Academic journal article American Journal of Pharmaceutical Education

A Systematic Meta-Ethnographic Review of the Beneficial Outcomes of International Internships to Student Pharmacists

Academic journal article American Journal of Pharmaceutical Education

A Systematic Meta-Ethnographic Review of the Beneficial Outcomes of International Internships to Student Pharmacists

Article excerpt

Objective. To describe the benefits that pharmacy students gain by completing international internships as a part of their pharmacy education.

Methods. A systematic literature search was conducted from database inception to November 2016. Articles that reported on any measure of outcome or impact on student learning were included in the study. A meta-ethnographic approach was used to translate and synthesize findings.

Results. Analysis of the reported outcomes produced nine distinct themes: cultural awareness, collaboration, communication, clinical skills, knowledge, adaptability, compassion, confidence, and personal growth.

Conclusion. Pharmacy students experienced many benefits that align with program competencies. The most frequently described benefits were development of clinical skills and compassion.

Keywords: pharmacy, medical education, culture, international, internship


Canadian and American accreditation standards require that experiential learning be a significant component of first degree (bachelor's or PharmD) pharmacy education. (1,2) The AccreditationCouncilforPharmacy Education (ACPE) in the US requires 300 hours of introductory pharmacy practice experience and 1440 hours of advanced pharmacy practice experience. (1) Similarly, the Canadian Council for Accreditation Pharmacy Programs (CCAPP) requires 1600 hours of experiential education for PharmD and 640 hours for bachelor's degree students. (2) These bodies also mandate students to be exposed to diverse practice settings and patient groups. ACPE states that core rotations should take place in a domestic setting so students are prepared to practice in the US, but elective rotations may be completed internationally. (1)

The concept of global health education is becoming increasingly common and numerous descriptions of international rotations for pharmacy students have been published. Cultural competence is also being recognized as a necessary skill for pharmacists and other health care providers. (3) Cultural competency in the health care setting is an ongoing process that requires cultural awareness, cultural knowledge, cultural skill, cultural encounters and cultural desire. (4) Furthermore, cultural encounters should not be limited to a few patients of a certain background; students should be exposed to many patients to appreciate diversity within a perceived cultural group. Both the ACPE and CCAPP, who set standards for pharmacy programs in the US and Canada, require students to be competent in a culturally diverse setting. (1,2) Various educational methods to increase the cultural competence of health care providers have been described in the literature. Formats investigated include lectures, discussion groups, case scenarios, interviews, role-play, clinical experiences and cultural immersion. (3) However, cultural competency is not something that can be easily learned or assessed. Immersive experiences, including educational rotations in a culturally diverse setting, appear to be an ideal method to achieve cultural competency.

A systematic review of the medical literature demonstrated that completion of international electives leads to increased diagnostic skill, confidence and cultural competence in medical students. (5) Similarly, some pharmacy programs have developed international rotations for their students to address the development of cultural competency. (6-8) Despite the wide uptake of these rotations with this objective, their utility in helping pharmacy students develop skills and competencies required for pharmacy practice has yet to be systematically reviewed. In fact, other potential benefits of international rotations to the pharmacy students who complete them, to the collaborating institutions, or to the patients treated have yet to be systematically quantified or synthesized. This review will describe the benefits that pharmacy students gain from completing international rotations (outside the country of the educational institution) as a part of their pharmacy education. …

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