The objective was to evaluate the growth in pharmacy student performance in entrustable professional activity (EPA) assessments across the experiential curriculum based on preceptor assessments on an entrustment–supervision (ES) scale. This retrospective cohort study used assessments based on the 2016 American Association of Colleges of Pharmacy Core EPAs and an expanded ES scale during introductory and advanced pharmacy practice experiences (IPPEs/APPEs) in the third and fourth professional years from fall 2020 to fall 2023. The primary outcome was the change in ES level, assessed by preceptors over time. The secondary outcomes were growth rates across types of experiences, training environments, and experience order. A conditional growth curve model and ordinal mixed effects model were used to demonstrate discrete entrustment decisions. A total of 509 students received 12,426 assessments by 557 preceptors. Raw ES levels and unconditional growth curves for EPA show increases in entrustability from years P3 to P4. Comparing care settings, there was lower entrustment in inpatient than outpatient settings and at academic medical centers than other settings. There were no significant differences in ES levels regardless of which IPPE was taken first. However, when the first APPE was an inpatient medicine experience, ES levels across APPEs for EPA 3 were higher when compared to ambulatory care as the first APPE, and they were higher for EPA 5 when compared to community pharmacy as the first APPE. Paired with ES scales, EPAs can be integrated into pharmacy experiential curricula to demonstrate longitudinal growth in student entrustment.
Background The maldistribution of pharmacy services in underserved areas is a national issue. Analysis of data from the 2019 National Pharmacist Workforce Study indicated that 13.9% of pharmacists were working in a rural community. However, the percentage of people living in rural communities in the United States is 20.0%.Currently, there are 20 rural pharmacy programs in the United States, including the Rural Pharmacy Education (RPHARM) Program at the UIC College of Pharmacy, which contain both didactic and experiential rural components. The purpose of this research project is to examine the postgraduate practice outcomes of the RPHARM Program. Methods Descriptive analysis was used to examine the practice outcome characteristics of RPHARM Program graduates between 2014 and 2023. The characteristics of the RPHARM graduates included the ruralities of hometowns, practice locations and populations, and distance of practice locations to hometowns. Rural practice outcomes were described utilizing frequently used rural definitions. The practice locations of 54 of the 61 RPHARM graduates were used in the analysis. Results Approximately 41% of the practicing RPHARM graduates were from rural hometowns and two-thirds were female. RPHARM graduates mostly work in either a community setting (44.4%) or a hospital setting (37.0%). Approximately 11% worked in a federal government organization and 5.6% worked in a long-term care pharmacy. When examining job movement, 37% of RPHARM graduates have always worked in a rural location as defined by the Federal Office of Rural Health Policy. However, 50% of RPHARM graduates have always worked in urban areas. Approximately 56% of practicing RPHARM graduates are working in a location < 50 miles from their hometown, and 13% are working 50 to 100 miles from their hometown. Approximately 74% of RPHARM graduates are practicing in Illinois. Conclusions Approximately 40% of RPHARM graduates practice in rural locations. A significant portion (37%) of RPHARM graduates have always practiced in rural locations, and many (55.5%) are practicing near their hometowns. Results indicate that the RPHARM Program is making meaningful contributions to increasing the rural pharmacy workforce. Due to the lack of information on rural pharmacy practice outcomes, all programs with rural pharmacy content are encouraged to track graduates’ practice locations.
OBJECTIVE:To explore advanced pharmacy practice experience (APPE) preceptor perspectives including implementation recommendations, barriers, and facilitators to using entrustable professional activity (EPA) assessment in pharmacy experiential education. METHODS:Two 90-min virtual focus group sessions were conducted to elucidate preceptor perspectives on EPA integration into APPEs through semistructured discussion. Preceptors with experience utilizing entrustment-supervision scales with EPAs for assessments for at least 4 APPE learners in the last year were eligible. The primary outcome was a description of implementation guidance for assessing learners using an EPA framework. Secondary outcomes include descriptions of barriers and facilitators to using an EPA framework in APPE learner assessment. All sessions were recorded, transcribed, and analyzed using inductive thematic analysis. RESULTS:Eleven APPE preceptors representing 9 institutions participated. Commonly identified implementation recommendations were regular, repetitive preceptor education using case practice vignettes, student orientation to assessment expectations, clear delineation of minimum competency level, frequent discussions with preceptors, and use of institutional resources. Identified barriers were the abstractness of entrustability, subjectivity of the entrustment-supervision scale and preceptor assessments, unclear grading schemes, length and complexity of the assessments, and EPA applicability to the specific practice setting. Commonly identified facilitators were clearly defined scales and expectations, preceptor education, student education, pass/fail grading schemes, and shorter, more frequent assessments. CONCLUSION:EPA-based assessments can be used by preceptors for workplace-based assessments during APPEs. Faculty/preceptor development and student orientation with benchmarking and clear expectations are needed to support implementation.
Objective. To determine pharmacy students’ impressions of their faculty’s interactions with diverse student and patient populations. Methods. Three student focus groups were convened. Eighty-four page transcripts were coded, and emergent themes were identified by qualitative analysis. Results. Students defined diversity as multidimensional beyond traditional categories. Emergent themes were faculty awareness or lack of awareness of cultural diversity, disparate cultural perspectives and preferences within student groups, teaching/learning approaches to prepare students to be more culturally competent, and student group dynamics. First- and second-year students emphasized student-to-student interactions, while third- and fourth-year students emphasized a lack of preparation for the realities of contemporary practice based on instructional methods. Conclusion. Students perceived the majority of their pharmacy faculty to be culturally sensitive and aware, but microaggression and discrimination from faculty and student peers were experienced. Study implications can potentially improve curricular offerings, cultural awareness of faculty and students, and care to diverse patient populations.
Objectives. To develop, implement, and assess an interprofessional rural health professions program for pharmacy and medical students.Design. A recruitment and admissions process was developed that targeted students likely to practice in rural areas. Pharmacy students participated alongside medical students in completing the Rural Health Professions program curriculum, which included monthly lecture sessions and assignments, and a capstone clinical requirement in the final year.Assessment. Fourteen pharmacy students and 33 medical students were accepted into the program during the first 2 years of the Rural Health Professions program. Approximately 90% of the rural health professions students were originally from rural areas.Conclusions. The rural health professions program is an interprofessional approach to preparing healthcare providers to practice in rural communities.