Academic journal article American Journal of Pharmaceutical Education

Patient Simulation to Demonstrate Students' Competency in Core Domain Abilities Prior to Beginning Advanced Pharmacy Practice Experiences

Academic journal article American Journal of Pharmaceutical Education

Patient Simulation to Demonstrate Students' Competency in Core Domain Abilities Prior to Beginning Advanced Pharmacy Practice Experiences

Article excerpt


The Accreditation Council for Pharmacy Education (ACPE) has identified 11 core domain competencies and abilities that pharmacy students should demonstrate prior to starting their APPEs. (1) ACPE has indicated that a majority of these competencies can be demonstrated within the IPPE, but colleges and schools may use other modalities instead of or in addition to IPPEs, such as simulations, practice laboratories, and objective structured clinical examinations (OSCEs). While IPPEs represent an ideal platform to demonstrate these competencies, it is difficult for colleges and schools of pharmacy to ensure that the IPPEs provide the experiences necessary to truly determine that the student has achieved minimal competencies in these core domains and abilities. In addition, there is little opportunity for remediation should the student fail to demonstrate minimal competencies. To elicit these competencies, students must be immersed in clinical situations that allow the educator to assess students' abilities in a consistent and controlled environment. Patient simulation is a tool that can be used to create a consistent environment using predetermined case scenarios that accurately measure a student's competency in various arenas. In the past 2 decades, simulation has been adopted in a wide spectrum of healthcare education and training programs to improve the quality of patient care and enhance patient safety. Worldwide, universities have been using state-of-the-art healthcare simulation techniques to train healthcare professionals in a range of areas including anesthesia, emergency medicine, intensive care, pain service, radiology, and surgery. Simulation training provides an intensive and interactive learning environment for interdisciplinary communication, collaboration, and crisis management among healthcare team players, such as physicians, pharmacists, and nurses. (2-20) The impact of simulation on pharmacy students has been demonstrated in pharmacy education, including in various clinical arenas. (9-20) For example Seybert and colleagues successfully used simulation to teach blood pressure technique and to reinforce concepts in a pharmacotherapy course, while Mieure used simulation to teach advanced cardiac life support (ACLS) basics. (18,19) Seybert and colleagues also described a hybrid acute-care elective course that used online learning modules and 3 simulation exercises per week, and resulted in significant increases in knowledge, pre- and post-simulation, on 9 out of 10 tests (p [less than or equal to] 0.05). (20) Although simulation has been used in a variety of training settings for pharmacy students, its role in assessing and remediating ACPE, pre-APPE core domain competencies has not been defined.

In this paper, we describe a 3 -week, 60-hour simulation-based IPPE that incorporated scenarios and experiences in multiple arenas, such as the emergency department, community pharmacy, acute care setting, immunization clinic, medication therapy management (MTM) setting, and intravenous (IV) medication compounding laboratory, to teach and assess 10 out of the 11 pre-APPE core competencies. The primary emphasis of this IPPE was to teach patient safety concepts and reinforce human fallibility.


California Northstate University College of Pharmacy enrolls 90 to 100 doctor of pharmacy (PharmD) students per academic year. Students are required to complete 300 hours of IPPE within the immediate Sacramento region. Twenty-eight students in their third year of the program were randomly assigned to the simulation IPPE, while the other 60 were assigned to various traditional IPPE practice sites in the community. Five clinical faculty members were involved in the simulation IPPE and served as content experts and observers during each simulation session.


The course solely used a mock pharmacy, standardized patient and familiy members, and high fidelity simulation. …

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