Tracking Patient Encounters and Clinical Skills to Determine Competency in Ambulatory Care Advanced Pharmacy Practice Experiences

Abstract

Objective. To determine if the amount of exposure to patient encounters and clinical skills correlates to student clinical competency on ambulatory care advanced pharmacy practice experiences (APPEs). Design. Students in ambulatory care APPEs tracked the number of patients encountered by medical condition and the number of patient care skills performed. At the end of the APPE, preceptors evaluated students' competency for each medical condition and skill, referencing the Dreyfus model for skill acquisition. Assessment. Data was collected from September 2012 through August 2014. Forty-six responses from a student tracking tool were matched to preceptor ratings. Students rated as competent saw more patients and performed more skills overall. Preceptors noted minimal impact on workload. Conclusions. Increased exposure to patient encounters and skills performed had a positive association with higher Dreyfus stage, which may represent a starting point in the conversation for more thoughtful design of ambulatory care APPEs.

What clinical rotation factors have an impact on trainee success?

“…Preceptors must make inherently subjective determinations of a student's competency based on past experiences. 5 These data show that over time, as predicted, trainees become more competent, as rated by both themselves and their preceptors. Additionally, these data show that despite differences in clinical sites and preceptors, trainees continue to progress professionally throughout residency.…”

“…Evaluating students’ competency as they proceed through residency is essential to the creation and evaluation of proper learning environments. Preceptors must make inherently subjective determinations of a student's competency based on past experiences . These data show that over time, as predicted, trainees become more competent, as rated by both themselves and their preceptors.…”

“…Additionally, rotations with high procedure or case volumes may also be ideal for training. Research shows that providing sufficient exposure to a breadth of case presentations is associated with elevated competency . Finally, rotations that allow trainees to practise their skills with higher levels of independence are also likely to result in increased learning .…”

“…Research shows that providing sufficient exposure to a breadth of case presentations is associated with elevated competency. 5 Finally, rotations that allow trainees to practise their skills with higher levels of independence are also likely to result in increased learning. 6 Trainees may initially learn how to do procedures by watching others, but ultimately they must manage patients and perform procedures independently to become competent health care providers.…”

Simulated Patients Are Predominantly Used to Teach and Evaluate Athletic Training Students' Skills: A 10-Year Follow-Up

“…These experiences are not sufficient to teach students to perform psychomotor skills competently, even for relatively straightforward patient problems. 26 Researchers in pharmacy education 27 found that students developed competency of clinical skills with more exposure to patient encounters or repeated skill performance. Interestingly, the educational content areas of psychosocial intervention and referral, acute care of injury/illness, and clinical examination and diagnosis were ranked as having more opportunities for real-time patient encounters.…”