On the clock: Time implications for pharmacist assessors for medical intern prescribing entrustable professional activities.

Abstract

Introduction: Entrustable Professional Activities (EPAs) are structured, observable units of daily work used internationally to assess the ability of a learner to complete a variety of workplace tasks. The Australian Medical Council is introducing EPA assessments for first and second-year graduate doctors. Recognising pharmacists' role as medication experts, pharmacists were proposed as one of the health professions appropriate to assess medical interns prescribing EPAs. While EPAs are popular and have been studied extensively, this is the first reported instance of interprofessional EPA assessment in health professional education. This pilot study investigates the time impact on pharmacists' workloads of conducting these EPA assessments. Method(s): Six units (across medicine, emergency, surgery and mental health) within a multisite hospital network participated in a pilot study where pharmacists assessed medical interns' undertaking prescribing EPAs. Medical interns could approach either pharmacists or medical staff to assess prescribing EPAs. Assessors completed Microsoft Forms at the time of the EPA, including rating level of entrust ability, providing qualitative feedback, assigning case complexity based on clinical judgement and recording time taken for EPA assessment and feedback. Data collection was conducted between May to October 2024. Descriptive statistics were performed using Microsoft Excel. Result(s): Ten pharmacist assessors completed 28 assessments over six-months; a median of 1.5 (range 1-6) assessments per pharmacist. The median time taken for each assessment was 10 minutes (range 3-21 minutes). Five EPAs were reported as high-complexity cases. Low-complexity cases took a median of 15 minutes (range 7-21 minutes), medium-complexity 10 minutes (range 3-20) and high-complexity 15 minutes (range 10-20). Conclusion(s): Pharmacists typically required less than 15 minutes per EPA assessment and completed a median of 1.5 assessments in six-months, indicating a feasible workload. Future studies should evaluate the impact of the complete roll out to determine scalability and sustainability for the pharmacy workforce.