Academic journal article American Journal of Pharmaceutical Education

An Elective Course on Current Concepts in Adult Ambulatory Care

Academic journal article American Journal of Pharmaceutical Education

An Elective Course on Current Concepts in Adult Ambulatory Care

Article excerpt


For more than a decade, ambulatory care has been a growing area of clinical pharmacy practice, and projections indicate a need for more than 165 000 pharmacists in this setting by 2020. (1) Even though some analyses suggest that the overall availability of pharmacist jobs is declining, leaving some recent graduates without an immediate career opportunity, (2) the need for ambulatory care pharmacists continues to be high. (3) The continual decline in the number of primary care physicians and the increasing health care needs of an aging population create a gap in primary care services that pharmacists are well positioned to fill. (4,5) The Center for Advancement of Pharmacy Education (CAPE) 2013 Educational Outcomes highlighted this opportunity for pharmacists and contained domains and objectives that apply directly to ambulatory care pharmacy practice (Domain 2: Essentials for Practice and Care; Domain 3: Approach to Practice and Care). (6) With 2 of the 4 domains described in the CAPE 2013 Outcomes focusing on objectives that pertain to ambulatory care pharmacy, it is clear that a greater emphasis is being placed on this component of pharmacy practice. As a result, colleges and schools of pharmacy must find a way to incorporate ambulatory care education into their curriculum.

The need for ambulatory care-focused education was historically met through the creation of elective courses. Multiple electives were developed that focused on specific topics such as diabetes, (7-11) anticoagulation management, (12,13) and cardiovascular disease. (14,15) Other electives encompassed ambulatory care concepts that may apply to multiple disease states but only focus on particular aspects such as lifestyle modifications (16-19) or management within the geriatric population. (20-22) Few ambulatory care or primary care electives described in the literature combined topics on a wide variety of disease states and other necessary ambulatory care clinical skills such as effective patient interviewing, careers and training in ambulatory care pharmacy, application of primary literature to patient care, etc. (23-26) The purpose of this paper is to describe an innovative elective course that covers a broad range of ambulatory care-related disease states, while incorporating patient care skills and fostering a mindset of continual learning.


In 2011, an elective course called Current Concepts in Adult Ambulatory Care Pharmacy was developed for third professional year doctor of pharmacy (P3) students. The elective focused on multiple commonly encountered disease states in adult ambulatory care pharmacy practice such as diabetes, hypertension, cardiovascular risk reduction through obesity management, pulmonary disorders, anticoagulation (arterial and venous), and heart failure. The curriculum provided no class with as broad of a focus on ambulatory care topics as this elective would provide, nor had any class been taught using similar learning strategies and approaches. IRB exemption was received for the use of course surveys and evaluations.

The course was developed with 2 primary goals: (1) to increase student ability to apply relevant concepts from primary literature to clinical practice through the discussion and understanding of landmark trials relevant to ambulatory care pharmacy; and (2) to promote in a learner-directed manner a continual learning mindset outside of the classroom environment through the introduction of external pharmacy resources and primary literature.

Specific learning objectives were developed to achieve these goals including development of techniques for critical evaluation and effective presentation of ambulatory care pharmacy literature, identification of relevant literature and guidelines used to support or refute currently accepted practice in ambulatory care, and identification of effective strategies for patient interview and promotion of medication adherence (see Table 1 for all learning objectives). …

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