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Qualifying Examination Blueprint

Introduction

The Pharmacist Qualifying Examination blueprint is based on the 2014 NAPRA Professional Competencies for Canadian Pharmacists at Entry to Practice. The exam blueprint informs candidates about what the exam will test and guides PEBC to design exams that are comparable from one time to the next, giving all candidates equal opportunity to show whether or not they have the competencies that are necessary to practise pharmacy safely and effectively in Canada. Therefore, all candidates should review this blueprint thoroughly and determine whether or not they are ready to practise pharmacy or if they need more preparation or experience in any competency area before taking the Qualifying Examination.

Competencies are defined as significant job-related knowledge, skills, abilities, attitudes and judgments required for competent performance (i.e., safe and effective practice). They provide an overview of what a pharmacist must be able to do at entry to practice, without supervision, when the need arises. Standards of practice describe ”good practice”, providing some detail about how to perform many of the tasks required to provide safe and effective pharmacy services. The national standards of practice are outlined in NAPRA’s Model Standards of Practice for Canadian Pharmacists. To meet these standards, pharmacists need to have and apply the competencies described. To be certified by PEBC and registered as a pharmacist, candidates are required to demonstrate that they have these competencies, by successfully completing the Qualifying Examination.

Qualifying Examination questions in Part I (MCQ) and station tasks in Part II (OSCE) are linked to these national competencies. The proportion of the overall Qualifying Examination that focuses on the nine major competencies is shown in the column on the right as a percentage (%). These percentages indicate how much of the Qualifying Examination (both Parts combined) is focused on each competency. This also indicates the relative importance of each competency in the exam results and final certification decisions. When both Parts assess the same competencies, they will often assess different aspects or elements of the same competency. The check marks in the columns on the left indicate whether the competency element is tested in one or both Parts of the exam. “Patient Care” has the highest overall weighting and the highest weighting in each Part (MCQ and OSCE). This reflects the paramount importance of this competency to achieve best possible patient outcomes.

A double check mark beside the key competency element in each section indicates that the competency has a higher weighting in one Part of the exam than in the other Part. For example, “Product Distribution” and “Practice Setting” have higher weightings in Part I (MCQ) than in Part II (OSCE), whereas “Communication and Education” and “Intra- and Inter-Professional Collaboration” are more highly weighted in Part II (OSCE) than in Part I (MCQ).

The role of the pharmacist in the Canadian health care system has evolved significantly over the past several years. Thus, pharmacists’ required knowledge and skills at entry to practice have also evolved, in order to fulfill their expanded scope of practice and meet patients’ needs. Thus, the blueprint now includes the following two competencies that were not as prominent in previous exam blueprints: “Health Promotion” and “Quality and Safety”.

The competencies for pharmacists and pharmacy technicians are closely aligned, with each group taking responsibility for their respective roles while working collaboratively. Pharmacists are primarily responsible for drug therapy advice and decision-making, focusing on the clinical aspects of patient care. Pharmacy technicians are primarily responsible for the technical functions and for referring patients to the pharmacist for drug therapy advice. In many workplaces, pharmacists take or share responsibility for these technical functions, and must be competent in “Product Distribution”.

Although some aspects of the scope of practice of the Canadian pharmacist may differ among jurisdictions and workplaces, the core competencies expected of pharmacists at entry to practice are the same. In all settings, when providing patient care, the pharmacist works in collaboration with the patient, pharmacy technicians and other health care professionals in order to achieve the best possible health outcomes for the patient.

Competencies

Competency 1: Ethical, Legal and Professional Responsibilities

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√	Competency 1: Ethical, Legal and Professional Responsibilities Pharmacists practise within legal requirements, demonstrate professionalism and uphold professional standards of practice, codes of ethics and policies.	8%
√	√	1.1 Practise within legal requirements. Apply legal requirements to practice, including federal and provincial/territorial1 legislation, policies, by-laws, and standards. Apply federal and provincial/territorial1 privacy legislation to the collection, use, storage, disclosure and destruction of personal health information.
√	√	1.2 Uphold ethical principles. Apply the principles of professional codes of ethics. Apply ethical principles in the decision-making process.
√	√	1.3 Manage actual and potential illegal, unethical, or unprofessional actions or situations in practice. Identify illegal, unethical or unprofessional actions or situations. Conduct appropriate intervention to address illegal, unethical or unprofessional actions or situations.
√	√	1.4 Apply principles of professionalism. Apply principles of self-regulation. Accept responsibility and accountability for own actions and decisions. Seek guidance when uncertain about own knowledge, skills, abilities, and scope of practice. Maintain appropriate professional boundaries. Protect the privacy and confidentiality of the patient. Manage situations of actual and perceived conflict of interest. Describe the Canadian health care system and the role of health professionals within it.
√	√	1.5 Document activities of practice in compliance with federal and provincial/territorial legislation¹, standards and policies. Maintain complete, accurate and secure patient records. Identify situations in which documentation should and should not be shared with other health professionals or third parties. Select appropriate methods to share documentation within the circle of care and facilitate patient care.

¹Provincial/territorial legislation is not tested in the PEBC Qualifying Examination.

Competency 2: Patient Care

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√	Competency 2: Patient Care Pharmacists, in partnership with the patient and in collaboration with other health professionals, meet the patient’s health and drug-related needs to achieve the patient’s health goals.	42%
	√	2.1 Develop a professional relationship with the patient. Establish and maintain rapport by using effective communication skills. Demonstrate a caring, empathetic, and professional attitude. Determine and acknowledge the patient’s needs, values, desired level of care and health goals. Identify and respect the roles and responsibilities of each party in the relationship.
√	√	2.2 Obtain information about the patient. Gather information from the patient using appropriate interview techniques, including active listening. Gather information from the patient’s health records and from other health care team members. Perform, order and/or retrieve relevant laboratory tests and other diagnostic assessments. Perform physical assessments. Organize, reconcile and record the patient’s information.
√	√	2.3 Assess the patient’s health status and concerns. Assess the patient’s health and drug-related needs, as expressed by the patient, considering the impact of factors such as culture, language, demographic and physical characteristics. Assess the relevance, accuracy, currency and completeness of the information in relation to the patient’s needs. Interpret relevant laboratory tests and other diagnostic assessments. Interpret findings of relevant physical assessments. Perform medication reconciliation. Assess the patient’s ability to access and use his or her medication.
√	√	2.4 Determine the patient’s actual and potential drug therapy problems. Identify actual and potential drug therapy problems. Prioritize drug therapy problems in collaboration with other members of the patient’s circle of care.
√	√	2.5 Develop the patient’s care plan, in partnership with the patient and in collaboration with other health professionals. Determine the patient’s health goals and optimal therapeutic outcomes, specifying measurable endpoints, target values and timeframes. Assess possible treatment options, including drug and other therapeutic methods, using an evidence-informed approach. Outline the potential benefits and risks of the treatment options. Recommend the optimal treatment for the patient. Provide education to support the patient in making informed decisions about their care plan. Determine the actions required, and person responsible for each action, to achieve the patient’s health goals. Consult other health professionals as appropriate and adjust the proposed care plan accordingly. Determine the monitoring parameters, including the clinical indicators, techniques and timelines. Communicate the rationale for the care plan within the circle of care.
√	√	2.6 Implement the patient’s care plan. Provide consultation and education to support the patient in successfully implementing the care plan Undertake the actions and interventions outlined in the care plan including prescribing drugs, adapting prescriptions, and collaborating within the circle of care.
√	√	2.7 Administer drugs to the patient by injection² using the necessary technical skills and applying the appropriate clinical knowledge.
√	√	2.8 Monitor the patient’s progress and assess therapeutic outcomes. Review monitoring parameters, end points and timelines outlined in the patient’s care plan. Discuss with the patient the ongoing monitoring and information sharing responsibilities of the pharmacist, patient and other health professionals. Follow-up with the patient to evaluate the effectiveness of care plan activities. Assess the patient’s adherence and tolerance to drug therapy. Assess the effectiveness and safety of the drug therapy. Undertake appropriate intervention based on the patient’s progress towards their health goals and revise the care plan accordingly.

²Detailed competencies required of pharmacists providing injections are outlined in the document entitled Supplemental Competencies on Injection for Canadian Pharmacists.

Competency 3: Product Distribution

Part I (MCQ)

Part II (OSCE)

COMPETENCIES

Parts
I and II
Overall

√√

√

Competency 3: Product Distribution

Pharmacists ensure accurate product distribution that is safe and appropriate for the patient.

13%

√

3.1 Dispense a product safely and accurately that is appropriate for the patient.

Address concerns related to the validity, clarity, completeness or authenticity of the prescription.
Assess the therapeutic appropriateness of the prescription for the patient.
Select appropriate products and ingredients using knowledge of bio-equivalency, therapeutic equivalency, interchangeability, quality, integrity and stability of drugs.
Perform pharmaceutical, compounding and patient-specific calculations, including pharmacokinetic and other therapeutic calculations.
Develop master compounding formulas.
Prepare and compound non-sterile and sterile products according to recognized guidelines and standards of practice.
Identify and address patterns of unusual drug prescribing and usage including possible diversion or drug misuse.
Check the product and its prescription label against the prescription using a systematic approach, including an independent double check.

Competency 4: Practice Setting

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√√		Competency 4: Practice Setting Pharmacists oversee the practice setting with the goal of ensuring safe, effective and efficient patient care.	3%
√		4.1 Optimize the safety, efficacy and efficiency of operations in the practice setting. Demonstrate the organizational and time management skills necessary to effectively prioritize, organize and manage patient care. Manage support personnel such that assigned functions are carried out to meet accepted standards.
√		4.2 Oversee pharmacy inventory to ensure safe, effective and efficient patient care. Address issues with the drug supply chain, including drug shortages and drug recalls. Develop procedures to ensure the return or proper disposal of recalled, expired and unusable products.

Competency 5: Health Promotion

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√	Competency 5: Health Promotion Pharmacists use their expertise to advance the health and wellness of patients, communities and populations.	3%
√	√	5.1 Engage in health promotion activities with the patient. Assess the primary health needs of the patient, considering the socio-economic, cultural, environmental and other factors that are barriers to, or facilitators of, health and wellness for the patient. Collaborate with the patient and other health professionals in the development and implementation of patient-specific health promotion strategies, including smoking cessation and immunization. Facilitate the patient’s access to and interaction with support agencies and health services within the healthcare system.
√	√	5.3 Contribute to the maintenance of a healthy environment for the public. Promote the proper handling and disposal of drugs and hazardous materials with the patient, self and others. Identify and minimize the risk of disease transmission from the pharmacy environment.

Competency 6: Knowledge and Research Application

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√	Competency 6: Knowledge and Research Application Pharmacists access, retrieve, critically analyze and apply relevant information to make evidence -informed decisions within their practice with the goal of ensuring safe and effective patient care.	6%
√	√	6.1 Apply knowledge, research skills and professional judgment to the decision-making process. Critically analyze and develop solutions to problems in pharmacy practice. Make decisions using an evidence-informed approach. Rationalize recommendations and decisions with critically analyzed evidence and accurate explanations.
√	√	6.2 Respond to questions using appropriate strategies. Use a variety of retrieval techniques to access reliable sources of relevant information, including evidence-based information when possible. Evaluate and interpret the information. Apply critical appraisal techniques to scientific and research information. Analyze the information to determine the appropriate response.
√	√	6.3 Apply relevant information to practice. Gather new information, including evidence-based information when possible, that may be applicable to practice. Evaluate and interpret the information using critical analysis techniques. Use current, relevant and reliable information to improve practice.

Competency 7: Communication and Education

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√√	Competency 7: Communication and Education Pharmacists communicate effectively with patients, the pharmacy team, other health professionals and the public, providing education when required.	14%
√	√	7.1 Establish and maintain effective communication skills. Demonstrate proficiency in written and verbal English or French. Demonstrate appropriate verbal and non-verbal communication skills, including listening skills. Demonstrate appropriate interview techniques. Select appropriate communication and education techniques for use with the patient and other health professionals. Conduct interpersonal interactions, including conflict management, in a professional manner. Communicate with sensitivity, respect and empathy.
√	√	7.2 Implement safe, effective and consistent communication systems. Use communication techniques that maximize safety and understanding, including repeating back verbal orders, using recognized terminology and avoiding unnecessary or unsafe abbreviations.

Competency 8: Intra- and Inter-Professional Collaboration

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√√	Competency 8: Intra- and Inter-Professional Collaboration Pharmacists work in collaboration with the pharmacy team and other health professionals to deliver comprehensive services, make best use of resources and ensure continuity of care in order to achieve thepatient’s health goals.	6%
	√	8.1 Create and maintain collaborative professional relationships. Identify potential collaborators with whom to initiate ongoing professional relationships. Collaborate with other parties in the relationship to define the roles and responsibilities of each party.
	√	8.2 Contribute to the effectiveness of working relationships in collaborative teams. Interact respectfully with other members of the team by accepting accountability for themselves and managing disagreements and conflict. Share decision-making activities with other members of the team.
	√	8.3 Participate in the delivery of collaborative health services. Participate in the formation and functioning of a collaborative team. Collaborate with team members to ensure appropriate utilization of resources. Collaborate with team members to determine and achieve team goals and objectives. Participate in the assessment of the patient and development of the care plan in collaboration with other members of the team. Facilitate continuity of care.
√	√	8.4 Accept and make referrals for specific services. Recognize signs, symptoms and risk factors indicative of health needs that fall beyond the scope of practice of pharmacy. Select the most appropriate health professional or health agency for the referral. Accept responsibility for referrals from other health professionals.

Competency 9: Quality and Safety

Part I (MCQ)	Part II (OSCE)	COMPETENCIES	Parts I and II Overall
√	√	Competency 9: Quality and Safety Pharmacists collaborate in developing, implementing, and evaluating policies, procedures and activities that promote quality and safety.	5%
√	√	9.1 Contribute to a culture of patient safety. Apply principles of patient safety to improve practice. Employ best practices when informing the patient of the occurrence of a medication incident or adverse drug event.
√	√	9.2 Contribute to continuous quality improvement and risk management activities related to pharmacy practice. Apply principles of continuous quality improvement to practice. Apply principles of risk management to practice by anticipating, recognizing and managing situations that place the patient at risk. Identify the occurrence of a medication incident, adverse drug event or close call and respond effectively to mitigate harm and prevent reoccurrence. Identify high-alert drugs and high-risk processes in order to respond effectively.
√	√	9.3 Ensure the quality, safety and integrity of products. Ensure that products are stored and transported under the conditions required to maintain product quality, safety and integrity, including cold chain management.
√	√	9.4 Create and maintain a working environment that promotes safety. Handle hazardous products safely by minimizing personal exposure and reducing environmental contamination.