Academic journal article American Journal of Pharmaceutical Education

Swedish Students' and Preceptors' Perceptions of What Students Learn in a Six-Month Advanced Pharmacy Practice Experience

Academic journal article American Journal of Pharmaceutical Education

Swedish Students' and Preceptors' Perceptions of What Students Learn in a Six-Month Advanced Pharmacy Practice Experience

Article excerpt

INTRODUCTION

As described in World Health Organization (WHO) and International Pharmaceutical Federation (FIP) reports, pharmacists have many different roles: caregiver, decision-maker, communicator, manager, lifelong learner, teacher, researcher, and leader. (1,2) The development of pharmacy practice has changed the work demands on pharmacists (3-5) as well as led to an increased focus on patient care (2,5-9) and reevaluation of pharmacists' professional knowledge. The pharmacy curriculum, including advanced pharmacy practice experiences (APPEs), needs to prepare students for this work life, (10,11) thus, APPE content has to be in line with the different roles mentioned above. (In Sweden, the APPE is similar to a combination of introductory pharmacy practice experiences (IPPEs) and APPEs in the United States, pharmacy internship in the Nordic countries, and preregistration training in the United Kingdom.)

Pharmacy curricula in Europe are aligned with the European Consortium (EC 2005/36), which states that at least 6 months of pharmacy practice experiences in community pharmacy. (12) The desired outcomes for an APPE are often described in terms of attainment/mastery of technical skills and increased professionalism. (13-15) Learning at a workplace is more multifaceted than that in formal education in a higher education institution setting in that a wide variety of knowledge and skills can be obtained. (5,16,17) The APPE is supposed to contribute to the transition between theoretical knowledge and professional work; hence, the outcome of an APPE is much more than just the skills developed.

The Learning in Nursing, Engineering and Accountancy (LINEA) project is a large study of novices learning at work during their first years of employment. (18-21) The project was based on empirical studies of novices in these 3 professions, identifying their perceptions of learning in the workplace. (19) Results from the study can be used as a typology (hereafter referred to as the LINEA typology) for possible outcomes of informal learning in work (ie, learning that occurs in daily work outside organized learning activities). (18-21) In the LINEA typology, the learning outcome categories are not workplace-specific but rather generic in nature, which makes comparisons possible across different health professions settings. The typology consists of 8 main categories: task performance, awareness and understanding, personal development, teamwork, role performance, academic knowledge, decision making, and judgment--all with several subcategories (Table 1). (19) Even though the categories originate from studies of early career learning, they may be applicable to studies of APPE learning, as newly employed graduates and APPE students share many common traits. During APPEs, students are introduced to work similarly to early career learning. However, in practice settings, pharmacy students are "peripheral participators" and do not have the same responsibilities as a newly graduated licensed pharmacist entering practice. (16) The typology also might support the identification of what is learned during an APPE. The solid empirical and theoretical reasoning behind the LINEA typology make it suitable as a framework for studying what pharmacy students learn during their APPE.

Pharmacy students' need to develop professionalism has been thoroughly discussed in North America, stressing the importance of professional skills, social skills, and knowledge (10,15,22) The outcomes of APPEs in North America have been evaluated based on standards (23) or professional perspective. (24,25)

While learning outcomes for an APPE are stated and assessed in educational practice, little qualitative research has focused on students' and preceptors' perspectives on what is learned during an APPE. A broader understanding of what students learn during the APPE is essential for further developing APPE curricula. The objective of this study was to identify and analyze, from the perspective of students and preceptors, what students learn during the APPE in Sweden. …

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