For many years, the authority to prescribe medications has been exclusively with doctors and dentists, but since the start of the century, there has been a worldwide expansion of this authority to other healthcare professionals (Cope et al, 2016). Globally, the UK is the only country which has currently granted extensive prescribing authority to various healthcare professionals. These include pharmacists, nurses and many other healthcare professionals such as chiropodists/podiatrists, optometrists, physiotherapists, paramedics, therapeutic radiographers and dietitians. Prescribers other than pharmacists and nurses are known as allied healthcare professionals (AHPs) and together, prescribers who are pharmacists, nurses or AHPs are referred to as non-medical prescribers (NMPs) (Omer et al, 2020).
To gain the authority to prescribe in the UK, a prospective NMP is required to undertake a non-medical prescribing programme. To enroll onto a non-medical prescribing programme, a healthcare professional is required to have a minimum period of post-registration experience (Cope et al, 2016). For nurses, the applicant is required to have been registered with the Nursing and Midwifery Council (NMC) for a minimum of one year prior to entry onto the programme (NMC, 2018). For pharmacists, the applicant is required to have been registered with the General Pharmaceutical Council (GPhC) for a minimum of two years prior to entry onto the programme and have at least two years of patient-orientated experience in a UK hospital or primary or community care setting (GPhC, 2019). Finally, AHPs must be registered with the Health and Care Professions Council (HCPC) in one of the relevant allied health professions, with at least three years of relevant post-qualification experience in their chosen clinical area (HCPC, 2012). The programme consists of a minimum of 26 days of in-class taught content and is supplemented with 12 days of practical experience referred to as the Period of Learning in Practice (PLP) (Cope et al, 2016).
The introduction of non-medical prescribing was to provide patients with quicker access to medications, decrease the heavy workload from medical prescribers and make better use of the skills nurses, pharmacists and AHPs could offer the healthcare service (Watterson et al, 2009). Although NMP programmes have been running since 2002, there is still a lack of information regarding the educational approaches adopted by these programmes. This was highlighted in recent systematic reviews conducted by Kamarudin et al (2013) and Omer et al (2020). Given that there is a growing consensus of NMPs being safe and effective in clinical practice (Latter et al, 2012; Baqir et al, 2014), it is imperative to gain a comprehensive insight into the content taught NMP programmes and the educational tools and methods used to teach this content.
Therefore, the aim of this study was to explore the taught content, the educational approaches and mode of delivery of NMP programmes.
Methods
Study design, participants and settings
This study utilised a qualitative research design due to the focus on obtaining information, perceptions and appraisals of NMP programme leads on the educational approaches of NMP programmes across the UK.
This study was conducted by researchers from the Hull York Medical School (HYMS). Across the UK, 71 NMP programmes were identified that were either pharmacist-specific, nurse and AHP specific or accepted all three groups of healthcare professionals onto the programme. The programme leads of each NMP programme were identified by visiting the university websites pertaining to the programmes.
Overall, 16 programme leads responded and agreed to participate in the study. These were spread geographically across the UK, with representation of NMP programmes from the south of England, the midlands, the north of England, Scotland and Northern Ireland. The first two participants served as pilot interviewees, however, the robustness of both interviews enabled them to be included in the overall data set.
Ethical approval was granted by the HYMS Ethics Committee under their file number 1924. Before the interview, all participants were sent a research information sheet and an informed consent form, which they were required to sign to document their agreement to participate and send back to the research team.
Data collection
Data collection took place from March to May 2020. Semi-structured, in-depth interviews were conducted through Zoom due to the constraints of the COVID-19 pandemic. The interviews allowed the participants to openly provide comprehensive information around the content taught on the programme and the educational approaches used to teach the content. Additionally, the interviews allowed participants to reflect freely upon and appraise the educational approaches of the programme and provide their thoughts on how the programme could be modified and enhanced for future cohorts. All interviews were recorded using an audio recorder with the consent of the participant. The interviews conducted were using the questions that had been informed using the Documentary analysis conducted by Omer et al (2020) on the core categories of a model prescriber, a separate study conducted by this research team.
All interviews varied, lasting 30-70 minutes and were transcribed verbatim by Omer et al, examining all of the transcripts through line-by-line checking for congruence between recordings and transcripts.
Data analysis
The interview transcripts were analysed through a hybrid inductive and deductive thematic analysis approach as recommended by Fereday and Muir-Cochrane (2006). This approach allowed for coding pertaining to taught content and educational approaches to be conducted deductively, mapped to the Omer et al (2020) documentary analysis, whilst on the other hand, codes pertaining to the appraisals of programme leads and their perspectives on how the programme could be modified to be identified inductively from the data itself. This approach was deemed more suitable given the flexibility afforded by thematic analysis in contrast to grounded theory and phenomenology.
Interview transcripts were read and coded both openly and in-depth by the Omer alone. However, the entire process was supervised by Veysey, Crampton and Finn. Transcripts were independently coded line-by-line by Omer and once the coding process was complete, Omer, Veysey, Crampton and Finn held in-depth discussions on the categories of the codes and how they could be clustered into appropriate themes. No new categories were identified after 12 interviews, with the final four transcripts serving to ensure data saturation (Clarke and Braun, 2014). The final themes were agreed by all authors. Memos compiled during the reading and open coding phase of data analysis were preserved to help inform the discussion section of the study.
Results
The results were set out into five major themes: taught content (pertaining to prescribing knowledge, safety, communication and continuing professional development); assessment methods of the programme; aims, objectives and goals of the programme; critical appraisals of programme leads on educational approaches and improving the programme for future cohorts.
Information around taught content and assessment methods are presented in Tables 1-4 and Table 5 respectively.
Table 1. Knowledge
| Subcategory of knowledge | Overview of coverage of subcategory across NMP programmes | Overview of educational approaches used to teach concepts around subcategory |
|---|---|---|
| Pharmacology, pharmacokinetics, pharmacodynamics and administration, distribution, metabolism and excretion (ADME) | Concepts pertaining to pharmacology are taught in a generic fashionProgrammes strive to teach kinetics, dynamics and ADME relevant to multiple drug groups and a range of conditionsTeaching of concepts around this subcategory more intense in programmes with nurses and AHPs and less intense for programmes with pharmacists only | Mostly through traditional, didactic lecturesLectures supplemented with approaches such as online self-directed learning, group discussions and case-study learning |
| Creating a personal formulary | Many programmes teach around basics of creating small personal formulary for each student.This approach enables students to understand why they choose a particular drug and learn to justify prescribing decisions | Information from lectures used by students to create formularies through self-directed learning |
| Drug prescription as a last resort, deprescribing and non-pharmacological treatments | Mentality of prescribing as a last resort adopted across all programmesAwareness raised around dealing with situations where pressure to prescribe could arise and how to negotiate these pressuresTeaching around considering non-pharmacological treatments on the rise. Students urged to consider patient lifestyle when considering appropriate treatment | Traditional, didactic lecturesCase-based sessionsSome programmes ask students to write reflections upon experiences in practice of patient scenarios. Asked to reflect what non-pharmacological treatments they could have considered |
| Cost-effective prescribing | Taught to the extent required by major prescribing guidelinesTreat as a consideration when attempting to justify prescribing decisions | Mainly taught through in-class discussions.Asked to discuss concept in reflective accounts for portfolio |
Table 2. Safety
| Subcategory of safety | Overview of coverage of subcategory across NMP Programmes | Overview of educational approaches used to teach concepts around subcategory |
|---|---|---|
| Drug calculations | All programmes teach this as an integral part of the curriculumBut some expectation from programmes that students enrol with satisfactory numerical skill.Some programmes have personal tutors for drug calculations should students need them. | LecturesWork bookletsOne-to-one sessions with personal tutors |
| Prescription-writing | Integral part of curriculum for all programmes.Major feature of student portfoliosStudents exposed to written templates from sources such as the British National Formulary (BNF) | Practical prescription-writing sessions using case studiesLearnt during time in clinical practice with supervisors |
| Monitoring effectiveness of treatment | High-level of attention afforded by all programmes towards treatment monitoring and safety nettingExtent to which individual student learns this depends on area of practice | Skill mainly learnt during time in clinical practiceCase study discussions in some programmes |
| Awareness of prescribing errors | Small number of programmes cover this through in-class discussions | Programmes discussing this use the Swiss Cheese Model as the basis of discussion. |
| Compliance with guidelines and regulations | Most programmes make students aware of the RPS Competency Framework and NICE GuidelinesStudents urged to follow guidelines from own healthcare professional backgrounds (e.g. GphC guidelines for pharmacists and NMC standards for nurses)Examples of some programmes asking students to look at GMC guidelines given their applicability to all prescribing backgrounds. Most programmes teach students selectivity around guidelines best suited to their respective areas of practiceStudents taught they must be prepared to justify any decision taken outside of guidelines | Limited amount of lecturesLearning of guidelines mainly through self-directed learning |
| Professionalism and accountability | Teaching around professional and legal frameworks heavily featured across most programmes.Expectation that students have some level of prior knowledge of ethical and professional procedures – but clear that refresher sessions should be incorporated.Consent and capacity covered in sessions around professionalism.Record-keeping also covered by curricula as a way of inculcating effective multidisciplinary working | Ethics and legal frameworks usually covered through traditional lecturesRole-playsOne example of a ‘speed-dating’ discussion approach with service usersReflective pieces for prescribing portfolio.Case studies |
Table 3. Communication
| Subcategory of communication | Overview of coverage of subcategory across NMP programmes | Overview of educational approaches used to teach concepts around subcategory |
|---|---|---|
| Communication with patients | Stated to be a major component of teaching on the curricula of all the programmes.Teaching conducted around consultation modelsCommunication teaching with patient based around medication adherence, concordance and shared decision making | Consultation models taught through lectures.Role-plays with patient actorsOne example of a blended-learning approach where students conduct prior reading before attending a discussion session around concordance and adherenceSkill developed in clinical practice working with supervisor |
| Communication and coordination with colleagues and other prescribers | A rich learning environment with students from various healthcare professional backgrounds inculcates developing this skillInsights are gained of the roles of other prescribers through in-class discussionsSome programmes implemented specific interprofessional working sessions | Group discussionsGroup presentations around specific case studies.Small group teaching through mixing different healthcare professionals |
Table 4. Continuing professional development (CPD)
| Subcategory of CPD | Overview of coverage of subcategory across NMP Programmes | Overview of educational approaches used to teach concepts around subcategory |
|---|---|---|
| Updating knowledge and skill in practice | Programmes strive to inform students of ways in which they can update prescribing knowledge and skillProgrammes adopt a though process that their role is of a supportive and advisory nature, but responsibility to develop this skill was on student beyond graduation | In-class discussionsSelf-directed learning |
| Critical thinking | Some programmes run sessions on critiquing literature sourcesOther programmes don't run specific sessions, but outsource developing skill to other departments in university | In-class discussions, followed by recommended reading in students' own time |
| Dealing with external pressures | Most programmes teach students to avoid drug representatives and events organised by pharmaceutical industryOne example of teaching a more balanced view of pharmaceutical industry due to participant's history working in the industry | LecturesIn-class discussions |
| Adapting to newer prescribing technologies | Most programmes don't teach this as it is beyond the programme's remit | N/A |
| COVID-19 and teaching remote prescribing | Remote prescribing not taught before, but programmes actively seeking ways of incorporating it further into curricula due to the events of the pandemic and the inevitable relevance of remote prescribing going forward | N/A |
Table 5. Assessment
| Assessment approach | Main features of assessment approach within programmes | Use of assessment approach across programmes |
|---|---|---|
| Written exam | Mixture of multiple-choice questions (MCQs) and short answer questions on pharmacology, pharmacodynamics and pharmacokineticsSome programmes have essay-based questions where the student can choose which questions to answer or omitEssay questions could also ask students around ethics and legalities of prescribing and public health-related questions.Some programmes also use written exam to assess prescription-writing skillsPass mark is 80% | All programmes implement a written examination, although the contents of the exam could vary |
| Essay writing | Usually a 2000 – 3000-word essay around a case study specific to the students' area of practiceEssay assesses aspects of prescribing beyond knowledge, such as safety netting, treatment monitoring and critical drug analysisSome programmes use essays as a reflective tool to appraise hypothetical or real-life case scenarios | Essays used as a primary assessment approach across all programmes |
| Numeracy exam | One hour examination consisting of 20 questionsPass mark is 100% - no margin for error. This has led to a higher failure rate in some programmes as compared to other assessments | All programmes use numeracy exams as a primary assessment approach. |
| Portfolio | Compiled by student throughout time undertaking programmePortfolio consists of submissions including written work, feedback from practice supervisor on observed consultation performance, written prescriptions and evidence of fulfilling requirements stipulated by the RPS Competency FrameworkPortfolio examined by personal tutor and moderated by programme lead on one programme.Reflective accounts submitted to portfolio aid in developing academic skills and critical thinking of students. | Portfolio a strong element of assessment in all programmes |
| Objective structured clinical examinations (OSCEs) | Usually organised as multiple clinical skills stations and primarily examine students' consultation and communication skills.Some programmes also use OSCEs to assess professionalism, obtaining consent and types of medications students prescribe.Some programmes videotaped OSCEs as a means of reflection for students over their prescribing practice | Although use of OSCEs as an assessment approach is widespread, a significant number of programmes have discontinued their useMain reasons for discontinuation of use included: time in clinical practice for student being adequate for Practice Assessor to determine competency; OSCEs being a source of unnecessary anxiety for some students and the expectation that students enrol onto programme with a satisfactory level of clinical skills |
Aims, objectives and goals of the NMP programme
The primary objective of enrolment in the programme is for the healthcare professional to become an independent prescriber within their own area of practice. However, some participants have spoken of how the programme aims to equip prescribers to deal with various situations they are likely to encounter in practice:
‘Interestingly with the current COVID situation, chatting to some students who are already prescribers, there's been a lot of chat around people changing their sphere of practice because they have the ability to prescribe, because they have been given the basics of everything within that programme.’
(P10 Interview)
Programmes teach students to be mindful of their current limitations and actively look to address these limitations:
‘We teach them that they should never be prescribing anything that they don't feel competent to do or is out of their scope. However, we also teach them that where there are ongoing deficits that their role, that we would expect them to be able to fill, that it's their responsibility to try and find a way to address those gaps and things.’
(P11 Interview)
Role of programme beyond qualification
Firstly, some participants talked about their levels of confidence before qualification:
‘They are absolutely scared I think, because we all know, in medicine and healthcare in general, litigation is absolutely rife and they all know as well, because we talk about it, that prescribing is the riskiest activity that a clinician will ever undertake.’
(P4 Interview)
In terms of the programme's role in the development of the students' prescribing practice, participants stated that the programme acted as a starting point in a long journey of learning for prescribers:
‘As I said to you, I tell them we've given you all of the tools, the knowledge, but you have got an L-plate on your back. So at the moment, you're consciously incompetent, you need more experience to be a good prescriber, you've got the qualification, but it's the beginning of your journey, you haven't flown yet, we've given you all of the tools.’
(P3 Interview)
Appraising educational approaches of the programme
Didactic lectures
Most of the teaching around pharmacological knowledge is through traditional, didactic lectures, which one participant states is the only and necessary approach to teach knowledge concepts a round pharmacology:
‘I do think as I say, the pharmacology stuff is hard, the students find it very difficult, but they know that they need to know it and I think there are not many ways that you can really teach that apart from in a lecture theatre with a recorded lecture for them to relisten to, because we've got classes of sixty, so it would be quite difficult.’
(P10 Interview)
As a result, there is a strong consensus among students and some prescribing educators that these traditional, didactic approaches are dry and mundane:
‘PowerPoints and face-to-face lectures, I just don't think they have the same sort of impact.’
(P12 Interview)
‘There's no question that people get bored if you just stand and talk at them, even if you think you're a great speaker, people will zone in and zone out.’
(P15 Interview)
As a result, some programmes have attempted to supplement this didactic teaching approach with other strategies, such as quizzes and online resources:
‘The mainstay and the basics are from our own pharmacist lecturer, and it's a mix of face-to-face kind of lectures, but we also have kind of online activities, quizzes, group work and things like that as well, but that's also supplemented by specialist clinicians that come out and deliver individual sessions as well.’
(P11 Interview)
Flipped classroom and blended learning
Programmes are increasingly implementing a flipped classroom and blended learning approach into their programme:
‘Yeah, devising some more interesting and exciting and interactive things with the students. The idea is this flipped classroom thing, where they do the studying before they come to the lesson, so they've already read all of the boring stuff, then they come in and actually do something during the lesson that applies that knowledge.’
(P3 Interview)
‘I'm leaning more and more towards a flipped-classroom approach, so that students come in with a degree of preparation and can use those sessions, those group activities to develop their knowledge, share them, ask questions…’
(P12 Interview)
One participant stated that the current COVID-19 pandemic could stimulate a further transition towards more flipped classroom learning:
‘I think the ideal scenario for teaching a course like this over six months is a blended learning approach.’
(P5 Interview)
Group learning as a preferred learning approach
Most communication skills are taught through a group work approach, and this is an educational approach, which has received universal praise across the board:
‘I'm afraid I'm going to be very traditional here and say I think students learn most by engaging together in group work.’
(P6 Interview)
‘The practicalities of getting in a group with other clinicians from all different backgrounds and getting you heads around the BNF and answering questions and thinking things through is I think engaging and appreciated normally by the students.’
(P15 Interview)
One of the reported advantages of group work is how students from different professional backgrounds can complement one another:
‘That's what's so lovely actually, the A&P presentations that they do, because they divide up into small groups and they just learn so much from each other and you very seldom get a room with forty very experienced and varied clinicians together, you know, all sharing their knowledge, so it's quite a privilege really to be involved in that I think.’
(P4 Interview)
Improving the NMP programme for future cohorts
Student evaluation
To track the success of the programme in the view of prescribing students, NMP programmes have implemented various systems of course evaluation where students are able to provide feedback on the programme. This was generally conducted through a process of survey and evaluation forms:
‘Yes, so there is a university-wide feedback, and I also send out a survey monkey as well, just 10 questions about… because we've actually gained more from that, about what they thought the strengths were, the weaknesses, what we could do better.’
(P13 Interview)
‘Every cohort at the end does the student evaluation form.’
(P15 Interview)
Some programmes implemented a mid-course review to ensure the programme was operating to the expectations of the students:
‘We do a mid-course review, and that's really to make sure no one is failing, everybody is getting what they need and are on course to pass and do well.’
(P3 Interview)
Improving and adapting teaching approaches of the programme
Despite the overall positive perceptions of participants on the running of the programme, some highlighted that improvement would always be required and that their programmes were constantly evaluating ways in which the teaching approaches could be improved:
‘So, whether there is a need for improvement, there's always a need for improvement, you can always learn different ways how to make your content more available for students, more interactive for students, and we keep on doing that, so for every year, we look at the content and we see how it can be improved, and we try to improve, adapt every year with the delivery of our content.’
(P14 Interview)
A teaching approach that participants mentioned as gaining traction was simulation-based education (SBE) and role-plays:
‘Some of our lectures sometimes can be a bit heavy-going, so we are all of the team now looking at how we break the lectures up, because the most effective way to teach them is simulation.’
(P8 Interview)
‘We do quite a lot of mock-up stuff, particularly on the consulting, using actors, that's kind of something we do on all of the ACP modules to get that kind of rehearsal element, so I suppose didactic, it wouldn't be how I would describe it, though our actual physical spaces are all very mobile and we know that people sitting in lines and listening for 3 hours at a time it doesn't work, it's just tedious for everybody concerned.’
(P7 Interview)
Adapting to a post-COVID world
One major area where participants reported a need for improvement was teaching around remote prescribing and adapting to newer prescribing technologies, especially considering the COVID-19 pandemic:
‘I think probably I'd say yes there are because we are going to be putting in elements like remote prescribing, that's an element, because we recognise that with new technologies, some of these prescribers, they're going to be faced in settings where they've got to undertake a consultation by using virtual methods, and for some of that, you know, that's definitely going to be on the increase, so things like Skype and Facetime.’
(P1 Interview)
Due to the constraints of the pandemic, some programmes were beginning discussions on how to deliver more remote teaching:
‘It's not an easy one to teach in class, to be honest with you, but we are going to have to do it going forward, one of our challenges will be starting again in September because the university has already told us that the likelihood is that we will not open up as a university as a physical building. So, we have to think about how we are going to teach from home only going forward.’
(P8 Interview)
However, participants voiced their concerns on how such changes to the delivery of teaching would impact the in-class experience:
‘If we have a considerable amount of time where we lose that face-to-face teaching element, that's a real worry for me.’
(P3 Interview)
Discussion
The qualitative findings of this study indicated standardisation across all programmes around concepts of prescribing safety including drug dosage calculations, prescription writing and treatment monitoring. The importance afforded by NMP programmes towards these three aspects of prescribing enhances confidence in the prescribing practices of NMPs, given that many prescribing errors conducted by medical prescribers have been associated with inaccurate dosage calculations, poor prescription writing and poor monitoring of prescribed treatments (Cope et al, 2016; Aronson et al, 2006; Dornan et al, 2009). This can also explain how limited studies have reported an incredibly low rate of prescribing errors in NMPs (Baqir et al, 2014). Additionally, all programmes aimed to inculcate a mindset in prescribers of viewing the prescribing of a medication as the last resort, however, teaching around alternative, non-pharmacological treatments was an area programmes were still developing. Areas such as remote prescribing were not covered by any programme, however, each participant stated the aim of enhancing teaching around this area given the current world situation and how healthcare provision would have to adapt.
All programmes looked to assess the same prescribing competencies of their students through a uniform approach to the assessment process with written and numeracy examinations and uploading content into portfolios. The use of numeracy examinations and portfolio highlight a clear distinction from orthodox prescribing curricula seen in medical schools, where the main assessment approaches to examine prescribing skill and competency are limited to written examinations and OSCEs. However, regarding OSCEs, there was a clear divide. Despite numerous opportunities of demonstrating clinical practice within the workplace, OSCEs are a proven and successful method of assessment, which can examine a myriad of skills pertaining to prescribing. Additionally, recorded OSCEs are an important source of feedback for students to reflect upon and aid in improving prescribing practice (Franklin et al, 2005; Meechan et al, 2011).
One of the major strengths of the teaching approaches of NMP programmes was the group learning approach. The synergistic learning stimulated by group exercises in the programme enabled the development of communication skills with other prescribers, which would potentially come under the category of hidden curriculum (Hafferty and O'Donnell, 2015). As most NMP programmes enrol a small number of students when compared to undergraduate programmes, the group exercises can be classed as small-group teaching, which research has suggested to be more effective in teaching prescribing as compared to large-group teaching (Omer and Danopoulos, 2020).
Flipped classroom learning enables didactic material to be assigned to learners before attending classes, where more time is afforded to active learning strategies such as reflections and group discussions (Hurtubise et al, 2015). Flipped classroom approaches would particularly be suited for NMP programmes, given that students are studying on a part-time basis and are attempting to balance academic and work-based commitments. Given that the group learning aspect is a major strength of the programme, the flipped classroom approach can potentially be implemented seamlessly and further bolster interprofessional and group learning on the programme. However, this must be validated through comparative trials between NMP students undertaking flipped classroom learning with those learning through traditional lectures. The same would need to be done to evaluate the success of teaching approaches involving simulation-based education. Moreover, as some programmes help students formulate a plan around CPD after qualification, there would need to be measures implemented to ensure prescribers are adhering to this plan and are both maintaining and updating their prescribing competencies. This could prove to further understand how much value undertaking the NMP programme provides to the prescriber as they progress in their professional practice.
This study had certain limitations. Had the programme lead from every UK NMP programme been interviewed, the authors may have obtained information on additional education approaches unknown to the participants selected for this study. The study was only limited to interviewing programme leads, who were mainly members of the teaching staff on the programme. To further widen the breadth of perspectives, it would be prudent to obtain the views of other stakeholders such as members of regulatory bodies, who bear a major influence on the development of programme curricula, and prescribers who have undertaken these programmes. Additionally, changes to current approaches can only be implemented when qualitative perceptions of teaching and assessment approaches are triangulated with objective, quantitative data, which examine the effects of the current approaches or lack thereof.
Conclusions
This study has highlighted the various teaching approaches programmes use to train NMPs and make them as safe and competent in practice as possible. Stringent assessment approaches are utilised to ensure preparedness to prescribe and so far, limited studies demonstrating low error rates in NMPs appear to indicate the effectiveness of both teaching and assessment methods of NMP programmes. However, programme leads have also identified areas where teaching and assessment approaches would need to be improved, such as supplementing traditional teaching approaches with interactive, blended and simulated learning. These views would need to be validated and supported by seeking perspectives of NMPs who have undertaken these programmes and be compared to the perspectives of programme leads. Additionally, teaching and assessment approaches that programme leads have highlighted as needing improvement should be modified and their effectiveness should be examined through longitudinal studies and the outcomes should be determined as positive before these modified approaches are recommended for prescribing curricula in countries seeking to expand prescribing authority to additional healthcare professionals.
Key Points
- There is a major gap in understanding how NMPs are trained and educated to become independent prescribers
- A major focus of NMP programmes is to develop a mindset of prescribing medications as a last resort
- Small-group learning approaches are a strong element of the NMP programme as they facilitate synergistic learning
- Innovative educational approaches such as flipped classrooms and simulation-based education could enhance learning on the NMP programme, but these must be piloted on NMP programmes to assess feasibility.
CPD reflective questions
- How can the NMP curriculum be adapted to incorporate teaching around remote prescribing in light of the pandemic?
- How can interprofessional group learning be of mutual benefit to healthcare professionals from different backgrounds?
- What are the advantages and disadvantages of OSCE examinations and should they be further implemented or discarded from NMP programmes?