Pharmacy Students' and Pharmacist Preceptors' Perceptions of the Hospital Rotation Experience during the COVID-19 Pandemic.

Background: The COVID-19 pandemic brought significant disruptions to pharmacy experiential education. To ensure the safety of students and staff, university and rotation site educators needed to make changes rapidly to adapt to the dynamic environment. Objectives: To explore the impact of the COVID-19 pandemic on pharmacy students and their preceptors during experiential rotations and to identify any barriers to learning that arose and opportunities for improvement. Methods: Two online questionnaires were developed to explore the perceptions of pharmacy students and preceptors during experiential rotations. The following topics were examined: support for rotations by the hospital and the university, perceived safety, accessibility of resources, interpersonal interactions, professional development, assessment and evaluation, and overall impressions. All Advanced Pharmacy Practice Experience students from the University of Toronto who completed 1 or more rotations at North York General Hospital during the 2020/21 academic year and their preceptors were invited to participate. Results: Sixteen and 25 questionnaires were completed by students and preceptors, respectively. Both groups agreed that they were adequately prepared for the rotations and felt safe. There was a decrease in interpersonal interactions, while the use of virtual communication tools increased. Lessons learned included the need for timely communications and access to resources for learners and preceptors, contingency plans for staff shortages and outbreaks, and workspace assessments. Conclusions: During the COVID-19 pandemic, implementation of experiential rotations was associated with many challenges, but pharmacy learners and preceptors believed the overall experience was not significantly affected.

Contexte: La pandémie de COVID-19 s'est accompagnée de perturbations importantes dans le domaine de la formation pratique en pharmacie. Les éducateurs de l'université et du lieu de stage ont dû rapidement apporter des changements pour s'adapter à l'environnement dynamique et assurer la sécurité des étudiants et du personnel. Objectifs: Étudier les effets de la pandémie de COVID-19 sur les étudiants en pharmacie et leurs précepteurs pendant les stages pratiques et identifier les obstacles qui se sont présentés ainsi que les améliorations possibles. Méthodes: Deux questionnaires en ligne ont été préparés pour étudier les perceptions des étudiants en pharmacie et des précepteurs pendant les stages pratiques. Les sujets suivants ont été examinés: le soutien de l'hôpital et de l'université pour les stages, la perception de la sécurité, l'accessibilité des ressources, les interactions interpersonnelles, le perfectionnement professionnel, l'évaluation et les impressions générales. Tous les étudiants du programme Advanced Pharmacy Practice Experience de l'Université de Toronto qui ont effectué un ou plusieurs stages à l'Hôpital général de North York au cours de l'année universitaire 2020­2021 et leurs précepteurs ont été invités à participer. Résultats: Les étudiants et les précepteurs ont répondu à 16 et 25 questionnaires, respectivement. Les deux groupes ont convenu qu'ils étaient bien préparés aux stages et qu'ils se sentaient en sécurité. On a observé une diminution des interactions interpersonnelles, tandis que l'utilisation d'outils de communication virtuels a augmenté. Les leçons tirées comprennent: la nécessité de communiquer en temps opportun et l'accès aux ressources pour les apprenants et les précepteurs; les plans d'urgence en cas de pénurie de personnel et d'épidémies; et les évaluations de l'espace de travail. Conclusions: Pendant la pandémie de COVID-19, la mise en œuvre des stages pratiques a été associée à de nombreux défis, mais les apprenants en pharmacie et les précepteurs ont estimé que l'expérience globale n'a pas été touchée de manière significative.

Curricular changes in times of crisis: Lessons learned.

BACKGROUND AND PURPOSE: During the early months of the COVID-19 pandemic, experiential education became challenging as sites began to cancel scheduled rotations, and the University of Florida College of Pharmacy had to cancel the first advanced pharmacy practice experience (APPE) block. This was allowable given the excess number of experiential hours built into the curriculum. EDUCATIONAL ACTIVITY AND SETTING: To meet total program credit hour requirements, a six-credit virtual course was created to mimic an experiential rotation. This course was designed to bridge didactic learning with experiential learning. The course included presentation of patient cases, topic discussions, pharmaceutical calculations, self-care cases, disease state management cases, and career development. FINDINGS: Students provided feedback via a survey containing 23 Likert type questions and four open-ended questions. Most students agreed or strongly agreed that participation in self-care scenarios, small group discussions (calculations and topic discussion), and disease state management cases (preceptor dialogue and verbal defense activities) were valuable learning experiences. The verbal defense portion of the disease management case and the self-care scenarios were the most highly rated learning activities. Peer review activities in the career development assignments were seen as the least beneficial component of the course. SUMMARY: This course allowed students an opportunity to further prepare for APPEs in a unique learning environment. The college was able to identify students requiring additional support during APPEs and provide earlier intervention. Additionally, data supported exploring incorporation of new learning activities into the current curriculum.

Important Factors in Remote Experiential Education.

Onsite and in-person experiential education has been well established to prepare practice-ready healthcare professionals, such as pharmacists. From COVID-19, the integration of remote educational delivery has occurred. As healthcare disciplines adjust to new experiential styles and innovate traditional methods, this paper highlights key areas for remote experiential education that can influence student experiences. Factors that are of importance to continuous quality improvement are described. A survey, utilizing the cloud-based software platform Qualtrics® headquartered in the United States, was developed to evaluate whether remote rotation delivery was comparable to traditional onsite experiential education, to assist with quality improvement for virtual experiential education, and to ensure the redesigned educational model meets accreditation standards for two schools of pharmacy. Numerous factors including work, time zone, Office of Experiential Education and preceptor responsiveness, and technology, were examined. Chi-Square test, t-test for proportions and odds ratios were utilized to evaluate results. Students with technology concerns throughout a remote rotation had a more than two-fold increase in identifying the virtual experience as worse than most/all other in-person rotations (p = 0.01). Preceptor responsiveness to questions and concerns significantly impact student perceptions of educational quality (p < 0.05). The majority of students perceived remote experiential education is equal to onsite experiences. Since continuous quality improvement is required by pharmacy accreditors and many other healthcare programs offering clinical opportunities, identifying factors is of importance to make future interventions in the remote experiential education delivery. This type of experiential learning became essential with COVID-19 impacting onsite clinical placements, and information can be used across health science disciplines at large.

Distance assessment of counselling skills using virtual patients during the COVID-19 pandemic

Background: Reports on using virtual patients to assess counselling skills is scarce. Aim(s): This paper describes the feasibility and acceptability of assessing patient counselling skills of pharmacy students using a virtual patient simulator. Description: In this innovative method, a high quality simulator 'Virtual Patient Learning' (VPL) was developed at Gulf Medical University (GMU) and was used to assess the counselling skills of 15 pharmacy graduate students. Counselling skills were measured using a four-domain scoring rubric of 1 to 5 marks followed by instant feedback for improvements. Student and faculty satisfaction scores were collected based on the feasibility and acceptability of the assessment method. Evaluation: The average counselling skills score for all students was 68.4 (85.5%) out of 80 (range 54-76), with a standard deviation of 5.8. The overall student agreement on the feasibility and acceptability of the assessment method was 92.8%;it was 100% agreement for faculty. Conclusion(s): The use of a high quality VPL simulator in assessing counselling skills was deemed feasible and acceptable for students and faculty. The assessment was repeated among 30 Doctor of Pharmacy (Pharm.D.) graduates with similar outcomes. The virtual counselling method will be used in the programme exit exams, as well as in students entering their experiential year. Further studies are required to assess its validity and reliability with more students. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.

Losses and gains in experiential education in a university pharmacy in Brazil: Lessons from a pandemic

The abrupt interruption of planned activities at the University Pharmacy (UP) in the Federal University of Santa Catarina forced a rapid change in routine services with the aim of ensuring continued access to medicines. Since March 2020, the UP has not been able to provide dispensing services or consultations inside its facility because of safety concerns around the spread of COVID-19. Internships are now dedicated to management tasks such as preparing documents to advise patients about particular medicines' utilisation. Virtual communication with the patients was established. This allowed students to be put in charge of keeping in touch with special groups of patients by telephone to track health outcomes, COVID-19 symptoms, and other particular needs. The Global Competency Framework and the National Pharmaceutical Education Guidelines were used as guides to develop the study. Three domains were affected by gains and losses: organisation and management competencies, professional/personal competencies, and pharmaceutical care. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.

Health-System Introductory Pharmacy Practice Experience as an online course in the United States

Introductory Pharmacy Practice Experiences (IPPEs) provide early experiential education in the Doctor of Pharmacy (Pharm.D.) curriculum in the United States (US). In response to Oregon's 'Stay Home, Save Lives' executive order issued during the COVID-19 pandemic, an online health-system IPPE course was developed to simulate the practice experiences that have historically been conducted in person. This case study describes experience from the online health-system IPPE course offered for incoming second-year student pharmacists enrolled in a three-year Pharm.D. programme at Pacific University in Oregon, US. The goals of the course were: 1) to expose students to pharmacy practice common in health-system settings in the US;and 2) for students to earn 50 experiential clock hours through simulation activities. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.

Experiential pharmacy education in trying times : Lessons learned from the COVID-19 pandemic

The COVID-19 pandemic has presented a slew of new obstacles for all health professionals, particularly those in charge of training students. Many pharmacy schools had to convert to virtual experiential learning with little to no existing literature, framework, or appropriate time for preparation. This review documents the virtual pharmacy practice training at a university in Lebanon during COVID-19 and several other colleges of pharmacy worldwide that have shared their experiences. A literature review of international publications was performed in PubMed and Google Scholar between 1 March 2022 and 30 May 2022, and relevant articles were included. The narrative offers a variety of approaches to ensure that pharmacy learners prioritise self-care, are adequately prepared to enter pharmacy practice, and reflect on their learning. However, other aspects, such as the use of a variety of online training platforms, the inclusion of more patient-centric activities, and the provision of live virtual patient experiences, should be enhanced in the future.

Exploring the Effect of Virtual Education on Student Pharmacists' Confidence toward APPE Readiness.

A drop in confidence in Advanced Pharmacy Practice Experience (APPE) readiness was observed in students in the Class of 2022 prior to starting APPEs. We aim to investigate potential causes of students' low confidence in APPE preparedness to provide solutions and to prevent this outcome with future students. We evaluated students' perceived confidence to start APPEs and compared this to curricular changes, employment obligations, and the impact of COVID-19 on delivery of the pre-APPE and APPE curriculum. Students' low confidence with APPE readiness was not indicative of the following factors: (1) delivery of the didactic curriculum, (2) students' performance in the didactic curriculum, or (3) number of summative assessments in key didactic courses. Rather, the low confidence perception may have been due to differences such as a fully remote didactic experience in the P3 year, more virtual Introductory Pharmacy Practice Experiences (IPPEs), a reduced course load in the P3 spring semester, and changes to a pre-APPE preparatory course compared to other class years. The students' self-reported midpoint scores during their first APPE block and preceptor's evaluations on their performance contrasted their pre-APPE perceptions. Frequent in-person and on-site skills assessments throughout the didactic curriculum seem to reinforce confidence before APPEs.

Students' Perceptions and Lessons Learned From Virtual APPE Rotations: A Multi-Institutional Perspective.

Objectives: The COVID-19 pandemic caused disruption in pharmacy experiential learning as clinical practice sites restricted student access to onsite rotations. Therefore, colleges of pharmacy across the country likely included virtual advanced pharmacy practice experiences (APPEs) to fulfill experiential education requirements. The objective of this paper is to evaluate students' perceptions of virtual APPEs during the 2020-2021 academic year. Methods: Experiential directors and faculty at 3 colleges of pharmacy in the south Florida region developed a survey to assess students' perceptions of their virtual APPE rotations during the 2020-2021 academic year. Students who took at least one fully virtual APPE rotation were asked about their perceptions of these rotations. Results: A total of 349 students were invited to take the survey and 92 (26.3%) completed the survey. Of these, 77 students (83.7%) completed at least one virtual rotation. These students completed a total of 152 virtual rotations, with elective and ambulatory care rotations being the most frequent. Most students agreed that rotation objectives were clear, and preceptors offered resources needed to be successful during the rotation. Responses regarding engagement during virtual rotations, rotation expectations being met, and rotations expanding students' knowledge were mixed. Conclusions: Virtual rotations may present unique experiential opportunities for students. Colleges of pharmacy and preceptors can benefit from additional guidance regarding how to incorporate virtual rotations into the experiential curriculum. Best practices for virtual rotations include high frequency of interactions with preceptors, clear objectives and responsibilities, and the use of a rotation calendar.

Development of a combination didactic-experiential elective course within a college-based pharmacy call center.

BACKGROUND: Pharmacy graduates should be prepared to provide patient care in a variety of healthcare settings as members of an interprofessional collaborative team. College-based pharmacy call centers can serve as settings to promote interprofessional practice through didactic and experiential coursework. An elective course, Team-Based Medication Management Practices, was developed to provide student pharmacists the opportunity to learn about pharmacy-led services within value-based care models and to prepare them for interprofessional care by incorporating experiential activities within a college-based call center. EDUCATIONAL ACTIVITY: A two-credit elective course was offered to third-year pharmacy students. The course was delivered through a combination of didactic lectures and experiential activities within a college-based pharmacy call center, with modules focused on medication adherence, medication therapy management, and transitions of care. A survey was administered to students at the end of the course to evaluate perceptions. FINDINGS: Six students enrolled in the elective and completed the survey. Most students "strongly agreed" or "agreed" that they gained a better understanding of interprofessional care within value-based care models and pharmacy services that can be provided within a college-based call center while acquiring patient care skills. The role of telehealth in the delivery of pharmacist-led patient care services is likely to continue expanding as a result of the COVID-19 pandemic and it will become increasingly important to train students to provide these services.

Remote experiential education: A silver lining from the COVID-19 pandemic COMMENT

This commentary addresses key differences between remote and on-site experiential education, including necessary resources and rotation structure. Health care education during the COVID-19 pandemic was primarily delivered electronically. Student-based resources such as computers/laptops, stable internet connections, and privacy (physical space and electronic security) became essential for student learning, testing, and provision of patient care. When student resources were limited, educational programs had to adapt to help students in need. Preceptors were required to restructure experiential rotations to provide learning experiences while keeping up with increased clinical-related workloads. Students had increased projects and papers and decreased face-to-face time with patients and professionals. Many community pharmacies were able to educate students on-site, whereas ambulatory care-based sites generally pivoted to telehealth-based interactions. Although telehealth appeared useful, rollout was difficult because of differences in technology, accessibility, and capability. Inpatient-based training proved most difficult and often had to be halted for patient and student safety. Many schools also used unique non-patient care electives to fill experiential gaps and keep students on target for graduation. Delivery of experiential education had a different set of challenges from didactic education. Creative examples to address these challenges included roving tablets with Zoom sessions during rounds, artificial or de-identified cases, and hybrid clinical/dispensing rotations, though most experiences were canceled or restricted by exclusion of patients with COVID-19 patients. Overall, pharmacy education continued. However, many of the methods for training with partly or entirely remote approaches were novel and may become integrated into the "new normal." The face of the world has changed, and pharmacy education must change with it.

Addressing the Challenges of Precepting Students Enrolled in Remote Research Advanced Pharmacy Practice Experiences.

As a result of restrictions imposed by COVID-19, many researchers have responded to the call for remote, advanced pharmacy practice experiences (APPEs) that do not involve direct patient care. The influx of materials on online pedagogy may be difficult for new preceptors to digest while familiarizing themselves with the APPE program. To complement the available guidance on remote learning for new preceptors, we describe our experiences with implementing a remote, research-focused APPE during COVID-19. Common challenges are discussed and potential solutions that may help new preceptors anticipate and overcome barriers to achieving the educational outcomes of research-focused APPE are proposed.

What does experiential education look like in a global pandemic? Reflecting back and looking forward.

PURPOSE: The purpose of this reflection or wisdom of experience article is to describe and reflect on the impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on experiential education (EE) leadership and teams. Additionally, this reflection will shift the focus from the spring 2020 environment of SARS-CoV-2 to what EE teams and college administration can learn from those experiences. Moving forward, EE teams and administrators can be better equipped to proactively plan for future emergencies. DESCRIPTION: Using the "What? So What? Now What?" model of reflection, this manuscript will broadly describe the experiences of three EE administrators and their teams during the SARS-CoV-2 pandemic. Proposed lessons learned as well as future planning strategies will be presented. ANALYSIS/INTERPRETATION: The world of education was unprepared for the SARS-CoV-2 pandemic, and most sectors were left scrambling to adjust to new models very quickly with no planning or preparation. In the realm of pharmacy education, SARS-CoV-2 caused complete disruption for pharmacy students on rotations, clinical sites, preceptors, and EE teams. In reflecting on spring 2020, much can be gained and applied to future planning efforts so that institutions can be better prepared for future crises. CONCLUSIONS/IMPLICATIONS: While still in the pandemic, schools must plan for the coming year. EE teams can work together to prepare for emergencies, craft contingency plans, and build additional capacity into their teams and available rotation offerings.

Health-system implementation of a collaborative core curriculum for advanced pharmacy experiential education during the COVID-19 pandemic.

PURPOSE: A collaborative advanced pharmacy practice experience (APPE) education model established within a healthcare institution during the coronavirus disease 2019 (COVID-19) pandemic is described. SUMMARY: The COVID-19 pandemic caused a nationwide disruption of APPE pharmacy education. Healthcare institutions faced the challenge of educating APPE students while attempting to simultaneously de-densify work areas and reduce transmission risk for employees and patients. A pharmacist coordinator and pharmacist academic partners at a large teaching hospital created a collaborative common core curriculum model for resourceful implementation of APPE education. Healthcare network pharmacists, clinical pharmacist academic partners, and pharmacy residents delivered the curriculum to 35 pharmacy students over a 9-week time period. Main components of the curriculum included patient case discussions, topic discussions, journal club presentations, live continuing education (CE) webinars, and development of pharmacy technician CE programs. A majority of students reported positive experiences working with a variety of preceptors from different specialties (81%) and collaborating with students from other universities (62%). CONCLUSION: A health system can leverage institutional, network-wide, and academic partner resources to implement a collaborative APPE curriculum during challenging times such as those experienced during the COVID-19 pandemic.

Strategies for Managing Pharmacy Experiential Education During COVID-19.

In recent months, the coronavirus pandemic has significantly affected almost every industry in the United States, including health care and higher education. Faculty and students at colleges and schools of pharmacy nationwide have needed to quickly adapt as the delivery of curricula has shifted to primarily online format. Additionally, experiential rotations have been significantly affected as practice settings such as hospitals and outpatient clinics have limited students' interactions with patients or stopped allowing students on-site altogether. Our commentary will explore strategies that have been employed by experiential education coordinators and pharmacy preceptors from various settings to navigate experiential education during these difficult times while ensuring students successfully meet requirements for graduation. These will include descriptions of transitioning advanced pharmacy practice experiences (APPEs) to virtual format, how to safely involve students in the care of COVID-19 patients, and managing scheduling issues.

YIMBY-Yes, In My BackYard!-The successful transition to a local online ecology field course.

Field biology courses provide the ultimate experiential education as students discover the links between theory and practice in ecology and evolution directly in nature. During the spring and summer of 2020, the COVID-19 pandemic led to the cancelation of face-to-face classes in almost every university in Canada. Whereas traditional university courses were mostly transferred online, the online transition for field biology courses was not so common. Here, I provide an account of a successful transition from traditional field biology course to an online "backyard biology" field course with a small class size of 10 students. While the online field course may not provide the same level of interpersonal benefits of the traditional field course experience, the model outlined here demonstrates that an online field course that incorporates direct experience with the natural environment is possible and should no longer be considered an oxymoron.

A Paradigm Shift in US Experiential Pharmacy Education Accelerated by the COVID-19 Pandemic.

The coronavirus identified in 2019 (COVID-19) has caused dramatic disruptions in pharmacy experiential education. Administrators and programs have worked to help external preceptors, faculty members, and students cope with the new realities of virtual or remote experiences and new or increased use of telemedicine. Clear and effective lines of communication as well as well-reasoned and resourced alternative plans are necessary to help manage the current issues and prepare for future challenges. Doctor of Pharmacy programs should enhance their focus not just on the physical health and well-being of students, faculty members, and external preceptors, but also on their mental and emotional health. The full scope of the impact of the pandemic on experiential education in pharmacy is still unclear, but this situation should serve as a stimulus for innovation and rethinking the paradigm of how pharmacy programs educate and prepare students for pharmacy practice.