Quality Assurance and Improvement Practices of Experiential Education Programs in Schools of Pharmacy

A Deeper Reflection on the Integration of the Pharmacists' Patient Care Process

OBJECTIVE

Given the importance of developing student understanding and application of the Pharmacists' Patient Care Process (PPCP), programs may be able to use successful approaches from other institutions to enhance their curricular and experiential learning and assessment of student outcomes. The study objective was to explore successful methods of integrating the PPCP and outline areas of challenge.

METHODS

This study used a qualitative study design with semistructured interviews to gain insight from participants' lived experiences. Pharmacy faculty members participating in a national survey or who were authors of articles about PPCP initiatives were recruited to provide greater detail about building successful and innovative curricula. Thematic analysis identified commonalities and differences among the interviewed participants.

RESULTS

A total of 10 interviews were conducted. The following 4 overarching themes arose from the data: discussions around intentional integration of the PPCP across multiple core courses may foster innovations in teaching strategies; intentional integration alone does not equate to PPCP integration across the curriculum; intentional integration may enhance program assessment; and PPCP data from experiential coursework may not be widely used in curricular continuous quality improvement.

CONCLUSION

Pharmacy programs will ideally involve the entire faculty, including experiential and basic and social/administrative science members, in weaving the PPCP throughout the curriculum. Rigorous assessment can better inform interventions related to student competency in various steps of the PPCP. Pharmacy programs should also clarify how data obtained from preceptors observing student performance in each of the PPCP steps are used to assess student mastery of this critical skill.

Rational redesign of an introductory pharmacy practice experience curriculum

OBJECTIVE

To utilize a process to identify strengths and weaknesses of an introductory pharmacy practice experience (IPPE) curriculum from stakeholder perspectives and undergo IPPE curricular revision.

METHODS

An IPPE Curriculum Redesign Taskforce was created, and a five-step systematic quality improvement (QI) process was developed and applied to redesign an IPPE curriculum. Steps were to (1) identify existing curriculum challenges and strengths; (2) determine potential solutions to challenges; (3) redesign IPPE curricular structure; (4) obtain stakeholder input and support; and (5) redesign IPPE content. Throughout these steps, surveys were administered, and feedback was solicited from stakeholder groups through focus groups and meetings. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using inductive content analysis and peer debriefing to identify themes.

RESULTS

Student survey and focus group results identified desires to limit student-preceptor negotiations when scheduling hours, decrease conflict between IPPE hours and scheduled classes, and increase direct patient care opportunities. Structural revisions included transition of IPPE hours from the first- and second-year of the program into the third-year (P3), revising course schedule grids to allow P3 students one day per week to complete hours, and aligning rotation dates during class-free times. Curricular content was strengthened through curricular mapping, threading, and course coordinator collaborations.

CONCLUSION

A 5-step IPPE redesign systematic QI process utilizing solicitation, analysis, and incorporation of stakeholder feedback was used to revise an IPPE curriculum to maintain framework and content strengths and address weaknesses. Other pharmacy programs could utilize this process to redesign their IPPE curriculum.

Virtual site visits - an emerging option for experiential quality assurance

BACKGROUND AND PURPOSE

Site visits are a valuable tool for experiential quality assurance. There is sparse literature regarding the use of a virtual modality for completion of site visits. This manuscript describes the experience of using of onsite and virtual site visits, including benefits and limitations of each approach, by two pharmacy experiential programs.

EDUCATIONAL ACTIVITY AND SETTING

Each experiential program utilizes both virtual and onsite visits to assess site quality, provide preceptor development, and connect with sites and preceptors. Information gathered and documentation processes are similar for both institutions for both visit modalities. The two pharmacy institutions differ in size, geographical location, number of experiential sites, and experiential department structure.

FINDINGS

Based on site evaluator feedback from the two institutions, both visit modalities achieved the goals of evaluating sites for quality, fostering relationships with preceptors, and affording opportunities to provide preceptor development. Positive features of virtual site visits were increased flexibility with scheduling, expanded participation and engagement, increased efficiency, and decreased cost. Drawbacks noted with virtual site visits were challenges touring the site, decreased ability to observe group dynamics and culture, and participant multi-tasking.

SUMMARY

A virtual approach to completing experiential site visits achieved programmatic goals. Utilizing a combination of virtual and onsite visits may facilitate a customized approach to navigating the advantages and disadvantages of each modality.

Trends in the Number of Authors and Institutions in Papers Published in AJPE 2015-2019

Objective. To investigate the number of authors and unique institutions per paper published in the American Journal of Pharmaceutical Education (AJPE) in 2015 through 2019, and to examine the number of authors and unique institutions for papers that were nominated for the Rufus A. Lyman Award in the same period.Methods. Articles published in AJPE from 2015 through 2019 were reviewed. Data collected for each article included article type, number of authors, and number of institutions.Results. Of the 811 articles published in AJPE during this period, the number of authors increased significantly from a mean (SD) of 3.5 (1.8) to 4.5 (2.2). The number of unique institutions also increased significantly from 1.7 (1.1) to 2.4 (1.8).Conclusion. There is a trend toward a greater number of authors and unique institutions for the publications in one pharmacy education journal. Explanations for this trend may include pressure to publish, increased research complexity, and expanded interprofessional collaboration.

Using technology to automate syllabus construction for programmatic, curricular, faculty and experiential assessment activities

Purpose

With a growing need to assess multiple aspects of healthcare education, the goal of this study was to develop an innovative web-based application to streamline assessment processes and meet the increasingly complex role of the educational manager.

Design/methodology/approach

AARDVARC (Automated Approach to Reviewing and Developing Valuable Assessment Resources for your Curriculum) was created with the core function of standardizing course syllabi through the use of a web-based portal and the ability to query fields within the portal to collect multiple points of data. AARDVARC permits quick and efficient gathering of programmatic, curricular, faculty, teaching, preceptor and financial data to facilitate meaningful change and a shared responsibility of assessment. This software has allowed automatic completion of complex analytics each semester, including coverage of program outcomes, course learning objectives, teaching and assessment methods, course readings, topics covered in the curriculum, faculty teaching hours, experiential activities, coverage of disease states and scheduling of peer observation of teaching.

Findings

Three years after its initial launch, AARDVARC is now used by 520 faculty, 60 staff, 44 preceptors and over 2,000 students across multiple health profession and science programs. Data analytics through AARDVARC have allowed the School to reimagine how assessment can be conducted and have provided a pathway for making evidence-based programmatic and curricular changes.

Originality/value

This original software has provided an innovative approach to conduct assessment that combines best practices in curriculum, assessment, data analytics and educational technology while improving the overall quality, speed, and efficiency of academic and business operations.

Leveraging an Implementation Fidelity Framework to Assess Quality in Experiential Education

Objective. Fidelity metrics can provide insight into the extent to which experiential programs are implemented as they were designed to be. The UNC Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill implemented a new curriculum that included a series of three, two-month introductory pharmacy practice experiences (IPPEs). The objective of this study was to design a logic model for the first IPPE within the series, identify key variables to program implementation, define fidelity indices and benchmarks, and compute a single fidelity score for each IPPE site.Methods. Data were collected from the course syllabus, learning outcomes, assignments, and evaluations from students and preceptors for 50 sites that had hosted 147 students for IPPEs. A logic model was defined to describe inputs, activities, outputs, and outcomes of the IPPE. Data were reviewed for key variables and measures to include in the fidelity framework and then a fidelity score was generated for each site.Results. Twenty-four variables were identified across three components that were deemed critical for experience implementation (eg, patient care activities, preceptor compliance, and overall site training and evaluation). The mean fidelity score for all sites was 59.1% (SD 16.4%).Conclusion. A logic model and fidelity framework provided an objective method to assess the extent to which practice sites delivered the IPPE course. This work could be used by schools as a basis for individualizing quality assurance efforts.

Assessment of Volunteer Preceptors at Colleges and Schools of Pharmacy in the United States

Objective. To identify the way colleges and schools of pharmacy in the United States assess the performance of volunteer preceptors who precept students in advanced pharmacy practice experiences (APPEs).Methods. In the summer and fall semesters of 2018, directors of experiential education were invited to complete an online, self-administered questionnaire that included questions dealing with assessment of APPE volunteer preceptors related to promotion and reappointment procedures, abilities and attributes assessed, methods of assessment, and frequency of conducting such assessments. Several attempts were made via email and phone to encourage participation.Results. Eighty-one of 132 (61.4%) fully accredited programs responded with all but one reporting that they evaluated the performance of APPE volunteer preceptors. Forty-one of these 80 (51.3%) indicated that preceptors cannot be promoted in rank, while 47 (58.8%) had a process for preceptor reappointment. The most commonly assessed preceptor abilities and attributes were accessibility, ability to provide feedback to students, communication skills, and professional demeanor. The most reported assessment strategies were summative student evaluations and on-site evaluation of the preceptor by college or school personnel. The frequency of assessments varied based on the assessment method the institution used.Conclusion. Assessment of APPE volunteer preceptors was an integral component of the quality assurance process at almost all responding US pharmacy colleges and schools. The institutions evaluated various preceptor abilities and attributes and used multiple assessment strategies. Findings from this study may help programs review their existing assessment practices, implement new ones, and help to standardize preceptor assessment.

Essential Elements for Core Required Advanced Pharmacy Practice Experiences

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.