Academic journal article American Journal of Pharmaceutical Education

Sequencing of Simulation and Clinic Experiences in an Introductory Pharmacy Practice Experience

Academic journal article American Journal of Pharmaceutical Education

Sequencing of Simulation and Clinic Experiences in an Introductory Pharmacy Practice Experience

Article excerpt


The Accreditation Council for Pharmacy Education (ACPE) requires that almost one-third of the doctor of pharmacy (PharmD) curriculum consists of experiential education, which is delivered in introductory pharmacy practice experiences (IPPEs), followed by advanced-pharmacy practice experiences (APPEs), the latter traditionally delivered in the final year of a pharmacy program. Unlike APPEs that have been in place for many years, colleges and schools of pharmacy have implemented IPPEs differently as their needs dictate and curricula allow. Regardless of how a school incorporates IPPEs into their curriculum, ACPE requires that students participate in them for a minimum of 300 hours. (1)

While implementation of IPPEs differs, schools of pharmacy have likely faced similar challenges. First and foremost is the challenge of developing and maintaining capacity to meet the needs of student placement. This includes accounting for the number of sites, monitoring student-to-preceptor ratios, and maintaining the proper diversity of sites to meet accreditation requirements. (2-5) Along with these challenges, experiential directors must be vigilant about "preceptor burn-out," which could be exacerbated by the need for sites and preceptors to provide students with experiences at both the IPPE and APPE levels. Identifying sites and preventing preceptor burnout can be particularly challenging when multiple pharmacy schools are using the same preceptor pool. (2) Schools of pharmacy also are tasked with fitting IPPEs into the curriculum as seamlessly as possible, which may be a significant scheduling challenge.

As of 2011, ACPE allows pharmacy schools to use structured simulation to help meet IPPE goals and objectives. Simulation is defined by ACPE as, "an activity or event replicating pharmacy practice." In the accreditation standards, ACPE further states, "For the purpose of satisfying introductory pharmacy practice experience expectations, simulation may include use of high-fidelity manikins, medium-fidelity manikins, standardized patients, standardized colleagues, role play, and computer-based simulations. Simulation as a component of introductory pharmacy practice experiences should clearly connect the pharmacy activity or delivery of a medication to a patient (whether simulated patient, standardized patient, or virtual patient)." (1)

Simulation can account for up to 60 hours of the 300-hour requirement. (1) It provides the opportunity for students to participate in controlled activities without the variation naturally present in real life environments. (2) This control permits a certain level of consistency to be built into an IPPE. Although endorsed as a viable component of IPPE by ACPE, a lack of published evidence pertains to simulation as an effective education component of an IPPE in pharmacy curricula. (2) A recent survey assessed the status of simulation-based teaching methodologies (referring to the use of high-fidelity manikins and standardized patients) in US schools of pharmacy. Seventy-four out of 88 schools participating in the survey reported using simulation. Several of the 14 schools that reported not using simulation, did report using role play (n= 12), partial-task trainers (n=7), and low-fidelity manikins (n=6). Only 29.7% of the schools participating in the survey reported using simulation for IPPEs. (6)

Two schools of pharmacy looked at the effects of participation in simulation activities on knowledge and skills. In 2010, University of Missouri-Kansas City School of Pharmacy described incorporating 9 hours of high-fidelity simulation involving 3 acute care cases into a longitudinal clinical IPPE that students on a satellite campus were completing in the fourth year of a 5-year professional program. (7) Twenty-eight students participated in the simulation activities, and 27 completed all accompanying assessments. Students completed a quiz prior to participating in each simulation session and again after to assess whether knowledge was improved through participation. …

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