Academic journal article American Journal of Pharmaceutical Education

Use of a Multisource Feedback Tool to Develop Pharmacists in a Postgraduate Training Program

Academic journal article American Journal of Pharmaceutical Education

Use of a Multisource Feedback Tool to Develop Pharmacists in a Postgraduate Training Program

Article excerpt

INTRODUCTION

Achieving and demonstrating the standards of professional competence in ensuring the proper use of medications requires the integration of pharmaceutical knowledge, clinical skills, and attitudes developed through appropriate undergraduate, professional, and postgraduate training. (1,2)

Traditional descriptions of assessment are based on a consistent set of theoretical beliefs and assumptions, typically consisting of written examinations that mainly test knowledge. (3) The assumption that knowledge has a universal meaning that is identical for every individual results in assessments that simply monitor students' learning, separating those who know from those who do not know. Consequently, a grading system is created that is based solely on "knowledge" in its particular context. (4) In contrast, modern approaches to assessment treat knowledge as a broad term that is specific to the individual and as a way of facilitating learning through feedback. (5) Although recent developments in the types and methods of assessment allow for a better understanding of the ability to practice safely (eg, objective structured clinical examinations [OSCEs]), most do not provide information relating to actual performance.

Multisource feedback is a method of assessing practitioner performance in the workplace so that experience is contextualized in order to consolidate strengths and overcome weaknesses. (6,7) It was first used to assess practicing physicians' oral communication skills, teamwork, and problem-solving abilities from the persepective of others. Some educators suggest that receiving feedback mindfully contributes to learning, and extensive literature shows that such assessment can, with certain caveats, be practical, valid, and reliable. (8,9) The peer-assessment tool (mini-PAT), which evolved from multisource feedback and collates the views of various healthcare professionals with the aim of facilitating personal development, offers a more well-rounded overview than is possible when only 1 source provides feedback. (10-12) First introduced for physicians in the early 1990s, mini-PAT was designed to provide trainees anonymous feedback from peers and colleagues. (13,14) Feedback can be motivating for individuals as they develop in the workplace, particularly when accompanied by facilitated discussion exploring the trainees' feedback and concerns. (8,9) Satisfaction is also greater if narrative comments are included and there is evidence that organizational benefits ensue as a result. (9,15) However, feedback potentially can be threatening and, if poorly managed, can impede rather than encourage change. (12) Additionally, feedback that is disconfirming can lead to a deterioration in performance. (16)

Early postregistration pharmacist development in UK hospital practice has traditionally been coupled with a postgraduate academic award (typically a postgraduate diploma). Major reforms in southeast England have included a shift toward making greater use of work-based learning and workplace-based assessment. The University College London Postgraduate Diploma in General Pharmacy Practice (www.jpbsoutheast.org), which has been used to develop junior postregistration pharmacists across London since 2005, is a program that integrates workplace-based learning with academically based learning sets and includes academic involvement in work-based learning and assessment. The program is supported by a validated professional development framework that lists the key competencies expected of a junior pharmacist in the UK. Performance assessment tools, such as the pharmacy mini-PAT, provide evidence that certain competencies have been met. (17)

The pharmacy mini-PAT uses elements from the mini-PAT for medical graduates as well as associated competencies from the framework that are considered appropriate for assessment by a range of healthcare professionals. This structure allows nominated mini-PAT assessors to objectively comment on the performance of their junior pharmacist. …

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