introduction to the NMP Course video transcript

Hello, my name is Jill Gould. I'm the programme leader for non-medical prescribing at the University of Derby. And this is an introductory video about the course. The course is subject to professional regulation.

And the three councils that are involved in this is the Health Care Professions Council, the Nursing and Midwifery Council and the General Pharmaceutical Council. These all have a statutory and legal authority to validate prescribing courses, as well as allow their registrants to be registered as nonmedical prescribers when they meet the conditions for the registering as a prescriber.

The Nursing and Midwifery Council has a suite of post registration standards that apply to prescribing. One of them is their basic standards framework for all programmes. Second, one of great pertinence to this is the standards for student supervision and assessment. Any course that is validated with the Nursing and Midwifery Council has to meet those standards for practice supervision.

Standards for prescribers is more about prescribing courses because what they have done for their standards is adopt the Royal Pharmaceutical Society's competency framework for all prescribers. That's been updated in 2021 and is embedded in the practice assessment document as well as being assessed throughout the course as theory.

The Nursing and Midwifery Council has some useful guides that you can access from their website if you want to know more and have some guidance about students and their assessment and the roles of Practice Supervisor and Practice Assessor The Health and Care Professions Council also have some additional information on their site if you want some further information about supporting their students.

There are four different professions who are permitted to do the prescribing course and we host three of them on our course. That's the podiatrists, paramedics and physiotherapists. Their standards also adopt the Royal Pharmaceutical Society's competency framework for all prescribers, but they also have some additional things written in their standards. And this is one example of the need to gain consent from service users.

So that's also embedded in the practice assessment document. The general pharmaceutical society decided to go their own way this time. So when they wrote their new standards for independent prescribers, they didn't adopt the Royal Pharmaceutical Society Competency Framework and instead wrote their own specific standards. Their standards are across domains of study in those four different domains. And also like we've adopted for all of the students, they advised 26 days of structured learning, as well as the 90 hours or 12 days in practice.

The other thing they've done differently with their standards is to adopt Miller's triangle so that is 'knows', 'knows how', 'shows how' and 'does'. So they've used that against their standards. And this is just one example of the learning outcomes that are required for the pharmacist to meet and and how Miller's triangle applies to those.

We have adapted the practice assessment documents so that it embeds the Royal Pharmaceutical Society's competency framework for all prescribers as its main core basis. But there are a couple of the GPHC specific learning outcomes that weren't in the competency framework and are now written into the PAD doc as separate outcomes.

In addition to the Royal Pharmaceutical Society's competency framework for all prescribers, it's also useful to become familiar with the designated prescribing practitioner's competency framework that they published last year as well. It's based on the role that the terminology, the DPP role is what the General pharmaceutical society calls it, But these competencies are applicable to anybody who is undertaking the role of a somebody who's assessing practice.

So, for example, the designated medical prescriber or as the nurses call it, the practice assessor or as the Health and Care Professions Council calls it, the practice educator. So all of that terminologies within this document. And it's worth knowing. So a quick overview of the course now. This is what we introduced to the students. The first thing to say is that the programme, its aims and objectives and standards, it's all regulated.

It's all impacted upon by the professional regulators right from the start with entry criteria to the taught content, the assessment and the practice assessment. To give it some context, it's in the College of Health, Psychology and Social Care. It is a module within other programmes. So, for example, if somebody is studying the district nursing masters, they can do it as a module within that or the Advanced Clinical Practice Programme. It's it's a module within that programme.

However, it's also a course in its own right and it or and or has an exit award of postgraduate practice certificate in... And then it's either nurses for nurses, pharmacists, etc. The only profession that can still do it at level six is nurses. And that's because there's a lot of different specialist roles that nurses can do at Level six. Professional standards, as mentioned, underpin every aspect of the course and are embedded throughout in that way.

Other influences on the course include feedback from previous students and current students that we listen to programme the programme team themselves bringing different perspectives to the course. University standards and teaching, teaching theories, etc., as well as external stakeholders who we meet with regularly. There is a learning journey that can seem confusing sometimes.

But basically what the students need to be able to do by the end of the course is show that they meet the requirements. They're safe and effective. It's all based on the professional standards 26 taught days. It's generic and specialist. So it's generic in the sense that we are aware that the students can prescribe from the full formulary by the time they end the course.

So there is generic content in relation to pharmacology, research, et cetera. But then it's specialist in the sense that in practice and in some of their assessments within the university, it's related to their specific area of prescribing practice. The course overview in terms of teaching, assessment and practice.

Teaching is twenty six days. The key themes that are embedded within the structured teaching is professional, ethical and legal aspects. There's a person centred assessment and consultation, and that takes many forms. It's taught as well as having some directed study materials. Lots of pharmacology and prescribing.

So it's not just the pure pharmacology aside from the one, the starter one, which is your fundamentals of pharmacology. The rest of them is applied pharmacology and prescribing. So the pharmacology as well as the evidence base. So the evidence, evidence based practice, there's some basic research starts included. And as well as a reference to the evidence base in relation to every topic, governance and teamwork is also covered.

There's a range of delivery modes. There's some pre-existing law webinars and videos available as well as on campus when we can. If it's not live, if it's not on campus, it's live of delivery by webinar as well as the the other methods by which we get across the materials. The assessment is various. Some of it's statutory. Some of it must be done. So, for example, for nurses and allied health professionals, they have calculations and the pharmacology exam, the pharmacists don't have either of those, but they have an additional set of clinical skills, clinical exams that they need to do.

The practice is 12 days. And that includes also some clinical skills assessments so that there is inter-rater reliability between the two venues, some standardisation. So we do some of these assessments on campus, but some of them are done in practice as practice assessments. There's also as the different stages, which is outlined when we look at the practice assessment document.

We explain to the students that it's it's a shared learning, but it's also not just you and not you know, it's a shared learning between all of us. So we do ask what they expect of the university and us lecturers as well as their DMP or practice assessors. Also in terms of their managers and supervisors, because it is an intense course over the six months and they do need support.

They also need to acknowledge some independence and being able to recognise what's required of them. This is just an overview of some of the routes of information that they have available to them. So there are lots of opportunities for them to find the information that they need. But we do recognise that sometimes stress levels are high for various reasons. We do ask that their student representatives, which helps and with the lecturers, there is now also a personal academic tutors. So each student gets an individual opportunity for an individual meeting so that they can discuss their learning journey.

We do tell them that we rely on the practice assessors to share their knowledge as well as help provide the opportunities and assess the students. We do hope to be informed quite briskly, quickly of any challenges or problems in practice, and that's both from the assessor's point of view as well as the students. I haven't put all this stuff names in, but just to illustrate that there is a wide range of stuff that teach into the programme.

There's a lot of court. There's core stuff which include active prescribers, as well as four pharmacists and a variety of other professionals, advanced clinical practitioners, as well as guest speakers from a range of areas. And then again, these are sort of the core of the main categories of teaching that we do. And then the other forms of support, student support services, et cetera.

So, as mentioned, it is a generic programme, but in practice they do. They do focus on their specialist area that they will be prescribing in. We do always expect and remind that they're working within their scope of practice, but also to be aware that they need to know about about things which they don't necessarily think are within their scope of practice. So, for instance, they could be prescribing for something very simple, like wound infection, if you want to call that simple. But they must be aware of the interactions with things like warfarin, etc.

So prescribing isn't in isolation. So even if they feel that it's not within their main scope of practice, what is important is that they recognise that it can impact on other areas. There are some topics and areas that we teach that they need to be able to apply to their own area of practice. So there is some participation expected and examples in class and it is taught in a group work approach.

There is mandatory sessions, but the expectation is 100 percent attendance at the live events. I think the the 80 percent that's the cut off in the standards that if they dip below 80 percent, we can ask them to leave the course. There are some specific mandatory sessions for pharmacists, and that's because of the requirement for them to be able to show that they can do the clinical skills.

This looks a bit - looks like a lot of information, but basically of the 26 days, these are the main taught days that this is just an illustration of what the timetable is like. So, for example, the first day we just give a programme and induction and then the session about the practice assessment and so on. It normally follows a trend that we do main teaching sessions, we offer mock assessments, we offer review sessions, and then we undertake the assessment. So it's a step to approach. The this is the second, and you can see it goes to 18, but then there's if you count them, there's six or seven.

Yeah, six or seven sessions that are directed study. And then at the end, there is more directed study because of their essay tutorials. There's a number of different ways that the university is expected to get the message across for the assurance of patient safety. So one of the ways we tried to do that is through can consistent, clear and repeated messages about the legal, ethical and professional aspects. So we can't underestimate that the students sometimes get more hung up on things like the pharmacology or if their pharmacist may be on the clinical skills.

But we we do continually send that message that they need to understand their scope of practice and the limits to that. There is robust, robust marking criteria and grids. And we there are some that are used in the practice assessment document that we also use in the university setting. There's processes for professional conduct. We also teach the requisite human rights equality and those sorts of topics as part of the legal, ethical and professional. And so just there's a bit more there talking about the how we have to check all of this prior to the students starting.

We checked the GMC numbers. If you're a DMP, otherwise the non-medical prescribing prescribers would check their registration. If they need training, we make sure that's done and signed off in the practice managers where applicable. Also sign off to say that the practice assessor is safe and effective. The update courses and this is this video is part of that need to be undertaken and we can do practice visits if needed.

The assessment to go into a little bit more detail, just to mention that it everything it is based on the professional requirements and standards, we are very much in favour of assessment for learning. So the mock assessments are formative assessments. There is variety. There's a range of exams, clinical exams, OSCEs There's essay as well as a poster presentation and pharmacology exam. So there's a lot of variety and it's constructivists in the sense that we start with the relatively simpler assessments and then as they go on, it gets more complex.

The allied health professionals and nurses have a calculation exam. We first deliver that pre admission, but then also within the first four weeks of the course to get it over and done with the consultation. OSCE and prescription writing is also fairly early on under the practical. The next two are at the end of the course, the clinical management plan and the practice assessment document. There's a pharmacology exam and that's near the end of the course. But the the coursework is a poster presentation, which is approximately halfway through the course.

And then the essay is near the end of the course as well. For pharmacists, it's slightly different. There's more of an emphasis on the practical skills, so they do the same OSCE and prescription writing as the other students near the beginning. But then they have a set of three types of clinical skills exams near the end of the course. One of those, they it's based on a case based discussions from practice.

So, in practice, they're asked to do three case based discussions. And here at uni, we select one of the three randomly and they undertake a viva of that case based discussion. They also have the practice assessment document, the poster presentation and the essay. Just to mention that there's an expectation of that they are reaching higher levels of thinking when they do the course.

And one of the things we used to show that especially for the essay, is the Bloom's taxonomy, where they're moving up from knowledge, understanding to application analysis and synthesis. You can hear more about that in Tony Daly's session about critical thinking. The other thing to mention is that we always have some service user or patient involvement in the course. And the group that's established at the university is called Expert by Experience.

And so they're either live or we use videos to embed that in the course to give that perspective of from the patient's point of view, what it feels like to be prescribed for. There's also involvement in the sense that in the practice assessment documenters, We do request that there's one testimony from somebody in the student's care. And that's it. I hope that's a sufficient overview of the course.