LETTERS

Abstract

Preceptors play an important role in the education of pharmacy students. According to the Accreditation Council for Pharmacy Education (ACPE) accreditation standards effective in 2007, approximately one third of the curriculum should be devoted to experiential education (5% to introductory experiences and 25% to advanced experiences).1 To meet this demand, colleges of pharmacy must depend on a large number of volunteer preceptors who have had a wide variation in knowledge and practice experience. Since preceptors serve as the primary link between students' didactic education and their entrance into the practice of pharmacy, it is vital that preceptors are aware of the many outcomes that are expected of students, including components of their curriculum. Skills necessary to the practice of evidence-based pharmacy such as research design and literature evaluation are required components of the doctor of pharmacy curriculum. According to both the ACPE accreditation standards and the Center for Advancement of Pharmacy Education (CAPE) outcomes statements, students are expected to be exposed to practical applications of primary literature in both the classroom and in practice.1,2 Furthermore, experiential education must “integrate, apply, reinforce, and advance the knowledge, skills, attitudes, and values developed through the other components of the curriculum.”1 Since literature evaluation skills are necessary components of the curriculum, preceptors should be able to provide supervision of the student's development in these areas while on any rotation. In 2003, a cross-sectional survey instrument was mailed to randomly selected pharmacists in Illinois.3 Pharmacists were asked to report their level of training in drug literature evaluation and their use of computerized bibliographic databases (eg, MEDLINE/PubMed). Of the 322 respondents, 131 (41%) indicated that they served as preceptors for pharmacy students. Of these preceptors, only 59% (n = 77) reported receiving any formal training in literature search strategy, and only 66% (n = 86) reported any formal training in drug literature evaluation. Less than two thirds (61%, n = 80) of preceptors indicated that they had performed a primary literature search with a database such as PubMed within the last year. Preceptors who had received formal training in literature search strategy were much more likely to have performed a primary literature search than those without formal training (81% v. 34%, p < 0.001). While 75% (n = 98) of preceptors indicated having access to the Internet at work, only two thirds (66%, n = 86) reported having access to PubMed at work, despite availability of PubMed to the public on the Internet. Access to the Internet varied based on practice site. Community preceptors were much less likely to have access to the Internet at work than preceptors in other practice settings (52% v. 90%, p < 0.001). Since more than a third of preceptors have received no formal training in literature search strategy and drug literature evaluation, it is imperative that colleges take steps necessary to prepare all of their preceptors to effectively supervise student development in this area. ACPE accreditation guidelines call for colleges to provide for the ongoing training and development of their preceptors (Guideline 14.1).1 In the design of such training programs, colleges should consider literature search strategy and drug literature evaluation skills as a priority. While training programs may help to close this gap, the integration of these skills into evidence-based pharmacy across practice settings is a multifaceted problem. There are barriers to the implementation of evidence-based practice in pharmacy, including resource constraints that keep schools from delivering and preceptors from attending training programs. Pharmacy practice settings vary in their support for access to resources necessary to apply evidence-based skills to patient care. ACPE standards and guidelines call for colleges to establish minimum quality criteria for pharmacy practice experiences.3 In the development of these quality criteria, colleges should consider access to the Internet and PubMed in selection of experiential education sites. To address our shared vision for the future of pharmacy, colleges and the practice community must work together in an effort to expand evidence-based practice. Jill S. Burkiewicz, PharmD David P. Zgarrick, PhD Avery L. Spunt, MEd Midwestern University Chicago College of Pharmacy