Developing an international industrial advanced pharmacy practice experience in Brazil.

INTRODUCTION: In this commentary, we advocate for implementing international industry-focused advanced pharmacy practice experiences (APPEs) that engage pharmacy students and schools with the pharmaceutical industry to develop products for the global market to broaden pharmacy student experiences in non-patient care electives. COMMENTARY: Our five-year experience suggests the following structural components are essential to the success of the APPE: (1) identification of suitable international industry partners through non-traditional methods, such as the local, United States (US) chamber of commerce; (2) commitment by the company and educational institutions to develop key personnel to work with international students in the host country; (3) development of a global regulatory affairs course and workshops that target the product development stage; (4) development of student experiences based on projects directly linked to a new product(s); (5) use of technology platforms to support weekly video conferencing and translation; (6) engagement of students in community service; (7) cooperative evaluation of students and the program. The aggregate of student projects led to the development of a line of dietary supplement products introduced to the US market. IMPLICATIONS: The implementation of this APPE benefits pharmacy students but also the academic and industry hosts. Pharmacy students obtained global manufacturing experience, an appreciation for a different culture, and supported commercial product development. The educational institutions developed joint courses and workshops. Students were embedded into various departments, carried out Food & Drug Administration regulations research, prepared comparative regulatory process maps, and provided company employees with an understanding of American consumers.

Describing pharmacy student participation in an international, interprofessional medical mission trip as part of an advanced pharmacy practice experience (APPE).

BACKGROUND AND PURPOSE: Several schools of pharmacy across the United States have taken steps to incorporate international medical mission trips into the doctor of pharmacy (PharmD) curriculum. This study aims to describe the impact of advanced pharmacy practice experience (APPE)-level student pharmacists on an interprofessional team during an international medical mission trip to Jamaica. EDUCATIONAL ACTIVITY AND SETTING: The Jamaica Medical Mission (JMM) trip is an annual event involving healthcare professionals from several disciplines across multiple universities and healthcare systems. At this institution, the JMM trip is included as part of a rural health elective APPE rotation. Students electing to participate in this rotation are provided with the opportunity to serve as active participants on an interprofessional healthcare team in underserved and under-resourced communities throughout Jamaica. The JMM trip that took place during June 2016 included healthcare professionals and students in the fields of medicine, dentistry, optometry, nursing, and pharmacy. A total of five pharmacist preceptors and 10 pharmacy students attended the JMM trip in June 2016. Approximately three to five clinic sites per day were conducted simultaneously on each of the seven clinic days at various locations throughout Jamaica. The interprofessional healthcare teams provided free medical care, including physical exams and access to prescription and non-prescription medications. FINDINGS: The interprofessional healthcare team saw a total of 1014 patients and dispensed 1879 prescriptions during the seven clinic days. A total of 811 clinical recommendations were made by student pharmacists and/or pharmacy preceptors. Of these recommendations, 561 (69%) were made by student pharmacists without pharmacy preceptor prompting, 103 (13%) were made by the student pharmacist with preceptor prompting, and 147 (18%) were made by pharmacy preceptors. Over 70% of recommendations made by student pharmacists without pharmacy preceptor prompting were accepted by prescribers. DISCUSSION AND SUMMARY: This study sought to describe the impact of APPE-level student pharmacists on an interprofessional team during an international medical mission trip. Our findings demonstrate that APPE-level student pharmacists were capable of making a substantial number of clinical recommendations without preceptor prompting. The number of recommendations made by students without preceptor prompting were consistently greater than the number of recommendations made with preceptor prompting throughout the trip. Future studies should address student competence in achieving learning objectives associated with international, interprofessional APPE rotations.

Development of a capstone course to improve student confidence and pharmacotherapy knowledge prior to advanced pharmacy practice experiences.

OBJECTIVE: To describe a capstone course designed to improve student confidence with clinical skills, improve confidence with providing medication therapy, and evaluate student knowledge. DESIGN: A 2-week capstone course was incorporated into the third-year pharmacotherapy course in a Doctor of Pharmacy program. Students evaluated complex patient cases and developed pharmacotherapy care plans. Pre- and post-capstone course survey results were used to assess change in student confidence using clinical skills and providing medication therapy, and quiz and exam results were used to assess student knowledge. RESULTS: Student confidence significantly improved from baseline for clinical skills (p < 0.02 across all clinical skills domains) and providing medication therapy (p < 0.01 across all disease states). Students reported the largest improvement in confidence for the clinical skill of creating a Subjective/Objective/Assessment/Plan (SOAP) note on a patient with multiple disease states (p < 0.001). Students reported the highest confidence increase for acute kidney injury (p < 0.001). The average written exam score was 87.2% (standard deviation ± 8.0) and the average verbal exam score was 79.1% (standard deviation ± 15.7). CONCLUSION: A 2-week capstone course can be valuable to improve confidence and assess student knowledge prior to advanced pharmacy practice experiences (APPEs).

A medical mission to Guatemala as an advanced pharmacy practice experience.

OBJECTIVE: To describe the development and outcomes of an advanced pharmacy practice experience (APPE) for a medical mission trip to Guatemala. DESIGN: Pre-mission preparation and post-mission reflection activities were combined with in-country activities to create a 5-week APPE. During the 10-day medical mission trip, pharmacy students dispensed medications, counseled patients, conducted quality improvement assessments, and presented their findings and experiences as part of an interdisciplinary health care team. ASSESSMENT: The students who completed the mission trip met the objectives of the APPE and reported substantial learning in the areas of interdisciplinary teamwork and cultural competency. All students' scores on the Inventory for Assessing the Process of Cultural Competence-Student Version (IAPCC-SV) increased. The majority (81%) of student-generated quality improvement recommendations were implemented by the mission team. CONCLUSIONS: The medical mission APPE provided a rich learning environment for pharmacy students and resulted in modifications to the medical mission operation. This type of APPE could be implemented in other colleges of pharmacy via formation of partnerships with established medical mission teams as this one was.