Module 3 - Aula Virtual Regional. Campus Virtual de Salud Pública

Module Study Guide
Module 3—“ The Pharmacist in the Face of Change”
Contents
Objectives ......................................................................................................................................................................2
General objectives ...................................................................................................................................................2
Specific objectives....................................................................................................................................................2
Competencies................................................................................................................................................................2
Teaching strategy ..........................................................................................................................................................3
Required reading. ....................................................................................................................................................3
Further reading ........................................................................................................................................................3
Video........................................................................................................................................................................4
Content development ...................................................................................................................................................4
Timetable.......................................................................................................................................................................5
Module assessment.......................................................................................................................................................6
Description of activities .................................................................................................................................................6
Activity 1 (M3A1): Introduction to Module 3 (week 1)............................................................................................6
Activity 2 (M3A2): 360° appraisal—self- appraisal and peer-appraisal (week 1) ....................................................7
Activity 3 (M3A3): Preparation of competency development plan (Week 2) .........................................................8
Activity 4 (M3A4): Mandatory tutorial session—synchronous forum (week 2) ......................................................8
Activity 5 (M3A5): Development of strategic plan (objective-oriented planning matrix—OOPM) (week 3) ..........9
Activity 6 (M3A6): Definition of indicators (week 3) ...............................................................................................9
Optional activity 1 (OP1): Glossary building (Week 3)...........................................................................................11
Optional activity 2 (OP2): Collaborative library (Week 3)......................................................................................12
Tools ............................................................................................................................................................................13
Tool M3A5. Objective-oriented Planning Matrix (OOPM) .....................................................................................13
2013
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Introduction
This course employs the method of successive approaches with increasing complexity. It is expected
that personal experiences, reflections, and competencies be used within the context of the learning
strategy.
The first module discussed the social determinants of health and the foundations of renewed
primary health care as a framework for the provision of pharmaceutical services integrated into the
health systems and services.
The second module discussed the processes involved in these services, with an emphasis on those
related to service delivery.
In this third module, students are expected to recognize the competencies needed for the
implementation of PHC-based pharmaceutical services and propose strategies for their development.
We will also discuss strategies for developing these competencies, taking into account the
institutional, national, and international context.
The second unit of the module is devoted to the development of the intervention proposal, which
will be country based or eventually a group of countries or region. We will practice the use of some
of the tools of objectives-oriented project planning (ZOPP) and development of indicators. The
proposal is the development of a plan for the strengthening of pharmaceutical services, including the
use of monitoring and evaluation indicators.
Objectives
General objectives
Recognize the competencies needed for the implementation of PHC-based pharmaceutical services
and propose strategies for their development.
Specific objectives
•
Recognize the competencies required to bring about change in the pharmaceutical services;
•
Propose strategies for developing the competencies required for the implementation of PHCbased pharmaceutical services;
• Draft a strategic plan with indicators for the strengthening of PHC-based pharmaceutical
services in your country.
Competencies
•
Identify the new role of pharmaceutical professionals within PHC health teams and develop
leadership and communication skills.
•
Prepare and implement a plan for development of the competencies required of
professionals involved in providing PHC-based pharmaceutical services.
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•
Identify problems and priorities and develop a strategic plan to achieve the objectives of
pharmaceutical services in the context of PHC renewal.
Teaching strategy
•
Individual and group activities
•
Videos
•
Review of required and further readings
•
Tutorial sessions (Synchronous and asynchronous interaction)
Required reading.
1. (M3O1) WHO (World Health Organization). Joint FIP/WHO guidelines on good pharmacy
practice: standards for quality of pharmacy services. Geneva, WHO: International
Pharmaceutical Federation; 2011.
2. (M3O2) PAHO/WHO (Pan American Health Organization/ World Health Organization).
Competencies of the Pharmacist for the Development of Pharmaceutical Services Based on
Primary Health Care and Good Pharmacy Practice; 2013.
3. (M3O3) Ramírez, V; Ivama, A. The competencies development as a tool for changes in the
pharmaceutical services, 2011.
4. (M3O4) Campbell, S. M., J. Braspenning, A. Hutchinson, and M. Marshall. “Research Methods
Used in Developing and Applying Quality Indicators in Primary Care.” Quality and Safety in
Health Care 11, no. 4 (2002): 358–364.
Further reading
1. (M3C1) WHO/FIP (World Health Organization/International Pharmaceutical Federation).
Developing pharmacy practice: a focus on patient care. Handbook – 2006 edition. Geneva:
WHO; 2006.
2. (M3C2) FIP (International Pharmaceutical Federation). FIP Statement of Professional
Standards: Codes of Ethics for Pharmacists. 2004 [updated 2004; cited];
3. (M3C3) Nebot C, Rosales C. Primary Health Care-Based Health Systems: Strategies for the
Development of Primary Health Care Teams. 1st ed. PAHO/WHO (ed.). Washington, D.C.:
PAHO/WHO; 2008.
4. (M3C4) WHO (World Health Organization). The role of the pharmacist in the Health Care
System. Preparing the Future Pharmacist: Curricular Development. Report of the third WHO
Consultative Group on the Role of the Pharmacist, 27-29 August 1997. Vancouver: WHO;
1997.
5. (M3C5) The Community Tool Box. SWOT Analysis: Strengths, Weaknesses, Opportunities, and
Threats. Community Tool Box; 2013.
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Video
M3V1 – Red Ant - Incredible_Team_Work_[SUB_ENG]
Content development
The module has two units: a) Competencies and strategies for the development of PHC-based
pharmaceutical services; and b) Development of an intervention proposal (part 3).
Weeks 1 and 2–Unit: Competencies and strategies for the development of PHC-based
pharmaceutical services
Specific objectives
Recognize the competencies required for implementing change in pharmaceutical
services;
Propose strategies for the development of competencies required for the
implementation of PHC-based pharmaceutical services.
Content
Learning strategies
Activities
Expected output
Recognition of
competencies
related to the
pharmaceutical
services
Week 1:
Activity #1 Entire group
meeting: Introduction to
the module
Active participation in the
synchronous forum;
Review of the essay on
SDOH, health systems, and
pharmaceutical services
(the output of Activity
M1A2);
Video M3V1;
Activity # 2. Individual:
360° appraisal (selfappraisal and peerappraisal)
o
360 appraisal conducted,
with recognition of existing
competencies and
identification of gaps.
Required readings M301,
M302, and M3O3
Development of
strategies to bring
about change in
your workplace
Week 2:
Required readings M302
and M3O3
Activity # 3. Preparation of
competency development
plan
Competency development
plan prepared
Activity # 4. Mandatory
tutorial session: discussion
on the competency
development plan
Active participation in the
discussion
Week 3–Unit two: Development intervention proposal (part 3)
Specific objectives
Develop a strategic plan with indicators for the strengthening of PHC-based
pharmaceutical services in your country.
Content
Learning strategies
Activities
Expected output
Development of
strategic plan (logical
framework).
Required reading
M3O4;
Activity #5: Develop the
strategic plan
Objectives-oriented
planning matrix (OOPM) or
logical framework
Identification of
indicators
Tutor office hours—M3
(week 3).
Activity #6: Define
indicators
Indicators defined.
Group discussion;
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Timetable
Module Stages
Deadline for
Completion/
Delivery
M3—Weeks I and II
Activity #1 Entire group meeting—Introduction to the module
Sep, 2
Review of the essay on SDOH, health systems, and pharmaceutical services (output of
Activity M1A2)
Sep, 2
Required readings M301, M302, and M3O3
Sep, 2
Start of Module 3 optional activities #1 and #2
Aug, 29
Video M3V1
Sep, 2
Activity #2 Individual 360o appraisal
Sep, 4
Activity #3 Preparation of competency development plan
Sep, 11
Activity #4 Mandatory tutorial session: discussion on the competency development
plan
Sep, 11
Wrap-up of Module 3 optional activities OP1 and OP2
Sep, 11
M3—Week III
M3 Tutor office hours—week III
Sep, 18
Required reading M3O4
Sep, 13
Activity #5 Development of strategic plan
Sep, 25
Activity #6 Definition of indicators
Sep, 25
Module 3 assessment
Sep, 16-20
End of Module 3
Sep, 18
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Module assessment
Activities
Expected outcomes
%
Criteria for evaluation
360° appraisal
(self-appraisal
and peerappraisal)
Self-appraisal essay
6
Self-criticism capacity and recognition of
strengths and weaknesses;
Preparation of
competency
development
plan
Competency development
plan prepared
6
Ability to use the proposed tools and apply them
in a plan for competency development that is
feasible and consistent with the needs identified
Development
of strategic
plan
Objective-oriented
planning matrix (OOPM)
or logical framework
6
Plan that is viable, has clear objectives, and is
guided by the proposals identified in the SWOT
analysis
Definition of
indicators
Indicators developed
3
Indicators developed according to the proposed
criteria
Participation
Participation of the
students
4
Active participation in the compulsory
synchronous discussion sessions for conceptual
review and progress in the subject at hand (as
assessed by each tutor).
Ability to evaluate and be evaluated, receive
criticism and respond constructively.
Fulfillment, in terms of time and quality, of the
criteria agreed upon for the learning program.
Involvement in optional activities.
Total for the module
25
Description of activities
Activity 1 (M3A1): Introduction to Module 3 (week 1)
Outline of the activity
This is an “Entire group meeting” activity. In this session the objectives, structure, and activities of
the module will be presented and described and it will be explained what is expected from the
student at the end of the module.
The specific time and date of this session will be announced in the academic coordination
announcement forum.
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Activity 2 (M3A2): 360° appraisal—self- appraisal and peer-appraisal (week 1)
Outline of the activity
Consider your scope of practice (local, regional, or national) and the changes that should be made in
terms of your own competencies and at the institutional level for the implementation of PHC-based
model of pharmaceutical services, in accordance with the tenets proposed in the Guideline.
Step 1. Review the essay produced during activity M1A2 (module 1).
Step 2. Watch M3V1 and read required texts M3O1, M3O2, and M3O3.
Students should revisit their reflections on “whither change” and should be able to translate the
proposed pharmaceutical services model to their context of work, so as to provide background for
the discussion on competencies.
Step 3. Conduct your self-appraisal using the tool M3A2 (360-degree appraisal). Please fill in all
required fields by marking with an “x”. When an item is not applicable (N/A), place an “x” in the
corresponding column. No lines should be left blank.
Step 4. Peer appraisal (optional): Find a colleague who is at a similar hierarchical level to yours and
ask him/her to evaluate your performance, using the second spreadsheet of the same Excel
workbook, and return the completed file to you. It is essential that this be done in the Excel file so
the corresponding scores can be generated. When items are not applicable (N/A) or your colleague
does not know the answer (DNK), he or she should place an “X” in the corresponding column. No
lines should be left blank. This appraisal is optional; if completed, it ensures an additional point
toward the credit for this activity.
Step 5. Review the chart shown in the third sheet of the same Excel workbook and answer the
following questions in a separate MS Word file.
1. What are your impressions of the exercise in terms of what you expected and the actual
result comparing your self-appraisal and that carried out by your colleague? Are there
any discrepancies? If so, how can you deal with them positively?
2. To what extent do you think that your formal education as a pharmacist in your country
and other supplementary formal or informal training have contributed to the
development of your competencies?
3. Considering the functions and services that need to be developed in PHC-based
pharmaceutical services, what are your strengths (competencies that you already have)
and what competencies do you think you need to develop? Please justify.
Step 6. Upload the following completed documents to the VCPH under Activity #2: a) Excel file
containing the forms (Note that the self-appraisal, peer appraisal, and chart should all be contained
in the same Excel workbook) and b) the Word file containing your reflections.
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Activity 3 (M3A3): Preparation of competency development plan (Week 2)
Outline of the activity
Step 1. Based on the results of M3A2 and taking into account the content of the videos and readings
you have seen, devise a plan for the development of your competencies.
Mastery—or lack thereof—of a given competency can have a positive or negative effect on the
execution of your functions. With the intention of affecting a positive influence on the development
of pharmaceutical services, conduct a critical review of the results of M3A2 and think about a
personal plan for development of your own competencies. We suggest you focus on the three
competencies in which you had the lowest scores in M3A2.
The plan should consist of a brief introduction (explaining the scope of the plan), your objectives, and
a matrix containing the following:
1. Competencies to be developed
2. Rationale
3. Strategy
4. Assumptions (one or more necessary conditions for success that are outside the immediate
control of a program or intervention. Assumptions are made explicit as part of an “analysis of
assumptions and risks” meant to assess whether results are achievable)1.
5. Resources needed
6. Final considerations and recommendations
7. References (if applicable).
Step 2. Upload your competency development plan to the VCPH under Activity M3A3.
Activity 4 (M3A4): Mandatory tutorial session—synchronous forum (week 2)
Outline of the activity
This is a “Mandatory Tutorial Session” activity, in which students, grouped by tutor, should express
their doubts and discuss the advantages, disadvantages, and shortcomings of implementation of the
competency development plan.
Guiding questions:
1. Do you believe the competencies and reflections presented in the activities of this module
add value to your work as a professional? How so?
2. How do you think competency development can contribute to the implementation of PHCbased pharmaceutical services at your workplace?
1
PAHO/WHO. PBR. Manual de Planificación Operativa de la OPS 2012-2013. Tomo I: Lineamientos para la
formulación del Plan de Trabajo Bienal. Washington DC: PAHO/WHO, 2010.
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3. How do you think you could have a positive influence on your own training or competency
development and on that of your team?
Activity 5 (M3A5): Development of strategic plan (objective-oriented planning
matrix—OOPM) (week 3)
Outline of the activity
In this activity, students (divided into groups per country) will develop a strategic plan by following
these steps:
Step 1. Define the time frame for the plan. It is important to define the time horizon for the plan—
how much time will be spent on implementation?
A strategic plan should cover a broader period, of 4 or 5 years.
Step 2. Using the general objective of the project (defined in step 3 of Activity M1A3) as a basis,
propose a short sentence that describes the plan. This will become the title of the project.
Step 3. Choose up to 10 proposed strategies from the pool of strategies defined in Activity 8 of
Module 2 (M2A8). If possible, prioritize use of the same criteria suggested for that activity. For each
of these proposed strategies, identify no less than one and no more than five lines of action.
Step 4. Discuss whether the proposed lines of action are antagonistic, complementary, or
independent—if they are antagonistic, implementation of these strategies within the framework of a
single plan is most probably not feasible.
•
Use the following criteria to select lines of action: number of resources needed
•
Cost of implementation
•
Political, social, or environmental ramifications
•
Time required to achieve effects
Step 5. Complete the OOPM and upload the file to the VCPH under Activity M3A5.
If the project manages to advance, it is important that the strategic plan evolve to a more detailed
operational plan. Reading M3C5 provides tools for operational planning. However, some aspects
bear stressing: in an operational plan, all resources need to be detailed; for instance, necessary
financial resources should be quantified.
Activity 6 (M3A6): Definition of indicators (week 3)
Monitoring and evaluation (M&E) is an essential stage of public policy development. It can be carried
out from the very start, to specify and measure the magnitude of problems (identification of needs),
throughout the implementation stage (formative evaluation), or at the end of the project so as to
confirm achievement of the proposed objectives (summative evaluation).
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According to Howlett, Ramesh and Perl (2009)2, a public policy goes through five main stages. These
stages are summarized in Table 1.
Table 1. Stages of public policy making
Stage of the policy cycle
Agenda setting
Policy formulation
Decision-making
Policy implementation
Policy evaluation
Phase of problem solving
Problem recognition
Proposal of solution
Choice of solution
Putting solution into effect
Monitoring results
Key stakeholders involved
Policy universe
Policy subsystem
Decision-makers
Policy subsystem
Policy universe
Source: Howlett, Ramesh and Perl, 2009
Contandriopoulos et al3 propose that six types of analysis can be conducted during the course of an
intervention: strategic analysis (assesses the strategic adequacy of the intervention and the problem
situation that prompted intervention), intervention analysis (assesses the ability of expected or
actual resources to achieve the proposed objectives), productivity analysis (assesses the possibility
of delivering more services with the same resources or of delivering the same services with fewer
resources), analysis of effects (analyzes the influence of the intervention on the state of health),
performance analysis (assesses correlations between the resources employed and the effects
obtained), and implementation analysis (analyzes the influence of the extent of project
implementation on the effects obtained, as opposed to the influence of the context where the
intervention occurs).
During this planning stage, prior to implementation of the plan, the first two forms of analysis—
strategic analysis and intervention analysis—are applicable and will be discussed in the closing
Module.
In addition, as in process-based management, these forms of analysis require contributions (inputs)
and result in effects (outputs, results or outcomes and impacts).
Therefore, M&E can be carried out at the various stages of a project.
In strategic planning, the definition of indicators for objectives or outputs—expressed as SMART
goals—is common practice.
The acronym SMART describes the characteristics of a good goal:
•
Specific: the objective is clear as to what, where, when and how it is going to change the
situation;
•
Measurable: its outcomes and benefits are quantifiable;
2
Howlett M, Ramesh M, Perl A. Studying public policy: policy cycles & policy subsystems. Oxford University
Press; 2009.
3
Contandriopoulos AP, Champagne F, Potvin L, Denis JL, Pineault R. A Avaliação na Área da Saúde: Conceito e
Métodos. In: Hartz ZMA (org.), editor. Avaliação em Saúde: dos Modelos Conceituais à Prática da
Implantação de Programas. Rio de Janeiro: Editora Fiocruz; p. 29-47; 1997.
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•
Achievable: the objective is achievable (taking into account the resources and capabilities at
the disposal of the community);
•
Realistic: the level of change reflected by the objective is feasible;
•
Time-bound: the time frame/deadline by which each goal should be completed is defined.
Goals correspond to outcome indicators.
The quality of an indicator can be defined on the basis of the following attributes:
�
Clarity—whether it is easy to understand and calculate.
�
Usefulness—whether it reflects an important dimension of the effort.
�
Measurability—whether it can be defined in quantitative or qualitative terms.
�
Reliability—whether it permits ongoing evaluation over time and by different observers.
�
Validity—whether it really does measure what it is intended to measure.
Outline of the activity
Step 1. Based on the OOPM you have just completed in activity M3A5 and following the same
organization into country-based groups, prepare indicators to measure the results of the plan.
Step 2. Using the proposed tool M3A6, devise indicators for the following aspects:
�
Resources or Inputs (aspects covered in column E of the OOPM)—at least 3 indicators.
�
Outputs (direct effects of the activity—column C of the OOPM)—at least 5 indicators.
�
Outcomes (measurable changes at the target population level)—at least 3 indicators.
Check required reading M3O4 for examples.
Step 3. Upload the indicators file to the VCPH under the activity M3A6.
Optional activity 1 (OP1): Glossary building (Week 3)
Outline of the activity
Step 1. Identify terms of interest related to the key concepts addressed thus far and propose
definitions for the glossary that will be built throughout the course.
Don’t forget to cite the source (reference) from which each definition was obtained. For instructions
on how to cite bibliographic references, see http:/revista.paho.org/uploads/1223320193.pdf.
Step 2. Send the selected term and its respective reference to your tutor through the VCPH message
function, so that your contribution can be assessed.
Step 3. Await appraisal by your tutor.
Step 4. Make any corrections suggested by your tutor (if necessary) and upload your contribution to
the glossary.
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Optional activity 2 (OP2): Collaborative library (Week 3)
Outline of the activity
Step 1. Propose texts of interest to the subject at hand. Suggested readings should have the
following characteristics:
1. Type: reference texts, country documents, etc.;
2. Format: preferably PDF, .doc or .rtf are also acceptable.
Step 2. Send the selected text and its respective reference to your tutor through the VCPH message
function, so that your contribution can be assessed.
1. The person who uploads the document is responsible for ensuring that copyright is
respected.
2. All minimum reference data (author[s], year, title, city, pages) should be identifiable.
Step 3. Await appraisal by your tutor.
Step 4. Make any corrections suggested by your tutor (is necessary) and upload your contribution to
the collaborative library. For instructions, see
http://devserver.paho.org/virtualcampus/moodle/file.php/37/RECURSOS_DE_AYUDA/Como_subi
r_archivos_a_la_biblioteca_colaborativa.doc (Spanish only).
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