An introductory pharmacy practice experience providing pharmaceutical care to elderly patients

Survey of undergraduates' perceptions of experiential learning in the MPharm programme: The TELL Project

Objective:

To determine the perception of undergraduate pharmacy students of their experiential learning (EL) placements both in the community and hospital settings.

Methods:

A cross-sectional survey was conducted utilizing a six-item online survey consisting of one open-ended and five closed-ended questions, the latter utilising five-point Likert-type scales ranging from strongly disagree (1) to strongly agree (5). All undergraduate pharmacy students from the School of Pharmacy (N=496) were included in the study. Survey questions assessed students’ perceptions on the effectiveness of the EL, tutors and placements sites, and organisation and structure of the EL. Thematic content analysis was performed on the open-ended comments, where relevant themes were generated.

Results:

From the 139 responses (response rate: 28%), 121 responses were analysed, and of these, 72.5% already had part-time jobs in community pharmacies. Close to 85% felt that their part-time work should contribute to EL hours, which is currently not recognised by the university. Respondents were positive about the effectiveness of EL in developing their professionalism and communication (M=3.84, SD=1.05), clinical (M=3.42, SD=1.22), and technical skills (M=3.32, SD=1.25) Respondents provided favourable feedback about their experience in the hospital as it gave them a real-world exposure to the role of a hospital pharmacist. Community placements were not viewed favourably and this was mainly attributed to the poor experience with tutors whom they felt used them as an extra pair of hands. This was thought to impede their learning experience. They also felt that hospital placements were of insufficient duration, reported by 72.5% of respondents. Respondents also felt they should be sent to other sites such as primary care for placements.

Conclusions:

Tutor-training is key to ensure tutors are aware of the responsibilities and expectations. Similarly, quality assurance measures should be adopted to ensure tutors and placement sites are capable of providing students with an effective placement experience. While placement durations are a concern, the focus should be on the quality of the placement experience, and ensuring there is structure and flexibility. Content changes are also needed to include emerging placement sites such as primary care to prepare students for evolving pharmacist roles in the changing healthcare system.

Experiential education in the pharmacy undergraduate curricula in Brazil

Objective:

Considering the curriculum reform process taking place in pharmacy undergraduate programs in Brazil and the importance of practical experience to students throughout their learning process in university, this study aims to provide an overview of pharmacy undergraduate programs in Brazil and their respective internships.

Methods:

An observational, descriptive, cross-sectional study. A documentary analysis of pharmacy undergraduate programs in the face-to-face modality was carried out, with data obtained from the Political Pedagogical Projects of the programs, the curricula, and course descriptions containing information on internships, all provided by the Brazilian Ministry of Education. The data collected concerned higher education institutions (HEIs), pharmacy programs and internships.

Results:

Pharmacy undergraduate programs in Brazil have a median duration of 10 semesters, requiring from students a median of 6 internships, from the 6^th semester on, totalizing 826 hours. The programs lack uniformity among their internships, mainly regarding total hours and the semester in which internships start. The pharmacy internships cover, in greater number, the areas of outpatient and community pharmacy, clinical analysis, and pharmaceutical technology, respectively, being clinical analysis the area with more hours. Public and private HEIs have different internship proceedings in their curricula, hence no homogeneity among them in the different regions of Brazil.

Conclusions:

This study demonstrates the diversity of pharmacy programs in Brazil in the context of internships, reflecting on the training and the activity of pharmacists in recent decades. Further studies are needed to deepen the understanding of this theme.

Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived

With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005-2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified seventy-seven relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

Teaching and Learning Pharmacy Services: A Teaching Method for Developing Competencies for Patient-Centered Care Through Experiential Learning in a Real Workplace

INTRODUCTION

Considering the transformation process that has been occurring in pharmacy education and the urgent need to address social health needs, proposals of teaching methods for the development of competences and skills in patient-centered care have become an issue worth discussing. The study describes and discusses the method that has been used for developing of these competencies through experiential learning in a university pharmacy in Brazil.

EDUCATIONAL ACTIVITY

The Teaching and Learning of Pharmacy Services (TLPS) method encompasses 2 components: theoretical-reflexive one (developing protocols covering the patient care process) and practical-reflexive one (using the protocols with real patients). TLPS connects the 2 components in a way to enable students to acquire and apply theoretical knowledge for a comprehensive assessment of the patients' needs and understand how clinical reasoning and decision-making take place. The assessment process is performed, by the supervisor, which evaluates the behaviors necessary for good professional performance.

DISCUSSION

The active learning methodologies have been effectively used in the classroom as a way to stimulate critical thinking, problem-solving, and clinical reasoning. However, experiential learning is considered a central point in the learning process and essential for knowledge building. Thus, the method herein described is shown as an innovative tool to promote self-learning, consolidation and interrelation of the acquired knowledge, easier identification of patients' needs, normalization of behaviors, and improvement in the quality of care.

Engaging with In-need Rural Patient Populations through Public Health Partnerships

A public health partnership was established between a state Medicare Regional Care Collaborative Organization (RCCO), the state health department, a pharmacy school and three community pharmacies located in rural Colorado to optimize the utilization of a free public health service provided through each pharmacy. Fourth-year pharmacy students were allocated year-round by the University of Colorado to support disease management and medication therapy management (MTM) services offered to patients in three rural towns served by the RCCO. Faculty from the school of pharmacy reviewed data provided by the RCCO to identify patients who could benefit from MTM or disease state management (DSM) services. These patients were contacted and encouraged to take advantage of these free pharmacy-based services. Additionally, a number of targeted interventions were performed within these populations to optimize their health. Concerted efforts were made to improve information flow and communication between these pharmacy sites and partnering medical offices. Additionally, pharmacy students were successfully integrated in to medical offices to work alongside medical providers in these communities. This manuscript describes the implementation and coordination of this project as well as the impact these pharmacies had on the communities they served.

Curriculum renewal: Alignment of introductory pharmacy practice experiences with didactic course content

BACKGROUND AND PURPOSE

The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) used the opportunity of curriculum renewal to integrate knowledge and skills learned from didactic courses into the introductory pharmacy practice experiences (IPPEs) occurring simultaneously. This paper describes and evaluates the meaningful application of course content into IPPEs, and evaluates the success using qualitative feedback.

EDUCATIONAL ACTIVITY AND SETTING

Students entering the renewed curriculum starting in fall 2012 were provided a list of pharmacy skills and activities from didactic course directors that reinforced course content for that semester. The skills and activities were to be completed during the students' IPPE visits in the community or health systems settings, depending on the program year and semester.

FINDINGS

Students successfully completed course assignments during their IPPE course program. Not all activities could be completed as designed, and many required modification, including simulated experiences. Feedback from faculty and preceptor members of the school's experiential education committee demonstrated that these activities were valuable and improved learning of course material, but were challenging to implement.

DISCUSSION AND SUMMARY

A renewed curriculum that mapped course assignments for completion in experiential settings was successfully established, after some modifications. The program was modified at regular intervals to improve the ability of preceptors to complete these activities in their individual practice environment. A balance between the school providing guidance on what activities students should perform and allowing unstructured independent learning with the preceptor is needed for an optimal experience.

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.

Geriatric care curriculum in US PharmD programs: What's happening?

OBJECTIVES

Current Accreditation Council for Pharmacy Education (ACPE) Standards are not explicit regarding geriatrics content. The objective of this review is to describe published examples of how care for older adults is integrated into Doctor of Pharmacy (PharmD) curricula at accredited schools/colleges of pharmacy across the United States.

METHODS

PubMed and Embase databases were searched. Manuscripts addressing care for older adults in pharmacy curriculum in the United States were included in the review.

RESULTS

Thirteen PharmD programs have thirteen published examples of how geriatric care was integrated into their curriculum. The most common way geriatric care is integrated into PharmD programs is through Introductory Pharmacy Practice Experiences (IPPE) followed by existing course content and elective course content.

CONCLUSION

There is a wide variety of curriculum strategies currently being utilized to incorporate geriatric education into PharmD programs in the United States. However, this may not be sufficient to support the care of the growing older adult population.

Home medication reviews in a patient care experience for undergraduate pharmacy students

OBJECTIVES

To evaluate the effectiveness of conducting medication management reviews (MMRs) and home medication reviews (HMRs) on improving undergraduate pharmacy students' pharmaceutical care skills and clinical knowledge.

DESIGN

Fifth-year bachelor of science in pharmacy students were enrolled in a structured course in which MMR cases based on real patient scenarios were completed, findings were discussed in groups, and comprehensive feedback was provided by course instructors. Each student was then asked to recruit a real patient through a community pharmacy and conduct an HMR.

ASSESSMENT

Students' pre- and post-course scores on the same MMR case improved significantly, with 84.6% of students passing the post-course assessment. Students also completed a new post-course MMR case and 74.8% received a passing score. Students' answers on a post-course self-assessment showed a significant improvement in their scores regarding knowledge and skills in conducting MMRs and HMRs.

CONCLUSION

Medication management reviews and home medication reviews are excellent tools for educating pharmacy students and providing them with needed actual clinical practice experience.