By: Mariyam Aly, PhD Candidate, BPharm; Carl R Schneider, PhD, BPharm (Hons), BN, PGCert Higher Ed, FHEA; Maria B Sukkar, PhD, B Pharm (Hons); Cherie Lucas, PhD, BPharm, Grad Cert Edu Stud (Higher Ed), MPS
The changing face of pharmacy
The role of the community pharmacist continues to evolve and expand, including the delivery of professional primary care services (e.g. immunizations, disease state management, and minor ailment services (MASs)).1 MASs provide a structured, protocol-driven approach to facilitate the management of self-limiting conditions in community pharmacies. These services currently exist nationally or locally in Scotland, Northern Ireland, and parts of England, Wales and Canada.2 They are also on the policy agenda in other countries, including Australia.2
The delivery of MASs entails a combination of clinical (e.g. assessment and treatment of minor conditions) and non-clinical components (e.g. record-keeping, administration, and interprofessional collaboration).2 It is therefore essential that pharmacists are equipped with the clinical expertise AND skills to implement and oversee these services.
Pharmacist delivery of MASs: the opportunity for micro-credentialing
Ensuring pharmacists are appropriately trained to deliver professional services, such as MASs, is paramount, as it improves their technical knowledge, confidence, and capacity to ultimately improve health outcomes.1 However, there is a lack of training standardization and completion enforcement for pharmacists wanting to deliver MASs, even though formalized practice guidelines do exist.2 For example, in England, the training requirements for pharmacists vary according to the local commissioning organization, potentially leading to variable service delivery, based on the individual pharmacist’s skills and experience. This may in turn influence uptake, utilization and MAS outcomes.
There are many media that can be used to train pharmacists to deliver MASs, including:
- Online/face to face courses
- Interactive learning platforms
- Discussion groups
- Reflective tasks
- Portfolio maintenance
- On- and off-the-job training
- Short courses (micro-credentials)
Micro-credentials (sometimes known as digital badges/nanodegrees) are a useful way to up-skill pharmacists as they offer convenient, industry-aligned programs that provide additional skills in specific areas. They are comprehensive and certify specific competencies to an employer.3
Professional organizations, universities and academic institutions have a real opportunity to develop higher level training courses such as certificates and continuing education programs to cater for this growing demand. Many universities are now developing strategies to incorporate micro-credentials into degree programs or as stand-alone qualifications, as this can enhance their educational value in the workforce.3 Pharmacists delivering MASs may benefit from micro-credentialing as they have the opportunity to build on the existing clinical skills they have gained from university and practice and attain new knowledge relevant to service delivery. These skills include service-specific training in aspects of MAS delivery such as logistics, communication, and workflow aspects. Micro-credentialing may enhance pharmacists’ understanding of the service components such as the patient experience, consultation skills, and follow-up processes. Attainment of the micro-credential may be achieved through any of the media noted above. The curricula of the micro-credential may include clinical and non clinical concepts:
- Patient history taking
- Diagnostic skills
- Effective communication strategies
- Effective use of technology and software programs
- Workflow considerations
- Leveraging other team members and support staff
Pharmacist micro-credentialing: a trickle-down effect
Pharmacists are responsible for the supervision and activities of their support staff while delivering MASs. Whilst support staff may not be involved in the clinical delivery of the service, they play a role in engaging clients and other administrative components. Pharmacy support staff are often the first point of access for clients with minor conditions seeking MASs.4 Ensuring they are equipped with the relevant expertise is essential to ensure beneficial patient outcomes and service operations.5 However, the aptitude for support staff to deliver MASs is often determined by the training and initiative of the supervising pharmacist.4 Pharmacists play a critical role in educating support staff, which includes non-clinical aspects. In order to offer support staff such training and education, pharmacists need to be able to clearly communicate with others, share their expertise, and objectively understand their team’s needs and requirements for further training.
Training pharmacists empowers them to lead, train and educate their support staff in a practical and engaging way to enhance MAS delivery. Therefore, it is valuable for pharmacists to harness their skills and experience to benefit the pharmacy team. Training support staff may involve pharmacists initiating activities such as:
- Role playing
- Online videos
- Case studies
- Review of protocols and formularies
- Explanation of standard operating procedures
These initiatives would clearly up-skill existing staff, and ultimately improve their capacity to deliver MASs. Thus, the value in ensuring pharmacists delivering MASs are effectively trained about both the clinical and non-clinical aspects of service delivery is significant as it has the potential to improve service delivery and outcomes.
What are your thoughts on micro-credentialing to enhance the value, delivery and outcomes of community pharmacy services such as MASs?
- Toklu HZ, Hussain A. The changing face of pharmacy practice and the need for a new model of pharmacy education. J Young Pharm. 2013;5(2):38-40.
- Aly M, García-Cárdenas V, Williams K, Benrimoj SI. A review of international pharmacy-based minor ailment services and proposed service design model. Res Social Adm Pharm. 2018;14(11):989-98.
- Ewan C. Higher education standards in a disaggregated learning environment. Canberra: Australian Government Department of Education and Training. 2016.
- Pumtong S, Boardman HF, Anderson CW. Pharmacists’ perspectives on the pharmacy first minor ailments Scheme. Int J Pharm Pract. 2008;(16):73–80.
- Banks J, Shaw A, Weiss MC. Walking a line between health care and sales: the role of the medicines counter assistant. Pharm J. 2005;274(7349):586-9.
Mariyam Aly is a PhD student at the University of Technology Sydney. Her educational scholarship interests include community pharmacy, self-care and public health. In her free time, she enjoys reading, travelling and spending time with family.
Dr Carl R Schneider is a Senior Lecturer of Pharmacy Practice at The University of Sydney Faculty of Medicine and Health, School of Pharmacy. Educational scholarship interests include: quality use of medicines, interprofessional education and patient safety. In his free time he enjoys music, fine wine and squash, not necessarily in that order.
Maria Sukkar is an Associate Professor at the University of Technology Sydney. Educational scholarship interests include the development of innovative approaches to improve pharmacy students’ performance in evidence based practice and professional pharmacy services. In her free time, she enjoys exploring new bars and restaurants and going on long walks.
Dr Cherie Lucas is a Senior Lecturer of Pharmacy Clinical Practice at the University of Technology Sydney (UTS) Australia. Educational scholarship interests include: reflective practice, interprofessional education and interprofessional collaboration. In her free time she enjoys salsa dancing, visiting art galleries, museums, and markets and loves the theatre and musicals.
Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning