Use of simulated patients to assess the clinical and communication skills of community pharmacists
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Objective To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Setting Community pharmacies in the southwest of England during 2007. Method Two simulated patient (‘mystery shopper’) scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John’s Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Main outcome measure Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. Results 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Conclusion Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.
KeywordsAssessment of practice Communication skills Community pharmacy Emergency hormonal contraception Simulated patients United Kingdom
The authors gratefully acknowledge the contribution of Mr. Solomon Lai to the conduct and analysis of this research. The authors would also like to thank all the community pharmacists, university staff and university students who participated in this research.
This project was funded by a small grant from the University of Bath.
Conflicts of interest statement
- 1.Office for National Statistics. Omnibus survey report no. 37—contraception and sexual health 2007/8. London: The Stationery Office; 2008. ISBN: 978 1 85774 677 8.Google Scholar
- 2.Social Exclusion Unit (CM4342). Teenage pregnancy. London: The Stationery Office; 1999.Google Scholar
- 3.Bayer Healthcare. Levonelle product website. http://www.levonelle.co.uk/scripts/pages/Page1.php. Accessed 17 Dec 2009.
- 5.Royal Pharmaceutical Society of Great Britain. Practice guidance on the supply of emergency hormonal contraception as a pharmacy medicine. http://www.rpsgb.org.uk/pdfs/ehcguid.pdf. Accessed 17 Dec 2009.
- 6.The Pharmaceutical Journal and the Centre for Pharmacy Postgraduate Education. PJ practice checklist: OTC emergency contraception. http://www.pharmj.com/pdf/checklist/EHC.pdf. Accessed 17 Dec 2009.
- 7.Department of Health. Implementing the new community pharmacy contractual framework—information for primary care trusts. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4109256. Accessed 17 Dec 2009.
- 9.Anon. A test of your own medicine. Which? October 2008, pp. 12–4.Google Scholar
- 10.Anon. Can your pharmacist cope? Which? February 2004, pp. 10–3.Google Scholar
- 11.Anon. Diet drug mis-sold. Which? August 2009, p. 4.Google Scholar
- 13.Jesson J. Mystery shopping demystified: is it a justifiable research method? Pharm J. 2004;272:615–7.Google Scholar
- 14.Norris P. Reasons why mystery shopping is a useful and justifiable research method. Pharm J. 2004;272:746–7.Google Scholar
- 16.Neto A. Changing pharmacy practice: the Australian experience. Pharm J. 2003;270:235–6.Google Scholar
- 19.Cohen MM, Dunn S, Cockerill R, Brown TER. Using a secret shopper to evaluate pharmacist provision of emergency contraception. Can Pharm J. 2004;137:28–33.Google Scholar
- 21.Baxter K., editor. Stockley’s drug interactions. 7th ed. London: Pharmaceutical Press; 2006. ISBN: 978 0 85369 624 1.Google Scholar
- 22.Joint Formulary Committee. British National Formulary, 54. London: BMJ Publishing Group Ltd and RPS Publishing; 2007. ISBN: 978 085369 736 7.Google Scholar