Implementing pharmacist training and annual competencies


Specialty Pharmacy Section

Upon graduation, pharmacists are required to take and pass at least two professional board exams in order to practice as a licensed clinician. These exams ensure that qualifying candidates have a specific level of competency in pharmacotherapy and pharmacy legislation. Like other health professionals, pharmacists must earn continuing education credits to renew their license on a biannual basis, as required by the Board of Pharmacy. Even after these specific requirements are fulfilled, how do establishments ensure their pharmacists are maintaining the proper level of operational and clinical competency within their area of practice? 


One answer to this question relates to the implementation of pharmacist-specific training and competency assessment. Creating and using a program to support pharmacists in continuous clinical and operational growth allows for the potential of enhanced self-confidence and patient care. With specialty pharmacy rapidly evolving, ongoing trainings and assessments are essential to ensure appropriate staff development; however, this is also a growing need across all practice settings. 


Training should commence soon after the hiring process, with an orientation program that is universally supported by company leadership. This training period should be followed by a baseline competency assessment to ensure pharmacists are operating independently in their role’s responsibilities (e.g., prescription verification, clinical consultation, adverse event reporting).



Crafting a training program


A structured training program should be developed to ensure sustained clinical competency and continuous development. Creating a training program starts with identifying a training need, which may be determined by a variety of departments within the organization (e.g., operations, quality, education). 


Clinical training formats may include a simple e-mail alert, a self-paced module, a team-based skills lab, and/or a clinical in-service focusing on one disease state or topic. 


Self-paced modules enable pharmacists to be in control of their learning by completing the required training at their own pace. Once this type of training is posted, it is imperative to schedule deadlines for completion, with consideration to the organization’s workflow. After successful completion, knowledge assessments and feedback evaluations may be administered to certify comprehension of the material and identify future areas of improvement. 


While pharmacists can be instructed on the methods of self-learning, an interactive platform is often more effective in generating positive results. Team-based skills labs facilitate learning by combining self-paced modules with hands-on learning. The typical design of a skills lab focuses on a specific disease state (e.g., rheumatoid arthritis, multiple sclerosis) and involves various components of learning structured in a creative format. The design of these sessions may be in the form of stations for pharmacists to complete in timed intervals or in a lecture-based format with incorporated hands-on learning (Figure 1).

Figure 1. Example layout of pharmacist skills lab


Most importantly, the activities should offer opportunities to learn and retain knowledge effectively without the loss of workplace applicability. Ideally, designing a comprehensive educational program that involves colleague collaboration will help facilitate open communication and team-building. 


Annual competencies


To ensure that the clinical staff are retaining the information presented and performing their daily functions appropriately, an organization may also develop annual competencies. Assessing the responsibilities of each pharmacist and recreating these in a controlled environment is the foundational start to evaluating pharmacist performance. The format of competencies can be structured similarly to that of a skills lab, with stations and activities for completion; however, pharmacists are not to be trained but rather appraised on their everyday tasks. 


Using evaluation forms (i.e., rubrics) with assessment indicators assists with consistency and structure. For every function that a pharmacist completes during the competency, points can be totaled to identify “satisfactory” or “unsatisfactory” completion status. If performance is deemed unsatisfactory, it is important to discuss this with the pharmacist and implement additional training as necessary; follow-up competencies should be completed until satisfactory performance has been documented. 


Challenges 


As with the implementation of any new program, challenges exist with clinical training and competencies. When rolling out a training program for pharmacists, it is often best to work alongside the pharmacy manager/supervisor to ensure that the proposed training aligns with the departments’ current operational structure and educational needs. It is also important to identify an appropriate schedule to ensure coverage for work demands. Many pharmacists have metrics that need to be met, so it’s essential to have a strategy to ensure attendees are not penalized for attending training. 


No matter the practice setting, the term “competency” can be intimidating, and even more so when a standardized competency is first introduced. As when designing a training program, it is important to collaborate with the pharmacy manager/supervisor when developing a clinical competency; this will help to ensure appropriate functions are being evaluated fairly. To mitigate staff concerns about a new competency, ensure that the purpose is clearly communicated. Inform staff that the competencies are not punitive, but will provide an opportunity for quality improvement and insight on training needs. However, follow-up is imperative to ensure that any identified deficiencies have been corrected. 


In recent years, the role of the pharmacist has continued to evolve, offering additional tasks and responsibilities within the health care setting. To ensure pharmacists are functioning at the expected standard, continuous training and assessments are required. The goal of pharmacist training and competencies should be to provide a safe learning environment for pharmacists by offering them the tools for both improvement and success within their practice setting. Ultimately, this will help guarantee that pharmacists are equipped to encounter their daily challenges with utmost confidence and readiness.