Transcript NEOMED IPPE Experiential Program

Development and Implementation of a Theme Based
Introductory Pharmacy Practice Experience (IPPE) Program
S. Scott Wisneski, Pharm.D., MBA, Louis D. Barone, Pharm.D., Susan P. Bruce, Pharm.D., BCPS
Robb W. McGory, MS, Pharm.D. & David D. Allen, R.Ph., Ph.D., FASHP
Northeastern Ohio Universities College of Pharmacy
Abstract
Objective: To create an IPPE program based on three distinct yearly
themes with the goal to provide exposure to multiple pharmacy
practice settings and to develop the student’s skills gradually
throughout the curriculum.
Methods: First professional year students are required to complete
72 hours of experiential training focused on the theme of “Dosage
Forms” at six practice settings. Second year students complete 192
hours of training focused on the theme of “Medication Use Systems”
at three practice settings. In the third year the students complete an
additional 192 hours of training at three practice settings focusing on
the theme of “Patient Safety”. Specific goals and objectives of the
program were developed based on the theme for each year of the
experiential program. Training on the program themes and objectives
were provided to the students and the preceptors. Preceptors and
students completed evaluations on the program following each
rotation.
Results: Since the start of the program in January 2008 two classes
completed the first year and one class completed the second year of
the theme based IPPE program. Results of preceptor and student
evaluations have been largely positive, particularly related to gradual
skill development of the student and the structure of the program
overall.
First Year (P1) IPPE
Third Year (P3) IPPE
Dosage Forms
Patient Safety
Student
The primary goal of the P1 IPPE is for the student to gain exposure to a variety
of practice settings and to begin the process of professional orientation to
attitudes, values and behaviors expected in pharmacy practice.
• Site visits take place during the winter and spring of the first year in the
professional curriculum.
• Students visit a total of six sites in practice settings to include community
chain, community independent, institutional, and three “other” settings.
• Students visit each site once a week (four hours in the afternoon) for three
weeks.
• Objectives for these visits focus on the theme of “Dosage Forms”:
1. Determine the scope of pharmacy services provided by the practice site.
The student will complete a site profile questionnaire which describes the
nature of the site.
2. Identify pharmaceuticals commonly utilized and dispensed at the site.
3. Identify pharmaceutical packaging needs, storage requirements, expiration
dating, handling, and preparing product for dispensing.
4. Identify various dosage forms of pharmaceutical products.
5. Participate in the dispensing process for the site.
6. Participate in the inventory management process for the site.
Implications: A unique theme based IPPE program can be a
successful method to provide pharmacy students with IPPE training to
develop skills needed for the advanced practice experiences.
The goal of the P3 IPPE is for the student to understand the processes and
systems utilized to achieve appropriate medication outcomes in the patient.
• Similar to the P2 visits, P3 students begin their visits in the fall and
extend throughout the entire third year of the professional curriculum.
• Students visit a total of three sites in practice settings to include
community, institutional, and an elective setting.
• Students visit each site twice a week (two four hour afternoons) for
eight weeks.
• Objectives for visits focus on the theme of “Patient Safety”:
1. Demonstrate the ability to counsel patients on medications utilizing
effective education techniques to include appropriate time and style for
counseling, use of patient education materials, assessment of patient
understanding, and documentation of educational activity.
2. Participate in the process and procedures utilized by the site in
monitoring medication safety.
3. Participate in the performance improvement of the medication use
system to include prescribing, transcription, dispensing, administration,
and monitoring.
4. Identify the appropriate monitoring parameters for drug therapy.
5. Participate in the process to ensure compliance with all legal,
regulatory, safety, and accreditation requirements.
6. Prepare and present a medication related patient case to the preceptor
and or staff.
7. Complete a project that involves an area of the medication use system
or addresses patient safety.
Second Year (P2) IPPE
The Accreditation Council for Pharmacy Education (ACPE) standards
and guidelines for the professional program in pharmacy leading to the
doctor of pharmacy degree, effective July 1, 2007, states the
curriculum must include introductory pharmacy practice experiences
(IPPE) of not less than 300 hours. At least 50% of IPPE must involve
actual practice experiences in community and institutional settings
and allow students under appropriate supervision assume direct
patient care responsibilities as permitted. The IPPE’s should begin
early in the curriculum, and correlate with the didactic course work
providing an introduction to the profession, and leading toward entry
into the advanced pharmacy practice experiences (APPE).1 The
Northeastern Ohio University College of Pharmacy established a theme
based IPPE program to meet this ACPE standard.
The goal of the P2 IPPE is for the student to be exposed and to gain
experience in the process of filling and dispensing prescriptions.
• Site visits begin in the fall and extend throughout the entire second
year of the professional curriculum.
• Students visit a total of three sites in practice settings to include
community, institutional, and an elective setting.
• Students visit each site twice a week (two four hour mornings) for eight
weeks.
• Objectives for visits focus on the theme of “Medication Use Systems”:
1. Determine the process utilized for dispensing medications by the site.
2. Participate in the prescription filling and dispensing process.
3. Demonstrate the ability to counsel patients on the selection and use of
OTC products.
4. Assist in the provision of medications to the underserved patient.
5. Recognize the role of various health care practitioners in the acquisition,
distribution, and administration of medications.
Student Time
At Each Site
(Hr)
Number
of Sites
P1 IPPE
12
6
72
121
P2 IPPE
64
3
192
74
P3 IPPE
64
Total Student
On Campus
Site Time Per Practice Related
Year (Hr)
Experience (Hr)
3
Total
192
30
456
225
Total On Campus and Site Hours
681
Practice Settings
Practice Setting Type
• The student is assessed by the preceptor on their ability to complete
each objective of the IPPE.
• Additional assessment criteria include: Attendance, Professionalism,
and Commitment to Learning.
• Each criteria is assessed as Unsatisfactory, Needs Improvement, or
Satisfactory.
• A reflective essay is required by the student at the end of each visit.
Preceptor
• Students complete an evaluation of the preceptor and site at the end
of each visit.
• Preceptors are evaluated on the following criteria: Interest,
Communication, Enthusiasm, Professionalism, Teaching, Training and
Resources.
• Students are also allowed to recount what he/she liked or disliked
about the preceptor or site, provide suggestions on how the IPPE
program can be improved, and how the IPPE was helpful in preparing
them for the profession of pharmacy.
Results
The following are some of the common remarks from the student evaluations
of the IPPE program:
“The IPPE program provides an opportunity to observe and experience a
variety of different practice settings beyond just community or hospital
practice.”
“The visits are helping to prepare one to practice as a competent professional
pharmacist.”
IPPE Hours
Medication Use Systems
Introduction
Assessment
Number
Accepting
Students
Community – Chain
71
Community - Independent
31
Institutional (Hospital)
37
Other/Elective (Managed Care, Long-Term
Care, Federal, Compounding, Home Infusion,
Industry)
36
“We are able to apply what is learned in the classroom to a real-world practice
setting.”
“Learning the basic skills of practice including dispensing and inventory related
activities provides a very good foundation to more advanced learning.”
“Increase amount of time during experiences to allow for more advanced
learning.”
“A formal list of responsibilities and tasks the student will accomplish while at
the site improves the overall experience.”
Suggestions from students for improvement to the IPPE program:
“Students should be able to spend less time performing inventory related tasks
and more time on patient counseling and clinical tasks.”
“Better utilization of downtime at practice settings by having students participate
in more of the tasks performed by pharmacists.”
Summary
The theme based IPPE program provides students with real-world
experiences in a variety of pharmacy practice settings which correlate
with the didactic classroom work and expand upon each other leading to
APPE.
References
1. Accreditation Council for Pharmacy Education. (2007). Accreditation standards and
guidelines for the professional program in pharmacy leading to the doctor of pharmacy
degree. Retrieved June 2, 2009, from http://www.acpe-accredit.org/standards/default.asp