INTRODUCTORY PHARMACY PRACTICE EXPERIENCES

Lori Ernsthausen, PharmD, BCPS

CASE

S.S. is a first-professional-year pharmacy student who has just been assigned to his first IPPE at a nearby community pharmacy. S.S. has worked for several years as a pharmacy technician at a similar community pharmacy in his hometown and is uncertain how this experience will be any different from what he is used to doing at his job. S.S.’s preceptor, a faculty member at the school of pharmacy, spends some time on the first day discussing S.S.’s previous experiences and developing a plan of activities S.S. must complete for school as well as several activities in which S.S. wishes to gain experience. S.S. is feeling a little bit more confident about his IPPE but is still uncertain about whether he will learn anything new.

WHY IT’S ESSENTIAL

IPPEs are intended to introduce you to the practice of pharmacy, the healthcare system, and the role the pharmacist plays within the healthcare system. You will typically gain experience in community and institutional pharmacy practice and may also have the opportunity to explore other areas of pharmacy practice. The fundamental skills that are cultivated during the introductory experiences are meant to prepare you for the APPEs of the final professional year.

The Accreditation Council for Pharmacy Education (ACPE) sets the standards to which all colleges and schools of pharmacy must conform. All schools are required to have at least 300 hours of IPPEs as part of their doctor of pharmacy degree (PharmD) curriculum. Per ACPE, a majority of the student’s time should be divided between community pharmacy and institutional health-system settings (i.e., hospital pharmacy), but time may also be spent in other practice settings (i.e., long-term care, compounding, ambulatory care, etc.). Schools are allowed to use simulation (an activity that replicates pharmacy practice) for up to 60 hours of the 300-hour requirement. Students who attend colleges or schools where simulation training is part of IPPEs may complete experiences with simulation manikins, computer-based simulations, or the use of standardized patients or healthcare providers.

In the most recent accreditation standards and guidelines for the PharmD degree, ACPE put forth a list of domains that are considered abilities students “must have” before entering APPEs (see Table 7-1). Students are required to demonstrate these abilities during the completion of their IPPE hours. Although every school of pharmacy must meet the ACPE standards, most programs have unique aspects to their didactic and experiential curriculum that serve to set them apart from others or may be driven by the school’s or university’s mission, size, location, or proximity to other schools of pharmacy or the teaching philosophy of faculty members. Depending on the school, you may complete IPPEs longitudinally throughout a semester or during a specific block of time. For example, one student may travel every Thursday afternoon to an IPPE site, whereas another student may complete all required IPPE hours for a given term during a 2-week time period. Not all colleges incorporate simulation activities into IPPEs, although some provide extensive experiences in a simulated environment. Additionally, IPPE students may participate in service learning as part of their IPPEs. This may include involvement in activities with local community partners or agencies during the school year, summer, or other holiday breaks.

TABLE 7-1. ACPE CORE IPPE DOMAINS

CORE DOMAINS

• Patient Safety—Accurately Dispense Medications
  
• Basic Patient Assessment
  
• Medication Information
  
• Identification and Assessment of Drug-Related Problems
  
• Mathematics Applied to Pharmaceutical Calculations, Compound Medications, Dose Calculations, and Application of Pharmacokinetics Calculations
  
• Ethical, Professional, and Legal Behavior
  
• General Communication Abilities
  
• Counseling Patients
  
• Drug Information Analysis and Literature Research
  
• Health and Wellness—Public Health
  
• Insurance/Prescription Drug Coverage

You will enter your professional program with a variety of pharmacy experience. Some students may have extensive work histories in pharmacies; however, others may have very little or no practical experience. Students may be assigned to IPPE sites that are similar to the site where they work as a paid intern. Although this might seem frustrating, it is important to keep in mind that every practice opportunity in a pharmacy or with a pharmacist preceptor can be a learning experience. It is up to you to make the most out of each site by doing the following:

• Prepare ahead of time.
  
• Ask questions.
  
• Get involved.
  
• Observe and take note of differences in managerial styles, patient care protocols, and dispensing procedures.

Every activity at a site might not be new or unique, but the more experience you gain as a pharmacy intern, paid or unpaid, the more prepared you will be for your APPEs.

A TYPICAL DAY

Depending on your professional year and college curriculum, you might find yourself in an IPPE in a community, ambulatory care, or institutional setting, among others. What a typical day might look like will vary from site to site. In general, there are standard activities that you may be involved with at each type of site.

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