Transition Times - Spring 2010

Alberta is looking forward to welcomingthe new profession of regulated pharmacytechnicians. This new profession willprovide benefits to patients, pharmacytechnicians, pharmacists, and our healthsystem.

The framework and processes forregulating technicians has evolved overseveral years and has been shaped by theinvolvement of many individuals andgroups. This newsletter outlines where weare today – including what possibilitieswere considered and what decisions werearrived at – and what the next steps will be.

Patients, professions, and theprovince will benefit fromregulated pharmacy technicians

Regulated pharmacy technicians will bedirectly responsible and accountable for thetechnical functions related to prescriptionpreparation and processing. They will haveto demonstrate key competencies throughnationally administered exams and willtake on the responsibility, accountability,and any resulting legal liability for theirwork. They will then be authorized to

TheTransitionTimes

Working towardregulation since 2003

Technician scopeof practice

Registering with ACP Next steps

H E L P I N G Y O U N A V I G A T E C H A N G E

Steps toregulation

Spring 2010

H e a l t h y A l b e r t a n s t h r o u g h e x c e l l e n c e i n p h a r m a c y p r a c t i c e

Welcoming a new healthcare profession

continued on page 2

Things to keep in

mind while reading:

n When the term pharmacy technician or

technician is used in this newsletter and

in the practice standards, it refers to a

regulated individual who will be

registered with ACP.

n The Pharmacists Profession Regulation

referred to is the legislation that defines

professional roles for pharmacists and

pharmacy technicians. It is currently

being amended to accommodate

regulated pharmacy technicians.

As part of the amendments, the name

Pharmacists Profession Regulation will

change to reflect that it applies to both

professions.

n The processes for technician regulation

outlined here will come into effect once

the amended Pharmacists Profession

Regulation is enacted. That is expected

to happen in late 2010.

Understanding the pharmacytechnician regulation process

work under the direction of a pharmacist(i.e., unsupervised), rather than undersupervision. This change will producemany benefits.

Patients will benefit becausepharmacists, freed from the technicalaspects of the dispensing process, will bemore accessible to patients and will beable to focus on more comprehensivepatient care through medicationmanagement, prescription adaptationand initial prescribing, immunization,counseling and follow-up.

Pharmacists will benefit because thework in the areas of prescriptionprocessing and preparation can shiftfrom the pharmacist to the technician,thereby allowing pharmacists to moreappropriately use their skills andknowledge to deliver patient care.Pharmacists will be able to let go ofsome dispensing roles, knowing thatpharmacy technicians have meteducational standards anddemonstrated their competency.

Pharmacy technicians will benefit becauseby having met defined and recognizedstandards for education and competency,they will have the knowledge, skills, legalauthority and confidence to practice moreindependently and to take on moreauthority. While pharmacists will still beresponsible for assessing the

appropriateness of each prescription andcounseling patients, pharmacy technicianswill be able to compound, dispense andsell drugs unsupervised. They will also beable to supervise other technicians,assistants and pharmacy technicianstudents in the pharmacy.

The health system will benefit becausehealth professionals’ skills will be usedmore appropriately and patients will haveincreased access to care from pharmacists.

The Alberta College of Pharmacists willbenefit because the regulation of pharmacytechnicians helps fulfill two of the college’sprimary goals: protecting the public andoptimizing the use of pharmacyprofessionals’ skills.

Unlike a professional association oradvocacy group which acts in the interestof its members, a professional college actsin the interest of the public. The mandateof the Alberta College of Pharmacists(ACP) is to protect the public’s health andwell-being. Therefore, ACP has aresponsibility to ensure that onlyindividuals who have the knowledge andwho can demonstrate the requiredcompetencies be registered.

By regulating pharmacy technicians, ACP can be assured – and can assure thepublic - that these regulated individualshave met national and provincial entry-to-practice standards and are competentto take on more responsibility within thecompounding and dispensing functions.

Spring 2010 TheTransitionTimes alberta college of pharmacists

2

Welcoming a new healthcare professioncontinued from page 1

If I do not qualify to registerwill I lose my job?

ACP does not expect that allindividuals currently working astechnicians will pursue registration.Pharmacy licensees will not berequired to hire a pharmacytechnician. In fact, we anticipate thatthe process will be gradual and thatthere will continue to be a variety ofviable pharmacy business modelswith and without regulatedtechnicians.

Can I still use the title pharmacytechnician if I don’t qualify forregulation?

No. Only individuals who areregistered on ACP’s pharmacytechnician register will be able to becalled a pharmacy technician andonly these regulated individuals willbe permitted to practice unsupervisedand conduct the final qualityassurance check on dispensedprescriptions.

Once the legislation has beenenacted, will there be a pay scalethat has to be followed?

ACP is not legally authorized to setpay scales or negotiatereimbursement for pharmacists orpharmacy technicians, so will not beentering into any reimbursementdiscussions. ACP’s mandate is toprotect the public by setting andenforcing high standards ofcompetence and ethical conduct.

ACP Alberta College of Pharmacists

CAPT AB Alberta branch of the Canadian Association of PharmacyTechnicians

CCAPP Canadian Council on the Accreditation of Pharmacy Programs

CPTEA Canadian Pharmacy Technician Educators Association

NAPRA National Association of Pharmacy Regulatory Authorities

PEBC Pharmacy Examining Board of Canada

PTCB Pharmacy Technician Certification Board of Alberta(later known as PTeB)

PTeB Pharmacy Technician Board of Canada

PTSA Pharmacy Technician Society of Alberta

Acronym Key

FAQs from technicians

For almost a decade, pharmacy technicians,pharmacists, and ACP have workedtogether to develop the framework fortechnician registration in Alberta.

A steering committee comprised ofpharmacy technicians and pharmacytechnician educators was established bythe Alberta branch of the CanadianAssociation of Pharmacy Technicians(CAPT AB) and the Pharmacy TechnicianCertification Board of Alberta (PTCB, laterknown as PTeB) to consider the merits ofself-governance of pharmacy technicians.

The CAPT AB/PTCB steeringcommittee made a proposal for technicianregulation to the provincial Minister ofHealth. At that time, the Minister indicatedsupport for the idea, but said no newprofessions would be recognized until allof the current professions said wererecognized under the Health Professions Act.

Pharmacy technicians formed thePharmacy Technician RegulatoryCommittee of Alberta. This committeewas comprised of volunteers from CAPT Alberta and PTeB and otherinterested individuals.

The Pharmacy TechnicianRegulation Working Group wasestablished to develop a plan to achievetechnician regulation in Alberta.

n 4 appointees from ACP, 3 appointeesfrom the Pharmacy TechnicianRegulatory Committee of Alberta

n This group recommended thatpharmacy technicians in Alberta beregulated within the Alberta College ofPharmacists.

ACP began accepting applicationsfor the voluntary Pharmacy TechnicianRegister. To date there are 975 pharmacytechnician members of ACP.

While technician regulation is a provincial

responsibility, there has been nationalcoordination to ensure that processes aresimilar and credentials are transferableacross the country.

The diagram below summarizes other keynational initiatives in which pharmacistsand pharmacy technicians have partneredto facilitate technician regulation. Allprovinces pursuing technician regulationare basing their programs on theseinitiatives.

In all cases there has been directparticipation or consultation withpharmacy technicians or pharmacytechnician educators from across Canada,including Alberta.

2008

2003

2005

2006

2007


Working toward regulation since 2003

Educational outcomes to support the standardization of pharmacy technician

training programs were led by CPTEA.

These outcomes outline the essentiallearning required by graduates at

entry-to-practice and provide consistent standards

for pharmacy technician programs both inter- and intra-provincially.

Abridging

program (fourcourses) to assist

in determining theacademic equivalence

of individuals who havenot graduated from

accredited programs wasdeveloped in Ontario through

the leadership of the OntarioCollege of Pharmacists and pharmacy techniciancandidates.

The accreditation of technician training programs is being led

by CCAPP at the request of technician, technician educator and pharmacist groups.

Accreditation standards are based on CPTEA’s Educational Outcomes and

NAPRA’s Entry to Practice Competencies.

CCAPP began accepting applications for accreditation and accrediting

programs in 2008.

1

5

4

2

3

CompetencyBased Standards

for Entry to Practicedevelopment was

led by NAPRA. They weredeveloped by technicians,

regulators and representativesfrom national pharmacy

organizations and approvedby NAPRA’s Board of

Directors in November 2007.This document outlines

the competencies requiredfor pharmacy technicians

to perform their role in a regulated

environment.

Examinations for entry to practice

are being led by PEBC.

3

Cooperativenational initiativestoward pharmacy

technicianregulation


4

The biggest changes resulting from the regulation of pharmacy technicians will not only bein the scope of their practice, but in the fact that technicians will become legally responsibleand accountable for their work. Although practitioners feel a personal responsibility for thework they undertake now, this is different than the legal accountability and liabilityconferred with regulation.

Some non-pharmacists may now be performing at higher levels than others in pharmacysettings, but there is currently no regulatory process which holds them directly responsible tothe public for their practice. Having mechanisms to ensure accountability is important tothe public, the profession, and the college. The regulation of technicians will provide agreater degree of protection for the public as pharmacy technicians move to higher levels ofresponsibility (e.g., conducting restricted activities unsupervised and supervising others)and permit more effective use of the skills of pharmacists.

What will a regulated pharmacy technician be able to do?

Schedule 19 of the Health Professions Act (as proposed in the Health Professions AmendmentAct) provides the following role statement for pharmacy technicians:

In their practice, pharmacy technicians promote safe and effective drug distribution and, in relation tothat, do one or more of the following under the direction of a pharmacist:

a) receive, gather, enter and store prescription and patient information,

b) store and repackage products,

c) participate in the management of systems for drug distribution and inventory control,

d) participate in the research, development, implementation and evaluation of quality assurance andrisk management policies, procedures and activities,

e) provide restricted activities authorized by the regulations,

f) instruct patients about the use of health aids and devices, and

g) teach the practice of pharmacy technicians.

Subsection (e) refers to restricted activities. What are these?

The amendments to the Pharmacists Profession Regulation propose that, under thedirection of a clinical or courtesy pharmacist, a pharmacy technician be authorized to:

a) dispense a Schedule 1 drug or Schedule 2 drug;

b) compound, provide for selling or sell a Schedule 1 drug or a Schedule 2 drug;

c) compound blood products.

Technicianscope ofpractice

Technicianobserversappointed toACP council in 2008 In 2008, the ACP council appointedtwo technician observers, RobinBurns and Teresa Hennessey, from alist of nominations submitted bytechnicians. Robin and Teresa haveparticipated in all councildiscussions, particularly thoserelated to the regulation ofpharmacy technicians. They, andother ACP staff, have presented atmany technician conferences andmeetings. Robin and Teresa havealso contributed input on theamendments to the PharmacistsProfession Regulation and thedevelopment of national fluencyrequirements for pharmacytechnicians at entry to practice.

Robin Burns

Teresa Hennessey


5

A pharmacy technician may only perform the restricted activity if:

a) a pharmacist has evaluated the prescription for the drug,

b) a pharmacist has assessed the patient, the patient’s health history and medication recordand has determined that the drug therapy is appropriate for the patient, and

c) a pharmacist is available to counsel the patient and to monitor the patient’s drugtherapy.

What does “under the direction of” mean?

For the purpose of this section, “under the direction of” means that the clinical pharmacistor courtesy pharmacist who is providing the direction must

a) practice at the same pharmacy* as the pharmacy technician, unless otherwise authorizedin writing by the Registrar,

b) ensure there is a system in place in the pharmacy that complies with the Standards ofPractice under which

i) a pharmacist is available to consult with, provide guidance to and, if necessary,provide assistance to the pharmacy technician,

ii) the involvement of the pharmacy technician in the restricted activities can bemonitored and assessed,

iii) the pharmacy technician reports to the pharmacist who is responsible for providingdirection to the pharmacy technician; and

c) be authorized to perform the restricted activities for which the pharmacist is providingdirection to the pharmacy technician.

Role comparisons

Pharmacists will

n assess patientn review patient history, medication

historyn ensure appropriate drug therapyn counsel patientn monitor ongoing therapyn provide direction to technician

(Pharmacists will continue to beauthorized to conduct all pharmacytechnician roles.)

Pharmacy Technicians will (proposed)

n prepare and distribute prescriptionsn compoundn selln check to ensure correct drug is dispensedn copy prescriptions for authorized recipients n transfer prescriptions to, and receive prescriptions from, other

pharmacies n receive and transcribe verbal prescriptions given by a prescribern instruct patients re: health aids and devicesn be authorized to check work of individuals employed in a

pharmacy

n continue to be accountable for theoverall supervision of pharmaciesand the systems that are in placeto ensure the safe storage,compounding, packaging anddistribution of drugs.

n continue to be solely responsibleand accountable for assessing theappropriateness of drug therapy(both new and continuing) andproviding patient consultation.A prescription cannot be releasedto the patient without apharmacist having performedthese functions.

n Always practice in an environment where: • procedures are in place to ensure the safety and integrity of

the dispensing or compounding process (i.e., under thedirection of a pharmacist).

• a pharmacist is available to ensure appropriatenessof drug therapy and consult with patients.

n Exercise professional judgement atall times and be able to recognizewhen the clinical expertise of the pharmacist isrequired.

Roles

Responsibilities

* Note the difference between directionand supervision.

Supervision is provided by thepharmacist on shift that day and thatpharmacist must be available toprovide hands-on assistance, eitherimmediately or within a reasonableperiod of time.

Direction is provided by a pharmacistwho works in the same pharmacy, butnot necessarily on the same shift as thetechnician. That pharmacist isresponsible for ensuring that there areappropriate policies and procedures inplace to maintain the integrity of thedispensing and compoundingprocesses and for making sure that apharmacist is available to work withthe technician as required in theregulations and the standards.


6

All provincial bodies pursuing technician regulation have agreed thatrequirements for pharmacy technicians will parallel the process forpharmacists where possible and will be in keeping with the Agreement onInternal Trade. Adhering to the Agreement means technician qualificationswill be recognized across the country. This will enable pharmacy techniciansto work anywhere in Canada without having to re-qualify.

To become a regulated pharmacy technician, individuals currently workingin the field as well as those just entering the profession will need tosuccessfully complete the required steps outlined below.

Technician Regulation Process

Path 1: Transition Path 2: New entries

2000 hours worked in past 3 yearsOR

Currently on ACP voluntary register

PEBC Evaluating Exam(or PTCB-AB or OCP exam)

Note: Must complete by Jan. 1, 2013

Bridging ProgramCompletion of all 4 courses

ORProfessional Practice course* andchallenge exam in other 3 courses

* includes jurisprudence/ethics exam

PEBC Qualifying Exam(written and practical)

Registration with ACP

Graduate from CCAPP accredited program

(available now)

m

m

Complete structuredpractical training

(SPT)

Jurisprudence/Ethics Exam

(through ACP)

m

m

mm

m

Exp

ires

2015

Step 1

Step 2

Step 3†

Step 4

Step 1

Step 2

Step 3†

Step 4

Steps to regulation

† Although PEBC does not require individuals to have successfully completed all four bridging courses (Path 1) or all three levels of SPT (Path 2) before sitting the Qualifying Exam, both PEBC and ACP stronglyrecommend this step. The extra knowledge and resource information attained will help candidates achieve success on the Qualifying Exam.


7

Individuals already working in the fieldwho did not graduate from a CCAPP-accredited program will have until Jan. 1,2015 to register via Path 1. After that time,anyone wishing to become regulated willhave to take Path 2 and successfullycomplete a pharmacy technician programoffered through a CCAPP-accreditedinstitution.

Meet Minimum Criteria

To enter the process, a currenttechnician must either be on ACP’svoluntary register or have worked inpharmacy practice for a minimum of 2000hours in the past 3 years. Specific dutiesdefined as pharmacy practice areidentified on the Pharmacy ExaminingBoard of Canada (PEBC) website atwww.pebc.ca (Note: if a current techniciandoes not meet the minimum criteria, theywould seek regulation through Path 2 byenrolling in an accredited pharmacytechnician program.)

PEBC Evaluating Exam andACP Bridging Program

Contrary to some other provinces thatrequire candidates to complete the PEBCEvaluating Exam prior to enrolling inbridging courses, ACP is letting candidatescomplete these in any order. ACP’s goal isto provide as much flexibility as possiblefor each candidate to meet therequirements.

The completion of both the PEBCEvaluating Exam and the ACP BridgingProgram is required1 by all individualsseeking regulation via Path 1. (Note: the onlyexception, as per PEBC’s policy, is that thosewho successfully completed the PTCB-AB (upto 2008) or OCP (up to 2008) exam do not needto sit the PEBC Evaluating Exam. They are stillrequired to complete the bridging program.)

The PEBC Evaluating Exam is a 3 hour, 150multiple choice question exam. The exam isoffered by the PEBC two times per year in

key locations across Canada. More detailson the Evaluating Exam, including theexam sitting schedule, are available atwww.pebc.ca.

Note: Path 1 candidates must complete thePEBC Evaluating Exam by Jan. 1, 2013.

The bridging program is designed toprepare individuals for their role asregulated health professionals, includingthe additional responsibilities described inthe entry-to-practice competencies for apharmacy technician.

One of the most essential requirements forentry to practice is completion of an

approved education program. UntilCCAPP accreditation in 2008, there was nosystem to ensure consistency acrosseducation programs, and no standardrequirement for an individual choosing tobecome a pharmacy technician. As a result,there is a high degree of diversity amongthose choosing to become regulatedpharmacy technicians. Their knowledgeand skills, and roles and practice settingsdiffer. This poses a challenge; as aregulatory body, ACP needs to ensure thatindividuals applying for registration havedemonstrated the defined competencies to

STEP 1

STEP 2

Path 1: Transition

2000 hours worked in past 3 yearsOR

Currently on ACP voluntary register

PEBC Evaluating Exam(or PTCB-AB or OCP exam)

Note: Must complete by Jan. 1, 2013

Bridging ProgramCompletion of all 4 courses

ORProfessional Practice course* andchallenge exam in other 3 courses

* includes jurisprudence/ethics exam



m

m

m

m

Exp

ires

2015

Step 1

Step 2

Step 3†

Step 4

Steps to Regulation

Path 1: Transition

1 Where candidates have not graduated from a CCAPP-accredited education program, PEBC requires that candidates also successfully pass an Evaluating Exam. This is not an ACP policy, but rather a PEBCpolicy consistent for both pharmacist and PT candidates.

continued on page 8

† Although PEBC does not require individuals to have successfully completed all four bridging courses before sitting the Qualifying Exam, both PEBC and ACP strongly recommend this step.


practice safely and effectively within thescope of their profession.

Because of the diversity amongstindividuals and the absence of previouseducational standards and measures, thecollege is incorporating a bridgingeducation program that will prepareindividuals to practice in the new regulatedrole. Building on the knowledge theseindividuals have gained through formaleducation or on-the-job training, thisbridging program will prepare them tomeet the educational requirements andresponsibilities of a regulated pharmacytechnician.

The bridging program is divided into fourcourses: Pharmacology, ProfessionalPractice, Management of Drug DistributionSystems, and Product Preparation. Thecontent is being developed nationally andthen modified as required for eachprovince.

Technicians who feel that they alreadyhave the necessary knowledge, skills, andabilities to challenge a particular bridgingcourse may do so through an exam processreferred to as Prior Learning Assessmentand Recognition (PLAR). The PLAR optionwas incorporated so technicians who areconfident in their skills can “fast track”bridging. All bridging courses, with theexception of the Professional Practicemodule which is mandatory for everyonein Path 1, are PLAR-eligible.

n Pharmacology (33 hours)

This course provides a practical, appliedapproach to pharmacology. Through avariety of learning tools such asassignments, quizzes, case studies andgroup work, students will enhance theirability to practice competently andcontribute to a safe patient care setting.Participants will gain basic knowledgerelated to the pharmacological uses ofdrugs within a variety of commonlyencountered medical conditions.

n Professional Practice (45 hours) –mandatory, no PLAR

Students will be prepared for entry topractice in five main areas of focus: legalrequirements, scope of practice, ethicalprinciples, professionalism and

communication skills. Students willenhance their ability to practicecompetently within the professionalpractice framework. To minimizelearners’ costs and time, APC hasincorporated the jurisprudence exam aspart of this course, rather then aseparate element.

n Management of Drug Distribution(39 hours)

This course will examine various drugdistribution systems in pharmacypractice, and prepare learners toeffectively manage operations indifferent practice settings to ensure safeand effective drug supply anddistribution. Learners will exploredistributive functions in institutionalsettings, as well as common drug plansand their formularies, adjudicationchallenges, inventory managementelements and common businesspractices. Accurate product releasewithin the parameters of the pharmacytechnician role receives specialemphasis.

n Product Preparation (33 hours)

This course deals with the theoreticalknowledge and practical skillsessential for safe and accuratepreparation of sterile and non-sterilepharmaceutical products. For non-sterile preparation, students will focuson compounding practices for variousinternal and external preparations andspecialty dosage forms, equipmentand tools, professional guidelines,standards and legislation,pharmaceutical calculations, anddocumentation requirements. Forsterile product preparation, areas ofemphasis include infection control,aseptic technique, parenteral dosageforms, accurate calculations,appropriate use of equipment, andquality control. Best practicesassociated with the preparation ofTotal Parenteral Nutrition (TPN) andantineoplastics are also covered.

ACP is working with three publiclyfunded colleges to offer the bridgingprogram. Each course will be offeredonline as well as in classroom. Each of

Path 1: Transition continued from page 7

continued on page 10

8

Overall process

Why was Jan. 1, 2015 picked as the end datefor current technician transition? Is that stillfeasible given that bridging hasn’t startedyet?

A deadline was required that allowed enough time forindividuals currently working in the field to completetransition without a great deal of pressure, but that senta clear message that those entering the field today areexpected to attend an accredited program rather thanattempt to begin working in the field. This date isconsistent with the date that other provinces are using.

Availability of the bridging courses has been delayed,but is expected by fall 2010. That will still allow morethan four years to complete the transition.

If the deadline for transition is Jan. 1, 2015,why does the PEBC Evaluating Exam have tobe completed by Jan. 1, 2013?

The transition pathway (Path 1) is intended forindividuals who are now working in the field. Thedeadline to complete the Evaluating Exam was set toclearly indicate to individuals who are entering the fieldnow that they must attend an accredited program andqualify via Path 2. In addition, completion of theEvaluating Exam by Jan. 1, 2013 ensures individualsworking toward regulation via Path 1 will have time tocomplete all the requirements by 2015.

Will individuals in other provinces be able towrite the PEBC Qualifying Exam and becomea regulated technician (in Alberta orelsewhere) without taking the bridgingprogram?

All provinces currently pursing technician regulationrequire completion of a bridging program. At presentthat, includes Ontario, BC, Alberta, Saskatchewan andNova Scotia.

How do I know the bridging program is of value?

All four bridging courses have now been delivered twicein Ontario. Participant evaluations show that 81% oflearners felt the courses met their learning needs.Furthermore, 83% of learners felt that the participantmaterials provided with the course were useful.

Why must technicians be evaluated more than once on the same subject matter (e.g., through bridging and/or PLAR and PEBC exams)?

Bridging is not an evaluation mechanism, but a process tosupplement the knowledge gained through formaleducation and on-the-job training with the competenciesthat will be required to take on the role andresponsibilities of a regulated pharmacy technician.

The requirement to take both the Evaluating andQualifying Examinations is a PEBC requirement,consistent with their requirement for pharmacists. PEBCis making one exception in their process: anyone whosuccessfully completed PTCB-AB (up to 2008) or OCP (upto 2008) exam is exempt from writing the EvaluatingExam. This will minimize time and costs for candidates.


9

FAQs re: process for individualswho did not graduate from aCCAPP-accredited program


the four courses is in various stages ofdevelopment and modification and theanticipated rollout is September 2010.Course information will be posted on theACP website as it becomes available.

Costs and grant information

Final course costs will be determined bythe colleges delivering them. It isestimated that the cost to complete allfour courses of the program will beapproximately $1400.00. The cost of thePLAR process is not yet known; however,it is expected to be approximately half thecost of completing the full module. ACP has requested that Alberta Healthand Wellness provide a grant toreimburse candidates for at least aportion of the registration costs for thebridging courses.

PEBC Qualifying Exam

The PEBC Qualifying Exam consists oftwo parts – a written multiple choicequestion exam (MCQ) and aperformance-based exam called anObjective Structured Performance Exam(OSPE). PEBC is expected to offer theexam nationally at key locations twicea year.

Note: Although PEBC does not requireindividuals to have successfully completed allfour bridging courses before sitting theQualifying Exam, both PEBC and ACPstrongly recommend this step. The extraknowledge and resource information attainedfrom the bridging courses will help candidatesachieve success on the Qualifying Exam.

Register with ACP

Other requirements at entry to practicesuch as fluency, good character,professional liability insurance, productrelease proficiency, and registration andannual permit fees will be established byACP council to coordinate with theamendments to the PharmacistsProfession Regulation (see pages 14 and15 for details).

All registration requirements areconsistent with those for pharmacists andother regulated health professionalsgoverned by the Health Professions Act.

STEP 4

STEP 3

10

PEBC Examinations for technicians If I passed the PTCB exam several years ago but did not recertifywith PTCB, will I have to write the PTCB exam again?

No. Anyone who successfully completed the PTCB exam is able to write theQualifying Exam without writing the Evaluating Exam. (You will still be requiredto complete the bridging program.)

What type of work “counts” toward the 2000 hours of workexperience listed in Path 1?

The PEBC website includes a list of duties that qualify for the 2000 hours of workexperience. It does not matter what your job title is as long as you have beencompleting duties that are included on the list for at least 2000 hours in the past 3years.

If I am currently voluntarily registered with ACP, do I still need tosubmit 2000 hours of work experience to be able to take the PEBCevaluating exam?

Yes. PEBC will require information about your work experience when you registerto write the Evaluating Exam.

When will the exams be available?

The next Evaluating Exam (which must be completed before the QualifyingExam) will be offered on Sept. 18. The application deadline is June 28.

The next Qualifying Exam will be offeredon Aug. 28 and 29. The applicationdeadline is June 4. See the PEBC website(www.pebc.ca) for the most currentexam schedule.

What happens if I write theQualifying Exam and do not pass?

As with pharmacists, pharmacytechnicians may attempt thePEBC Qualifying Exam threetimes. The ACP Registrar hasthe option to permit a fourthattempt, but may require theapplicant to completecoursework, examinationsand structured practicaltraining before the fourthand final attempt.

Path 1: Transition continued from page 8


11

An accelerated regulation process forpharmacy technicians sounds appealing atfirst. However, there are many reasons whyACP council decided againstgrandfathering current technicians.

1. To date there has been no standardizededucation, scope of practice, roledefinition, restricted title, or legalresponsibility for individuals identifiedas pharmacy technicians. The result is avery mixed population of “technicians.”ACP respects that, amongst these, someindividuals do perform at higher levelsthan others as a result of their educationand experience. However, without theproposed process, the college currentlyhas no way to measure the competenceof pharmacy technicians and thuscannot assure patients, technician peers,pharmacists, other health professionals,and the public of their competency.

2. Pharmacy technicians have no historyof being regulated, contrary to otherprofessions that are becoming self-regulated under the Health ProfessionsAct. Pharmacy technicians will be a newregulated profession.

3. Pharmacy technicians have had norequirement to maintain personalcompetence, regardless of how theyhave gathered knowledge and skills toperform their roles. Therefore, ACP hasno means of ascertaining themaintenance or growth of anindividual’s knowledge and skillsduring the period of their past practice.

4. Pharmacy technicians have only beenauthorized to practice undersupervision, and have held no legalresponsibility, accountability, or sharedin any potential liability whenproviding this assistance.

The competencies for entry to practicecannot be measured through a singleexamination or by a single evaluation tool.

Grandfathering alternatives are at the bestsubjective and introduce an unacceptablelevel of risk; it is not possible to objectivelyidentify programs or cut-off dates thatwould provide confidence to ACP orfairness to all candidates.

Throughout the planning, council hasalways sought to minimize time and coststo participants while still protecting thepublic. This is demonstrated through:

n the option for when candidates maywrite the PEBC Evaluating Exam,

n ACP’s work to ensure the bridgingcourses will be offered in class andonline from multiple colleges,

n the incorporation of the jurisprudenceexam into the Professional Practicecourse,

n the PLAR option in bridging, and

n ACP ’s pursuit of government fundingto offset bridging program costs fortechnicians.

ACP council believes that the proposedframework for pharmacy techniciancandidates to transition to regulated healthprofessionals appropriately balancesaccountability, accessibility, andaffordability.

ACP’s approach to evaluating pharmacytechnician candidates at entry to practice isconsistent with that being pursued byother provinces and with the processesestablished under the Health Professions Act,as used in evaluating pharmacists at entryto practice.

What grandfathering alternativeswere considered? Extending the recognition date for those graduating from now-accreditedprograms

Recognizing those who graduated from aCCAPP-accredited program for a setnumber of years before accreditation wasconsidered by ACP council. For example,although Red Deer College’s program wasonly accredited in 2009, recognition couldhave been extended to those whograduated two, five, or eight years earlier.However, council realized that it wasimpossible to know how educationalprograms had changed over the years,and thus to know how many years wasenough or too many. A line had to bedrawn at some point; council decided thatCCAPP accreditation was the best place todraw the line.

Grandfathering those with formaleducation

There was no standardization of educationprograms prior to the development ofCPTEA educational outcomes and theresulting CCAPP accreditation standards.Therefore, programs offered very differentlevels of knowledge and practicalexperience. It is impossible to evaluate andcompare programs that were delivered inthe past, in some cases many years ago, soa fair assessment can not be made. Becausethere have been no requirements forcontinuing education, the college also can’tknow if individuals maintained all theknowledge and skills required ofpharmacy technicians. Additionally,graduates of each program have differentpractice experiences since graduating,depending on their employment.

Applying conditions on the title orhaving two levels of technicians

The Health Professions Act outlines onescope of practice for a pharmacy technicianand all national documents, includingentry to practice competencies andeducational outcomes, describe a singlegroup of competencies for a pharmacytechnician. Individuals who wish to qualifyas a pharmacy technician mustdemonstrate all the required competencies.

Keep in mind that the regulation ofpharmacy technicians does not precludepharmacists from hiring unregulatedpersons to work in the pharmacy. Apharmacist may hire whomever they wishto assist them as long as the pharmacistprovides direct supervision and takesresponsibility for the work completed bythe unregulated individuals.

Grandfathering individuals already onthe ACP voluntary register

The voluntary register established in 2008was always intended to be an interim steptoward the regulation of pharmacytechnicians. All candidates were informedthat registration on the voluntary registerwould not imply eligibility as a regulatedtechnician because additional evaluationwould be required.

Why wouldn’t grandfathering current pharmacy technicians be wise?


CCAPP-AccreditedProgram

An accredited program is a program ofstudy offered by either a public orprivate post-secondary institute that hasmet the accreditation standards for apharmacy technician programestablished by the Canadian Council forAccreditation of Pharmacy Programs(CCAPP). The CCAPP accreditationprocess ensures that accreditedprograms contain the necessary contentto teach the competencies (knowledge,skills and abilities) necessary forsuccessful graduates to safely andeffectively do the job of a regulatedpharmacy technician.

In Alberta, four colleges began offeringCCAPP-accredited PharmacyTechnician programs: NorQuest Collegein 2008, and Red Deer College, BowValley College, and CDI (Edmonton)in 2009.

The CCAPP-accredited programs are aminimum duration of 34 weeks andconsist of a minimum of 26 weeksinstruction (25 hours/week in class orlab; 5 days/week), and 8 weeks ofpracticum experience (35 hours/week; 7 hours/day). The program curriculumcovers the same broad content areas asfound in the bridging program requiredfor current technicians:

n Pharmacology

n Professional Practice

n Management of Drug Distribution

n Product Preparation

Structured PracticalTraining (SPT) andJurisprudence/Ethics Exam

Once a student has graduated from aCCAPP-accredited program, they willbe required to successfully complete aStructured Practical Training (SPT)program2; a supervised competency-

based training period within apharmacy that includes regularassessment by a pharmacist or anotherregulated technician. This trainingallows soon-to-be-regulated techniciansthe opportunity to practice their skills ina supervised practical environmentbefore assuming sole responsibility.

The Alberta College of Pharmacists’pharmacy technician SPT program isdivided into three levels:

Level 1 – minimum 320 hours*

n The learner is required to acquireand/or demonstrate competencies atan acceptable level. The focus of this

level is the provision of drugdistribution. This level may becompleted as part of an individual’sprogram practicum.

Level II – minimum 320 hours*

n The learner is required todemonstrate competenciesproficiently. Expectations regardingthe demonstration of professionalismand management knowledge andskills, and quality assurance areincreased.

Level III – minimum 160 hours*

n Level III is intended to confirmproficiency. Learners are expected to

STEP 1

STEP 2

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Steps to Regulation

Path 2: New entries

Path 2: New entries



Graduate from CCAPP accredited program

(available now)

Complete structuredpractical training

(SPT)


(through ACP)

m

m

m

m

Step 1

Step 2

Step 3†

Step 4

2 S3(1)(b) Pharmacists Profession Regulation

† Although PEBC does not require individuals to have successfully completed all three levels of SPT before sitting the Qualifying Exam, both PEBC and ACP strongly recommend this step.


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work independently, acting as apharmacy technician,

n Successful completion of Level IIIrequires demonstration ofproficiency of product release,specifically ensuring the accuracyand quality of the final product.

* The hours listed are minimums.Successful completion of each levelrequires demonstration of the requiredcompetencies; additional time may berequired to do so.


The requirement to successfullycomplete a jurisprudence/ethics examis consistent with the registrationprocess for pharmacists and is designedto test relevant provincial legislationand ethics which is not included on thenational PEBC Qualifying Exam.

PEBC Qualifying Exam

The PEBC Qualifying Exam consists oftwo parts – a written multiple choicequestion exam (MCQ) and aperformance-based exam called anObjective Structured PerformanceExam (OSPE). PEBC is expected tooffer the exam nationally at keylocations twice a year.

Register with ACP

Other requirements at entry to practicesuch as fluency, good character,professional liability insurance, andregistration and annual permit fees willbe established by ACP council tocoordinate with the amendments to thePharmacists Profession Regulation (seepages 14 and 15 for details).

All registration requirements areconsistent with those for pharmacists andother regulated health professionalsgoverned by the Health Professions Act.

STEP 3

STEP 4

Education

FAQsWho determines which post-secondary programs are accredited?

The Canadian Council for Accreditation of Pharmacy Programs (CCAPP), whichis the same organization that accredits pharmacy programs, is responsible foraccrediting pharmacy technician programs in Canada. A committee withrepresentatives from pharmacy technician, technician educator, and pharmacistgroups developed the accreditation standards.

The accreditation process ensures that accredited programs contain the necessarycontent to teach the competencies (knowledge, skills and abilities) necessary forsuccessful graduates to safely and effectively do the job of a regulated pharmacytechnician.

Which post-secondary institutions are currently offering aCCAPP-accredited Pharmacy Technician program?

Please check the CCAPP website for the list of Accredited Pharmacy TechnicianPrograms: www.ccapp-accredit.ca/documents.

Will regulated pharmacy technicians be required to completecontinuing education?

Yes. Registrants on the pharmacy technician register must earn a minimum of 15continuing education units (CEUs) per year (1 hour of learning is equivalent to 1unit). These credits may be earned either from accredited pharmacy continuingeducation or non-accredited learning or a combination of the two.

Continuing competence program requirements will be developed by the ACPCompetence Committee and pharmacy technician representatives.


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Registeringwith ACPCreation of new registers

Upon approval of the regulation, ACP willcreate a provisional register for thoseworking toward registration, a pharmacytechnician register for those who have metthe registration requirements, and acourtesy register for individuals registeredas pharmacy technicians in good standingin another jurisdiction and who requireregistration in Alberta on a temporary basisfor locum work or accredited CE provision.

Registration on the provisional register willbe open to:

n graduates of CCAPP-accreditedpharmacy technician programs, or

n candidates on the ACP voluntaryregister, or

n candidates enrolled in bridgingprograms, or

n candidates who successfully completedthe PEBC Evaluating Exam (or PTCB-AB or OCP exam), or

n candidates who have 2000 hoursworked in the last 3 years.

Individuals currently on ACP’s voluntaryregister will be eligible to moveimmediately to the provisional register, butmust apply to do so. The applicationprocess will be introduced once thelegislation is proclaimed.

Registration requirements forpharmacy technicians

In addition to completing the steps toregulation already described, pharmacytechnicians will be required to provide thefollowing:

Proof of English fluency

For Path 1: Candidates who have notgraduated from a high school, university,community college, private vocationalcollege or equivalent in Canada or theUnited States, must provide evidence offluency by submitting the results of aNAPRA-recognized English languagefluency test completed within the past twoyears.

For Path 2: Candidates educated outside ofNorth America must provide proof ofEnglish language fluency using any one ofthe tests approved by ACP council. (Seehttps://pharmacists.ab.ca/nCollege/resource.aspx?id=6744 for details.)

Demonstration of good character

For the purposes of demonstrating goodcharacter and reputation, applicants mustprovide:

n a statutory declaration indicating

• whether they are undergoinginvestigation or discipline or havebeen previously disciplined by aprofessional college, and

• whether they have pleaded guilty orbeen found guilty of a criminaloffence for which they have not beenpardoned

n a criminal records check current withinsix months of application.

Proof of citizenship

Applicants must provide evidence in theform of a Canadian birth certificate orpassport or a valid Canadian employmentvisa that they are a Canadian citizen or areentitled to work in Canada.

ResourcesNote: The inclusion of a resource on this listdoes not imply any endorsement by ACP.

Associations, Organizationsand Licensing Boardsn Alberta College of Pharmacists –

pharmacists.ab.ca

n American Association of Pharmacy Technicians –www.pharmacytechnician.com

n Canadian Association of PharmacyTechnicians – www.capt.ca

n Canadian Council for Accreditationof Pharmacy Programs –www.ccapp-accredit.ca/index.php

n Canadian Pharmacy TechnicianEducators Association –www.cptea.ca

n National Association of PharmacyRegulatory Authorities –www.napra.org

n Pharmacy Examining Board ofCanada – www.pebc.ca

n Pharmacy Technician EducatorsCouncil – www.rxptec.org

n Pharmacy Technician Society ofAlberta –www.pharmacytechnicians.ab.ca

Useful Linksn Moving Forward - Pharmacy Human

Resources for the Future –www.pharmacyhr.ca/index.html

n Canadian Healthcare Network(formerly Pharmacy Gateway) –www.canadianhealthcarenetwork.ca

Documentsn Agreement on Internal Trade

www.ic.gc.ca/eic/site/ait-aci.nsf/eng/home

n Educational Outcomes for PharmacyTechnician Programs in Canadawww.cptea.ca/private_pgs/Educational OutcomesMar2007.pdf

n Professional Competencies forCanadian Pharmacy Technicians atEntry-to-Practicewww.napra.org/Content_Files/Files/Professional_Competencies_for_Canadian_Pharmacy_Technicians2007.pdf

n Standards for Accreditation ofPharmacy Technician Programs www.ccapp-accredit.ca/standards


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ACP council has established the following 2011 fee schedule for pharmacy technicians:

Liability insurance

Registrants on the pharmacy technicianregister must maintain a minimum of $1 million of personal malpracticeinsurance (claims made or occurrence). Thepolicy must be in the technician’s name.

We anticipate that liability insurance fortechnicians will be available from avariety of vendors. For example, PTSA isfinalizing details for one option and willhave program specifics soon.

Demonstrated product releaseproficiency

Individuals with the practice experiencerequired for Path 1 have been exemptedfrom the structured practical trainingportion that is included in Path 2, butACP council felt it was important that

there be a demonstrated proficiency incompleting the final check for productrelease. Therefore, council has directedthat individuals applying for registrationmust demonstrate this proficiency bycompleting 100 final checks with 100%accuracy, with a minimum of 20 checks aday within three months. Individualswho have successfully completed theAlberta Health Services checkingverification may instead submit that asproof of proficiency.

Path 2 candidates will demonstrate thisproficiency in their structured practicaltraining.

Registration fees

ACP will create and manage the registerfor pharmacy technicians. In addition to

managing the registration process, ACPwill also:

n manage the continuing competenceprocess for technicians,

n manage the complaints resolutionprocesses for technicians,

n organize the election of pharmacytechnician members to ACP council,

n maintain and make available thejurisprudence exam for techniciancandidates,

n make college publications available totechnicians, and

n liaise with government and otherstakeholders concerned with practiceand patient safety issues on behalf ofpharmacy technicians.

Fee Name Amount Formula used Rationale When it applies

Technician registration fee

$250 Same as pharmacistregistration fee

Same work involved inregistering regulatedtechnician as a pharmacist;therefore, should be equal.

Voluntary technicians arecurrently paying $234 forregistration.

First time registration with ACP.

Those who have already paid to join the voluntaryregister will not be charged this fee when they aremoved to the provisional register.

Provisional Registerpermit fee

$80 $78 (current voluntarytechnician permit fee) + 2% cost of livingallowance (COLA)

This equates to currentvoluntary register fee.

When registering as a provisional technician until allconditions have been met to register as a regulatedtechnician.

Regulated technicianpractice permit fee 2011

$450 $735 (pharmacistpermit fee) + 2% COLAx 60%

Calculated as 60% of thepharmacist permit fee.

When registering on the pharmacy technician register.

Pro-rated regulatedtechnician practicepermit fee 2011

$248 $450 annual fee x 50%+ 10% for admin costs

This calculation is consistentwith what is used for thepharmacist pro-rated fee.

When a provisional technician or locum technician ischanging status to a regulated technician and is a first-time registrant as a regulated technician is joining ACPbetween July 1, 2011 and Dec 31, 2011.

Non-compliance fee $77 $75 (current non-compliance fee forpharmacists) + 2% COLA

There is the same amount ofwork and costs involved fornon-compliant technicians asfor pharmacists.

Dec 1, 2011- Dec 31, 2011 for technicians who do notmeet the payment or submission requirements prior tothe end of the renewal period.

Reinstatement fee $250 $245 (currentpharmacistreinstatement fee) + 2% COLA

There is the same amount ofwork and costs involved forreinstating a technician asthere is for a pharmacist.

If a cancelled (cancelled for non-renewal, discipline orother reasons) or suspended technician is reinstating to aregulated technician.

Jurisprudence Exam fee(re-challenge orreinstatement)

$139 $136 (currentpharmacist exam fee) +2% COLA

The exam will cost ACP thesame whether it is apharmacist or technicianwriting.

If a provisional registrant fails the first attempt of theexam, the fee will be charged for all subsequent attempts.

If a reinstating regulated technician has been away frompractice for 2 years or more, they must pay to write theexam.

Courtesy register/ locumpermit

$248 $450 x 50% + 10%admin

Based on same formula usedfor pharmacist locum fee.

When registering as a courtesy pharmacy technician topractice temporarily in Alberta (locum) or to provide CE.


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Suite 1200, 10303 Jasper Ave NWEdmonton, AB T5J 3N6Telephone: 780-990-0321Toll free: 1-877-227-3838Fax: 780-990-0328pharmacists.ab.ca

Amend the Pharmacists Profession Regulation

ACP and technicians have worked togetherwith government to draft the amendmentsnecessary to the Pharmacists ProfessionRegulation for technician regulation. Aconsultation on the amendments will beconducted by Alberta Health and Wellnessthis summer. Once the amendments areapproved, an effective date for theRegulation will be set and technicianregulation in Alberta can begin.

Amend the Standards of Practice

ACP, again with technician input, hasdrafted amended Standards of Practice toaccommodate regulated technicians. ACPwill conduct a consultation on theseamendments this summer.

Amend ACP by-laws

ACP will be circulating a discussiondocument as a precursor to amending its

by-laws to accommodate the election ofvoting pharmacy technician members tothe council.

Read, listen, ponder, andparticipate

ACP is looking forward to theconsultations and to receiving yourfeedback. Only through the input andparticipation of all parties can we ensurewe’ve explored all the possibilities andended up with the best process for creatingthis new profession.

How do you participate in theconsultations?

Alberta Health and Wellness is conductingthe consultation on the amendments to thePharmacists Profession Regulation. Theywill be using all channels available to themto solicit your feedback.

For the consultations on the Standards ofPractice and ACP’s by-laws, ACP will

circulate information via our website(pharmacists.ab.ca), The Link (our e-newsletter), emails to registrants, andacpnews (our quarterly newsletter). We will also work with PTSA(www.pharmacytechnicians.ab.ca) todistribute information to technicians.

If you have questions or would like tocomment on any of the information in thisnewsletter, please email us [email protected].

Stay tuned

Technician regulation is an evolvingprocess. To keep up to date, look to thePharmacy Technician Information link in theBulletin Board section of the ACP websiteand The Link, ACP’s e-newsletter,delivered every two weeks. (Note thatarchived editions of The Link are availableon the ACP website under News &Events/ACP newsletters.)

Nextsteps

Transition Times - Spring 2010

Documents

Transcript of Transition Times - Spring 2010