Development and Implementation of a Theme Based Introductory Pharmacy Practice Experience (IPPE) Program S. Scott Wisneski, Pharm.D., MBA, Louis D. Barone, Pharm.D., Susan P. Bruce, Pharm.D., BCPS Robb W. McGory, MS, Pharm.D. & David D. Allen, R.Ph., Ph.D., FASHP Northeastern Ohio Universities College of Pharmacy Third Year (P3) IPPE Patient Safety The goal of the P3 IPPE is for the student to understand the processes and systems utilized to achieve appropriate medication outcomes in the patient. Similar to the P2 visits, P3 students begin their visits in the fall and extend throughout the entire third year of the professional curriculum. Students visit a total of three sites in practice settings to include community, institutional, and an elective setting. Students visit each site twice a week (two four hour afternoons) for eight weeks. Objectives for visits focus on the theme of “Patient Safety”: 1.Demonstrate the ability to counsel patients on medications utilizing effective education techniques to include appropriate time and style for counseling, use of patient education materials, assessment of patient understanding, and documentation of educational activity. 2.Participate in the process and procedures utilized by the site in monitoring medication safety. 3.Participate in the performance improvement of the medication use system to include prescribing, transcription, dispensing, administration, and monitoring. 4.Identify the appropriate monitoring parameters for drug therapy. 5.Participate in the process to ensure compliance with all legal, regulatory, safety, and accreditation requirements. 6.Prepare and present a medication related patient case to the preceptor and or staff. 7.Complete a project that involves an area of the medication use system or addresses patient safety. Abstract Objective: To create an IPPE program based on three distinct yearly themes with the goal to provide exposure to multiple pharmacy practice settings and to develop the student’s skills gradually throughout the curriculum. Methods: First professional year students are required to complete 72 hours of experiential training focused on the theme of “Dosage Forms” at six practice settings. Second year students complete 192 hours of training focused on the theme of “Medication Use Systems” at three practice settings. In the third year the students complete an additional 192 hours of training at three practice settings focusing on the theme of “Patient Safety”. Specific goals and objectives of the program were developed based on the theme for each year of the experiential program. Training on the program themes and objectives were provided to the students and the preceptors. Preceptors and students completed evaluations on the program following each rotation. Results: Since the start of the program in January 2008 two classes completed the first year and one class completed the second year of the theme based IPPE program. Results of preceptor and student evaluations have been largely positive, particularly related to gradual skill development of the student and the structure of the program overall. Implications: A unique theme based IPPE program can be a successful method to provide pharmacy students with IPPE training to develop skills needed for the advanced practice experiences. Introduction The Accreditation Council for Pharmacy Education (ACPE) standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree, effective July 1, 2007, states the curriculum must include introductory pharmacy practice experiences (IPPE) of not less than 300 hours. At least 50% of IPPE must involve actual practice experiences in community and institutional settings and allow students under appropriate supervision assume direct patient care responsibilities as permitted. The IPPE’s should begin early in the curriculum, and correlate with the didactic course work providing an introduction to the profession, and leading toward entry into the advanced pharmacy practice experiences (APPE). 1 The Northeastern Ohio University College of Pharmacy established a theme based IPPE program to meet this ACPE standard. Assessment Student The student is assessed by the preceptor on their ability to complete each objective of the IPPE. Additional assessment criteria include: Attendance, Professionalism, and Commitment to Learning. Each criteria is assessed as Unsatisfactory, Needs Improvement, or Satisfactory. A reflective essay is required by the student at the end of each visit. Preceptor Students complete an evaluation of the preceptor and site at the end of each visit. Preceptors are evaluated on the following criteria: Interest, Communication, Enthusiasm, Professionalism, Teaching, Training and Resources. Students are also allowed to recount what he/she liked or disliked about the preceptor or site, provide suggestions on how the IPPE program can be improved, and how the IPPE was helpful in preparing them for the profession of pharmacy. Results The following are some of the common remarks from the student evaluations of the IPPE program: “The IPPE program provides an opportunity to observe and experience a variety of different practice settings beyond just community or hospital practice.” “The visits are helping to prepare one to practice as a competent professional pharmacist.” “We are able to apply what is learned in the classroom to a real-world practice setting.” “Learning the basic skills of practice including dispensing and inventory related activities provides a very good foundation to more advanced learning.” “Increase amount of time during experiences to allow for more advanced learning.” “A formal list of responsibilities and tasks the student will accomplish while at the site improves the overall experience.” Suggestions from students for improvement to the IPPE program: “Students should be able to spend less time performing inventory related tasks and more time on patient counseling and clinical tasks.” “Better utilization of downtime at practice settings by having students participate in more of the tasks performed by pharmacists.” References 1. Accreditation Council for Pharmacy Education. (2007). Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree. Retrieved June 2, 2009, from Second Year (P2) IPPE Medication Use Systems The goal of the P2 IPPE is for the student to be exposed and to gain experience in the process of filling and dispensing prescriptions. Site visits begin in the fall and extend throughout the entire second year of the professional curriculum. Students visit a total of three sites in practice settings to include community, institutional, and an elective setting. Students visit each site twice a week (two four hour mornings) for eight weeks. Objectives for visits focus on the theme of “Medication Use Systems”: 1.Determine the process utilized for dispensing medications by the site. 2.Participate in the prescription filling and dispensing process. 3.Demonstrate the ability to counsel patients on the selection and use of OTC products. 4.Assist in the provision of medications to the underserved patient. 5.Recognize the role of various health care practitioners in the acquisition, distribution, and administration of medications. First Year (P1) IPPE Dosage Forms The primary goal of the P1 IPPE is for the student to gain exposure to a variety of practice settings and to begin the process of professional orientation to attitudes, values and behaviors expected in pharmacy practice. Site visits take place during the winter and spring of the first year in the professional curriculum. Students visit a total of six sites in practice settings to include community chain, community independent, institutional, and three “other” settings. Students visit each site once a week (four hours in the afternoon) for three weeks. Objectives for these visits focus on the theme of “Dosage Forms”: 1.Determine the scope of pharmacy services provided by the practice site. The student will complete a site profile questionnaire which describes the nature of the site. 2.Identify pharmaceuticals commonly utilized and dispensed at the site. 3.Identify pharmaceutical packaging needs, storage requirements, expiration dating, handling, and preparing product for dispensing. 4.Identify various dosage forms of pharmaceutical products. 5.Participate in the dispensing process for the site. 6.Participate in the inventory management process for the site. Student Time At Each Site (Hr) Number of Sites Total Student Site Time Per Year (Hr) On Campus Practice Related Experience (Hr) P1 IPPE P2 IPPE P3 IPPE Total Total On Campus and Site Hours 681 IPPE Hours Practice Setting TypeNumber Accepting Students Community – Chain71 Community - Independent31 Institutional (Hospital)37 Other/Elective (Managed Care, Long-Term Care, Federal, Compounding, Home Infusion, Industry) 36 Practice Settings Summary The theme based IPPE program provides students with real-world experiences in a variety of pharmacy practice settings which correlate with the didactic classroom work and expand upon each other leading to APPE.