Improvement in Pharmacist's Performance Facilitated by an Adapted Competency‐Based General Level Framework

Abstract

Background: The General Level Framework (GLF) is a tool for evaluating pharmacists' performance, providing tailored feedback and training, and guiding professional development. Aim: To ascertain the changes in pharmacists' workplace performance over time using the GLF and to describe pharmacists' views on the baseline evaluation process. Method: The UK GLF was mapped against Australian pharmacy competency standards and practice guidelines. 61 of the 92 competencies from the Queensland Health version of the GLF representing core professional activities of Australian pharmacists were analysed. Trained evaluators used the adapted GLF to observe pharmacists from 18 Queensland public hospitals in their workplace (baseline and repeat) and rate the frequency with which competencies were completed to a defined standard. The evaluators then provided pharmacists with tailored feedback, encouraged self-problem solving, and identified and addressed their training needs. Pharmacists' views of the baseline evaluation process was assessed using a 7-point rating scale. Results: 66 pharmacists from 18 Queensland hospitals underwent the evaluation. At baseline, pharmacists had a median of 3 (1 to 10) years hospital experience. A median of 14 (5 to 22) months lapsed between baseline and repeat observations. Of the 61 competencies analysed, 35 (57%) competencies showed a significant improvement from baseline to repeat observations (p ≤ 0.05). Competencies that improved significantly from baseline included: aspects of medication history taking; medication management; identification, documentation and resolution of drug-related problems; appraisal of therapeutic options; and communication with doctors and nurses. For 9 (15%) competencies, pharmacists were already performing at the maximum level (median score 4) at baseline and no change was recorded between observations. No competency demonstrated a decrease in performance between observations. When the mean scores with 95% confidence intervals for the clusters of competencies were compared over time all the mean scores except for discharge

Use of a General Level Framework to Facilitate Performance Improvement in Hospital Pharmacists in Singapore

“…This compares with 95% (n558; p , 0.05) at 6 months (sustained at 12 months) in the original London study, and 57% (n561; p , 0.05) over a median of 14 months in the Queensland study. 23,24 Performance improvements are comparable between the London and Singapore cohorts, but there is an obvious disparity in the Queensland results. Although the competency frameworks used in the 3 studies contained different behaviors so that a direct comparison is not feasible, some observations can be made.…”

“…Others found the process taxing, a sentiment echoed by colleagues in the Queensland study. 24 Both of these aspects are expected to become easier with time as the GLF is integrated into daily practice and a more open learning culture develops.…”

“…The competencies that this applied to related to tasks that were widely accepted as comprising fundamental roles of a hospital pharmacist in Singapore, an observation that has also been made in other studies. 23,24 The behaviors in the problem-solving cluster all demonstrated significant improvement as well as the largest change in performance over time out of the 3 clusters (Table 2). This finding reflects research results from other countries using this tool and emphasizes the American Journal of Pharmaceutical Education 2012; 76 (6) Article 107.…”

“…23,24 This cluster measures knowledge-based behaviors, such as describing the pharmacology of drugs, pathophysiology of disease, and mechanisms of interactions, which require a more complex understanding and continual learning, compared with the process-based behaviors that comprise the majority of the other 2 clusters. Process-based behaviors that involve the learning and refining of processes related to daily activities appear to be mastered more quickly than knowledge-based behaviors, which are subject to continual improvement and can be fully refined only over time in conjunction with appropriate mentoring and continued professional development.…”

“…[24][25][26][27][28][29] In fact, the current global interest in efficient programs for development and evaluation of competencies for pharmacists resulted in the International Pharmaceutical Federation forming an ongoing partnership with WHO and the United Nations Educational, Scientific and Cultural Organization in 2008 (Global Pharmacy Education Taskforce www.fip.org/education). This partnership included an objective to develop a globally acceptable competency framework.…”