Workplace-based Learning and Supervised Learning Events (SLEs)

The Quality Assurance Agency (QAA) consider workplace-based learning to involve supervision of authentic activities in the workplace, delivered though structured learning opportunities.  Based on this definition there's a strong argument that true workplace-based learning must involve activities that can only be experienced in a workplace setting - therefore providing lectures in a workplace does not meet this description.  Since learning has been shown to be improved when individuals take a more active role in the process, workplace-based learning has clear benefits compared to didactic lectures as it allows practitioners to consolidate knowledge and skills through application to real life scenarios.  

Work-based learning can be facilitated by:

• Providing opportunities to work in a variety of areas / specialties

• Supporting learners in producing a personal development plan, which is reviewed periodically to assess progress made

• Encouraging a safe space for reflection on practice

• Conducting supervised learning events (SLEs) to provide regular formative feedback to aid development

One of the barriers to effective work-based learning is when rotations are disrupted due to staffing shortages.  Read this blog, which provides some reflections and advice on how work-based learning can still be achieved (to some extent) when this happens.

"Time for training", a review of the European Working Time Directive on the quality of training for junior doctors, states that medical training and the delivery of patient care are inextricably linked and acknowledges that most training should occur in a workplace environment.  Most doctors reported to the General Medical Council demonstrate communication or interpersonal problems rather than a lack of knowledge.  Following in the footsteps of medical education, pharmacy education and training has moved towards a more competency-based approach (which covers more than just knowledge and decision-making), ultimately requiring assessment of practitioners in the workplace. 

Supervised Learning Events (SLEs) use real-life patients and scenarios to assess specific knowledge (and its application), skills and behaviours.  They are essentially developmental tools and thus help students to identify their strengths as well as areas for improvement through the provision of formative feedback.  Although SLEs are not summative (i.e. no mark is given), they can still help to identify students in difficulty so that additional guidance and support can be offered aid their development.  

SLEs have greater educational value if:

• A wide variety of cases / scenarios is used

• (Some) more challenging cases / scenarios are used

• They are spread out - if SLEs are completed all at once (or very close together) it is not possible to demonstrate progression

• A range of assessors is used (to improve reliability) - however, assessors should have been trained in the use of these tools to reduce inter-assessor variability

• Feedback received is reflected upon and used to inform on-going development needs

Read this blog post for further tips on how to maximise the usefulness of SLEs. 

Links to pages that provide information about individual SLEs are provided below:

• Acute Care Assessment Tool 

• Mini-Clinical Evaluation Exercise (Mini-CEX) 

• Direct Observation of Practical Skills (DOPS) 

• Case-based Discussion 

• Direct Observation of Non-Clinical Skills 

• Multi-source Feedback 

• Teaching Observation 

• Case Presentation 

• Journal Club Presentation

• Leadership Assessment Skills (LEADER) 

• Quality Improvement Project Assessment Tool (QIPAT) 

One dilemma involving supervised learning events (SLEs) relates to when and how often they should be completed.  Minimum numbers of each SLE are not required for Post-registration Foundation credentialing and not all tools have to be used as evidence in the pharmacist’s portfolio.  However, completing at least one SLE per month provides a rotational pharmacist with regular feedback and an opportunity to cover different scenarios as they rotate between different areas.  This short video discusses a suggested blueprint for when to undertake supervised learning events during a rotation, to help space them out and maximise their educational value. The summary blueprint is shown below.

Assessors must have an appropriate level of experience in practice to be able to provide objective feedback on a student’s performance.  For the purposes of this programme, assessors must be either:

• Pharmacists that are working at band 7 grade or above and have either a PgDip in Clinical Pharmacy (or equivalent experiential learning).  Pharmacists that are currently studying a PgDip (even if they are in the final stages and / or are working in a band 7 post) cannot be assessors, however they can complete the multi-source feedback (MSF) tool as this can be completed by any staff member that the pharmacist has worked with on a regular basis.

• Some Direct Observation of Non-clinical Skills assessments (e.g. tasks undertaken in the aseptic unit) may be assessed by senior pharmacy technicians

• Doctors that have completed the General Medical Council’s Foundation Programme

• Nurse prescribers

Ideally, assessors should be trained in the use of the SLE tools and providing effective feedback.  All work-based educational supervisors are invited to on-line training sessions provided by LJMU, and this can be extended to other practice-based supervisors as appropriate.

Both pharmacists and assessors have specific responsibilities relating to the facilitation of SLEs.

Pharmacists are responsible for

• Familiarising themselves with the different SLEs and feedback forms

• Arranging dates for SLEs with an appropriate assessor (see previous section on this page)

• Identifying appropriate assessors.  Whilst other pharmacists that are currently studying a PgDip in Clinical Pharmacy (or equivalent) and those that are waiting to enrol on such a course can complete multi-source feedback forms they cannot be assessors for other SLEs – any SLEs conducted by inappropriate assessors will not be recognised as suitable evidence in a portfolio and may result in the delaying of a student passing a module if they need to replace that piece of evidence

• Choosing a variety of case / scenario types for the assessments (i.e. minimise repetition of cases on one therapeutic topic)

• Recognising learning opportunities in the workplace and using them for SLEs (e.g. discussing a challenging on-call query with their practice or educational supervisor)

• Undertaking any preparation required for a SLE

• Reflecting on feedback received for each SLE

• Promptly informing both their university Personal Tutor and their department's Education Lead if they have trouble arranging SLEs or they are not receiving adequate/timely feedback from assessors.

Assessors are responsible for

• Familiarising themselves with the different SLEs and feedback forms

• Honouring any dates scheduled for SLEs or in the event of an unexpected cancellation, re-arranging for the earliest mutually convenient date

• Providing timely feedback - ideally the same day but the following day at the latest.

Timely feedback is essential to enable pharmacists to have sufficient recollection of the event and reflect on the feedback given.  Assessors should endeavour to provide both verbal and written feedback on the day of the assessment or at the very latest, by the end of the following day.  Feedback should include a combination of an individual's strengths and areas for development.  The agreed actions should focus on learning activities the pharmacist should undertake to address the development needs identified. 

The RPS Post-registration Foundation e-portfolio can be accessed by pharmacists regardless of their membership status.  However, non-members will have to become a registered user to gain access.  Feedback for SLEs completed can be provided using the "ticketed collaborators" option - please ensure that a collaborator's work-based e-mail address is used to help ensure authenticity.  There are also Word document versions of these feedback forms on the Post-registration Foundation Curriculum page of the RPS website.  If these are used they must be signed in ink by the assessor (although there is no designated signature, assessors can sign next to their name).  They can then be scanned (and saved as a Single PDF file) and added to the "File uploads" section of the e-portfolio.  Feedback may be handwritten, but illegible forms will be rejected as evidence by university-based assessors.