PM4B-Advanced Clinical Pharmacy & Pharmacy Practice

Module Provider: Pharmacy
Number of credits: 60 [30 ECTS credits]
Level:7
Terms in which taught: Spring term module
Pre-requisites: PM3A Therapeutics and Medicines Optimisation D and PM3B Therapeutics and Medicines Optimisation E and PM3C Delivering Pharmacy Services 2
Non-modular pre-requisites:
Co-requisites: PM4A Pharmaceutical Research and Enquiry
Modules excluded:
Current from: 2023/4

Module Convenor: Mrs Sue Slade
Email: s.j.slade@reading.ac.uk

Type of module:

Summary module description:

This module focuses on the integration of knowledge and skills from previous years’ modules, and their application to a number of complex patient care scenarios. Students will consider a range of patient groups and the complications and pharmaceutical care considerations associated with each. Students will maintain their technical and clinical skills associated with each of the scenarios being addressed, and will integrate changes in the law into their clinical practice. Students will further their learning regarding the safe and effective delivery of pharmacy services and the management of these, whilst healthly living assessments (HLAs)��will provide students with the opportunity to utilise their clinical skills in supporting patients to achieve healthy life-styles. Students will also gain experience of supporting the learning of others, through assisting in the facilitation of workshops and practicals for students in lower years. Interprofessional Learning will foster a collaborative approach to patient care alongside other members of the healthcare team.

Aims:
This module will provide students with the opportunity to:
' integrate learning accumulated over the previous 3 years of study to up-to-date clinical scenarios, using paper-based, computer-based and expert patient simulation scenarios
' further develop professional skills required for working as an effective member of the multidisciplinary healthcare team
' deliver hands-on public-facing healthy living assessments and advice to volunteer patients
' develop excellent reflective professional development skills

Assessable learning outcomes:

Students will be able to:

• Discuss the pharmaceutical care of patients in the following specialities: obstetrics, neonatology & paediatrics, poisoning, hepatic disease, renal disease, surgery, clinical nutrition, elderly care, cancer and palliative care.�� This will include:
  
  
  
  • Drug treatment options and their place in therapy
  
  
  • The evidence available and its utilisation to support recommendations for disease management
  
  
  • Discovery, design and delivery of drug treatment options (including metallotherapeutics)
  
  
  • Pharmacology (including pharmacokinetics and pharmacodynamics) of drugs used in treatment
  
  
  • Monitoring for safety and efficacy of treatment and action that should be taken in view of results obtained
  
  
  • Patient centred care and medicines optimisation: tailoring treatment to the individual, personalised medicine, effect of disease on the patient, health beliefs & behaviours, promoting adherence and self-care, providing medicines-related information����
  
  
  • The role of the pharmacist, including how they may work with public groups to improve outcomes
  
  
  • How pharmacists may work with other healthcare professionals to achieve effective patient care
  
  
  • Public health aspects, where appropriate
  
  
  
  


• Analyse prescriptions (from community and hospital settings)
  
  
  
  • Assess for legal and contractual validity and clarity
  
  
  • Assess for clinical appropriateness
  
  
  • Where necessary, make suggestions for modifications to maximise outcomes
  
  
  
  


• Carry out calculations (including those relevant to dosing, administration rates, determining renal function and drug pharmacokinetics


• Discuss NHS structure & governance systems and how new pharmacy services are commissioned based upon justified local or national need. Consider how pharmacy services are designed, implemented, delivered and maintained to ensure maximal health outcomes


• Prepare a report for the implementation of a safe and effective pharmacy service considering the legal and ethical issues and, minimisation of risks to staff, patients and the public


• Discuss how the development of others can be effectively supported, including through the provision of constructive feedback and coaching


• Support the education and training of other students through effective guidance and supervision


• Undertake a health promotion-related consultation, including safely performing and interpreting diagnostic tests, explaining results in a suitable form to be understood by patients, provide pharmacological and non-pharmacological advice, signpost to other sources of support and appropriately record details of the consultation


• Discuss pharmacy and health-related law and apply this to clinical practice


• Discuss pharmacy and health-related ethical dilemmas and how they could be managed, taking account of professional requirements and codes of conduct


• Perform a range of consultations with patients and healthcare professionals, including maintaining a professional approach, agreeing an agenda, obtaining relevant information through effective questioning, identifying and communicating solutions/options, supporting decision-making, responding to further questions/concerns, concluding the consultation and providing supplementary information where required, and making appropriate records where necessary.Scenarios will include: assessing patients’ own medicines, responding to symptoms, discussing modification of therapy with prescribers, and responding to medicines information enquiries.


• Work under time pressures and time constraints


• Demonstrateeffective time management when completing consultations and practice-related tasks


• Reflect upon their learning from university arranged pharmacy work placements, inter-professional learning and supervision of Part 1 and 2 students

Additional outcomes:

In addition to the assessed outcomes students will further develop their time-management, ability to work under pressure/time constraints and prioritisation skills. They will learn how to work with others in formal and informal communication, and develop an understanding of the importance of acting as a professional role model within pharmacy.

Outline content:

Introduction to module: Put module in context with Part 4 teaching, and explain the key concepts covered in the module, and how material from previous years and PM4A should be drawn upon in this module.

Delivery & Management of Pharmacy Services:��Managing service provision and ensuring appropriate resources to maximise benefit and minimise risk.�� Responding to local health needs and priorities.�� Managing change in processes and organisations.��

Managing and developing others: this teaching theme is to support students in their preparation for providing support in workshops and practicals for earlier years.

Compulsory Student-led healthy living assessments.

Medicines Use in Pregnancy & Breastfeeding: Treatment of pregnancy related conditions and assessing medicines for risk in pregnancy and breastfeeding.

Neonatology & Paediatrics: Paediatrics and Neonatal care: Diseases affecting the newborn/prematurely born; drug use and pharmaceutical care considerations in neonates and children; role of pharmacist; information sources/reference texts for paediatrics.

Pharmaceutical care for surgical patients; hepatic and renal failure; poisoning and overdose; and clinical nutrition

Care of the elderly and multi-organ disease:�� Main multi-organ disorders of old age; co-morbidities (i.e. diseases whose aetiology may not be directly linked but are frequently co-incident) and how they “interplay”; falls; special considerations/needs (e.g. supporting patients with visual and hearing impairment); supporting adherence.

Complex cancer: Detecting and staging metastatic cancer; routes of metastasis; resistance to chemo- and radiotherapy; emerging anti-cancer drug discovery programmes, advances in personalised medicines, the localized delivery of anti-cancer agents, anti-angiogenic agents

Palliative care: Symptoms and their management; role of the pharmacist: polypharmacy, patient beliefs, shared decision making, use of unlicensed/off-label medicines, continuity of care (e.g. community supply issues), parenteral compatibility/subcutaneous syringe drivers; the multidisciplinary team.

Advanced concepts in medication safety: Critical discussion of key concepts in Safety I and Safety II; Safety I approach to error management; Safety II approach to increasing safety; and translating theory into practice.����

Law & Ethics update: Update of aspects of law and ethics that have changed since covered earlier in the course

Workshops: Workshops will build on private directed study and will include debate/discussion of topic case scenarios, case-based learning, role play and practical tasks involving prescription assessment and validation, accuracy checking, assessing Patients’ Own Drugs, screening drug charts, responding to symptoms, communication with healthcare professionals (written (e.g. writing in notes) and verbal), medicines information�� enquiries.

Interprofessional Learning Symposium (IPL): A compulsory interprofessional learning symposium will be held as part of this module and will focus on one of the topic themes.�� Students from other healthcare disciplines will be invited to attend and the symposium will comprise of seminars and case-based workshops to provide students with the opportunity to network and learn from and alongside each other.

Brief description of teaching and learning methods:

Teaching and learning methods include lectures and workshops, work-based learning and guided independent study.

Contact hours:

��	Autumn	Spring	Summer
Lectures		61
Seminars		8
Demonstration		4
Practicals classes and workshops		64
Work-based learning		2
Guided independent study:	��	��	��
�� �� Exam revision/preparation		212
�� �� Advance preparation for classes		65
�� �� Preparation for tutorials		64
�� �� Preparation of practical report		30
�� �� Completion of formative assessment tasks		30
�� �� Group study tasks		60
��	��	��	��
Total hours by term	0	600	0
��	��	��	��
Total hours for module	600

Summative Assessment Methods:

Method	Percentage
Written exam	50
Report	5
Oral assessment and presentation	10
Practical skills assessment	30
Class test administered by School	5

Summative assessment- Examinations:

Four written examinations will be sat in the summer examination period, one Law & Ethics examination (15%; 2 hours), one Synoptic examination (Parts 1-4 content, 17.5%; 2hrs) one MCQ and SAQ examination (Part 4 content only, 15%; 2 hrs) and one Calculation examination (2.5%; 1.5hrs). The synoptic exam will consist of case-based essay questions based on content from all four years and will require application of integrated knowledge.

The examination for this module will require a narrowly defined time window and is likely to be held in a dedicated exam venue.

Summative assessment- Coursework and in-class tests:

OSCE:��Students will sit an 8 station OSCE practical assessment in the summer examination period and will submit reflective entries based on specified compulsory Part 3 and 4 learning activities, including interprofessional and placement learning.

PAD:��Students must complete a reflection on learning for the following: the University arranged 1-week pharmacy placement, Supervision of Part 1 or Part 2 pharmacy students, Interprofessional learning from the HLA, medicines safety workshop and Symposium.�� The reflections will be submitted as part of the OSCE assessment in the Summer term.

Pharmacy service proposal:��Students will prepare a proposal for a pharmacy service.�� Students will be assigned a specific scenario and required to undertake a risk assessment of the proposed service and consider relevant legal and ethical issues.�� Students will receive individualised written feedback on their submission.

Cancer PBL:��Students will work in groups on a cancer case study to produce and deliver a presentation. Self and peer assessment will also be undertaken.

Healthy living assessments:��Students’ competence will be assessed through a Blackboard test.�� Students must pass this test to be permitted to undertake a healthy living assessment on volunteer patients.

Formative assessment methods:

Formative assessment will be provided through workshops (such as the OSCE preparation workshops) and mock assessments.�� These will include peer marking to support students’ familiarity with the relevant marking schemes.

Penalties for late submission:

The Support Centres will apply the following penalties for work submitted late:

• where the piece of work is submitted after the original deadline (or any formally agreed extension to the deadline): 10% of the total marks available for that piece of work will be deducted from the mark for each working day (or part thereof) following the deadline up to a total of five working days;
• where the piece of work is submitted more than five working days after the original deadline (or any formally agreed extension to the deadline): a mark of zero will be recorded.

The University policy statement on penalties for late submission can be found at: /cqsd/-/media/project/functions/cqsd/documents/cqsd-old-site-documents/penaltiesforlatesubmission.pdf
You are strongly advised to ensure that coursework is submitted by the relevant deadline. You should note that it is advisable to submit work in an unfinished state rather than to fail to submit any work.

Assessment requirements for a pass:

Students must obtain an overall module mark of 50%, with a mark of 50% in the Law and Ethics examination, 70% in the calculations examination and a pass in the OSCE.

Reassessment arrangements:

For the OSCE, three attempts are available if needed. If students do not pass on the 1st attempt, the 2nd attempt OSCE mark is capped at 50%. For the 3rd OSCE attempt the entire module mark is capped at 50%.

Re-examination of each of the individual assessment areas will be in August and will be in the same style as the original assessment areas.

Additional Costs (specified where applicable):

Required text books – the University library has a large number of text books and specialised reading material. There are also an excellent number of e-books available to the students. There might be core text books, which the students wish to purchase at varying costs.

Printing and binding - Currently library costs for printing are 5p a sheet b/w. A simple ring binder can be purchased from stationers for around £3.

Last updated: 30 March 2023