MPharm Pharmacy

This unit builds on skills and knowledge gained in the previous three years of the MPharm curriculum. The unit is designed to prepare the student to deal with complexity in their foundation year and career beyond. During the course unit, the student will have further insight on the link between basic sciences to clinical applications, gain new knowledge in pharmaceutics, pharmacogenetics, pharmacoepidemiology, health economics, patient care (including prescribing) and management of cancer’s multimorbidity at the cutting edge of practice and drug development. Furthermore, they will apply previous learning in chronic disease, pharmacokinetics, patient safety, law, and pharmacy practice to understand the multi-disciplinary and complex nature of the holistic management of cancer. EBL and skills workshops will allow the student to develop competencies and skills in communication (specifically focusing on communicating information to patients facing problems associated with life-threatening illness), teamwork, clinical reasoning and decision making, prescribing and care planning in a safe environment. This is the top of the spiral curriculum where the knowledge and concepts learned in the previous years of study are put into practice so that the student will leave the MPharm programme competent to begin practice as a foundation pharmacist.

The unit aims to:
Develop students’ advanced knowledge and problem-solving skills relating to patients with cancer, using exemplars where topics can be explored in-depth, including breast, bowel and lung cancer. The unit takes a holistic approach from bench to bedside, using clinical applications of drug discovery and drug development, personalised medicine, clinical trials, drug regulation and health economics, patient safety, prescribing, pharmacy services and pharmaceutical care applied to patients living with and beyond cancer.

The teaching and learning philosophy for the MPharm places an emphasis on learner-centred rather than teacher-centred approaches. Learning is therefore structured to maximise guided self-directed learning, with enquiry driven project work and EBL workshops provided to support greater conceptual understanding of the material and deep, rather than superficial learning. This helps students prepare for their future careers by helping them to develop independence, confidence and resilience. A wide range of teaching and learning activity is included to meet the learning needs of a diverse range of students:

• Core concepts lectures: A very small number of didactic lectures are included to provide a step-by-step guide to the threshold concepts in pharmacy 
• Online learning: A small amount of guided self-directed learning in year 4 is provided via the VLE Blackboard. This consists of videos, bespoke elearning packages, NHS elearning (e.g. Skills for health), factsheets and directed reading (which can be downloaded). In year 4, students are expected to supplement guided self-directed learning with extensive use of high-quality resources that they have identified themselves
• EBL workshops: All learning is brought together and consolidated in a series of multidisciplinary integrated sessions. Workshops are led by a team of staff who act as specialist facilitators, directing student learning via discussion of case studies and project work.
• Professional skills classes: These span the full 4 years of the MPharm to ensure students are prepared to become prescribers after their foundation year. Classes focus on further developing advanced consultation skills, assessment and examination skills and clinical decision-making. Regular role play and interaction with medical actors is used to increase confidence and to ensure students receive tailored feedback.
• MyDispense: This is an online platform utilising real-world cases to recreate prescription processing and to apply pharmacy law. It is used with increasing complexity in all four years of the MPharm course to develop skills in clinical checking, dispensing and accuracy checking.
• Placements: Compulsory workplace placements are provided in hospital and community pharmacy and GP practice settings in year 4, to gain practical experience in providing pharmacy services and to apply learning in order to prepare for their foundation training year.
• Academic adviser meetings: Students meet with their named academic adviser twice per semester in formal timetabled meetings. Academic advisers support students with their personal and professional development throughout the MPharm course. 

Students will be able to:

• Understand and apply knowledge about advanced formulation, such as ATMP, used in the treatment of cancer
• Discuss the impact of functional and comparative genomics, proteomics, epigenetics and personalised medicines on the treatment of cancer, using a named cancer as an exemplar
• Describe holistic ways in which the pharmacist can contribute to the quality of patient care and improve outcomes for patients with cancer 
• Discuss safeguarding procedures and issues relating to this they may encounter as a prescriber with a focus on addressing the transition to accountability and autonomy of being an independent prescriber
• Demonstrate an understanding of decision-making concerning own attitudes and behaviours
• Demonstrate an understanding of the need for a support system of their own with a mentor checking in with them
• Demonstrate a sound understanding of the requirement to prescribe within own scope of practice, and identify the limits of their knowledge and skill
• Demonstrate an understanding of when clinical reasoning goes wrong and how their reasoning will develop as they embark on the foundation year
• Describe the legal framework, professional regulation and fitness to practise principles in relation to prescribing and their practice as they progress to foundation year
• Discuss the law as it relates to dispensing errors and the role of the coroner’s court as well as how they might encounter this in practice
• Describe the mechanism of action of chemotherapeutic agents, radiopharmaceutical therapies and immune therapies (including CAR-T) in the management of a named cancer
• Discuss the range, uses, relative toxicities and efficacy of agents used in the management of a named cancer (including personalised medicine) 
• Discuss the place of complementary and alternative medicine in the holistic management of an individual with cancer.

Students will be able to:

• Access, use and critically evaluate evidence to support safe, rational and cost-effective use of medicines 
• Recommend, monitor and modify prescribed treatment to  optimise health outcomes in collaboration with the prescriber and patient
• Apply principles of evidence-based practice to address actual and potential problems with individual patients’ therapy and advice on appropriate drug therapy for patients with cancer
• Synthesise medicines optimisation to conduct a multi-morbidity review based on all steps of the process, comprising: gathering information from history and examination/investigations, forming a diagnosis/assessing severity considering priorities and options, supporting shared decision-making, management planning, documentation and prescribing, transfer of care and safety netting
• Formulate an appropriate management plan in uncertainty (e.g. person does have a current diagnosis, diagnosis is uncertain/inaccurate/incomplete/incorrectly communicated, the dilemma on devising a management plan based on conflicting evidence/influences)
• Interpret correspondence when people transfer between care providers to keep them safe, demonstrating how to formulate and implement relevant action plans, including shared care arrangements
• Evaluate own decision making and that of others to improve practice
• Apply patient safety tools and understanding of safe clinical systems to monitor and improve the safe use of medicines
• Apply to learn on capacity and consent to the care of complex patients with cancer, including end of life care
• Apply learning on clinical negligence to describe how evidence-based practice is used and evolves where there is a need to use unlicensed/off-license medicines.

Students will be able to:

• Instruct patients, carers and healthcare professionals in the safe and effective use of immune therapies and cytotoxic agents.
• Document accurate, concise, legible and contemporaneous clinical records (i.e. prescribing decisions, history, diagnosis, clinical indications, discussions, advice given, examinations, findings, interventions, action plans, safety-netting, referrals, monitoring and follow-ups.
• Work with patients, prescribers and other members of the healthcare team in a professional manner to negotiate the safe and effective resolution of problems when dealing with conflict, critical incidents and complaints.
• Mentor or coach other student healthcare professionals.

Students will be able to:

• Work effectively within multi-professional teams, demonstrating critical skills and attributes associated with leadership (communicating with influence; negotiation skills; using integrity, networking and advocacy; coaching; situational judgement).
• Engage in inter-professional and clinical simulations to further develop team-working and communication skills.

Please see the above assessment methods.

Directed reading consists of a small number of papers from journals, clinical guidance or policy documents (e.g. NICE). As clinical practice and cutting edge medicines discovery and development is constantly changing, this material will be reviewed before each session is delivered to ensure it remains relevant. 

As part of EBL, students have developed sound literature searching skills in order to identify their own individualised reading lists to address their learning objectives.

Other Scheduled teaching an learning activities:

• Placements: 5 days (dependent upon HEE commission)
• MyDispense online learning: 10 hours
• Online drop-ins (CPD, calculations, EBL support): 1 hour per week
• Academic adviser meetings: 1 time