Search

Introduction: Longitudinal Integrated Clerkships (LICs) have demonstrated benefits for students' learning and development in medical education globally. The model emphasises importance with respect to continuity and time in the workplace for learners. There is a need to explore how LICs become a viable training model for learners. An amalgamative LIC model was drawn upon to inform the design of a placement for trainee pharmacists on a hospital ward. This study sought to determine the local viability of a longitudinal placement for trainee pharmacists, using communities of practice learning theory to interpret findings. Methods: A design-based research approach informed study design. A longitudinal placement was implemented on two hospital wards for 13 weeks. Trainees (n = 3) were interviewed four times over a 14-week period. Ward staff (n = 14) were interviewed at week 14. Interviews were transcribed verbatim. Qualitative longitudinal analysis, using the trajectory approach, was conducted using abductive analysis. The coded data were organised into a framework and subthemes were created. Results: Trainees acquired membership within the multi-disciplinary ward team over time. This led to an enriched learning experience and the trainee's professional development improved as they attained more responsibilities. This enabled them to make a greater contribution to patient care; more medication consultations occurred, and discharge times improved. Discussion: The local viability of the longitudinal placement appears to be linked to the trainee's ability to acquire membership within the ward community of practice. Membership gave trainee's access to learning opportunities, supporting their development, and they earnt the trust of staff, leading to more responsibilities for providing patient care. Further research into developing longitudinal placements that support trainee healthcare professionals to acquire membership within communities of practice is warranted.

Background and purpose: There is increasing demand for suitably trained pharmacists to undertake clinical roles in primary care general practices across the United Kingdom. This necessitates development of sustainable training opportunities to both better prepare future registrants for such roles and raise awareness of the new career pathway. Educational activity and setting: Hospital pre-registration trainee pharmacists undertook four or eight-week placements in general practice as part of their training year. Trainees attended an introductory session and received educational support tools six weeks prior to their placements. Each trainee had an allocated clinical supervisor in general practice and maintained communication with their hospital tutor. On completion of all placements, trainees and general practice staff were asked to share perceptions and outcomes via online questionnaires. Findings: Most trainees reported that the clinical supervision arrangements were satisfactory and found the placement workbook useful for guiding daily activities. Key benefits from the placements included enhanced understanding of the patient journey across healthcare sectors, increased confidence, and raised awareness of general practice as a career option. Main limitations included restricted opportunities to engage in patient-centred activities and lack of integration with general practice teams. All trainees stated that the presence of a general practice pharmacist was essential for learning support. Summary: This model demonstrated the feasibility of structured block placements of trainee pharmacists in general practice with identified benefits for trainees and pharmacy workforce requirements. Future research:Identified key limitations to this model need further investigation, to improve the design of future placements.

If foundation training is to equip future pharmacists with the clinical and prescribing skills they need, the registration assessment must be held near the end of the MPharm, rather than after it, says pharmacy practice lecturer Hannah Kinsey.

Objective To explore pharmacist’s views on the shift in ethos, funding and service delivery model introduced through the New Zealand’s Community Pharmacy Services Agreement (CPSA). Methods A purposive sampling approach drew pharmacists from a matrix who were then contacted via telephone and invited to be interviewed. Semistructured interviews were conducted face-to-face with community pharmacists (n = 17) across urban and rural New Zealand. An interview schedule exploring 12 subject areas was used to facilitate discussion and determine pharmacist’s views and understanding of the CPSA. The interviews were recorded and transcribed verbatim and a general inductive approach was taken to identifying emergent themes. Key findings Key themes that emerged were: pharmacists supported the philosophy behind the CPSA, pharmacists understanding of the CPSA, implementing CPSA-related services, perceived impact on patient outcomes and future sustainability of the CPSA. Overall, pharmacists supported the alignment of funding with patient-centred services, but pharmacy owners reported difficulty understanding the funding model, resulting in uncertainty over income. Several pharmacists believed the quality of care offered had not changed, while others found their attitudes towards care had evolved. All pharmacists communicated an increase in their workload and many perceived the sustainability of the CPSA to be linked to its ability to financially sustain community pharmacies. Conclusions The majority of pharmacists believed in the philosophy of the CPSA, but expressed concerns over funding, workload and benefits for patients. Future research is required to determine generalisability of these findings, investigate patient perspectives and assess the effect of the CPSA on patient outcomes.

he present study compared the patterns and efficiencies of Mn accumulation in field populations of two earthworm species (Lumbricus rubellus and Aporrectodea caliginosa) with acknowledged differences in their Ca physiologies. Moreover, electron paramagnetic resonance spectroscopy (EPR) was used to determine Mn speciation in frozen-hydrated, powdered, whole-worms tissue. Earthworms and soils were collected at nine sites in the vicinities of abandoned Mn (pyrolusite) mines. The main findings were: (i) soil Mn ranged from 9000 μg/g to 45,000 μg/g dry weight (conc. HNO3-digests) across the study sites, values exceeding the global ‘background’ soil maxima by factors from >2-fold to >11-fold; (ii) Lumbricus rubellus (epigeic species) tended to have higher tissue Mn concentrations than the endogeic, Aporrectodea caliginosa, although significant differences were only recorded at two of the seven sites where they were co-resident in sufficient numbers to allow comparisons; (iii) consistently low Mn bio-concentration factors (BCF) in earthworms (i.e., mean BCFMn for both worm species combined across all sites was 0.030) indicated strong homeostatic regulation; (iv) shallow earthworm-to-soil (‘total’ or conc. HNO3-digestible) Mn regression slopes confirmed the ability to regulate Mn; (v) Mn accumulation seemed not to be strongly influenced by soil pH, although more earthworm populations inhabiting Mn-contaminated acidic soils need to be investigated; and, (vi) EPR indicated that Mn (II) is the predominant species in earthworm tissues.