Restructuring the inpatient advanced pharmacy practice experience to reduce the risk of contracting coronavirus disease 2019: Lessons from Saudi Arabia

Student Pharmacist Perspectives of a Remote Ambulatory Care and Community Pharmacy Dual-Cohort APPE

OBJECTIVE

The primary aim of the study is to describe the development and implementation of a remote required ambulatory care and required community pharmacy dual-cohort Advanced Pharmacy Practice Experience (APPE) rotation from the student pharmacist perspective. The secondary objective is to identify elements of a remote APPE to integrate into traditional onsite rotations.

METHODS

An electronic post-survey was developed to evaluate rotation effectiveness based on the Center for the Advancement of Pharmacy Education (CAPE) outcomes, and to identify rotation attributes to inform future rotations. Students from different graduating classes on rotation between April and June 2020 participated in the survey. Likert-scale, ranked-response, and fixed-answer-choice questions were analyzed using descriptive statistics, and comparisons between cohorts and rotation groups were completed using the Chi-squared statistic (alpha .05). Open-ended questions were assessed for recurring themes. Study was exempted by university's Institutional Review Board.

RESULTS

Twenty-four of 45 invited students completed the survey (53% response rate). Of the surveyed CAPE outcomes, agreement was highest (95.7%) that the rotation improved students' abilities within 1.1 Learner, 2.2 Manager, and 4.4 Professional subdomains. Diversity of experiences and topic discussions were elements most frequently identified for inclusion in future rotations.

CONCLUSION

Student feedback was largely positive and indicated the remote APPE rotation experience was meaningful and improved abilities on key CAPE outcomes. Although remote rotations are unique, aspects including diverse learning experiences and preceptor collaboration may be considered for integration into traditional onsite rotations.

Strategies Proposed by Students and Pharmacists for Virtual Experiential Patient Care Practicums

Background: The University of British Columbia (UBC) Pharmacists Clinic (the Clinic) is a pharmacist-led patient care clinic serving as a practice site for experiential education in a team-based primary care practice. Given the unprecedented circumstances surrounding COVID-19, some pharmacy practice sites have permanently transitioned select experiential education activities to a virtual format. Currently, there is limited literature on teaching practices that are conducive to students' success in a virtual environment. Objective: To determine the factors that enable successful development of a virtual patient care practicum experience at a university clinic from the perspectives of student pharmacists and practice educators. Methods: A qualitative research methodology was used to gain the perspectives of student pharmacists, who did not have experience with virtual practicums, and practice educators, who had some experience with virtual practicums at the time of the study. Separate focus group interviews were conducted using a semi-structured approach and consisted of questions aimed at gathering insight into participant perspectives on virtual practicums. The focus group sessions were audio recorded with participant consent and transcribed. A thematic analysis was conducted to analyze the data. Results: Three pharmacist practice educators and three student pharmacists participated in their respective focus groups. Six major themes were developed based on the data: (1) technology optimization, (2) patient care related activities, (3) student-practice educator relationship, (4) student skill development, (5) student support, and (6) in-person vs virtual practicum preferences. Proposed strategies to mitigate the limitations of virtual practicums included setting communication guidelines, arranging enriching learning opportunities, and having reliable internet connection. Conclusion: The participants in this study provided insight on factors to support successful development and delivery of a virtual patient care practicum. The results from this study can be applied to other health disciplines and their approach to virtual practicums during and following the COVID-19 pandemic.

Students' Reflections on Learning Experiences in Federally Qualified Health Centers

Introduction: Final year pharmacy students participate in advanced pharmacy practice experiences in multiple settings. Each practice setting offers different opportunities for student learning and growth. Experiences at Federally Qualified Health Centers (FQHCs) allow student pharmacists to work with patients with unique health and socioeconomic challenges. Objective: The objective of this study was to examine the impact of an ambulatory care rotation at an FQHC on pharmacy students' learning. Methods: Final year pharmacy students submitted weekly reflections about their experiences at an FQHC using the Driscoll method of reflection. They reflected on activities, examined their effects on learning and growth, and discussed the impact the experiences would have on future practice. Qualitative analysis of students' reflections was conducted to identify themes related to learning and professional growth. Results: Pharmacy students (N = 11) reflected upon a variety of topics during their rotations at an FQHC. Fifteen themes and 11 sub-themes were identified by the reviewers within 43 reflections. Reflections covered three general areas: types of experiences students participate in at an FQHC, current and future effects of those experiences on student learning or patients' health, and students' emotional reactions during the experiences. Conclusions: Student reflections demonstrated that rotation experiences contributed to their growth and learning in communication, collaboration, and empathy. Additionally, students indicated that they gained confidence and skills throughout the rotation. By identifying the meaning students attributed to their learning experiences, reflections can be used to assess rotation activities for modification or continued inclusion.

The Benefits and Challenges of Precepting Pharmacy Students Virtually in Interprofessional Primary Care Teams

OBJECTIVE

The objective of this study was to identify pharmacists' perspectives on the benefits and challenges of precepting pharmacy students during circumstances that require using virtual care in team-based primary care practices.

METHODS

A cross-sectional online survey was disseminated through Qualtrics software from July 5, 2021, to October 13, 2021. We used a convenience sampling technique to recruit a sample of pharmacists working in primary care teams across Ontario, Canada, who were able to complete a web-based survey in English.

RESULTS

A total of 51 pharmacists participated in the survey and provided complete responses (response rate of 41%). Participants noted benefits at 3 levels of precepting pharmacy students in primary care during the COVID-19 pandemic: (1) benefits to pharmacists, (2) benefits to patients, and (3) benefits to students. Challenges of precepting pharmacy students were: (1) difficulty training students virtually, (2) students not being ideally prepared to begin a practicum training during a pandemic, and (3) reduced availability and new workload demands.

CONCLUSION

Pharmacists in team-based primary care highlighted substantial benefits and challenges for precepting students during a pandemic. Alternative mechanisms of experiential education delivery can provide new opportunities for pharmacy care yet can also restrict immersion into interprofessional team-based primary care and diminish pharmacist capacity. Additional support and resources to facilitate capacity are critical for pharmacy students to succeed in future practice in team-based primary care.

Career Readiness Among Saudi Pharmacy Students: Exploring the Need for and the Impact of Career Counseling Services

PURPOSE

Employers place emphasis on graduates' work experience and interpersonal skills while academia mainly focuses on developing students' learning ability. One proposed strategy is through career guidance by universities; however, supportive evidence is lacking. This study explored the career readiness of pharmacy students for the Saudi job market. It also examined the availability of career guidance services for pharmacy students and alumni in Saudi Arabia and the impact of such services on recipients' career path choices and development of competencies.

SUBJECTS AND METHODS

This cross-sectional study utilized an online-based survey. Pharmacy students in the last three years of their program and recent graduates participated in the survey. The study used descriptive statistics to describe participants' demographic data. Respondents were asked to rate aspects related to career readiness on a 5-point Likert scale, and their responses were reported as frequencies with percentages or means as appropriate. Comparisons between groups were made using t-test or one- way ANOVA as required.

RESULTS

A total of 576 responses were collected. About 25% of participants acknowledged the career guidance services provided at their pharmacy college, whereas the majority indicated that they have never reached out to a career counselor at their university (89.6%). The highest level of disagreement was noticed in impact of career guidance services on participants' establishment of their CV/portfolio (50.7%). Using the work readiness scale, the lowest mean was seen in the social intelligence domain (3.64 ± 0.94).

CONCLUSION

Although substantial proportion of students reported the presence of career guidance services in their university or college, very few stated that they had utilized such services. This could have impacted the students' career readiness for the rapidly changing Saudi job market. Therefore, proper measures to advertise the availability of career guidance services in Saudi pharmacy schools have to be implemented.

Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status

Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.

A team-led remote ambulatory care rotation: Creating efficiency without sacrificing quality

BACKGROUND AND PURPOSE

Advanced pharmacy practice experiences (APPEs) are a highly anticipated part of the doctor of pharmacy program. Traditionally, these rotations are offered as full-time, onsite experiences. However, there are situations in which geography, transportation, and housing requirements limit the accessibility of these experiences. Additionally, unexpected changes in rotation schedules or resource limitations may leave students in a difficult situation when completing their rotation hours. Having the ability to provide a remote APPE that results in similar student learning outcomes provides flexibility to experiential directors and ensures students' continued progression towards graduation.

EDUCATIONAL ACTIVITY AND SETTING

A group of faculty members and post-graduate trainees collaborated to create a remote, one-month ambulatory care experience for 18 students over three months. Students had access to the electronic health record (EHR) from their homes through a partnership with a local federally qualified health center. Access to the EHR enabled the students to participate in telehealth visits and have meaningful interactions with patients as if they were on-site. Students were also able to participate in topic discussions, answer drug information questions, complete a literature evaluation series, and work on projects remotely through this rotation.

FINDINGS AND SUMMARY

This remote rotation allowed preceptors to meet the educational needs of students while allowing them to provide patient care through telehealth. Data from summative student evaluations, student evaluations of preceptor and site, and a supplemental survey demonstrate that this remote rotation is a meaningful learning experience for students and is comparable to similar in-person rotations.

Clinical Advanced Pharmacy Practice Experience Rotations During COVID-19: Evaluation of a Transition to Virtual Learning

Background

All Advanced Pharmacy Practice Experience (APPE) pharmacy rotations at a large academic medical center were converted to virtual experiences during the beginning of the coronavirus disease 2019 (COVID-19) pandemic.

Objective

This study aimed to describe information obtained through pre- and post-rotation surveys, implemented to improve experiences for future students who may be required to complete virtual APPE pharmacy rotations.

Methods

A single-center, descriptive study was conducted at a 1382-bed academic medical center. A pre- and post-rotation survey was sent to 32 students, and a post-rotation survey was sent to 38 preceptors via email to assess newly implemented virtual rotations.

Results

Students’ response rate for pre- and post-rotation surveys was 59% and 41%, respectively, and the preceptors’ response rate for the post-rotation survey was 37%. A statistically significant improvement in videoconferencing abilities after the rotation was found for students but no differences in other skills were noted. In the post-rotation survey, students rated all of the following areas as being “effective”: rotation as a whole, virtual topic and patient discussions; but were “neutral” regarding the utility of the introductory training guide. In the post-rotation survey, preceptors rated all of the following areas as being “effective”: rotation as a whole, virtual topic and patient discussions.

Conclusion

Abrupt shifts to virtual pharmacy clinical rotations due to COVID-19 have led to many challenges. Both students and preceptors felt that virtual rotations were an effective alternative to in-person experiences; however, further studies are warranted to evaluate actual performance compared to perceived effectiveness.

Impact of COVID-19 pandemic on training of pharmacy residents and fellows: Results from a national survey of postgraduate pharmacy trainees

Purpose

The coronavirus disease 2019 (COVID-19) pandemic has impacted the activities of healthcare workers, including postgraduate pharmacy trainees. Quality training experiences must be maintained to produce competent pharmacy practitioners and maintain program standards.

Methods

A cross-sectional survey of postgraduate pharmacy trainees in the United States was conducted to evaluate training experience changes and assess perceived impacts on residents and fellows following the COVID-19 pandemic’s onset.

Results

From June 4 through June 22, 2020, 511 pharmacy trainees in 46 states completed the survey. Participants’ median age was 26 (interquartile range [IQR], 25-28) years, with included responses from postgraduate year 1 residents (54% of sample), postgraduate year 2 residents (40%), and postgraduate fellows (6%). Compared to experiences prior to the onset of the COVID-19 pandemic, fewer trainees conducted direct patient care (38.5% vs 91.4%, P < 0.001), more worked from home (31.7% vs 1.6%, P < 0.001), and less time was spent with preceptors per day (2 [IQR, 2-6] hours vs 4 [IQR, 1-4] hours, P < 0.001). Sixty-five percent of respondents reported experiencing changes in their training program, 39% reported being asked to work in areas outside of their routine training experience, and 89% stated their training shifted to focus on COVID-19 to some degree. Most respondents perceived either major (9.6%) or minor (52.0%) worsening in quality of experience, with major and minor improvement in quality of experience reported by 5.5% and 8.4% of respondents, respectively.

Conclusion

Pharmacy resident/fellow experiences were perceived to have been extensively impacted by the COVID-19 pandemic in varying ways. Our findings describe shifts in postgraduate training and may aid in the development of best practices for optimizing trainee experiences in future crises.

Reshaping experiential education within Qatar University's Health Programs during the COVID-19 pandemic

Health professions programs heavily depend on experiential learning to prepare learners for practice within the healthcare system. Learners acquire a significant proportion of patient care skills as they participate in experiential learning activities. As the coronavirus disease 2019 (COVID-19) pandemic disrupts education globally, educators have been challenged to reexamine existing teaching approaches to minimize the impact on experiential educational outcomes. This article describes how educators from the College of Pharmacy and College of Medicine at Qatar University utilized nontraditional teaching methods to ensure the continuation of experiential learning despite the disruption due to the pandemic.

Leading a Digital Transformation in Pharmacy Education with a Pandemic as the Accelerant

The global COVID-19 pandemic has not only posed a challenge to education but created an opportunity to spearhead a digital transformation and the novel delivery of a Pharm.D. curriculum. The process to transform the curriculum in a sustainable and iterative manner involved multiple steps including: (1) Communication, (2) Maintaining faculty engagement, (3) Allowing outside the box thinking, (4) Providing resources and tools and (5) Creating accountability and timelines. At our institution, we have been interested in digital transformation since completing our interview of global leaders. We began our journey using the current COVID-19 pandemic as an accelerant for change. Digital transformation in any industry is not a simple undertaking. However, with planning, aligned organizational interests, consistent and regular communication, provision of resources and tools, engaging faculty and creating accountability and timelines with deliverables the implementation can be successful. When the global pandemic wanes and educational institutions commence in-person classes, having undergone the stages of digital transformation, we will be able to embrace these changes and transform education, not having to reproduce pre-pandemic educational systems.

Ambulatory Care Practice in the COVID-19 Era: Redesigning Clinical Services and Experiential Learning

The coronavirus disease (COVID‐19) has created a variety of challenges for health care professionals, including ambulatory care clinical pharmacists. High‐quality remote and minimal‐contact care has become a necessity. Ambulatory care clinical pharmacists around the nation have adjusted their practice. In many cases, this included implementation of telehealth programs for comprehensive medication management. The redesign of ambulatory care Advanced Pharmacy Practice Experiences (APPE) also required quick adaptation. In this paper, we describe the clinical practice and experiential education challenges encountered by an ambulatory care clinical pharmacist workgroup in a COVID‐19 “hotspot,” with an emphasis on solutions and guidance. We discuss how to adapt ambulatory care clinical pharmacy practices including methods of minimal‐contact care, reimbursement opportunities, tracking outcomes, and restructuring ambulatory care APPE. As ambulatory care clinical pharmacists continue to expand the services they provide in response to COVID‐19, we also describe opportunities to promote pharmacists as providers during times of pandemic and into the future.

Restructuring the inpatient advanced pharmacy practice experience to reduce the risk of contracting coronavirus disease 2019: Lessons from Saudi Arabia

Introduction

On March 11, 2020, the World Health Organization announced the rapidly spreading epidemic of the coronavirus disease 2019 (COVID‐19) pandemic. Almost all countries started to take proactive precautionary measures to reduce the risk of contracting the virus. The education sector, including pharmacy education, has been drastically impacted by this pandemic. During the outbreak, many hospitals instructed the health profession's schools to restrict or prevent the presence of their students and interns in their hospitals in an effort to limit the spread of the virus.

Objectives

Constraining the presence of interns in the affiliated hospital has impacted the integrity of delivering the learning outcomes of each clinical rotation. In this paper, we present the experience of four faculty preceptors in restructuring the advanced pharmacy practice experience in different clinical settings, including critical care, infectious diseases, cardiology, and internal medicine, in order to reduce the risk of contracting COVID‐19 at a large academic medical institution in Saudi Arabia.

Conclusion

We believe that this experience could provide guidance and insights for other pharmacy schools dealing with this issue during this global pandemic.