Certificate of achievement template

Julienne K. Kirk(a), Pamela U. Joyner(b), Austin J. Lee(c) and Karen S. Oles(a)

The purpose of this article is to describe certificate program criteria development and the implementation of a diabetes certificate program for pharmacists in North Carolina. Discussion of the difference between a certificate program and certification is reviewed along with program participation levels of a diabetes certificate program. Specific components including didactic, skills, and patient care experiences are discussed with regard to program requirements, time course, costs, certificate update and outcome measures. The primary findings of this experience are that a certificate program in diabetes was requested, developed, implemented, and attended by numerous pharmacists in North Carolina. Certificate programs are continuing to emerge. This program represents an important phase in the evolution of certificate programming in North Carolina.

INTRODUCTION

As a result of the changes in health care and the movement toward pharmaceutical care, there is a critical need for pharmacists to upgrade their skills and assume greater responsibility for patient care outcomes. Certificate programming is rapidly becoming one method of focused competency-based, continuing education. Certificate programs offer pharmacists the opportunity to acquire knowledge and skills necessary to develop new roles in disease state management(1,2).The approach of imparting focused knowledge and skills through patient case application will hopefully allow pharmacists to take on new roles in patient education and disease state management.

Certificate Program versus Certification

According to the 1989 American Association of Colleges of Pharmacy (AACP) and the American Council on Pharmaceutical Education (ACPE) Conference on Certificate Programs, certificate programs provide opportunities for practitioners to acquire knowledge and develop skills that enable the development of predetermined practice competencies(3,4). Upon meeting the program requirements, a certificate of achievement is usually given to the participant(5). In North Carolina (NC), the NC Center for Pharmaceutical Care has been developed to evaluate and certify programs. Providers of certificate programs submit their program for approval in order to obtain recognized certification for pharmacists in the state.

In contrast, certification indicates recognition of competency in a specialized area and requires consistent performance in didactic, skills and patient care activities(2-6). The purpose of certification is to grant recognition to practitioners who are competent in an area and to safeguard the public(26) On the national level, the Board of Pharmaceutical Specialties (BPS) is the only organization empowered to certify specialists in pharmacy. Currently, BPS administers speciality certification examinations in pharmacotherapy, nuclear, nutrition support, oncology, and psychiatric pharmacy(7). In addition, the American Society of Consultant Pharmacists is currently developing a national certification exam for pharmacists in geriatric pharmacy(8). Another certification of interest to pharmacists is the Certified Diabetes Educator (CDE), a national certification process for health care professionals. Requirements include documentation of one thousand patient care hours and successfully completion of an exam every five years(9). Some disagree on the use of the term certificate program since the terminology can be confusing when compared to the examples of national certification processes described above(3,10,11). While the specific terminology is debated, the potential utility of certificate programs in continuing pharmacy education is compelling.

One of the areas of concern regarding certification has been the lack of consistency. A review of existing certificate programs indicates great variation in time requirements, ranging from a few days to more than a year(12,13). In an attempt to develop standardization and quality control of certificate programs in NC, a certificate programs task force was appointed jointly in 1996 by the Deans of two Schools of Pharmacy in NC. Members of the task force included representatives from both Schools of Pharmacy, the NC Society of Health-System Pharmacists, the NC Pharmaceutical Association and the NC Area Health Education Centers Program. The task force studied the definition adopted by the 1989 AACP/ACPE Conference on Certificate Programs and developed a definition for NC certificate programing(3).

A certificate program was defined by the NC task force as an educational experience that has the components of the acquisition of new knowledge, the development of skills, and the application of knowledge and skills to practice via experiential training. The specific criteria for certificate programs are outlined in Table I. The primary objective of this paper is to describe a certificate program in diabetes that was developed to fill an ongoing need of improving the delivery of diabetes care as requested by numerous practicing pharmacists in NC.

METHODS

Development of a Diabetes Certificate Program

Certificate program design and delivery continues to evolve in NC. One of the first certificate programs to be offered under the NC task force guidelines was in diabetes. This program serves as an example of certificate program implementation and was designed as a statewide effort in NC through the Northwest Area Health Education Center and the School of Pharmacy at the University of NC at Chapel Hill. The proposed template for NC certificate programs requires three levels of participation as described in Table II. It was estimated that the total time commitment for this program averaged 57 hours (15 hours for home study manual and posttest, 13 hours for skill sessions, four hours per patient case including education sessions and write-up for a total of 24 hours, and five hours for case presentation). In general, the program requires a minimum of three months to complete but the rate is dependent on the participant.

Level 1- Content Update

A certificate program brochure was mailed to all licensed pharmacists in NC approximately three months prior to the skills seminar. This allowed time for the participant to complete a study manual and pass a posttest which fulfilled Level 1 criteria in Table II. A pharmacist could apply to the program as long as he/she had access to working with patients who have diabetes. Selection of participants was on a first-come, first-served basis.

The home study manual provided an avenue for pharmacists to update, strengthen, and build their diabetes knowledge base at their own pace. The sections of the study manual included pathophysiology, exercise, stress management, nutrition, pharmacotherapy, self-monitoring, acute and chronic complications, special management issues, and the pharmacist's role in diabetes management. The manual was written using a number of references primarily from the American Diabetes Association(14). A posttest was designed by developing 40 multiple choice questions covering each area in the study manual to assure that participants had some baseline competency. Field testing took place to determine the amount of time required to read the study manual and complete the posttest. The material was mailed to 10 practicing pharmacists who were not enrolled in the program. A total of five completed and returned the material. The average time for completion of the manual and posttest was approximately 15 hours. It was decided that if participants did not pass the posttest with a score of at least 80 percent, a re-test would be offered once using a different set of multiple choice questions for the posttest. If participants successfully completed the manual and passed the posttest, they were allowed to register for a two day skills seminar.

Level 2 - Clinical Application of Skills

A maximum of 25 participants were allowed to participate in a two-day skills seminar. Prior to attending the skills seminar, participants were sent information regarding how to prepare a case presentation and a SOAP (SubjectiveObjective-Assessment-Plan) note. Other information provided to aid in the case work-up of at least one patient included a request for the release of patient medical information and a sample cover letter to a physician that explained the program and how the pharmacist might work with the patient. Additional materials consisted of a data collection for initial patient work-up, an interview form, a flow sheet, and educational objectives for patients with diabetes.