A mixed methods study of student pharmacist perceptions of their confidence and competence in the provision of clinical assessment
Authors: Rattray Z , Alhasso N , Lam H , Whitelaw J , Boyter A , Forsyth P 
Published: November 2024

Abstract

Introduction
Pharmacist involvement in clinical assessment or examination has recently come into the focus in the United Kingdom with the transition of the pharmacy workforce to prescribers. Clinical assessment starts with the collection of information on an individual’s past medical history and clinical presentation, and the interpretation of tests, observations, and physical assessments to inform a differential diagnosis.1
The range of clinical skills student pharmacists gain from placements during the MPharm is variable and shaped by local demands for pharmacy services. Therefore, there is a need for additional training on clinical assessment skills in classroom teaching.2-4

Aim
To identify student pharmacist perceptions and beliefs on their competence in conducting clinical assessment.

Methods
Ethics approval for this research study was granted by the Strathclyde Institute of Pharmacy and Biomedical Sciences Ethics Committee and conducted between October-December 2023. A mixed-methods study was conducted using a survey and focus group discussions developed from the literature and validated through discussion to collect student pharmacist perceptions of the role of the pharmacist and current gaps/barriers to pharmacist provision of clinical assessments. Students from all years of the MPharm were invited by email to participate (n=615). Audio recordings captured from focus group discussions were thematically analysed to identify key themes.

Results
Four focus groups were held with a total of 30 students. There were 89 respondents to the online survey (119 in total). Across both approaches, five key themes were identified from the survey and four from the focus group interviews. These themes centred around student pharmacist perceived role of the pharmacist, time and technical resources available in the pharmacy workplace, and the current curriculum. Most students agreed that such clinics would be beneficial to their training.

Discussion and Conclusions
Student-led clinics are gaining popularity as a work-based approach to learning. We found varied perceptions of the pharmacist’s role by participant response, suggesting that the clinical nature of pharmacy as a profession must be highlighted to prospective students to ensure those entering the profession are aware of the responsibilities they may be required to undertake. A limitation of this study is that student perceptions reflect the views of a single institution. Careful design of future clinics is required to ensure their seamless integration in the existing MPharm curriculum, in a realistic setting reflecting the workplace, and sufficient support from practitioners to implement them. Future work in this area should focus on how clinical assessment skills should be learned and assessed in student populations.

References
1. Miller, G. E. The assessment of clinical skills/competence/performance. Academic Medicine 65, S63-67 (1990).
2. Chin, S., Richardson, C. L., Gardner, A. & Nazar, H. The impact and user experience of a student-led clinic providing preventative services. International Journal of Pharmacy Practice 32, 237-243, doi:10.1093/ijpp/riae016 (2024).
3. Nazar, H., Rathbone, A. P., Richardson, C., Livsey, L. & Husband, A. K. Young@Heart clinic: a feasibility study of an undergraduate pharmacy student-led blood pressure and healthy lifestyle clinic. International Journal of Pharmacy Practice 29, 277-284, doi:10.1093/ijpp/riab008 (2021).
4. Kent, F. & Keating, J. Patient outcomes from a student-led interprofessional clinic in primary care. Journal of Interprofessional Care 27, 336-338 (2013).