Clinical Pharmacy: An Example of Interprofessional Education in the Late 1960s and 1970s.

Abstract

In 1968, the associate editor of Modern Hospital announced that pharmacy was the hot new trend in pharmacy circles.1 Pharmacy educators developed the concept of pharmacy-and launched the first pharmacy programs-in the mid-1960s as a new type of pharmacy practice that was patient oriented, rather than drug product oriented. The new pharmacist was to function as an integral member of the patient's health care team and will be personally involved with all aspects of the patient's medication problems from the time of admission to the time of discharge, and he may well be involved in follow-up supervision of the medical regimen for the discharged patient.2This new type of pharmacist required a new type of training, one that introduced pharmacy students to working within the health-care team, provided them with experience in the clinical practice of pharmacy at the patient's bedside, and exposed them to medical terminology and knowledge of diseases.3 As pharmacy educators at Purdue University School of Pharmacy and Pharmaceutical Sciences recommended in 1968, the new pharmacist be familiar with the principles of disease so he can converse easily on common ground with the physician. The physician should be able to present a disease or problem to the pharmacist and, if drug therapy is indicated, the pharmacist should be able to recommend the best drug regimen available.4The early pharmacy programs in schools of pharmacy are a study of interprofessional education. They used a combination of pharmacy clerkships (modeled on the medical student clerkship), student participation in patient rounds, and, in many cases, student participation in medical school classes. By exposing pharmacy students to their future colleagues in medicine and nursing, pharmacy educators hoped to foster concepts of team spirit among all members of the health-care team.5 In September 1967, for example, Wayne State University College of Pharmacy in Detroit introduced an elective course in pharmacy to final professional year students, making it a core course in the pharmacy curriculum the following year. The components of the course were conducted at Providence Hospital in Southfield, Michigan. In addition to fifteen hours of lectures, the course involved students' participation in patient rounds in various specialties. These rounds exposed pharmacy students to patients' lived experience of disease, surgical intervention, and trauma and allowed them to see firsthand the ways in which drugs were administered and managed on the wards.6The students also spent two hours on a nursing unit in which each student would be assigned to a nurse. During those two hours, the pharmacy student would observe the nurse's medication procedure: the ordering, administering, and charting of medications. For one pharmacy student, the experience on the nursing unit made him realize the importance of the pharmacist's in educating, as well as learning from, the nurses.7 Pharmacy students also participated in a teaching exercise so as to prepare them for their role of educator in both community and institutional practice. Here, pharmacy students presented pharmacology lectures to student nurses. Through this teaching experience, one pharmacy student reflected, really felt that I contributed to and also played the of a member of the health care team.8 The nursing students also found the pharmacy students a worthwhile addition to the health-care team. As one nursing student noted, Who knows drug information better than one who has devoted his entire education to it? For another nursing student, while it was not necessary to have the pharmacist on the nursing unit . . . I do think it would be beneficial to be able to call on his knowledge when necessary.9While at Wayne State University, pharmacy training was incorporated as part of the undergraduate curriculum, in September 1967, Purdue University School of Pharmacy and Pharmaceutical Sciences established a cooperative graduate program in pharmacy with Indiana University School of Medicine. …