A demonstration study comparing “role-emergent” versus “role-established” pharmacy clinical placement experiences in long-term care facilities

Abstract

BackgroundIncreasing challenges to recruit hospital sites with full-time on-site pharmacy preceptors for institutional-based Advanced Pharmacy Practice Experiences (APPE) has made it necessary to consider alternate experiential models. Sites with on-site discipline specific preceptors to supervise students have typically been referred to in the literature as “role-established” sites. In British Columbia, long-term care (LTC) facilities offered a unique opportunity to address placement capacity issues. However, since the majority of these facilities are serviced by off-site community pharmacists, this study was undertaken to explore the viability of supervising pharmacy students remotely – a model referred to in the literature as “role-emergent” placements. This paper’s objectives are to discuss pharmacy preceptors’ and LTC non-pharmacist staff experiences with this model.MethodsThe study consisted of three phases: (1) the development phase which included delivery of a training program to create a pool of potential LTC preceptors, (2) an evaluation phase to test the viability of the LTC role-emergent model with seven pharmacists (two role-established and five role-emergent) together with their LTC staff, and (3) expansion of LTC role-emergent sites to build capacity. Both qualitative and quantitative methods were used to obtain feedback from pharmacists and staff and t-tests and Mann–Whitney U tests were used to examine equivalency of survey outcomes from staff representing both models.ResultsThe 76 pharmacists who completed the training program survey rated the modules as “largely” meeting their learning needs. All five role-emergent pharmacists and 29 LTC participating staff reported positive experiences with the pharmacy preceptor-student-staff collaboration. Preceptors reported that having students work side-by-side with facility staff promoted inter-professional collaboration. The staff viewed students’ presence as a mutually beneficial experience, suggesting that the students’ presence had enabled them to deliver better care to the residents. As a direct result of the study findings, the annual role-emergent placement capacity was increased to over 45 by the end of the study.ConclusionsThis study demonstrated that role-emergent LTC facilities were not only viable for quality institutional APPEs but also provided more available sites, greater student placement capacity, and more trained pharmacy preceptors than could be achieved in role-established facilities.

Nationwide survey of experiential learning in MPharm programmes in UK Universities

“…Obtaining/retaining hospital placements was, however, ranked by our respondents as the most challenging factor related to EL. Hospitals are reluctant to take on students mainly due to limitations in logistics, shortage of pharmacists, difficulty balancing between professional duties and teaching students, and the challenge of training large student numbers . Obtaining/retaining community placements was ranked as the fifth most important challenge, and indeed, this has been highlighted by several universities in various countries …”

“…Hospitals are reluctant to take on students mainly due to limitations in logistics, shortage of pharmacists, difficulty balancing between professional duties and teaching students, and the challenge of training large student numbers. [22,42] Obtaining/retaining community placements was ranked as the fifth most important challenge, and indeed, this has been highlighted by several universities in various countries. [10,14,25,32,35] While schools face increasing difficulty in finding placement sites at hospitals and community pharmacies due to the increase in demand, the GPhC has not stipulated that placements are limited to these two settings.…”

An Advanced Pharmacy Practice Experience for Community Pharmacies Based on a Clinical Intervention Targeting Patients With Inflammatory Bowel Disease

“…The approach taken in this rotation is similar to “role-emergent” rotations where students are placed in long-term care facilities that do not have a full-time pharmacist presence. 12 In both cases, students are carrying out clinical activities that are not traditionally offered at the host site. Clearly, students can thrive in these settings despite lacking an established service model by staff pharmacists.…”

Exposing Pharmacy Students to Challenges Surrounding Care of Young Children via a Novel Role-Emerging Placement

“…Currently there is limited literature around the use of REPs in pharmacy. One study conducted in Canada highlighted the positive aspects of REPs within the profession (Kassam 2013). However, it must be noted that this particular study focused on a placement which was significantly longer, six weeks in duration.…”

“…There has been little research into developing practical experience or REPs in pharmacy. The first published study in 2013 in British Columbia, Canada, highlighted some potential benefits for the use of REPs in pharmacy (Kassam et al, 2013). The study, however, concentrated solely on pharmacy preceptor's and staff experiences rather than students.…”