Group 3 Goals Group 3 Goals are significant learning goals that address identified learning needs, and follow the four steps in the CPD cycle. 1. Reflection 2. Planning 3. Action 4. Outcomes What is significant? To some extent you must make your own personal and professional assessment of what is significant. This may be different from what is significant for another pharmacist colleague. Significant can be described by the following statements: An identified learning need subsequent to a reflective process that includes a structured review of your practice. NOT a “One Day Wonder”! Learning activities are usually extended over a number of months Usually more than one type of learning activity Requires major effort Substantial gain in new knowledge, attitude or skill that provides evidence (= more than one example!) of sustainable and beneficial change and improvement to practice LIFT tool outcome of ‘HIGH’ or ‘SIGNIFICANT’ - see further information on the LIFT tool from the LIFT TOOL section of the Reflection step of a Group 3 Goal Pharmacists are required to discuss the outcomes and application of the structured review of their practice with their Learning Partner 1 Standard One Elements of Competence Standard One (Practise Pharmacy in a Professional and Culturally Competent Manner) must be incorporated into at least one of your Group 3 goals in each three year period. This is not nearly as difficult as it sounds! Examples of this could be: Learning Activity and Outcomes Undertake some learning (in any professional pharmacy field) then learn communication and computer skills to give a presentation to your staff, Learning Team (peer group) or community group Complete MUR Training, or learn how contract LTC patients are best managed, then actively build relationship(s) with local GP practices to ensure that patients receive the support services they need Identify the cultural diversity of your own practice (e.g. identify area of significant Indian population) then target your identified clinical learning around this (e.g. CV/Diabetes). Find out what the local health initiatives are for your DHB or PHO, then target clinical learning and input into community information programmes around this e.g. asthma programme Start to provide methadone dispensing learn about this & also extend your learning to include updating your knowledge of the legal requirements of this service, especially your responsibilities within the Privacy Code in relation to your clients, their prescribers, and the police. Move to a pharmacy that provides clozapine dispensing and as well as learning how to dispense clozapine safely and correctly, also work on learning how best to support and communicate with patients with mental health conditions Become a manager, and decide to undertake some further learning in conflict management. Become involved in a Quit Smoking campaign and learn techniques of motivational interviewing. Standard One Elements and Activities Activity 1.1.6 - Shares professional strengths with others (Trains other staff e.g. gives presentations relevant to pharmacy practice) Activity 1.3.1 - Listens effectively, and speaks and writes clearly in English Activity 1.3.4 – Establishes and maintains effective working relationships (Identifies and builds relationships with key partners within one’s own practice; Collaborates with and includes others (pharmacy staff, colleagues, other health professionals, cultural groups) in decision making) Activity 1.4.2 - Identifies the cultural diversity of one’s own practice (Knows where and how to access local community support organisations) Activity 1.4.2 – Identifies the cultural diversity of one’s own practice (Develops community profile to identify cultural mix; Uses knowledge of their own community profile to better understand the impact of health disparities in relation to that profile) Activity 1.4.5 – Identifies and works towards reducing factors that contribute to disparities in health outcomes (Participates in programmes targeted at reducing health disparities; Acts as an advocate for patients in seeking provision of appropriate resources for treatment; Uses evidence-based approach to advise/treat individual patients and to educate community; Accesses local data on community health needs and uses knowledge to contribute to improvements in health care) Element 1.2 – Comply with legal requirements and codes of ethics especially Activity 1.2.2 Complies with those parts of the legislation that apply to his/her pharmacy practice (Fulfils all legal requirements that regulate pharmacy practice e.g.Methadone dispensing within the Misuse of Drugs Act & Regulations; Complies with the HDC Code of Health & Disability Services Consumers’ Rights; Complies with the Health Information Privacy Code) Activity 1.3.4 - Establishes and maintains effective working relationships (Treats patients and colleagues as equal partners, building rapport, respect and trust in partnerships; Practises whanaungatanga (establishing connections) in order to build connections and trust in relationships with Maori; Works co-operatively with appropriate family, whanau, and community resource people where this is desired by the patient, and when it does not conflict with other clinical or ethical responsibilities) Activity 1.7.2 – Resolves conflicts (Identifies causes of conflict in the workplace; Participates in conflict resolution processes; Uses negotiating and problem-solving skills in shared decision making with a patient or colleague) Activity 1.4.3 – Respects the individual (Avoids stereotyping e.g. recognises that culture/ethnicity is not necessarily reflected in an individual’s physical appearance; Demonstrates awareness that general cultural information may not apply to specific patients; Shows consideration for the patient’s knowledge of their own condition and preferred course(s) of treatment; Negotiates terms of the therapeutic relationship with the individual where appropriate; Recognises the right of individuals to have health beliefs and practices different to one’s own; Respects the right of the individual to exercise autonomy in decision making; Treats the individual as an equal partner) 2 Learning goals should be measured using S M A R T criteria Learning Goals need to be clear, well-defined and concisely state what you want to learn. For example “I want to learn about complementary medicines used for the treatment of sleep disorders, their indications, side effects and interactions.” rather than “I want to learn more about complementary medicines” You should be able to test whether you have actually learned what you set out to learn. If your goal has been stated in specific terms, then this should be straightforward. Think about how you will know when you have completed it. Take into account constraints such as time, cost and the support you have available. Be realistic. You must have the appropriate knowledge, skills, and abilities needed to achieve the goal. Goals should stretch you slightly so you feel challenged, but should not be extreme. If the goal is out of reach or becomes too hard, it’s easy to become demotivated and give up leaving it uncompleted. For example, deciding to lose 5kg each week for six weeks is not realistically achievable but setting a goal to lose 250 - 500g this week and then, when that’s been achieved, aiming to lose a further 250 – 500g the following week keeps it achievable. Success creates the motivation to keep going. It’s important to choose goals that are meaningful. A pharmacist’s goal to "make 50 peanut butter sandwiches by 2pm." may be specific, measurable, attainable, and time-bound, but lacks relevance to their work (unless a lot of non-allergic people were hungry!!). If you have appropriately identified your learning need then your learning will almost always be relevant. You can check this by completing the ‘reflection’ section of a group 3 goal – if you cannot identify any anticipated outcomes for your learning, it may not be relevant to your practice right now. Goals should add useful value within the context they are set. Set yourself some deadlines for completing your learning. A goal should be grounded within a time frame that adds an appropriate sense of urgency and importance and ensures that the objectives are not extended over an unreasonably long timescale. If you seriously want to lose that 5kg, when do you want to lose it by? “Someday” never arrives! But if you anchor it within a timeframe, “by May 1st”, then you’ve got something concrete to work with and plan around. 3 How do you identify your learning needs? It is important to follow a robust process to identify your learning needs. The initial step in the Group 3 goal process is to think about what you do and how you do it. Reflect on your practice to clearly identify what you need to learn. This is a crucial foundation step because learning will only be meaningful and bring sustainable, beneficial change to your practice if it relates to your identified learning needs, and can be incorporated into your practice. Learning needs can be divided into two categories: those required for maintaining competence and those required to advance professionally. There are always regular opportunities to keep up-to-date, such as attending courses & lectures and reading journals. Practice issues arising on the job also provide learning opportunities – these situations require reactive (and usually more immediate) learning solutions. However, a structured reflection process makes your learning more personally and professionally meaningful and therefore more likely to improve what you do and how you do it. Reflection is an on-going process and it is expected that you will continue to think about your practice by considering other events or practice issues you encounter that you want or need to learn more about. You need to answer two basic questions: 1. What do I need to learn? 2. How do I know that’s what I need to learn? Self assessment or ‘self diagnosis’ of your learning needs can be challenging, especially as sometimes you don’t know what you don’t know, and it’s impossible to identify this by yourself. This is where your Learning Partner will be invaluable to support, advise or even challenge you. When? 1. Now! (the start of the current 3 year learning cycle) 2. Later – if your practice changes, or if you are currently learning something identified from a recent Practice Review How? It can be difficult to decide the most important areas to focus on. Using the objective tools we have provided (Practice Review, Clinical Knowledge Assessment) can significantly help this process. Think about what you do, what you know, what you know you don’t know and plan to fill the gaps! i.e. Review your practice! Measure your knowledge and/or performance against standards and objective assessments. 1. The Practice Review (see separate green booklet, or online @ ENHANCE 1.0 website) allows you to review your current practice against the Pharmacy Council’s Competence Standards for Pharmacists, and identify which areas will benefit from further professional development. This is required every three years, but you should determine whether you need to do a full review. A modified or abridged review may be appropriate, and supported using other standards and guidelines. For example, you may decide to: Place greater focus on key standards, for example, a standard identified for professional development in previous reviews Supplement your review against other standards, for example, Medicines Management Standards, Pharmacy Services Standard Complete assessments to identify knowledge gaps 4 2. Clinical Knowledge Self-assessment The ENHANCE 1.0 website provides interactive quizzes and associated learning resources to enable to you to identify your strengths, weaknesses and learning possibilities. It may help you identify particular clinical areas you want to focus on for your CPD. This self-assessment process is optional for you to use. You can access this from the blue index column of the ENHANCE 1.0 website after you have logged on. Triggers for the need for extended learning could come from the following pharmacy experiences: Source Specific practice problem or issue/s Management/organisation issue/s Example A specific practice problem or a patient issue or series of issues may have triggered an awareness that you need more information and skills to address the issue for the future e.g. you become aware that you no longer know about the current guidelines for Type 2 Diabetes treatments, and neither do you know about the new types of drugs that see being prescribed more regularly e.g. GLP-1, DPP-4 inhibitors. Organisation or planning issues that (indirectly) improve the care provided to patients e.g. learning how to effectively chair a peer group or interdisciplinary meeting. An article you read could highlight an issue that you consider would impact on your practice – you may decide to focus your Reading: article/journal/magazine learning on this issue e.g. you see an article on a particular topic relevant to your practice in which you want to update and extend your knowledge. From participating in continuing education (CE) Discussion with colleagues Attending CE programmes may make you aware of a potential area/issue relating to your practice of pharmacy. eg OMRO, Symposia Discussions with peers or other health professionals may identify issues that impact on your practice and that you need to gain more information about. Don’t overlook the value of discussing your practice and learning needs with colleagues – often our perception of ourselves can be very different from that of others. Feedback from others (external, customer survey, complaint) Your customers or others may help you identify potential areas for learning that could improve or expand your practice. From preparing teaching tools Preparing talks, presentations and teaching often identifies potential areas for increased learning. New professional service identified A potential service prospect could provide a learning opportunity eg Medicine Management Services, ECP or Trimethoprim accreditation, CPAMS, vaccinator training The PSNZ LIFT tool (Learning Impact Frequency Tool) 5 What records do you need to keep? Pharmacists are encouraged to keep a learning portfolio to record all their professional development. Your Practice Review (structured review of your practice using what ever standards are appropriate), and Groups 1, 2 and 3 documentation together are ‘evidence’ that you are participating in ENHANCE. The ENHANCE 2.0 website allows you to meet all the documentation requirements for groups 1, 2,and 3. Examples of further evidence you could keep: There are many ways of demonstrating your learning outcomes, either directly or indirectly. It is better to have direct evidence of your outcomes. Work samples i.e. written copies of: drug information enquiries, interventions, primary health care evidence forms, other records (with patient identification removed), guidelines/articles/patient information sheets you have prepared etc Copy of a presentation you have prepared Policy or procedure or staff training material you prepared Feedback from your manager, colleagues or other health professionals you work with Feedback from patients or those that your practice impacts on Video or audio tape demonstrating your practice Remember: Documenting specific examples from your practice in the Outcomes section of how you actually applied your learning is the most effective way of providing evidence 6
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