Evaluation of Pharmaceutical Care Opportunities Within an Advanced Pharmacy Practice Experience

Abstract

Objective. To determine the nature and extent of learning opportunities presented to students during a community advanced pharmacy practice experience. Methods. Learning opportunities were determined by reviewing students' portfolios. The numbers of unique learning opportunities in which students were engaged were calculated. Results. While all students had ample opportunities to participate in consultations involving the assessment of new and refill prescriptions and nonprescription drugs, only 78% of students had the opportunity to engage in even 1 comprehensive pharmaceutical care consult over an 8-week period. Students' experiences in providing follow-up care, participating in a patient care project, and shadowing another healthcare professional were also limited. Conclusion. Analysis of the student portfolios suggested that the learning environment did not provide students with adequate opportunities to develop pharmaceutical care competencies.

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

“…Although students in this study may have underreported interventions because documentation is not yet common practice in community pharmacies; results obtained for the 2 control arms were consistent with those observed in an earlier evaluation of the traditional APPE program. 1 Overall, the patient care data collected in this study provided valuable insight to all community pharmacy managers and preceptors about the students' experiences in the pharmacies.…”

“…Specifically, students had limited opportunities to be involved in comprehensive pharmaceutical care activities such as consulting with patients on drug-related needs, identifying and preventing drug-related problems, collaborating with patients on care plans, and providing continuity of care through follow-up. 1,2,7 In their feedback, preceptors reported that students were hindered in their learning opportunities due to unfamiliarity with their site's workflow and technology, and by an inability to execute core dispensing and patient-care procedures efficiently. They also alleged that the provision of an APPE manual and proposed 4-week schedule while helpful was not sufficient for a successful student-preceptor experience.…”

“…One of the greatest challenges has been recruitment of preceptors and sites within the community pharmacy setting that are able and willing to provide students with opportunities to hone skills, knowledge, and attitudes related to patient-centered care/pharmaceutical care. [1][2][3][4][5][6] Despite the formidable work done to move practice education forward, in most situations, student activities continue to focus on the technical aspect of medication dispensing and less on designing/implementing drug therapy plans with patients and providing continuity of care through follow-up. 1,6 Community-based experiential sites face a number of challenges that make attaining the desired educational outcomes difficult.…”

“…[1][2][3][4][5][6] Despite the formidable work done to move practice education forward, in most situations, student activities continue to focus on the technical aspect of medication dispensing and less on designing/implementing drug therapy plans with patients and providing continuity of care through follow-up. 1,6 Community-based experiential sites face a number of challenges that make attaining the desired educational outcomes difficult. Some of these challenges include time-consuming third-party billing, lack of reimbursement models to allow pharmacy staff members to engage in direct patient care activities, insufficient staffing to handle high prescription volume, inability to access patient information, lack of adequate software, lack of private areas for confidential patient consultations, and lack of education programs to support preceptors in their new role as educators.…”

Web-based Portfolios for Pharmaceutical Care Plans During Advanced Pharmacy Practice Experiences

“…Kassam discussed the use of learning portfolios to record direct and non-direct pharmaceutical care by students, and also as an assessment tool to determine students' clinical reasoning and pharmaceutical care skills. 4 Other portfolios described include those for competency assessment, 5 experiential practice portfolios to document instruction and learning, 6 and also reflective portfolios.…”