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Summary

This article contains information on how to complete a Collaborative Case Based Discussion.

What is a Case Bases Discussion (CBD) LX?

The Case Based Discussion (CBD) is a Workplace Based Assessment (WBA) tool that can be used to provide formative assessment as part of an approved training and development program and/or for inclusion towards ANZCAP recognition.

It can be used to facilitate exploration of a pharmacist's professional knowledge and judgement and problems solving skills through retrospective review of a direct patient or indirect patient case.

Similar to a Case Presentation (CP), a case-based discussion (CBD) allows the pharmacist to highlight professional knowledge, judgement and problems solving skills through retrospective review of a real case they have been involved in. However, the setting is less formal one-on-one discussion with the collaborator.

The main outcome of the interaction between pharmacist and collaborator should be to promote feedback and reflection of current professional practice (knowledge, critical thinking and problem solving) in a chosen professional setting or topic.

Case Bases Discussion (CBD) Process

🧩 Prepare

🗓️ Engage

💭 Reflect

The pharmacist arranges a time suitable with the collaborator(s) to engage in the CBD process. The pharmacist and collaborator should also confirm the practice recognition level and clinical setting/topic that the CBD is to focus on.
The pharmacist prepares notes on a professional case that they wish to discuss with the collaborator(s)

Pharmacist discusses the direct patient or indirect patient case with the collaborator(s)
Collaborator engages pharmacist in discussion to further explore knowledge and skills critical to the case

This discussion should typically take 15-20 minutes.

Pharmacist and collaborator engage in reflection of this discussion utilizing the Pendleton/Positive critique method
Collaborator assists pharmacist to identify key development goals from the reflection utilizing the SMART goal method

The reflection and goal setting should typically take 10-15 minutes

The total time for a CBD should take between 20-30 minutes.

Some collaborators who are conducting a CBD with a pharmacist in a formalized training program may choose to use this tool as an initiation for delivery of formal teaching which may extend the time. This is an extension of the CBD tool and not a requirement.

A CBD should be conducted in an appropriate working space that lends itself to privacy due to patient confidently and pharmacist comfort.

Choosing a Case

A Case Based Discussion can focus on either a direct patient or indirect patient case.

Examples

Management of renal failure patient
Implementation of digital health content build
A patient who has recently had a MedsCheck or HMR/RMMR completed
A patient recently admitted to an aged care facility
A patient who has recently been discharged from a hospital
Lactation clinic patient
Men’s Health clinic patient
Complex OTC patient

Ideally a CBD should focus on a case that is retrospective, where the pharmacist has previously been involved in the health care or service delivery. This allows the discussion between pharmacist and collaborator(s) to focus on justification of professional decision making and to incorporate primary literature or more specialized resources and references. As such the cases discussed in a CBD are likely more complex or specialized scenarios than those that are covered in a Mini-Clinical Examination (Mini-CEX).

Prior to the CBD the pharmacist and collaborator should confirm the practice recognition level and clinical setting/topic that the CBD case will allow the pharmacist to show.

Practice Recognition Level

The CBD Learning Experience is mapped to Domain 1 of the National Competency Standards Framework for Pharmacists in Australia 2016.

Please refer to the ANZCAP recognition descriptors article for the further guidance on markers of performance for each ANZCAP recognition level. The pharmacist and collaborator should indicate on the learning experience tool which of the three levels of practice recognition (resident, register, consultant) they are currently practicing at or a candidate for. Please note that not all the domain 1 indicators listed in this document may be relevant to this Learning Experience.

Complexity

In some scenarios the same patient case may be used for pharmacists aiming for different levels of practice recognition. However, the complexity and expected knowledge and skills expected to be displayed will vary.

The pharmacist and collaborator should come to an agreement on the complexity (low, medium or high) of the case in relation to the level of recognition the pharmacist is practicing at.

Collaborator

The Collaborator must be familiar with the Case Based Discussion LX process.

The Collaborator must ensure that they have the required expertise and scope of practice to confidently provide the candidate with feedback on the setting/topic being assessed in the CBD.

Collaborators may come from a variety of health professional backgrounds e.g. pharmacy, medical, surgical, nursing.

Further guidance for collaborators involved in this learning experience can be found here.

Reflection, Feedback & Goal Setting

The main aim of the CBD as a Learning Experience is to promote feedback and reflection of a pharmacist's professional knowledge, judgement and problems solving skills in a chosen direct patient or indirect patient case. This feedback can cover the clinical/professional aspects of the case as well as the methods that the pharmacist uses to present the case.

Skill Evaluation

Within the CBD tool there are key skills (and descriptors) that the pharmacist and collaborator should discuss during the feedback and reflection. Each skill should be evaluated with comments from the discussion and a marker of; Not yet met, meets, exceeds or n/a.

Not yet met	Performance does not yet meet the expected for the indicated practice recognition level.
Meets	Performance meets the standard expected for the indicated practice recognition level.
Exceeds	Performance is above the standard expected for the indicated practice recognition level and is moving towards progression in recognition level.

Feedback

The CBD tool encourages use of the Pendleton feedback method to guide reflection. This method encourages self-reflection and proactive discussions for development.

Development Goals

The pharmacist and collaborator are encouraged to utilize the SMART goal technique to develop any learning or development goals that are identified from the reflection and feedback discussion.

Although some collaborators who are also supervisors or clinical educators in a formalized training program may choose to use this tool as an initiation for delivery of formal teaching, this is an extension of the CBD tool and not a requirement.

Forms and Templates

The CBD tool is available on the ANZCAP Digital platform. Ideally pharmacists and collaborators will enter relevant information into the digital tool in real time and confirm involvement and accomplishment of the Collaborative Learning Experience.

Alternatively, pharmacists may use CBD tools from their own workplace and upload it to the digital platform where they can then confirm completion of a Collaborative Learning Experience.

For further details on how to complete a Learning Experience on the ANZCAP digital platform please refer to the How to complete a Learning Experience article.

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