Skills for MURs - How to complete a Case Study
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On this page you can read the instructions on how to complete a case study, watch a demonstration of how to complete a case study and practice completing a case study yourself.
At the bottom of the page you will find the Top Tips and it is highly recommended you read them prior to commencing the assessment.
Click here to watch a demonstration on how to complete a case study.
Click here to try a case study.
Once you have registered and paid your Assessment fee you will be e-mailed a username and password.
Use your user name and password to log into www.skillsformurs.co.uk site.
When you log in you will see the screen below. From here you can:
  1. Begin an assessment
  2. Track your progress
  3. Change the details on your account
  4. Learn more about the course
  5. View instructions on how to complete a case study
  6. Try attempting a case study
  7. View top tips

Begin Assessment
You can start your Assessment by pressing the Begin Assessment (1) button at the middle of the page. This will take you to a case study.
Once you commit to begin assessment you must dedicate a continuous hour to the process as exceeding this time limit or aborting part way through will result in a failed case study and hence loss of attempt.
Click on the image to see larger view

Starting a Case Study
You will see a screen like the one on the right

From this page you will be able to:
  1. View a Patient History (2)
  2. Review a Patient Medication Record (3)
  3. Watch a video clip of a pharmacist interviewing a patient.
    A transcript of the interview (4) will run in the panel to the
    right of the video.
  Click on the image to see larger view
Tabs at the top of the page (5) allow you to click through to an MUR form (MUR Page 1 and MUR Page 2) that you must complete.
You will not be able to do this until you have clicked Play  (6) on the video.

Completing the MUR form
1. You have 40 minutes to complete the MUR Case Study. The Clock (7) starts as soon as you click Play (6) on the video. It counts down from 40 minutes.
   
2. A reminder message will come up when you have five minutes remaining. You MUST acknowledge this message. If you exceed your time the case study will be automatically submitted for you.
   
3. You may download and read the Patient History and Patient Medication Record before the clock starts. Please note that you have a maximum of 20 minutes before you press play on the video to look at the PMR and PH.
  Click on the image to see larger view

MUR Form page 1
Some parts of the MUR form are already filled in for you, eg the patient's name and address, the GP's name and surgery. (8)
You need to complete the remaining parts of the form, using the tick boxes,
drop-down menus and text boxes as appropriate.
For the Action Plan (9) there are three key issues that have been identified using information from the patient's history, their PMR and the interview.
For each issue you must make a Recommendation. (10)
A selection of recommendations is offered in a drop down menu.
This requires you to select the most appropriate recommendation for the issue you have chosen.
Click Add (11)  to add another issue.
Click Delete (12) to delete an issue.
  Click on the image to see larger view

MUR Form page 2
Some parts of the MUR form are already filled in for you, eg Current medicines. (13)
 
You will need to complete the remainder of the form, and enter comments where appropriate, eg general comments relating to advice, side effects and other issues. (14)
 
The assessment has been designed to ensure that pharmacists get an opportunity to practise the complete MUR process, including the paperwork. To this end it is important to remember that the general comments box must only be filled with concise and important information. If there is no comment to be made then it should be left blank.
 
Do not over-think this section - it is there to demonstrate to you that you know what the form looks like and help you get the practice of completing it fully. Keep the comments, if any, to a minimum.
  Click on the image to see larger view

Review
Having completed both pages of the MUR form you have the option to review your entries using the Review tab (15).
 
If you want to amend any entries you can click back to MUR Page 1 or MUR Page 2 and make changes - time permitting.
 
Once you are satisfied with your answers click Submit (16) to submit your Case Study.
  Click on the image to see larger view

Stay on-line after you submitted your Case Study for your result
After a short period of time, you will receive a message telling you whether you have passed or failed the Case Study.
 
You can continue to the next Case Study straight away by clicking Close Window (17) and returning to Begin Assessment, or you can log out and return at a later date.
  Click on the image to see larger view
Click here to watch a demonstration on how to complete a case study.
Click here to try a case study.

Top Tips
We hope that you find the following notes useful in helping you successfully complete this online short course from the Medway School of Pharmacy and Chemist and Druggist.
Registering for the course:
1. You must complete the registration form before you can do the assessment.
2. If your course has been paid for already, then you will be given an individual PIN and company ID number with instructions on how to fill out the registration form.
3. Once you have successfully completed the registration process, you will receive an email with your password. If your email is not in the inbox please check your junk/spam folder.
4. You will need the email address you registered with AND the password to be able to log in to the website.
Before you start your first case study:
Enter and read the section 'About the Course'. In particular, you need to access the section "how to complete a case study". There is a high failure rate in students who skip this section. Ensure the demonstration video works on your computer. In the event of problems contact Pauline Sanderson on 0207 921 8425.
Print out blank copies of the MUR forms to make notes on as you watch the video - http://www.psnc.org.uk/data/files/mur_form_v2_final.doc
You have to pass three case studies in total to pass the course. You have three lives to do this in - ie you can fail two case studies, but you must pass three overall. You have 40 minutes to complete each case study. The clock starts when you press play on the video.
You should have a quick look (you have a maximum of 20 minutes) at both the PMR and PH BEFORE you watch the video. This is so that you get a good idea about the patient's background and medical condition.
You will be asked if you want to begin a case study- only respond 'yes' if you have allowed a clear, uninterrupted and quiet 40 minutes to do the case study. You cannot stop half way through- this will result in a fail. Forty minutes is plenty of time- dont rush. There is time, as there is in a real MUR, to look things up in your BNF, for example, so make sure you have it handy.
Completing your assessment:
To complete each case study you have to fill out pages 1 and 2 of the MUR form. Both pages are partly pre-populated by the computer for you, eg patient name and address.
On page 1 of the MUR form you must choose the most appropriate recommendation for EACH of the three issues already identified for you. This will form the basis of your assessment. Some more tips on this are included on the next page.
Page 2 of the form requires you to complete tick boxes. Do not over-think this section- it is there to demonstrate to you that you know what the form looks like and help you get the practice of completing it fully. Keep the comments, if any, to a minimum.
During your case study you can return to watch all or part of the video again when you want to. Use the rewind, forward and pause controls to help you.
If you want to look at, for example, the PMR again at any stage, you can move around the case study by selecting the tabs to navigate between the different screens.
Do NOT click on the cross at top right hand of the page to come out of it. This will close the case study and result in you failing that case.
You will get a reminder when you have 5 minutes remaining. You need to acknowledge this. When your time is over the case study will be automatically submitted for you. If you finish before that, check the review page and then click submit. Most students finish in plenty of time and submit their own work.
You will get your result instantly and it will also be sent to your email account. You will also have the option to print a temporary certificate. The original certificate will arrive in the post to the address you registered with within six to eight weeks.
Tips on the case studies themselves:
The patients in these scenarios are based on real people. The answers need to be 'real life' answers too. If you are faced with a patient who needs to lose weight, there is no point in giving the text book answer of 'start on a very low-fat diet immediately', this simply isn't going to happen. In real life you would perhaps suggest ways in which the patient might start to make their diet more healthy by reducing their fat intake over a period of time, or cutting back on certain high fat foods. Look for 'real life' solutions when considering these cases studies. Remember the practical patient issues. Someone who's driving around all day is unlikely to find using suppositories regularly convenient.
Be consistent. Watch that your recommendations don't contradict each other. If for one issue you select an option that says 'patient to reduce painkillers', but in another issue in the same case study, you select a recommendation option that says 'patient to increase painkillers'. In real life your patient and GP receiving a copy of the MUR form would be confused. In this assessment, you are likely to be wrong.
These case studies include an element of clinical opinion, which is bound to vary between pharmacists. In some cases your preferred recommendation to a particular issue may not be an option. One of the 3 is the best fit answer. If you are unsure, you might prefer to consider which is the 'least wrong'. You will also have to take priorities into consideration. The most urgent aspect of the case must be acted on. If you ignore an urgent problem in favour of an albeit correct, but less urgent one, you are likely to fail.
Finally, watch the language used in the case studies. Recommendations including words such as 'insist', 'must', 'force' and 'never' require a more closer look. There can be few occasions when a pharmacist would force a patient to do anything.
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