The University of Auckland’s School of Pharmacy has announced that fourth year pharmacy students will complete their clinical placements at the national telehealth service, Healthline. This Healthline placement will replace a two week community or hospital pharmacy placement, which was due to start on March 30th, but was cancelled as a result of the Alert Level Four Lockdown.
The School of Pharmacy, in an email to students on March 30th, announced that it was unlikely students would be able to complete the originally planned placements – one in Semester One and another in Semester Two – anytime in the near future. To satisfy requirements of the BPharm degree, the email said, students would complete a four week placement at Healthline instead.
Students are to be based at home, and trained by a supervisor, before being rostered on to shifts on a 24/7 rotating roster. Students may have five days of shifts in a row before three rostered days off. One of these shifts may be a night shift between 10:30pm and 7am. Students are told to expect to learn clinical triage tools, policy and procedures, and to give appropriate clinical information regarding COVID-19. Students may also act to refer patients to Healthline nurses if necessary.
Jeff Harrison, Head of the School of Pharmacy, told Craccum that whilst a placement at Healthline is not necessarily an exact substitute for working in a pharmacy environment, the aim of the Year 4 placement is to “consolidate and extend” pharmacy knowledge of students who should already have learnt and been assessed on ‘core pharmacy practice skills’ during placements in year 3. Harrison notes also that approximately 75% of fourth year BPharm students are employed part time in pharmacies and that this may provide other avenues for students to learn and consolidate their studies as well. Harrison believes that Healthline provides an opportunity for students to experience a public health service as well as contribute to the COVID-19 response effort. “Students are not being contracted to volunteer for Healthline; this is a placement learning experience and is designed to meet learning outcomes”.
Students have had a mixed response to the redeveloped placement. While many have noted that they will provide assistance to an important public health service during an extraordinary time, many have expressed concern that Healthline is not an adequate replacement for learning gained in a pharmacy environment. Harrison notes that fourth year placements can occur in wider pharmacy environments, including at the Ministry of Health, PHARMAC, or in specialised secondary or tertiary services. However, these short term learning experiences may not be granted to these students again. Furthermore, with 75% of fourth year students employed in pharmacies, some students have expressed that they may be of more assistance in their workplaces – community pharmacies are essential services and have experienced periods of unprecedented business at Alert Level Four. Some students may also be impacted in their ability to work part time during the placement at Healthline and so may struggle to earn income for living expenses. Students prepare for two weeks without work and may now have to face four weeks without pay as well as other issues as a result of the lockdown.
The Healthline placement was originally scheduled to begin in the first week of April but has been postponed due to issues with the virtual training and service programme required by students to begin the placement. In addition, Healthline have run out of physical space in their Auckland office for students to use if required. Pharmacy students were told that the placement would likely start some time after the mid-semester break.
APSA (the Auckland Pharmacy Students’ Association) says they are aware of the “mixed opinions regarding the new Healthline placements”. “It is definitely different from our usual placements and we understand why some students feel concerned about the redevelopment,” a spokesperson told Craccum, “However… we believe that the redevelopment was the best alternative, an inevitable decision in order to ensure our fourth-year students are fully qualified to graduate”.
The Pharmacy Council of New Zealand, which regulates Pharmacy programmes in New Zealand, requires all programmes to incorporate practical placements into their teaching programmes. Harrison notes that the Healthline placement fulfills this requirement whilst still allowing fourth year students to complete their degrees on schedule.
The Pharmacy Council, according to the guidelines outlined in their Statement on Telehealth and the supply of Pharmacy Services over the internet, require “any workspace, device, software or service used by the pharmacist for the purposes of telehealth and internet supply must be secure, private and fit for purpose”. Pharmacy students are expected to follow Pharmacy Council guidelines and so must have appropriate environments in their homes. Harrison states that students unable to complete this placement at home may be able to use Healthline offices. He hopes that students won’t be made to do shifts at times that are not suitable for them.
Healthline currently employs an interdisciplinary team of nurses, paramedics and health advisors. The knowledge base of Healthline staff is notably different from the pharmaceutical knowledge of pharmacy students. Healthline has been experiencing a large increase in the number of enquiries as a result of the COVID-19 pandemic – with 10,000 calls between March 1 and March 23 this year, a 5x increase on the entire month of March in 2019.
Craccum is reaching out to the other clinical programmes in the Faculty of Medical and Health Sciences for comment regarding their plans for placements for students.