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Am J Pharm Educ. 2010 September 10; 74(7): 125b.
PMCID: PMC2972520

Overdraft Protection for Experiential Education

To the Editor. You may have heard someone say in jest, “How can my bank account be overdrawn? I still have checks.” A similar situation may apply to a couple who shares a bank account for which each individual has a checkbook. Systematic monitoring is needed to protect against an overdraft and the consequences when people spend more money than they have earned.

This analogy can be applied to experiential education. As of January 2010, there are 120 schools and colleges of pharmacy at some stage of accreditation.1 Part of the accreditation process includes introductory pharmacy practice experience (IPPE) and advanced pharmacy practice experience (APPE) capacity charts.2 Each school submits these forecasts to confirm a sufficient supply of sites and preceptors for their students.

Much like the couple who shares a bank account, colleges and schools of pharmacy are creating their charts independently. Established colleges/schools base the numbers of IPPEs and APPEs on enrollment and rotation histories, with capacity margins based on experience. For example, the requirement for acute care/general medicine has created demand (and therefore competition) for APPE sites in this area. A new school makes contacts with sites and preceptors and projects numbers for each year of the curriculum.

So how can our “account” be overdrawn when we still have preceptors?

  • (1) As new colleges/schools create IPPEs and APPEs, preceptors can give the same availability to multiple programs. This may set up adversarial relationships among colleges/schools and a first-come, first-served approach3 may have to be used, which forces experiential personnel to seek site availability even 2 years before students will be assigned. Workload is increased to take care of IPPE/APPE changes when preceptors change sites, schedule vacations, and encounter health issues over such an extended time interval.
  • (2) The only assured capacity is that which is negotiated and contracted with faculty members to serve as preceptors or when college/schools pay other individuals to precept students. The remainder is based on the goodwill of preceptors who enjoy teaching, want to give back to the profession, desire to share expertise, and seek fulfillment through mentoring students, as reported on preceptor applications for Academy of Preceptors continuing education sessions.4
  • (3) Honoraria are a factor for preceptors.3 There is disparity in payments to preceptors among colleges/schools. Some pay a flat rate to all preceptors, and others pay a higher rate to preceptors at those sites in higher demand (and shorter supply). The honorarium for a given APPE within a region can range from zero to $1100, based on an informal poll of the Mid-Atlantic Experiential Consortium.

The following are some recommendations to promote experiential solvency:

  • (1) Colleges/schools should fully utilize regional consortia as reported for Southeastern Pharmacy Experiential Education Consortium.5 There are many throughout the country, and the collaborative approach works if each college/school is contributing to preceptor recruitment, development, and retention.
  • (2) Regions should reach agreement on dates to solicit availability and to finalize experiential matches. External entities that require an application process for preselection of students for their experiences will need to be consulted about appropriate timelines.
  • (3) Experiential directors are beginning to use new approaches for forecasting capacity.6 These methods should be explored for planning and accreditation reports.
  • (4) Practice site development involves intensive resources from a school and practice partner. Much like the banking analogy, schools should be able to earn dividends from their investments. Schools should be able to designate prime partners, or even exclusive partners, for those school-sponsored initiatives that are similar to intellectual property.

Experiential education is the intersection of curriculum, students, faculty members, preceptors, stakeholders, sites, and pharmacy practice. Experiential personnel have an extensive network for advice, networking, and problem-solving for increasingly complex responsibilities. By working together to address potential overdraft situations for experiential capacity, colleges/schools will meet the needs of their students and their invaluable preceptors.

Cynthia J. Boyle, PharmD
University of Maryland School of Pharmacy

REFERENCES

1. American Association of Colleges of Pharmacy. Academic Pharmacy's Vital Statistics. Available at: http://www.aacp.org/about/Pages/Vitalstats.aspx. Accessed July 26, 2010.
2. Accreditation Council for Pharmacy Education. Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree. Effective July 1, 2007. Available at: http://acpe-accredit.org/standards/default.asp. Accessed July 26, 2010.
3. Skrabal MZ, Jones RM, Nemire RE, Boyle CJ, Assemi M, et al. National survey of volunteer pharmacy preceptors. Am J Pharm Educ. 2008;72(5) Article 112. [PMC free article] [PubMed]
4. Boyle CJ, Morgan JA, Layson-Wolf C, Rodriguez de Bittner M. Developing and implementing an academy of preceptors. Am J Pharm Educ. 2009;73(2) Article 34. [PMC free article] [PubMed]
5. Duke LJ, Unterwagner WL, Byrd DC. Establishment of a multi-state experiential pharmacy program consortium. Am J Pharm Educ. 2008;72(3) Article 62. [PMC free article] [PubMed]
6. Danielson J, Weber S, Ramirez J, Krueger J, Harshberger C, Rice L, Christensen L, Hudgins G. Applying Business Models to Experiential Education. Special Session. American Association of Colleges of Pharmacy Annual Meeting, Seattle, Washington, July 12, 2010.

Articles from American Journal of Pharmaceutical Education are provided here courtesy of American Association of Colleges of Pharmacy