Essential Elements for Core Required Advanced Pharmacy Practice Experiences

Abstract

Since 2004, concerns and calls for greater quality assurance in experiential education have been published. The Accreditation Council for Pharmacy Education (ACPE) "Standards 2016" provide limited differentiation across the four required practice experiences, and, as such, schools interpret them differently. Both schools and accreditation site visit teams would benefit from a common set of guidance for the required Advanced Pharmacy Practice Experiences (APPEs), so that they can ensure consistency and quality in student experiences across practice sites. To address this need for greater standardization, a taskforce of the American Association of Colleges of Pharmacy (AACP) Experiential Education (EE) Section conducted a peer-reviewed, consensus-building process, including experiential faculty and staff across multiple colleges and schools of pharmacy, to determine a common set of elements that could be used to bring consistency to the experiences and expectations for student learning in practice. Over a two year period, the taskforce reviewed the relevant literature and then drafted and revised the elements through an iterative process which allowed for established EE consortia and members of the EE section to review the draft and provide input for revision. The resulting essential elements presented here can be used to guide faculty and staff within experiential education programs in their quality assurance processes in ensuring students receive consistent experience as part of their education prior to graduation.

Striving for excellence in experiential education

“…Examples of activities are provided in the 2016 ACPE Standards and the list of AACP EPA core statements 3,17 . In addition, an AACP task force survey on the essential elements of APPEs found consensus on the essential elements for community, ambulatory care, and inpatient internal medicine APPEs, but not for the health‐system APPE 36 . Approaches to structuring health‐system APPEs include (1) a focus on the pharmacy operations and distributions aspects of the medication use process, (2) a focus on pharmacy administration and management, and (3) exposure to clinical pharmacy responsibilities blended with other pharmacy operations.…”

“…Design of the health‐system APPE should consider the outcomes expected of the curriculum and those expected to be developed during the health‐system IPPE. C/SOPs have been concerned that requiring students to have mandatory sterile compounding experience would be impractical, given the rigorous training and certification requirements at hospital sites before individuals can participate in these activities 36 . Although USP <797> and <800> are important regulations for students to gain exposure to, the impracticality of the actual training experience limits the ability to realistically require this experience for all students in all C/SOPs.…”

“…External organizational structures, such as experiential consortia or local/regional groups, can be greatly help deliver experiential programs in regions or states where experiential sites and preceptors are largely shared among C/SOPs 36,63‐65 . These external structures can focus on strategies that enhance use, efficiency, and expansion, such as developing a calendar of standardized start and stop dates for APPEs and possibly IPPEs to enable better use of sites and preceptors, adopting standard evaluation forms to enhance consistency in grading and decrease preceptor workload, and standardizing regional preceptor training programs for efficiency and consistency.…”

“…Core elements of quality assurance of the experiential educational program include demonstration that IPPEs and APPEs meet the expected outcomes in student abilities in addition to assessments of IPPE and APPE course syllabi, curricular mapping, IPPE and APPE sequencing, and course and site evaluations by students 3 . Moreover, quality assurance should extend to additional measures of the organization, including administration and delivery of experiential education, assessments of the quality of students' learning experiences in each type of IPPE and APPE, extent of student roles and engagement in IPPEs and APPEs, overall quality and quantity of sites and preceptors, standardization across sites and among preceptors, and staffing levels at experiential sites and in the C/SOP experiential office(s) 3,36,71,81,82 . C/SOPs are encouraged to include preceptors in ongoing and periodic comprehensive reviews of the experiential education program.…”

Striving for excellence in experiential education

“…In the final professional year, APPEs must continue to assist in developing practice‐ready graduates and remain current as the profession continues to advance. APPEs should focus on active student participation and direct patient care and should build on the IPE introduced in the IPPE setting 18,19 . Using the EPAs as an outcome‐based assessment measure is an innovative way to guide students through their APPEs and represents an important shift in experiential education 11 …”