Academic journal article American Journal of Pharmaceutical Education

Objective Structured Clinical Examinations (OSCEs) Compared with Traditional Assessment Methods

Academic journal article American Journal of Pharmaceutical Education

Objective Structured Clinical Examinations (OSCEs) Compared with Traditional Assessment Methods

Article excerpt


Training of pharmacy undergraduates in the United Kingdom (UK) in preparation for their careers as pharmacists is undergoing change. The seminal White Paper (1) by Anne Galbraith illustrates the need for the discipline to evolve to accommodate the changing demands of the population. Without community pharmacists playing a more prominent, clinical role in the routine management of chronic and lifestyle-related diseases, economic pressures place the National Health Service (NHS) at risk of being unable to provide appropriate quality of care. As highlighted in the white paper, the biggest risks to the nation's health include the prevalence of obesity, smoking, sexually transmitted infections, and alcohol abuse. The aging population also poses a significant threat to the provision of quality healthcare. By 2029, the UK population 65 to 74 years old will increase by an estimated 40%, and the population 75 to 84 years old will increase by 50%. Over the same period, the proportion of people over 85 years old is expected to double, placing the greatest burden on the healthcare sector. (2)

There are approximately 12,500 community pharmacies across the United Kingdom. (3) With increasing frequency, these pharmacies are offering a range of extended services, such as smoking cessation clinics, cholesterol and blood-pressure testing, and screening for chlamydia. Services such as these, coupled with the community pharmacist supplying excellent advice regarding lifestyle choices, aim to tackle the biggest risks to public health and ease the burden on the healthcare sector as a whole in the near future. To prepare future graduates for the challenges facing modern practicing pharmacists, however, undergraduate training has to adapt accordingly.

The UK undergraduate master's degree in pharmacy is a 4-year university-based degree, followed by a 1-year vocational "preregistration" year, after which students take a set of examinations. Candidates who have displayed competence in practice and pass the examinations are able to work as pharmacists in the United Kingdom.

The undergraduate program can be divided into 4 disciplines: pharmaceutical chemistry, pharmaceutics, pharmacology, and pharmacy practice. Traditionally, the emphasis for undergraduate training of pharmacists has been on science, with pharmacology, pharmaceutical chemistry, and pharmaceutics accounting for the majority of the academic content. As the role of the pharmacist has predominantly been dispensing medications prescribed by the doctor and advising regarding administration, this theoretical bias was adequate training to prepare undergraduates for a career in the field. While a solid foundation in the scientific basis of medicines and the way in which they interact with the body is still paramount to any pharmacist's training, the evolution of the pharmacist as a clinician warrants a concomitant change on the emphasis placed on pharmacy practice in undergraduate degree programs.

Research by The Royal Pharmaceutical Society of Great Britain (RPSGB), in conjunction with the University of East Anglia, has highlighted the poor correlation between academic achievement and performance during the preregistration year. (5) To meet the necessary high standards of professional practice, the RPSGB advocates the inclusion of competency-based learning and assessment in the form of objective structured clinical examinations (OSCEs), alongside traditional methods of assessments such as written examinations. However, OSCEs should take into account that the measure of competence is contextual and that the assessment of competence (ie, what the student is able to do under examination conditions) should ideally reflect what the student will habitually do when not being observed. (6)

The master of pharmacy (MPharm) degree at the University of Hertfordshire (UH) has been developed as a degree that integrates the clinical and scientific aspects of a pharmacist's training from day 1 of the program. …

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