Role-Emergent Model: An Effective Strategy to Address Clinical Placement Shortages

Abstract

Purpose: To evaluate the effectiveness of an advanced pharmacy practice experience (APPE) delivered at “role-emergent” placement sites within long-term care (LTC) facilities that are preceptored by off-site community pharmacists.Method: Seven LTC facilities participated: five newly recruited test sites preceptored by off-site pharmacists who supervised students remotely (“role-emergent” placements), and two previously established hospital-based facilities with on-site pharmacists who provided continuous student supervision (“role-established” placements) as a comparison group. Students participated in pre-APPE training. Both qualitative and quantitative methods were used to obtain student learning performance on 13 pre-defined learning objectives and 21 indicators of site resources and skills-development opportunities. Structured open-ended feedback questions and reflective student observations elicited more personal and situational experiences. These combined with faculty reviews of student documentation of their patient care delivery encounters and LTC Staff perspectives enabled comparisons between the two APPE formats. Results: A total of 23 students participated: three at role-established and 20 at role-emergent sites. Evaluations indicated that all students successfully completed their learning objectives. Some differences were apparent – for example students at role-emergent sites expressed a desire for more one-to-one time with their pharmacy preceptor, but they also benefitted from more inter-professional collaboration and interacted with a broader range of health professionals than students with on-site APPE preceptors. Conclusions: This study demonstrated that equivalent but non-identical learning occurs at LTC locations with off-site preceptors (role-emergent) as in role-established hospital-based settings with on-site preceptors. Importantly, it also opens opportunities for many new APPE placement opportunities since there about three times as many LTC facilities as acute care hospitals in our jurisdiction.