David Cunningham GP Section and Leon Zlotos Pharmacy Directorate NHS Education for Scotland

2. Practice-based small group learning: the perceptions and experiences of a pharmacy pilot in NHS Scotland David Cunningham GP Section and Leon Zlotos Pharmacy Directorate NHS Education for Scotland @drcunningtroon @leonzlotos

3. NHS Education for Scotland NHS Education for Scotland responsible for the training of post-graduate professionals in Scotland Operates from 5 regional offices in Scotland: Aberdeen, Dundee, Edinburgh, Glasgow and Inverness Professions involved include: medicine, nursing, allied health professions, pharmacy, psychology and others Provides the majority of postgraduate CPD for pharmacists

4. PBSGL Started in Canada in 1986 Not-for-profit organisation Modification of problem-based learning Peer facilitated small groups Ongoing CPD for health practitioners in Canada

5. PBSGL in Canada • Piloted in 1988 from McMaster University • Available to all in 1992 • Now 751 groups across Canada • 5 884 members

6. PBSGL In NHS Scotland • Successful pilot of 5 groups in 2003 • Grown to over 220 groups across all of Scotland with 2 000+ members • Involves mostly GPs and small number of practice nurses • Some groups continue to meet since the pilot • Modules mostly produced in Scotland

7. 2011 - PBSGL Pharmacy project • Involved pharmacists from 4 health areas • Pharmacy facilitators trained • Various settings: community pharmacists evening events, in-house training for primary care pharmacists, prescribing pharmacists • 10 PBSGL modules adapted for pharmacists

8. Qualitative evaluation ofpharmacists and PBSGL Five research focus groups: Moderated by DC One in-depth interview 21 participants in total Audio-recording and transcribed Data analysed by two researchers (DC and LZ)

9. Results Participant demographics 12 community pharmacists 8 primary care pharmacist 1 secondary care (hospital) pharmacist Five themes were identified Cunningham, Zlotos and Power (2014) Education for Primary Care 25(3).

10. Pharmacists in Scotland “We are the only people within that pharmacy, we have nobody of a similar knowledge to bounce that off.” Pharmacists like this But not this

11. Can PBSGL help with this? “And it is not until you get into an environment like this [PBSGL group] the honesty is there that you are able to say: ‘Well I had this.’ And sometimes someone says: ‘So did I!’ And you find that what you perceive as loneliness is just because you are on your own.” “Being able to take the question down to the nth degree because you have got somebody who knows what they are talking about there and you have also bared enough of your own soul that they are not going to say: ‘Oh! I can’t really tell them that you know.’”

12. And also... PBSGL was seen as a way to bring a diverse range of professionals together “we had well-experienced hospital pharmacists, we had quite newly qualified hospital pharmacists, the community pharmacists of long experience, newer qualified and also we had those that were about to start the prescribing course and those that were in the first cohort of qualified prescribers all round that table.” And potential for multi-professional groups with GPs / nurses “I think it would snowball, successfully snowball.”

13. Are there any concerns? Stick to the PBSGL guidelines: “I just left feeling instantly deflated and felt like I had completely failed the group because instantly my, any insecurities that I might have with my lack of knowledge were brought to the forefront” (facilitator) “I think we need to explain more about the raison d’être of the model. I think we need to explain it better and we need to say to people: ‘You either get involved or it is not for you.’ And we need to explain more to them about small group learning.”

14. And also.. “I am not mentioning any names but I have been in a GP’s company before ... I found him quite insulting and just arrogant. I did not enjoy it one little bit.”

15. “I like seeing other people’s solutions to my problems…If I have an issue and [another pharmacist] has dealt with it at another time, well I’ll use [their] solution, I am not proud.”