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A Sociedade Brasileira de Farmácia Clínica (SBFC), criada em 2017, tem como objetivo o desenvolvimento da Farmácia Clínica no Brasilcomo área científica e especialidade profissional. Uma das prioridades foi a discussão sobre os conceitos e a nomenclatura relacionados à área, uma vez que o seu desenvolvimento no país ocorreu com diferentes interpretações. Neste sentido, foram elaboradas duas questões norteadoras e dois artigos considerados basilares foram utilizados na pesquisa, realizada pela revisão de artigos científicos e de outras publicações relevantes. Foi elaborado um documento que representava a posição desta sociedade sobre o tema, intitulado “A Origem da Farmácia Clínica no Brasil, seu desenvolvimento, conceitos relacionados e perspectivas”, o qual foi apresentado em assembleia dos associados e publicado na página eletrônica da SBFC, em 2019. Posteriormente, houve a revisão e a atualização deste documento para subsidiar a preparação de material de caráter técnicocientífico, objeto desta publicação, visando a colaborar com a discussão e a disseminação de conceitos e nomenclaturas harmonizados, aplicáveis às atividades de ensino, pesquisa e extensão universitária na área de Farmácia Clínica e de Cuidado Farmacêutico.

Objective: To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study. Methods: A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs’ performances and adjustments). Step 3 and session 3: training role-play and performance’s evaluation. Step 4: SPs' standardization and performances’ evaluation (Sessions 4 and 5: first and second rounds of SPs' standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC. Results: In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances "It seems authentic", "Can be a real patient" and "Answered questions naturally", presented “moderate or complete agreement” of all evaluators. The dimensions "Seems to retain information unnecessarily", "Remains in his/her role all the time", "Challenges/tests the student", and "Simulates physical complaints in an unrealistic way" presented “moderate or complete disagreement” in all evaluations. The SPs "Appearance fits the role" showed “moderate or complete agreement” in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process’s had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity. Conclusions: The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision.

The Brazilian National Health System (BR-NHS) is one of the largest public health systems in the world. In 2019 Brazil had 114,352 community pharmacies (76.8% private owned), that represent the first point of access to healthcare in Brazil due to their wide distribution. Unfortunately, from the government's point of view, the main expected activity of private and public community pharmacies is related to dispensing medicines and other health products. Public community pharmacies can be part of a healthcare center or be in a separate location, sometimes without the presence of a pharmacist. Pharmacists working in these separated locations do not have access to patients’ medical records, and they have difficulty in accessing other members of the patient care team. Pharmacists working in public pharmacies located in healthcare centers may have access to patients’ medical records, but pharmacy activities are frequently under other professional’s supervision (e.g., nurses). Private pharmacies are usually open 24/7 with the presence of a pharmacist for 8 hours on business days. Private community pharmacies have a very limited integration in the BR-NHS and pharmacists are the third largest healthcare workforce in Brazil with more than 221,000 registered in the Brazilian Federal Pharmacist Association [CFF - Conselho Federal de Farmácia]. A University degree in pharmacy is the only requirement to entry into the profession, without any proficiency exam for maintenance or career progression. The Brazilian pharmacist's annual income is ranked as the 2nd better-paid profession with an annual average income of € 5502.37 (in 2020). Description of clinical activities for pharmacies by the CFF increased in the recent years, however there is still a long way to effectively implement them into practice.