This advanced pharmacy practice experience (APPE) provides clinical pharmacy activity on a variety of adult medicine inpatient services. It exposures students to a variety of disease states, allowing them to actively participate in drug therapy monitoring and the therapeutic decision-making process. Additional competencies to be achieved during this APPE include: (1) how to develop a problem list, (2) how to present a patient, (3) how to develop and implement a monitoring plan, (4) how to take a medication history, (5) how to respond to a drug information request, and (6) a review of the policies and procedures at the institution.
The experience in acute care is designed to provide student pharmacists with advanced training and experience in the inpatient management of patients with a wide variety of acute illnesses. The experience will allow students to apply didactic knowledge to patient care and build general professional abilities developed in the preceding professional years. Also, the experience is designed to instill in the student an appreciation for how pharmacists are integrated into an interdisciplinary team in order to assist in optimizing pharmaceutical care.
This course is scheduled to meet for one calendar month with a minimum of 160 hours spent on activities directly related to the objectives identified below. The preceptor has the authority to determine specific meeting time parameters within the aforementioned schedule. See the PCSP Bulletin (p.31) for the Experiential Policy for Attendance and Absence.
Hours: State hours the student is to be on site, including situations where student may need to stay after hours. Specify lunch & departure times. Time at lunch does not count toward hours spent at site. Daily Schedule/Assignment Calendar: Provide daily schedule indicating when different activities or breaks may take place. Include time to meet with the student to discuss the student’s performance and make recommendations for improvement. Attach a weekly calendar.
Pre-Arrival Instructions & Logistics for Students:
Describe or outline specific department or site requirements. For example, “HIPPA training to be conducted by district office or PIC on Day 1 of rotations.”
List information such as directions to facility, parking instructions, and other site requirements.
Provide information (links or attached reading material) about any topics that the student should review prior to the start of the rotation.
Acute Care APPE Objectives/Goals:
Communication: The student will demonstrate effective written and verbal communication skills.
Evidence-based Decisions in the Practice of Pharmacy: The student will demonstrate competency in using drug information skills to promote evidence-based practices.
Problem Prevention and Solving: The student will effectively evaluate information and critically think through issues to provide appropriate solutions to drug-related problems.
Providing Pharmaceutical Care to Individual Patients: The student will exercise appropriate clinical judgment to provide optimal pharmaceutical care to patients with common disease states.
Inter-professional Interaction and Teamwork: The student will demonstrate effective interpersonal and team behaviors in a variety of social and professional situations and circumstances.
Ethical and Legal Judgment: The student will recognize the ethical dimensions of pharmacy practice and health policy; identify alternatives in difficult ethical choices; analyze systematically the conflicting considerations supporting different alternatives; and formulate, defend, and effectively carry out a course of action that takes account of these ethical complexities. The student will combine a willingness to recognize the nature of the value systems of patients and others with commitment to his/her own system and the ethical choices necessary to maintain his/her own ethical integrity.
Acute Care APPE Competencies:
Experiential activities are matched to the PC 12 Competencies, which are based on the ACPE competencies. Using the aforementioned objectives as a guide, consider student activities applicable to your practice setting; then to standardize student achievement for your experience, use specific metrics when assessing competence. PC 12 COMPETENCIES:
Evidence-based Decisions in the Practice of Pharmacy
Problem Prevention and Solving
Dispensing of Pharmaceuticals
Providing Pharmaceutical Care to Individual Patients
Providing Pharmaceutical Care to Patient Populations
Each student must complete at least one activity from competencies 1-4 shown below and all components of competencies 5 and 6 in order to successfully complete the Acute Care APPE:
Performs patient counseling without excessive assistance from preceptor
Presents a patient case presentation which includes all relevant information, demonstrates a thorough understanding of the presented disease states, and is able to defend his/her recommendations with regards to therapeutic options
Completes a journal club by presenting a study and being able to describe the targeted patient population, use of statistics, strengths, weaknesses, and applicability to clinical practice
Presents an in-service/noon conference, which is delivered to healthcare providers in a professional manner, including accurate and cited information
Provides interdisciplinary educational sessions/presentations which provide information to a medical team, patients, or other disciplines which is appropriate with regards to audience
Explains rationale for drug therapy recommendations
Evidence-based Decisions in the Practice of Pharmacy:
Responds correctly and in a timely fashion to a drug information question either verbally or in writing
Utilizes guidelines and evidence based medicine for therapy recommendations
Presentation of professionally worded recommendations to treatment team, preceptor, and colleagues
Student arrives to APPE on time and completes tasks in the allotted time
Student is appropriately dressed and tidy
Student is respectful towards patients
Ethical and Legal Judgment:
The student is able to adjust his/her pharmaceutical plan according to the patient’s religious or cultural beliefs as well as socioeconomic status and funding options
The student is aware of funding status of all patients
The student abides by hospital policies and HIPAA regulations regarding patient privacy and protected health information
The student pharmacists on an Acute Care APPE will be assessed for achieving the APPE objectives and competencies subjectively and objectively by the preceptor. Preceptors are to evaluate the student based on objective materials and subjective assessment and are required to complete a formative mid-point evaluation and a summative final evaluation using E-Value.
(OPTIONAL) Objective evaluations may include, but are not limited to:
The optional objective evaluation forms identified above are available to preceptors who choose to utilize them. The subjective assessment shall include the competencies as determined by the Office of Experiential Education at Presbyterian College School of Pharmacy. Students will receive a letter grade as determined in the final evaluation. To satisfactorily complete the Acute Care APPE, students must receive a grade of C or higher, complete the competency checklist, and upload the requested materials in their online portfolio (My Folio).
Grading Scale: 93 - 100% A
90- 92% A-
87 - 89% B+
83 - 86% B
80 - 82% B-
77- 79% C+
70- 76% C
60- 69% D
(Grading scale approved by PCSP faculty)
Level of Student Responsibility
The student on an Acute Care APPE is expected to have face-to-face interaction with patients and interdisciplinary healthcare teams under the supervision of a pharmacist preceptor or a healthcare provider. The student is expected to interact in a professional manner with other healthcare professionals and patients.
Type of Setting for APPE
An Acute Care General Medicine rotation should occur in an inpatient setting where a multi-disciplinary team of healthcare professionals, utilizing pharmacologic and other means, provides clinically based patient care.
Student Professionalism and Code of Conduct
A student pharmacist on an Acute Care APPE is expected to follow the rules, policies and procedures pertaining to the honor code and professional standard at Presbyterian College School of Pharmacy. Any violation of the Honor Code (e.g., cheating, plagiarism, falsification, withholding information, tampering with records, etc.) or the professional standards (e.g., unprofessional behavior, including tardiness, absences, behavior, appearance, etc.) will be reported immediately upon discovery and will be dealt with per Presbyterian College School of Pharmacy policy and procedure. See Student Bulletin for full details of this policy.
Any student pharmacist on an Acute Care APPE who has a disability that may prevent him/her from fully demonstrating his/her abilities should inform the preceptor personally as soon as possible to discuss accommodations necessary to ensure full participation and facilitate his/her educational opportunities.
Student Responsibilities During Experience
Please detail specific competency-based student activities as needed. Apply, edit, delete, and/or replace those examples listed below as you deem appropriate, being sure to offer specific direction/instruction to the student. All assignments should be completed on time. Activities and presentations may include but are not limited to
New drug presentation
Drug comparison charts or tables
Patient case presentations
Teaching a staff/department education topic
Pharmacy team in-service
Development and/or implementation of a pharmacy service