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The Accreditation Assessment Process – Hints and Tips for Candidates
What are the markers looking for?
There are five broad areas that the markers use to assess case study answers. Each of these areas
have performance criteria associated with them which are listed at the end of this document in table
format. The performance criteria describe the overall evidence from which your competency is
assessed. The marker will be looking to see that you have demonstrated evidence of your
competency in each of these areas:
1. Ability to identify gaps in the information available & suggest methods for obtaining that
information from an appropriate source
2. Ability to identify actual, suspected or potential drug- and disease-related problems,
relevant to the individual patient
3. Appropriate level of clinical judgment and skills to provide prioritised recommendations
to GP resulting from medication review
4. Appropriate knowledge and use of references to support decision making
5. Appropriate written communication skills and language in a letter or report to the GP.
Question 1 of the case studies asks: What further information would assist in making your
assessment of this patient. Explain reasons for obtaining this information. Who/where would you
obtain this information? Here are some tips:
• Read the case closely – is there information missing about medication management (e.g. if
half a tablet is being taken does the patient have a tablet cutter?). To assess compliance –
would a dispensing history help?
• Consider the sources of information that might be available to you e.g. the patient, carer,
pharmacy, GP surgery. The marker will be looking to see that you sought information that is
specific to the patient in the case – not a list of generalised questions.
• Does the patient have any concerns/issues that are not being managed or that might be
related to medicines?
• Is information missing that might be useful for specific conditions e.g. swallowing ability in
patient who has had a stroke, or caffeine intake in patient with insomnia.
• Do you have access to the relevant information to decide if the patient is being well
controlled including recent laboratory test results? If you need more results, be specific
about what you need and the reasons why you need them.
Question 2 of the case studies asks: Based on the information provided, identify potential and actual
medication-related and disease related problems, and patient concerns. Suggest how these could be
addressed and/or monitored. Here are some thoughts for consideration:
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• The marker will be looking to see that you have a process for identifying potential issues and
that you apply advanced pharmaceutical and therapeutic knowledge to consideration of
whether medication use is indicated, appropriate, safe and effective.
• In your answer to this question, you need to demonstrate your clinical knowledge to the
marker
• What is the effectiveness of the medication/s and the risks vs benefits to the patient?
• Is the patient’s compliance/adherence a problem?
• What is the appropriateness of the dose, frequency and duration of use of each medication?
• Are there potential drug interactions (and if so are they clinically significant)?
• Are there any drug/disease interactions?
• Are any patient symptoms present that could be related to adverse drug reaction/s?
• Is there any discrepancy between what is being taken and what has been prescribed?
• Referencing your answer to this question is important. These references should be inserted
at the conclusion of your answer to question 2. Refer to the AACP Reference Guide.
Question 3 of the case studies requires you to Write a letter or report to the doctor, outlining your
key findings for this patient and your suggestions or recommendations to the prescriber. To do this
effectively you should:
• Use your assessments of medication related issues and patient concerns from Question 2 to
form the basis of your letter. You need to demonstrate your judgement when you decide
what information should be included in the report and what could be left out.
• If the patient is currently unwell it would be prudent to telephone the GP – please indicate
to the marker if you would do this (this can be a “note to assessor” and would be reflected in
your written report also).
• Your report needs to be patient focused and it should list any concerns the patient might
have with symptoms, (and whether any medications might be contributing to these
symptoms) and how they are coping with their medications.
• Make sure you prioritise the issues according to your clinical judgement – as a rule of thumb
address patient concerns and/or reason for referral as your priorities– please identify what
you think are high and low priorities (and why) in question 2.
• Offer supported recommendations using appropriate communication and language
• Do not diagnose. Ensure that your discussion describes medication related issues and
patient concerns. Overall management of chronic conditions and triaging of patients to
other health professionals is the role of the GP and if addressed at all in your report requires
great tact.
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• Make sure that the letter is coherent and that spelling is correct (in particular it looks
unprofessional if medications, patient names or the GP name is incorrect). Use the approved
name of each medication with the brand name in brackets if appropriate.
• Make use of headings, paragraphs – there is no required format but ensure that you include
a list of medications that the patient is actually taking so that the GP can reconcile your list
with their referral list of medicines.
• Ensure you add a disclaimer to your letter.
References to the report are only required if you mention something that is new, controversial
or that you feel the GP might want to verify. Do not reference information the GP already knows
• Make sure your letter or report to the GP can be read and interpreted in isolation to your
answers to questions 1 and 2. You should provide a compelling patient-focussed, evidencebased reason/s for changes to the patient’s medication regimen.
References
References are your ‘tools of the trade’ for medication review services and are the basis of your
credibility. You are required to provide references in order for AACP to assure that you have
appropriate resources available that are independent, credible and respected by GPs when
undertaking reviews–consider using NPS MedicineWise publications, Australian Prescriber, relevant
National Guidelines, TGA Medication Safety Updates (all available online).
• Use relevant, up-to-date references that are interpreted correctly and that will justify your
recommendations
• Use references that a GP is familiar with or has access to such as those listed above and
AMH, Therapeutic Guidelines.
Please refer to Reference Guide available from the Resources page on the AACP web site before
attempting the case study (log in required).
AACP sample case studies
Make sure you carefully read the HMR and RMMR sample cases on the AACP website before
attempting your first case study. These samples provide an indication of what you need to include in
your answer.
Also available on the website are four voice over power point presentations (VOPs) of Clinical Case
Study Preparation Guides. These VOPs have been designed to assist candidates as they complete the
case study component of the AACP accreditation process. They each provide an overview of an
appropriate answer to an AACP case study, discuss some of the common issues encountered when
completing the case studies and illustrate different ways of addressing the case study questions.
Mentor Support
AACP mentors are trained, experienced, practising, accredited pharmacists who are available to
assist candidates as they proceed through the case study component of the accreditation
assessment.
You will need to negotiate the fee for this service with your mentor, and also the time frame for the
review of your case study.
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The names and contact details of the AACP mentors are available on the AACP website in the Stage
Two Assessment Process Resources section (login required)
MMR Case Study Marking Assessment Sheet
For each case that you submit you will be provided with an assessment sheet. The marker will
provide you with formative feedback but will usually only document examples (not in every
instance) of areas where improvements are required to meet the relevant competencies.
The assessment sheet is reproduced below.
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MMR CASE STUDY ASSESSMENT MARKING SHEET
| Candidate MRN: |
| CASE STUDY number: |
| First attempt | Resubmission | Other |
| Initial HMR | ||
| HMR2 | ||
| RMMR1 | ||
| RMMR2 |
Candidates please note:
• Your assessment rating for each performance criteria has been assessed
based on the following:
| Consistently | Consistently demonstrates the expected standard of practice with very rare lapses |
| Usually | Demonstrates the expected standard of practice with occasional lapses |
| Sometimes | Demonstrates the expected standard of practice less than half of the time – much more haphazard than “Usually” |
| Rarely | Very rarely meets the standard expected. No logical thought process appears to apply |
• Competence requires “Consistently” or “Usually” to be obtained for all
performance criteria.
• This MMR case study assessment marking sheet will be used to mark both
initial and resubmitted case studies. Should a candidate’s initial case study be
assessed “Not yet competent” the resubmitted case study will be marked on
the same marking sheet using the resubmit boxes.
Assessor’s comment:
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1. Demonstrate ability to identify gaps in the information available & suggest
methods for obtaining that information from an appropriate source
| PERFORMANCE CRITERIA | ASSESSMENT |
| First | Resubmit |
| 1.1. Obtains additional relevant clinical information through consultation with consumers and/or carers or other health professionals (with consumer consent). | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 1.2. Uses relevant information sources to clarify or confirm information, or meet additional information needs. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 1.3. Identifies factors likely to adversely affect adherence to intended medication treatment regimen. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| FORMATIVE FEEDBACK: | |
| Resubmission: |
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2. Demonstrate ability to identify actual, suspected or potential drug- and diseaserelated problems, relevant to individual patient
| PERFORMANCE CRITERIA | ASSESSMENT |
| First | Resubmit |
| 2.1. Understands the pathophysiology and required monitoring of the consumer’s medical condition/diseases. Considers the appropriateness of the current medication treatment in the context of consumer and drug factors. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 2.2. Applies evidence-based resources, treatment guidelines or protocols to assess the medication treatment regimen. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 2.3. Identifies clinically significant potential or actual medication- related problems in the current medication treatment regimen. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 2.4. Understands the pharmacological and/or therapeutic basis for use of medicines and the therapeutic goals to be achieved. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| FORMATIVE FEEDBACK: | |
| Resubmission: |
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3. Demonstrate appropriate level of clinical judgment and skills to provide
prioritised recommendations to GP resulting from medication review of patient
| PERFORMANCE CRITERIA | ASSESSMENT |
| First | Resubmit |
| 3.1. Participates in assessment of whether medication treatment is achieving therapeutic goals/outcomes. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 3.2. Assesses treatment options and formulates evidence based recommendations for changes to medication management that, where appropriate, are informed by laboratory tests or investigations. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 3.3. Uses professional judgment to determine whether changes in the medication treatment regimen are warranted in the interest of improved safety or efficacy. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 3.4. Prioritises the care needs of consumers. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| FORMATIVE FEEDBACK: | |
| Resubmission: |
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4. Demonstrate appropriate knowledge and use of references to support decisionmaking
| PERFORMANCE CRITERIA | ASSESSMENT |
| First | Resubmit |
| 4.1. Ensures information resources are sufficient and appropriate for the types of information usually requested/provided. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 4.2. Applies a standardised referencing technique to link information to the evidence base. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| FORMATIVE FEEDBACK: | |
| Resubmission: |
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5. Demonstrate appropriate written communication skills and language in a letter
or report to the GP
| PERFORMANCE CRITERIA | ASSESSMENT |
| First | Resubmit |
| 5.1. Develops a report that formalises medication management recommendations (including calculated doses and dosing frequency) and the evidence base from which they were developed. Communicates recommendations to the consumer/carer, prescribers, other health professionals/facility personnel, as appropriate. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 5.2. Ensures communication is appropriate to the audience and the material. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| 5.3. Expresses thoughts and ideas clearly, consistently and unambiguously. | Consistently |
| Usually | |
| Sometimes | |
| Rarely | |
| FORMATIVE FEEDBACK: | |
| Resubmission: |
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OVERALL ASSESSMENT
| First attempt | ||
| COMPETENT* | NOT YET COMPETENT | Assessor’s COMMENTS |
| Resubmission | ||
| COMPETENT* | NOT YET COMPETENT | Assessor’s COMMENTS |
| Other | ||
| COMPETENT* | NOT YET COMPETENT | Assessor’s COMMENTS |