Intern hours completed but competencies outstanding
A fourth-year intern in a busy Auckland community pharmacy has logged 1,860 of the 2,000 supervised practice hours required by the PSNZ Intern Training Programme. Their 12-month contract ends in three weeks. The intern has completed all but two e-portfolio competencies: medication reconciliation in transitions of care, and responding to a clinical inquiry. The preceptor, who has been on extended sick leave for six weeks, returns next week and tells the intern they will sign off the remaining competencies based on good work observed earlier so the intern can sit the Competence Assessment next month. The intern is anxious about delaying registration and asks you, the pharmacist manager, whether this is acceptable. The training programme coordinator has not yet been contacted. The pharmacy is also short-staffed, and the owner is keen for the intern to become a registered pharmacist as soon as possible.
1. What should you advise the intern and preceptor about signing off the two outstanding competencies? Explain your reasoning.
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The sign-off cannot proceed as proposed. Competence must be demonstrated against the required standard, not inferred from earlier general observation, and the preceptor has not supervised the intern for six weeks. Signing off unobserved competencies would breach the PSNZ Intern Training Programme requirements and the profession's honesty and patient-safety expectations. My advice: (1) the intern and preceptor should review the specific performance criteria for each competency; (2) the preceptor should plan direct observation or verified evidence in the remaining three weeks, e.g. a medication reconciliation on a complex discharge and a documented clinical inquiry with follow-up; (3) if that is not feasible, the intern should not be signed off and should discuss an extension with the PSNZ training coordinator. The coordinator must be contacted now, not after the contract ends. I would remind the owner that registration cannot be accelerated by shortening the competency requirements; a delayed assessment is safer than a false declaration. Document the conversation and the remediation plan.
2. What are the options and consequences if the competencies cannot be completed before the contract ends?
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Options include a short extension of supervised practice, completing the competencies in a different approved setting, or deferring the Competence Assessment. The intern should contact the PSNZ training coordinator to see what the programme permits. Consequences of proceeding with sign-off would include potential eligibility problems for the assessment, professional disciplinary risk, and unsafe practice. The intern's anxiety about registration is understandable, but the correct pathway is a documented learning plan with clear dates. The pharmacy manager should also consider whether the preceptor's sick leave created a supervision gap that needs to be remedied; if so, the programme coordinator should be told. The intern should not be pressured by staffing shortages.
3. What should you document and communicate, and to whom?
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Document the meeting with the intern and preceptor, the competency gaps, the planned evidence, dates, and who is responsible. Communicate in writing to the PSNZ training coordinator, the intern, the preceptor, and the owner as appropriate, keeping patient and staff confidentiality. Record that the proposed retrospective sign-off was declined and why. Keep the e-portfolio evidence contemporaneous. If the intern is asked to work beyond supervision, record that too. Good documentation protects the intern, the preceptor, and the pharmacy, and shows the Council that the programme's standards were upheld.