Advanced Pharmacy Practice Experiences Research Articles

Multifaceted Strategy That Improves Students’ Achievement of Entrustable Professional Activities Across Advanced Pharmacy Practice Experiences

ObjectiveTo outline an approach to help students achieve Entrustable Professional Activities (EPAs) entrustment during a sequence of Advanced Pharmacy Practice Experiences (APPEs) by implementing longitudinal monitoring and individualized intervention and remediation strategies. MethodsUsing the recommended EPAs within the core APPEs (acute care, ambulatory care, community, institutional), students were expected to achieve entrustment on all EPAs by graduation. A longitudinal monitoring approach, using an “EPA report card,” was implemented to continuously identify students at risk of not meeting the EPA requirement of “Level 3” entrustment (perform with reactive supervision). Individualized interventions, including proactive outreach and in-sequence remediation, were incorporated into the APPE core and elective sequence to help ensure all students were entrusted by the end of APPEs without requiring further end-of-year remediation to graduate. ResultsFor the graduating classes of 2023 and 2024, 12% (8 of 69) and 16% (12 of 75) students, respectively, were identified as at risk of not meeting EPA entrustment. Proactive outreach, in-sequence remediation, or a combination of both strategies, were used to enhance learning and EPA performance. As a result, all students achieved “Level 3” entrustment on the deficient EPA(s) by the end of the APPE sequence. No student required further end-of-year remediation to graduate. ConclusionUtilizing a multifaceted strategy provided timely, real-world practice opportunities to improve the students’ achievement of EPAs across the APPE curriculum and decreased the need for end-of-year remediation and potential graduation delays.

Correlating Advanced Pharmacy Practice Experience Exam Scores and Pharmacist Licensure Status in a Single Program

ObjectivePharmacist licensure exam first-time pass rates have declined for several years. Predictors of licensure exam performance including the Pharmacy College Admission Test are no longer required, necessitating alternative strategies. Our aim is to assess the relationship between numerical scores on advanced pharmacy practice experience (APPE) exams and pharmacist licensure exams first-time pass rates. MethodsWe conducted a single center retrospective observational analysis. APPE examination results between May 2020 and November 2023 were analyzed for association with licensure information from the Texas State Board of Pharmacy. Exam scores were collected for student cohorts graduating from 2021-2022 as study cohort data. Correlation between exam scores and probability of successful licensure was assessed using logistic regression. A classification and regression tree analysis identified the most significant threshold. Predictive ability of the best-fit model was prospectively validated using the 2023 graduate cohort. ResultsOverall licensure success rate were 80.6% for the study cohort (2021-2022, n=206). Exam scores were well correlated to the likelihood of licensing success. The most significant threshold was 77.8%. The success rate was 82.5% vs. 16.7% for those scoring above and below the threshold. The observed and predicted licensure success rates were 91.0% and 88.8% in the validation cohort (2023, n=89). The positive and negative prediction values were 94.9% and 40.0%. ConclusionPerformance on APPE exams were reasonable in predicting the first-time licensure success rate for a graduating class. Our assessment appears promising as a risk stratification tool for students in gaining successful pharmacist licensure.

How Preceptors Support Pharmacy Learner Professional Identity Formation

ObjectivePharmacy preceptors play a role in helping learners form professional identities during experiential education. However, it is not clear what specific roles and precepting strategies best foster professional identity formation (PIF). The objective of this study was to explore how preceptors support pharmacy learner PIF. MethodsThis qualitative study used an interpretative descriptive approach. Preceptors from 5 experiential education programs were recruited using purposive sampling for individual semistructured interviews. Interviews were recorded, transcribed, coded, and analyzed by thematic analysis. Team members used a reflective and iterative approach for data analysis and generation of themes. ResultsA total of 22 participants were interviewed from various pharmacy practice settings and precept a range of learners, including introductory pharmacy practice experiences, advanced pharmacy practice experiences, and residents. Four main themes were identified to support pharmacy leaner PIF: making learners part of the practice and team, preparing learners to assume the role of a pharmacist, helping learners navigate emotions during practice experiences, and supporting learners in finding the right fit within the profession. Specific precepting strategies associated with each theme were identified. ConclusionPreceptors play an important role in supporting learners in thinking and acting as professionals while also helping navigate emotional experiences that may impact PIF and having conversations to help define learner’s future aspirations of the pharmacist they want to become. Strategies identified can inform curricular approaches and preceptor development that intentionally supports PIF.

Safely gaining experience in death and dying: Simulation in palliative care and end-of-life education

BackgroundTraining in palliative and end-of-life (EOL) care provision represents a critical topic in health professional curricula for ensuring a workforce prepared to provide safe and person-center care at the end of one's life. This manuscript describes the incorporation of a simulation-based learning experience (SBLE) and the evolution of a professional elective course for student pharmacists related to palliative and EOL care. Educational activityA SBLE was incorporated into a long-standing professional pharmacy elective course in palliative and EOL care. The decision to incorporate and utilize SBLE to introduce topics of deprescribing, communication, prioritization of quality of life, and establishing goals of care was utilized in recognition of a need to establish a psychologically safer environment to allow students to explore these topics prior to the advanced pharmacy practice experiences. DiscussionIncorporation of SBLE in this professional elective course resulted in a favorable effect on course enrollment. Observations from structured debriefing and anecdotal student feedback suggest that students had trouble tailoring care plans to the circumstances, particularly in focusing on de-escalating medication treatments, emphasizing the need for training in the care for this patient population which incorporate considerations for goals of care. Lessons related to the influence of environmental distractions, expressions of discomfort conveyed by body language, and challenges in prioritizing and focusing on tailoring care plans given evolving information at hand were identified. ImplicationsWe describe the effective implementation and utilization of SBLE in a professional elective focused on palliative and EOL care for student pharmacists. Future directions include research initiatives designed to evaluate the impact of simulation on key competencies and areas developed through participation in such exercises. Systematic evaluation of outcomes and competencies related to team dynamics, sympathetic communication, professional identity formation and resiliency and preparation for dealing with death and dying in experiential learning are planned.

Evaluating Curriculum Differences in US PharmD Programs: A Peer Evaluation

ObjectiveTo evaluate the differences in curriculum structure and content and observe commonalities across various Doctor of Pharmacy (PharmD) programs in the United States. MethodsThis research involves the collection of course content and credit hour data from the curricula and course descriptions, course catalogs, and student handbooks of all the PharmD programs available on their websites and categorization based on the content areas outlined in the Accreditation Council of Pharmacy Education. The core courses, elective offerings, and experiential education (eg, Introductory and Advanced Pharmacy Practice Experience) were evaluated using Excel® for credit hours, integration, non-integration, program duration (3-year vs 4-year), and online offerings. ResultsOf 142 accredited schools/colleges, 135 were included in the study, which met the inclusion criteria. In total, 85 of these schools have an integrated curriculum, 19 have a 3-year curriculum, and 15 offer a distance learning pathway for a PharmD degree. Fourteen of the 37 required content areas from the Accreditation Council of Pharmacy Education Appendix 1 were identified, with more than 50% of schools listing no credit hours allocated. Only 9 areas had 90% or more of pharmacy schools allocating credit hours. On average, biomedical, pharmaceutical, social/administrative/behavioral, clinical sciences, experiential education, and electives allocate 10.6, 25.3, 17.1, 40.5, 45.5, and 7.0 credit hours, respectively. ConclusionEach school’s curriculum has a significant variation in credit hours, and there is an opportunity to simplify the curricular structure and content by reducing redundancy and increasing flexibility based on health care needs.

Pharmacy students' interprofessional experience and performance in advanced pharmacy practice experience rotations amid COVID-19 pandemic.

Interprofessional education (IPE) is essential in pharmacy training, providing students with vital collaborative skills for real-world healthcare. Advanced Pharmacy Practice Experience (APPE) is integral to IPE, allowing students to apply their knowledge in diverse healthcare settings. The COVID-19 pandemic has disrupted healthcare education and raised concerns about its impact on IPE during APPE rotations. Our study investigates the pandemic's influence on pharmacy students' interprofessional interactions and APPE performance. To assess the interprofessional experiences of fourth-year pharmacy students before and during the COVID-19 pandemic in the context of APPE. This retrospective observational study examined the experiences of P4 pharmacy students in the United States during APPEs before and during the pandemic. We employed electronic surveys with 21 questions to gauge interactions and interprofessional team effectiveness, employing Likert scale response options. We compared responses between the 2019-2020 and 2020-2021 APPE rotations using statistical tests. Our study encompassed 83 and 86 students for the 2019-2020 and 2020-2021 APPE rotations, respectively, achieving a 100% response rate. Amid the pandemic, written communications between pharmacy students and healthcare providers in general medicine rotations increased, while in-person engagement decreased. Pre-COVID, students reported higher colleague referrals and greater interprofessional utilization during ambulatory care rotations. COVID-19 shifted interactions from in-person to written communication between pharmacy students and healthcare providers. Students reported decreased satisfaction with their interprofessional experiences. This research offers insights into the changing landscape of pharmacy education, helping students prepare for evolving challenges in healthcare delivery and education.

The Divergence between Self- and Preceptor-Assessments of Student Performance during Advanced Pharmacy Practice Experiences.

(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: Preceptor-assigned grades for APPE rotations from 2017-2022 were analyzed to identify instances of letter grade B or lower. The self- and preceptor-evaluations of APPE rotation were compared to determine the domains of divergence in evaluation between students and preceptors. (3) Results: Between 2017 and 2022, 305 student APPE rotations were graded as B or lower (~14%) by the preceptors. A statistically significant difference was noted between self- and preceptor-assigned letter grades across all practice settings including ambulatory patient care, community pharmacy, general medicine patient care, hospital/health system pharmacy, and special population patient care APPE rotations. In addition, examining the self- and preceptor evaluation rubric for these rotations revealed a statistically significant overestimation of clinical skills by students in all 9 domains of APPE evaluation. Finally, the divergence in the rating of clinical skills between student- and preceptor evaluation was found to be highest in the domains of planning and follow-up of patient care, disease knowledge, and communication with patients. (4) Conclusions: Students who fail to exhibit exemplary practice readiness during APPEs tend to overestimate their clinical skills in all domains of APPE evaluation. The results from our study support the need for additional avenues to assist in the identification of deficits in student learning before APPEs to increase their self-awareness (metacognition).

Entrustable professional activities-based objective structured clinical examinations in a pharmacy curriculum

Entrustable professional activities-based objective structured clinical examinations in a pharmacy curriculum

Implementation and evaluation of a learner-driven leadership initiative for pharmacy students and pharmacy residents.

Introduction: Leadership training is a crucial component of the pharmacy education curriculum. The Accreditation Council for Pharmacy Education (ACPE) emphasizes and encourages the use of different leadership initiatives, and universities employ tactics with varying levels of success to implement these initiatives. "Leadership theory" debates if leadership can be learned or if it is a natural-born skill. This article explores learned leadership and describes a small study deployed to different levels of pharmacy learners to foster leadership confidence and self-awareness. Educational Context and Methods: Second- and third-year didactic students in a leadership elective, voluntary fourth-year Advanced Pharmacy Practice Experience (APPE) students on an ambulatory care rotation, and first postgraduate year (PGY1) pharmacy residents were included in this initiative. Each cohort facilitated a leadership book club discussion and completed professional development activities over the course of their experience. Learners' perspectives on leadership were surveyed utilizing a pre-post survey study, administered prior to beginning the initiative and after completing the initiative. Findings and Discussion: Results demonstrated learners' perceived confidence and self-awareness in their leadership skills increased from pre-survey to post-survey. Evaluation of qualitative responses exhibited that participants found value in adding more leadership development to their pharmacy training. Most participants noted leadership book discussion facilitation as the most valuable part of the initiative and posited they would utilize skills gained through these discussions nearly every day in their careers. Results suggest PGY1 pharmacy residents showed the most significant increase in their scores from pre- to post-study, while didactic students showed the least significant increase. Implications: Our findings suggest learner-driven leadership initiatives, specifically learner-facilitated book club discussions, are beneficial to incorporate into both didactic and experiential coursework. Implementation of these discussions could be applied in many aspects of the curriculum with minimal resources and a reasonable expectation of perceived benefit to student leadership development.

Predictors of student preparedness for advanced pharmacy practice experiences

BackgroundA capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training. The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs).MethodsStudent data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs. Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis.ResultsA statistically significant positive correlation was observed between the overall APPE GPA and students’ capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score. A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185). In the linear regression model, capstone GPA emerged as a significant predictor (β = 0.155; p = 0.019) of APPE GPA amongst the tested variables. Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students.ConclusionPerformance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs.

Review of Objective Structured Clinical Examination Practices Within Pharmacy Programs Throughout the United States

ObjectiveTo update the description of current objective structured clinical examination (OSCE) practices within pharmacy schools in the United States and identify barriers to OSCE implementation and expansion. MethodsA survey was deployed to all accredited Doctor of Pharmacy programs within the United States. The survey was designed to collect information regarding the curricular mapping of OSCEs, OSCE design, OSCE delivery, assessment of OSCE performance, and barriers to OSCE implementation and expansion. ResultsOf the 135 US-accredited programs identified, 109 (81%) programs completed the survey. In total, 93 (85%) programs reported using OSCEs to assess students; however, implementation throughout the curriculum and current practices varied by institution. Most programs place OSCEs within specific courses (96%), with the applied skills coursework being the most used (80%). The most common number of OSCEs that occur throughout a curriculum is 6 (18%), however, 20 (22%) programs execute 10 or more OSCEs throughout their curriculum. Forty (43%) programs use OSCEs as high-stakes assessments where poor performance could prevent a student from progressing to advanced pharmacy practice experiences. Of the responding programs, over half (56%) use teaching objective structured examinations to enhance learning. Common barriers to OSCE expansion exist and are related to resource utilization. ConclusionSignificant expansion of OSCE development and implementation has occurred over the last decade. There is substantial variability in implementation and utilization among programs. Although standards of best practice for OSCEs exist for other health professions, best practices in pharmacy education have not been widely accepted or adopted.

A Call to Action for Integrating Introductory Pharmacy Practice Experiences With Purpose

Introductory pharmacy practice experiences (IPPEs) are essential to exposing students to contemporary pharmacy practice and promoting advanced pharmacy practice experience readiness. An IPPE curriculum should be sequenced and progressive, with IPPE experiences built upon each other and coordinated with the didactic curriculum. Pharmacy programs are faced with several internal and external challenges that can influence the design and implementation of their IPPE curriculum. Periodic IPPE curricular review is imperative as new challenges arise and existing challenges abate. Pharmacy programs should use a systematic and holistic process to evaluate and revise their IPPE programs. It is an opportune time to begin this process, with new standards being released in 2024. This commentary describes common challenges associated with integrating a high-quality IPPE program into a Doctor of Pharmacy curriculum along with potential solutions, with the intention for individual programs to use this as a tool to guide IPPE evaluation and revision.

Preceptors' perceptions of an entrustable professional activities-based community introductory pharmacy practice experience curriculum

IntroductionIn 2021, the Southeastern Pharmacy Experiential Education Consortium implemented Entrustable Professional Activities (EPAs) into the community introductory pharmacy practice experience (IPPE) curriculum at five colleges/schools of pharmacy. The objective of this study was to evaluate community IPPE preceptors' perceptions regarding the newly implemented EPA-based community IPPE curriculum and corresponding preceptor training. MethodsCommunity IPPE preceptors who precepted first-year student pharmacists in the EPA-based curriculum during the 2021 and 2022 community IPPE cycles were invited to complete a voluntary electronic survey. The survey collected preceptor feedback regarding the required EPA tasks, assessment tool, and preceptor development module. ResultsEighty-eight preceptors began the survey, and approximately half completed the entire survey. Greater than 92% of preceptors surveyed agreed or strongly agreed EPA domain tasks were developed at an appropriate level for a student to complete by the end of the community IPPE, and ≥ 94% agreed or strongly agreed tasks prepared a community IPPE student for the community advanced pharmacy practice experience (APPE). Overall, most preceptors agreed or strongly agreed that the assessment tool was easy to navigate and effective at evaluating students' performance. All preceptors who viewed the recorded preceptor development module found it helpful to their understanding of the new assessment tool. ConclusionsPreceptors' feedback supports the use of an EPA-based community IPPE curriculum to assess student performance and prepare students for community APPEs. Preceptor involvement is valuable in the evaluation of a revised experiential curricula to assure IPPE expectations are appropriate and align with contemporary pharmacy practice.

Evaluating preceptorship during advanced pharmacy practice experiences in Saudi Arabia: A Cross-Sectional Study

IntroductionDoctor of Pharmacy (PharmD) programs offer students’ academic coursework and Advanced Pharmacy Practice Experiences (APPEs). APPEs are crucial for students, providing hands-on training in practice settings and enhancing clinical skills and decision-making abilities. Nevertheless, successful APPEs relies mainly on preceptorship. Hence, this study aims to evaluate preceptorship during APPEs in one of the non-major cities in Saudi Arabia. MethodA Cross-Sectional survey study was conducted among 40 PharmD students at Taibah University's College of Pharmacy which involved two telephone interviews conducted seven months apart. The survey instrument consisted of 46 questions divided into eight sections which covered various aspects such as demographics, clarity of rotation objectives, clinical and communication skills, assessment of the training and learning opportunities, preceptors' feedback and evaluation, interaction with patients, healthcare providers, and preceptors. Descriptive statistics and Cronbach's alpha coefficient were utilized to analyze the collected data and to assess the internal consistency of the multi-item Likert questions. ResultsPreceptors were predominantly male, aged 26–35, with extensive experience in pharmacy practice and mentorship, yet they lacked specialized post-graduate training or education certification. Almost 50% of the preceptors exhibited competence in pharmacotherapy-related science, demonstrated a willingness to teach students and acknowledged the students’ knowledge and skills. Furthermore, most of the students reported understanding of the APPEs objectives as the internship progressed. However, only 15% of late rotation participants strongly agreed on the safety of the learning environment, adequate time and regular contact with their preceptors. Starkly, only 3.0% of early rotation students and 6.1% of late rotation students strongly agreed with the improvement of their written and verbal communications. ConclusionThis study reported a noted decline in perceived learning support and environment safety as the APPEs’ year progressed. Feedback and communication skills development were areas of concern, with limited satisfaction reported. The study highlights regional disparities in training quality, emphasizing the need for structured learning experiences and re-evaluation of preceptorship. Future research should aim to better understand the challenges associated with APPEs in non-major cities and rural areas, thereby making significant contributions to the enhancement of the pharmacy profession.

Student perspectives on peer education using a virtual platform to enhance advanced pharmacy practice experiences (APPE)

Background: The COVID-19 pandemic caused dramatic disruptions in the education of pharmacy students who graduated in 2022. As an additional active learning opportunity at a New York City hospital site with multiple preceptors and faculty, a monthly student-led virtual educational conference was implemented. The objective of this study was to assess student perspectives on the implementation of a virtual peer education conference. Methods: Between May 2021 and May 2022, a total of twenty-eight students participated as presenters or attendees. All students completed a 13-item survey to evaluate the impact their participation in the virtual conference had on their overall learning and how similar opportunities could impact their future learning experiences. Results: When asked to rate on a scale from 1 (did NOT improve at all) to 5 (greatly improved my learning), 93% (26/28) of students rated their change in learning after attending the student-led conference as a four or five. Students identified that participation enhanced their drug/disease state knowledge, improved their presentation skills and/or improved their critical thinking and clinical application skills. Conclusion: In the future, advanced pharmacy practice experiences (APPE) can consider the inclusion of peer education through an online platform as a strategy to facilitate learning in pharmacy programmes.

Enhancing application and long-term retention of clinical knowledge using an extracurricular non-credit course

Background and purposeCurricular overload in doctor of pharmacy (PharmD) programs is necessitating innovative approaches to support student learning. The purpose of this study was to describe the design, delivery, and assessment of a non-credit extracurricular course that reinforced foundational concepts through the application of learning in case-based activities. Educational activity and settingA 14-week extracurricular course, designed using principles of spaced repetition and interleaving in the context of case-based exercises, was offered to third-year PharmD students. Content focused on Top 300 and over-the-counter medications, brown bag sessions/drug utilization review, and medication therapy management. Short-term course effectiveness was assessed through post-course focus groups. Longitudinal effectiveness was assessed nine months post-course using an online survey. Qualitative data were analyzed using a content analysis process with overarching themes identified. Clinical interventions identified in the post-course survey were analyzed descriptively. FindingsTwenty-four students completed the course and all assessments. Focus group themes were: (1) making connections to prior learning; (2) moving beyond memorizing facts; and (3) benefit from a low-stakes course. Students identified 162 course-linked clinical interventions during advanced pharmacy practice experiences (APPEs) in 16 different settings. SummaryStudent learning can be enhanced through integration of evidence-based teaching strategies both within and across the curriculum. This can be accomplished not only through introduction of an extracurricular course but through modification of existing courses. Providing additional opportunities for reinforcing core clinical knowledge and applying clinical decision-making in a low-stakes environment was well-received by students and helped them make clinical interventions during APPEs.

Evaluation of an ambulatory care elective to improve practice readiness perceptions utilizing entry-level competencies

Background and purposeThe objectives of this study are to (1) describe the impact of an ambulatory care elective on students' future interests in ambulatory care careers and (2) evaluate students' perception of practice readiness using entry-level competencies. Educational activity and settingThis study employed a mixed methods approach to provide a comprehensive evaluation of a newly designed ambulatory care elective. A pre-post survey was developed to evaluate students' career plans and perceptions of practice readiness in an ambulatory care setting. The primary outcome analyzed the change in students' career plans and pre-post changes in self-perceptions using the institutional advanced pharmacy practice experience (APPE) ambulatory care rotation assessment and key skills from the American Society of Health-System Pharmacists entry-level readiness objectives. A qualitative analysis was also conducted to analyze open-ended response questions within the post-survey as well as the overall course reflections from the students. FindingsThere was no significant difference in career plans; however, students' perception of practice readiness for the ambulatory care setting significantly improved following the elective course. SummaryThis elective course improved students' perception of practice readiness for the ambulatory care setting. Future research is required to assess the impact of student performance in APPE and post-graduate pursuits.

Earthquakes, Hurricanes, Pandemics: Pharmacy Students Impacting Pharmacy Practice in Puerto Rico Through Medication Therapy Management Services During Disasters.

Community-based medication therapy management advanced pharmacy practice experiences (MTM APPE) can engage pharmacy students in public health initiatives, including emergency response preparedness, to successfully impact patient care. This study aimed to evaluate pharmacy students' perceptions of their experience on an MTM APPE during disasters in Puerto Rico. After completing the MTM APPE during times of hurricanes, earthquake or pandemic, pharmacy students were asked to voluntarily participate in a questionnaire about their perception of assisting during a disaster. The survey consisted of 5 questions. Four questions were based on a Likert scale with answers choices ranging from Agree, Not Sure, Disagree, or Not Applicable. One question requested free text comments from participants. Sixteen students completed the survey. Pharmacy students agreed that the MTM APPE taught them the clinical skills needed to assist and educate individual patients and the community that suffered from a disaster, and that the role of the pharmacist is vital when a disaster disrupts a community's health-care system. Training in emergency response to disasters should be a considered component of MTM APPE.

Collaborative inpatient and ambulatory care topic discussions in experiential education: An approach to assessing the Pharmacists' patient care process and transitions of care

IntroductionThe Pharmacists' Patient Care Process (PPCP) is woven throughout the doctor of pharmacy program; however, advanced pharmacy practice experiences (APPEs) are not structured in a specific order allowing students to apply the PPCP across the care continuum. Two faculty preceptors from two practice sites, inpatient family medicine and ambulatory care, joined to provide twice weekly, preceptor-led collaborative topic discussions to bridge this gap. This paper describes an approach to improve students' knowledge by incorporating progressive cases and assessments highlighting care across the continuum aligned with the PPCP. MethodsPreceptors developed topic discussions, progressive cases, and assessments to emphasize the PPCP and transitions of care (TOC) during month-long APPEs. Students' perceptions were assessed through an anonymous Likert-type item survey. To assess learning, students completed anonymous, preceptor-developed, multiple-choice pre- and post-assessments aligned with the different components of the PPCP and TOC. ResultsIn two academic years (2021−2023), 24 perception surveys were distributed and 21 were received from 19 unique students (87.5%). Compared to pre-implementation surveys, a significant increase was seen in the students strongly agreeing the incorporation of progressive cases improved their ability to apply the PPCP to patient care (48% vs. 76%, P value = .06). Twenty-four pre- and post-assessments (100%) were completed by 22 unique students, showing a statistically significant difference in students' understanding of content (71.8% vs. 81.6%, P value = .02). ConclusionsThe incorporation of collaborative topic discussions for APPE students between inpatient and ambulatory care preceptors increased students' knowledge to apply the PPCP during TOC.

Health and Wellness Projects Created by Student Pharmacists during Advanced Pharmacy Practice Experiences: Exploring the Impact on Professional Development.

A curricular expectation of pharmacy educators is to equip students with strategies for the promotion of health and wellness. The impact on student professional development with involvement in such health promotions has been sparsely documented. The specific aim of this project was to explore the impact on student learning and professional development when they create, implement, and reflect upon a Health and Wellness Project (HWP). In 2022-2023, each student completing a Community Advanced Pharmacy Practice Experience created and implemented an HWP with the goal of serving as a "health promoter" (205 projects). A multi-method design of quantitative and qualitative assessment techniques was used to analyze the impact of creating/implementing the HWP on students' learning, with a self-determination theory (SDT) framework utilized to evaluate professional development. Upon review, all projects met the acceptability criteria. Qualitative data analysis from a subset of 48 students identified themes of impact on learning, which included knowledge acquisition, enhancement of communication skills, opportunity for patient-centered interaction, selection of targeted educational strategies, and immersion into the role of health promoter. All three components of SDT were found to support professional development: competence in the field; relatedness to patients and the profession; and autonomy in creating the HWP. Student quotations demonstrated strong professional identity formation as students began to think, act, and feel like pharmacists.