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

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Competency in pharmacy is the ability of the pharmacist to make deliberate choices from a repertoire of behaviors for handling situations and tasks in the specific context of professional pharmacy practice by using and integrating knowledge and personal values in accordance with professional role and responsibilities. (1) Knowledge can be assessed using various tools eg, examinations and questionnaires. (2) However, more sophisticated methods of testing are needed to assess skills, judgment, and attitudes in the context of clinical performance, eg, direct observation and objective structured clinical examinations (OSCEs). The assessment methods may include observation, review of documentation, surveys of those using pharmacy services, or role-playing using standardized or real patients. (3,4) It is also possible to assess competency by comparing pharmacists' behavior to documented, effective actions of other pharmacists in real pharmaceutical care situations.

By assessing the differences between the current and desired levels of pharmacist competencies, it is possible to develop an individual education plan aimed at achieving the desired level of competency. (5) Knowledge, skills, attitudes, and personal pharmacist values thereby receive real significance through experience in practice. Educational programs therefore should focus on integrating knowledge and practice. (6) In this way, education should be tailored to suit individual needs, taking into account the pharmacist's desire for advancement and professional development. (7) However, educational needs pertaining to the development of competency can be assessed at the level of the organization, and with regard to national or international plans or movements within the profession. (8) In 2007, the Global Education Taskforce, established by the International Pharmaceutical Federation (FIP), United Nations Educational, Scientific and Cultural Organization (UNESCO), and the World Health Organization (WHO), called for increased testing of competencies, additional educational programs and tools for their improvement, as well as international cooperation. (9) In attempting to sum up the common educational needs related to the development of competencies, various models for competency testing have been examined at the global level. (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. There are 4 competency clusters: delivery of patient care, problem-solving competencies, personal competencies, and management and organization competencies. The delivery of patient care cluster is comprised of 8 different competencies (Table 1), and was selected by researchers to evaluate and develop the community pharmacists' professional competence level in Croatia. Each of these competencies has several statements that define the competency, known as behavioral statements (Table 1). All 26 behavioral statements can be evaluated through a monitoring method, ie, observation of performance in real situations involving the delivery of pharmaceutical care.

Croatia has a population of 4.5 million. Pharmacies are a part of the primary health care system, and there are 2,773 registered pharmacists working in community pharmacies. Pharmacist licenses are renewed every 6 years by the Croatian Chamber of Pharmacists based on points collected through CPD programs or mentoring. It is not an obligation for pharmacists in Croatia to keep a learning portfolio, and it is not yet part of the licensing process. In Croatia, like in other Eastern European countries, the primary role of community pharmacists remains the traditional role of dispensing, supplying, and compounding medicines, with few structured clinical engagements and little advanced collaborative practice. …