The purpose of this article is to describe the experiential program created at the newly formed University of Hawai‘i at Hilo College of Pharmacy (UHH CoP). The Introductory Pharmacy Practice Experience (IPPE) rotations were developed to prepare student pharmacists for their final year of Advanced Pharmacy Practice Experience (APPE) rotations by improving clinical skills and patient interactions. In partnership with the John A. Burns School of Medicine (JABSOM) Department of Family Practice, physician and pharmacist teams collaborate to deliver patient care for chronic diseases and elevate educational opportunities provided by UHH CoP. Another goal of the experiential program is to determine whether the investment of pharmacist faculty and adjunct physician/nurse preceptors prepares students for the final year of APPE rotations. A survey was administered to non-faculty pharmacist preceptors who taught the third IPPE rotation during the summer of 2009. Twenty-nine surveys were received from six facilities on O‘ahu and the Big Island. Initial survey results revealed an overall rating average of 3.72 (Likert scale: 1-lowest to 5-highest), an average of 4.14 for professionalism, an average of 3.41 for overall clinical skills, and an average of 3.45 for overall readiness for experiential rotations. Average ratings when compared with fourth-year students from several mainland colleges ranged from 1.7 to 2.2 (1-worse than, 2-same, 3-better). This data demonstrates that UHH CoP is investing faculty and preceptor resources wisely to enhance the preparation of students for APPE rotations.
The pressures driving the need for an expanded practice scope in community pharmacy have been building for the past 2 decades. Many pharmacists have chosen to embrace the pharmaceutical care model in their practice sites to meet patient and healthcare system needs. The potential for medication therapy management (MTM) services provide an additional career opportunity for pharmacy graduates. Colleges of pharmacy offer advanced pharmacy practice experiences (APPEs) in the community setting that are designed to prepare students for these opportunities. These sites provide students with the opportunity to observe the integration of pharmaceutical care activities into community practice. Although developing an APPE site is challenging, serving as a preceptor benefits the students, the site, and the patients served. Therefore, colleges of pharmacy and community pharmacists are collaborating to increase the number of APPE sites to prepare pharmacy students for practice today and tomorrow.
curriculum; advanced pharmacy practice experience; community pharmacy; preceptor
Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site.
community pharmacy; experiential education; advanced pharmacy practice experience; preceptor
To compare patients' expectations and experiences at pharmacies offering traditional APPE learning opportunities with those offering enhanced APPEs that incorporate pharmaceutical care activities.
A survey of anchored measures of patient satisfaction was conducted in 2 groups of APPE- affiliated community pharmacies: those participating in an enhanced APPE model versus those participating in the traditional model. The enhanced intervention included preceptor training, a comprehensive student orientation, and an extended experience at a single pharmacy rather than the traditional 2 x 4-week experience at different pharmacies.
While patient expectations were similar in both traditional and enhanced APPE pharmacies, patients in enhanced pharmacies reported significantly higher in-store satisfaction and fewer service gaps. Additionally, satisfaction was significantly higher for patients who had received any form of consultation, from either pharmacist or students, than those reporting no consultations.
Including provision of pharmaceutical care services as part of APPEs resulted in direct and measurable improvements in patient satisfaction.
advanced pharmacy practice experience; patient satisfaction; pharmaceutical care; community pharmacy
Objective. To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden.
Methods. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories.
Results. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development.
Conclusions. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire.
advanced pharmacy practice experience; curriculum; pharmacy practice experience; learning outcomes; assessment
Objectives. To evaluate the impact of student pharmacists delivering medication therapy management (MTM) services during an elective advanced pharmacy practice experience (APPE).
Methods. Student pharmacists provided MTM services at community pharmacy APPE sites, documented their recommendations, and then made follow-up telephone calls to patients to determine the impact of the MTM provided. Students were surveyed about the MTM experience.
Results. Forty-seven students provided MTM services to 509 patients over 2 years and identified 704 drug-related problems (average of 1.4 problems per patient). About 53% of patients relayed the recommendations to their physician and 205 (75%) physicians accepted the recommendations. Eighty-eight percent of patients reported feeling better about their medications after receiving MTM services. A majority of the students perceived their provision of MTM services as valuable to their patients.
Conclusions. Providing MTM services to patients in a pharmacy practice setting allowed student pharmacists to apply skills learned in the doctor of pharmacy (PharmD) curriculum.
medication therapy management; experiential education; doctor of pharmacy program; advanced pharmacy practice experience; community pharmacy
To implement the Partner for Promotion (PFP) program which was designed to enhance the skills and confidence of students and community pharmacy preceptors to deliver and expand advanced patient care services in community pharmacies and also to assess the program's impact.
A 10-month longitudinal community advanced pharmacy practice experience was implemented that included faculty mentoring of students and preceptors via formal orientation; face-to-face training sessions; online monthly meetings; feedback on service development materials; and a web site offering resources and a discussion board. Pre- and post-APPE surveys of students and preceptors were used to evaluate perceptions of knowledge and skills.
The skills survey results for the first 2 years of the PFP program suggest positive changes occurring from pre- to post-APPE survey in most areas for both students and preceptors. Four of the 7 pharmacies in 2005-2006 and 8 of the 14 pharmacies in 2006-2007 were able to develop an advanced patient care service and begin seeing patients prior to the conclusion of the APPE. As a result of the PFP program from 2005-2007, 14 new experiential sites entered into affiliation agreements with The Ohio State University College of Pharmacy.
The PFP program offers an innovative method for community pharmacy faculty members to work with students and preceptors in community pharmacies in developing patient care services.
community pharmacy; pharmaceutical services; administration; advanced pharmacy practice experience
In the last decades, the provision of pharmaceutical care by community pharmacists has developed in OECD countries. These developments involved significant changes in professional practices and organization of primary care. In France, they have recently been encouraged by a new legal framework and favored by an increasing demand for health care (increase in the number of patients with chronic diseases) and reductions in services being offered (reduction in the number of general practitioners and huge regional disparities).
Objectives: This study aimed to investigate final-year pharmacy students' opinions on 1/expanding the scope of pharmacists' practices and 2/the potential barriers for the implementation of pharmaceutical care. We discussed these in the light of the experiences of pharmacists in Quebec, and other countries in Europe (United Kingdom and the Netherlands).
All final-year students in pharmaceutical studies, preparing to become community pharmacists, at the University Paris-Descartes in Paris during 2010 (n = 146) were recruited. All of them were interviewed by means of a questionnaire describing nine "professional" practices by pharmacists, arranged in four dimensions: (1) screening and chronic disease management, (2) medication surveillance, (3) pharmacy-prescribed medication and (4) participation in health care networks. Respondents were asked (1) how positively they view the extension of their current practices, using a 5 point Likert scale and (2) their perception of potential professional, technical, organizational and/or financial obstacles to developing these practices.
143 (97.9%) students completed the questionnaire. Most of practices studied received a greater than 80% approval rating, although only a third of respondents were in favor of the sales of over-the-counter (OTC) drugs. The most significant perceived barriers were working time, remuneration and organizational problems, specifically the need to create a physical location for consultations to respect patients' privacy within a pharmacy.
Despite remaining barriers to cross, this study showed that future French pharmacists were keen to develop their role in patient care, beyond the traditional role of dispensing. However, the willingness of doctors and patients to consent should be investigated and also rigorous studies to support or refute the positive impact of pharmaceutical care on the quality of care should be carried out.
Background: Injection drug use and other high-risk behaviours are the cause of significant morbidity and mortality and thus have been the focus of many health promotion strategies. Community pharmacists are considered underutilized health providers and are often thought to be more accessible than other health professionals. The purpose of this review is to provide an overview of community pharmacists' practices as well as pharmacists' attitudes and identified barriers toward providing harm reduction services. We will highlight the major harm reduction services being offered through community pharmacies, as well as identify barriers to implementing these services.
Methods: A review of the literature from 1995 to 2011 was conducted using the electronic databases MEDLINE, PubMed and Scopus, encompassing pharmacists' involvement in harm reduction services. Keywords included pharmacist, harm reduction, disease prevention, health promotion, attitudes, competence and barriers. References of included articles were examined to identify further relevant literature.
Results: Pharmacists are primarily involved in providing clean needles to injection drug users, as well as opioid substitution. Pharmacists generally have a positive attitude toward providing health promotion and harm reduction programs and express some interest in increasing their role in this area. Common barriers to expanding harm reduction strategies in community pharmacists' practice include lack of time and training, insufficient remuneration, fear of attracting unruly clientele and inadequate communication between health providers.
Conclusion: As one of the most accessible health care providers, community pharmacists are in an ideal position to provide meaningful services to injection drug users. However, in order to do so, pharmacists require additional support in the form of better health team and system integration, as well as remuneration models.
Collaborative working relationships (CWRs) between community pharmacists and physicians may foster the provision of medication therapy management services, disease state management, and other patient care activities; however, pharmacists have expressed difficulty in developing such relationships. Additional work is needed to understand the specific pharmacist-physician exchanges that effectively contribute to the development of CWR. Data from successful pairs of community pharmacists and physicians may provide further insights into these exchange variables and expand research on models of professional collaboration.
To describe the professional exchanges that occurred between community pharmacists and physicians engaged in successful CWRs, using a published conceptual model and tool for quantifying the extent of collaboration.
A national pool of experts in community pharmacy practice identified community pharmacists engaged in CWRs with physicians. Five pairs of community pharmacists and physician colleagues participated in individual semistructured interviews, and 4 of these pairs completed the Pharmacist-Physician Collaborative Index (PPCI). Main outcome measures include quantitative (ie, scores on the PPCI) and qualitative information about professional exchanges within 3 domains found previously to influence relationship development: relationship initiation, trustworthiness, and role specification.
On the PPCI, participants scored similarly on trustworthiness; however, physicians scored higher on relationship initiation and role specification. The qualitative interviews revealed that when initiating relationships, it was important for many pharmacists to establish open communication through face-to-face visits with physicians. Furthermore, physicians were able to recognize in these pharmacists a commitment for improved patient care. Trustworthiness was established by pharmacists making consistent contributions to care that improved patient outcomes over time. Open discussions regarding professional roles and an acknowledgment of professional norms (ie, physicians as decision makers) were essential.
The findings support and extend the literature on pharmacist-physician CWRs by examining the exchange domains of relationship initiation, trustworthiness, and role specification qualitatively and quantitatively among pairs of practitioners. Relationships appeared to develop in a manner consistent with a published model for CWRs, including the pharmacist as relationship initiator, the importance of communication during early stages of the relationship, and an emphasis on high-quality pharmacist contributions.
Pharmacists; Physicians; Collaborative working relationships; Pharmacist-physician collaborative index; Community
Objective. To describe the implementation of an advanced pharmacy practice experience (APPE) in medication therapy management (MTM) designed to contribute to student pharmacists’ confidence and abilities in providing MTM.
Design. Sixty-four student pharmacists provided MTM services during an APPE in a communication and care center.
Assessment. Students conducted 1,495 comprehensive medication reviews (CMRs) identifying 6,056 medication-related problems. Ninety-eight percent of the students who completed a survey instrument (52 of 53) following the APPE expressed that they had the necessary knowledge and skills to provide MTM services. Most respondents felt that pharmacist participation in providing Medicare MTM could move the profession of pharmacy forward and that pharmacists will have some role in deciding the specific provisions of the Medicare MTM program (92% and 91%, respectively).
Conclusion. Students completing the MTM APPE received patient-centered experiences that supplemented their confidence, knowledge, and skill in providing MTM services in the future.
medication therapy management; advanced pharmacy practice experience; student pharmacists; patient-centered care
To develop, implement, and assess an Internet-based vidcasting project to promote the pharmacist's role in public health.
This was a collaborative effort for 2 different courses taught at 2 different schools of pharmacy. Faculty members created a special instructional design for students to follow in planning, producing, and publishing video public service announcements on the Internet.
Formative and summative assessments, including course examinations, a grading rubric, student survey, and focus group, were implemented to evaluate student learning and public reaction. Students believed Internet video public service announcements served as a useful reference for patients and professionals, aided in promoting disease prevention and wellness initiatives, positively impacted patient-provider relationships, and increased awareness regarding significance and financial impact of disease burden.
Producing a public health information video and vidcasting it on the Internet increased pharmacy students' self-esteem, respect for peers, creative and critical-thinking abilities, and understanding of the need for and importance of pharmacists providing accurate public health information.
Internet; video; public health; technology; self-care; nonprescription medication
Objective. To implement a 5-week advanced pharmacy practice experience (APPE) in community engagement and assess the impact of the APPE on students’ confidence and ability to provide community-based services.
Design. Working with community partners, students provided medication reconciliation, attended interprofessional healthcare meetings, developed health-promotion activities, and conducted medication-therapy reviews.
Assessment. Responses to pre- and post-APPE 10-item surveys, preceptor and practice-experience evaluations, and the documented number of pharmacy student recommendations were determined.
Conclusion. This APPE provides students opportunities in nontraditional community settings to increase their confidence and enhance their skills in health-promotion activities, medication-therapy management, and interprofessional care of patients, all of which are essential to the practice of pharmacy.
community engagement; community partners; medication therapy management (MTM); health promotion; geriatrics
In Poland, 38.0% of men and 25.6% of women smoke daily. One method for expanding access to smoking cessation services is through community-based pharmacists. Surveys were administered in 2007–2008 to (a) current smokers, (b) members of a pharmacy association, and (c) pharmacy students in their final year of training. Pharmacists were the highest ranked health professionals to whom Polish smokers reported they would turn for information about pharmacological support for smoking cessation. Most pharmacists (79%) reported their knowledge allowed them to provide basic smoking cessation information to their patients. Pharmacy students reported being more able to provide information about the health consequences of tobacco smoking than to help patients quit smoking (85% vs. 61%). In Poland, community-based pharmacists are positioned to provide smoking cessation interventions to all segments of the population. To extend and promote smoking cessation efforts, comprehensive tobacco cessation training should be a required component of the pharmacy school curriculum.
smoking cessation; pharmacists; health professionals; pharmaceutical care
Objective. To develop and assess the impact of an elective course (HealthWISE) on student pharmacists’ skills in communication and health promotion and elementary school students’ knowledge of and attitudes toward science.
Design. Three colleges and schools of pharmacy collaborated to develop a 1-credit elective course that used online and classroom teaching and learning techniques to prepare student pharmacists to teach science in elementary school classrooms. Student pharmacists delivered 6 science lessons to elementary students over the course of 2 months.
Assessment. In weekly journal reflections and a final paper, student pharmacists reported improved communication and health promotion skills. Elementary teachers reported they were satisfied with student pharmacists’ performance in the classroom. On pretest and posttest evaluations, elementary students demonstrated increased science knowledge and enhanced enthusiasm for science following the lessons taught by student pharmacists.
Conclusions. The HealthWISE elective course provided positive benefit for student pharmacists, elementary school teachers, and elementary students.
service-learning; communication skills; health promotion; STEM education
The role of community pharmacists in disease state management has been mooted for some years. Despite a number of trials of disease state management services, there is scant literature into the engagement of, and with, pharmacists in such trials. This paper reports pharmacists’ feedback as providers of a Pharmacy Asthma Management Service (PAMS), a trial coordinated across four academic research centres in Australia in 2009. We also propose recommendations for optimal involvement of pharmacists in academic research.
Feedback about the pharmacists’ experiences was sought via their participation in either a focus group or telephone interview (for those unable to attend their scheduled focus group) at one of three time points. A semi-structured interview guide focused discussion on the pharmacists’ training to provide the asthma service, their interactions with health professionals and patients as per the service protocol, and the future for this type of service. Focus groups were facilitated by two researchers, and the individual interviews were shared between three researchers, with data transcribed verbatim and analysed manually.
Of 93 pharmacists who provided the PAMS, 25 were involved in a focus group and seven via telephone interview. All pharmacists approached agreed to provide feedback. In general, the pharmacists engaged with both the service and research components, and embraced their roles as innovators in the trial of a new service. Some experienced challenges in the recruitment of patients into the service and the amount of research-related documentation, and collaborative patient-centred relationships with GPs require further attention. Specific service components, such as the spirometry, were well received by the pharmacists and their patients. Professional rewards included satisfaction from their enhanced practice, and pharmacists largely envisaged a future for the service.
The PAMS provided pharmacists an opportunity to become involved in an innovative service delivery model, supported by the researchers, yet trained and empowered to implement the clinical service throughout the trial period and beyond. The balance between support and independence appeared crucial in the pharmacists’ engagement with the trial. Their feedback was overwhelmingly positive, while useful suggestions were identified for future academic trials.
Pharmacy; Asthma; Disease management service; Experiences; Feedback
To develop, refine, and integrate introductory-level strengths instruction within a doctor of pharmacy (PharmD) curriculum.
Over 8 years, student pharmacists completed the StrengthsFinder assessment tool and identified their top 5 Signature Themes (talents). They then participated in either Web-based learning modules or live workshops designed to facilitate professional development.
Students preferred the live instruction over Web-based learning modules. Post-instruction evaluations demonstrated that students discussed their Signature Themes with peers, preceptors, and family members. Pharmacists working with students in strengths-related activities reported that the students applied the information in the practice setting. Both pharmacists and students recommended that this material be required for all students.
Identifying a role in pharmacy that aligns with one's personal talents is critical for the success of pharmacy graduates. Strengths instruction is an important component of professional and career development, and can aid in identifying roles.
strengths; student development; professional development; career development
Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors.
community pharmacy; drug information; advanced pharmacy practice experience
To implement and assess a 4-week advanced pharmacy practice experience in transitional care.
Students participated in the transitional care planning of patients being discharged from 4 general medicine services. Students interviewed patients; assessed discharge medications; reconciled preadmission and discharge medications; provided medication counseling; and conducted postdischarge follow-up by phone to assist patients with medication-related problems and identify additional concerns.
Student involvement increased the number of patients who could be assessed and interviewed by the pharmacist preceptor from 10 patients/day to 15 to 20 patients/day. Students strengthened their provider-patient and provider-provider communication skills and developed skills in identifying and resolving barriers to medication adherence.
This transitional care APPE provided students an opportunity to gain experience and self-confidence in the application of pharmaceutical care skills in a transitional care setting, while also providing valuable patient care services to the hospital.
advanced pharmacy practice experience; transitional care; pharmacy student; medication reconciliation
To describe PharmD students' work experiences and activities; examine their attitudes towards their work; examine perceptions of preceptor pharmacists they worked with; and determine important issues associated with career preference.
A written survey was administered to third-year doctor of pharmacy (PharmD) students at 8 colleges and schools of pharmacy in the Midwest.
Five hundred thirty-three students (response rate = 70.4%) completed the survey instrument. Nearly 100% of PharmD students reported working in a pharmacy by the time their advanced pharmacy practice experiences (APPEs) began. Seventy-eight percent reported working in a community pharmacy, and 67% had worked in a chain community pharmacy. For all practice settings, students reported spending 69% of their time on activities such as compounding, dispensing, and distribution of drug products.
Most students are working in community pharmacy (mainly chain) positions where their primary function is traditional drug product dispensing and distribution. Having a controllable work schedule was the variable most strongly associated with career choice for all students.
pharmacy student; work experience; work activities; attitudes; career choice
Supporting preceptors is critical to the expansion of experiential learning opportunities for the pharmacy profession. Informal learning opportunities within communities of practitioners are important for hospital preceptors. However, such communities may be limited by geographic separation of preceptors from peers, faculty members, and supports within the pharmacy services department.
To use computer-mediated conferencing to create a sense of community among preceptors, specifically by using this medium to provide initial development of and continuing support for preceptors, and to examine preceptors’ satisfaction with this approach.
Thirty-nine preceptors who had completed a day-long face-to-face preceptor development workshop and who were supervising students in 1 of 2 specific rotation blocks were invited to participate in the study. The pharmacists used computer-mediated conferencing to meet for virtual networking about specific topics. They met once before the student rotation to receive instructions about the technology and to discuss student orientation and scheduling, and 3 times during the student rotation for open discussion of specific topics. Evaluation and feedback were solicited by means of an electronic survey and virtual (i.e., computer-based) feedback sessions with an independent facilitator.
The response rate was 66% (26/39) for the electronic survey, but only 15% (6/39) for the virtual feedback sessions. All of the respondents were experienced preceptors, but for 92% (22/24), this was their first experience with computer-mediated conferencing. Overall, the sessions had a positive reception, and participants found it useful to share information and experiences with other preceptors. The main challenges were related to the technology, perceived lack of support for their participation in the sessions, and inconvenience related to the timing of sessions.
Computer-mediated conferencing allowed preceptors to learn from and to support each other despite geographic distance. The participants felt that these sessions encouraged them to serve as preceptors regularly. Such encouragement could contribute to the retention of preceptors, which is important to the expansion of experiential learning.
preceptorship; computer-mediated conferencing; students; préceptorat; téléconférence assistée par ordinateur; étudiants
Pharmacy students should be given opportunities to learn and practice interpersonal communication skills during their community advanced pharmacy practice experience (APPE). Preceptors have the responsibility of setting the stage for the pharmacy students during their initial encounter. During this orientation to the site, students should become familiar with the history of the practice, the types of services provided, and the staff members. Once the orientation is completed, preceptors can develop strategies for incorporating the students into the practice's patient care activities. Students should participate in patient counseling, interviewing, and educational sessions. Also, students should participate in collaborative work with other health care providers. To ensure the development of communication skills in pharmacy students, preceptors can incorporate the teaching process “see one, do one, teach one” into their teaching activities. By following these strategies, preceptors can effectively and positively impact the communication skills of their students.
community pharmacy; advanced pharmacy practice experience; communication skills; preceptor
To establish statewide medication, disease management, and other clinical programs to serve as advanced pharmacy practice experience (APPE) training sites for the University of Colorado at Denver and Health Sciences Center School of Pharmacy, and to guarantee year-round support for the programs by providing pharmacy students with the necessary competencies to carry a significant proportion of each program's workload.
Partnerships with pharmacies willing to use students to expand their scope of clinical practice or support existing programs were established. Partners were asked to choose the clinical program(s) they wished implemented or supported and were guaranteed that APPE students would contribute to carrying each program's clinical service workload for 48 week/year under the supervision of the partners' pharmacists. In addition, partners implementing new programs were offered other support, including equipment, supplies, and training and mentoring for their pharmacists.
Twenty-two partnerships involving anticoagulation, diabetes, immunization, medication reconciliation, and other clinical programs were established with hospital, community, and community health center pharmacies. The partnerships provided 213 APPE placements in the 2006-2007 academic year.
This work demonstrates that by using innovative approaches, a pharmacy school can form new partnerships with hospital, community health center, and community pharmacies, as well as work with existing clinical programs, to create a variety of medication, disease management, and other APPEs to meet its increasing placement needs and evolving accreditation standards.
pharmacy student; competency; advanced pharmacy practice experience; accreditation standards
To introduce a requirement for second-professional year (P2) and third-professional year (P3) students to administer vaccinations to adults in community pharmacy-based immunization clinics.
Second-professional year students were trained to administer influenza, pneumococcal, and other vaccinations to adults following the American Pharmacists Association's standards. All P2 students in fall 2004 and all P2 and P3 students in fall 2005 were assigned to 2 community pharmacy-based immunization clinics in the metropolitan Denver area under the supervision of immunization-certified staff pharmacists. An evaluation of the experience was conducted using retrospective preceptor and student-based survey data.
In 2004 and 2005, the students administered approximately 5,000 (30-50 immunizations per student) and 15,000 (60-70 per student) immunizations, respectively. Students and preceptors agreed that the requirement to administer vaccinations was an appropriate activity for students and that it increased the students' self-confidence. When asked to rate the value of the students' work administering adult immunizations in the fall 2004 semester, the mean score given by the P2 students' immunization-certified preceptors was 9.2 on a 10-point Likert scale (1 = no value and 10 = great value).
Consistent with accreditation standards for students to have direct patient care responsibilities in introductory pharmacy practice experience courses, a requirement for P2 and P3 students to administer vaccines to adult patients in community pharmacies was successfully introduced.
immunization; vaccination; pharmacy student; introductory pharmacy practice experience; accreditation standards
To measure agreement between advanced pharmacy practice experience students using a guided interview process and experienced clinical pharmacists using standard practices to identify drug therapy problems.
Student pharmacists enrolled in an advanced pharmacy practice experience (APPE) and clinical pharmacists conducted medication therapy management interviews to identify drug therapy problems in elderly patients recruited from the community. Student pharmacists used a guided interview tool, while clinical pharmacists' interviews were conducted using their usual and customary practices. Student pharmacists also were surveyed to determine their perceptions of the interview tool.
Fair to moderate agreement was observed on student and clinical pharmacists' identification of 4 of 7 drug therapy problems. Of those, agreement was significantly higher than chance for 3 drug therapy problems (adverse drug reaction, dosage too high, and needs additional drug therapy) and not significant for 1 (unnecessary drug therapy). Students strongly agreed that the interview tool was useful but agreed less strongly on recommending its use in practice.
The guided interview process served as a useful teaching aid to assist student pharmacists to identify drug therapy problems.
guided interview; drug therapy; advanced pharmacy practice experience; interview; medication therapy management