A qualitative analysis of common concerns about challenges facing pharmacy experiential education programs

A Cycle of Reinforcing Challenges and Ideas for Action in Experiential Settings

Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and cyclic set of behaviors being reinforced between students and preceptors. These behaviors can contribute to or are the result of higher levels of burnout and a decrease in the development of student clinical skills and subsequent performance on rotation. In this review, the authors investigate various challenges commonly encountered in the experiential environment. These challenges can range from an observed decrease in student engagement, motivation, and critical thinking skills to an increase in preceptor burnout and culture shifts in the clinical practice environments. These factors all ultimately impact patient care and overall student performance. For each challenge identified, strategies will be presented that can be implemented by students, preceptors, and pharmacy programs to break the cyclic pattern identified.

A Description of Required NAPLEX Preparation Courses Among US Pharmacy Programs

OBJECTIVE

One of the final tasks for pharmacy graduates to enter practice is passing the North American Pharmacist Licensure Examination (NAPLEX). Given the recent national declines in pass rates, programs are making significant investments of time and money in NAPLEX preparation. The objective is to characterize the structure and content of required NAPLEX preparation courses.

METHODS

A survey on NAPLEX preparation practices was developed and distributed to all Accreditation Council for Pharmacy Education-accredited pharmacy schools. NAPLEX preparation course syllabi were also collected as part of this survey. Syllabus information was summarized into 4 elements: course structure, content, resources, and assessment strategies.

RESULTS

Of 144 colleges/schools of pharmacy, 100 responded to the survey, 87 reported having a NAPLEX preparation program, and 47 reported having a NAPLEX preparation course. Twenty syllabi were collected. Most courses (14) were longitudinal through the Advanced Pharmacy Practice Experiences year, 16 were credit-bearing, and 19 included a vendor NAPLEX preparatory product. Fourteen courses were hybrid delivery, and 12 focused on licensure preparation and included test-taking strategies, calculations practice, case-based discussions, etc. All 20 courses reported using unproctored timed quizzes and practice examinations, half conducted proctored timed assessments, and 11 included written reflections and/or continuous professional development activities. Most courses were pass/fail (15), and high stakes (16) were defined by delayed or withheld graduation as a consequence for failure. Only 3 of 20 NAPLEX preparation courses were mapped to NAPLEX competencies.

CONCLUSION

Although required NAPLEX preparation courses focus on assessments, the content is infrequently mapped to NAPLEX competencies. This project provides some information on how schools might create their own NAPLEX preparatory courses.

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.

A Pharmacy Drug Knowledge Assessment Pilot: Who Will Fly Farthest and What Downs the Plane?

OBJECTIVE

To evaluate the effectiveness of a sequenced drug knowledge pilot in third professional year students in a capstone course.

METHODS

A three-phase drug knowledge pilot was conducted in spring 2022. Students completed a total of thirteen assessments, including nine low-stakes quizzes, three formative tests, and a final summative comprehensive exam. Results from the previous year's cohort (historical control) who only completed a summative comprehensive exam were compared to the pilot (test group) results to assess effectiveness. The faculty spent over 300 h developing content for the test group.

RESULTS

The pilot group had a mean score of 80.9% on the final competency exam, which was one percent lower than the control group who had a less rigorous intervention. A sub-analysis was conducted that removed the students who failed (<73%) the final competency exam, and no significant difference in the exam score was found. One practice drug exam was found to be moderately correlated and significant (r = 0.62) with the final knowledge exam performance in the control. The number of attempts on the low-stakes assessments had a low correlation with the final exam score in the test group compared to the control (r = 0.24).

CONCLUSION

The results of this study suggest a need to further investigate the best practices for knowledge-based drug characteristic assessments.

Pharmacy Student Perceptions of the Roles and Attributes of Pharmacist Preceptors in Australia

The pharmacist preceptor is key to the success of pharmacy student experiential placements with a recent focus being placed on the quality of preceptors. This study sought to investigate student perceptions of the ideal roles and attributes of pharmacist preceptors to inform the development of a preceptor training program. This was a mixed methods study using an online survey of pharmacy students from levels two to four of an undergraduate pharmacy honours program at a regional Australian university followed by qualitative, semi-structured focus group interviews. Surveys were analysed using descriptive statistics and content analysis while interviews were thematically analysed. Thirty-seven complete survey responses were received, and three student focus groups were conducted. Students identified the key role of preceptors in linking theory to practice and felt that the role of the preceptor in student assessment should focus on practical skills, such as communication and professionalism. There was overall strong agreement between the quantitative and qualitative findings on the ideal preceptor attributes with good communication, enthusiasm for the profession and the provision of clear and honest student feedback thought to be most important. Students regarded these attributes as essential for a good preceptor-student relationship to promote learning in the practice environment.

Characterizing the role and associated stakeholder perceptions of a novel pharmacy experiential education facilitator role within the inpatient practice setting

INTRODUCTION

To address practicum challenges commonly reported in inpatient pharmacy practice settings, a novel experiential education facilitator (EEF) role was created and implemented to provide on-the-ground support for students and practice educators (PEs). This article characterizes the daily activities of the EEF and associated perceptions of their role by students and PEs.

METHODS

In this prospective, descriptive study, EEFs, students, and PEs involved with inpatient advanced pharmacy practice experiences (APPEs) participated. Day-to-day activities were captured by EEFs through completion of logs, and student and PE perceptions of the EEF role were collected through surveys.

RESULTS

Seven EEFs, 14 students, and 20 PEs participated. During the practicum, EEFs frequently organized student activities, provided education to PEs, assisted with student evaluations, and provided logistical support. Orienting students to the site and providing teaching sessions took the greatest amount of time. These activities were perceived to be beneficial by students and PEs, and 12 of 14 (86%) students stated that they felt more confident in their clinical skills after working with their EEF. The majority of students and PEs did not experience challenges with the EEF role. The main challenge identified by both groups was inaccessibility to the EEF due to illness, vacation, or competing clinical responsibilities.

CONCLUSIONS

EEFs within inpatient practice settings are valued for their involvement in providing on-site support for students and PEs. Orientating students to the site, facilitating teaching sessions, and supporting student evaluation were perceived as beneficial and addressed some of the key needs identified by inpatient stakeholders.

An Advanced Pharmacy Practice Experience in a University's Office of Experiential Education

The Accreditation Council for Pharmacy Education (ACPE) requires pharmacy students to complete 1440 hours of advanced pharmacy practice experiences (APPEs). The majority of all APPE hours should be in direct patient care; however, non-patient care electives can also help to prepare students to become practice ready as well as allow them to explore areas of interest. Many pharmacy schools offer elective academic rotations, but an office of experiential education (OEE) academic rotation offers a unique academic elective. This Commentary describes an OEE APPE and includes the views of a preceptor and a pharmacy student regarding the experience. A detailed list of activities for an OEE APPE that can be easily duplicated by other schools is provided. The OEE APPE can be completed online or in-person, creating greater flexibility for administration.

Examining participant perceptions of the UCSF school of pharmacy master preceptor program

INTRODUCTION

The University of California San Francisco School of Pharmacy faculty created the Master Preceptor Program (MPP) to instill best practices in clinical precepting, leadership and professional development, and interprofessional education (IPE). Graduates of the program are encouraged to mentor colleagues at affiliated sites. This study aimed to explore MPP participants' perceptions about the program and to collect general feedback.

METHODS

A descriptive qualitative study of MPP participants who completed the program between 2017 and 2019 was conducted. Semi-structured interviews and focus groups were used to collect general programmatic feedback and examples of skill implementation. All encounters were conducted and recorded online via Zoom. Three investigators independently analyzed transcripts for codes related to key programmatic areas using conventional content analysis.

RESULTS

Ten of 14 past MPP participants participated. Themes included confidence and skills gained in clinical teaching, self-reflection and network opportunities supporting professional and leadership development, and a need for structured expectations and deliverables. Participants noted several benefits of the MPP on clinical teaching, such as improving confidence and adopting teaching techniques, structural and organizational skills, and a learner-centered approach. Participants also mentioned programmatic offerings that improved leadership and professional development, such as networking opportunities in the MPP and at conferences. Participants did not mention IPE in their responses.

CONCLUSIONS

All participants recognized the MPP as an effective training program to enhance clinical precepting skills, leadership, and professional development. Program structure and intentional incorporation of IPE skills are areas of improvement for future cohorts.

A Qualitative Preceptor Development Needs Assessment to Inform Program Design and Effectiveness

Objective. To assess preceptor teaching challenges and development programming design preferences through a qualitative needs assessment of Doctor of Pharmacy student and resident preceptors.Methods. In 2018, 148 experiential education stakeholders across North Carolina (eg, preceptors, residency program directors, experiential faculty administrators, and practice site administrators) were invited to participate in a 60-minute semi-structured interview as part of a broad preceptor development needs assessment. Interview questions focused on: precepting challenges, positive and negative features of development programs, and preferences for program design. Interview transcripts were coded using thematic analysis.Results. Forty-two participants completed interviews, including preceptors from various rotation types, residency program directors, experiential faculty administrators, and institution administrators. Participants identified numerous teaching challenges related to learners, preceptors, and institutional level factors. Participants often noted there was inadequate time, resources, and support to effectively teach. Desirable preceptor development program features included practical strategies, collaboration with preceptors, delivery by education and practice experts, and topics specific to precepting experience. Participants identified live, on-demand, and webinar formats as acceptable if collaboration and engagement were included. Participants also desired unique training opportunities such as online platforms, coaching programs, and simulated learning environments.Conclusion. Preceptors for pharmacy students and residents face numerous challenges and require sufficient time, support, and resources to develop their skills. Participants requested training that included on-demand, frequent sessions delivered through various modalities, collaboration opportunities, a choice in topics and delivery formats, and sessions from educational and practice experts.

Health-system pharmacist preceptor development and educational needs for accessible resources

INTRODUCTION

Skilled preceptors are crucial to the pharmacy profession as they contribute to the growth and development of student pharmacists and resident pharmacists. As a result, providing education and further growth for preceptors is vital. The purpose of this survey was to determine preceptor development topics of interest and preferred platforms for receiving education.

METHODS

A survey was conducted by the American Society of Health-System Pharmacists Section Advisory Group on Pharmacy Practice Experience Precepting. The survey was designed to identify preceptor needs based on experience and background. Professional development opportunities, tools needed to assist preceptors, and the preferred method of delivery were also determined.

RESULTS

Two hundred seventy-two pharmacists completed the entire 30 question survey. On demand webinars were identified as the preferred method of education delivery. A preceptor tip of the week email was selected as the most favored type of online education resource for preceptors. There was no major difference on the types of online resources for students that preceptors would use. A survey to assist in self-identifying areas for developmental improvement was favored by 81% of respondents.

CONCLUSIONS

This needs assessment identified that preceptor development materials are in high demand for all surveyed topic areas provided via live and/or on demand webinars or other virtual means. Accessibility of resources should be highlighted in multiple forums in order to ensure the information reaches all preceptors.

An analysis of Canadian doctor of pharmacy hospital preceptor experiences in alternative preceptor models

OBJECTIVE

To describe pharmacy preceptors' experiences in alternative preceptor models and their perceptions of these models' impact on the knowledge, skills, attitudes, behaviors, and professional practices of both themselves and their students.

METHODS

Pharmacy preceptors with experience using alternative preceptor models participated in semi-structured interviews. Models included peer-assisted learning (PAL) (≥ two students of the same educational level), near-peer teaching (NPT) (≥ one junior student with ≥ one senior student), and co-preceptorship (CoP) (≥ two preceptors). Interviews were transcribed, coded, and analyzed for themes using the Kirkpatrick framework for evaluating educational interventions.

RESULTS

Twenty hospital pharmacy preceptors from 13 institutions were interviewed, and 13 themes were identified. Fourteen preceptors had experience with PAL, 9 with NPT, and 9 with CoP. Preceptors perceived that NPT and PAL fostered comfortable learning environments that supported student success; challenges included increased time teaching multiple students and completing evaluations. CoP allowed preceptors to balance teaching with clinical duties while broadening students' exposure to different practice settings. Preceptors improved skills in time management, communicating feedback, and adapting to individual students' learning needs and styles. Alternative models enabled preceptors to provide care to more patients and complete projects, thus extending their professional practice. They also described that students participating in these models developed a sense of responsibility for patient care and will be primed to work collaboratively with pharmacy colleagues in the future.

CONCLUSIONS

Preceptors expressed satisfaction with alternative preceptor models. The models enhanced the learning, skill development, and professional practice of both preceptors and students.

Developing a process to manage challenges encountered by experiential education administrators

INTRODUCTION

This study explored preceptor and student related issues reported in pharmacy experiential education settings and solutions that experiential education administrators (EEAs) applied to inform a process to manage these challenges.

METHODS

This mixed-methods study was conducted in two phases. In phase one, five EEAs from three schools of pharmacy collected quantitative and qualitative data over a two-year period on issues reported by students and preceptors and the solutions EEAs employed. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data, respectively. Interviews with six EEAs from four schools were completed in phase two. An additional school was added in phase two. Open coding, pattern coding, and summative analysis were completed on interview data.

RESULTS

Preceptors and students reported 156 and 65 issues, respectively. The most common issues reported were student reliability/responsibility (22, 14%) and preceptor communication (13, 20%). The most frequently applied solutions were coach preceptor (51, 24%) and meet with student (20, 24%). Interviews revealed more information about the strategies EEAs used. Approaches included reactive responses such as talking to and coaching preceptors or students. Preventative strategies were desired, such as tracking data and training.

CONCLUSIONS

Results informed two approaches that EEAs can employ to resolve student and preceptor issues. In the proactive process, issues are tracked to inform student and preceptor development. The reactive approach involves meeting with the preceptor or student, gathering information from both parties, coaching the preceptor or student, and involving other administrators as needed for serious concerns.

Remote introductory pharmacy practice experiences focused on veterans prescribed chronic opioid therapy

PURPOSE

The Department of Veterans Affairs (VA) Northern California Health Care System (NCHCS) uses a dashboard to identify monitoring needs for veterans prescribed chronic opioid therapy (COT). Schools of pharmacy require introductory pharmacy practice experiences (IPPEs); however, resources for providing IPPEs at medical facilities are limited. This article describes collaboration by a primary care service and a school of pharmacy to provide services for patients prescribed COT through remote access to the VA electronic health record (EHR) system.

SUMMARY

Pharmacy students in a required population health IPPE provided clinical services for veterans remotely. Students were supervised by VA clinical pharmacists and granted remote EHR access privileges. Using personally owned laptops and VA cell phones, students performed prescription drug monitoring program (PDMP) activities, reviewed urine drug screening (UDS) results, called patients to assess pain, and documented progress notes. Students completed an assessment on the first and final days of the experience; a retrospective analysis was conducted to examine differences in student knowledge of and confidence in providing COT-focused services. The dashboard scorecard and student workload were tracked over a 1-year period. In that year, 143 students wrote 7,001 PDMP notes, reviewed 6,130 UDS results, and documented 202 pain assessments. Statistically significant improvements were reported in students' level of confidence in performing population health activities for patients prescribed COT, including interpreting PDMP and UDS results and talking with patients.

CONCLUSION

The ongoing collaboration provides real-world population management experiences for future pharmacists and supports monitoring requirements for veterans prescribed COT. The program has helped NCHCS accomplish its teaching mission without dedicating clinic workspace or computers and gain an additional team to address quality measures and support population health activities.

Experiential Education in Pharmacy Curriculum: The Lebanese International University Model

Experiential education is an essential component of pharmacy education in order to allow intern students to experience real conditions and training opportunities in different inpatient and outpatient settings. This paper provides a description of the pharmacy practice experiences (PPEs) in the Lebanese International University (LIU) 5-year bachelor of pharmacy (BPharm) and postgraduate doctor of pharmacy (PharmD) programs; focuses on the opportunities and challenges encountered; and presents a model for experiential education in Lebanon. Learning outcomes and thus students’ acquisition of predefined competencies are evaluated in actual practice settings through assessment tools. Our experiential education program aligns with the accreditation/certification criteria set by the Accreditation Council for Pharmacy Education (ACPE) and equips future pharmacists with the knowledge and skills to become major components in the healthcare team.

A Module in Medication Safety Involving Remote Access and Review of Veterans' Health Records

Objective. To describe and assess the effectiveness of an ambulatory care introductory pharmacy practice experience (IPPE) module in medication safety monitoring that was conducted remotely for first- and second-year pharmacy students in collaboration with a Department of Veterans Affairs (VA) health care system.Methods. A module in medication safety was developed and piloted as part of a required, one-unit IPPE in ambulatory care. The module encompassed three sessions of the 15-week course. Working remotely at the school under the direct supervision of VA clinical pharmacists, students accessed the electronic health records (EHRs) of veterans for whom methotrexate, sulfasalazine, or mineralocorticoid receptor antagonists had been prescribed as such patients require ongoing laboratory monitoring to screen for adverse drug effects. After reviewing the record, students ordered laboratory tests under the prescriber's name, documented notes in the patient's EHR, and sent laboratory reminder letters to patients. Students completed a brief survey at the beginning and end of the course. Differences in survey responses were compared using the Wilcoxon signed rank test.Results. Fifty-eight students reviewed 148 patient records, including non-VA electronic records, and ordered laboratory tests for 79 patients. On the follow-up survey at course completion, students reported significant changes in their ability to monitor laboratory tests, use an actual (non-simulated) EHR to perform patient care, and explain the role of a clinical dashboard to conduct population health activities.Conclusion. Remotely conducting an ambulatory care IPPE course in which pharmacy students used an actual EHR to participate in medication safety monitoring for ambulatory patients expanded the pharmacy school's ability to provide crucial practice experience. Other pharmacy schools struggling with logistical challenges and limited resources should explore this approach to fulfilling the experiential education requirements for pharmacy students.

A Scoping Review of Pharmacy Preceptor Training Programs

Objective. To review the literature pertaining to pharmacy preceptor training programs. Findings. Preceptor training is becoming increasingly important to maintain the quality of experiential training and professional development of pharmacy students, preregistration trainees, and residents. This review found limited documented examples of preceptor training programs and wide variation in both their design and delivery, which was attributed to the diversity of pharmacy practice workplaces and the different types of trainees. The majority of programs included a significant online component, often supported by a face-to-face orientation, with a focus on developing core competencies and with some tailoring of content to suit the specific workplace environment. Evaluations of these training programs showed high preceptor satisfaction rates, with preceptors appreciating the ease of access of online training and the benefits of interaction with other preceptors in face-to-face training. Preceptors also reported positive changes in their behavior during and attitudes toward precepting and an increased understanding of student learning. Summary. This review has highlighted that a structured and evidence-based approach to preceptor training is needed. Programs should be educationally sound, practically focused, and flexible in meeting the needs of a diverse range of preceptors and practice environments. Prospectively, programs should be evaluated not only in terms of outcomes for preceptors, but also for student, preregistration trainee, and resident engagement and attainment of educational outcomes.

A Review of Development Initiatives for Pharmacy Student and Resident Preceptors

Objective. To review the published literature describing and evaluating pharmacy student and resident preceptor development. Findings. Database searches yielded 32 published articles on pharmacy preceptor development: 22 for experiential preceptors, eight for resident preceptors, and two encompassing both experiential and resident preceptors. The identified articles covered a variety of preceptor development strategies, including live, web-based, and multifaceted approaches, which were disseminated via analytical studies, needs assessment surveys, and descriptive reports. In analytical studies, the evaluation methods most commonly used were preceptor pre- and post-perception surveys. Summary. Preceptor development strategies vary among pharmacy schools and residency programs. The evaluation methods used also varied, and there is a lack of evidence-based practices related to preceptor development. Preceptor development should be tailored based on preceptor type and program needs. An opportunity exists to further evaluate which strategies are most effective for improving precepting techniques, with an ultimate goal of delineating best practices for pharmacy preceptor development.

Engaging student pharmacists to improve Hospital Consumer Assessment of Health Care Providers and Systems scores

INTRODUCTION

Student pharmacists have historically served in shadowing roles for their experiential training at our institution. However, engaging students through active learning assignments has the potential to benefit both the student and the institution. The purpose of this project was to evaluate the impact of student pharmacists on Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) scores, a direct reflection of patient satisfaction within the hospital.

METHODS

In a four-month quality-improvement pilot project, student pharmacists were given active learning assignments directed at helping patients understand the purpose and side effects of their medications. Patients with hospital-initiated medications were provided with medication cards via student pharmacist-run counseling programs. The primary outcome was top response ("always") in medication-related HCAHPS scores. Secondary outcomes included scores on individual questions, number of medication education encounters, number of interventions, cost savings, and student feedback.

RESULTS

There were 482 medication education encounters. The top response for all medication-related HCAHPS scores improved by 14% (49% to 63%). Top response regarding medication indication increased 23% (63% to 86%). There were 552 interventions accepted, projecting a savings of $135,658. The top score on student evaluations of the practice site increased 20% (69% to 89%).

CONCLUSIONS

Student pharmacists can have a meaningful impact on medication-related HCAHPS scores. Additionally, student pharmacists benefit from active learning opportunities by providing and improving patient care leading to a more meaningful experience.

The Status and Adequacy of Preceptor Orientation and Development Programs in US Pharmacy Schools

Objective. To identify current preceptor orientation and development programs at US colleges and schools of pharmacy and propose future initiatives for preceptor programs. Methods. An anonymous 28-item survey was administered in January 2017 to 128 experiential education personnel at accredited US schools and colleges of pharmacy. Data from completed survey instruments were tabulated and qualitative responses to open-ended questions were examined using thematic analysis. Results. Eighty-five experiential education administrators participated in the survey (response rate=67%). Most preceptor orientation programs met the majority of requirements as outlined within the Accreditation Council for Pharmacy Education's Standard 20.3, although only 42% of programs mandated preceptor orientation prior to student placement. Two-thirds of respondents offered annual, live preceptor development, and 75% of programs used commercially available online products. Nearly 40% of respondents collaborated with other schools or professional organizations to offer preceptor training. Only 29% of programs had specific requirements for pharmacists to maintain their active preceptor status. Seventy percent of respondents reported spending over $2500 and 39% over $5000 annually on preceptor development. Programs with the highest monetary investment (>$10,000/year) in preceptor development offered multiple venues (live and online) for preceptor training. Programs with significant personnel commitment (≥0.5 FTE devoted to preceptor development) frequently had dedicated site visitors. Conclusion. Preceptor orientation programs at US schools of pharmacy are generally similar, but development programs vary significantly across the Academy. Highly invested programs featured live and online training or site visitors who provided individualized feedback or training. Future studies should explore the cost-effectiveness of program options and their impact on preceptor learning and behaviors.

Characteristics of High-Performing Interprofessional Health Care Teams Involving Student Pharmacists

Objective. To identify key themes of interprofessional models of care that offer experiential education opportunities for pharmacy learners. Methods. Six pharmacists from four Area Health Education Centers in North Carolina participated in individual, 60-minute interviews. Using two pre-established frameworks, the data were analyzed qualitatively by two members of the research team to identify the characteristics of interdisciplinary care teams. Results. At the level of the organization or health care system, the theme of appropriate resources and procedures emerged. At the level of the team, the themes of appropriate resources and procedures, communication, appropriate skill mix, climate, quality and outcomes of care, and respecting and understanding roles emerged. At the level of the individual, the themes of communication, respecting and understanding roles, and individual characteristics emerged. Three themes identified in a previous study failed to emerge in the interviews: leadership and management; personal rewards, training and development; and clarity of vision. Conclusion. Although a growing body of evidence highlights the importance of designing practice models to achieve interdisciplinary care that is patient-centered and effective, capacity to support learners and effectively educate them in the principles and practices of team-based care is limited. This study provides critical insight into characterizations of interprofessional models that integrate pharmacy learners. Further research is needed to better understand the barriers to designing and implementing IPE in experiential settings.

Demystifying Content Analysis

Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.

An Analysis of Canadian Doctor of Pharmacy Student Experiences in Non-Traditional Student-Preceptor Models

Objective. To describe students' experiences and perceptions of non-traditional student-preceptor learning models and evaluate the effectiveness of these models on students' learning experience. Methods. Pharmacy students who had completed at least one experiential rotation with a non-traditional learning model participated in semi-structured interviews. Models included peer-assisted learning (PAL; two or more students of same educational level), near-peer teaching (NPT; one or more junior students with one or more senior students), and co-preceptorship (CoP; two or more preceptors). Interviews were transcribed, coded, and analyzed for themes. Themes were mapped according to the Kirkpatrick model for evaluating educational training. Results. Twenty semi-structured interviews were conducted. Forty-three experiences (19 CoP, 14 PAL, 10 NPT) from 14 institutions were described. Many themes overlapped between the three models. In CoP, learners described increased preceptor availability and exposure to different patient care approaches. Challenges arose when preceptors had different expectations. Students overwhelmingly endorsed a multi-learner environment. Both PAL and NPT learners felt supported as collaboration with other learners was readily fostered. Potential challenges in PAL and NPT were difficulties when personalities conflicted and when there was a significant knowledge gap between the learners. All three models allowed for the development of skills, including communication and collaboration. Learners reported an enhanced approach to patient care and professional practice, including approaches to teaching as new preceptors. Conclusion. Pharmacy students and graduates valued their experiences in non-traditional student-preceptor models. Institutions may find support for using these precepting models to increase placement capacity.

A Job Analysis to Define the Role of the Pharmacy Preceptor

Objective. To use a comprehensive job analysis to identify and describe the roles and responsibilities of pharmacist preceptors. Methods. After gathering input from local pharmacist preceptors, a task inventory questionnaire was created that included 92 tasks divided among nine domains related to the job of preceptors. The task inventory questionnaire was distributed to expert pharmacist preceptors in the United States, which were those who had been recognized for excellence in precepting by a national organization. Participants evaluated each task and determined whether they were responsible for the task, as well as the importance, difficulty, and frequency of each task. A composite score for each task was calculated based on a unique combination of these ratings. Descriptive statistics summarized the findings for each task and across the domains. Results. Nineteen pharmacist preceptors completed the task inventory questionnaire. The three most salient domains were professionalism (M=41.9, SD=12.9), communication (M=37.0, SD=11.7), and interpersonal skills (M=37.0, SD=10.3). The three most critical tasks related to professionalism were maintaining professional composure in stressful situations, demonstrating a commitment to service and the profession, and engaging in sound ethical and moral decision-making. Conclusion. This study represents the first attempt of using a job analysis to define pharmacist preceptor roles and responsibilities. More research is needed to fully understand the implications of these results, to understand how the relative significance of tasks may vary based on the population assessed (eg, learners and less experienced pharmacists), and to improve and validate the findings of the task inventory questionnaire developed in this study.

Perceived value of partnerships between schools of pharmacy and health systems

INTRODUCTION

This study sought to quantify opinions of statewide health systems stakeholders regarding the value of partnerships with schools of pharmacy. Being better able to meet the needs of preceptors and their employers will allow schools to increase capacity of high-quality pharmacy practice experiences.

METHODS

A brief survey was developed and administered to statewide contacts from systems currently partnering with member schools of the North Carolina Experiential Education Consortium. Respondents were asked to rate, using a Likert scale, 15 incentive statements relating to potential benefits provided by schools in exchange for experiential rotations.

RESULTS

Forty-one responses were received from 53 invitees (77% response rate). The two most highly-valued incentives per survey respondents were continuing education (CE) accreditation by the school (74% essential), and access to school resources (74% essential). The lowest scoring incentives included system-wide committee involvement by faculty (26% essential), co-funded faculty positions (29% essential), and resident precepting by faculty (34% essential).

CONCLUSIONS

Incentive ratings differed significantly from previous reports describing value, which primarily focus on clinical interventions and cost savings provided by student pharmacists. Experiential staff at schools of pharmacy should consider a similar study to ascertain how best to meet the needs of their local partners and maximize commitments for pharmacy practice experiences.

Value of Pharmacy Students Performing Population Management Activity Interventions as an Advanced Pharmacy Practice Experience

Objective. To assess the value of an advanced pharmacy practice experience in which students engaged in population health management (PHM) activities for a managed care setting. Methods. Students were provided with a list of patients, trained on the requirements for each PHM activity and completed them independently. The students reviewed the electronic record for each patient on their list to identify those who were non-adherent to dual antiplatelet therapy (DAPT) within one year of coronary stent placement, non-adherent to beta blockers (BB) within six months post-acute myocardial infarction, or with renal dysfunction and requiring dose adjustment of lipid-lowering therapy. Students coded each intervention based on predefined categories such as patient education, medication discontinuation, or medication reconciliation, and then if necessary were reviewed with the pharmacy preceptor. The primary investigator determined the intervention to be either actionable or non-actionable. The primary outcome was the proportion and type of interventions made by each student. The secondary outcome was clinical pharmacist time offset. A retrospective, data-only pilot study was conducted to determine the outcomes from the program over four years. Results. Forty-six students made 3,774 interventions over the study period, 37% of which were categorized as actionable. The most common actionable interventions were providing patient education (52%), verifying prescription adherence (23%), and medication therapy adjustment (10.5%). Over the study period, an estimated 765.6 hours of clinical pharmacist time was offset, or approximately 191.4 hours per academic year. Conclusion. This study demonstrated that a population health management approach can be used successfully within an APPE. This approach can result in offset pharmacist time for precepting organizations, while offering meaningful clinical interventions for patients and learning opportunities for students.

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.

Benefits and Challenges of Partner Site Engagement with Community-Based Dental Education Programs: The Partner Sites' Perspectives

The aim of this qualitative study was to examine the perspectives of key personnel at partner sites providing community learning experiences to dental students to gain more understanding of the effects that community-based programs have on the sites themselves. Fourteen semi-structured interviews were conducted in 2015 with individuals from nine extramural sites. Interviewees had a range of roles from clinicians to CEOs, with six also reporting they were faculty preceptors. Three of the researchers developed a coding scheme focused on the benefits and challenges that community sites experience from participating in a community-based dental education (CBDE) program. Each coder then reviewed the interview transcripts independently before final group discussions and recoding to agreement. The main themes related to benefits were recruiting future dentists, staying current with clinical developments, sites' indirectly improving their missions by exposing students to broader roles of oral health providers, raising awareness regarding the need for dentistry in community settings, and nurturing a positive workplace environment. The main themes related to challenges were balancing education and training for students with clinical demands, communication with the university, and managing distinctive clinical and professional characteristics of students. This study's participants reported that the main benefit of CBDE for partner sites was dentist recruitment. The study also provided insights for both partner sites and dental schools to consider when developing and maintaining these partnerships.

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

Objective. To identify common practices for measuring quality of experiential education (EE) programs at US schools and colleges of pharmacy. Methods. In-depth, semi-structured phone interviews were conducted with directors of experiential education or their equivalent, to identify elements of quality assurance (QA) processes for EE. To ensure representativeness from all fully accredited programs, purposeful sampling was used for participant solicitation and enrollment until both code and meaning saturation were reached. Participants were asked questions in six domain areas (preceptor and student performance, site quality, role of site visits, coursework, and achievement of learning outcomes). An iterative data coding and analysis process identified themes and notable practices within each domain area. Results. Interviews were conducted with representatives of 29 programs. All participants reported evaluating preceptor performance. Fewer participants identified a deliberate site assessment process, with most equating preceptor and site evaluation. Participants conducted site visits primarily to assess site quality and maintain relationships with preceptors. Few participants were able to provide details of a process used for evaluating experiential education coursework and student outcomes. All participants used student performance assessments to measure the quality of student performance. Overall, participants almost universally reported collecting data, less frequently described processes for data evaluation, and rarely shared outcomes arising from data collection and analysis. Conclusion. Themes and notable practices identified in this study provide initial benchmarks for QA programs for EE and will inform content and metrics of subsequent follow-up studies. A six-step process for QA for EE is proposed.

A Qualitative Approach to Improving Advanced Pharmacy Practice Experiences in an ACPE International Certified Program

Objective. To explore the opinions and recommendations of university and health care professional experts regarding the Advanced Pharmacy Practice Experiences (APPE) curriculum at the King Saud University College of Pharmacy. Methods. Forty-eight health care professionals of different backgrounds participated in a roundtable discussion during a 1-day meeting. The discussion revolved around three predefined themes: the doctor of pharmacy (PharmD) program learning outcomes, regulations and responsibilities and APPE activities and syllabi, non-clinical rotations, and assessment. The discussion was transcribed verbatim. Discussion of each theme was summarized and incorporated in the result. Results. Discussion regarding the PharmD program learning outcomes emphasized clinical outcomes with an additional focus on basic sciences. The regulations and responsibilities table incorporated guidance toward developing student professionalism. APPE activities and syllabi, non-clinical rotations and assessment recommendations encompassed crucial issues such as effective communication among the college, preceptors, and students, scheduled site visits, financial reimbursement for preceptors, student preparatory workshops, and non-clinical rotations. Conclusion. This roundtable discussion identified many of the concerns and recommendations previously encountered or currently being addressed in many of the previous studies and current accreditation standards. International candidates should consider these recommendations when applying for certification.

Nationwide survey of experiential learning in MPharm programmes in UK Universities

OBJECTIVES

To determine the current structure of experiential learning (EL) in Master of Pharmacy (MPharm) programmes in UK universities, and assess how they meet the standards specified by the General Pharmaceutical Council.

METHODS

A cross-sectional survey of staff in charge of EL in MPharm programmes was conducted, utilising a 31-item online survey, consisting of both open-ended and close-ended questions. Variables of interest were administrative aspects and structure of the EL component, tutor issues and placement sites. To pinpoint the challenges faced with EL, the Relative Importance Index (RII) was calculated.

KEY FINDINGS

Twenty (66.7%) universities responded. EL coordinators were mostly academic/teaching fellows (19) and spent 0.29 ± 0.31 full-time equivalents on coordination. Tutors completed training annually in 53.8% of universities, with topics focusing on placement structure (85.7%) and requirements (78.6%). Total placement hours in all practice sites over the 4 years of study ranged from 54 to 496 h, and included hospitals, community pharmacies, hospices, prisons and nursing homes. The three biggest challenges faced with regard to EL were in obtaining/retaining hospital placements (1st), financial support (2nd) and quality assurance (QA) of tutors (3rd).

CONCLUSIONS

While there has been an increase in the variety of placement sites and hours since the last survey in 2003, universities face challenges in terms of staffing and obtaining placement sites. There are also gaps in tutor training. More standardisation and regulation of the QA of the EL programme, placement sites and tutors is needed to ensure students obtain the most out of their placements.

Preceptor Perceptions of Virtual Quality Assurance Experiential Site Visits

Objective. To determine preceptor perceptions of the value of experiential quality assurance site visits between virtual and onsite visits, and to gauge preceptor opinions of the optimal method of site visits based on the type of visit received. Methods. Site visits (12 virtual and 17 onsite) were conducted with 29 APPE sites located at least 200 miles from campus. Participating preceptors were invited to complete an online post-visit survey adapted from a previously validated and published survey tool measuring preceptor perceptions of the value of traditional onsite visits. Results. Likert-type score averages for survey questions ranged from 4.2 to 4.6 in the virtual group and from 4.3 to 4.7 in the onsite group. No statistically significant difference was found between the two groups. Preceptors were more inclined to prefer the type of visit they received. Preceptors receiving onsite visits were also more likely to indicate no visit type preference. Conclusion. Preceptors perceived value from both onsite and virtual site visits. Preceptors who experienced virtual site visits highly preferred that methodology. This study suggests that virtual site visits may be a viable alternative for providing experiential quality assurance site visits from a preceptor's perspective.

Predicting performance in health professions education programs from admissions information - Comparisons of other health professions with pharmacy

BACKGROUND

The goal of the present review was to assess the state of performance prediction in healthcare programs generally, versus performance prediction in pharmacy schools, using didactic and non-didactic admissions measures. This is important because clinical success represents a combination of skills that are not fully predicted by either type of measure alone.

METHODS

PubMed searches were conducted focusing on work published from 2000 onwards, since it is during this period that non-didactic admissions measures have come to be incorporated into the applicant evaluation process. Relevant free full text papers available were used. When these papers were not available by direct import into EndNote, we went directly to the journal to try to retrieve the paper.

RESULTS

We acknowledge that health professions programs have been successful in recruiting excellent candidates into their schools. However, based on the modest amount of healthcare program performance accounted for by didactic measures, admissions committees should consider expanding their holistic evaluation of applicants. Schools would benefit from using two-step screening phases in the application process - perhaps evaluating didactic potential in phase 1 and experiential in phase 2. Using combination measures throughout the admission process should help ensure admission of students more likely to be successful throughout their healthcare practice.

IMPLICATIONS

Future investigations of the prediction of healthcare program performance by formal combinations of didactic and non-didactic admissions measures are imperative. In addition, it is likely that combination admission measures will incorporate more metrics of critical thinking than do simpler approaches. Furthermore, systematic evaluation of the usefulness of the two-step screening approaches to admissions used by most competitive health professions programs also needs to be done.

A Qualitative Study Identifying Key Components to Standardize Across Inpatient General Medicine Advanced Pharmacy Practice Experiences

Objective. To identify common components of inpatient general medicine advanced pharmacy practice experiences (APPEs) across sites, determine which components were important to standardize, and distinguish a benchmark of each component that would indicate standardization. Methods. In-depth interviews about the student experience were conducted with two students and one or more preceptors at each of 12 inpatient general medicine sites in the greater Seattle metropolitan area. Data from transcribed interviews were analyzed, then collapsed into a single spreadsheet for comparison. Overall themes for component groups were identified and components within each theme tested for importance in overall quality of the student experience. Components important for quality of the student experience were deemed "key components" and component metrics were developed for benchmarking. Results. Three themes were essential in the quality of the learning experience at inpatient general medicine sites: welcoming of the student by the preceptors, integration of the student into the site, and student interaction with patients and other health care providers. Key components to be standardized across sites were a structured orientation, written site-specific student guidelines and performance expectations, regular and meaningful student-preceptor interactions, identified performance competency standards, clear delineation of student patient care load and responsibilities, and daily interactions with patients and other health care providers. Conclusion. Qualitative evidence from sites can be used to identify key components to standardize across practice sites offering the same experiential course. These key components aid in the welcoming of the student to the site, integration of the student into the workflow, and daily opportunities for the student to interact with patients and with health care providers.

Third-Party Onboarding Organizations as Gatekeepers for Student Placement Decisions

Health system human resource departments are putting new requirements, paperwork, and processes in place to meet new Joint Commission standards for treating students like employees who onboard at the beginning of employment. These processes have significantly increased the workload of experiential education offices and present an additional burden to students. In an attempt to streamline these processes, health systems are contracting with third-party tracking and placement organizations. Converting this process to an electronic one (such as what third-party organizations offer) could present advantages; however, there are many concerns about going through a third-party organization that could control placement decisions. This commentary describes these concerns and provides guidance to schools should they choose to work with one of these organizations.

Prevalence and characteristics of pharmacies owned and operated by schools of pharmacy in the United States

INTRODUCTION

To identify schools/colleges of pharmacy that own and operate a pharmacy and to gather key details about such pharmacies.

METHODS

Schools of pharmacy (n = 134) in the United States were contacted to determine whether they own and operate a pharmacy. Schools identified as having a pharmacy were subsequently sent an online questionnaire to solicit information about school and pharmacy characteristics.

RESULTS

Eighteen (13.4%) schools reported owning and operating at least one pharmacy; of these, 14 (77.8%) responded to the questionnaire. The provision of education was a goal for all pharmacies. Pharmacy services were provided to students, faculty/staff, and community members (85.7%, 78.6%, and 50%, respectively). Student pharmacists were regularly involved in the operations of 13 (92.9%) pharmacies, largely as part of their introductory and advanced pharmacy practice experiences and/or as paid employees.

CONCLUSION

Few schools of pharmacy in the United States own and operate a pharmacy. These pharmacies primarily serve as teaching and learning venues and provide services to the campus community and/or the community at large.

Development of a template to facilitate reflection among student pharmacists

BACKGROUND

Reflective practice activities utilizing appropriate tools enhance learning during and after experiential placements. Reflective tools described in the literature, used to support students on traditional placements of a duration of at least two weeks, sit at the unstructured end of a continuum (completely unstructured to just minimal structure). Additionally, non-traditional settings in role-emerging placements are of value as an alternative for experiential education. There were no reflective tools in the literature to provide a means of supporting pharmacy students as novice reflectors in non-traditional settings.

OBJECTIVES

To develop one fit-for-purpose tool that students could utilize across their experiences, regardless of type or duration of experiential placement.

METHODS

A multi-phased approach was adopted, including a mix of methodologies: interviews, focus groups, informal feedback from stakeholders, and grading reflective accounts utilizing Mezirow's categories of reflection. A range of stakeholders were involved at each stage to ensure the reflective tool was fit-for-purpose. These included students, placement preceptors, and academic staff acting as graders of student reflective accounts.

RESULTS

A total of 24 students participated in focus groups, 13 supervisors/preceptors engaged in interviews and informal feedback, and 853 student reflective accounts were graded, over 3 years. The final tool that has been developed and evaluated in this research supported students to develop to critical reflectors (6% - Phase 2 increased to 62.9% - Phase 3).

CONCLUSIONS

This novel and innovative approach supports novice reflectors, encourages reflection on action and enhances professional development. It is a structured yet flexible tool, for which there was a gap in the published literature. It can be utilized in varied placements in pharmacy curricula internationally.

Reassessment of Health-System Capacity for Experiential Education Requirements

Objective. To provide an update to the 2007 ASHP-AACP survey by examining the current capacity of hospitals/health systems' ability to conduct experiential education for doctor of pharmacy students. Methods. Pharmacists identified as pharmacy directors were sent an invitation to participate in an online survey tool. The survey tool asked IPPE- and APPE-specific questions, the nature of support provided by colleges/schools of pharmacy, the types of experiences available for students, and the factors influencing the quality, value, and challenges of experiential education. Results. Four hundred sixty five of the 2,911 surveys sent were completed yielding a response rate of 16%. Respectively, 45.1% and 28.5% of respondents believe that the capacity for APPE and IPPE will increase in the next five years. Overall, respondents believe that students receive a high-quality experiential education (91.4%). Conclusion. The results of this survey provide insight to the capacity, benefits and challenges of experiential education from the perspective of hospitals/health systems.

Clinical Track Program Expansion Increases Rotation Capacity for Experiential Program

Objective. To evaluate the rotation capacity at the University of Maryland School of Pharmacy and see if the implementation of clinical track programs across the state correlates to an increase in rotation capacity for the school. Methods. The following information was collected: number of preceptors over the years in the school's experiential learning program, number of clinical track programs from 2012 to 2015, rotation type, availability submissions per rotation type per year, and availability submissions per hospital participant in the clinical track program per year. The rotation capacity and rotation types from 2012 to 2015 academic years were assessed and compared to see if there was any impact on the clinical track programs implemented. Results. There was no statistically significant difference in the frequency distribution of rotation types among all sites from 2012 through 2015 academic years. However, there was a statistically significant difference in the total number/capacity of rotations from 2012 to 2015 academic years. There were also statistically significant differences in the rotation capacity in all sites except for three sites. Conclusion. Adding clinical track programs can help increase the capacity of a school's clinical rotations.

Analysis of the Student Experience in an Attending Pharmacist Model General Medicine Advanced Pharmacy Practice Experience

Objective. To characterize and determine the quality of the student experience in an attending pharmacist model (APM). Methods. In-depth interviews were conducted with students completing an advanced pharmacy practice experience (APPE) at two general medicine services using the APM over a 2-year time period. Quantitative information about student learning and interprofessional interactions were extracted from student evaluations of the site. Data from the mixed model were analyzed to identify strengths of the APM and areas needing improvement. Results. Strengths of the APM included positive student interaction with the pharmacy resident and more students reporting full integration in and accountability to the interprofessional team for patient outcomes compared to students in non-teaching models. A few students at one site reported a need for greater delineation of expectations, more initial support from preceptors, and initial responsibility for fewer patients. These factors were modified before the second APM year and subsequent reports from students at this site were uniformly positive. Students at the second site did not note areas needing improvement. The APM increased student capacity at both sites. Conclusion. The attending pharmacist model provided a high quality learning experience for students, particularly with regard to integration into and accountability for patient outcomes to the interprofessional team. Qualitative research methods enabled precise detection of areas needing improvement at one site and confirmed that changes made at that site improved the student experience.

Use of Entertainment Elements in an Online Video Mini-Series to Train Pharmacy Preceptors

Objective. To create an entertaining approach to training pharmacy preceptors. Design. A training program was developed to provide an innovative, entertaining, and flexible continuing education program for pharmacy preceptors. Three instructional design principles - providing an authentic context, offering a diversity of content, and engaging and maintaining attention - were foundational to this concept. The mini-series consisted of 12 online video episodes. Participants completed three reflective questions and one evaluation after watching each episode. Three months following completion of the training, a survey was distributed to analyze the long-term impact of the mini-series on precepting skills. Assessment. Two hundred two participants completed all 12 episodes. After completing the training series, the participants' confidence level in their knowledge pertaining to the objectives was significantly greater than before they started. Among the 32% of participants who responded to the three-month follow-up survey, the mean score for precepting confidence was 6.8 on a scale of 1 to 10 on which 1=no increase to 10=big increase. Also, 99% of participants indicated they would complete a similar training program and recommend to others. Conclusions. Feedback from the mini-series provides evidence of the effectiveness of its delivery format and use as a preceptor learning tool.

The Offering, Scheduling and Maintenance of Elective Advanced Pharmacy Practice Experiences

The Accreditation Council for Pharmacy Education (ACPE) provides standards for colleges of pharmacy to assist in the provision of pharmacy education to student pharmacists. An integral part of all college educational programs includes the provision of experiential learning. Experiential learning allows students to gain real-world experience in direct patient care during completion of the curriculum. All college of pharmacy programs provide several Advanced Pharmacy Practice Experiences (APPEs), which include a balance between the four required experiences and a number of other required or elective APPEs. Required APPEs include advanced community, advanced institutional, ambulatory care, and general medicine. The elective APPEs include a myriad of opportunities to help provide a balanced education in experiential learning for student pharmacists. These unique opportunities help to expose student pharmacists to different career tracks that they may not have been able to experience otherwise. Not all colleges offer enough elective APPEs to enable the student pharmacist to obtain experiences in a defined area. Such an approach is required to produce skilled pharmacy graduates that are capable to enter practice in various settings. Elective APPEs are scheduled logically and are based upon student career interest and site availability. This article describes the offering, scheduling and maintenance of different elective APPEs offered by The University of Tennessee College of Pharmacy.

Does a transition in education equate to a transition in practice? Thai stakeholder's perceptions of the introduction of the Doctor of Pharmacy programme

BACKGROUND

Pharmacy education and pharmacy practice are facing remarkable changes following new scientific discoveries, evolving patient needs and the requirements of advanced pharmacy competency for practices. Many countries are introducing or undertaking major transformations in pharmacy education. The Thai pharmacy curriculum has been changed from a 5-year BPharm and a 6-year PharmD to only a 6-year PharmD programme. Curriculum change processes usually involve stakeholders, including both internal and external educational institutions, at all levels. This study aims to understand the experiences and perceptions of stakeholders regarding the transition to an all-PharmD programme in Thailand.

METHODS

Semi-structured interviews were conducted in Thailand with 130 stakeholders (e.g., policy makers, pharmacy experts, educators, health care providers, patients, students and parents) from August-October 2013. The interviews were audio recorded, transcribed verbatim and analysed using an inductive thematic analysis.

RESULTS

Three main themes were derived from the findings: 1. influences on curriculum change (e.g., the needs of pharmacists to provide better patient care, the US-Thai consortium for the development of pharmacy education); 2. perceived benefits (e.g., improve pharmacy competencies from generalists to specialists, ready to work after graduation, providing a high quality of patient care); and 3. concerns (e.g., the higher costs of study for a longer period of time, the mismatch between the pharmacy graduates' competency and the job market's needs, insufficient preceptors and training sites, lack of practical experience of the faculty members and issues related to the separate licenses that are necessary due to the difference in the graduates' specialties).

CONCLUSIONS

This is the first study to highlight the issues surrounding the transition to the 6-year PharmD programme in Thailand, which was initiated due to the need for higher levels of competency among the nation's pharmacists. The transition was influenced by many factors. Many participants perceived benefits from the new pharmacy curriculum. However, some participants were concerned about this transition. Although most of the respondents accepted the need to go forward to the 6-year PharmD programme, designing an effective curriculum, providing a sufficient number of qualified PharmD preceptors, determining certain competencies of pharmacists in different practices and monitoring the quality of pharmacy education still need to be addressed during this transitional stage of pharmacy education in Thailand.