be completed, identify if the final CPD record that will form the evidence will be in the form of a reflective or action page. For VT2 trainees there is a document that provides timelines for when activities should be completed.

Evidence formats

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Evidence takes a variety of different formats. In the curriculum a form of evidence is specified. However, so long as you prepare a suitable form of evidence, other forms of evidence are normally accepted so long as they meet the basic criteria.

Examples as specified - where specific examples are specified, trainees are expected to demonstrate achievement of the competency against all of the examples.

VT training is undertaken in the workplace and it is imperative that personal examples from a trainee’s workplace are detailed within their evidence.

Reflection and highlighting learning from undertaking a task to achieve a competency, is key to the development of evidence. Trainees should detail personal examples throughout their portfolio.

Anonymise all pieces of evidence. There should be no patient details, CHI numbers, hospital numbers, bar codes, doctor’s names within your portfolio. Anything that could trace back the evidence to the patient should not be included. Hospital logos on headed notepaper do not need to be deleted. Use the templates provided and do not upload any original prescriptions or documents to your eportfolio.

Cross reference items throughout your portfolio wherever possible. Ensure that assessors will understand why each piece of evidence meets the competency.

Personal Library within eportfolio

Organise your eportfolio Personal Library so that it, is organised as per the headings within the competency framework. Make sure that you link all evidence within your Personal Library to a competency within the curriculum.

Receiving Feedback on evidence

Share evidence for feedback with your tutor on a monthly basis and your Locality tutor / Educational Supervisor on regular basis so that they are aware of your progress.At least ONE ‘Feedback Form’ is required for each section of the Competency Framework

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The Pharmacy Vocational Training Scheme VT2 training Generalist training

Guidance for completion of Version 7 (September 2015) of the Competency Framework

July 2015

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General points for completion of the VT2 - Version 7 September 2015 competency framework.

Please check the information relating to the resources that are available to help you with your training.

Section A

Element A

Professional and Personal practice

Learning outcomes for this Element are:

an awareness of personal behaviour and the impact of personal behaviour on others

the ability to accept responsibility for own actions the ability to communicate in a variety of different formats the ability to organise workload the ability to work collaboratively the ability to review a service and propose developments for a service the ability to relate work undertaken to national priorities to

Within this Element, trainees are expected to demonstrate personal awareness and the development of basic leadership skills. Evidence should be provided for each competency and should where possibly not be cross referenced to the Clinical section. This is a change from previous guidance for previous frameworks.

The Clinical Care of Patients

Learning outcomes for this Element are the :

ability to document a patient assessment ability to document identified pharmaceutical care issues for specific patients ability to document pharmaceutical care outcomes for specific patients ability to document the pharmaceutical care provided for a specific patient in line

with the evidence base. ability to provide seamless care through the resolution of actions to prevent primary

care / secondary care interface issues ability to provide healthcare information to patients / carers in clinical practice

Within this Element, trainees are expected to provide evidence as care plans and case studies and where appropriate mini Clinical Examinations (mini - CEX) and Case Based discussions (CbDs).Trainees are also expected to demonstrate within one of their care plans/ case studies knowledge and understanding of the storage and the use of medical gases.

Word documents should be developed and uploaded to your Personal Library. Do not use the eportfolio care plans as they have been problematic.

Care plans should follow the format as described on the NES Pharmacy website. A short summary (paragraph) [~200 words] as a front page should describe the case and highlight; reasons for choice of

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case, learning from developing the care plan and reflections for future practice from the learning undertaken. Pharmaceutical inputs and outcomes should be detailed within the care plan making reference to evidence base where possible. Include pharmacy care issues identified, the actions that you undertook to address the issue and the output from your action. Did the care reflect current guidelines? Within e portfolio there is a template for a care plan and a case study.

Case studies should be 2,000 words in length, use single spacing, Vancouver style referencing with numbered pages and should follow the guidance on the NES Pharmacy website. The actual number of words is not critical, just ensure that the cases are ‘full’ enough and that they include a discussion that that describes the disease state and your input to the case. A summary sheet [~200 words] should form the front page and should describe the case and highlight; reasons for choice of case, learning from developing the care plan and reflections for future practice from the learning undertaken. References should be used throughout the case study and should be listed at the end of the case study in Vancouver style. Reflections and your input to the care of the patient are important.

The evidence required to support the competencies takes the form of a set number of care plans using the standard documentation provided, some of which should be accompanied by a more detailed case study. Where you are undertaking mini - CEX and Case based Discussions (CbD) as part of your clinical rotation the number of care plans and case studies required to be developed are reduced in number.

The care plans and case studies should encompass medicine, surgery and a further two specialist area. The specialist areas can be from within Medicine e.g. respiratory, The requirement is to experience and provide evidence for a mix of clinical experience. There is a requirement to develop a case study or a care plan that demonstrates knowledge about medical gases in the clinical setting. You should ensure that one of your case studies or care plans include detail about oxygen saturation levels. This can be cross referenced to the Medical gases section.

The training is progressive and we wish to see the progress. All case studies will not be perfect unless they are completed at the end of training. The clinical specialist within the relevant area should sign off the case studies. When the clinical specialist provides feedback on the case studies, the learning from the feedback should be incorporated in a summary at the front of the case study.

All references should be anonymised. ‘Local guidelines’ should be referred to as opposed to ‘NHS [Health Board name] guidelines’.

Current medication needs to include everything that the patient was taking on admission.When detailing the drug and the medical history the whole medical and drug history should be covered at the start and then aspects that are relevant to the case focussed upon.

The templates are available within e portfolio and the NES website. www.nes.scot.nhs.uk/pharmacists

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Ensuring the Safety of Patients

Learning outcomes for this Element are the :

ability to personally contribute to the local clinical governance agenda ability to apply procedures relating to information governance, financial and

corporate governance ability of to analyse a significant event to a satisfactory standard ability to undertake an audit and a PDSA cycle to a satisfactory standard ability to apply local procedures for the management of risk ability to contribute to the Scottish Patient Safety Programme ability to report an adverse drug reaction

Within this section trainees are required to demonstrate competence in various Clinical Governance tasks that they undertake within their practice. There is analysis of a Significant Event and the undertaking of one cycle of an audit.

Significant Event Analysis (SEA)

The SEA submitted will be put out for peer review. The proforma on the NES website should be completed and e mailed to [email protected] Feedback normally takes about 4 weeks from receipt of the submission.

Look at samples of SEA on NES website. This shows the level of detail required. This is an analysis of an event that was significant to you, that you were involved in. Give the reviewers detail as to the situation. Was the ward busy? What type of ward was it? Why do you think the event happened? Remember the reviewers are national peer reviewers and may be based in community pharmacy as opposed to hospital pharmacy. Detail any changes made to prevent the event happening again. What was the impact? The event doesn’t have to be negative and doesn’t need to be a Critical Incident/medication error. Submitting an SEA doesn’t take away from submitting a Yellow Card or a local Critical Incident report. Submitting an SEA is all about personal reflection and learning. The idea of getting feedback from others is to highlight any issues that you may not have considered to ensure that the event has been analysed fully and therefore will not happen again.

If submitting an SEA for an incident this may be cross referenced.

Audit

The audit received will be put out for peer review. The proforma on the NES website should be completed and e mailed to [email protected] Feedback normally takes about 4 weeks from receipt of the submission.

Topics for audit can be varied. If a trainee has undertaken an audit within their pre registration year they may undertake a further audit of the same work. The pre registration audit should not be submitted. All training is required to be current and not from a previous training programme. The pre registration audit should not be submitted. An audit undertaken as part of another course e.g. Clinical Pharmacy course, within the past 6 months, may be submitted. It is advisable to transfer the information to the proforma to enable as constructive feedback as possible to be provided. There are examples on the website.

Where the work of another pharmacists is used e.g. design of the audit, the individual should be recognised. The audit must include criteria [specific, not a general over arching aim] and specific standards [with percentages]. Where possible, undertake a 2nd cycle and re audit. One cycle is sufficient for VT2 training but two cycles are better and if you keep it simple, two cycles and effecting a change is achievable.

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Cost Effective Use of Resources

Learning outcomes for this Element are:

awareness of the procedures for the introduction of new medicines to NHS Scotland ability to manage the procedures for the prescribing of a non formulary medicine awareness of the local mechanisms for pharmaceutical homecare services

Within this section you are expected to demonstrate an understanding of the cost effective use of resources. The section involves reading through the Standing Financial Instructions (SFIs) and relating the instructions briefly to pharmacy practice. This could be quite a tedious task but when you have reviewed the SFIs discuss with your tutor or Locality tutor and think about how in a future role you may be affected by the SFIs.

Dispensing of Prescriptions

Learning outcomes for this Element are the:

ability to consistently and systematically professionally check a variety of different types of prescriptions to the required standard being sensitive to patient needs

ability to apply local procedures for the supply of medicines where there are various problems with the supply chain

ability to dispense clinical trial medication and a medicine without a product licence

This section involves the demonstration of competence when dispensing medicines. Professional aspects should be signed off by a pharmacist. So you may wish to organise a pharmacist trainer or your tutor to supervise you undertaking a task.

Prior experience e.g. when a trainee transfers from community to hospital practice will be taken into account and as in Aseptic services the individual will be required to undertake a series of simulations to demonstrate competence, rather than spend a specified time within the dispensary.

The section specifies preparation of extemporaneous medication. However, if no opportunity to make an extemporaneous product then the requirement of development of evidence demonstrating acquisition of knowledge of processes for dispensing of extemporaneous products is required.

Also within this section the trainee is required to demonstrate practice with an unlicensed medication and clinical trial medication. N.B. Unlicensed medication is a medicine without a product licence as opposed to a licensed product being prescribed out with the product licence.

Keep information anonymous! No actual prescriptions or any patient details should be included in your portfolio. There are templates on which you should transcribe the relevant information from the original prescriptions.

The templates are available within e portfolio and the NES website. www.nes.scot.nhs.uk/pharmacists

Education, Training and Development

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Learning outcomes for this Element are:

the ability to provide education for a variety of healthcare professionals the ability to provide education for students the ability to provide feedback to others

Within this section trainees are required to demonstrate competence in different teaching sessions. The teaching needs to be of staff and not patients. Personal learning from undertaking each of the events needs to be demonstrated with reflections on how the session would be handled in future via development of CPD records (short reflective report) and training plans.

The evidence needs to include information pertaining to the background, prep for session, audience, reflections on; personal learning from delivery of the session, what went well, areas for improvement and actions for future delivery of similar session.

Work by other members of staff needs to be recognised. e.g. use of power point slides.

Developing a brief training plan is an important part of the learning and teaching process. Plans should include the:

aim, learning outcomes and programme handout (where available) feedback/evaluation form (completed formal evaluation and/or VT Feedback form)

Feedback forms may be given to one or more participants of the training. If a formal evaluation form of the training episode is available this should also be included.

There is a sample of a training plan on the NES website within the Vocational training section about developing your portfolio.

www.nes.scot.nhs.uk/pharmacists

Section B

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Dispensing of Aseptic products

Learning outcomes for this Element are:

knowledge and understanding of aseptic technique knowledge and understanding of aseptic products knowledge and understanding of the need for personal hygiene and clean room

clothing the ability to professionally finally check a variety of aseptic products knowledge and understanding of the various aspects of good aseptic dispensing

practice

Pharmacists are expected to have undertaken the technical role of preparation of aseptic products within their pre –registration year. Where this has not occurred, the pharmacist and their tutor, needs to review the competencies undertaken as part of pre reg training. Trainees who are required to undertake a specified number of products due to not having prepared products in their pre registration year, often prepare products in a simulated environment with confirmation of competency from their trainer. If you can gain technical experience and can complete pre reg competencies then this would be ideal.

B22: Intrathecal injections. Complete local training programme. If intrathecal injections are not made at your site and you do not receive actual preparation experience, state this up front. If you have no opportunity to make intrathecal products then you need to complete a CPD record (n=1]) starting at ‘action’ demonstrating knowledge of processes involved in the dispensing of intrathecal products.

B23 & B24: Include a mix of prescriptions for your templates. Link aseptic theory with your own personal experience and include short examples of the products that you have checked to show that you are competent. Include your reflections. What have you done? How would you do it differently next time? B24: The report may be done individually for each type that is covered for this competency. e.g. short report for TPN, short report for Chemotherapy and a short report for CIVAS if there are examples of CIVAs included or one longer report covering the different types of examples included may be developed.

Where ONE report(s) is the route of choice, it should highlight relevant aspects about the example as specified in the competency to show understanding of differences in practice due to e.g. differences in formulation, legislation, processes, environment and QA processes.Include reflections.

Focus on the professional role of the pharmacist.

The templates are available within e portfolio and the NES website. www.nes.scot.nhs.uk/pharmacists

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Information about Medicines

Learning outcomes for this Element are:

knowledge and understanding of Medicine Information processes and procedures the ability to answer Medicine Information enquiries

This section requires the completion of a variety of medicine information enquires of a varying degree of complexity and also tasks within the MiCal workbook.

Enquiries may include ward based clinical enquiries from your practice but some enquiries need to be more complex than others and need to demonstrate the ability to undertake a literature review.

There is also a peer review sheet to complete and include in your portfolio.

The enquiries should not be those that you may have undertaken within your pre registration year.

No patient detail should be included. This includes patient name, DOB, Hospital number, Hospital name and address, Doctor’s name and address.

There are templates on which you should transcribe the relevant information from your original enquiry including any relevant information from the UKMi database.

A range of complex/simple satisfactory enquiries (using different categories as listed in the MI workbook and within e portfolio) should be transcribed onto the relevant template as evidence in support of the different competencies within this section. A description of the enquiry answered, self reflection learning points and a statement about which competency (ies) the enquiry relates to, should be included.

For sections requesting completion of the relevant MiCAL/workbook sections, ONE feedback Form signed by the trainee and their tutor/trainer is sufficient as evidence that the various sections have been completed.

It is not necessary to copy sections of the workbook for submission within your portfolio.

N.B. workbook sections completed during pre-registration should be read again as a refresher but need not be done again.

Only ONE Feedback form is required to be signed off for this section.

Templates are available on the NES website within the Vocational training section about developing your portfolio.

www.nes.scot.nhs.uk/pharmacists

References

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1. NHS Education for Scotland. Pharmacy, Vocational Training www.nes.scot.nhs.uk/Pharmacy/Vocational training (accessed December 2014).

2. The Scottish Executive Health Department. The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. Edinburgh: The Scottish Executive, 2004.

3. Relaunch of national training scheme for hospital pharmacist in Scotland. The Pharmaceutical Journal.Forum:2000;264:381.

4.McMillan F. Is this Examination Fit for Purpose? [assignment]. Edinburgh:Univ. Edinburgh.2006.

5. McMillan F., What were the learning experiences of Pharmacists who have completed VT2 of the Scottish Hospital Pharmacists’ Vocational Training Scheme? [Dissertation] Edinburgh :Univ Edinburgh. 2009.

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Appendix A (1)

Forms within the VT e Portfolio

Forms Ticketed? SectionFeedback Form Y Forms > Ticketed FeedbackWitness Testimony Y Forms > Ticketed FeedbackAdditional Action Plan N Forms > Appraisal / Meeting FormsVT Appraisal Y Forms > Appraisal / Meeting FormsWeekly Review Meeting Record N Forms > Appraisal / Meeting FormsVT Record of Meeting N FormsRecord of Completion of Section N Forms > CompletionVT Rotation Record N Logs > Learning and Reflection Case-based Discussion (CbD) Y Logs > Learning and Reflection Mini-Clinical Evaluation Exercise (Mini-CEX) Y Logs > Learning and Reflection Action Record N Logs > Learning and Reflection Scribble N Logs > Learning and Reflection Case study log N Logs > Learning and Reflection Medicines Information Activity and Reflection N Logs > Learning and Reflection Dispensing Services activity and reflections log N Logs > Learning and Reflection Aseptic services reflection log N Logs > Learning and Reflection Aseptic services activity log N Logs > Learning and Reflection Declaration of own work N Logs > Learning and Reflection CMS Care Plan N Logs > Learning and Reflection Reflection Log N Logs > Learning and Reflection Record of Completion (MCQ Scores) N Logs > Learning and Reflection Personal development form N Logs > Personal Development PlanCare Plan: Clinical Management N Profile > Care Plan Do not useCare Plan: Continuity Of Care N Profile > Care Plan Do not useCare Plan: Current Medication N Profile > Care Plan Do not useCare Plan: Factors Affecting N Profile > Care Plan Do not useCare Plan: Investigations N Profile > Care Plan Do not useCare Plan: Medical and Drug History N Profile > Care Plan Do not use Care Plan: Patient Details N Profile > Care Plan Do not useCare Plan: Pharmaceutical Care Plan N Profile > Care Plan Do not useCare Plan: Reviews N Profile > Care Plan Do not useCare Plan: TDM N Profile > Care Plan Do not useCare Plan: Summary N Profile > Care Plan Do not useCare Plan: Reflection and learning N Profile > Care Plan Do not useCare Plan: Feedback Form N Profile > Care Plan Do not use

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Appendix A (2)

Different forms for different forms of evidence

Form/ evidence

typeUse when? Used by

whom?

Completed by whom?Comments

CPD record To evidence reflective practice VT Trainee VT trainee CPD/PDP plan

Completion of resources

Record completed resources

VT TraineeVT trainee

Completion of Resources Form

Feedback form

Obtain feedback from healthcare

professionalsVT Trainee

Other healthcare professionalsPharmacists

TrainersTutor

Feedback form(Each section pf the CF should have a min of 1

Feedback form).

Witness testimonial

Obtain feedback on performance of undertaking a

specific task

VT Trainee

Other healthcare professionalsTrainers

Tutor Witness testimonial

Clinical care plan and

case study guidance

To evidence pharmaceutical

care issuesVT Trainee VT trainee

TrainersTutor

Clinical care plan guidanceClinical case study guidance

Medicines information

template

To record MI enquiries + reflections

VT2 Trainee

VT traineeTrainersTutors

( Sign off by trainer using Ticketed Feedback process and witness

testimony)

Enquiry Answer Assessment FormTemplate for MI enquiry

Clinical governance and patient

safety

To record analysis of a significant

eventTo record an

audit

VT2 Trainee VT2 Trainee SEA template Audit template

Aseptic template(s)

To record aseptic products checked

+ reflectionsVT2 Trainee

VT2 Trainee( Sign off by trainer using Ticketed

Feedback process and witness testimony)

Products checked Reflections

Dispensing template

To record prescriptions

checked + reflections

VT2 TraineeVT2 Trainee

( Sign off by trainer using Ticketed Feedback process and witness

testimony)

Products checked and reflections

Education and training

To record a training plan for an educational

session

VT2 Trainee VT2 Trainee Training plan

Evidence scoring tool

A tool to help tutors provide feedback on

specific pieces of evidence

TutorTrainer

TutorTrainer Evidence scoring tool

Completion of activities

guidance

To check which activities should be done when

VT2 trainee VT2 trainee Guidance for completion of activities

Appraisal 6, 9 and 15 mths VT2 Tutor Appraisal form

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form trainee (e mail [email protected] when completed)

Record of meetings form

Monthly when meet with tutor/trainer

VT2 trainee Tutor

Record of meetings

(meet with tutor 1/mth)

Record of rotation form

Monthly to record your rotation

VT2 trainee VT2 trainee

Record of rotational experience

Completion of section form

On completion of each section

VT2 trainee

VT2 traineeTutor

(Specialist should provide feedback via Ticketed Feed

back process using a witness testimonial then

tutor should complete Completion of Section

form)

Completion form

Declaration of own work form

On submission for assessment

VT2 trainee

Prior to submission for assessment +15mth appraisal

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Appendix B

Format of VT2 and VT3 final assessmentVT pharmacists may be awarded a Pass, Pass with merit or Pass with distinction. To achieve a Pass with merit, trainees need to have a good pass in the ‘core areas’ of their portfolio plus their face to face assessment. Each assessment generally last approximately 1 hour.

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IntroductionsDescription of the assessment forms

Discussion about the pharmacist’s training experience

VT2 Generalist Questions from panel members about the presentation

VT3 SpecialistQuestions from panel members based on question proforma.

VT3Discussion of evidence from eportfolio

Assessment of, response to questioning, systematic approach, awareness of own limitations, Assessment of application of specialist knowledge in practice

Assessment of problem solving skills from 4 practice based scenarios. Assessment of, response to questioning, systematic approach, awareness of own limitations, generalist knowledge and Understanding of the various areas of the curriculum.

Question using proforma

Discussion of items from

VT3Discussion of VT3 journey, reflections and close

VT2Discussion of VT2 journey, reflections and close

Discussion of items from eportfolio

Successful trainee receives certificate of completion of VT2 or VT3 Specialist module

Appendix C

Format of portfolio assessment for VT2 and VT3 trainees

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VT2 / VT3 pharmacist indicates to NES Pharmacy that they wish to submit their portfolio for the final assessment

VT pharmacist completes and uploads the Own Work Declaration Form, ensures that all aspects are complete with satisfactory appraisals completed by VT pharmacist and their Educational Supervisor / tutor.

VT2 tutors need to ensure that each section is signed off.

VT3 Educational Supervisors / tutors do not need to ensure that each Element is signed off.

Portfolio assessed by pair of assessors using standard framework

Feedback provided. Trainee advised of items for final assessment

Trainee receives information about final assessment

Trainee submits any requested items to NES

Final face to face assessment by panel

VT2 – NES, PEC/LT)

VT3 – NES, 2 members of SIG + external SIG representative

Trainee asked to defer to next set of final assessments.

Successful trainee receives certificate of completion of VT2 or VT3 Specialist module