22 23

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A key challenge in addressing the global health workforce shortage is that countries in Africa tend to have fewer trained pharmacy personnel and fewer training institutions within the country infrastructure. Physical resource and supply capacity therefore remain an important issue for FIPEd.

4.3 Quality assurance

While virtually all countries have established systems for oversight and quality assurance (QA) of education in general, fewer countries have QA systems specific to pharmacy education that are well developed. In some countries, such systems are emerging; in others, they are non-existent or, at best, rely on internal (institutional) QA processes.

Data from the Global Pharmacy Workforce Survey suggest that only one respondent country (Uruguay) did not have any pharmacy schools accredited and only one respondent country (Burundi) did not have any pharmacy technician training schools accredited. Eight (out of 49) countries have variance between the total number and the number of accredited pharmacy schools and five (out of 26) countries have variance between total number and the number of accredited pharmacy technician training schools; Forty-two countries have their full national compliment under a national accreditation system for pharmacy schools and 23 countries for pharmacy technician training schools.

Further study of national accreditation systems is needed to gain greater insights into how such systems impact the quality of pharmacy education; such research has been proposed by PET. Ideally, countries should have their own national QA system and standards for pharmacy education that reflect contemporary and emerging pharmacy practice and education and meet the specific needs of the country.

To support national efforts to improve systems and standards for QA of pharmacy education, FIP developed and adopted the Global Framework for Quality Assurance of Pharmacy Education [10]. The framework (available at www.fip.org/education_taskforce) provides the context for QA of pharmacy education, presents a framework for a national QA system, and offers quality criteria for pharmacy education. The Framework is intended to serve as a foundation that can be adapted and built upon to suit national needs, systems, and conditions; it focuses on the elements that need to be included and how these elements are applied in principle, rather than being specific or prescriptive. The Framework does not advocate for any one overall model or QA system, but comments on different approaches that exist and outlines trends that are emerging globally [11].

In 2008, WHO and PET supported studies in Ghana and Zambia to undertake a preliminary examination of the potential relevance of the Framework for advancing quality assurance of pharmacy education through detailed stakeholder analysis. Content validity of the Framework was evaluated by

the Department of Pharmacy at the University of Zambia and the Faculty of Pharmacy at the Kwame Nkrumah University of Science and Technology in Ghana. There was an overwhelming acceptance of the concept by policy makers, regulators, educators, and practitioners who emphasized the need for broader stakeholder involvement in developing QA systems.

In 2009-10, the Framework underwent further validation involving expert reviewers (representing pharmacy practice, academia, regulation and quality assurance of pharmacy education) from 24 participating countries. The survey instrument used examined the validity and national applicability of each component of the Framework. All sections of the Framework including the philosophy and purpose of quality assurance; structure, policies, and procedures for a national quality assurance system; and quality criteria for the outcomes, structure and processes of a pharmacy school and its professional degree program achieved high percentage validity scores: 60 of the 62 elements rating greater than 90%. Data and comments from the validation exercise are being used to inform the revision of the Framework, and release of the updated version is anticipated in 2013.

The quality assurance domain of PET is collaborating with WHO to develop an instrument that institutions can use for self-assessment and quality improvement of their academic program in pharmacy. The instrument, which uses the quality criteria of the Framework, has been piloted in Nigeria and the findings and conclusions from that exercise will inform its revision. It is planned that the updated instrument will be further tested and validated in several additional countries prior to final adoption. Also under consideration is adaptation of the instrument for use with other health professional education.

4.4 Practitioner development approaches in professional education

Over the last ten years, competency frameworks in health care have become increasingly popular due to the need for transparency in the training, development, and accreditation of health care professionals [12]. Continuing Professional Development (CPD) is advocated as a means of ensuring the competence of health care professionals and is now mandatory for many of the health care professions. In order for CPD to be meaningful, health care professionals need to know the areas of competence for their role so they can accurately identify their learning needs. In essence, they need to know what it is they need to be able to do [13-15]. Competency frameworks can provide this, and are based on real life roles and experience; experiential or applied learning is essential for the development of competence.

Perhaps a shift should be made towards Continuing Professional Education (CPE), a more fit-forpurpose and competent practitioner according to the specificity of the country or sector needs. There is a need to globally define a career pathway, since there is no seamless evolution of the practitioner.

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Pharmacy schools (Country level: sample mean 26.6)

Technician schools (Country level: sample mean 31.3)

Number of technician training schools (sorted by size: Country level)

Number of pharmacy schools

................................................................................. .................................................................................

Figure 4.4. Schools of pharmacy by population and by WHO region

(n=61 countries and territories)

Figure 4.5. Comparative frequencies for pharmacy schools and pharmacy technician training schools (logarithmic scale to enable case comparison)