Physician Preceptors Research Articles

How early clinical experiences in rural communities influence student learning about rural generalism considered through the lens of educational theory.

Rural communities have poorer health compared to urban populations due partly to having lesser healthcare access. Rural placements during medical education can equip students with the knowledge and skills to work in rural communities, and, it is hoped, increase the supply of rural physicians. It is unclear how students gain knowledge of rural generalism during placements, and how this can be understood in terms of place-based and/or sociocultural educational theories. To gain insight into these questions we considered the experiences of pre-clerkship medical students who completed two mandatory four-week rural placements during their second year of medical school. Data was collected using semi-structured interviews or focus groups, followed by thematic analysis of the interview transcripts. Rural placements allowed students to learn about rural generalism such as breadth of practice, and boundary issues. This occurred mainly by students interacting with rural physician faculty, with the effectiveness of precepting being key to students acquiring knowledge and skills and reporting a positive regard for the placement experience. Our data show the central role of generalist physician preceptors in how and what students learn while participating in rural placements. Sociocultural learning theory best explains student learning, while place-based education theory helps inform the curriculum. Effective training and preparation of preceptors is likely key to positive student placement experiences.

Management of sleep disorder by preceptors in a family medicine residency program in Calgary, Alberta: a mixed-methods study.

Most prescriptions for sedative-hypnotics are written by family physicians. Given the influence of preceptors on residents' prescribing, this study explored how family physician preceptors manage sleeping problems. Family physician preceptors affiliated with a postgraduate training program in Alberta were invited to participate in this mixed-methods study, conducted from January to October 2021. It included a quantitative survey of preceptors' attitudes to treatment options for sleep disorder, perceptions of patient expectations and self-efficacy beliefs. Participants indicated their responses on a 5-point Likert scale ranging from "strongly disagree" to "strongly agree." Respondents were then asked whether they were interested in participating in a semistructured qualitative interview that elicited preceptors' management of sleep disorder in response to a series of vignettes. We analyzed the quantitative data using descriptive statistics and the qualitative interviews using thematic analysis. Of the 76 preceptors invited to participate, 47 (62%) completed the survey, and 10 were interviewed. Thirty-two survey respondents (68%) were in academic teaching clinics, and 15 (32%) were from community clinics. The majority of participants (34 [72%]) agreed they had sufficient expertise to use nondrug treatment. Most (43 [91%]) had made efforts to reduce prescribing, and 45 (96%) felt able to support patients empathically when not using sleeping medication. The qualitative data showed that management of sleeping disorder was emotionally challenging. Participants hesitated to prescribe sedatives and reported "exceptions" to prescribing, many of which included indications within guideline recommendations. Participants were reluctant to change a colleague's management. Preceptors were confident using nonpharmacologic management to treat sleep disorder and hesitant to use sedative-hypnotics, presenting legitimate use of sedatives as exceptional behaviour. Acknowledging social norms and affective aspects involved in prescribing may support balanced prescribing of sedative-hypnotics for sleep disorder and reduce physician anxiety.

The impact of medical students on work after clinic for neurology preceptors

ObjectiveTo determine whether medical students significantly impact preceptor physicians’ clinic volume and work after clinic (WAC), we compared the time to note completion and the number of patients seen per hour (PPH) for outpatient neurologists with and without students present in their clinic. MethodsOutpatient neurologists (n = 47) involved in the Johns Hopkins Neurology Clerkship from 2015 to 2017 were included. WAC for each patient encounter was calculated as the interval between the date and time of a scheduled patient appointment and the time of clinic note completion. The number of patient encounters per scheduled clinic hour (PPH) was also calculated for each preceptor. Measurements were compared for each preceptor, serving as their own control, to account for variability in efficiency between preceptors. ResultsThere was no statistically significant difference in WAC or PPH for individual preceptors with and without students (WAC p-value = 0.837; PPH p-value = 0.139). Preceptors did see significantly more patients per day with students than without (6.28 with students, 5.07 without students, p-value <0.001). ConclusionsIn this study, assigning a student to an outpatient ambulatory clinic did not significantly increase work after clinic. In addition, students did not significantly alter the number of patients faculty saw per hour. Public Interest SummaryBoth medical students and educators have highlighted the importance of greater student involvement in clinic in providing a valuable outpatient educational experience, but it is often difficult for academic programs to recruit physician preceptors willing to teach and actively involve students in outpatient clinics. This study shows that medical student presence in clinic does not delay physician preceptors’ note completion and is not associated with less patients seen. To further optimize the outpatient educational and efficiency model, it is important for future investigations to evaluate training programs that enhance the efficacy of a student in clinic, particularly for students with less outpatient experience. This could encourage more preceptors to involve medical students in their clinic, potentially increasing student competence and interest in outpatient medicine.

Midclerkship Feedback Quality Improvement via Introduction of Simple Form (P3-2.004)

<h3>Objective:</h3> The provision of formative midpoint feedback in clerkships is required under Accreditation Standard 9.7 of the Liaison Committe on Medical Education (LCME). Our institution uses an end of clerkship evaluation by the medical students to evaluate education program quality (LCME Standard 8.5). The Clerkship Director aimed to improve the perceived quality of mid-clerkship feedback by introducing a form to prompt students to undergo specific discussion of strengths and weaknesses at the end of the first week of the clerkship. <h3>Background:</h3> The Neurology Clerkship at New York Medical College is a four-week required third year medical school clerkship with 4 clinical sites. The largest clinical site is Westchester Medical Center (WMC) with typical enrollment of 10 students per month. <h3>Design/Methods:</h3> Students scored the quality of mid-clerkship feedback on a Likert scale from 1–5, with 5 being best, during their end of clerkship evaluation. Starting in Block 8 (February 2022), a mid-clerkship preparation form was given to students which asked students to solicit individualized feedback from their resident and attending physician preceptors. Students were prompted to list two strengths and two areas to work on. They brought the paper to the formal mid-clerkship feedback session with the Site Director during week 2. <h3>Results:</h3> The average score on the Likert scale for mid-clerkship feedback quality was 3.58 in the 3 blocks preceding the change and 3.71 in the 3 blocks following the change. <h3>Conclusions:</h3> Structured interview tools can improve mid-clerkship feedback experience. <b>Disclosure:</b> Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurocrine Biosciences, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acorda, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva Neuroscience, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acadia Pharmaceutical, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Adamas Pharmaceutical, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine Biosciences, Inc.. Dr. Fekete has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amneal Pharmaceuticals, Inc.. Dr. Fekete has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda Therapeutics, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink, Inc.. The institution of Dr. Fekete has received research support from Lundbeck. Dr. Fekete has received publishing royalties from a publication relating to health care. Dr. Fekete has a non-compensated relationship as a Neurological Working Group Member with Alliance for Patient Access that is relevant to AAN interests or activities.

Physician stress in the era of COVID-19 vaccine disparity: a multi-institutional survey.

Healthcare workers are at a high risk of infection during infectious disease outbreaks, such as the COVID-19 pandemic. Despite the availability of several vaccines against COVID-19, the absence of vaccination in patients and colleagues remains a continuous source of stress in healthcare workers. We conducted a survey of physician preceptors, both MDs and DOs, to explore the impact of differences in the patients' and colleagues' vaccination status on their well-being, stress, and burnout. The objective of this study is to determine whether exposure to unvaccinated patients and/or colleagues increases stress and burnout in physician preceptors by utilizing a self-reported survey. This multi-institutional study was carried out in the United States in 2022. An online survey questionnaire was utilized to collect data from physicians working as preceptors for multiple academic institutions. The anonymous Qualtrics® survey utilized a modified version of the questionnaire from the expanded Physician Well-being Index (ePWBI) designed by MedEd Web Solutions (MEWS). Statistical analysis on both descriptive and qualitative data were performed. Utilizing a threshold of p≤0.05, data analysis revealed many statistically significant relationships between the variables. A total of 218 physician preceptors completed the survey. The survey results showed that physicians overwhelmingly (p<0.001) felt that all patients (and healthcare workers) should be vaccinated. The results also indicated that physicians experienced more stress when working with unvaccinated patients (p<0.001), and these stressors were often associated with the physician's gender and age. Furthermore, physicians stated that both their assessment and treatment plans were significantly different for vaccinated vs unvaccinated patients (p=0.039 and p=0.0167, respectively). Most importantly, stress levels (p<0.001) and burnout characteristics (p=0.024) were noted by physicians, both in themselves and in their colleagues. Findings suggest that physician stress and burnout is a common theme due to the differences in vaccination status of patients admitted to COVID-19 clinics. Due to a more rapid progression of COVID-19 in unvaccinated patients, treatment plans for vaccinated vsunvaccinated patients were also considerably different.

Insights for New and Developing Rural Family Medicine Residency Programs.

Rural family medicine residency programs (RFMRPs) encounter unique hardships that threaten their sustainability and efficacy despite their recent success at addressing the rural physician shortage. The aim of this study was to explore strategies employed by RFMRP program directors from across the United States to strengthen their programs in the context of evolving paradigms in graduate medical education (GME). The authors conducted a qualitative semistructured telephone interview with 19 program directors of RFMRPs in June and July of 2020. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Two major themes emerged: (1) community enrichment and (2) the ability to evolve to meet demands. Community enrichment had five subthemes: evaluate local resources, prioritize community buy-in, design a robust continuity clinic, identify or cultivate a local physician champion, and support faculty and physician preceptors. Programs evolving to meet demands had four subthemes: frequently revisit program mission to align with scope of family medicine, redefine expectations in medical education, integrate longitudinal experiences, and implement innovation in curriculum design. Community enrichment and programs' ability to evolve to meet demands are important attributes of a successful RFMRP. Our findings highlight strategies utilized by RFMRPs to help meet the needs of the changing landscape of rural family medicine GME and help identify best practices for developing RFMRPs.

Non-physician and physician preceptors in Landscapes of Practice: a mixed-methods study exploring learning for 1st-year medical students in clinical experiences

ABSTRACT Medical education has traditionally relied on physician educators. With expanding Health Systems Science competencies, non-physician healthcare providers are required. To investigate preceptor-role types, communication frequency, and importance of preceptors in value-added patient navigator roles (PN) and clinical preceptorships (CP). Using a mixed-methods approach, medical students participating in PN and CP during the first year of medical school (n=191) identified individuals with whom they communicated and communication frequency (1=never, 7=frequently), and importance of preceptors to work/education (1=not important, 7=extremely important; open-ended responses). Quantitative data were analyzed via repeated measures using a mixed-effects model and McNemar’s test; effect size was calculated via Cohen’s d or Cohen’s h; qualitative data was analyzed using thematic analysis. Comparing ratings for non-physicians to physician healthcare professionals in PN, communication frequency (5.54 vs 3.65; p<0.001, d=1.18), importance to work (5.77 vs 4.28, p<0.001, d=0.89) and education (5.02 vs 4.12, p<0.001; d=0.49) were higher for non-physician educators. Comparing ratings for non-physicians to physician healthcare professionals in CP, communication frequency (4.93 vs. 6.48, p<0.001, d=1.33), importance to work (5.12 vs 6.61 vs, p<0.001, d=1.29) and education (4.32 vs 6.55, p<0.001, d=1.89) were higher for physician educators. Qualitative analysis indicated that non-physician healthcare providers in PN focused on Health Systems Science concepts, including social determinants of health and healthcare delivery. In PN, students observed collaboration from the perspective of multiple providers. In CP, healthcare providers, mainly physicians, focused on physician-centric clinical skills and interprofessional collaboration from the physician’s perspective. Educational benefits of non-physician healthcare professionals related to Health Systems Science in work-based clinical settings – or Landscapes of Practice – can help students understand systems-based concepts such as social determinants of health, healthcare delivery systems, and interprofessional collaboration. Differences in the educational value of non-physician healthcare educators perceived by students should be further explored.

Impact of a professional development session based on learner evaluations within a preceptor community of practice

Background Physician preceptors play key roles in teaching medical professional trainees but receive little formal teacher training. One proposed way to improve teaching is by providing preceptors with learner feedback. The feedback from learner evaluations often has a limited impact with changes to teaching practice difficult to implement. This study explores the effect of using learner feedback to create a professional development session on teaching within a preceptor community of practice. Methods In this case study, 15 preceptors agreed to release their learner evaluations, and ten participated in the professional development session. Immediately and 2–3 months after the session, participants completed surveys on their intention to change and the changes made. The community of practice lead was interviewed to discuss the professional development session’s impact. Qualitative approaches were used to analyze the data. Results From the learner evaluations, nine areas of improvement were identified and discussed. All attendees made changes to their teaching practices, which the community of practice lead confirmed. Fewer changes were identified at the community of practice group level. Conclusion Using learner evaluations to structure a professional development session within a community of practice can help identify areas of improvement and create strategies to address these challenges.

A Qualitative Study of Preclinical Medical Students Randomized to Patient-Partnered vs Traditional Clinical Experiences.

Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient-centered track (PCT) or traditional track (TT) longitudinal clinical experience. PCT students (n=24) were paired with 2 patients and a physician to participate in their patients' care across multiple settings. TT students (n=56) were paired with a physician preceptor and participated in caring for a variety of patients in a single setting. This qualitative study used a phenomenological approach to template analysis, examining and comparing student reflective essays for areas of learning. Three domains of learning emerged: 1) Focus of learning (biomedical, patient-centered); 2) Roles and relationships (clinical skills, relationship-building, teaching from preceptor and patients); and 3) Context of care (health systems science, interprofessional care). PCT students described patient-centered learning, relationship-building, and patients' role as teachers. In contrast, TT students emphasized biomedical learning, clinical skills development, and teaching from physician preceptors. Longitudinal patient-partnered clinical experiences provide rich opportunities for preclinical students to cultivate empathy and develop patient-centered values.

Approach to advanced practice nursing student clinical during COVID-19.

Approach to advanced practice nursing student clinical during COVID-19.

Virtual Clinical Shadowing for Pre-Clinical Medical Students in an Emergency Medicine-Based Leadership Course.

Purpose: The COVID-19 pandemic limited pre-clinical medical students from participating in traditional clinical in-person shadowing. Rather than eliminating clinical shadowing from an established leadership course, we describe the experience of six pre-clinical medical students shadowing physician preceptors remotely through virtual platforms.Methods: Six pre-clinical medical students enrolled in 2020's Weill Cornell Medicine's Healthcare Leadership and Management Scholars Program were prepared with training materials for on-camera patient care. Students shadowed emergency medicine (EM) physicians providing clinical care in one of our New York Presbyterian emergency departments (EDs) and through telemedicine. Pre- and postsurveys were provided to these students.Results: From three different U.S. time zones, students were safely able to shadow EM physicians. The educational fidelity was maintained in physician–student relationships, but revealed opportunities for improvement in students' clinical learning, in ED clinical care, and in telemedicine visits.Conclusions: Virtual clinical shadowing is a viable option for pre-clinical students, when in-person options are not available. With logistical adjustments, this medium may be a long-term educational option especially for telemedicine.

Development of collaborative family nurse practitioner education using physician preceptors: A focused critical ethnographic study

BackgroundGlobal oppressive power structures in healthcare systems and between professions hinder care delivery. The family nurse practitioner is a new role in Israel. Through an innovative international collaborative education partnership, 19 Israeli nurses were trained as family nurse practitioners. Israeli physician preceptors integrated them into a national health maintenance organization despite national and organizational resistance. ObjectivesExplore Israeli physicians' experiences while providing clinical mentorship to family nurse practitioners and develop strategies for the implementation of the new community role. DesignQualitative focused critical ethnographic approach. ParticipantsEleven Israeli physician preceptors were recruited from a larger pool of 50. MethodsPhysicians were interviewed via recorded phone calls and asked open-ended questions about precepting family nurse practitioners. Observations of the program were included from the year prior to the interviews. Data were analyzed using Carspecken's five steps for critical ethnographic approach. ResultsThree categories for transforming the current status were identified: role clarification, logistics, and collaborative education. Exemplar cases described collaborative practice regarding measurable outcomes. Learning happened through “shadowing” and “coaching” techniques. Findings led to the Collaborative Team Development Illustration which mirrors current recommendations from the World Health Organization and Institute of Medicine. ConclusionsThe Collaborative Team Development Illustration offers a structured strategy for advocacy and transformation in other oppressive health systems considering introducing nurse practitioners. This paper provides evidence that physician participants believed partnerships with nurse practitioners could improve patient care delivery. We hope this research will contribute to changing power relations in healthcare and improve outcomes. This may offer hope for integration of family nurse practitioners in countries that currently do not support advanced practice nursing roles.

University of Wisconsin School of Medicine and Public Health.

University of Wisconsin School of Medicine and Public Health.

Northern Ontario School of Medicine.

Northern Ontario School of Medicine.

Geisinger Commonwealth School of Medicine.

Geisinger Commonwealth School of Medicine.

Addressing Kentucky's Physician Shortage While Securing a Network for a Research-Intensive, Referral Academic Medical Center: Where Public Policy Meets Effective Clinical Strategic Planning.

A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of "training Kentuckians in Kentucky to practice in Kentucky."

Development and evaluation of physician-precepted advanced pharmacy practice experiences (APPEs) within an accountable care organization (ACO)

Background and purposeThe American Council of Pharmaceutical Education (ACPE) standards emphasize that pharmacy graduates should be “practice- and team-ready,” and the American Society for Health-System Pharmacists (ASHP) Task Force on accountable care organizations (ACOs) states that curricula at pharmacy schools should be evaluated and reworked to prepare students to practice effectively as members of the health care team within ACOs. The objective of this study was to describe the development of an ACO-based advanced pharmacy practice experience (APPE) rotation block, clinical activities and interventions completed by students during the experience, and perceptions of students, patients, and physician preceptors regarding the experience. Educational activity and settingThe rotation block was within outpatient ACO offices and consisted of a four-week rotation with one pharmacy faculty, immediately followed by a four-week elective experience in a different office with a physician serving as primary preceptor. FindingsEight students completed the rotation block between August 2017 and April 2018. Students documented a total of 1299 clinical activities and 65 interventions. Medication reconciliation and recommendations to initiate a medication were the most commonly completed activities and interventions documented. The experience was positively perceived among surveyed students, patients, and physician preceptors. SummaryThe rotation block was successfully implemented with a positive response from students, patients, and physician preceptors. As a result, the program has expanded in accordance with ACPE Standards to create “practice- and team-readiness” among graduates and expose students to interdisciplinary care within ACOs and other settings.

Physician Preceptor Satisfaction and Productivity Across Curricula: A Comparison Between Longitudinal Integrated Clerkships And Traditional Block Rotations

Phenomenon: Physicians are under intense pressure to improve clinical productivity. High clinical load, limited availability, and decreased clinical efficiency are well-documented barriers to precepting medical students and threaten clinical productivity. In an era of increasing medical student enrollment, these barriers have already led to a decreased availability of clinical teachers and training sites across the United States. Improved preceptor satisfaction could have a great impact on recruitment and retention of medical student preceptors and is likely linked to changes in productivity. Curriculum structure could impact both preceptor productivity and satisfaction. Comparing productivity and satisfaction of physician preceptors teaching in longitudinal integrated clerkships (LICs) to those teaching in traditional block rotations (TBRs), or in both settings (LIC-TBR), could lead to a better understanding of the impact of curriculum structure on preceptor productivity and satisfaction. Approach: Data were collected through a quantitative cross-sectional survey of outpatient physician preceptors in North Carolina in 2017. Preceptor satisfaction and student influence on productivity-related aspects of practice were analyzed with bivariate chi-square statistics and multivariate logistic regression. Findings: Analyses included 338 physician preceptors: 79 LIC (23%), 50 LIC-TBR (15%), and 209 TBR preceptors (62%). LIC preceptors were more likely to indicate being “very satisfied” with precepting than either their LIC-TBR or TBR counterparts. There were no differences in perceived productivity-related aspects of practice across the different curricula, such as patient flow, income, or physician working hours. Logistic regressions controlling for potential confounding variables suggested that those teaching in LICs were almost 3 times more likely to be “very satisfied” relative to those teaching in LIC-TBR and TBR settings and that the negative influence of students on patient flow and physician working hours had an adverse effect on preceptor satisfaction. Insights: Preceptor satisfaction was high overall, though satisfaction was significantly higher among preceptors who teach in LICs. The perceived impact of students on clinical productivity was stable across the different curricula. In an era of increasing need for physician preceptors, the higher satisfaction of those who teach in LICs should be considered in curricular design and for preceptor recruitment and retention.

Precepting nurse practitioner students in the graduate nurse education demonstration: A cross-sectional analysis of the preceptor experience.

The Graduate Nurse Education (GNE) Demonstration seeks to increase the number of advanced practice registered nurses (APRNs) in clinical practice. With the overall increase in APRN programs and, particularly, enrollment in nurse practitioner (NP) programs, there is growing competition among students to secure quality clinical precepting experiences. This study describes NPs' and physicians' experiences with precepting APRN students within the Greater Philadelphia GNE Consortium. This was a cross-sectional descriptive survey of 1,021 NP and physician preceptors who provided clinical practicum experiences for at least one of the nine Greater Philadelphia GNE Consortium schools. Differences between NP and physician precepting experiences regarding the importance of various factors in their decisions to precept were explored. Both NP and physician preceptors provide clinical practicum experiences to APRN students because they enjoy doing so. However, they differ regarding what they find important in their decisions to precept such as having protected time to precept and educational opportunities. As universities work to recruit quality preceptors, they should consider tailoring their approach based on the preceptor's clinical role. In addition, schools located within the same region should consider streamlining administrative processes to form sustaining and productive clinical partnerships.

Optimizing differentiation of human pluripotent stem cell-derived cytotrophoblast into extravillous- and syncytio- trophoblast.

The American Council of Pharmaceutical Education (ACPE) standards emphasize that pharmacy graduates should be “practice- and team-ready,” and the American Society for Health-System Pharmacists (ASHP) Task Force on accountable care organizations (ACOs) states that curricula at pharmacy schools should be evaluated and reworked to prepare students to practice effectively as members of the health care team within ACOs. The objective of this study was to describe the development of an ACO-based advanced pharmacy practice experience (APPE) rotation block, clinical activities and interventions completed by students during the experience, and perceptions of students, patients, and physician preceptors regarding the experience.The rotation block was within outpatient ACO offices and consisted of a four-week rotation with one pharmacy faculty, immediately followed by a four-week elective experience in a different office with a physician serving as primary preceptor.Eight students completed the rotation block between August 2017 and April 2018. Students documented a total of 1299 clinical activities and 65 interventions. Medication reconciliation and recommendations to initiate a medication were the most commonly completed activities and interventions documented. The experience was positively perceived among surveyed students, patients, and physician preceptors.The rotation block was successfully implemented with a positive response from students, patients, and physician preceptors. As a result, the program has expanded in accordance with ACPE Standards to create “practice- and team-readiness” among graduates and expose students to interdisciplinary care within ACOs and other settings.