Advanced practice internship: experiential learning in a drug use and disease state management program

Experiential Education in Pharmacy Curriculum: The Lebanese International University Model

Experiential education is an essential component of pharmacy education in order to allow intern students to experience real conditions and training opportunities in different inpatient and outpatient settings. This paper provides a description of the pharmacy practice experiences (PPEs) in the Lebanese International University (LIU) 5-year bachelor of pharmacy (BPharm) and postgraduate doctor of pharmacy (PharmD) programs; focuses on the opportunities and challenges encountered; and presents a model for experiential education in Lebanon. Learning outcomes and thus students’ acquisition of predefined competencies are evaluated in actual practice settings through assessment tools. Our experiential education program aligns with the accreditation/certification criteria set by the Accreditation Council for Pharmacy Education (ACPE) and equips future pharmacists with the knowledge and skills to become major components in the healthcare team.

An Analysis of Canadian Doctor of Pharmacy Student Experiences in Non-Traditional Student-Preceptor Models

Objective. To describe students' experiences and perceptions of non-traditional student-preceptor learning models and evaluate the effectiveness of these models on students' learning experience. Methods. Pharmacy students who had completed at least one experiential rotation with a non-traditional learning model participated in semi-structured interviews. Models included peer-assisted learning (PAL; two or more students of same educational level), near-peer teaching (NPT; one or more junior students with one or more senior students), and co-preceptorship (CoP; two or more preceptors). Interviews were transcribed, coded, and analyzed for themes. Themes were mapped according to the Kirkpatrick model for evaluating educational training. Results. Twenty semi-structured interviews were conducted. Forty-three experiences (19 CoP, 14 PAL, 10 NPT) from 14 institutions were described. Many themes overlapped between the three models. In CoP, learners described increased preceptor availability and exposure to different patient care approaches. Challenges arose when preceptors had different expectations. Students overwhelmingly endorsed a multi-learner environment. Both PAL and NPT learners felt supported as collaboration with other learners was readily fostered. Potential challenges in PAL and NPT were difficulties when personalities conflicted and when there was a significant knowledge gap between the learners. All three models allowed for the development of skills, including communication and collaboration. Learners reported an enhanced approach to patient care and professional practice, including approaches to teaching as new preceptors. Conclusion. Pharmacy students and graduates valued their experiences in non-traditional student-preceptor models. Institutions may find support for using these precepting models to increase placement capacity.

Creating a Pharmacy Internship: A Toolbox for Success

Objective:

To describe available compensated student internships and provide guidance for new program development.

Methods:

A search was conducted using PubMed, MEDLINE, and Google with the following search terms: pharmacy, intern, internship, and student. All English language publications were considered for inclusion. Articles describing IPPE or APPE student utilization were excluded.

Key findings:

Pharmacy student internship programs are common in practice, though there are few with published outcome data. Most often, interns serve as pharmacist extenders and participate in activities that center around extension of pharmacy services within the institution. Development of new programs should include partnering with nearby pharmacy programs and state boards of pharmacy to develop a well matched curriculum and allow for interns to practice at the top of their license. Lastly, outcomes should be measured and disseminated for the benefit of the academy. Additional considerations for developing a student internship program and guidance are provided.

Conclusions:

Although in existence for decades, minimal published reports showcase institutional outcomes associated with student internships. No data is available to show the downstream effect an internship can have on direct patient care activities.

Competencies for the provision of comprehensive medication management services in an experiential learning project

OBJECTIVE

To understand students' and tutors' perceptions of the development of clinical competencies for the delivery of comprehensive medication management services in an experiential learning project linked to a Brazilian school of pharmacy.

METHODS

An autoethnographic qualitative study was carried out based on participant observation, focus groups and individual interviews with students and tutors involved in an experiential learning project.

RESULTS

The study revealed the development of competencies related to the philosophy of practice, the pharmacotherapy workup of drug therapy and interprofessional relationships.

CONCLUSIONS

The experiential learning project contributed to the professional development of pharmacy students in pharmaceutical care practice, pointing to its potential benefits for incorporation into professional pharmacy curricula.

The Redesign of a Community Pharmacy Internship Program

Background:

Pharmacy internships provide students with practical experiences that lead to enhancement of clinical skills and personal growth.

Objective:

To describe the design and implementation of a structured 10-week summer pharmacy internship program in a supermarket chain pharmacy.

Methods:

The pharmacy leadership team developed and piloted a new format of the pharmacy internship during the summer of 2013. Pharmacy students in professional year 1 (P1), 2 (P2), and 4 (P4) were invited to apply for a paid internship. Pharmacy students were recruited from all colleges of pharmacy in the state of Michigan. The goal of the new program was to create a focused learning opportunity that encouraged students to develop knowledge, skills, and abilities about patient care, pharmacy management, and working within a team.

Results:

A total of 19 interns were recruited (P1 = 7, P2 = 7, and P4 = 5). Students practiced 40 hours per week and participated in the medication dispensing process and employee biometrics screening program. Interns provided approximately 500 assessments on pharmacy employees and all P1 and P2 interns completed a patient care project.

Conclusions:

The restructured internship program provided pharmacy students with a 10-week program that exposed them to many aspects of community pharmacy practice. The program needs future refinement and assessment measures to verify interns improve skills throughout the program.

Practice experiences at a single institutional practice site to improve advanced pharmacy practice examination performance

OBJECTIVE

To determine whether sequential assignment of students to the same facility for institutional practice experiences improves their advanced pharmacy practice experience (APPE) examination scores.

DESIGN

Student volunteers were assigned to the same healthcare facility for all institutional introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs). Other students completed institutional IPPEs and APPEs at separate healthcare facilities, ranging from 2 to 4 different facilities per student. APPE examination scores of students assigned to the same facility for all institutional learning experiences were compared with those of students assigned to more than 1 institutional practice site.

ASSESSMENT

Holding grade point average constant, students assigned to the same facility for institutional IPPEs and APPEs scored 3 percentage points higher on the APPE institutional examination compared with students assigned to separate facilities for these experiences.

CONCLUSION

Assigning students to the same facility for both institutional IPPEs and APPEs positively influenced knowledge-based APPE examination performance.

Role of student pharmacist interns in hospital-based standing orders pneumococcal vaccination program

OBJECTIVE

To describe the role of student pharmacist interns in supporting a standing orders program (SOP) for pneumococcal polysaccharide vaccination in hospitalized patients.

SETTING

University of Pittsburgh Medical Center (UPMC) Presbyterian, an academic teaching hospital in Pittsburgh.

PRACTICE DESCRIPTION

The hospital-based Drug Use and Disease State Management (DUDSM) program designs, implements, and promotes evidence-based practice guidelines to ensure safe and cost-effective drug therapy. PRACTICE INNOVATION/INTERVENTIONS: Paid student pharmacist interns provide manpower for screening and maintaining the vaccination SOP. Student preparation includes classroom learning about immunization concepts, on-site SOP workflow training, and direct patient care activities. Students participate in the vaccination SOP by (1) screening daily admissions through computerized information systems, (2) reviewing databases for documented prior vaccination, (3) completing preprinted orders for pharmacists, (4) inserting orders into patient charts, (5) checking vaccine administration, (6) educating nurses, and (7) managing the databases. Pharmacists verify and sign vaccine orders. Nurses obtain patient history and consent and administer vaccines.

MAIN OUTCOME MEASURES

Hospital vaccination rates as determined monthly for quality improvement reporting, and student time required to complete SOP functions.

RESULTS

In 2005, an average monthly vaccination rate of 70% for hospitalized elderly was achieved by this inpatient SOP, with the highest rate (89%) occurring in March. On average, 800 patients were screened each month, with 480 vaccine orders placed into patient charts.

CONCLUSION

A vaccination SOP is resource-intensive and requires a diligent effort from qualified personnel. In our institution, trained student interns in the DUDSM program perform the necessary daily functions, such as patient screening, that are instrumental in maintaining the SOP.

A strategy to develop advanced pharmacy practice experiences

OBJECTIVE

To establish statewide medication, disease management, and other clinical programs to serve as advanced pharmacy practice experience (APPE) training sites for the University of Colorado at Denver and Health Sciences Center School of Pharmacy, and to guarantee year-round support for the programs by providing pharmacy students with the necessary competencies to carry a significant proportion of each program's workload.

METHODS

Partnerships with pharmacies willing to use students to expand their scope of clinical practice or support existing programs were established. Partners were asked to choose the clinical program(s) they wished implemented or supported and were guaranteed that APPE students would contribute to carrying each program's clinical service workload for 48 week/year under the supervision of the partners' pharmacists. In addition, partners implementing new programs were offered other support, including equipment, supplies, and training and mentoring for their pharmacists.

EVALUATION

Twenty-two partnerships involving anticoagulation, diabetes, immunization, medication reconciliation, and other clinical programs were established with hospital, community, and community health center pharmacies. The partnerships provided 213 APPE placements in the 2006-2007 academic year.

CONCLUSION

This work demonstrates that by using innovative approaches, a pharmacy school can form new partnerships with hospital, community health center, and community pharmacies, as well as work with existing clinical programs, to create a variety of medication, disease management, and other APPEs to meet its increasing placement needs and evolving accreditation standards.