June 2014
The Pharmacy Vocational Training Scheme:
Learning from experience, learning in practice.
Stages 2, 3 & 4.
June 2014
Review date February 2015
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June 2014
Background
The Pharmacy Vocational Training Scheme[1,2,3] originated in 1995 and is supported by the NHS
Scotland Directors of Pharmacy, both Schools of Pharmacy in Scotland and The Royal
Pharmaceutical Society.
The Training Scheme was originally introduced for junior pharmacists within secondary care, with
the view to provide them with a comprehensive structured training programme over a two year
period. Over the past five years, the training scheme has been redesigned and redeveloped to
meet the changing needs of the service. Developments have also included the introduction of
Specialist Training Frameworks.
Introduction
The Pharmacy Vocational Training Scheme is a structured, work-based training experience for
hospital pharmacists to enable them to deliver safe and effective pharmaceutical care. It is
available for pharmacists working within secondary care within NHS Scotland. Currently available
at Stage 2 (Generalist Level), it is being developed at two further levels;
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Stage 2 [general/foundation training]
Stage 3 [specialist clinical training]
Stage 4 [education, leadership and research modules].
Pharmacists should have completed Stage 2 prior to embarking on Stage 3 training. However, it
is envisaged that whilst undertaking Stage 3 training they may start a module within Stage 4.
There will be instances where the previous level of training has not been achieved and there are
pre requisites to help where previous stages of training have not been achieved.
What is the aim of the Vocational Training scheme?
The aim of the Pharmacy Vocational Training Scheme (VTS) is to facilitate the acquisition of
knowledge and skills necessary for pharmacists to participate fully in their post as a general
(hospital) pharmacist. The emphasis is on developing competence (the ability to perform tasks
consistently to the required standard) using activities in the workplace and a structured training
rotation. The training is based on gaining experience by undertaking a task, demonstration of
competence and reflection on learning from undertaking the task. This may require the task to be
undertaken on a specified number of occasions.
Stage 1 (Pre registration training) training is undertaken in either community or hospital
pharmacy.
Stage 2 (General/foundation training) is for junior pharmacists (Band 6 or equivalent), currently
working in secondary care, who need to develop general skills and gain a broad experience in
pharmacy practice prior to specialising in a clinical area of practice.
Stage 3 (Specialist training) is for more senior pharmacists (Band7 or equivalent) who need to
develop more specialist skills, in particular clinical skills.
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June 2014
Specialist modules that are available/in development are:
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Cancer
Clinical Trials
Critical care
Infection and Antimicrobial Stewardship
Older people
Public health
Rheumatology
Stage 4 (Advanced training) is currently under development but it is anticipated that it will
comprise of 3 advanced modules:
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Education
Leadership
Research.
Currently there is a course entitled ‘Taking the Pharmacy Vision Forward : a leadership course for
pharmacy staff’ that comprises 6 days of face - to - face learning over a 9 month period. The
course requires demonstration of application of leadership theory with pharmacy practice by
participants undertaking a series of short work based projects throughout the course. To this end,
the days are scheduled throughout the year to enable projects to be commenced, undertaken and
evaluated. Participants are also required to develop professional CPD records as evidence of
undertaking the course. A certificate of completion is issued at the end of the course.
A competency framework is currently being developed and will replace the e portfolio for
Leadership that was launched several years ago.
Further opportunities for multidisciplinary leadership training are also sign posted after completion
of the pharmacy course. They include opportunities to attend a multi - professional course
‘Leadership and Management’ which is organised by the NES, Medical Directorate and Leading
for the Future which is organised by the NES Leadership Unit.
How do I register to start training?
There is registration information on the NES Pharmacy website. Each year there is the
opportunity to register for training, three times per annum, in September, January and May.
Registration is online. After registering trainees are expected to undertake the relevant induction
training prior to starting completing their competency framework. Details of the induction materials
are on the NES Pharmacy website.
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June 2014
Requirements prior to starting the different stages of Vocational Training
There are some requirements that trainees need to undertake prior to starting training at Stages 2
and 3.
To undertake Vocational Training Stage 2 (VT2), currently, the trainee needs to be employed in
secondary care within the NHS in Scotland and they ideally should have undertaken their Pre
Registration training (PRPS) within secondary care. However, this is not mandatory.
Prior to embarking on Stage 2 trainees need to understand the fundamentals of aseptic
dispensing, dispensing and the provision of pharmaceutical care. They need to have completed
the following :
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aseptic training - aseptic dispensing and checking processes, the aseptic environment ,
formulation and stability of aseptic products, the preparation of intrathecal injections
(written modules available, simulation for preparation of 3 products required.
dispensing training -the in- patient and out - patient dispensing processes
the provision of pharmaceutical care to patients using the documentation provided
(webinar available)
the Adverse Drug Reaction reporting modules (available on NES website)
In each instance they need to develop as a piece of evidence a testimonial and have a discussion
with their tutor.
Prior to embarking on any module of Stage 3 of The Pharmacy Vocational Training Scheme,
trainees need to have completed the following resources:
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the provision of pharmaceutical care to patients using the documentation provided
(webinar available)
the audit process (completed an audit, see NES CPD web pages)
the reporting of an analysis of a Significant Event (completed and SEA, see CPD web
pages)
the process of Critical appraisal (completion of Critical appraisal modules 1 and 2, plus
MCQs)
patient safety (webinar available)
risk management (webinar available required)
leadership theory (webinar or attendance at a course introducing leadership theory)
the Adverse Drug Reaction reporting modules (available on NES website)
In each instance they need to develop as a piece of evidence a testimonial and have a discussion
with their tutor or Educational Supervisor.
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June 2014
Prior to starting a specific Stage 3 module, there are some further pre requisites depending on
the specialist module.
All pre requisites should be demonstrated by having a discussion with the tutor after completing
the relevant resource to ensure that the pre requisite is met. Where there is no resource,
guidance should be sought from the Educational Supervisor.
Pre requisites for the Antimicrobial module of Stage 3 of The Pharmacy Vocational
Training Scheme
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Pre requisites for Stage 3 of the Pharmacy Vocational Training Scheme
Below are the specific pre requisites for the VT3 Infection and Antimicrobial Stewardship module
that are required to be completed as well as the generic VT3 pre requisite activities before you
start your VT3 training.
Critical appraisal skills Level 1 and 2. If you have previous experience of critically appraising
literature, then there is no need to undertake any activities that are included as part of the
presentations.
• Health Associated Infection (Mandatory training package)
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Health Associated Infection (Mandatory training package,)
http://ow.ly/pBLs6
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June 2014
Vocational Training: Stage 2
Completing Stage 2 of the training scheme ensures that pharmacists achieve a ‘well rounded’
‘general’, structured training within their first two years of starting within the hospital setting. It also
enables trainees to gain experience in some areas that they may not have been able to
experience had they not been part of the training scheme .[4,5] Stage 2 of the Vocational Training
scheme has been mapped to the KSF.
The training is recognised by the Directors of Pharmacy and the Schools of Pharmacy (SOPs) in
Scotland as well as Queens University, Belfast. For details of any Approved Prior Learning (APL)
trainees should contact the various universities.
The training takes approximately 18 months to 2 years to complete during which trainees
complete tasks and develop a variety of different forms of evidence to demonstrate that they have
achieved competency for a particular performance standard. The evidence is collated into a
portfolio which is then submitted as part of the assessment process.
Trainees who are unable to complete within the 2 years period should indicate an estimated date
for final assessment unless due to exceptional circumstances this is not possible.
The in - practice training provides trainees with the opportunity to gain knowledge, skills and
experience in the following key rotational areas of :
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Dispensary
Aseptic services
Clinical Pharmacy
Medicines Information.
For each rotation there are a specified set of competencies which are used to plan, conduct and
evaluate the trainee’s performance.
There are also rotational practice activities which the trainee must complete, to help them achieve
the competencies.
The rotation is also supported by a series of ‘modules’ that help the trainee develop underpinning
knowledge for their rotation.
Competence is also required to be demonstrated in some ‘wider’ areas e.g. medical gases,
procurement and formulary management. This helps the trainee gain an insight into the ‘wider’
practice of pharmacy which should, as the trainee progresses, complement their practice.
The workplace rotations are intended to be flexible to accommodate individual learning needs
and service requirements. For example, experienced trainees moving into hospital practice from
another area of pharmacy, such as community pharmacy, may be able to demonstrate their
competence in some rotations in a shorter time than a newly qualified pharmacist. In such
instances the previous experience should be recorded in the paperwork with ‘gaps’ identified and
targeted as part of their rotation.
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June 2014
Frameworks for training
What is the framework for each of the stages of training?
For each stage of the Vocational Training Scheme, the trainee completes a competency
framework and provides evidence in the form of an e -Portfolio.
Within VT2 training there are 9 domains:
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aseptic dispensing
clinical services
cost effective use of medicines
dispensing services
education and Training
medical gases
medicines information
patient safety
professionalism.
Within VT3 training each framework comprises specialist clinical areas with the more generic
aspects of training being covered in the VT4 modules of Education and training, Leadership and
Research.
What type of evidence can be collected?
A wide variety of different types of evidence can be collected within the VT e Portfolio. For VT2
trainees, the main form of evidence is the development of GPhC CPD records. However, both
VT2 and VT3 trainees are also required to collect and develop:
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case based discussions (CbDs)
feedback forms
mini – clinical evaluations (mini – CEX)
presentations
short reports
training plans.
What does the e - Portfolio comprise of?
The e- Portfolio is a resource to help trainees collect and organise their evidence online. The
format of the e- Portfolio has been designed to enable tutors and assessors to view the evidence
in a systematic fashion. There are areas for:
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forms - appraisal, completion of section of framework, rotation details, meeting with tutor,
declaration of work and templates for; aseptic dispensing, dispensing services and
medicines information
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logs - care plans, case studies and reflective and action based logs
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compilation of references (personal library)
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resources (underpinning knowledge modules).
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June 2014
Support for training
There is a variety of support available for VT2 and VT3 trainees when they are undertaking
training namely:
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locality tutors (LT) (VT2 trainees)
specialist tutors (ST) (VT2 trainees)
pharmacy Practice Education Coordinators (PECs) (VT2 and VT3 trainees)
vocational Training tutors
local site based trainers (VT2 and VT3 trainees).
The LT and ST role are similar in principle. However, the LTs have a greater responsibility for
larger areas (usually regional) and provide guidance and support to STs and tutors within this
larger remit.
The LT also delivers training sessions, attends National meetings and ensures that the VT
curriculum is in line with service redesign as well as being involved in portfolio assessments and
final assessments where they may be required to be the Chair a panel.
Vocational Training Specialist Tutors are expected to support other pharmacists locally during
training towards Stage 2 of The Pharmacy Vocational Training Scheme within their sector of
practice within their Health Board Area. This will involve acting as a role model in practice and
supporting pharmacists with achievement of the competency framework, hosting local peer
review sessions for trainees and guiding and advising the tutors of trainees. Support with this role
will be available from your Regional Practice Education Coordinator (PEC).
Pharmacy Practice Education Coordinators, employed by NES, are responsible for different
regions within Scotland and will meet with trainees shortly after registration to ensure that they
are informed prior to starting training. They may also run local induction and peer sessions to
ensure that trainees progress with their training throughout the 18month to 2 year period.
Vocational Training Tutors are experienced pharmacists. They are required to register with
NHS Education for Scotland as part of the Vocational Training Scheme and are expected to keep
themselves abreast of developments by attending at least every 3 years a Vocational Training
Peer session at least every 3 years. They are expected to facilitate training but will not observe
practice on a daily basis.
It is anticipated that tutors will meet with trainees on a monthly basis to;
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review progress
sign off/discuss completed evidence
develop objectives
complete appraisal forms.
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June 2014
The tutor has a supportive role, and is involved in facilitating the trainee’s learning and assessing
their development.
They do this by:
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helping the trainee to identify their development needs
supporting, advising and encouraging the trainee during their training
undertaking
a) formative assessments (to monitor and review the trainee’s progress)
b) summative assessments (to check that the trainee has met the required standards).
At the end of each rotation, the workplace tutor will use the competency framework to carry out a
summative assessment, which will check that the trainee has met the required standard.
Evidence should be reviewed, competencies signed off and any ‘gaps’ for further training
identified.
The criteria for tutors, is under development. However, within their application to register as a
tutor they are required to detail their; professional journey/experience to date, training/mentoring
experience and their commitment to CPD (for which they may submit a Significant Event
Analysis).
Trainers are experienced technicians and pharmacists who may sign off activities whilst the
trainee is within their section. Trainers are not currently registered with NHS Education for
Scotland, nor do they routinely attend training however, any trainers are welcome to attend any of
the training days
Mentors are pharmacists who have recently completed the training scheme. They may informally
advise new trainees and may share their experiences of completing the training scheme.
Are there resources for training?
Once registered for training, trainees will receive/be able to access a copy of the competency
framework and modules which they will need to refer to whilst undertaking training. There are
induction materials for trainees and tutors as well as a series of webinars available via the NES
website.
Assessment
What is the format of the assessment processes?
VT2 and VT3 trainees are assessed throughout their training on a regular basis.
For VT2 trainees this tends to be by their tutor at their base. For VT3 trainees there are In
Training Reviews (ITRs) that are peer review sessions that are held on a regular basis.
In Training Reviews for VT3 trainees
In Training reviews are designed to be supportive and to enhance learning whilst providing
feedback on progress. The sessions are attended by 3 or 4 members of the Specialist Group,
NES and the specialist trainees.
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June 2014
The format comprises – presentation from each trainee (case study), training completed to date
and objectives for the next 3 months. All trainees are present at the session and are expected to
contribute. Written feedback is provided. Vc is available where possible. Trainees need to attend
at least one ITR during their VT3 training.
Appraisal
Tutors forVT2 are expected to submit regular appraisal forms to NES. Appraisal forms are
monitored and where required guidance and support is provided to tutors and trainees.
Submission of a suitable final appraisal indicates that the tutor supports the trainee coming
forward for final assessment.
Formative assessment
There are two diets of assessment per annum in May and November.
When trainees are ready to submit their portfolio for assessment they should register for
assessment via their locality tutor (VT2) or their Educational Supervisor (VT3). Names for
assessment will then be passed to NES.
For VT2 and VT3 trainees there is a portfolio assessment and a final assessment. They are
generally about 3 weeks apart. See Appendices A, B and C)
Portfolio assessment
Trainee portfolios are submitted to NES by the deadline specified. The portfolios are examined by
pairs of assessors using a standard marking schedule. Trainees receive written feedback and are
advised what they need to prepare for discussion at their final assessment. Should the trainee
require to prepare only a few minor items (< 5 items) for discussion at the final assessment then
they will be invited to attend the final assessment. Should they require to prepare more than a few
minor items (>5 items) for discussion at final assessment then they will be deferred to the next set
of assessments.
After a successful portfolio assessment the trainee is invited to attend for a final face - to- face
assessment.
Items for discussion at the final assessment are generally submitted prior to the assessment but
are discussed at the final assessment.
On successful completion of both parts of the external assessment process (portfolio and panel
interview), the pharmacist will be issued with a Certificate of Completion. This certificate will
enable them to gain accreditation for prior learning for further postgraduate studies, if appropriate.
Please see Appendix A for further detail of the assessment scoring proforma and the final
assessment process.
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June 2014
Summary
The Vocational Training Scheme continues to develop and be redesigned in light of the needs of
pharmacists working in secondary care in the NHS in Scotland. Trainees demonstrate
competence through achievement of a variety of tasks and develop an online e – Portfolio.
Trainees are supported by experienced pharmacists and have access to a variety of resources to
facilitate completion of their training. Assessment is both formative and summative with
assessments being held twice per annum.
A variety of specialist modules at a higher level than Stage 2 are currently in development - Stage
3 (VT3). Advanced modules are also in development and when available may be achieved whilst
a specialist module is being completed.
For the various specialist frameworks, specialist e - Portfolios (using the VT2 prototype) will be
developed and it is anticipated that several of these specialist online portfolios will be launched in
early 2014.
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June 2014
References
1. NHS Education for Scotland. Pharmacy, Vocational Training
www.nes.scot.nhs.uk/Pharmacy/Vocational training (accessed December 2007).
2. The Scottish Executive Health Department. The NHS Knowledge and Skills Framework
(NHS KSF) and the Development Review Process. Edinburgh: The Scottish Executive,
2004.
3. Relaunch of national training scheme for hospital pharmacist in Scotland. The
Pharmaceutical Journal.Forum:2000;264:381.
4.McMillan F. Is this Examination Fit for Purpose? [assignment]. Edinburgh:Univ.
Edinburgh.2006.
5. McMillan F., What were the learning experiences of Pharmacists who have completed
Stage 2 of the Scottish Hospital Pharmacists’ Vocational Training Scheme? [Dissertation]
Edinburgh :Univ Edinburgh. 2009.
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June 2014
Appendix A
Extract from final assessment scoring form
Scoring proforma : VT3 Specialist Module
……………………………
Put a ‘x’ in the relevant box
Criteria / score
8
Exceptional
7
Extremely
good
6
Very
good
5
Good
4
Acceptable
3
Poor
2
Very
poor
1
Extremely
poor
0
Exceptionally
poor
Specialist
Pharmaceutical
knowledge
Demonstrates
specialist
pharmaceutical
knowledge for this
specialist group
Planning,
monitoring and
review
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June 2014
Demonstrates ability
to plan, monitor,
advise and review
specialist
pharmaceutical care
for this group of
patients
Accountability for
patient care
Demonstrates
accountability for
the delivery of a
pharmacy service to
this defined patient
group
Reasoning and
judgment
Demonstrates skills
of
analysis,
judgment
&
interpretation
Appendix B
Format of VT2 and VT3 final assessment
Introductions
Description of
the assessment
forms
Presentation of
case (10 mins)
VT2 Generalist
(1 hour)
Questions from
panel members
about the
presentation
Assessment of presentation
skills, response to
questioning, systematic
approach, awareness of
own limitations, generalist
knowledge and
VT3 Specialist (1.5 hours)
Questions from panel
members based on
question proforma
question proforma
VT3
Discussion of ‘hot topic’
as per question proforma
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Assessment of specialist
knowledge and
understanding, team
working skills.
Scenarios 1-4 from cases
within trainee portfolio
Question using proforma
VT2
Discussion of VT2
journey, reflections
and close
VT3
Discussion of VT3
journey, reflections
and close
Appendix C
The final assessment process for VT2 and VT3
Trainee indicates to
LT that they wish to
submit their portfolio
for the final
assessment
Portfolio submitted to
NES assessment by
specified deadline
Feedback provided.
Trainee advised of
items for final
assessment
Portfolio assessed by
pair of assessors
using standard
framework
Trainee asked to
defer to next set of
final15
assessments.