5 Quick Tips to Create a Transformative Advanced Pharmacy Practice Experiences Rotation

Experienced pharmacists open their practices to students throughout the year as preceptors.They teach about their setting, best practices, and provide feedback to students on their professional skills. Often, the focus is on the educational development of the student to introduce them to the practice site and focus on direct patient care.

However, what many preceptors may not realize is that in addition to learning about practice settings, all graduates of pharmacy schools in the United States must also be able to demonstrate leadership, innovation, and entrepreneurship.¹ At the same time, pharmacy practice is rapidly changing in many settings to a more value-based care model.

Specifically, community pharmacies are offering more clinical and outreach services, which brings a substantial amount of work, including writing new protocols, staff training, comparing vendor options, and determining the exact needs of the community or provider.

Restructuring the experience of students completing Advanced Pharmacy Practice Experiences (APPE) can be a viable mechanism to assist preceptors in transforming (e.g., expanding or improving) their practice, in addition to giving students opportunities to practice leadership, innovation, and entrepreneurship.

Consider restructuring your APPE to provide students with a one-of-a-kind learning experience especially during periods of transition, growth, or transformation. Exposing students to building sustainable business practices, management, and clinical service development, in addition to meeting any requirements or objectives from the college of pharmacy will enhance students’ learning.

These experiences will help them to be successful practitioners in this rapidly changing health care system, regardless of the practice setting they choose after graduation.

We share 5 quick tips to start enhancing your rotations to be a tool in transforming your practice.

Tip #1: List Your Big Goals For Your Practice

First, reflect and identify the areas you would like to see your practice grow, advance, or transform. Think about current programs and services. Is workflow streamlined for delivery and documentation? Do you have the capacity to grow?

Consider new opportunities you would like to pursue or your biggest hurdles or challenges you would like to overcome. Then, prioritize your goal list for those most appropriate for student participation.

For each big goal, write a description that includes measurable elements for demonstrating optimization.

Example: To train 3 staff in point-of-care testing and launch the service in the next 6 months.

Setting out a plan for major projects is a great way to mobilize your transformation and move items off your wish list. Identifying and prioritizing the big goals for your practice will help guide the activities and tasks you can incorporate into your APPE.

Further tips below detail how best to do this. It is also important to note that your big goals that are incorporated into the APPE will not, and should not, be solely reliant on students to maintain—but rather to jumpstart progress, build protocols, or educate staff.

The goal is to create sustainable change for the pharmacy while providing an enriched learning experience for the student. Finally, re-assessing your big goals on a yearly basis can keep your practice on the forefront as new opportunities arise.

Tip #2: Plan for Your “Year” of Students

APPE schedules are typically finalized and emailed to students and preceptors early each spring for the entire academic year. Including all preceptors at your location, determine how many months your practice will have students. Then consider how the rotation months will align with milestones of your big goals.

Example: For launching a point-of-care testing service in 6 months, your milestones may be submitting a Clinical Laboratory Improvement Amendment (CLIA) waiver in the first month, choosing and ordering testing supplies by month 3, and creating a protocol or workflow for the service by month 5.

Examining when you have students aligned with these milestones will help you in developing specific endpoints for each rotation—ones that students can tackle. This is what you will be asking the student to accomplish during their rotation (typically 4-6 weeks in length).

Example: In month 1, complete CLIA waiver application, review and present assessment of available tests, draft outline for patient intake forms.

The key to planning student activities is to be as realistic and specific as possible. There is not a predefined number of activities per student because it depends on the complexity of the big goal and each student’s stage of learning.

Ensure that the students are aware of your desired outcomes and deadlines (either in a syllabus or calendar) and schedule regular check-ins about the project. This helps students understand the big picture and enhances their learning experience.

Assisting in the details of a larger goal or project will align with student objectives from the college of pharmacy. These activities are crucial to teach leadership, management, and problem-solving.

Planning out milestones and tangible goals for students on rotation in a shareable manner is important. For example, keeping the outline of the big goal in a shared document that can be shared by the preceptor from one rotation student to the next. This can help with continuity of the project between APPE students and aid students on rotation in seeing the bigger picture of the project and their contributions.

Another great benefit of incorporating students to drive one of your big goals is the chance to try new things or a variety of approaches to see what fits best with your practice. Iteration is good and ultimately helps drive a better outcome.

For example, do you want to try a reminder call for appointments? Assign this to a student and have them report to you the outcome of the effort so you can decide if that was helpful. Remember, to sustain a new service, the students’ activities should help drive progress or answer an unknown, not to “own” the big goal.

Tip #3: Structure the Student’s Day

Set clear expectations early by creating a daily schedule for your student, split between pharmacy-related tasks and projects that will help you get to your big goal. This makes it clear to the student what they are allowed (expected) to be working on.

Example: Half-day dispensing workflow and patient care and half-day project time.

This could also be just one day per week, but regardless of the total number of hours, carve out dedicated time for the student to work on activities related to your big goal. Outline this expectation clearly in your syllabus and during orientation on the first day.

Another idea is to send students off-site to learn something new to bring back to your practice.Is there an event or presentation that you can’t attend but wanted to? Send students with actionable assignments to observe and bring back to your site. This is a great way to close knowledge gaps for pharmacy staff.

Example: New point-of-care testing regulations were just passed and are being presented at the Board of Pharmacy. Send student(s) to learn, summarize, and teach those to the staff.

Overall, dedicated project time for students means benefits for your pharmacy.

Tip #4: Request a Resource

Is there something you must explain over and over again to each new rotation student? Ask for help.

Faculty at colleges of pharmacy are skilled to create a “just-in-time” module, mini-presentation, or resource document to help you focus your time on application.

The Academia-CPESN Transformation (ACT) Pharmacy Collaborative is an active learning collaborative among colleges of pharmacy and community-based pharmacies committed to advancing community pharmacy practice. Local contacts are designated as ACT Champions.

Check out actforpharmacy.com/act-champions to see whether your local college of pharmacy has an ACT Champion listed. Consider reaching out to your local college of pharmacy’s ACT Champion to uncover mutual priorities and identify opportunities for collaboration and connection to resources.

Additionally, you can access worksheets and facilitated videos using a self-guided toolkit on the National Community Pharmacists Association (NCPA) website:² ncpa.org/advanced-community-appe-preceptor-resources.

Also included in this toolkit are some just-in-time modules about eCare Planning and the Community Pharmacy Enhanced Services Network, as well as a syllabus. There is a “Request a Resource” button on the bottom of the page you may use if you think of an additional resource that would benefit your practice.

Other possible sources of collaboration to support your APPE are NCPA student chapter advisors, state pharmacy organizations, and even your current Introductory Pharmacy Practice Experience (IPPE) or APPE students to create resources for future students.

Tip #5: Market Your Site

Colleges of pharmacy often provide opportunities to showcase your site to prospective students. Take advantage of these chances to showcase your staff, location, and big goals (whether that's via a live event, Zoom meeting, or by submitting materials such as a video or PowerPoint).

This has 2-fold benefits: it may encourage students to select your site over one that is closer or more familiar to them and it may also attract students particularly interested and passionate in the service(s) you hope to grow.

Some unique aspects you could promote are:

• Could housing be available for students coming to your rotation site, through individual connections or through a local health-system or college?
• Will they have the opportunity to network with other health professionals or health professions students?
• Is your local area known for anything non-pharmacy-related—for example, the best burgers in the state or a top-rated golf course?

Even if there is no formal opportunity to market your site to potential APPE students, here are some informal options:

• Create marketing materials for the student experience and upload them to your account in the college’s learning management system (i.e., CORE, eValue, etc.).
• Include information for students on your website or social media pages.
• Chat with the experiential education department about your site and big goals.
  • Students often seek mentoring from experiential education departments about site selection, so they may be able connect students interested in your practice setting and big goals with you.
• Inform your local college’s ACT Champion about your site and your big goals.
  • Students with particular interest in advancing community pharmacy practice are likely to seek out and work with faculty focused on community practice. ACT Champions may have students in mind that would be a good fit for your site.
• Overall, we encourage you to involve your APPE students during periods of transition, growth, and practice change activities. They are an incredible resource to help you establish a new practice or evaluate the effectiveness of your current services.

In addition, these experiences will prepare them for the challenges they will face as independent practitioners in the changing health care landscape.

References:

1. Accreditation Council for Pharmacy Education. 2016. Accreditation standards and key elements for the professional program in pharmacy leading to the Doctor of Pharmacy degree. Available at https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf. Accessed July 12, 2021.
2. Smith M, O’Connor S. Advanced Community APPE Preceptor Resources. National Community Pharmacists Association. https://ncpa.org/advanced-community-appe-preceptor-resources. Accessed July 13, 2021.

The ACT (Academia-CPESN Transformation) Pharmacy Collaborative is an operational learning and ACTing collaborative between 93 colleges/schools of pharmacy and clinically integrated networks of community-based pharmacies. The goal is to support the transformation of community-based pharmacy practice from a product-focused care model to a patient-centered care delivery model. The ACT Pharmacy Collaborative was founded by the University of Pittsburgh School of Pharmacy with grant funding from the Community Pharmacy Foundation and support from CPESN USA and AACP. The work of the Collaborative is guided by a task force of AACP Faculty Appointees, CPESN USA Appointees, and representatives from NCPA and ACCP. To learn more, visit:www.actforpharmacy.com or email us at:actforpharmacy@pitt.edu