Opleidingsprogramma ENG - Marnix

Education Plan
Advanced Community Pharmacist

Education Programme
Royal Dutch Pharmacists Association

EDUCATION PLAN – ADVANCED COMMUNITY PHARMACIST EDUCATION PROGRAMME
Version of April 2012
Table of Contents
I Introduction 2
II Cohesion of the education plan 4
III Profile of the community pharmacy specialisation 6
IV Competences of a specialist community pharmacist 8
IV.1 Four sub-competences in the seven competence areas of the specialist
community pharmacist specialist 9
IV.2 Description of the competence areas and sub-competences 10
V Task areas and application of the competences of the specialist community
pharmacist 16
VI Assessment 31
VI.1 Assessment and assessment instruments 32
VI.2 EPAs per area of activity, applicable assessment instruments and frequency
of assessment 35
VI.3 Programme assessment schedule 43
VI.4 Linking task areas, EPAs and competences 44
VI.5 Linking EPAs and assessment forms with review dates and proficiency levels 47
VII Education methods and activities 52
VIII Education material 52
IX Quality assurance 53
Appendices
A. Knowledge and skills checklist 55
B. Overview of centrally organised courses within the specialist community
pharmacist advanced education programme 58
C. Pharmacist Supervisor (ApOP) competence profile 63

1
I Introduction
The education programme for the profession of community pharmacist was introduced as an advanced
specialisation within the field of community pharmacy in 1995. This document will hereinafter use the
term ‘advanced community pharmacist education programme’ or simply ‘advanced education programme’.
In October 2004, the general assembly of the KNMP approved the professional association’s ambition to develop
a specialisation in community pharmacy registered under the Dutch Individual Healthcare Professions Act
(Wet beroepen in de individuele gezondheidszorg, BIG). This decision was based in part on the 2002 report
published by the Committee on the Pharmacy Education Continuum (Commissie Opleidingscontinuüm
Farmaci, COF), titled De apotheker als zorgverlener1 (‘The pharmacist as health-care provider’).
In 2005, the Subsequent Committee on the Pharmacy Education Continuum (Vervolgcommissie

Opleidingscontinuüm Farmacie) followed up with another report titled De openbaarapotheker: specialist
(‘The community pharmacist as a specialist’), setting out an education model comprised of a bachelor’s phase
in pharmacy or pharmaceutical sciences, a master’s phase in pharmacy, and a concluding specialisation in
community pharmacy, hospital pharmacy or industrial pharmacy2.
A ‘high level’ advanced (i.e. post-graduate) education programme continues to be regarded as a key requisite for
an accepted specialisation in community pharmacy. Initial steps to modernise the existing programme were
taken with the publication of two reports in 2007: Structuurplan specialisme openbare farmacie3 (‘Master plan
for the community pharmacy specialisation’ and Opleidingsplan specialisme openbare farmacie4 (‘Education
plan for the community pharmacy specialisation’).
Implementation of the modernisations themselves commenced in the course of 2008 with the appointment
of a part-time education director. The incentive for these modernisations also came from a number of other
factors. There had been indications from the professional field, including from the Young Pharmacists Society
(Vereniging van Jonge Apothekers, VJA) that the education programme was due for a thorough evaluation
and overhaul. As well, today’s dynamic pace of development makes it vital to periodically examine education
programmes to ensure they continue to align with practice. With the changing times it had also become clear
that the old ‘master/apprentice’ system for workplace learning was outdated. This view was also expressed in
the reports on renewal of the intramural medical specialist advanced education programmes, which proposed
a radically different training structure.
The Central Board for Pharmacy Specialists (Centraal College Specialisten Farmacie, CC) decided to establish
a register for specialist community pharmacists with effect from 1 January 2012, at the same time amending
the education requirements for the specialist community pharmacist education programme. This resulted in
an education plan, drawn up on the basis of the guiding principles set out in the Central Board’s decision on
education requirements that was issued in September 2011. The education plan furnishes supervisors, trainees
and lecturers with handholds for teaching and assessing the knowledge, skills and attitudes needed to be a
specialist community pharmacist.
Coordination between all the various education tracks, from undergraduate through post-graduate
programmes, has had a decisive impact on the quality of specialist community pharmacists. Education
providers, and even more so those responsible within these forums, must remain in constant dialogue to
ensure a continuing high standard of coordination between and quality in their respective programme tracks.
Figure 1 provides a schematic overview of how the different programmes fit together. Universities are responsible
for the basic training of pharmacists, while advanced education and the subsequent process of re-registration
and ‘lifelong learning’ falls under the remit of the specialist societies. After completing their training as
specialist community pharmacists, graduates are registered in the specialists register of community pharmacists.
Specialists in the register are subsequently evaluated every five years to assess if they have met the continuing
1 Commissie Opleidingscontinuüm Farmacie. De apotheker als zorgverlener. The Hague: KNMP; 2002.
2 Vervolgcommissie Opleidingscontinuüm Farmacie. De openbaar apotheker: specialist. The Hague: KNMP; 2005.
3 Leufkens HGM, Daemen BJG. Structuurplan specialisme openbare farmacie. The Hague: KNMP; 2007.
4 Schobben AFAM, De Gier JJ, Schalekamp T, Daemen BJG. Opleidingsplan specialisme openbare farmacie. The Hague: KNMP; 2007.
2
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MaCOMMUNITY PHARMACIST EDUCATION PROGRAMME
EDUCATION PLAN – ADVANCED
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at ha cha
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Or for re-registration. The attitude of a trained specialisten
education requirements jk to be such that he5
is expected
Samenwerking
is always actively engaged in seeking out training opportunities to fill gaps in his knowledge and skills; this
process is referred to as Continuing Professional Development (CPD). As figure 1 shows, various proposals
have also been put forward for the future. Among them is to enable a select group of specialist community
pharmacist trainees (Apothekers in Opleiding tot Openbaar Apotheker Specialist, ApIOS) to pursue a PhD
degree in addition to their advanced education programme. Another possibility under consideration is to
introduce education programmes leading to registration in specific sub-domains as part of the continuing
education and re-registration process.
Figure 1 The pharmacy education continuum
The pharmacy education continuum
University Specialty society
Bachelor’s Advanced Continuing education/

phase education re-registration
programme
Master’s
phase
Training as specialist
community pharmacist
Training as specialist community

pharmacist in conjunction with a PhD track
Continuing education; Lifelong learning;

Specialist re-registration
Special registration
(e.g. pharmacist supervisor)
5 Where the text refers to he/him, read also she/her.
3
II Cohesion of the education plan

This education plan follows along the general lines set out by the medical specialty societies in modernising
their education programmes since 2002, including in the use of the practical tool designed by the Supervisory
Group for the Development of Continuing Education Plans (Begeleidingsgroep Beschrijving Opleidingsplannen
Vervolgopleidingen, BBOV), generally referred to as the BBOV ‘house’ or ‘Heineman’s house’ (Figure 2).
This instrument specifies basic components needed in an education plan, which it envisions as ‘filling’ the
rooms of a house with ‘furniture’. The present education plan discusses different rooms in turn. Section III
outlines the core profile of the community pharmacy specialisation, followed in Section IV by the competence
profile of a specialist community pharmacist. This profile sets out the relevant core competences in conformity
with the model developed by the Canadian Medical Education Directives for Specialists (CanMEDS) in 20006.
The CanMEDS competences are a key element in the CCSF’s education requirements.
Figure 2 Heineman’s ‘house’
Quality assurance
Education process
Assessment framework decree
Professionalisation of supervisor &
trainee doctors (AIOs) Research on education
Education Education Educational

methods activities material
Operationalised
Themes competences Assessment
Profile of the advanced Competences

education programme of specialists
Framework decrees
Specific decrees
Basis of support
Section V gives as detailed as possible a description of the activities in which a specialist community
pharmacist engages. These activities are broken down into themes based on shared features and as such form
recognisable elements in the education programme. These recognisable elements are here designated as ‘task
areas’. There are ten task areas in total, classified as follows:
1. Patient communication and counselling

2. Health-care questions from patients and the general public
3. Medication surveillance
4. Periodic medication review
5. Consultation with colleagues
6. Preventive care and screening
7. Collection and management of patient data
8. Product care
9. Quality assurance in the pharmacy
10. Knowledge, education and scientific understanding
6 The CanMEDS 2005 Physician Competency Framework. Better standards. Better physicians. Better Care http://meds.queensu.ca/medicine/obgyn/pdf/CanMEDS2005.
booklet.pdf
4
The links between competences and task areas correspond with the transfer from theory to practice.
Section V discusses these links in terms of the operationalisation of competences.
Assessment is a fundamental instrument in education and a critical component of this advanced education
programme. Incorporated throughout the education programme, assessment should form an integral part
thereof. Section VI describes the assessment plan, including the application of Entrustable Professional
Activities (EPAs), different forms of assessment and how these link into general competences. The structure
of the advanced education programme and in particular the assessment plan are clarified in sections V
and VI (see also figure 3 for a schematic diagram). Descriptions of the content of the specialisation and of
the advanced education programme are broken down in line with the ten task areas. Within each of these
task areas (in conjunction with their operationalised competences; see Section V), a number of EPAs have
been selected for inclusion in the assessment plan. Specialist community pharmacist trainees (ApIOS) are
assessed on these EPAs using suitable assessment instruments, in some cases on multiple occasions during
the education programme. Linking the EPAs with the assessment instrument makes it possible to assess
one or more of the CanMEDS core competences. With a sufficient number of EPAs and suitable assessment
instruments and a sufficient frequency of assessment, we can ensure that the full set of competences is
adequately assessed over the course of the programme. Core competences are assessed by indirect means,
which is an approach to practical training substantiated in literature (see Section VI.4).
opleiding. De combinatie van EPA en toetsingsinstrument zorgt voor toetsing van één of meer van de CanMeds
kerncompetenties. Met voldoende EPA’s, daarbij geschikte toetsingsinstrumenten en voldoende vaak toetsen
Figure 3
zorgen we ervoor dat alle competenties in de loop van de opleiding in voldoende mate worden getoetst. Er
Schematic diagram of the structure of the advanced education programme, showing how general
vindt dus een indirecte toetsing plaats van de kerncompetenties, wat een in de literatuur onderbouwde wijze
van werken is bij opleiden in de praktijk. (Zie hoofdstuk VI.4).
competences are embedded in the programme.

Figuur 3 Schematische weergave van de opbouw van de vervolgopleiding die de inbedding van de
algemene competenties in de opleiding weergeeft

Vervolgopleiding openbaar apotheker specialist
Specialist community pharmacist advanced education programme

Taakgebied
Task area Task area Task area Task area Task area Task area Task area Task area Task area Task area
Taakgebied Taakgebied Taakgebied Taakgebied Taakgebied Taakgebied Taakgebied Taakgebied Taakgebied

EPA
EPA EPA
EPA EPA
EPA

Competentie Competence
Competence Competentie Competence
Competentie

In hoofdstuk VII tot en met IX komen achtereenvolgens aan de orde: opleidingsmethodiek en
Sections VII through IX discuss, in order: education methods and education activities, education material, and
opleidingsactiviteiten, opleidingsmateriaal en kwaliteitszorg. Het rapport wordt gecompleteerd met enige
quality assurance. The end of the report contains a brief bibliography and a number of integral appendices.
literatuurverwijzingen en enkele – niet onbelangrijke ‐ bijlagen.

III Profiel specialisme openbare farmacie

In het “Witboek Farmacie”, dat in 2011 door de KNMP werd gepubliceerd8, wordt de context waarin de
openbare farmacie zich beweegt omschreven. Wij citeren:

“De Nederlandse bevolking zal tot 2050 sterk vergrijzen. Het geneesmiddelgebruik zal daarbij blijven
stijgen. De intrinsieke effectiviteit en veiligheid van geneesmiddelen is de afgelopen decennia flink
verbeterd. Indien deze geneesmiddelen op de juiste wijze worden voorgeschreven en gebruikt dan
kunnen deze flinke gezondheidswinst bieden. Bij verkeerd voorschrijven en gebruik kan de balans
tussen positieve en negatieve effecten van deze geneesmiddelen echter naar de verkeerde kant
doorslaan. Recent werd in het HARM onderzoek becijferd dat meer dan 5% van de acute
ziekenhuisopnamen in Nederland het gevolg is van het verkeerd voorschrijven, monitoren en gebruik
van medicijnen. In verschillende onderzoeken is daarnaast vastgesteld dat het dramatisch is gesteld
met de therapietrouw van patiënten. Afhankelijk van het type geneesmiddel stopt tot 80% van de
mensen voortijdig met behandelingen voor chronische aandoeningen als hoge bloeddruk, glaucoom
5
en osteoporose. De theoretische gezondheidswinst van deze geneesmiddelen wordt daardoor ernstig
III Profile of the specialisation in community pharmacy

The KNMP’s 2011 publication Witboek Farmacie (‘Pharmacy White Paper’)7 describes the operational context
of community pharmacy as follows:
‘The Dutch population will show a strong ageing trend until 2050. The use of medicines will continue
to rise accordingly. Medicines’ intrinsic efficacy and safety has improved considerably in recent decades
and, provided they are prescribed and used correctly, can yield considerable health gains. However, if
incorrectly prescribed and used, the balance between medicines’ positive and negative effects will tip in
the wrong direction. The recent HARM study calculated that more than 5% of acute hospital admissions
in the Netherlands are due to the incorrect prescription, monitoring and/or use of medicines. Various
studies have further established deplorable adherence to medication among patients. Depending on the
type of medicine, up to 80% of people prematurely stop their treatments for chronic conditions such
as high blood pressure, glaucoma and osteoporosis. The theoretical health gain of these medicines is
therefore severely undermined. Another major issue in health care, in addition to efficacy and safety,
is efficiency. Medicines may at times be expensive, but provided they are optimally used and supervised,
can also lead to considerable health gains and even save on costs in other areas of care. Research into
drug-related problems among the elderly (published in a major foreign study) indicates that at least
ten euros are saved for every euro invested in pharmaceutical care. In view of the stated problems,
promoting the effective, safe and efficient use of medicines poses a major challenge, demanding the
best efforts of care providers (both individually and collaboratively) working in the health care sector.
Over the next few years, difficulties are anticipated in maintaining a large enough workforce of highly
qualified care providers to facilitate optimum supervision of medicine users. This makes it especially
important that pharmacies fulfil their health care role to the fullest extent possible. This white paper
describes specific areas in which this role can be further developed and the resources needed to support
pharmacists in their new role.’
The field of community pharmacy is rapidly evolving. Although practitioners’ knowledge about the product
– mainly medicines – is substantial, there is a growing urgent need for a broader and more thoroughgoing
application of pharmacotherapeutic knowledge to ensure patients’ medication safety and the effective use of
medicines. In other words, community pharmacists need to be able to prevent, detect and resolve (potential)
pharmacotherapy-related problems so as to optimise patients’ quality of life, provide them the best possible
treatment for their conditions and minimise the chance of adverse effects. Pharmacists carry out this task in
various contexts, such as when dispensing medicines, in situational circumstances (such as at the start of an
individualised method of distribution) and periodically when carrying out medication reviews, for example.
As will be explained in the descriptions of the specialist community pharmacist task areas
(Section V), caring for individual patients has become a central focus of the community pharmacist’s work.
Accordingly, the first seven task areas are directly related to the pharmacist’s role as carer. This change in the
profession is also evident internationally and remarked by, among others, the International Pharmaceutical
Federation (FIP), which has as its motto: ‘patient-focused, medicine-centred’. Today, pharmacists’ patient
care role is being widely promoted by both the KNMP and the Scientific Community Pharmacists Section
(Wetenschappelijke Sectie Openbare Farmacie, WSO. However, this is not to detract from the duty of product
care that is a key niche of the community pharmacist’s expertise. Community pharmacists must possess
extensive knowledge not only of ready-to-use medicines but also of compounded medicines and preparations,
and product care remains the province of the pharmacist. Further, this role extends not only to medicines, but
also to related product groups collectively known as medical and assistive devices, responsibility for which also
falls to the community pharmacist. As small to medium enterprises, pharmacies are strongly focused on the
organisation of pharmaceutical care. To fulfil these various tasks, pharmacists must have an effective system
of quality assurance in place for their business, as well as to be able to provide an adequate demonstration of
their quality.
7 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPWitboekFarmacie.pdf; last consulted on 05 July 2011.
6
Where feasible, community pharmacists work according to the ‘evidence-based’ guidelines, drawing in part
on their own area of specialisation and in part on related domains such as general medicine. Both individually
and as an occupational group, community pharmacists are continually engaged in activities to improve the
pharmaceutical care provided to patients. Development and application of specific pharmaceutical care
guidelines is one of those activities, as is the provision and maintenance of continuing and targeted education
programmes as part of CPD.
Community pharmacists work in close consultation with general practitioners and others who prescribe
medicines. In the current system of integrated care, there is also a call for collaboration with parties other than
prescribers, for example with nurse practitioners, medical assistants, homecare assistants, nursing home staff
and others.
The profession shares common ground with transmural pharmacy as practised at hospital outpatient
pharmacies and at pharmacy service points (Apotheek Service Punt, ASP), as well as with the specialised field of
hospital pharmacy, which has its own advanced education programme.
Community pharmacists are generalists who have to contend with new developments on an ongoing basis.
These include developments in the field of pharmacotherapy and product care as well as in the broad domain
of the health care system. As an example, for several years now community pharmacists have been responsible
for the distribution and product care of specialised medicines such as oral oncolytics. Increasing concerns
about medication safety are also necessitating changes at community pharmacies. At the same time, they
must take account of current or imminent changes in other areas such as health care reimbursement and the
organisation of integrated care. These changes will have a defining impact on the position of pharmacies and
how they are organised.
This education plan forms part of the KNMP’s broadly supported ambition as an expert in the field of
community pharmacy to make a significant contribution to the effective, safe and efficient use of medicines,
as set out in the Witboek Farmacie, mentioned above, and in the Nationaal Routeplan Farmacie8 (‘National
Pharmacy Roadmap’).
8 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPNationaalRouteplanFarmacie.pdf; last consulted on 6 July 2011.
7
IV Competences of the specialist community pharmacist

A competence is defined as the ability to carry out complex tasks in an effective manner through the
integration and application of a specific combination of knowledge, skills and attitude. General competences
have been defined in line with the model developed by the Canadian Medical Education Directives for
Specialists 2000 (CanMEDS 2000). These core competences are divided into seven areas of competence. The
CanMEDS model refers to seven overlapping roles, in which the role of the ‘medical expert’ (in the case of the
pharmacist, ‘the pharmaceutical expert’) represents the core integrating role. We refer to ‘pharmaceutical
expertise as being the core role of the specialist community pharmacist. The other six roles are: communicator,
collaborator, scholar, health advocate, manager and professional. The considerable and necessary overlap
between these various roles and the core integrating role of the pharmaceutical expert are clearly visualised
in the CanMEDS diagram (see figure 4). Each of the seven areas of competence is further broken down into four
sub-competences. These have been formulated along the lines of the medical specialist advanced education
programmes as translated to the domain of community pharmacy. Section IV.1 provides a summary of these
sub-competences, followed by a detailed description in Section IV.2.
Figure 4 The CanMEDS diagram
Core competences of the

specialist community pharmacist
8
IV.1 Four sub-competences in the seven competence

areas of the specialist community pharmacist
1. Pharmaceutical Expertise
1.1. The specialist possesses up-to-date knowledge of and skills in the field.
1.2. The specialist correctly applies the full arsenal of his or her field of expertise, demonstrating efficacy,
safety and efficiency in the pharmacotherapy of individual patients.
1.3. The specialist provides effective and ethically responsible patient care.
1.4. The specialist swiftly finds the requisite information and correctly applies it to patient care and education.
2. Communication
2.1. The specialist builds effective treatment relationships with patients.
2.2. The specialist listens closely and attentively to patients and efficiently obtains relevant patient information.
2.3. The specialist discusses pharmaceutical and other medical information thoroughly with patients and
any family members.
2.4. The specialist provides proper verbal and written reports on patient cases.
3. Collaboration
3.1. The specialist consults with the pharmacy team and its members, colleagues, prescribers and other care
providers in an efficient manner.
3.2. The specialist provides proper referrals to the medical sector.
3.3. The specialist is an effective discussion partner for colleagues, including within the pharmacy team.
3.4. The specialist contributes to effective interdisciplinary collaboration and integrated care.
4. Scholarship
4.1. The specialist considers medical and pharmaceutical information from a critical perspective, has
knowledge of basic research methods and practises pharmacy in accordance with evidence-based
guidelines as far as possible.
4.2. The specialist promotes the expansion and development of scientific expertise.
4.3. The specialist develops and pursues a personal continuing education plan.
4.4. The specialist promotes the expertise of students, specialist community pharmacist trainees (ApIOS),
colleagues, patients and others involved in health care.
5. Health Advocacy
5.1. The specialist knows and recognises the most important determinants of disease and of medicine
use in particular.
5.2. The specialist promotes the health and correct use of medicine by patients and the community
as a whole.
5.3. The specialist acts in accordance with the relevant statutory provisions.
5.4. The specialist responds appropriately to care-related incidents.
6. Management
6.1. The specialist organises work so as to balance patient care and personal development.
6.2. The specialist works effectively and efficiently within a health care organisation.
6.3. The specialist spends the resources available for patient care in a responsible manner.
6.4. The specialist uses information technology to optimise patient care and for refresher training and
continuing education.
7. Professional
7.1. The specialist provides a high standard of patient care with integrity and in a sincere and engaged manner.
7.2. The specialist demonstrates proper personal and interpersonal professional conduct.
7.3. The specialist knows the limits of his or her own competence and acts within these limits.
7.4. The specialist practises pharmacy in conformity with the customary ethical standards of the profession.
9
IV.2 Description of the competence areas and

sub-competences
1. PHARMACEUTICAL EXPERTISE
Pharmaceutical expertise is the core competence and draws on all the other competences. Narrowly defined,
pharmaceutical expertise centres on professional expertise.
Description of the competence area
The specialist has oversight of the knowledge domain relevant to his or her own sphere of knowledge
and action and is capable of finding scientific pharmaceutical information swiftly and efficiently. He or she
systematically and continuously monitors the risks of medicine use using various methods and taking account
of all relevant clinical and pharmacotherapeutic data, and on the basis of these formulates reasoned hypotheses
for improved medicine use by individual patients. He or she monitors the quality of products intended for
individual patients. He or she possesses the manual skills required to apply specific medication, compound
medication and ensure product care. He or she is respectful of the wishes of patients and their families. He
or she adheres to standard working methods, proceeding from a reasoned and scientifically founded approach
to pharmacy/pharmacotherapy. The specialist makes appropriate use of medical pharmaceutical technology
as needed and is aware of the benefits and drawbacks associated with specific interventions.
General sub-competences of Pharmaceutical Expertise
1:1. The specialist possesses up-to-date knowledge of and skills in the field
This is the fundamental basis of all pharmaceutical expertise. This does not require ready encyclopaedic
knowledge, but sufficient knowledge, insight and the skills to provide efficient, high-quality patient care.
1:2. The specialist correctly applies the full arsenal of his or her field of expertise, demonstrating
efficacy, safety and efficiency in the medicine use of individual patients
This includes the ability to define a request for assistance, hear/record a relevant, concise and accurate case
history pursuant to such a request or in connection with an analysis of medicine use, following relevant
procedures for the collection, analysis and interpretation of data, compiling a targeted risk management
profile and determining the correct pharmacotherapeutic treatment needed to help resolve a patient’s
problem. It also includes monitoring the quality of products intended for individual patients.
1:3. The specialist provides effective and ethically responsible patient care
This entails the ability to take correct decisions based on an evaluation of pharmacotherapeutic options and
their limitations in terms of the burden to the patient and other constraints.
1:4. The specialist swiftly finds and correctly applies the requisite information
This includes knowing how to ask the right patient-related questions, systematically researching the literature
for validation and critically evaluating medical and pharmaceutical literature and other evidence, all with a
view to optimising pharmacotherapeutic or pharmaceutical decision-making.
10
2. COMMUNICATION
The specialist provides patients (or the patient’s representative) with the required and desired (and occasionally
unwelcome) information in correct, comprehensible and empathetic wording and observes the time and has
the patience needed to do so. He or she has the ability to give a concise verbal or written case report concerning
a disease, medicine use or compounding medication, formulating final or provisional conclusions and
remaining questions.
General sub-competences of Communication
2:1. The specialist builds effective treatment relationships with patients
This includes developing and maintaining good relations with patients (and their families) and cultivating an
environment characterised by understanding, trust, empathy and confidentiality.
2:2. The specialist is patient-focused, listens closely and attentively to patients and efficiently
obtains relevant patient information
This includes demonstrating interest in the patient’s ideas, concerns and expectations regarding the origins,
nature and treatment of their disease or pharmacotherapeutic problem. Specialists are able to accurately assess
the influence of factors such as age, gender, ethnic and cultural background, social network and emotions.
2:3. The specialist discusses pharmaceutical information thoroughly with patients and any family members
This entails the capacity to inform and advise patients in a sympathetic and respectful manner whilst
simultaneously promoting patients’ understanding of, and encouraging them to discuss and actively
participate in decisions relating to their treatment and particularly their medicine use. This involves the
ability to listen to patients with a view to assuring both them, their families of an optimum and consistent
level of patient care. It also requires verifying patients’ comprehension. Equally, it demands the skills to
maintain clear and accurate records. All of the above must be carried out in accordance with the applicable
statutory rules.
2:4. The specialist provides proper verbal and written reports on patient cases
During consultations, transfers and meetings about patients the specialist provides concise but accurate
summaries of patients’ pharmacotherapeutic and other pharmacotherapy-related problems, for example as
regards correct preparation methods, and explains and as necessary defends the proposed or implemented
strategy, and formulates clear questions for productive discussion with colleagues.
3. COLLABORATION
The specialist acknowledges limits in his or her knowledge, skills and experience, demonstrating in ways
including a willingness to consult with colleagues and through proper consultations or referrals provided
with a sense of personal engagement and the acceptance of responsibility. He or she has insight into the
consequences of his or her actions on other professionals involved in the care of the patient concerned and
furthermore works well as part of a team.
11
General sub-competences of Collaboration
3:1 The specialist consults with the pharmacy team and its members, colleagues, prescribers
and other care providers in an efficient manner
This entails the capacity to develop pharmacotherapeutic analysis and treatment strategies as well as follow-up
strategies in conjunction with patients and other care providers. It requires knowledge of the roles and
specialisms of the other involved parties, informing patients and their family members and including them in
decision-making, and explicitly accounting for the opinions of patients and care providers in treatment plans.
3:2. The specialist provides proper referrals
This presupposes insight into the limits of the specialist’s own expertise and capacities and familiarity with
the resources of other medical care disciplines and areas of expertise within the field of patient care.
3:3. The specialist is an effective discussion partner for colleagues, including within the pharmacy team
This includes the ability to present thoroughly substantiated verbal and written evaluations and
recommendations following meetings with colleagues in the pharmacy team, colleagues or other care
providers.
3:4. The specialist contributes to effective interdisciplinary collaboration and integrated care
This includes insight into the integrated care of individual patients, effective communication with other care
providers and familiarity with activities carried out at hospitals, doctor’s surgeries, in committees, and at
research, teaching and knowledge institutions, among others. It also implies an ability to distinguish the
specialisms of other team members, a respectful attitude towards the opinions and roles of individual team
members, contributing to healthy team development and conflict resolution and contributing individual
expertise to help fulfil team tasks. This general competence also includes taking all necessary steps to ensure
the safe transfer of patient information and taking responsibility for patient care continuity.
4. SCHOLARSHIP
The specialist has the ability to distinguish the numerous scientific aspects as intermeshed with the medical
pharmaceutical practice, to view these from a critical perspective and possibly develop scientific research
questions on the basis of personal observation and experience, and actively pursues and organises refresher
and continuing education in accordance with current views on education, quality assurance and continuous
professional development.
General sub-competences of Scholarship
4:1. The specialist considers information from a critical perspective
This competence is about working in conformity with the spirit of scientific research and using rational
grounds to make medical pharmaceutical decisions. Similar to pharmaceutical expertise, this competence
includes the ability to ask the right questions, to efficiently research the literature for and assess the quality of
validating evidence and to keep abreast of validated care standards for the most common disorders
encountered at his or her practice.
4:2. The specialist promotes the expansion and development of scientific expertise
Though not every specialist conducts independent scientific research, they must nevertheless possess the skills
needed to take part in collaborative research projects, quality assurance and in developing guidelines that are
relevant to medical and pharmaceutical practice.
12
4:3. The specialist develops and pursues a personal continuing education plan
This entails taking charge of determining personal learning needs and includes setting personal learning
objectives, choosing suitable learning methods and evaluating personal learning outcomes with a view to
optimising personal practice.
4:4. The specialist promotes the expertise of students, specialist community pharmacist trainees
(ApIOS), colleagues, patients and others involved in health care
This includes educational and other activities designed to train younger generations in the pharmaceutical
profession. It entails helping others determine their learning needs and development pathways, giving
constructive feedback and applying the principles of adult knowledge acquisition when interacting both with
students and specialist community pharmacist trainees (ApIOS) as well as with patients, colleagues and others
involved in health care.
5. HEALTH ADVOCACY
Specialists are members of society and must remain conscious of their role as public health advocates, and in
doing so respond to the challenges of the social, environmental and biological factors which affect the health
of patients and society overall. The specialist understands that advocacy plays a key part in promoting health at
the patient, practice and community level. Specialists promote health through their individual and collective
actions to influence policy and public health.
General sub-competences of Health Advocacy
5:1. The specialist knows and recognises the most important determinants of disease and medicine use
in particular
This includes the ability to recognise, assess and respond to key psychosocial, economic and biological factors
affecting patient health and particularly medicine use (efficacy and safety). The specialist assimilates
information about health determinants in individual and community patient care. At the level of the
pharmacist/patient relationship, this involves (1) the ability to adapt patient treatments and information with
a view to promoting patients’ overall health and their use of medicines in particular, and to increase their
understanding of proper procedures, particularly as these relate to the use of medicines and (2) helping
patients to learn to cope with illness and in particular to promote the use of medicines to this end and to foster
active participation in the pharmacotherapeutic decision-making process. At the societal level this involves (1)
identifying risk groups and recognising societal developments that can influence public health and medicine
use in particular, (2) identifying relevant government policies and (3) where appropriate, contributing to
policies beneficial to public health and to medicine use in particular.
5:2. The specialist promotes the health and correct use of medicine by patients and the community
as a whole
This includes the application of pharmaceutical expertise in situations not directly related to patient care,
such as when issuing statements as a pharmaceutical expert or holding presentations.
5:3. The specialist acts in accordance with the relevant statutory rules
The specialist keeps abreast of the relevant prevailing statutory rules and practises in conformity with his or
her own legal position and that of patients, also as regards the duty of professional confidentiality, and
understands the consequences for his or her provision of pharmaceutical expertise.
13
5:4. The specialist responds appropriately to care-related incidents
The specialist correctly identifies incidents in patient care and product care, detects personal errors and the
errors of others and has learned to discuss and manage these with a view to implementing an effective policy
in the given situation, to learning from the incident, to preventing its recurrence and to the interests of the
patient. The specialist is familiar with the standard medical pharmaceutical procedures for reporting incidents
and knows how to respond to complaints relating to patient care.
6. MANAGEMENT
In their daily decisions about tasks, policy, staff and resources, specialists must also be effective managers.
Such decisions are made in connection with individual patient care, professional organisations and in the
broader context of the health-care system as a whole. The specialist must therefore have the ability to set
priorities, work efficiently as part of a team of colleagues and make rational decisions about the deployment
of limited resources. Specialists may also take a position at the head of a health-care organisation. In that case,
the specialist has oversight of the myriad of associated interests and aspects that factor into patient care (such
as administrative, financial/economic and management-related) and manages these in an ethically, legally and
economically responsible manner.
General sub-competences of Management
6:1. The specialist organises work so as to balance patient care and personal development
This includes effectively using time-management and self-evaluation skills to formulate realistic expectations
and develop a balanced lifestyle.
6:2. The specialist works effectively and efficiently within a health-care organisation
This refers to insight into the roles and responsibilities of specialists and organisations involved in and
mechanisms driving the health-care system and societal relationships. It includes the ability to work efficiently
in a team of colleagues, to lead a practice, and to work as part of a broader organisational management
structure or as a representative within the national health-care system.
6:3. The specialist spends the resources available for patient care in a responsible manner
Though the patient’s interests always come first, the specialist must be able to fully weigh the pros and cons of
allocating medicines in terms of the benefit to individual patients and the population at large.
6:4. The specialist uses information technology to optimise patient care and for refresher
training and continuing education
This includes the ability to use patient-related databases and electronic information and understanding the
fundamentals of medical pharmaceutical information technology so as to provide the best possible patient
care and maintain personal professional expertise.
14
7. PROFESSIONAL
Specialists have a unique social role as professionals whose specific expert knowledge, skills and conduct
are aimed at improving the health and well-being of others. Specialists strive to meet the highest possible
standards in pharmaceutical care and ethical conduct and also continually engage in perfecting their
expertise. The specialist uses moral and ethical considerations to decide whether or not to commence or
continue pharmaceutical interventions, and is able to substantiate these decisions. The specialist has the
ability to empathise with the patient’s questions, culture and living conditions to enable him or her to gain
a good understanding of the patient, but can still discern and distinguish his or her own feelings. He or she
understands the complexity of supervising patients who are at the end of life and acts accordingly. The
specialist is able to reflect critically on his or her own competence and professionalism.
General sub-competences of Professionalism
7:1. The specialist provides a high standard of patient care with integrity and in a sincere
and engaged manner
This includes the awareness that the patient is of central importance. Also, the ability to discern and adapt to
diversity in ethnic and cultural backgrounds and social issues that can impact the provision of patient care,
and to maintain and expand relevant knowledge, skills and professional conduct.
7:2. The specialist demonstrates proper personal and interpersonal professional conduct
This includes taking responsibility for personal actions, self-awareness, maintaining a proper balance between
personal and professional roles and addressing interpersonal differences in professional relations.
7:3. The specialist knows the limits of his or her own competence and acts within these limits
This includes determining if and when other experts need to be called in to contribute to the provision of care
to a patient.
7:4. The specialist practises pharmacy in conformity with the customary ethical standards
of the profession
This includes an understanding of and adherence to the ethical and medical pharmaceutical code of conduct,
the ability to recognise ethical dilemmas and when to call in assistance to resolve these, and the ability to
recognise and respond to unprofessional conduct at other health-care providers, with due regard for local
and national rules and regulations.
15
V Task areas and operationalisation of the specialist

community pharmacist competences
The activities performed by a specialist community pharmacist are broken down into components based on
shared features, and as such form recognisable elements in the education programme. These recognisable
elements are designated as ‘task areas’. The education programme has, as it were, been broken down on the
basis of task areas corresponding to the specialist’s duties. The task areas provide an overall rather than a
detailed educational plan. They do, in fact provide the concrete building blocks for the education programme,
and provide specialist community pharmacist trainees (Apothekers in Opleiding tot Openbaar Apotheker
Specialist, or ApIOS), clarity on the areas of the education programme they should focus on. These task areas
help to structure the development of competences by linking competences to task areas. The ten task areas are
described below. The description of each task area is followed by a text linking the task area to the CanMEDS
competence areas and is referred to as the operationalisation of the competence area.
Task area 1. Patient communication and counselling
Description of task area 1

Providing verbal information to a patient takes centre stage when dispensing medicines and medical aids.
The provision of information and counselling should be based on the expectations and needs of the patient.
When dispensing medicines and medical aids to patients for the first time, it is key to actively assist the pa-
tient in using the prescribed medicine. In any event this includes explaining the effect of the medicine, the
main side effects and how the medicine should be taken. The user's experience should be discussed particu-
larly when dispensing the medicine for the second time, and on subsequent occasions, including adherence
to medication (proper use), the side effects, difficulty in swallowing and the use of medicine combined with
daily activities. The pharmacist evaluates use together with the patient. There are specific issues that only
come to light when talking to the patient, such as the incorrect use of the medication as a result of failure to
understand the medication or aversion to, or fear of a specific medicine. In communicating with and coun-
selling the medicine user, the pharmacist should always bear in mind that many people have difficulty in ac-
cepting the use of medication, which over time may lead to non-adherence to medication if inadequate com-
munication is provided. For specific groups of patients, specific consequential aspects are attached to patient
counselling. Examples of such groups are children, care home residents, patients with psychiatric or cogni-
tive problems, home care and palliative care patients. One particular form of information provision involves
giving instructions concerning the use of dosage forms that require special patient skills, e.g. inhalation aids,
insulin and eye drops. Consequently, the instructions may also be directed to carers or the home care nurse.
The provision of written information supports and complements verbal information. Although the provision
of written information is laid down by law in the form of government-approved instruction leaflets issued by
the manufacturer, pharmacists provide supplementary non-conflicting written information. During patient
communication the pharmacist takes account of the aspect of privacy. In addition to providing information
when dispensing medicines or medical aids, information concerning the organisation of pharmaceutical
care, including the procedure, the services offered and the pharmacy’s privacy policy should also be given.
16
Competence area Operationalisation of the competence area:

Specialist community pharmacist trainee (ApIOS)
Pharmaceutical • When dispensing medicine for the first time, has sufficient knowledge to be able
expertise to explain its effect, the main side effects and how the medicine is used.
• When dispensing the medicine a second time and on subsequent occasions, has
sufficient knowledge to be able to interpret and explain the patient’s experi-
ence with the use of the medicine (adherence to medication, any side effects,
difficulty in swallowing the medicine, and using the medicine in combination
with 18 daily activities).
• Has sufficient knowledge to be able to advise and assist specific patients, such
as children, care home residents, patients with psychiatric or cognitive prob-
lems, and home care and palliative care patients.
• Has sufficient knowledge and skills to be able to provide instructions concern-
ing special dosage forms (e.g. inhalation aids, insulin and eye drops).
Communication • Builds an effective treatment relationship with patients keeping their social,
psychological and cultural backgrounds in mind.
• Is patient-focused, listens closely and attentively to the patient and obtains and
interprets relevant patient health information, which is important when com-
municating about the medicine the first time it is dispensed.
• Is patient-focused, listens closely and attentively to the patient and obtains and
interprets relevant patient health information, which is important when com-
municating about the medicine the second time it is dispensed or on subse-
quent occasions (evaluates use of the medicine).
• Discusses the pharmaceutical information, including information about the
risks involved, in a comprehensible manner with the patient or the patient’s
carer.
• Makes available written information to support the verbal information.
• Communicates how pharmaceutical care is organised, such as the procedure,
the services offered and the pharmacy’s privacy policy.
• During communication with the patient or the patient’s carer always verifies
whether the information has been understood and asks whether they have any
further questions.
Collaboration • When communicating with and counselling the patient, works with pharmacy
staff, prescribers and other care providers, such as home care nurses.
Scholarship • Has knowledge of communication skills and discussion techniques and applies
these in practice.
• Is familiar with and follows specific guidelines for dealing with the drug inter-
actions as well as contraindication monitoring.
• Is familiar with and employs general medical and pharmaceutical resources,
such as instructional leaflet texts, Farmacotherapeutisch Kompas (a Dutch ref-
erence book on the appropriate use of medicines for health care professionals),
Informatorium Medicamentorum (a Dutch reference book of all medicines in
the Netherlands, for both registered and unregistered use), and Recep-
teerkunde (a Dutch book dealing with product care and the compounding of
medication).
• Has knowledge of and follows professional guidelines and standards containing
sections devoted to the use of pharmacotherapy in treating disease/disorders,
e.g. the standards issued by the Dutch College of General Practitioners (NHG),
consensus texts issued by the Quality Institute for the Health Care Sector in the
Netherlands (CBO) and Farmacotherapeutisch Kompas.
• Continuously monitors advances in scientific knowledge in the field of phar-
macy and pharmacotherapy.
Health advocacy • Knows and recognises the main determinants of disease and the incorrect or
problematic use of medicine, including difficulty in accepting the use of medi-
cation (non-adherence to medication).
• Knows the legal requirements concerning the provision of written information.
• Duly observes the relevant laws, such as the Medical Treatment Contracts Act
(Wet op de Geneeskundige Behandelingsovereenkomst, WGBO) and the Per-
sonal Data Protection Act, (Wet Bescherming Persoonsgegevens, WBP).
17
Management • Instructs and manages pharmacy staff to ensure effective patient communica-
tion and counselling.
• Makes agreements with prescribers and other care providers concerning
patient communication and counselling, and acts accordingly.
• Uses information technology to enhance patient communication.
• Records patient communication in the patient’s record.
Professional • Communicates with integrity in an engaged and sincere manner with the
patient or the patient’s carer.
• Knows the limits of his or her own level of competence and acts within these
limits.
• Demonstrates appropriate professional conduct towards the patient or the
patient’s carer.
Task area 2. Health-care questions from patients and the general public

In this task area the patient - who often does not have a prescription - seeks to communicate with the
pharmacist or pharmacy team. The pharmacy may have to deal with a wide range of health-care questions,
including those relating to medicines supplied under the supplementary health insurance scheme, phar-
macy and chemist-only drugs, pharmacy-only drugs, or patient self-care in general. Other queries relate to
prescription-only medicines (insulin and oral contraceptive medicine), incontinence products, a side effect,
possible poisoning, pharmaceutical care, the use of medicine or medical aids prior to, during or after admis-
sion to hospital, travel vaccination, a request to fill in a travel passport or a Schengen declaration for medi-
cines, or a request for a second opinion. The pharmacist assesses the problem or the health-care question
in the context of the information available on the patient (in the electronic patient record (EPR) and/or the
patient’s current symptoms, complaints, disorders and current forms of treatment, including pharmaco-
therapy. The pharmacist communicates with the patient to obtain a clear understanding of the health-care
question, such as asking self-care patients the ‘WHAM’ questions. In general the basic format for conducting
a consultation is as follows (six phases): analyse the patient’s problem, set a treatment goal, determine the
relevant treatment options, and use this as a basis to determine a choice of treatment tailored to the patient
providing supporting arguments, perform the treatment (medical or non-medical), and lastly perform fol-
low up. The outcome of the pharmaceutical or pharmacy consultation may involve referral to a doctor, who
usually also is the prescriber, or another care provider. Documentation should be provided for non-regular
clients to ensure that their medical records or patient record remains updated.

Pharmaceutical • Has a broad knowledge of the field of pharmacotherapy and non-pharmaco-
expertise therapy, such as the domain of self-care, medical aids and travel vaccination.
• Has the skill to respond to health-care questions in a process-oriented manner.
• Has the ability to locate the required information swiftly in order to respond to
the health-care question.
Communication • Is patient-focused and listens closely and attentively to the person asking the
question to ensure that he clearly understands the health-care question.
• Discusses the outcome of the health-care question thoroughly with the person
asking the question properly and with the patient in mind.
Collaboration • Works with pharmacy staff when responding to health-care questions.
• When responding to health-care questions refers to other care providers, where
necessary.
• Works with The Netherlands Pharmacovigilence Centre Lareb when dealing
with and reporting a side effect.
• Works with the Area Health Authority (GGD), general practitioner (GP) or hospi-
tal concerning travel vaccination information.
18
Scholarship • Knows the evidence-based guidelines for diseases and the relevant pharmaco-
therapy for these diseases, including the guidelines for self-care patients.
• Knows the specific evidence-based guidelines relevant to the provision of phar-
macy-only drugs. Has knowledge of how to deal with and report possible side
effects (including Lareb) and medication errors.
• Is familiar with and employs the resources relevant to travel vaccination,
poisoning and the care and treatment of drug addicts.
• Develops the required academic expertise and skills in order to respond appro-
priately to health-care questions, including the less familiar clinical features,
off-label use and orphan drugs.
Health advocacy • Knows and recognises the most important determinants of disease and the
incorrect or problematic use of medicine.
• Understands the potential risks involved for patients using medicine.
• Takes appropriate action in the event of the risk of a potential health hazard
for the patient.
(Wet op de Geneeskundige Behandelingsovereenkomst, WGBO) and the Per-
sonal Data Protection Act, (Wet Bescherming Persoonsgegevens, WBP).
Management • Instructs and supervises pharmacy staff to ensure they can respond optimally
to health-care questions, particularly those concerning self-care. Makes agree-
ments about responding to health-care questions, including self-care, with
prescribers and other care providers and acts accordingly.
• Uses the medication surveillance module in the pharmacy information system
to identify pharmacotherapy-related problems relevant to self-care products, in
any event for the pharmacy-only type.
• Records the health-care question, the care process and results thereof in the
patient’s record.
Professional • Responds to the health-care question with integrity, in an engaged and sincere
manner,
limits.
• Demonstrates appropriate professional conduct towards the person asking the
question.
Task area 3. Medication surveillance910

The pharmacist can identify any pharmacotherapy-related problems the patient may have at various stages
in the care process. For instance, when issuing a prescription, supplying a self-care medicine, while talking
to a patient or when checking the prescription and checking the medication surveillance alerts, which is
referred to as the final check. For the purpose of medication surveillance the pharmacist uses tools such as
the medication surveillance module on the pharmacist’s computer, which detects a pharmacotherapy-relat-
ed problem by generating a computerised alert. Examples are dosage-related problems, drug interactions,
contraindications9, intolerance, double medication, medicines prescribed on incorrect or irrational phar-
macotherapeutic grounds, off-label use, medication prescribed for the wrong patient, omitted medicines10,
medication adherence problems, overuse, underuse, use for too long a time, use for too short a time and
technical issues with the use of the medicine. The problem may arise with the prescriber of the medicine
or the user. The pharmacist is conversant with the checking options provided in the pharmacy information
system and incorporates his or her own appropriate checks, as required. The pharmacist interprets - and pri-
oritises, if required – the problems identified in line with the guidelines set out for correctly responding to
medication surveillance alerts using clinical and laboratory data. The pharmacist reaches a decision on how
to respond to the problem and discusses his or her proposal, stating reasons as appropriate, with the general
practitioner and/or the patient. The pharmacist records his or her ultimate response in the patient’s record.
9 Includes: disorders, reduced kidney function, pharmacogenetic parameters, pregnancy and breast feeding.
10 Where the word ‘medicine’ appears in the text, in some cases it also means ‘medical aid’.
19

Pharmaceutical • Responds to pharmacotherapy-related problems systematically, including those
expertise found via ICT (medication surveillance alerts): dosage-related problems, drug
interactions, contraindications, intolerance, double medication, medicines pre-
scribed on incorrect or irrational pharmacotherapeutic grounds, off-label use,
medication prescribed for the wrong patient, omitted medicines, medication
adherence problems, overuse, underuse, use for too long a time and use for too
short a time.
• In responding to pharmacotherapy-related problems, takes account of the
potential risk factors, such as comorbidity, clinical-chemical parameters,
pharmacokinetic and pharmacogenetic data sets and suchlike.
• Checks prescriptions and the corresponding medication surveillance alerts
upon completion of the prescription process.
• Performs medication surveillance when compounding medication based on a
prescription using pharma raw materials or adapting a commercial product.
Communication • Consults with the patient or the patient’s carer in a clear and comprehensible
manner (and provides reassurance as appropriate) in the event of pharmaco-
therapy-related problems arising from a prescription or the outcome of an
intervention.
Collaboration • Works with pharmacy staff when performing medication surveillance.
• When performing medication surveillance collaborates with prescribers,
on a one-off basis, and where possible on a regular basis.
• Intervenes as appropriate in response to medication surveillance alerts and has
the ability to determine an alternative pharmacotherapy policy in consultation
with the prescriber.
• When performing medication surveillance works with care providers other
than prescribers, such as the Thrombosis Service.
Scholarship • Is familiar with and follows specific guidelines in dealing with drug interac-
tions and contraindication monitoring.
• Is familiar with and employs general resources in order to respond to medica-
tion surveillance issues, such as instructional leaflet texts, Farmacotherapeu-
tisch Kompas and Informatorium Medicamentorum.
• Is familiar with and follows professional guidelines and standards providing
sections devoted to the use of pharmacotherapy in treating disease, e.g. the
standards issued by the Dutch College of General Practitioners (NHG), consen-
sus texts issued by the Quality Institute for the Health Care Sector in the Neth-
erlands (CBO) and Farmacotherapeutisch Kompas.
• Continuously monitors developments concerning scientific expertise in the
field of pharmacotherapy-related problems and how to respond to these
problems.
Health advocacy • Understands the potential risks involved for patients using medicine.
• Takes appropriate action in the event of the risk of a potential health hazard
for the patient.
(WGBO) and the Personal Data Protection Act, (WBP).
Management • Complies with the rules and procedures for responding to problems identified,
including delegation to assistants (levels of response and consultation with
prescribers and the Thrombosis Service).
• Instructs and manages pharmacy staff to ensure good medication surveil-
lance practice.
• Makes agreements with prescribers and other care providers concerning
medication surveillance and acts accordingly.
• Uses the medication surveillance module in the pharmacy information system
in order to identify pharmacotherapy-related problems.
• Records the outcome of the response to pharmacotherapy-related problems in
the patient’s record in the correct manner.
20
Professional • Performs medication surveillance with integrity, in an engaged and sincere

manner,
limits.
• Demonstrates appropriate professional conduct towards the doctor and the
patient.
Task area 4. Periodic medication review

A proactive and periodic review of pharmacotherapy is essential, particularly for at-risk patients, such as
elderly and polypharmacy patients and of at-risk points in time, e.g. admission to or discharge from hospi-
tal. Patients eligible for a medication review are recommended by their general practitioner, the home care
provider, the carer, and other prescribers or are selected by the pharmacist when processing the prescription
or by performing searches on the computer. The patient may also take the initiative to have a medication re-
view performed. There are a range of sources for gathering data for the purpose of ultimately formulating a
treatment plan: the patient’s record available at the pharmacy (containing details of medication and clinical
data), the patient’s details which are available to the prescriber (their medical history and clinical data), and
by talking directly to the patient. Information can be obtained when the pharmacist and, in turn, the patient
contacts the doctor. One way of collecting information in order to gain an idea of potential problems is to
perform searches. A medication review can be performed on the basis of the above information. The identi-
fied drug-therapy related problems are prioritised and incorporated in the treatment plan, in collaboration
with the responsible prescriber. The patient’s record should be updated accordingly. The periodic medication
review takes place on the basis of a Continuum of Care for the individual patient, and therefore includes ad-
equate follow-up. (A special type of periodic medication review is the prescribing and protocol-led processing
of repeat medicines by the pharmacist).

Pharmaceutical • Selects at-risk patients and at-risk points in time for the purpose of conducting
expertise a periodic medication review.
• Has the ability to collect and assess information about the patient from the
patient’s record as part of a periodic medication review.
• Has the ability to collect and assess information about the patient recorded by
the doctor in the patient’s record as part of a periodic medication review.
• Has the ability to collect and assess information about the patient by talking to
the patient or the patient’s carer as part of a periodic medication review.
• Assesses the information collected as part of a periodic medication review.
• Prioritises the identified pharmacotherapy-related problems.
• Translates pharmacotherapy-related problems into recommendations for the
purpose of formulating a pharmaceutical treatment plan.
• Records the treatment plan in the patient’s record in the appropriate manner.
Communication • Communicates the intent and outcomes of the periodic medication review in a
clear and comprehensible manner to the patient and/or the patient’s carer.
• Is patient-focused, listens closely and attentively to the patient and effectively
obtains information relevant to the patient.
Collaboration • Works with the prescriber to obtain the information required for the medica-
tion review.
• Discusses the identified pharmacotherapy-related problems and the corre-
sponding recommendations in the appropriate manner with the prescriber/
doctor as part of a pharmaceutical treatment plan.
• Makes clear agreements with the doctor about the action to be taken.
• Makes referrals in a timely manner as appropriate, if required during the
review process.
• Works with pharmacy staff to obtain the information required for the medica-
tion review.
21
Scholarship • Knows the evidence-based guidelines specific to the pharmacotherapy of dis-

eases.
• Develops the required scientific knowledge and skills in order to competently
perform the periodic medication review.
Health advocacy • Knows and recognises the most important determinants of disease and the
incorrect or problematic use of medicine.
• Promotes the health of a specific group of patients by performing a periodic
medication review, in which the balance between effectiveness and harmful-
ness could be at issue due to the nature of the disease and/or the use of medi-
cine.
• Acts in accordance with the relevant statutory provisions, such as those under
the Medical Treatment Contracts Act (WGBO).
Management • Guarantees that the medication review and the treatment plan form part of
the regular care provided to the patients referred to.
• Ensures that this activity is organised such that is performed effectively and
efficiently within the pharmacy organisation.
Professional • Performs the periodic medication review with integrity, in an engaged and sin-
cere manner.
• Demonstrates appropriate professional conduct towards the patient and the
doctor.
limits.
Task area 5. Consultation with colleagues11

The pharmacist consults regularly with a pharmacy staff member about individual patients. Consultations
are held regularly with prescribers, such as the general practitioner, but occasionally with another doctor or
the Thrombosis Service as well. The reason for a consultation usually is a problem with a prescription. The
pharmacist also consults with other care providers, such as the medical assistant, the general practitioner’s
support staff, the prescribing nurse, the clinical chemist or the hospital pharmacist. It may also be neces-
sary to consult with other parties, such as the home care provider. Topics that might be discussed during the
consultation are: the course of the disease, the therapeutic effect or side effects of a medicine, drug interac-
tions, user problems11, biomarkers , the medication review and agreements made in the treatment plan. The
pharmacist also holds regular consultations with doctors (pharmacotherapy consultation, FTO) and possibly
other care providers (pharmaco integrated care consultation, FKO). The key themes include the development
of formularies, including implementation in ICT, the application of medical and pharmaceutical standards
and efficiency. Joint activities in the area of pharmaceutical patient care, the development of integrated
health care and care groups, including implementation therefore, could also come up for discussion both
during and outside the pharmacotherapy consultation. The aim of the latter consultation is to make agree-
ments with colleagues, provide feedback on prescriber data and monitor agreements.

11 A new term, which includes clinical-chemical values, plasma levels in medicines and clinical values, such as blood pressure and genetic data.
22
Pharmaceutical • Analyses pharmacotherapy-related problems and transcribes these into recom-

expertise mendations for the purpose of consultation with colleagues.
• Includes in the analysis and the recommendation the appropriate information
about the course of a disease, the therapeutic effect or side effects of a medi-
cine, drug interactions, user problems, biomarkers, the medication review and
agreements made in the treatment plan.
• Has the ability to prepare and present a topic during regular consultation
meetings.
• Contributes to the adoption of agreements made with colleagues and records
these in documents, such a formulary.
• Generates, analyses and ensures that feedback is provided on prescription data.
• Monitors agreements made with colleagues in the course of time and provides
feedback.
Communication • Has the ability to communicate the outcome of consultations with other care
providers to the patient or the patient’s carer.
Collaboration • Consults effectively about care for individual patients with other care provid-
ers, such as the GP, the medical assistant, the GP’s support staff, the prescrib-
ing nurse, the clinical chemist, the hospital pharmacist and the home care pro-
vider.
• Provides effective input during consultations with doctors – and occasionally
with other care providers – on pharmacotherapy policy, including during the
pharmacotherapy consultation (FTO).
• Works with pharmacy staff to ensure the effective transfer of patient health
information during individual clinical consultation on a patient with another
practitioner.
Scholarship • Uses evidence-based information during one-off and regular consultations with
other care providers.
• Promotes the expertise of other care providers as well as his or her own exper-
tise during regular consultations.
• Monitors relevant developments in the area of medical and pharmaceutical sci-
ences, guidelines, etc.
Health advocacy • Acts appropriately in compliance with the provisions laid down by law, includ-
ing privacy laws and the Medical Treatment Contracts Act (WGBO).
• Allows the efficiency factor (the lowest possible costs for the highest possible
quality) to play a part during consultations with other care providers in line
with responsible business practice.
Management • Appropriately implements in the pharmacy organisation the agreements made
during the consultations with other care providers.
• Uses supporting information technology, such as searches.
• Understands the role and expertise required of pharmacy staff, and makes
agreements concerning individual clinical consultations conducted by phar-
macy staff members with another practitioner (delegation of duties).
Professional • Holds consultations with colleagues with integrity, in an engaged and sincere
manner.
• Demonstrates appropriate professional conduct towards the doctor (and the
patient).
limits.
23
Task area 6. Preventive care and screening

Pharmacists provide general information to specific groups of patients, such as those suffering from mi-
graine or diabetes, the elderly, or in general to schools. Pharmacists may do so in conjunction with other
care providers or on an individual basis. The general information could relate to medicine, self-care, travel
or other types of vaccinations as well as medical aids or lifestyle. General information focusing specifically
on the primary prevention of disease is also given, i.e. how to stop smoking (cardiovascular diseases) or how
to deal with obesity (diabetes). Pharmacists can be deployed to screen the state of health of specific at-risk
groups. This involves measuring risk factors, such as blood pressure, cholesterol, glucose levels, etc. which is
performed in consultation with general practitioners as far as possible.

Pharmaceutical • Has sufficient knowledge of the areas on which general information is pro-
expertise vided.
• Has sufficient knowledge of the prevention of the diseases on which informa-
tion is provided.
• Is familiar with and the skills required to screen risk factors.
Communication • Communicates general information in the appropriate manner to the selected
target groups.
• Communicates the limits of the screening methods to the client.
• Communicates the meaning of the screening outcomes to the client.
Collaboration • Consults and where possible collaborates with other care providers or patient
organisations on the provision of general information, the prevention of dis-
ease and the use of screening methods.
• Works with pharmacy staff in the area of preventive care and screening.
• Makes referrals to other care providers following the provision of general infor-
mation, preventive care and screening.
Scholarship • Knows the evidence-based guidelines for diseases and the pharmacotherapy for
these diseases as set out in the relevant guidelines.
• Knows the evidence-based guidelines concerning the use of screening.
• Knows the limits of diagnostic screening methods.
Health advocacy • Knows and recognises the determinants of disease and the incorrect or prob-
lematic use of medicine.
• Promotes the health of patients and the community in general.
• Acts in accordance with the relevant statutory provisions, such as those under
Management • Ensures that the activities are organised such that they are performed effec-
tively and efficiently within the pharmacy organisation.
• Ensures that the activities referred to are organised as effectively and effi-
ciently as possible in collaboration with other care providers or with patient
organisations.
• Records patient screening and the results thereof in the patient’s record.
Professional • Provides general information, information concerning the prevention of dis-
ease and the use of screening methods with integrity, in an engaged and sin-
cere manner.
• Demonstrates appropriate professional conduct towards the patient and doctor.
limits.
24
Task area 7. Collection and management of patient data

The pharmacist collects and manages patient data in the pharmacy information system to ensure effective
medication surveillance and patient counselling, as well as for administrative purposes. The data collected
comprises personal data (address and insurance details) and specific information, such as medication in-
formation, clinical information (conditions, diagnoses, symptoms and clinical-chemical data), cultural and
psychosocial information, and care activities performed by the pharmacy. Information is collected with the
patient's assistance and/or by other care providers by exchanging or transferring the relevant information
(via the Open Care Information System - OZIS, and the national centre that offers access to patient health
information - LSP), with due observance of the privacy rules and having regard to the guideline concerning
the safe transfer of medication information. The pharmacist builds up a patient record in which the relevant
information has been incorporated and can be used effectively. The pharmacist is familiar with the holder-
ship/ownership principle of patient records – with the launch of the national electronic patient record (EPD)
– and informs the patient thereof as required. Patients may be given access to their patient record.
The pharmacist has documented what information should or should not be included in the patient record.
Care activities are also coded as far as possible for the purpose of retroactive analysis.

Pharmaceutical • Is familiar with keeping patient records.
expertise • Collects, documents and manages relevant and current patient health informa-
tion.
• Has the ability to exchange patient health information with other care provid-
ers to ensure the continuity of the pharmacotherapy.
• Uses the health information in the patient’s record effectively for the purpose
of medication surveillance and patient counselling.
• Is familiar with the coding of care activities.
Communication • Effectively communicates and discusses medical and pharmaceutical informa-
tion with the patient or the patient’s carer.
• Effectively acquires the relevant patient health information.
• Explains to the patient or the patient’s carer that information has been
recorded in the patient’s record, including the duty of confidentiality, and has
the ability to deal with the patient’s objections to having the information
placed on record.
• Explains the exchange of health information among care providers to the
patient or the patient’s carer, including the duty of confidentiality.
• Makes clear to the patient or the patient’s carer that they have the right to
access the patient’s health information.
Collaboration • Consults with other care providers, including pharmacist colleagues, concern-
ing the exchange of patient health information.
• Works well with pharmacy staff in performing these activities.
Scholarship • Is familiar with the guideline for the safe transfer of medication information.
• Is familiar with the ICT parameters binding the pharmacy’s own information
system and the exchange of information.
• Has the ability to analyse coded care activities.
Health advocacy • Is familiar and acts in accordance with the regional and national formats and
standards applicable to patient records.
• Is familiar and acts in accordance with the privacy laws applicable to patient
records.
• Is familiar and acts in accordance with the statutory provisions laid down in
25
Management • Instructs and supervises pharmacy staff in collecting and managing patient
health information, including treating privacy-sensitive information as confi-
dential.
• Uses the pharmacy information system to optimise management of patient
health information.
• Shares patients’ health information electronically to optimise patient care.
Professional • Acts with integrity, is engaged and sincere in collecting, recording and
transferring patient health information.
Task area 8. Product care

Product care entails ensuring the availability of the proper medicine until such time as it is dispensed. In
other words, the pharmacist ensures that the required medicine is available in the correct form, for the cor-
rect patient and that it complies with the required quality standards. The pharmacist should judge whether
the prescribed medicine is easy to administer and sufficiently user-friendly. Storing medicines in the phar-
macy and delivering medicines to the patient form part of regular product care. It also means providing
instructions on storage conditions and handling products outside the pharmacy, at the patient’s home or
care institution. Special activities may occasionally need to be performed in order to make available medi-
cines and medical aids, such as locating medicine suppliers, for orphan drugs for instance, which cannot be
obtained through the usual distribution channel. The medicine may need to be compounded using pharma
raw materials. Prior to compounding the pharmacist weighs the rationality and quality in terms of pharma-
cotherapy, and the pharmaceutical quality and the feasibility of the request. He or she will propose an al-
ternative in consultation with the prescriber. To create an easy-to-administer medicine, the pharmacist may
need to adapt a commercial product, such as turning tablets into capsules. Product care also involves com-
pounding medication for administration. This activity is performed both inside and outside the pharmacy,
at the patient's home or in the care institution and, for example, involves working with parenterals, enteral
feeding tubes, grinding tablets or measuring the correct dosage with a dose syringe. The information and
instructions relate not only to the methods used for the activities but also acquiring mathematical skills and
knowledge of hygiene. Pharmacists must ultimately be able to perform a recall procedure for all products.
Product care covers the whole of the integrated care spectrum. In performing product care the pharmacist
works with other care providers, patients or carers, suppliers of pharma raw materials, medicines and medi-
cal aids and with compounding pharmacies.

Pharmaceutical • Makes medicines and medical aids available in a timely manner.
expertise • Weighs rationality and quality in terms of pharmacotherapy before compound-
ing medication.
• Assesses the pharmaceutical quality before compounding medication.
• Assesses the feasibility of the request concerning the compounding of medica-
tion prior to doing so.
• Has the ability to draw up a protocol and/or work instruction for compounding
medication based on pharma raw materials.
• Compounds medicine based on pharma raw materials.
• Makes available a medicine by adapting a commercial product.
• Compounds medication that is to be administered to a patient both at the
pharmacy and outside the pharmacy.
• Assesses whether the prescribed medicine is sufficiently user-friendly or suit-
able for administering to a patient.
• Ensures that medicines are stored safely in the pharmacy and during delivery
to the patient, and advises the patient on how to store the medicine.
• Performs recall procedures.
26
Communication • Communicates effectively about the aspects of product care with the patient or
the patient’s carer, for instance on how to order the medicine, compound the
medication and a possible change in the prescribed product.
• Ensures that instructions are provided about the product dispensed to ensure
that it is used effectively.
• Ensures that instructions are provided about the storage conditions of the
product dispensed and how the product should be handled at the patient’s
home or care institution.
• Records the aspects of product care in the patient’s record.
Collaboration • Consults effectively with the prescriber about the product care aspects, propos-
ing an alternative medicine if necessary, stating reasons.
• Consults effectively with suppliers of pharma raw materials, medicines and
medical aids.
• Consults effectively with nurses or carers about the specific aspects of product
care, such as compounding medication for administration to the patient, stor-
age, etc.
• Respects the expertise of pharmacy staff concerning product care and delegates
tasks effectively.
• Has the ability to assess and respond to an authorisation letter and a doctor’s
statement.
Scholarship • Ensures that he or she maintains and advances his or her scientific knowledge
in the area of product care.
• Is familiar with and uses resources, specific guidelines and protocols concern-
ing product care, as described in Recepteerkunde (a Dutch book dealing with
product care and the compounding of medication), for instance.
Health advocacy • Is receptive to and responds effectively to any queries and complaints the
patient or the patient’s carer may have about the product.
• Acts in compliance with the provisions laid down by law, including those under
the Medical Treatment Contracts Act (WGBO), the health insurance scheme and
in compliance with the Dutch Pharmacy Quality Standard (NAN).
Management • Is familiar with and contributes to agreements made within the pharmacy
concerning the quality of the products that is to be provided.
• Has the ability to organise the availability of medicines, and medical and assis-
tive devices efficiently in a timely manner at the required quality level.
• Uses computer systems and information technology to deliver a high-quality
product.
Professional • Performs product care with integrity, in an engaged and sincere manner,
• Has the ability to reflect on his or her own actions in the appropriate manner.
• Knows the limits of his or her own qualities and areas in which he or she lacks
the required expertise or skills.
27
Task area 9. Quality assurance in the pharmacy

Quality assurance is a broad concept and covers the intrinsic care aspects of the pharmacy, on the one hand,
and business matters, on the other. Aside from being a specialist in his or her field, the pharmacist also
functions as an entrepreneur and manager - a person who delegates part of his or her tasks. The aspects of
this task area are as follows:
• ·Quality assurance policy. The pharmacist pursues a quality assurance policy based on the Deming Quality
Circle, which is also referred to as the ‘Plan, Do, Check, Act’ or PDCA cycle. In performing quality
assurance, the pharmacist employs a quality manual, certification and recertification, an annual quality
report, quality indicators and other formats to reflect quality, including patient consultation, quality
surveys involving mystery guests and quality circle surveys, and a complaints procedure and error
registration to guarantee and help improve the quality of the care provided.
• Stock management and logistics. The logistics to and inside the pharmacy as well as stock management
play a key role in ensuring that medicines and other products that are of good quality are available on a
timely basis (see also task area 8). Account should also be taken of the economic aspects, i.e. the stock
management system (design, management, economics), distribution system inside the pharmacy
(traditional system, robots, medicine cabinets and analysis of the distribution system), the distribution
channels to the pharmacy (reliable suppliers, central filling and automated distribution systems [ADS],
the organisation of distribution to and inside nursing and care homes, etc. The pharmacy complies with
the specific record-keeping formats laid down by law, such as those for opiates.
• Human resource management. The pharmacy is an organisation in which people increasingly work at
a wider range of levels. Different educational and continued education requirements and salaries apply
to the different positions. Human resource policy in the pharmacy covers task areas, such as terms of
employment, working conditions, education and training, individual and group consultation,
recruitment and selection, the distribution of duties, etc.
• Administration. The pharmacy is also a business involving economic, fiscal and legal aspects, whereby
factors such as relations with debtors, creditors, the tax authorities, the industrial board, professional
association, health insurers and other organisations come into play. The primary care pharmacy is
required to comply with numerous legal and statutory aspects, including privacy guidelines, the rules
laid down under the Medicines Act and the Medical Treatment Contracts Act (WGBO) and third-party
liability. The pharmacist is required to monitor current issues and implement the relevant aspects as
appropriate, including insurer guidelines concerning the reimbursement of health care costs and
authorisations, for instance).
• The pharmacy business. The pharmacist carries joint responsibility for business continuity. The aspects
described above play a role in ‘conducting business’. Other matters that come into play are a locality scan,
recognising and responding to the needs of the client population, the relationship with the municipality,
dealing with key financial figures and the auditor-client relationship.

Pharmaceutical • Is responsible for the following quality assurance aspects at the pharmacy:
expertise quality assurance policy, stock management and logistics, human resource
management, administration and the pharmacy business.
Communication • Demonstrates the quality of the pharmacy, based on indicators for instance,
to his or her patients/clients by presenting an annual report.
• Provides information on quality assurance in the pharmacy, if asked by the
patient.
28
Collaboration • Consults regularly with all or a group of pharmacy staff on quality assurance
policy, stock management and logistics, staff matters and, if required, on
aspects of the pharmacy business.
• Consults regularly with each member of pharmacy staff individually about the
personal aspects of the sub-areas of quality assurance described.
• Works with a range of external parties in the area of quality assurance, such as
wholesalers, the professional association, the inspectorate, educational bodies,
the accountant/auditor, health insurers, patients, etc.
• Works on quality assurance with other care providers involved in providing
integrated care.
Scholarship • Is familiar with the standards and guidelines and key developments in quality
assurance.
Health advocacy • Acts appropriately in the event of care-related incidents.
• Seeks certification and exposure for quality assurance.
• Complies with the standards and guidelines concerning human resource man-
agement, such as terms of employment, education and training, etc.
• Complies with the privacy guidelines, the rules laid down under the Medicines
Act and the Medical Treatment Contracts Act (WGBO), third-party liability, and
health insurance guidelines.
• Complies with the statutory rules concerning the pharmacy business.
Management • Organises and implements the various aspects of quality assurance in the phar-
macy ensuring a proper balance between day-to-day patient care.
• Uses information technology to support the implementation and development
of quality assurance policy.
• Organises improvement programmes on the basis of quality surveys.
Professional • Performs quality assurance, including the human resource management
aspects, with integrity, in an engaged and sincere manner.
Task area 10. Knowledge, education and scientific understanding

The scientific mindset the pharmacist has acquired whilst studying at university, should never diminish
during professional practice. Health care in general and the individual patient's often complex state of
health demand that the pharmacist embraces a scientific mindset. The medical pharmaceutical sciences are
advancing continuously. Advances are published in both primary and secondary literature and incorporated
in professional multidisciplinary guidelines, nationwide collaboration agreements and standards. Pharma-
cists are required to be conversant with developments and have the ability to implement these in peripheral
areas, such as nutrition and homeopathy. Societal developments also occur, such as the changing care needs
of patients, developments in the organisation of care (in integrated care, for instance, which requires more
knowledge of the peripheral care areas), legislation amendments (in part on the basis of policy changes
and/or due to political developments), advancements in ICT and communication or changed quality stand-
ards. Pharmacists will need to adapt their care accordingly. Continuing education is key, which means that
pharmacists should upgrade their knowledge and skills, develop and maintain a personal development plan
(PDP), reflect on their own development (preferably allowing others to do so too), disseminate and demon-
strate their knowledge and skills (to pharmacy assistants and trainee pharmacists), and apply what they have
learned in practising care. Research too plays a key role, i.e. generating knowledge and effectively translating
it into day-to-day care (enhancing standards and guidelines, for instance).

Pharmaceutical
expertise
Communication • Has the ability to communicate research and research results, both in writing
and verbally, to both experts and non-experts.
• Has the ability to communicate effectively as part of teaching.
29
Collaboration • Works with other parties, such as care providers, educators and researchers in
the area of research and education.
Scholarship • Upgrades one’s knowledge and skills by constantly and critically keeping
abreast of advances in scientific knowledge in the area of pharmacotherapy,
as published in professional and scientific Dutch and international journals.
• Upgrades knowledge and skills by constantly and critically keeping abreast of
developments concerning professional guidelines and standards providing sec-
tions devoted to the use of pharmacotherapy in treating diseases, e.g. the stan-
dards issued by the Dutch College of Practitioners (NHG), consensus texts
issued by the Quality Institute for the Health Care Sector in the Netherlands
(CBO) and Farmacotherapeutisch Kompas, Receptuurkunde and other profes-
sional or multidisciplinary guidelines, nationwide collaboration agreements
and standards
• Upgrades knowledge and skills by constantly and critically keeping abreast of
developments in other areas, such as technological developments (e.g. dosage
forms) and peripheral areas, such as homeopathy.
• Develops and maintains an individual development plan (PDP), a key aspect of
which entails reflecting continuously on one’s own development.
• Disseminates knowledge and skills to pharmacy staff, trainees and trainee
pharmacists.
• Promotes the expansion and advancement of scientific knowledge by being
involved in research activities.
Health advocacy • Keeps constantly but critically abreast of societal developments, such as
changes in patients’ care needs, developments in the organisation of care,
legislation amendments, developments in the area of ICT and communication
or changes in quality standards.
Management • Adapts the organisational structure of the pharmacy and the care provided
by the pharmacy in response to scientific and societal developments.
• Applies the knowledge acquired during training and continued education
programmes in the pharmacy organisation and the care provided by the
pharmacy.
Professional • Demonstrates appropriate personal professional conduct in pursuit of
knowledge, education and science.
• Practices pharmacy, in pursuit of knowledge, education and science,
in compliance with the Code of Ethics governing the pharmacy profession.
30
VI Assessment
Assessment forms the core of each education programme. The education programme would in fact be
ineffective if an assessment would not be incorporated. Assessment drives learning by the specialist
community pharmacist trainee (ApIOS) and enables the supervisor to determine the trainee’s progress during
the programme and identify any gaps in knowledge, where further work is required.
The quality of the education programme will improve as a result of assessment. The nature of the assessment
is primarily development-oriented, educational and formative. Assessment definitely is an aspect that trainees
themselves must carry out. Self-reflection or self-assessment is key to their development throughout the two-
year programme. Assessment moreover encourages the pharmacist supervisor (apotheekopleider, ApOP) and
any others who are in some way involved in the education programme to provide feedback. In addition two
selective assessments are conducted during the two-year programme.
Assessments are held at certain points in time – at the end of the first and second years of the programme –
to determine whether the trainee is making sufficient progress. These assessments could have implications for
the continuation of the education programme, for the trainee’s further individual education plan and whether
or not the trainee will ultimately qualify for registration as a specialist community pharmacist.
In addition to the education programme in the pharmacy, education is also provided centrally. Specific
assessment instruments are used in centrally organised courses, such as knowledge assessment and
participation in education. The primary aim of assessment is to assist the specialist community pharmacist
trainee in becoming fully proficient during the programme. This means that he or she should acquire the right
combination of knowledge, skills and attitude and has the ability to apply these in day-to-day practice. This
education plan uses a range of assessment instruments, also referred to as forms of assessment, for conducting
assessments, a description of which is provided in Section VI.1. Assessments are required in order to assess
the competences of and day-to-day activities performed by the specialist community pharmacist trainee. This
means that further factors can be assessed, aside from solely knowledge or practical skills. A range of activities
have therefore been selected which are performed by community pharmacists within the various task areas
and which typify the activities performed in professional practice, or Entrustable Professional Activities’
(EPAs), as referred to in the education programme. There are 40 EPAs in total, a description of which is given
in Section VI.2 for each task area. The assessment of one or several EPAs in each task area – using specific
assessment instruments – involves assessing a number of competencies in the relevant task area each time.
Section V1.2 describes the specific assessment instruments that are to be employed for assessing the various
EPAs as well as the frequency of assessment during each year of the education programme. Section VI.3
provides a summary of the frequency of assessment applicable to the various assessment instruments. The
specialist community pharmacist trainee is ultimately required to have undergone and passed the – indirect -
assessment of all key competence areas based on all EPAs using the applicable instruments. Section VI.4 clearly
demonstrates that this education plan enables trainees to successfully undergo assessment. Lastly, Section VI.5
links EPAs and the various forms of assessment to review dates and levels of proficiency.
31
VI.1 Assessment and assessment instruments

A range of instruments are available for the purpose of conducting assessments, a description of which is
provided in table 1. These instruments are simply tools designed primarily for the purpose of providing or
obtaining feedback. Not every instrument is suitable for assessing every Entrustable Professional Activity (EPA)
and the various competences. The knowledge assessment, for example, does not measure communication with
patients. Moreover, not one single instrument will help to adequately assess all of the community pharmacist’s
competences at once. Assessment of 40 EPAs with the aid of the applicable assessment instruments once
or on multiple occasions during the two-year education programme will help obtain a good idea of the
competences of the specialist community pharmacist trainee (ApIOS). The progress reviews conducted between
the specialist community pharmacist trainee and the pharmacist supervisor (ApOP) during the course of the
education programme are vital. The results of the assessments performed to date are discussed during the
review sessions. All of the results are retained in the portfolio, which has a key and valuable role. The portfolio
may also contain other information, such a written account of the trainee’s experience of the education
programme (including the number of activities), a strengths and weaknesses analysis and the tasks set as a
result thereof. The constantly updated Personal Development Plan (PDP) forms an integral part of the above.
Feedback is vital in the specialist community pharmacist trainee’s education programme. The pharmacist
supervisor is required to provide feedback during the assessment periods and assessment reviews as well as
on a regular basis at work and during the short, scheduled reviews that should take place preferably each
fortnight. The trainee is responsible for scheduling the consultation periods! Forms or manuals for the various
assessment instruments are or will be made available.
Table 1 Assessment and assessment instruments
a. Assessment instruments applicable to the pharmacy providing hands-on training
Discussing critical incidents

This form of assessment discusses a situation in which the specialist community pharmacist trainee has
learned or could learn a lot. Both the trainee and the pharmacist supervisor may take the initiative to discuss
a critical incident. The trainee should first write a short report or perform an analysis. The trainee’s role is
discussed, i.e. what went well, what could have gone better and what lessons were learned from the situation.
Examples of critical incidents are aggressive parents, a difficult patient, an error made by the pharmacy or the
trainee, a side effect or problems in coaching a staff member or trainee/work placement student.
Case-based discussion
This form of assessment is devoted to the pharmacotherapy used in treating a patient and potential drug-
related problems. A case is analysed and the various pharmacotherapy treatment options are substantiated and
discussed.
Directly observed preparation skills (DOPS)

This feedback instrument has been developed for the purpose of the observation and assessment of product
care inside the pharmacy. The whole process of compounding medication for administration is systematically
assessed.
Assessment of the patient record

This instrument focuses on a patient’s electronic patient record. The documentation of an activity and/or a
patient consultation is discussed with the pharmacist supervisor. The discussion might relate to the intake of a
new patient or a medicine consultation in connection with admission to hospital. A patient record assessment
may also involve assessing a completed protocol, for instance when first dispensing a medicine. The knowledge
and skills checklist has a role in the assessment of patient records, see Appendix A. Regular emphasis is placed
on the key aspects of creating a patient record, working on a protocol-led basis, disseminating information,
transferring a patient and the continuity of care as a result of conducting patient record assessments.
The competences assessed depend on the EPA.
360° feedback
Feedback is usually provided by the pharmacist supervisor. Feedback based on assessments by various
immediate colleagues and staff, such as the supervisor, the pharmacist’s peers, pharmacy assistants, other
pharmacy staff, administrative staff, patients and other care providers, such as doctors, is referred to as multi-
32
source or 360° feedback. A unique aspect of this type of feedback is that different perspectives underlie
the opinions given. The 360° feedback method reflects the overall opinion of a range of different parties.
This assessment instrument gauges the competences of professionalism, communication and collaboration.
Self-assessment
The self-assessment’ and strengths and weaknesses analysis performed by the specialist community pharmacist
trainee are correlated. Comparison of the results thereof with the results of the 360° feedback is an excellent
way to identify the trainee’s strengths and weaknesses. The trainee also performs a self-assessment of his or her
behavioural competences. The information could prove beneficial for the continuation and further scope of the
education programme
Short practical assessment

During a short practical assessment the supervisor observes the trainee performing an activity in day-to-day
practice, which includes a patient consultation. This might, for instance, be a consultation concerning patient
counselling when dispensing a medicine for the first time, a pharmaceutical case history relevant to a care
question or responding to a medication surveillance alert. Two competence areas are usually assessed, i.e.
pharmaceutical expertise and communication.
Model letter
The model letter represents all types of written material prepared by the trainee, such as written information
material or a report regarding the collection and analysis of quality indicators. The material forms the basis
of the review with the supervisor. The purpose of the review is to improve the quality of correspondence and
knowledge dissemination. The competences assessed depend on the EPA.
Reflective report
The trainee submits a self-reflection report on an EPA. The trainee should include the following in the self-
reflection report: what were my learning objectives for the activity, what went well, what did not go so well
and what would I like to improve. The self-reflection report serves as the starting point for the review with the
supervisor.
b. Assessment instruments applicable to centrally organised courses
Knowledge assessment
A written assessment of progress is a reliable method for assessing knowledge, as incorporated in the
education plan (task areas). Knowledge assessment aligns with the mix of assessment instruments used to form
a reliable and valid opinion. The knowledge assessment is administered centrally.
Participation in education
Participation in or assessment of centrally organised individual courses, such as presenting an assignment.
c. Review instruments
Knowledge and skills checklist

The knowledge and skills checklist has been designed as an instrument for monitoring the trainee’s learning
process in acquiring knowledge and skills. The trainee fills in the checklist while performing activities. The
checklist is discussed during the progress reviews with the supervisor. The checklist forms part of the trainee’s
portfolio, an example of which is included in Appendix A.
33
Job suitability assessment

Two reviews are held during the education programme relating to the suitability of the trainee for the role of
specialist community pharmacist, which, in fact, also serve as a progress review. The assessment takes place at
the end of the first and second years of the education programme.
Orientation interview
During the orientation interview, on the basis of the trainee and pharmacist supervisor’s mutual expectations
agreements are made on what the trainee should learn. A key component is the preliminary discussion of the
Personal Development Plan (PDP) to be drawn up by the trainee.
Personal Development Plan

As part of his or her portfolio each trainee is required to prepare a PDP that serves as a guideline for the
education programme activities. The document is dynamic and should be updated regularly following each
progress review. The PDP contains the planned activities relating to patient and product care, self-study,
individual courses, and agreements concerning supervision and assessment. The PDP is determined in
consultation with the supervisor.
Portfolio
The trainee’s portfolio forms a key component of the education programme. It contains a collection of
documents that reflect the trainee’s progress. In any event the documents include the results of the progress
and job suitability assessment reviews that are required to be conducted at certain points in time between
the supervisor and the trainee, including the PDP, the trainee’s self-assessment and the results of courses
and other educational activities. The trainee is responsible for maintaining and updating his or her portfolio,
which is checked for completeness by the pharmacist supervisor. The portfolio is made available to the trainee
electronically.
Progress review
The development of the trainee’s skills and competences are discussing during a progress review. Evidence as
submitted and included in the portfolio forms a key component thereof. During the review the pharmacist
supervisor and the trainee examine a possible lag in the development of competences and establish
improvement areas. A key starting point for the review, however, is to bolster the trainee’s self-confidence,
support the trainee’s learning process and to provide positive feedback. A progress review is scheduled every
three months.
34
VI.2 EPAs broken down by task area, the applicable

assessment instruments and frequency of assessment
Assessments are required in order to assess the competences of and the day-to-day activities performed by the
specialist community pharmacist trainee (ApIOS) at the pharmacy providing the hands-on training. A range
of activities have therefore been selected which are performed by community pharmacists within the various
task areas and which typify the activities performed in professional practice, or the ‘Entrustable Professional
Activities’ (EPAs), as referred to in the education programme. There are 40 EPAs in total, a description of which
is given below for each task area. The description is followed by the applicable assessment instruments and the
frequency of assessment each year, broken down by task area and EPA.
Task area 1. Patient communication and counselling
EPAs
1 Patient counselling when Cover all ‘major diseases’: diabetes, asthma/ COPD, cardiovascular disease,
dispensing a medicine for the psychiatric disorders (particularly depression), rheumatic diseases and
first time cancer. This includes providing technical instructions, e.g. for inhalation
devices, blood glucose meters, etc. Keep the patient’s social, psychological
and cultural background in mind, e.g. in respect of a psychiatric patient,
elderly dementia patients, etc.
NB: Language barrier/communication problems, Ramadan, a child suffering
from a chronic disease, disabilities, the desire to have children, pregnancy
and breast feeding (see knowledge and skills checklist in Appendix A).
2 Patient counselling when In any event dispense the medicine a second time. Cover all ‘major
dispensing a medicine on a diseases’. See also the explanation under EPA 1 and the knowledge and
second or subsequent occasion skills checklist in Appendix A.
3 Counselling a palliative care A prescription for an opiate may signify the time to begin counselling.
patient Termination of Life on request may sometimes signify the termination
of care for a palliative care patient. Although this is not considered as
palliative care, this particular aspect of care has been included here.
4 Counselling a patient or the • Incontinence products
patient’s carer in using care and/ • Surgical dressings
or medical aids • Liquid foods
• Injection systems, drips, cartridges (see knowledge and skills
checklist in Appendix A).
Form of assessment Subject Frequency

Short Practical EPA 1: Patient counselling when dispensing a 1x in first year
Assessment medicine for the first time (with different 1x in second year
aspects, where possible).
Short Practical EPA 2: Patient counselling when dispensing a 1x in first year
Assessment medicine a second time (with different 1x in second year
Short Practical EPA 4: Counselling a patient or the patient’s carer 1x in first year
Assessment in using care and/or medical aids. 1x in second year
Assessment of patient EPA 1: Copy of an anonymised EPR or a completed 7x in first year
record protocol concerning dispensing medicine 7x in second year
for the first time to patients suffering from
diseases, in accordance with the knowledge
and skills checklist in Appendix A.
35
Assessment of patient EPA 2: Copy of an anonymised patient’s EPR or a 7x in first year

record completed protocol concerning dispensing 7x in second year
medicine for a second time/on subsequent
occasions to patients suffering from diseases,
in accordance with the knowledge and skills
checklist in Appendix A.
Case-based discussion EPA 3: Counselling a palliative care patient. 1x in second year
Task area 2. Health-care questions from patients and the general public
EPAs
5 Dealing with a self-care patient Use WHAM questions as an aid; pharmacy-only drugs. Keep the
social, psychological and cultural background of the person
requesting self-care in mind.
6 Responding to a patient’s health- Including the health-care questions asked by the patient’s
care question, carers. The questions may relate to any side effects experienced,
non-self-care complaints, travel vaccination advice, and possible poisoning. Keep
the social, psychological and cultural background of the person
requesting self-care in mind. (see knowledge and skills checklist in
Appendix A).

Short Practical EPA 5: Dealing with a self-care patient. 1x in first year
Assessment 1x in second year
Discussion of critical EPA 6: Responding to a patient’s health-care 4x in first year
incidents question, non-self-care.
Task area 3. Medication surveillance
EPAs
7 Responding to an ‘alert’ Aspects that should be covered include: phased assessment, the
indicating a pharmacotherapy- relationship between the pharmacy assistant and the pharmacist,
related problem, generated by a consultation with the prescriber as well as the patient. Responding
computerised adverse drug event to a range of problems: See knowledge and skills checklist in
alerting system or otherwise. Appendix A. Take account of the potential risk factors, such as
comorbidity, clinical-chemical parameters, pharmacokinetic and
pharmacogenetic data sets and suchlike.
8 Checking prescriptions and Responding to a range of problems: See knowledge and skills
the corresponding medication checklist in Appendix A. Take account of the potential risk factors,
surveillance alerts upon such as comorbidity, clinical-chemical parameters, pharmacokinetic
completion of the prescription and pharmacogenetic data sets and suchlike.
process.
36

Short Practical EPA 7: Responding to an ‘alert’ indicating a 1x in first year
Assessment pharmacotherapy-related problem, generated 1x in second year
by a computerised adverse drug event
alerting system, or otherwise.
Assessment of patient EPA 7: Copy of an anonymised EPR concerning 6x in first year
record medication surveillance alerts that have been 7x in second year
dealt with as referred to in the knowledge
and skills checklist.
Discussion of critical EPA 8: Checking the list of medication surveillance 2x in first year
incidents alerts. 2x in second year
Knowledge assessment The pharmaceutical care needs of certain patient 1x in second year
groups and pharmacotherapy-related problems.
Task area 4. Periodic medication review
EPAs
9 Performing a technical The medication review concerns a polypharmacy patient and/
medication review for an at-risk or geriatric patient, usually suffering from multimorbidity (for a
patient, including preparing number of major diseases, see EPA 4).
a pharmacotherapy treatment Patient selection may also relate to the at-risk timing, such as
plan (PTP). discharge from hospital. Performing a review and preparing a PTP
in consultation with the doctor.
10 Patient pharmacotherapy Possible visit to a patient’s home.
consultation in connection with See also EPA 9.
a medication review, including
preparing a PTP.
11 Carrying out a PTP and ensuring Further activities resulting from EPA 9 and/or 10,
the continuity of care all of which after having consulted with the doctor or the doctor’s
support staff. Consultation with the patient. Determine the timing
of checks. Repeat the medication review.
consultation in connection with See also EPA 9.
admission to hospital or another Key components: what medicine is the patient currently taking and
care institution. what problems is the patient experiencing.
consultation in connection See also EPA 9.
with discharge from hospital or Key components: what medicine is the patient currently taking,
another care institution differences in medicine use history, and ensuring patient
understanding.
Includes monitoring following the consultation.
37

Short Practical EPA 10: Patient pharmacotherapy consultation 1x in first year
Assessment in connection with a medication review, 2x in second year
including preparing a pharmacotherapy
treatment plan (PTP).
Short Practical EPA 13: Patient pharmacotherapy consultation in 1x in first year
Assessment connection with discharge from hospital or
another care institution
Case-based discussion EPA 9: Performing first technical medication review 2x in first year
for an at-risk patient, including preparing a 10x in second year
PTP.
Assessment of patient EPA 11: Carrying out a treatment plan and ensure 2x in first year
record continuity thereof. 10x in second year
Assessment of patient EPA 12: Assessing a patient pharmacotherapy 1x in first year
record consultation in connection with admission
to hospital or another care institution.
Knowledge assessment Medication review 1x in second year
Task area 5. Consultation with colleagues
EPAs
14 Consultation with the prescriber It may also be necessary to consult/communicate with the
concerning a prescription, or as Thrombosis Service. What agreements have been made on the
a result of a different problem delegation of this task to assistants?
15 Involvement in and/ Including presentation during the FTO.
or preparation of a Including determining the location of new medicines.
pharmacotherapy consultation
(FTO)
16 Participation in and/or Including consultation with care groups. In relation to the
consultation concerning pharmacy itself, e.g. in connection with a health-care centre.
integrated care In addition: developing a regional formulary, care consultation
with a care or nursing home, etc.

360º feedback and self- This form of assessment involves various EPAs, 1x in first year
assessment such as EPA 14 (consultation with the prescriber), 1x in second year
EPA 15 (involvement in and/or preparation and
implementation of an FTO), and EPA 16 (involvement
in integrated care).
Discussion of critical EPA 14: Consultation with the prescriber concerning 8x in first year
incidents a prescription, or as a result of a different 4x in second year
problem.
Reflective report EPA 15: Participation in, and/or preparation of and 2x in first year
holding a pharmacotherapy consultation 2x in second year
(FTO).
Reflective report EPA 16: Participation in and/or consultation 1x in second year
concerning integrated care.
38
Task area 6. Preventive care and screening
EPAs
17 Providing general information – Including presentations to groups, and preparing written
either in writing or verbally – to information material. Including information for website
a group of patients and/or non- publication.
experts
18 Offering screening and In conjunction with general practitioners, where possible.
performing screening activities This may include performing a search in order to select a specific
group of patients.
This may include obtaining, analysing and describing screening
results, as well as reporting thereof in the annual quality report.

Model letter EPA 17: Providing general information in writing to a 1x in first year
group of patients and/or non-experts.
Reflective report EPA 17: Providing general information verbally to a 1x in first year
group of patients and/or non-experts. 1x in second year
Reflective report EPA 18: Reporting on a screening activity performed. 1x in first year
2x in second year
Task area 7. Collection and management of patient data
EPAs
19 Conducting an intake interview Includes:
• New patient
• Passer-by
• Passer-by with an official prescription
Including updating the patient record, exchanging information
(passer-by after-care) and taking measures to ensure the protection
of privacy.

Short Practical EPA 19: Conducting an intake interview. 1x in first year
Assessment 1x in second year
Assessment of patient EPA 19: Copy of an anonymised EPR for a patient or 1x in first year
record passer-by, with whom an intake interview has 1x in second year
been conducted.
39
Task area 8. Product care
EPAs
20 Making available medicines that Including imported orphan drugs.
are difficult to obtain
21 Compounding based on a As part of total product care, which therefore includes assessing
prescription using pharma raw quality (analysis) and performing medication surveillance.
materials
22 Compounding a medication for This is carried out at the pharmacy and/or at the patient’s home.
administration, including • Medication administration systems: Drip and injection systems,
• product care for special medi- cartridges
cation administration sys- • Special medicines: Suspensions, cytostatic drugs, protein medi-
tems cines, sterile medicines, etc. This also involves storage inside the
• product care for special medi- pharmacy, transportation/delivery, storage at the patient’s home,
cines providing the patient information and instructions on how to
store and administer the medicine at home and explaining the
weekend emergency protocol.
23 Performing a recall procedure Traceability through to the patient.

Discussion of critical EPA 20: Making available medicines that are difficult 2x in first year
incidents to obtain.
Directly observed EPA 21: Compounding based on a prescription using 2x in first year
preparation skills (DOPS) pharma raw materials. 1x in second year
Directly observed EPA 22: Compounding a medication for 1x in first year
preparation skills (DOPS) administration. 1x in second year
Discussion of critical EPA 23: Performing a recall procedure. 2x in first year
incidents
Task area 9. Quality assurance in the pharmacy
EPAs
24 Using an individualised form of Including analysing why this is necessary, and providing
distribution information.
25 Preparing, implementing and Including consultation with other care providers and/or the health
evaluating: insurer.
• a pharmaceutical patient care
project (PPC)
• an annual or project plan
• the annual report
26 Maintaining a quality assurance Including a quality assurance manual, quality assurance
system documents, certification and re-certification.
27 Collecting and analysing quality Applying the Deming Quality Circle.
indicators
28 Collecting and analysing errors Including working with the Central Medication Incidents Registry
or near errors (CMR), the national registration centre that records medication
incidents.
29 Collecting, reporting and Including liaising with the Netherlands Pharmacovigilence Centre
analysing side effects LAREB; and advising the patient to report side effects directly to
LAREB, where applicable.
40
30 Performing the relevant • Stock control system: timely availability, economics and user
activities and analysing: data. Including opium legislation. Pertaining to the outcome:
• the stock control system possibly changing the way stock control is organised. Including
• the distribution system understanding purchasing efficiencies, substitute medicines and
• working conditions parallel imports of medicines.
• Distribution system: including any special aspects, such as the
use of robots, lockable medicine cabinets, patient online orders,
at nursing and care homes.
• Working conditions: various aspects, including sickness reports,
monitoring absenteeism due to illness, working conditions, stat-
utory OHS requirements (also applicable to the compounding of
medication), etc.; employee satisfaction survey (concerning the
pharmacy organisation and working conditions).
NB: OHS during home care and at care institutions should also
be taken into account.
31 Relationship with suppliers, Including selection on the basis of aspects such as the continuity of
the industry and the software delivery/supplies, delivery times, the quality of order processing and
supplier certification.
32 Preparing an employee job Including salary, and the recruitment and selection of new
description employees.
33 Conducting an employee Including preparing and evaluating employee Personal
performance and appraisal Development Plans (PDPs).
review
34 Work meeting/progress meeting Group work meeting. Including education and training, and
implementation. Involves participating in, holding a presentation
at and chairing the meeting.
35 Implementing a change on Including providing instructions, stating reasons and checking
the shop floor or introducing a (quality circle). Targeted at a specific group, and individuals.
procedure or a work regulation
36 Relationship with insurers Entering into contracts. Including collecting and analysing
management information in preparation of the contract
negotiations. Specific guidelines. Authorisations.

Short Practical EPA 24: Using an individualised form of distribution 1x in first year
Assessment (providing information to a new patient).
Model letter EPA 25: Report on the Implementation and Innovation 1x in first year
project as part of centrally organised courses:
Management & Quality Activity I.
Model letter EPA 26: Work out assignment about maintaining a 1x in first year
quality assurance system. 1x in second year
Model letter EPA 27: Report on collecting and analysing quality 1x in second year
indicators.
Model letter EPA 30: Work out assignment concerning an analysis 1x in first year
of the stock control or distribution system or 1x in second year
the working conditions.
Model letter EPA 31: Work out assignment concerning the 1x in second year
pharmacist’s relationship with suppliers, the
industry and the software supplier.
Model letter EPA 32: Employee job description. 1x in second year
Model letter EPA 36: Work out assignment concerning the 1x in second year
pharmacist-insurer relationship.
41
Discussion of critical EPA 28: Collecting and analysing errors or near errors. 2x in first year
incidents 1x in second year
Discussion of critical EPA 29: Collecting, reporting and analysing side 1x in first year
incidents effects.
Reflective report EPA 33: Conducting an employee performance and 2x in first year
appraisal review. 2x in second year
Reflective report EPA 34: Work meeting/progress meeting. 2x in first year
1x in second year
Reflective report EPA 35: Implementing a change on the shop floor or 2x in first year
introducing a procedure or a work regulation. 1x in second year
360° feedback and self- This form of assessment relates to several EPAs and 1x in the first year
assessment involves third-party assessment of the quality of 1x in the second
performance within the pharmacy organisation. It year
covers various EPAs described in task area 9, as well as
other task area EPAs. You may choose to combine this
form of assessment and the same form of assessment
described in task area 5 to enable other parties to assess
both internal and external performance simultaneously.
Task area 10. Knowledge, education and scientific understanding
EPAs
37 Analysis of major external Preferred supplier policy, modifying the medicine
influences reimbursement method, price adjustments, etc. Identifying
potential ethical problems associated with external influences.
Discuss internally, where required.
38 Processing new information on From the Medicines Evaluation Board (MEB) (changes in
medicines the information provided in medicine leaflets and risk
management plans), the manufacturer (product information),
Gebu Medicines Bulletin (new medicines), Pharma Selecta (a
Professional Information Bulletin on Medicines), etc.
39 Initiating, performing and/or
taking part in practice research
40 Supervising a trainee/work Including providing feedback.
placement student in certain
areas of care and/or coaching a
staff member

Model letter EPA 37: Work out assignment concerning an analysis 1x in second year
of major external influences.
Model letter EPA 38: Work out assignment concerning processing 1x in first year
new information on medicines.
Model letter EPA 39: Paper (taking part in a research project) as part 1x in second year
of centrally organised courses: Pharmaceutical
practice – Research Activity I
Reflective report EPA 40: Supervising a trainee/work placement student 2x in the first year
in certain areas of care and/or coaching a staff 2x in second year
member
42
VI.3 Education programme assessment schedule

The frequency of assessment applicable to the various assessment instruments is shown in the table below.
Assessment instruments Three Six Nine First Three Six Nine Second
months months months year months months months year
Education requirements √ √ X √ √ √ √ X
decree
√ Progress review
X Job suitability review
Orientation interview √
Personal Development ongoing
Plan (PDP)
Portfolio ongoing
Discussion of critical 21 x a year 7 x a year
incidents
Case-based discussion 2 x a year 11 x a year
Directly observed 3 x a year 2 x a year
preparation skills (DOPS)
Assessment of patient 24 x a year 32 x a year
record
360o feedback and self- √ √ √
assessment
Short practical 9 x a year 8 x a year
assessment
Model letter 5 x a year 8 x a year
Reflective report 12 x a year 11 x a year
Knowledge assessment 1 x a year
43
VI.4 Linking task areas, EPAs and competences

The specialist community pharmacist trainee (ApIOS) is ultimately required to have undergone adequate
assessment in all key competence areas based on all EPAs using the applicable assessment instruments. The
table below clearly demonstrates that this education plan enables trainees to successfully undergo assessment.
EPAs Assessed competences
Communication
Pharmaceutical
Collaboration
Management
Professional
Scholarship
expertise
Advocacy
Health
Task area 1: Patient communication and counselling
1. Patient counselling when dispensing a SPA+PRA SPA KA (SPA) PRA
medicine for the first time
2. Patient counselling when dispensing a SPA+PRA SPA KA (SPA) PRA
medicine on a second or subsequent occasion
3. Counselling a palliative care patient CBD CBD +
KA)
4. Counselling a patient or the patient’s carer SPA SPA KA
in using care and/or medical aids.
Task area 2: Health-care questions from patients and the general public
5. Dealing with a self-care patient. SPA SPA KA (SPA)
6. Responding to a patient’s health-care CI CI (CI) CI CI CI
question, non-self care.
Task area 3: Medication surveillance
7. Responding to an ‘alert’ indicating a SPA+PRA SPA (SPA) KA PRA (SPA)
pharmacotherapy-related problem, generated
by a computerised adverse drug event alerting
system or otherwise.
8. Checking prescriptions and the corresponding CI (CI) CI CI + CI CI (CI)
medication surveillance alerts upon KA
completion of the prescription process.
Task area 4: Periodic medication review
9. Performing a technical medication review CBD (CBD) CBD + (CBD)
for an at-risk patient, including preparing a KA
pharmacotherapy treatment plan (PTP).
10. Patient pharmacotherapy consultation in SPA SPA KA
connection with a medication review,
including preparing a PTP.
11. Carrying out a PTP and ensuring the PRA PRA KA PRA
continuity of care.
12. Patient pharmacotherapy consultation in PRA PRA KA PRA
connection with admission to hospital or
another care institution.
13. Patient pharmacotherapy consultation in SPA SPA KA
connection with discharge from hospital or
another care institution.
44
Communication
Pharmaceutical
Collaboration
Management
Professional
Scholarship
expertise
Task area 5: Consultation with colleagues
14. Consultation with the prescriber CI CI KA CI CI
concerning a prescription, or as a result of
a different problem.
15. Participation in, and/or preparation of and RR RR RR RR (RR)
holding a pharmacotherapy consultation
(FTO).
16. Participation in and/or consultation RR RR RR RR (RR)
Task area 6: Preventive care and screening
17. Providing general information – either in ML ML ML ML
writing or verbally – to a group of patients
and/or non-experts
18. Offering screening and performing RR RR (RR) RR RR
screening activities.
Task area 7: Collection and management of patient data
19. Conducting an intake interview. SPA+PRA SPA PRA
Task area 8: Product care
20. Making available medicines that are difficult CI CI CI
to obtain.
21. Compounding based on a DOPS DOPS
prescription using pharma raw materials.
22. Compounding a medication for PRA PRA
administration, including:
• product care for special medication adminis-
tration systems
• product care for special medicines
Task area 9: Quality assurance in the pharmacy
23. Performing a recall procedure. CI CI CI
24. Using an individualised form of SPA+ SPA
distribution.
25. Preparing, implementing and evaluating: ML ML ML
• a pharmaceutical patient care project (PPC)
• an annual or project plan
• the annual report
26. Maintaining a quality system. ML ML ML ML
27. Collecting and analysing quality indicators. ML ML ML ML
28. Collecting and analysing errors or near CI CI CI CI CI
errors.
29. Collecting, reporting and analysing side CI (CI) (CI) (KA) CI CI
effects.
45
Health Advocacy
Communication
Pharmaceutical
Collaboration
Management
Professional
Scholarship
expertise
30. Performing the relevant activities and ML ML
analysing:
• the stock control system
• the distribution system
• working conditions
31. Relationship with suppliers, the industry and ML ML
the software supplier.
32. Preparing an employee job description. ML ML
33. Conducting an employee performance and RR RR RR
appraisal review.
34. Work meeting/progress meeting. RR RR
35. Implementing a change on the shop floor or RR RR
introducing a procedure or a work regulation.
36. Relationship with insurers. ML ML
Task area 10: Knowledge, education and scientific understanding
37. Analysis of major external influences. ML ML ML
38. Processing new information on medicines. ML ML
39. Initiating, performing and/or taking part in ML ML ML ML ML
practical research.
40. Supervising a trainee/work placement student RR RR RR
in certain areas of care and/or coaching a staff
member.
Abbreviations used for the forms of assessment

CBD = Case-based discussion
CI = Discussion of critical incidents
PRA = Assessment of patient record
DOPS = Directly observed preparation skills (DOPS)
SPA = Short Practical Assessment
KA = Knowledge assessment
ML = Model letter
RR = Reflective report
(..) = Assessment is not always possible
46
VI.5 Linking EPAs and assessment forms with review dates

and proficiency levels
A review date refers to a point in time for evaluating what the specialist community pharmacist trainee (ApIOS)
has learned and how he or she has developed. Four review dates have been defined in the new education plan
as follows:
Review dates
Review date I after six months
Review date II after one year
Review date III after 18 months
Review date IV after two years, at the end of the education programme
All EPAs are linked to a review date on which the required level of proficiency should be achieved. There are
four proficiency levels:
Proficiency level
Level 1 has knowledge of/is familiar with
Level 2 acts under strict supervision
Level 3 acts under limited supervision
Level 4 acts without supervision
At present, the degree to which the levels of proficiency are realistic is not quite clear. The requirements
established are minimum requirements. They are deemed realistic. However, the goals may need to be adjusted
in some areas. The table below describes how often the assessment instrument should be deployed in the first
and second year of the education programme. It also indicates at what point in time, in other words on what
review date, the required level of proficiency should be achieved. In some cases a proficiency level may be
achieved at an earlier stage. Please bear in mind that the requirements are minimum requirements.
Short practical assessment
Proficiency level
is familiar with
4. Acts without
knowledge of/
3. Acts under
under strict
supervision
supervision
supervision
limited
2. Acts
1. Has
EPA 1: Patient counselling when dispensing a 1x in first year I

medicine for the first time (with 1x in second year III
different aspects, where possible).
EPA 2: Patient counselling when dispensing a 1x in first year I
medicine a second time (with different 1x in second year III
EPA 4: Counseling a patient or the patient’s 1x in first year I
carer in using care and/or medical aids. 1x in second year III
EPA 5: Dealing with a self-care patient. 1x in first year I
1x in second year III
EPA 7: Responding to an ‘alert’ indicating a 1x in first year II
pharmacotherapy-related problem, 1x in second year III
generated by a computerised adverse
drug event alerting system, or
otherwise.
47
EPA 10: Patient pharmacotherapy consultation 1x in first year

in connection with a medication 2x in second year I III IV
review, including preparing a PTP.
EPA 13: Patient pharmacotherapy consultation 1x in first year I
in connection with discharge from
hospital or another care institution
EPA 19: Conducting an intake interview. 1x in first year II
1x in second year III
EPA 24: Using an individualised distribution form 1x in first year II
(providing information to a new patient).
Assessment of patient record
Proficiency level 1 2 3 4
EPA 1: Copy of an anonymised patient’s EPR 7x in first year I
or a completed protocol concerning 7x in second year III
dispensing medicine for the first time
to patients suffering from diseases, in
accordance with the knowledge and skills
checklist.
EPA 2: Copy of an anonymised patient’s EPR 7x in first year I
or a completed protocol concerning 7x in second year III
dispensing medicine for a second time/on
subsequent occasions to patients suffering
from diseases,
in accordance with the knowledge and skills
checklist.
EPA 7: Copy of an anonymised EPR concerning 6x in first year I II
medication surveillance alerts that have 7x in second year III
been dealt with as referred to in the
knowledge and skills checklist.
EPA 12: Assessing a patient pharmacotherapy 1x in first year I
consultation in connection with
admission to hospital or another care
institution.
EPA 11: Carrying out a pharmacotherapy 2x in first year I II
treatment plan (PTP) and ensuring the 10x in second year III IV
continuity of care.
EPA 19: Copy of an anonymised EPR for a new 1x in first year I
patient or passer-by, with whom an intake 1x in second year III
interview has been conducted.
Case-based discussion
EPA 3: Counselling a palliative care patient. 1x in second year
IV
EPA 9: Performing a technical medication 2x in first year I
review for an at-risk patient, including 10x in second year IV
preparing a pharmacotherapy
treatment plan (PTP).
48
Model letter
EPA 17: Providing general information in writing 1x in first year II
to a group of patients and/or non-experts.
EPA 25: Report on the Implementation and 1x in second year IV
Innovation project as part of centrally
organised courses: Management and
Quality Activity I.
EPA 26: Work out assignment about maintaining 1x in first year II
a quality system. 1x in second year IV
EPA 27: Report on collecting and analysing 1x in second year IV
quality indicators.
EPA 30: Work out assignment concerning 1x in first year I IV
an analysis of the stock control or 1x in second year
distribution system or the working
conditions.
EPA 31: Work out assignment concerning the 1x in second year IV
pharmacist’s relationship with suppliers,
the industry and the software supplier.
EPA 32: Employee job description. 1x in second year IV
EPA 36: Work out assignment concerning the 1x in second year IV
pharmacist-insurer relationship.
EPA 37: Work out assignment concerning an 1x in second year IV
analysis of major external influences.
EPA 38: Work out assignment concerning 1x in first year II
processing new information on
medicines.
EPA 39: Paper (participation in a research project) 1x in second year IV
as part of centrally organised courses:
Pharmaceutical practical research
Activity I.
Directly observed preparation skills (DOPS)
EPA 21: Compounding based on a prescription 2x in first year I II III
using pharma raw materials. 1x in second year
EPA 22: Compounding a medicine for 1x in first year II IV

administration. 1x in second year
Reflective report
EPA 15: Participation in, and/or preparation 2x in first year I II III
of and holding a pharmacotherapy 2x in second year
consultation (FTO).
EPA 16: Participation in and/or consultation 1x in second year IV
49
EPA 17: Providing general information verbally to 1x in first year I III

a group of patients and/or non-experts. 1x in second year
Reflective report based, in part, on a
participant survey.
EPA 18: Report on a screening activity performed. 1x in first year I III
1x in second year
EPA 33: Conducting an employee performance 2x in first year I II III IV
and appraisal review. 2x in second year
EPA 34: Work meeting/progress meeting. 2x in first year I II III
1x in second year
EPA 35: Implementing a change on the shop floor 2x in first year I II III
or introducing a procedure or a work 1x in second year
regulation.
EPA 40: Supervising a trainee/work placement 2x in first year I II III IV
student in certain areas of care and/or 2x in second year
coaching a staff member.
Discussion of critical incidents
EPA 6: Responding to a patient’s health-care 4x in first year I II
question, non-self care.
EPA 8: Checking the list of medication 2x in first year I II
surveillance alerts. 2x in second year IV
EPA 14: Consultation with the prescriber 8x in first year I II
concerning a prescription, or as a result 4x in second year III
of a different problem.
EPA 20: Making available medicines that are 2x in first year I II
difficult to obtain.
EPA 23: Performing a recall procedure. 2x in first year I II
EPA 28: Collecting and analysing errors or near 2x in first year I II
errors. 1x in second year III
EPA 29: Collecting, reporting and analysing side 1x in first year I
effects.
50
360° Feedback and self-assessment
This form of assessment involves various EPAs, 2x in first year I II
such as EPA 14 (consultation with the prescriber),
EPA 15 (involvement in and/or preparation and
implementation of an FTO), EPA 16 (involvement
in integrated care) as well as task area 9 EPAs
(quality assurance). A self-assessment of behavioural 1x in second year IV
competences commences in the first year.
EPA 14: Consultation with the prescriber I II III
concerning a prescription, or as a result
of a different problem.
EPA 15: Participation in, and/or preparation of I II III
and holding a pharmacotherapy
consultation (FTO).
EPA 16: Participation in integrated care. I II III IV
Knowledge assessment
This refers to the pharmaceutical care needs of 1x in second year IV
certain patient groups, pharmacotherapy-related
problems and a medication review.
51
VII Education methods and activities

The main education method used is the performance of professional activities by the specialist community
pharmacist trainee (ApIOS) under the supervision of the pharmacy providing the hands-on training. The hands-
on training is supplemented with a relatively limited number of individual courses. The trainee carries joint
responsibility for his or her learning process. The pharmacist supervisor’s key role is to supervise the learning
process. He or she acts as a role model for the trainee, gives instructions, observes the activities performed by
the trainee and provides feedback. The pharmacist supervisor also is also responsible for providing an optimum
learning and working environment.
Performing activities in the pharmacy, such as patient and product care

The day-to-day activities in the pharmacy and the discussions that may be linked to the activities form the basis
of the education programme. Agreements concerning the nature, intensity and the way in which supervision is
organised are made between the trainee and the supervisor. These agreements are incorporated in the trainee’s
personal development plan and are regularly updated as the education programme progresses. Explicit
attention should be paid to the education programme, and this takes place when conducting assessments.
Individual courses
In addition to the hands-on training in the workplace, dedicated classes are held during the education
programme. Individual courses cover the main topics in the domain of community pharmacy, such as
pharmacotherapy, patient communication, product care and management of the pharmacy organisation.
Appendix C describes the components of the individual courses. A central assessment is a component of the
individual courses.
VIII Education material

While part of the education material is available, some of the education material still needs to be developed.
The material does not form an integral part of this education plan but is described in the appendices. Examples
of material that has already been developed are as follows: this education plan for the community pharmacy
specialisation, the prevailing KNMP guidelines or the guidelines that are to be drawn up by the KNMP in
association with the Scientific Community Pharmacy Section (Wetenschappelijke Sectie Openbare Farmacie,
WSO) and a range of assessment instruments, such as the short practical assessment, the patient record
assessment, the 360° feedback questionnaire and the progress review form.
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IX Quality assurance
The Specialist Community Pharmacist education programme embraces several quality assurance components
as follows:
1. Education and training process
2. Review of decrees issued by the Central Board for Pharmacy Specialists (Centraal College Specialisten
Farmacie, CC)
3. The pharmacist supervisor
4. The professionalisation of the specialist community pharmacist trainee (ApIOS)
5. Education survey
6. The lecturer involved in centrally organised courses.
Re 1. Education and training process

The education method described should primarily align with developments in day-to-day practice. The
changing views on pharmacotherapy and the changing roles in the health-care sector are deemed to have
implications for the content of the curriculum. It is vital that this be constantly taken into account and that
the education programme undergoes regular evaluation. The director of the advanced education programme,
the Central Board for Pharmacy Specialists (WSO), the Community Pharmacy Council (Consilium Openbare
Farmacie) to be established and possibly other institutions, such as an ‘Education Special Interest Group (SIG
‘Onderwijs’), all have a role in the above.
Re 2. Review of decrees issued by the Central Board for Pharmacy Specialists

The decrees issued by the Central Board for Pharmacy Specialists (CC) set out the requirements the specialist
community pharmacist trainee must meet and the required quality of the pharmacist supervisors in the
pharmacy providing the hands-on training. The Specialists Registration Committee (Specialisten Registratie
Commissie, SRC) is responsible for monitoring compliance with the established requirements. SRC assesses
pharmacies providing hands-on training, pharmacist supervisors and the individual courses taken by specialist
community pharmacist trainees, (e.g. the trainee’s portfolio). The SRC assessment is a key instrument for
monitoring compliance with the required standards.
Re 3. The pharmacist supervisor (ApOP)

In the first place, the quality of the supervisor is guaranteed by the pharmacist supervisor education
programme. The description of the principles of competence-based education and training, the competences
themselves as well as the relevant quality indicators, which form the basis of the pharmacist supervisor
education programme, are incorporated in Appendix D of this education plan. The education programme
commences with the basic pharmacist supervisor education programme. Upon registration in the pharmacist
supervisor register, pharmacist supervisors are required to pursue selected refresher courses to strengthen
their pharmacist supervisor competences. The refresher courses still need to be developed. Information on the
pharmacist supervisor’s performance is obtained during assessments (see
re 2 above) and by means of feedback received from specialist community pharmacist trainees. The above
information is obtained on a regular basis, and covers the level of the hands-on training provided in the
workplace, the education and training environment and the atmosphere at work.
Re 4. Professionalisation of the specialist community pharmacist trainee (ApIOS)

Specialist community pharmacist trainees should be trained in accordance with the modern competence-based
education methods, as described in this education plan. They are required to learn to direct and maintain
the development of their own competences. This requires specific skills in order to derive maximum benefit
from the learning periods in the workplace. This also means actively creating sufficient knowledge acquisition
periods and dealing with feedback. In addition this specifically implies deploying the assessment instruments
appropriately or using the portfolio. Explicit attention is placed on the professionalisation of the specialist
community pharmacist trainee during the centrally organised courses.
Re 5. Education survey
Traditionally education and training surveys are rarely conducted in the field of Pharmacy. This contrasts
with Medicine, where surveys are conducted on the basic education offered at university level as well as on
advanced programmes and post-graduate continuing university education. These surveys generally focus on the
academic validation of the selected content of the curricula, as well as on the effectiveness of the programmes.
Consequently the modernisation of advanced education programmes is a valued theme. Education and
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training surveys will need to be developed in the field of pharmacy following the example of Medicine.
Pharmacy may be able to utilise the experience and expertise gained in the field of Medicine. Themes that may
be worthwhile surveying in the field of Pharmacy are: the alignment between basic university education and
the advanced education programme, and the quality of the specialist community pharmacist trainee’s learning
environment in day-to-day practice.
Re 6. Lecturers in centrally organised courses

Various lecturers teach the central curriculum. Emphasis will be placed on developing a programme aimed
at raising the level of lecturer professionalism. Lecturers will need to be familiar with the principles, format
and content of the advanced education programme and will need to work on developing didactic, assessment
and feedback competences. Lecturer quality can be monitored on the basis of feedback forms concerning the
teaching provided.
54
Appendices
Appendix A Knowledge and skills checklist
Appendix B Overview of centrally organised courses within the Advanced Specialist Community Pharmacist
education programme
Appendix C C. Pharmacist Supervisor (ApOP) competence profile
55
Appendix A. Knowledge and skills checklist
The knowledge and skills checklist has been designed as an instrument for monitoring the trainee’s learning
process in acquiring knowledge and skills. The specialist community pharmacist trainee (ApIOS) fills in
the checklist while performing activities. The checklist is discussed during the progress reviews with the
supervisor and forms part of the trainee’s portfolio.
When responding to a pharmacotherapy-related problem, detected through Quarter

a computer-generated alert or otherwise, during and upon completion of the
prescription procedure, including checking, you will have responded to the
alerts or situations listed below.
1 2 3 4 5 6 7 8
Pharmacotherapy-related problems (see also EPAs 7 and 8)
Dosage-related problems
Drug interactions
Contraindications
Intolerance
Double medication
Incorrectly/irrationally prescribed pharmacotherapy medicines
Off-label use
Medication prescribed for the incorrect patient
Omitted medicines
Medication-adherence problems
Overuse
Underuse
Use for too long a time
Use for too short a time
When counselling patients about medication, you have assisted patients Quarter
suffering from the following diseases, conditions, or using the following care
and/or medical aids or have responded to their questions.
1 2 3 4 5 6 7 8
Diseases/conditions (see also EPAs 1 and 2)
Diabetes
Asthma/COPD
Cardiovascular disease
Depression
Rheumatic disease
Cancer
Desire to have children
Pregnancy
Breast feeding
Language barrier / communication problems
Ramadan
Children suffering from a chronic disease
Disabilities
56
Care/medical aid (see also EPA 4)

Eye drops
Inhalation medication
Insulin and blood glucose meter
Incontinence products
Surgical dressings
Liquid foods
Injection systems, drips, cartridges
Health-care question (see also EPA 6).
Side effects
Complaints
Travel advice
Possible poisoning
57
Appendix B. Overview of centrally organised courses within the Specialist Community

Pharmacist advanced education programme
Outline of centrally organised courses
Seven clusters:
• Pharmacotherapy
• Product Care
• Communication
• Active Learner
• Professionalism and Pharmaceutical Ethics
• Management and Quality
• Pharmaceutical Practical Research
Centrally organised study sessions

Some of the study sessions will be organised in conjunction with components from other clusters, where possible.
58
Combined
Cluster Name Subtitle Duration Order with
Pharmacotherapy Pharmacotherapy I Cluster orientation and 1 half-day Day 1
Cardiovascular diseases session: 3.5
I hours
Pharmacotherapy II Interpreting laboratory 1 half-day Day 1
values session: 3.5
hours
Pharmacotherapy III Cardiovascular diseases 1 half-day Day 2 Combined
2 session: 3.5 with another
hours cluster:
P & E II
Pharmacotherapy IV Medication review 1 half-day Day 3
training session: 3.5
hours
Pharmacotherapy V Diabetes 1 half-day Day 3
session: 3.5
hours
Pharmacotherapy VI Cardiovascular diseases 1 half-day Day 4
III session: 3.5
hours
Pharmacotherapy Pain and pain control 1 half-day Day 4
VII session: 3.5
hours
Pharmacotherapy Geriatrics 2 half-day Day 5
VIII sessions: 7 hours
Pharmacotherapy IX Palliative care 1 half-day Day 6 Combined
session: 3.5 with another
hours cluster:
P & E IV
Pharmacotherapy X Psychiatry 1 half-day Day 7 Combined
hours cluster: Com-
munication
III
Combined
Product Care Product Care I: Dispensing medicine 1 half-day Day 1 Double group
session: 3.5
hours
Product Care II: Compounding 1 half-day Day 1
medication for session: 3.5
administration (incl. hours
high-risk substances)
Product Care III: Compounding 1 half-day Day 2 Double group
session: 3.5
hours
Product Care IV: Suppliers, purchasing 1 half-day Day 2
and outsourcing session: 3.5
hours
59
Combined
Communication Communication I Transferring 1 half-day Day 1 Both sessions
information to a patient session: 3.5 are combined
hours on one day
Communication II Questioning patients 1 half-day Day 1
about problems session: 3.5
concerning the use of hours
medication
Communication III More serious patient 1 half-day Day 2 Combined
issues, pharmaceutical session: 3.5 with another
case history hours cluster:
Pharmaco-
therapy X
Communication IV GP collaboration 1 half-day Day 3 Combined
hours cluster: P & E II
Combined
Active Learner Active Learner I Kick-off meeting 2 half-day Day 1
sessions:
8.5 hours
Active Learner II Conclusion 1 half-day Day 2
session: 3.5
hours
Combined
Professionalism P&EI The role of the 1 half-day Day 1 Combined
and pharmacist who carries session: 3.5 with another
Pharmaceutical ultimate responsibility hours cluster: M &
Ethics Q III
P & E II Professionalism in the 1 half-day Day 2 Combined

pharmacy: What is a session: 3.5 with another
good leader? hours cluster:
Pharmaco-
therapy III
P & E III Professionalism in 1 half-day Day 3 Combined with
integrated care: the session: 3.5 another clus-
issue owner hours ter: Communi-
cation IV
P & E IV Professionalism in 1 half-day Day 4 Combined
society: How do session: 3.5 with another
you represent your hours cluster:
profession? Pharmaco-
therapy IX
60
Combined
Management and Management and Leadership I 2 half-day Dag 1
Quality (M & Q) Quality I ‘Management’ sessions: 7 hours
Management and Leadership II 2 half-day Day 2

Quality II ‘Change Management’ sessions: 7 hours
Management and Management and Quality: 1 half-day Day 3 Combined

Quality III The Link session: 3.5 with another
hours cluster: P &
E II
Management and Management and Quality: 2 half-day Day 4
Quality IV The Quality System sessions: 7 hours
Management and Strategy and Policy: 2 half-day Day 5
Quality V Innovation and sessions: 7 hours
Implementation
Management and Employees I 2 half-day Day 6
Quality VI ‘Collaboration’ sessions: 7 hours
Management and Values I 1 half-day Day 7
Quality VII Care indicators session: 3.5
hours

Quality VIII Business session: 3.5
Administration I: Financial hours
Indicators
Management and Personnel II 1 half-day Day 8

Quality IX Employment Matters session: 3.5
hours

Quality X Business session: 3.5
Administration II: hours
Financial Indicators
Management and Personnel III 1 half-day Day 9

Quality XI ‘Individual Coaching’ session: 3.5
hours
Management and Values II 1 half-day Day 9

Quality XII Care indicators session: 3.5
hours
Management and Strategy and Policy: Privacy 1 half-day Day 10

Quality XIII issues and complaints session: 3.5
hours
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Activities
Pharmacotherapy Pharmacotherapy 9 x Pharmacotherapy During Pharmacotherapy case-based

Activity I knowledge assessment discussion I-X, except for IV.
Pharmacotherapy Case presentation During Pharmacotherapy case-based
Activity II discussion I-X, except for II and V.
Pharmacotherapy 10 medication reviews Commences after Pharmacotherapy
Activity III case-based discussion IV.
Pharmacotherapy Feedback on 2 x 10 Peer review of two trainee peers by the
Activity IV medication reviews specialist community pharmacist trainee
(ApIOS); commences after Pharmacotherapy
Activity III (or earlier, to be mutually
agreed).
Pharmacotherapy 2 medication reviews Assessment by experts.
Activity V
Pharmacotherapy Written abstract
Activity VI
Product Care Product Care Product Care During Product Care I & II & III & IV.
Activity I knowledge assessment
Active Learner Active Learner PDP (first version) Assignment during Active Learner I:
Activity I Kick-off meeting.
Active Learner PDP (subsequent version)
Activity II
Active Learner National knowledge
Activity III assessment
Communication No activities
Professionalism P & E Activity I Essay on a current Commences after P & E IV Central Seminar.
and moral theme
Pharmaceutical
Ethics
Management and M & Q Activity I Report on the Commences after M & Q V Central Seminar.
Quality Implementation and
Innovation project
Pharmaceutical Pharmaceutical Paper

practical research practical research (Participation in
Activity I conducting research)
62
Appendix C. Pharmacist Supervisor (ApOP) Competence Profile
Pharmacist Supervisor (APOP)
APOP
Didactic
Competences
Individual
Competences
Knowledge
Competences
Commissioned to, compiled and developed in association with

HPC the Human Perspective in Consulting
The Hague 2010
63
1. Introduction
Competence-based learning takes centre stage in the curriculum designed for the Community Pharmacist
Specialisation. The robustness of the education programme will be determined primarily by the qualities
of the Pharmacist Supervisor (ApothekerOpleider, ApOP), responsible for training the specialist community
pharmacist trainee (Apotheker in Opleiding tot Specialist, ApIOS) in the pharmacy. The qualities of the
Pharmacist Supervisor will similarly be expressed in competences. This document incorporates these
competences in the form of a Pharmacist Supervisor Competence Profile, a compact and comprehensive version
of which is provided.
2. The route to the Pharmacist Supervisor competence profile: principles and procedure
Three areas of competence, i.e. Didactics, Individual competences and Knowledge, have ultimately been defined
together with the relevant sub-competences. Each competence includes performance indicators formulated in
terms of the Pharmacist Supervisor’s observable behaviour.
The principles underlying these profiles are derived from various sources:
A. The CanMEDS-model with its core competence areas, which KNMG used as a model when recently
modernising its advanced medical programmes.
B. The competences and component principles applied in the Renewed Dutch Education Programme for
General Practitioners as implemented in recent years.
C. The doctoral research conducted by Dr Peter Boendermaker, which included the traits of a good
general practitioner supervisor and the instruments he developed for the Department responsible for
the Education Programme for General Practitioners in Groningen.
D. The Manual detailing the Appraisal System for Pharmacists in Salaried Employment (KNMP, February
2005), which incorporates the competences required for various community pharmacy roles.
E. ‘The pharmacist supervisor should be proficient in what the specialist community pharmacist trainee
should ultimately be able to do’, according to the adage. Drawing on the adage, the competence
diagrams as currently used in the KNMP Community Pharmacist Registration Programme were
consulted for reference.
F. The Primary Pharmacy Task Areas and the Entrustable Professional Activities (EPAs) also serve as the
basis of the profile.
G. The principles as used in the Assessment Centre Method, which is also a competence-based method,
observable behaviour and assessment thereof.
The Pharmacist Supervisor competence profile was submitted to ‘The Quality of the Pharmacist Supervisor’
Focus Group (Klankbordgroep Kwaliteit van de ApOP), and was assessed during workshops held on 14 May
2009, the date on which the Community Pharmacy Section was established, and during a Teach-the-Teacher
Symposium on 25 June 2009.
3. Purpose of the Pharmacist Supervisor Competence Profile
The Pharmacist Supervisor Competence Profile serves several purposes:
1) The competences describe the exit qualifications relating to the pharmacist supervisor education
and training programme: What criteria should the Pharmacist Supervisor meet after having acquired
the required knowledge, skills and behavioural competences after two years of education and training?
2) The profile is the standard against which the aspiring Pharmacist Supervisor measures himself or
herself on a number of occasions through Self-Assessment, and serves as the basis of assessment as part
of the 360° feedback provided by other parties included in the Pharmacist Supervisor’s feedback
circle. The profile thus serves as the basis of the assessments carried out at various stages in the
education programme.
3) The profile offers vital input for the aspiring Pharmacist Supervisor’s Personal Development Plan
(PDP). After all, individual action points are linked to the scores on the profile.
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4) The competence profile serves as a crucial guideline in structuring the curriculum and providing
content to the ‘Teach-the-Teacher for Pharmacist Supervisors education programme. All teaching
methods (exercises, simulations, analyses, DVD, etc.) are required to contribute to developing the
Pharmacist Supervisor’s competences.
4. What is a competence?
The term ‘competence’ has multiple definitions. In the context of the Pharmacist Supervisor education
programme, the following definition applies: a combination of pharmacotherapy and care-based knowledge and
insight, individual attitude and didactic skills are observable in the behaviour of the Pharmacist Supervisor, the
aim of which is to train and supervise the specialist community pharmacist trainee (ApIOS) in the pharmacy.
The objectives of the specialist community pharmacist trainee are described in the exit qualifications which
the trainee is required to have achieved at the end of the registration period, and in the future at the end of
the Specialist Community Pharmacist education programme.
In the compact profile in Section 5 and comprehensive profile in Section 6, three clusters of competences have
been distinguished.
A. Didactic competences describing whether the Pharmacist Supervisor possesses a didactic attitude
and didactic skills to enable him or her to transfer (or ‘teach’) knowledge and experience of
pharmacotherapy, leadership and management of the pharmacy business to the specialist community
pharmacist trainee.
B. Individual competences A Pharmacist Supervisor who achieves a good score for didactics, may
nonetheless not have the ability to withstand stress, or may be inflexible. And, a Pharmacist Supervisor
who is indeed able to withstand stress and is flexible does not necessarily profess to be good teacher. He
or she should possess more competences rather than solely ‘educator’ competences. These competences
are referred to as individual competences and are not relevant to the presence of a specialist
community pharmacist trainee in the pharmacy. They are competences the pharmacist requires in
situations other than in training situations.
C. Knowledge or specialist competences ‘The pharmacist supervisor should be proficient in what the
specialist community pharmacist trainee should ultimately be able to do’, is a key adage. This means
that the Pharmacist Supervisor or the aspiring Pharmacist Supervisor must be fully proficient in
pharmacotherapy and should possess up-to-date knowledge of areas, such as pharmaceutical patient
care, medicines, and the management and administration of the pharmacy. The Pharmacist Supervisor
or aspiring Pharmacist Supervisor is viewed by the specialist community pharmacist trainee as a role
model. Or, to quote Peter Boendermaker “… which is part of the master-assistant situation, and the
supervisor should be aware that his actions, to a greater degree than his words, will be observed and
emulated by the trainee very carefully.” (Meesterschap 2003; p.42). This holds true particularly for the
knowledge or specialist competences.
5. The Compact Pharmacist Supervisor (ApOP) Profile
To view the Pharmacist Supervisor’s competences at a glance, the Pharmacist Supervisor competence profile is
set out in a compact format below. For the underlying definitions and performance indicators, please refer to
the Comprehensive Competence Profile in Section 6.
Cluster 1 Didactic competences
1.1 The Pharmacist Supervisor has the ability to empathise with the specialist community pharmacist
trainee (ApIOS).
1.2 The Pharmacist Supervisor offers the specialist community pharmacist trainee room for personal
development.
1.3 The Pharmacist Supervisor has the ability to adapt and act according to the situation in his or her
working relationship with the specialist community pharmacist trainee.
1.4 The Pharmacist Supervisor is not afraid to delegate patients to the trainee.
1.5 The Pharmacist Supervisor has the ability to deal with criticism.
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1.6 The Pharmacist Supervisor has the ability to provide individual supervision to the specialist
community pharmacist trainee.
1.7 The Pharmacist Supervisor continuously works on life-long learning and peer feedback.
1.8 The Pharmacist Supervisor makes available time to train and supervise the specialist community
pharmacist trainee.
1.9 The Pharmacist Supervisor motivates the specialist community pharmacist trainee.
1.10 The Pharmacist Supervisor is not afraid to give feedback.
1.11 The Pharmacist Supervisor has the ability to observe, record, classify, appraise and evaluate
competences.
1.12 The Pharmacist Supervisor gives the specialist community pharmacist trainee responsibility
for his or her own development.
1.13 The Pharmacist Supervisor structures and divides the two years of the education programme in
the pharmacy into phases.
1.14 The Pharmacist Supervisor has the ability to avoid or manage any conflicts according to the
situation.
1.15 The Pharmacist Supervisor has the ability to communicate well with the specialist community
pharmacist trainee.
1.16 The Pharmacist Supervisor has the ability to analyse any problems thoroughly during the
education programme before taking a decision.
1.17 The Pharmacist Supervisor involves the members of the pharmacy team in the trainee’s education
programme.
1.18 The Pharmacist Supervisor maintains contact with the lecturers involved in the education
programme concerning the trainee’s progress.
Cluster 2 Individual competences
2.1 The Pharmacist Supervisor demonstrates vision concerning the direction to be pursued by his or
her own pharmacy in the years ahead.
2.2 The Pharmacist Supervisor is flexible.
2.3 The Pharmacist Supervisor is able to withstand stress.
2.4 The Pharmacist Supervisor is highly motivated to deliver excellent performance.
2.5 The Pharmacist Supervisor is enthusiastic about the profession and teamwork.
2.6 The Pharmacist Supervisor acts with integrity.
2.7 The Pharmacist Supervisor creates an educational climate where trust and security take centre stage.
Cluster 3 Knowledge competences
3.1 The Pharmacist Supervisor possesses up-to-date knowledge and understands all aspects of the
community pharmacist role.
3.2 The Pharmacist Supervisor serves as a community pharmacist role model for the specialist
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6. The Comprehensive Pharmacist Supervisor (ApOP) Competence Profile

and Performance Indicators
The competences that the Pharmacist Supervisor is required to meet are shown by category. However,
the profile has been specified in further detail to reflect the definition of each competence as well as the
performance indicators. Performance indicators provide a detailed description of the observable behaviour
of the Pharmacist Supervisor in day-to-day practice, which serve as a basis for assessing the Pharmacist
Supervisor’s competence scores.
6.1 Cluster 1 Didactic competences
1.1 The Pharmacist Supervisor has the ability to empathise with the specialist community
pharmacist trainee
The Pharmacist Supervisor demonstrates that he or she has the ability to empathise with the
professional standards, motivation, personal and educational situation, the views and opinions
of the specialist community pharmacist trainee and bears this in mind when taking decisions
or action.
Performance indicators:
1 The Pharmacist Supervisor is a good listener, (maintains eye contact, utters words
of encouragement, nods, does not interrupt, and summarises).
2. The Pharmacist Supervisor asks the specialist community pharmacist trainee open
questions, and continues to ask questions.
3. The Pharmacist Supervisor gives the specialist community pharmacist trainee the
opportunity to speak.
4. The Pharmacist Supervisor provides an explanation if a certain view offered by the
specialist community pharmacist trainee cannot be incorporated in decisions.
1.2 The Pharmacist Supervisor offers the specialist community pharmacist trainee room for
personal development
The Pharmacist Supervisor offers the specialist community pharmacist trainee the room to
develop into a pharmacist with his or her own style of working and accepts that that particular
style may differ from the supervisor’s own style.
1. The Pharmacist Supervisor encourages the specialist community pharmacist
trainee to take initiative.
2. The Pharmacist Supervisor delegates responsibilities to the specialist community
pharmacist trainee.
trainee to be creative.
4. The Pharmacist Supervisor allows the arguments put forward by the specialist
community pharmacist trainee to convince him or her.
5. Shows that he or she appreciates another view and a different opinion.
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1.3 The Pharmacist Supervisor has the ability to adapt and act according to the situation in his or
her working relationship with the specialist community pharmacist trainee
Depending on the situation in the pharmacy, the Pharmacist Supervisor has the ability to
alternate between the role of educator, coach, peer pharmacist and manager of the specialist
1. The Pharmacist Supervisor schedules in evaluations.
2. The Pharmacist Supervisor schedules in progress reviews.
3. The Pharmacist Supervisor schedules in meetings with colleagues.
4. The Pharmacist Supervisor demonstrates different behavioural styles and has the
ability to switch from content to emotion, from expert to equal partner, from
giving approval to giving rewards, etc.
1.4 The Pharmacist Supervisor is not afraid to delegate patients to the trainee
The Pharmacist Supervisor has the ability to delegate patients entrusted exclusively to his or her
care to the specialist community pharmacist trainee for the purpose of broadening the trainee’s
personal development.
1. The Pharmacist Supervisor delegates patient contacts to the specialist community
pharmacist trainee.
2. The Pharmacist Supervisor discusses patient contacts afterwards with the
specialist community pharmacist trainee.
3. The Pharmacist Supervisor accepts that the specialist community pharmacist
trainee may opt for a different approach towards the patient than the approach he
or she would choose, provided that the same goal is achieved.
1.5 The Pharmacist Supervisor has the ability to deal with criticism
The Pharmacist Supervisor is open to criticism or negative feedback from the specialist
community pharmacist trainee, adopts a vulnerable attitude, shows that he or she is eager to
learn, allows himself or herself to be observed by the other person and allows discussion of his or
her own errors.
1. The Pharmacist Supervisor is a good listener, (maintains eye contact, utters words
of encouragement, nods, does not interrupt, and summarises).
2. The Pharmacist Supervisor asks questions and asks for examples.
3. The Pharmacist Supervisor does not get defensive (does not revert to ‘yes, but’) and
is actually eager to hear the arguments put forward by the specialist community
pharmacist trainee.
4. The Pharmacist Supervisor places his own performance on the agenda, for
example by scheduling in a performance review.
5. The Pharmacist Supervisor also learns from the specialist community pharmacist
trainee.
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1.6 The Pharmacist Supervisor has the ability to provide individual supervision to the specialist
community pharmacist trainee
The Pharmacist Supervisor has the ability to guide and direct the development of, and tasks
performed by the specialist community pharmacist trainee and has the ability to view each
specialist community pharmacist trainee as an individual, in other words he or she recognises
and acknowledges that each trainee is different and that they often require a different approach.
1. See the performance indicators under 1.1 concerning empathy.
2. Prepares the trainee’s Personal Development Plan together with the specialist
community pharmacist trainee based on the trainee’s current competences.
3. Discusses the specialist community pharmacist trainee’s work and study load.
4. Enables discussion of the specialist community pharmacist trainee’s PDP.
5. Seeks activities that are in line with the specialist community pharmacist
trainee’s current level of competence.
1.7 The Pharmacist Supervisor continuously works on life-long learning and peer feedback
The Pharmacist Supervisor desires to undergo continuous training in the supervisor role,
progresses from aspiring Pharmacist Supervisor to fully fledged Pharmacist Supervisor and is
open to receiving peer feedback as an instrument for remaining alert and for learning from
other Pharmacist Supervisors, for instance.
1. The Pharmacist Supervisor is fully proficient in pharmacotherapy and business
administration
(see Cluster 3 ‘Knowledge’).
2. The Pharmacist Supervisor also has a Personal Development Plan (PD) and ensures
that it is regularly updated.
3. The Pharmacist Supervisor takes regular refresher courses.
4. The Pharmacist Supervisor is a member of a peer feedback group and regularly
participates in peer group meetings.
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1.8 The Pharmacist Supervisor makes time available to train and supervise the specialist
community pharmacist trainee
The Pharmacist Supervisor makes time available for the education programme and for
consultation with the specialist community pharmacist trainee on the programme, does not
consider the trainee’s questions as ‘disruptive’ but understands that the trainee is eager to
learn and is engaged, and is prepared to answer a question or seek a solution to a problem in
collaboration with the trainee.
1. A regular progress review will be held at least twice each month between the
Pharmacist Supervisor and the specialist community pharmacist trainee and will
be scheduled in advance.
2. The review will rarely be cancelled by the Pharmacist Supervisor.
3. The Pharmacist Supervisor will assess progress made by the trainee on the basis of
the trainee’s Personal Development plan.
4. After a specialist community pharmacist trainee has taken part in a course in the
KNMP Registration Programme, the Pharmacist Supervisor will take the initiative
to enquire how the trainee has found the course.
5. The Pharmacist Supervisor is prepared to adapt his or her own schedule if
requested by the specialist community pharmacist trainee.
1.9 The Pharmacist Supervisor motivates the specialist community pharmacist trainee
The Pharmacist Supervisor provides encouragement and motivation by helping to raise the
specialist community pharmacist trainee’s self-confidence, making the trainee feel competent and
by delegating tasks previously allocated to the Pharmacist Supervisor.
1. The Pharmacist Supervisor gives compliments, as appropriate.
2. The Pharmacist Supervisor ensures an equal measure of positive and negative
feedback.
3. The Pharmacist Supervisor expands the authority, responsibilities and duties of the
specialist community pharmacist trainee on the basis of the progress made by the
trainee.
4. The Pharmacist Supervisor delegates not only the execution of duties to the
specialist community pharmacist trainee, if possible and desired, but also the
authority to take decisions.
70
1.10 The Pharmacist Supervisor is not afraid to give feedback
The Pharmacist Supervisor recognises and acknowledges that providing positive and negative
feedback to the specialist community pharmacist trainee is a key component of the training
situation and makes a significant contribution to maintaining good behaviour on the one hand,
and behavioural change, on the other.
1. The Pharmacist Supervisor ensures an equal measure of positive and negative
feedback, where possible.
2. A specific example of a situation confronting the specialist community pharmacist
trainee will always be included in the feedback given.
3. Feedback will be provided by the Pharmacist Supervisor as soon as possible after
the situation and behaviour of the specialist community pharmacist trainee has
occurred.
4. The Pharmacist Supervisor speaks for himself or herself and not on behalf of the
team.
5. The specialist community pharmacist trainee will be given the time to change his
or her attitude and behaviour.
6. The Pharmacist Supervisor remains critical, even if a training situation proceeds
smoothly.
1.11 The Pharmacist Supervisor has the ability to observe, record, classify, appraise and evaluate
competences
The Pharmacist Supervisor has the skills to perform ORCAE: i.e. to Observe the specialist
community pharmacist trainee in day-to-day practice, Record and Classify observations based
on the competences in the ‘Registered Pharmacist’ profile, perform an Appraisal and to Evaluate
the scores on a regular basis during the two years of registration jointly with the specialist
1. The Pharmacist Supervisor will be present in the pharmacy at least three days a
week.
2. The Pharmacist Supervisor will maintain a log book.
3. The Pharmacist Supervisor schedules in progress reviews.
5. The Pharmacist Supervisor employs the appropriate assessment instruments as
used in his or her own education programme and that of the trainee.
71
1.12 The Pharmacist Supervisor gives the specialist community pharmacist trainee responsibility
for his or her own development
The Pharmacist Supervisor does not explain everything in minute detail but allows the specialist
community pharmacist trainee to come up with ideas and draw conclusions about his or her
own learning process, areas on which to focus and the action that needs to be undertaken, for the
purpose of corrective adjustment, for example.
1. The Pharmacist Supervisor delegates responsibility to the specialist community
pharmacist trainee for preparing, implementing and updating his or her own
Personal Development plan.
2. The Pharmacist Supervisor asks a range of open questions.
3. The Pharmacist Supervisor allows the specialist community pharmacist trainee
to score himself or herself against the competences in the Registered Pharmacist
Profile on several occasions during the two years of registration.
4. The Pharmacist Supervisor offers the specialist community pharmacist trainee the
opportunity to incorporate action points in his or her PDP on the basis of these
scores.
trainee to take initiative and challenges the trainee in this regard.
6. The Pharmacist Supervisor assesses the progress made by the trainee on the
delegated responsibilities.
1.13 The Pharmacist Supervisor structures and divides the two years of the education and training
programme at the pharmacy into phases
In allocating responsibilities, authority, duties, projects and pharmacy-related activities outside

the pharmacy the Pharmacist Supervisor has the ability to divide appropriately the two years of
the education and training programme at the pharmacy into logical, chronological phases as
the specialist community pharmacist trainee becomes fully proficient in performing tasks.
1. The Pharmacist Supervisor provides structure on the basis of the trainee’s Personal
Development plan.
2. The Pharmacist Supervisor adapts his style of management in line with the
progress made by the specialist community pharmacist trainee in becoming fully
proficient in performing tasks.
3. The Pharmacist Supervisor has the ability to formulate education programme
objectives.
4. The Pharmacist Supervisor has the ability to set priorities.
72
1.14 The Pharmacist Supervisor has the ability to avoid or manage conflict according to the
situation
The Pharmacist Supervisor has the ability to recognise conflicts or potential conflicts, has the
ability to apply different styles for managing conflict depending on the situation and has the
skill to determine the position of the specialist community pharmacist trainee and his or her
own position in the conflict.
1. The Pharmacist Supervisor has the ability to be assertive/forceful in the event of a
conflict.
2. The Pharmacist Supervisor is not afraid to sit down and analyse the problem, have
his or her say and let people have their say, and reach a compromise.
3. The Pharmacist Supervisor demonstrates that he knows whether and when third-
party mediation is called for.
1.15 The Pharmacist Supervisor has the ability to communicate well with the specialist community
pharmacist trainee
The Pharmacist Supervisor has the ability to clearly communicate his or her ideas, opinions,
plans, feedback, tips and advice in understandable language to the specialist community
pharmacist trainee.
1. See the performance indicators under 1.1 concerning empathy.
2. The Pharmacist Supervisor has the ability to structure discussions with the
specialist community pharmacist trainee (in other words a discussion has a
beginning, middle and end).
3. The Pharmacist Supervisor demonstrates that he or she is aware of his or her
non-verbal behaviour during discussions (facial expression, eye contact, nodding,
loudness of speech, intonation, etc.) and what effect it has on the specialist
4. The Pharmacist Supervisor adapts the level of communication to the trainee’s
level of knowledge and experience.
5. The Pharmacist Supervisor picks up on signals expressed by the trainee both
verbally and non-verbally.
73
1.16 The Pharmacist Supervisor has the ability to analyse any problems thoroughly during the
education programme before taking a decision
The Pharmacist Supervisor first obtains an idea of the situation in which the trainee performs
activities in the pharmacy (forms an Idea), subsequently analyses any problems that have arisen
and identifies what is going well (forms an Opinion) and then takes decisions in order to improve
the situation, where necessary (takes a Decision).
1. See the performance indicators under 1.12 ORCAE.
2. The Pharmacist Supervisor has the ability to distinguish between key issues and
side issues.
3. He or she has the ability to recognise and examine problems.
4. He or she sees the connection between the education plan and the specialist
community pharmacist trainee’s current phase of development and problem
situations in day-to-day practice.
5. The Pharmacist Supervisor does not adopt a wait-and-see attitude but takes action.
6. The Pharmacist Supervisor discusses viewpoints thoroughly and is not afraid to
take final decisions.
7. The Pharmacist Supervisor has the ability to determine when he or she should
take a decision or whether he or she can leave this up to the trainee.
1.17 The Pharmacist Supervisor involves the members of the pharmacy team in the training
situation
The Pharmacist Supervisor has the ability to gain the interest of, and involve other pharmacists,
pharmacy assistants and other pharmacy staff in the training situation.
1. The Pharmacist Supervisor explains to the team why the pharmacy is being used
for education and training.
2. The Pharmacist Supervisor explains the authority, responsibilities and duties of
the specialist community pharmacist trainee.
3. The Pharmacist Supervisor clearly explains the content of and time that is to be
spent on the Registration Programme to the team jointly with the trainee.
4. The Pharmacist Supervisor clearly outlines the phases and duration of the
education plan to the team jointly with the trainee.
5. The Pharmacist Supervisor allocates one or several assistants an active role in
assisting/supervising the trainee in the initial phase.
6. The Pharmacist Supervisor ensures the continuity of the education programme
during his absence.
74
1.18 The Pharmacist Supervisor maintains contact with the lecturers involved in the education
programme concerning the trainee’s progress
The Pharmacist Supervisor actively liaises with the lecturers involved in the education
programme on the trainee’s progress, and asks them, where necessary, to focus on specific
competences or on specific aspects of the trainee’s performance.
2. The Pharmacist Supervisor assesses the trainee’s progress on the basis of the
trainee’s Personal Development plan.
3. On the basis of points 1 and 2, the Pharmacist Supervisor should have spoken to
each lecturer involved in the KNMP Registration Programme on one occasion at
least concerning the acquisition of competences by the trainee.
6. 2 Cluster 2 Individual competences
2.1 The Pharmacist Supervisor demonstrates vision on the direction to be pursued by his or her
own pharmacy in the years ahead
The Pharmacist Supervisor operates actively in the relevant environment (pharmaceutical

market, patient preferences, politics, legislation, health insurer and local developments) and
translates the main aspects into long-term policy for his or her own pharmacy, components of
which he or she will discuss with the pharmacy staff.
1. The Pharmacist Supervisor monitors developments in the field by reading
professional
literature, through his or her own network and by taking part in departmental or
quality circle meetings.
2. The Pharmacist Supervisor regularly performs a SWOT analysis of his or her own
pharmacy and its environment.
3. The Pharmacy Supervisor involves the pharmacy team in the analysis and
discusses future aspects with them.
4. The Pharmacist Supervisor not only prepares an Annual Plan at operational level
but substantiates the plan with a strategic and tactical vision for the pharmacy
and the pharmacy environment for the next three years.
75
2.2 The Pharmacist Supervisor is flexible
The Pharmacist Supervisor has the ability to adapt his behaviour should problems, obstruction
or opportunities arise in the training situation without losing sight of the predefined goal.
1. In the event of obstruction or problems, the Pharmacist Supervisor has the ability
to adopt a different behavioural style, switching from:
- content to emotion
- vague to firm
- task-oriented to human-oriented
- nuanced to direct and challenging
- a wait-and-see attitude to taking initiative
- expert to equal discussion partner
- giving approval to giving rewards/motivating
- providing information, to asking for information
- exploring a problem to problem-solving
2.3 The Pharmacist Supervisor is able to withstand stress
The Pharmacist Supervisor will continue to demonstrate effective performance in a self-confident

manner under time pressure and when facing setbacks, disappointment or opposition.
1. Opposition and resistance on the part of the specialist community pharmacist
trainee, or arising during discussions with other parties will in no way deter the
Pharmacist Supervisor. Instead, he or she will examine the root cause of resistance
and endeavour to remove it.
2. The Pharmacist Supervisor will not deviate from predefined goals, plans and
procedures until the goal has been achieved, or the plan has been implemented or
can no longer be reasonably carried out.
2.4 The Pharmacist Supervisor is highly motivated to deliver excellent performance
The Pharmacist Supervisor sets high standards for his or her own work and the work performed
by others, is not satisfied with average performance and acts accordingly.
1. The Pharmacist Supervisor maintains at least the prevailing quality standards.
2. The Pharmacist Supervisor points out whether members of the pharmacy team
and the specialist community pharmacist trainee deviate from the quality
standards and allows this to be discussed.
3. The Pharmacist Supervisor implements changes in order to improve the quality of
care provided to patients.
76
2.5 The Pharmacist Supervisor shows enthusiasm for the profession and teamwork
The Pharmacist Supervisor shows enthusiasm for the profession as well as working in and
with the pharmacy team, and is able to kindle similar enthusiasm in the specialist community
pharmacist trainee as well as others.
1. The Pharmacist Supervisor is aware that he or she should act as a role model.
2. The Pharmacist Supervisor usually communicates in terms of what is possible
rather than what is not possible.
3. The Pharmacist Supervisor thinks more in terms of opportunities rather than
threats.
4. The Pharmacist Supervisor also gives positive feedback (compliments).
2.6 The Pharmacist Supervisor acts with integrity
The Pharmacist Supervisor observes generally accepted social, ethical, professional and legal
standards in all activities relating to his role as a pharmacist and Pharmacist Supervisor.
2. The Pharmacist Supervisor observes the agreements made and the established
standards.
3. The Pharmacist Supervisor treats confidential information that she or she has
received from the specialist community pharmacist trainee as confidential.
4. The Pharmacist Supervisor safeguards the balance between trainee commitment
on the one hand, and distance, on the other.
2.7 The Pharmacist Supervisor creates an educational climate where trust and security take
centre stage
The Pharmacist Supervisor creates a work and educational climate within the pharmacy
team for the specialist community pharmacist trainee in which trust, respect for each other’s
personality traits, collaboration and to a certain extent tolerance for error take centre stage.
1. See the performance indicators under competence 1.18.
2. The Pharmacist Supervisor enables discussion of any strengths and weaknesses in
the team.
3. The Pharmacist Supervisor enables immediate discussion of any collaboration
problems.
4. Any errors made will be dealt with by means of a case by the Pharmacist
Supervisor jointly with the team.
77
6.3 Cluster 3 Knowledge competences
3.1 The Pharmacist Supervisor possesses up-to-date knowledge and understands all aspects of
the community pharmacist role
The Pharmacist Supervisor possess demonstrable and up-to-date knowledge and understands
pharmaceutical patient care, medicines, the compounding of medicine, the management and
administration of the pharmacy, and communication with patients, doctors and other external
parties.
1. The Pharmacist Supervisor complies with the Re-Registration requirements.
2. The Pharmacist Supervisor possesses up-to-date knowledge as set out in the
Primary Care Pharmacist Requirements.
3.2 The Pharmacist Supervisor serves as a community pharmacist role model for the
specialist community pharmacist trainee
As a community pharmacist, the Pharmacist Supervisor serves as a role model for the specialist
community pharmacist trainee in terms of the various competences set out in the ‘Community
Pharmacist Position Description and Competence Profile’ (see the ‘Manual detailing the
Appraisal System for Salaried Pharmacists’, published by KNMP in February 2005).
1. The Pharmacist Supervisor achieves a good score for Competence 3.1 (see above).
2. The Pharmacist Supervisor achieves a good score for the competences described in
the Community Pharmacist Competence Profile’.
4. The Pharmacist Supervisor clearly explains his or her own actions stating reasons
to the specialist community pharmacist trainee.
78
Credits
This education plan was written by Dr Henk Buurma, Director of the Specialist Community
Pharmacist advanced education programme at KNMP, who was responsible for modernising the
programme. We wish to extend our appreciation in particular to Annemieke Floor-Schreudering,
pharmacist, for her significant contribution.
Various components of the plan were submitted to numerous colleagues – practitioners, our
colleagues at the KNMP office and at educational institutions. The Young Pharmacists Society (VJA)
has also made a significant contribution as have countless external experts, including the experts at
HPC the Human Perspective in Consulting and the University of Utrecht Faculty of Medicine.
KNMP
Alexanderstraat 11
2514 JL The Hague
The Netherlands
+ 31 (0)70-37 37 373
Inforegistratie@knmp.nl
www.knmp.nl/opleiding-registratie
While this publication has been formulated with all due care, KNMP is not in any way liable for any
information that may nonetheless not be free from errors or omissions.
79

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Education Plan

Advanced Community Pharmacist

Royal Dutch Pharmacists Association

Version of April 2012

In 2005, the Subsequent Committee on the Pharmacy Education Continuum (Vervolgcommissie

Figure 1 The pharmacy education continuum

The pharmacy education continuum

University Specialty society

Bachelor’s Advanced Continuing education/

Training as specialist community

Continuing education; Lifelong learning;

5 Where the text refers to he/him, read also she/her.

II Cohesion of the education plan

Figure 2 Heineman’s ‘house’

Education Education Educational

Profile of the advanced Competences

1. Patient communication and counselling

III Profile of the specialisation in community pharmacy

7 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPWitboekFarmacie.pdf; last consulted on 05 July 2011.

8 http://www.knmp.nl/downloads/over-de-knmp/knmp-vereniging/KNMPNationaalRouteplanFarmacie.pdf; last consulted on 6 July 2011.

IV Competences of the specialist community pharmacist

Figure 4 The CanMEDS diagram

Core competences of the

IV.1 Four sub-competences in the seven competence

IV.2 Description of the competence areas and

Description of the competence area

General sub-competences of Pharmaceutical Expertise

Description of the competence area

General sub-competences of Communication

2:1. The specialist builds effective treatment relationships with patients

Description of the competence area

General sub-competences of Collaboration

3:2. The specialist provides proper referrals

Description of the competence area

General sub-competences of Scholarship

4:1. The specialist considers information from a critical perspective

Description of the competence area

General sub-competences of Health Advocacy

5:4. The specialist responds appropriately to care-related incidents

Description of the competence area

General sub-competences of Management

Description of the competence area

General sub-competences of Professionalism

V Task areas and operationalisation of the specialist

Task area 1. Patient communication and counselling

Description of task area 1

Competence area Operationalisation of the competence area:

Description of task area 2

Competence area Operationalisation of the competence area:

Task area 3. Medication surveillance910

Description of task area 3

Competence area Operationalisation of the competence area:

Professional • Performs medication surveillance with integrity, in an engaged and sincere

Task area 4. Periodic medication review

Description of task area 4

Competence area Operationalisation of the competence area:

Scholarship • Knows the evidence-based guidelines specific to the pharmacotherapy of dis-

Task area 5. Consultation with colleagues11

Description of task area 5

Competence area Operationalisation of the competence area:

Pharmaceutical • Analyses pharmacotherapy-related problems and transcribes these into recom-

Task area 6. Preventive care and screening

Description of task area 6