Breaking with tradition in training prescribers: eLearning and the Northern Ireland experience

In 1999 the Crown Report 1 recommended the extension of prescribing rights to other health professions; initially this applied only to pharmacy and nursing. All training had to comprise a minimum of 27 days taught plus 12 days in-practice training, and had to be completed within six months 2 . In addition, only those who had been practising for at least two years were eligible to undertake the course. At the time of entry onto the course, pharmacists would have engaged in five years undergraduate and pre-registration training, with a minimum two years in practice. Initially (2003), the course was only open to pharmacists practising in hospital, but since 2004 community pharmacists have also been accepted onto the course. These areas of practice comprise 96% of the profession and represent a geographically dispersed audience from varied working environments. From an early stage in development, it was evident that the Department of Health 3 favoured a predominantly face-to-face approach to programme delivery. Conversely, the directors of hospital pharmacy worried that this approach would adversely affect business continuity and limit the number of staff who could be released for training. In balancing these views, we proposed that distance learning should be used where most appropriate in order to encourage participation. Thus, seven days were provided as face-to-face learning (clinical assessment and consultation) and 20 days of distance learning, in addition to in-practice training. Adoption of print-based distance learning would not enable us to meet the timescale for programme delivery (11 months), nor would it be affordable; thus we adopted eLearning. Because we had little experience in this area we collaborated with a local eLearning company. The six module programme runs over six months and is supported by a bespoke virtual learning environment (VLE), which facilitates discussion forums, online assessment/feedback, ongoing communication and evaluation and downloaded resources. Brief outline of the findings/results Eleven cohorts (n=207) of pharmacists have undertaken training and have reported favourable first encounters with eLearning. The completion rate since 2003 is 98%.  Findings of a recent DHSSSPS 4 study on the effectiveness of pharmacy prescribers were generally positive in terms of overall patient care and how pharmacist prescribers have been able to translate their learning into practice. It demonstrated increased continuity of care, increased compliance and improved patient safety. Pharmacist prescribing also reduced the workload of medical practitioners. This experience highlighted the benefits of eLearning, particularly course administration, ease of updating content and inclusion of novel content such as video. We have accelerated eLearning development in preference to print-based distance learning. eLearning has enabled us to respond more rapidly to educational needs and reach large numbers of geographically dispersed health professionals. It has also allowed us to extend this provision to multi-professional audiences, both locally and throughout the UK. In developing this course we were focused on course content and interactivity. One unexpected surprise was how much easier the VLE made course administration. As a result of our experience in this project, all other course assessments, evaluations, individual and tutor feedback are now undertaken via a VLE.