How to prepare for the Oriel national foundation trainee pharmacist recruitment scheme

Introduction

The Oriel process can be a nerve-wracking experience. The foundation training year is directly connected to your performance in the Oriel exams: the better you perform in Oriel, the higher you rank in the country, increasing your chances of securing your first-choice trainee pharmacist placement.

However, succeeding in Oriel requires you to reflect on the purpose of the assessment and evaluate what the process is designed to measure. Understanding the rationale behind the assessment and developing an ability to break down the questions to identify strategic words and phrases will help you perform to your full potential, giving you the confidence you need to succeed on the day.

This article provides a starting point for MPharm students beginning their preparation for the Health Education England (HEE) Oriel assessments. Based on the recent experience of an ex-Oriel interviewee, it provides a series of tips to help you prepare effectively, with suggestions made on where to go next for further support prior to the assessment. The Pharmaceutical Journal has also published other useful articles that can be used to familiarise yourself with the Oriel assessments:

• Oriel situational judgement test: what pharmacy students need to know;
• Oriel numeracy test: what pharmacy students need to know;
• How to tackle the Oriel numeracy assessment.

Tip 1: Focus on patient safety

Patient safety is at the core of healthcare; all healthcare professionals have a duty to ensure patients do not come to harm and receive safe, high-quality care.

In the first part of the Oriel situational judgement tests (SJTs), you will be given a scenario and five responses. Scenarios may include dealing with a difficult patient, problem solving or working effectively within a team. After reading the scenario and the available responses, you will be asked to arrange them in order of most appropriate to least appropriate. The second part of the SJTs involves a scenario with eight potential responses, asking you to select the three most appropriate. More information on the SJTs can be found in this article: ‘Oriel situational judgement test: what pharmacy students needs to know’. 

Many previous Oriel candidates describe there typically being an obvious worst answer — this could include ignoring or refusing to help a patient or colleague, or acting outside of the GPhC principles. In turn, candidates also report a fairly obvious best answer — for example, reporting cheating in an exam or going above and beyond for a patient. With five, often similar, responses remaining, it can be daunting to know how to rank them as most appropriate. However, by analysing each option in the context of patient safety, you can start to evaluate answers effectively. For example, arguing with colleagues and dealing with conflict in an inappropriate manner may lead to a reduction in the standard of care provided to a patient. Similarly, ensuring that essential medicines are supplied in a timely manner and identifying colleagues who may be deemed not fit to work can reduce the risk of diminished patient safety.

Tip 2: Use the Professional Attributes Framework 

The SJT questions will be assessing specific attributes that you should demonstrate as a pharmacy professional and future trainee pharmacist. These attributes are described in the Professional Attributes Framework, which will be your central reference for the Oriel assessments​[1]​. For the SJTs, only four attributes are assessed:

• Person-centred care;
• Multi-professional working and leadership;
• Professional integrity and ethics;
• Problem solving, clinical analysis and decision making.

Additionally, providing ‘person-centered care’ is the first of nine standards demanded of the pharmacy profession in the General Pharmaceutical Council’s (GPhC’s) standards for pharmacy professionals​​​[2]​. When pharmacy professionals can identify and understand the patient’s values and what is important to that individual, and make big or small changes to the care provided in response, person-centered care is demonstrated. The PAF breaks down each attribute further into behavioural indicators that demonstrate the attribute. For example, professional integrity and ethics is demonstrated by behaviours such as honesty and trustworthiness, including being open and honest when mistakes have been made.

Tip 3: Gain work experience

Students who have had some form of practical experience in the pharmacy world, whether it be a part-time job or previous work experience in a pharmacy, can sometimes be at an advantage in the Oriel assessments, owing to their exposure to real-life pharmacy scenarios and interactions. During your MPharm degree, it is likely you have been sent out on day placements to community and hospital pharmacies, but you are also free to find your own placements in addition to these. This includes sectors that you may not be able to access through your university (e.g. industrial placements, specialisms or specific settings that you are most interested in). You may also be able to secure paid work or a part-time job that will provide you with access to real-world situations that the Oriel assessments will test you on. Having a senior member of staff present to shadow your performance and provide feedback during placements and work experience will help you to understand the right and wrong things to do, as well as identify the small details that may help you distinguish between two similar responses in the SJT scenarios.

Tip 4: Prepare, prepare, prepare!

Oriel assessments are designed to be challenging and unlike the exams you may have been successful in during your prior academic career. The Oriel process is calibrated to ascertain your baseline competence in pharmacy practice and your ability to appropriately deal with difficult and uncertain situations.

It is natural for all interviews and exams to trigger a certain degree of stress and anxiety. In some circumstances, this can affect cognitive performance, where our brains may let us down and ‘go blank’. The best way to combat this is to ensure you have prepared as much as possible and understand the reasoning behind certain scenarios and the underpinning rationale for the Oriel assessments.

In addition to the SJTs, you will also be required to complete a numeracy exam. This consists of 10 questions in 20 minutes and covers basic pharmaceutical calculations. It is important to note that not all areas of pharmaceutical calculations are included in the numeracy test; therefore, you must tailor your revision to your weaker areas accordingly, ensuring you do not practice calculations for non-assessed topics (e.g. displacement values).

These videos on how to answer common calculation types, produced by The Pharmaceutical Journal, may be useful:

• Medication maths: how to solve dose and dosage calculations
• Medication maths: how to solve infusion calculations
• Medication maths: quantities to supply and using provided formulae calculations
• Medication maths: how to solve pharmacy calculations — concentrations, dilutions and health economics

Tip 5: Think like a trainee, not a pharmacist

Although your responsibility will increase as a trainee pharmacist, there are some things that you will not be able to do. There are also some things a fully trained pharmacist cannot and should not do; for example, discharging a patient is not the job of a hospital pharmacist, whether the patient wants to leave or not — this is the role of the medical team responsible for the patient’s care. The Oriel SJTs present scenarios for you to answer as a trainee pharmacist. Recognising your own professional limitations is vital, as well as being able to refer onward and seek senior support where appropriate. You can jeopardise your career, as well as patient safety, if you act outside of your legal or professional boundaries.

Tip 6: Review and adapt online situational judgement test examples

There are hundreds of resources online for other medical professionals, including doctors and dentists, who have to undertake their own Oriel-style interviewing and ranking. Searching online will present a vast range of scenarios and practice questions created to help other healthcare professionals prepare for their respected assessment. Practice scenarios written for other healthcare professions can still be valuable and provide insight into how certain scenarios involving patients might be approached. Although different professions have different assessment criteria, the core values of healthcare are universal — patient safety is the priority, patients and colleagues should all be treated as equal without judgement, and all members of the team should work collectively for the benefit of the patient.

HEE has also published some example SJT questions that are helpful to work through and understand the rationale behind certain marking schemes​[3]​.

Conclusion

The Oriel process is an important milestone in your journey to becoming a fully qualified pharmacist in the UK. If you have reached your third or fourth year of university, your clinical knowledge will be well developed, and there will be other methods in place to assess your clinical ability. However, knowledge of medicines and pharmacology alone does not make you a good pharmacist. For this, you will require the attributes articulated by the GPhC, which include respect, effective communication skills, professional integrity and a strong ethical compass. Oriel can be thought of as analogous to a sieve — it separates the prepared from the unprepared, the competent from the incompetent and the professional from the unprofessional. By avoiding inadequate preparation and using your time effectively, your chances of success will be improved, allowing you to benefit from a preregistration placement that will enable you to demonstrate your full potential as a trainee pharmacist.