Entry-level Competencies Needed for Managed Care Pharmacy ...

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esponsibilities the employer has for the orientation, mentoring and development of a new pharmacist employee. AMCP views the education and training of managed care pharmacists to be a shared responsibility between educators and practitioners. We set forth in this document a list of those competencies that we feel might reasonably be expected of all new graduates. We believe that pharmacists entering managed care pharmacy practice with a good foundation in these areas will be able to succeed if appropriately coached and mentored by more experienced practitioners. There is also a growing need in managed care pharmacy for a certain number of advanced-level practitioners. In order to help in meeting this need, a number of managed care pharmacy organizations provide accredited residency training programs. (Part of the information provided above is excerpted directly from one or more of the following AMCP sites: www.amcp.org/WorkArea/DownloadAsset.aspx?id=9040 www.amcp.org/WorkArea/DownloadAsset.aspx?id=14955 www.amcp.org/WorkArea/DownloadAsset.aspx?id=14956 The reader is referred to these sites for more complete information about managed care organizations and the roles and responsibilities of managed care pharmacists.) Process Following an initial planning meeting (conference call), individual members of the Task Force generated lists of the competencies they felt were necessary for entry-level pharmacists practicing in a managed care environment (i.e., competencies that all PharmD graduates should possess). These initial lists were collected by staff and organized into the following categories: areas of knowledge required (the cognitive domain), skills required (the psychomotor domain), and attitudes and values required (the affective domain). The resulting list was sent as a questionnaire to all task force members, with instructions to mark each proposed competency statement as too specific, too broad, or OK as stated. Respondents were also asked to indicate (with a yes or no reply) if the item was appropriate for a new PharmD graduate. A space for comments was provided for each competency. The initial list was refined based on feedback received from Task Force members, and the revised list was sent to Task Force members. A second conference call was scheduled for discussion of the results. This discussion led to the development of an amended competency list, totaling 55 items that served as the basis for a survey of the total AMCP membership (using Survey Monkey®). Respondents were asked to rate each of the 55 competency statements in two ways: first, they were asked to indicate (with a yes or no vote) if they expected new PharmD graduates to possess the competency upon graduation; and second, they were asked to rate the level of importance of each competency item in the practice of managed care pharmacy (using a 1 to 5 scale, where 5 represents the highest level). The AMCP survey instrument and results are shown in Appendix 1, beginning on page 8. 2
Following completion of the AMCP membership survey, a third Task Force conference call was held to discuss the results (including individual comments received from respondents). In preparation for that call staff prepared a summary report that reported the average number of yes votes for each item (indicating respondents’ expectations that new PharmD graduates would possess that competency) and the average importance rating for each. That report is provided in Appendix 2 (beginning on page 43). Based on this discussion, all the competency statements were sorted into three categories: (1) those items that received at least 85% yes votes in response to the question about expectations of new graduates plus an importance rating of 4.0 or greater (on a scale of 1 to 5); (2) those items that met one of these two thresholds but not both (i.e., 85% or greater on expectations and less than 4.0 on importance, or less than 85% on expectations but 4.0 or greater on importance); and (3) those items that met neither threshold. It was agreed that a final survey of Task Force members would be conducted, to allow members to indicate, for each competency statement, whether it should be retained or rejected (based on the results of the ratings just described). It was understood that the results of this survey would generate a final list of competencies expected of new PharmD graduates in a managed care practice setting, to be included in the Task Force’s final report. Staff prepared a survey questionnaire for this purpose, which is shown in Appendix 3 (beginning on page 47). Responses were received from seven Task Force members. For most of the items that were retained, there was unanimous approval. In certain other cases, items were retained without a unanimous vote. There was a split vote in each case where items were ultimately rejected. In such cases, the majority vote (i.e., 4 out of 7) was used in generating the final list. Results Based on the processes described here and data provided in the appendices, the AMCP-ACPE Task Force concludes that new Doctor of Pharmacy graduates seeking employment in a managed care environment should possess each of the competencies listed below. These are organized into three domains: the cognitive (knowledge-based) domain, the psychomotor (skills-based) domain, and the affective (attitudes/values) domain. From the original list of 55 proposed competency statements, this list includes 44 items. The remaining items (those not included here) were either combined with other statements in this final list or were rejected based on the results of the membership survey and subsequent analysis by members of the Task Force. Cognitive domain 1. Explain the general concept of managed care. 2. Describe the differences between health care delivery models, including PPOs, ACPs, integrated systems, and patient-centered medical homes. 3. Define pharmacoeconomics and explain practical applications. 4. Outline the general provisions of Medicare Parts A, B, C and D, and Medicaid, including coverage of medications. 5. Define formulary system and explain the rationale for and practical applications of a formulary system. 6. Describe the steps involved in developing a formulary system. 3
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Page 5 and 6: 34. Conduct medication utilization
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Entry-level Competencies Needed for Managed Care Pharmacy ...

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