A controlled study of the general level framework: Results of the South of England competency study†

Abstract

Background: Inconsistency in the practice of clinical pharmacy at a junior level encouraged our group to develop a general level competency framework (GLF) to facilitate practitioner development and assessment. The framework consists of patientrelated, personal and problem-solving clusters of competencies assessed on a four-point frequency scale. This study describes a large, controlled study to determine whether the framework could improve the clinical practice of junior hospital pharmacists.Method: One hundred and two junior grade pharmacists in 22 acute NHS trusts in the south of England were recruited. The hospitals were enrolled as either intervention (n ¼ 13; 72 pharmacists) or non-intervention sites (n ¼ 9; 30 pharmacists). The pharmacists ("tutees") and senior supervisors ("tutors") in the active sites used the competency framework for practice development. Tutees and tutors in the control sites did not have access to the competency framework, and measures were taken to ensure these trusts remained isolated from the assessment outcomes. All pharmacists were assessed at baseline, 3, 6 and 12 months. Non-intervention pharmacists were assessed by external evaluators.Results: A repeat measures analysis (month-6 compared to baseline, month-12 compared to baseline) revealed that the intervention group showed an improvement in 24 of the 25 competencies at month-6, which was sustained at month-12. In contrast, the non-intervention pharmacists demonstrated an improvement in just 7 of the competencies at month-6 increasing to 12 competencies by month-12 (Table III). Using an aggregated competency score for each recruit, intervention and nonintervention pharmacists were compared using an application of Kaplan-Meier analysis. Event status was defined as the achievement of competence, detected by the attainment of a predefined threshold score. A significant difference existed between the groups at all time points (log rank ¼ 7.97, p ¼ 0.0048).Discussion: This controlled study demonstrates that tutees in the intervention sites improved significantly in 24 of the 25 patient-related competencies at 6 months and that this was sustained at 12 months. By contrast, non-intervention candidates showed progression in only 12 of the 25 competencies.

Individualized Education and Competency Development of Croatian Community Pharmacists Using the General Level Framework

“…27 The present study demonstrated significant improvements in all competencies evaluated. This finding supports other studies that used the GLF to assess competencies, 12,23 though the results presented here show even greater improvement in pharmacist competencies. Coombes and colleagues demonstrated improvements in 57% of the competencies evaluated (35 of 61), and none of the remaining competencies demonstrated a decrease in performance between evaluations.…”

“…23 The South of England competency study was designed as a controlled study, and demonstrated that junior pharmacist competencies developed using the Framework improved in 24 of 25 areas assessed at 6 months and that this improvement was sustained at 12 months. 12 In both the above studies, the sample consisted of hospital/clinical pharmacists. Therefore, the greater improvement in competencies found in this study may have been due to the use of the GLF to evaluate community pharmacists.…”

“…10 In 2005, the Competency Development and Evaluation Group developed the General Level Framework (GLF). 11 The GLF is in use for competency testing of pharmacists in hospital and community settings in Great Britain, 12 Australia, 13 Croatia, 14 Singapore, and Serbia. 15 The GLF contains a detailed description of knowledge, actions, and skills that should be applied by a pharmacist in delivering competent pharmaceutical patient care.…”

Evaluation of Croatian Community Pharmacists' Patient Care Competencies Using the General Level Framework

“…14 The GLF allows accurate determination of a precise described meanings and level of such competencies. 10,11,15 There is a strong connection between competency and performance. Multiple-choice tests, oral examinations, or essays can be used to test factual knowledge, but more sophisticated methods are needed to assess performance, including observation, objective structured clinical examinations, and role play using standardized or real patients.…”

“…10 GLF studies of postgraduate students and pharmacists employed in hospital pharmacies have been conducted in Great Britain and Australia. 11,12 Research studies also have been conducted of pharmacists delivering pharmaceutical care in community pharmacies in Great Britain. 13 The extrapolation of discovered patterns in community pharmacies in Croatia as a new field of investigation is presented in this study.…”