|Year : 2009 | Volume
| Issue : 2 | Page : 226
Standardization of Rotation Schedules for Pharmacy Students' Advanced Practice Rotations and Potential Impact on Rotation Site Availability
ML Brackbill1, PL Weist2, WL Coffey1
1 Shenandoah University, Winchester, Virginia, USA
2 MacDonald's Pharmacy, Harrisonville, PA, USA
|Date of Submission||03-Jun-2008|
|Date of Acceptance||25-Apr-2009|
|Date of Web Publication||04-Aug-2009|
M L Brackbill
BJD School of Pharmacy 1775 North Sector Court Winchester, Va 22601
Source of Support: None, Conflict of Interest: None
Background: Increasing enrollment in pharmacy schools has led to a shortage of adequate advanced pharmacy practice
experience (APPE) sites.
Objective: We sought to assess our preceptors' support for a standardized rotation schedule for the multiple schools that compete for APPE sites in our area. A secondary objective was to ascertain preceptors' beliefs about the impact a regional standardized rotation schedule might have on the number of students their sites would be able to accept on rotation.
Methods: A short questionnaire was developed. All APPE preceptors at our institution were invited to participate by e-mail, telephone and/or U.S. mail.
Results: A total of 232 preceptors were contacted; questionnaires were returned by 133 preceptors (57%). A proposed region-wide rotation schedule was supported by 75.2% of respondents. Most (79%) believed that the standardization of schedules will not affect the number of students they will be able to accommodate on rotations, while 18.1% believed the new schedule will allow them to accept more students.
Conclusion: APPE preceptors in our area generally support standardization of pharmacy students' community rotation schedules, and this may increase the APPE availability but perhaps for only a minority of sites.
Keywords: Experiential, rotations, perceptions, preceptors, advanced pharmacy practice rotations (APPE), pharmacy
|How to cite this article:|
Brackbill M L, Weist P L, Coffey W L. Standardization of Rotation Schedules for Pharmacy Students' Advanced Practice Rotations and Potential Impact on Rotation Site Availability. Educ Health 2009;22:226
|How to cite this URL:|
Brackbill M L, Weist P L, Coffey W L. Standardization of Rotation Schedules for Pharmacy Students' Advanced Practice Rotations and Potential Impact on Rotation Site Availability. Educ Health [serial online] 2009 [cited 2020 Dec 4];22:226. Available from: https://www.educationforhealth.net/text.asp?2009/22/2/226/101538
In response to a workforce shortage of registered pharmacists, existing pharmacy schools in the United States have been accepting greater numbers of students per class and other institutions have founded new pharmacy programs. This has led to an increase in the number of pharmacy students but also a shortage of adequate advanced pharmacy practice experience (APPE) sites necessary for fourth-year pharmacy students (Traynor, 2004). Students enrolled in a Doctor of Pharmacy (Pharm.D.) program in the U.S. are required to complete a series of four to six week rotations throughout their fourth year of training in order to expose students to a variety of pharmacy practice environments. These rotations include both required rotations in common areas of pharmacy practice (i.e., hospital, retail, and community pharmacies) as well as elective rotations.
Studies conducted by Plaza and Draugalis in 1999 and 2004 addressed the difficulties faced by pharmacy schools in securing and maintaining a sufficient number of rotation sites for their fourth-year students (Plaza & Draugalis, 2000; Plaza & Draugalis, 2005). In one survey (2005), 41% of the 73 responding pharmacy schools reported an increase in inter-school competition in acquiring and retaining APPE sites. Fifty-five percent anticipated a level of difficulty of five or greater on a seven-point scale (1 = not at all difficult and 7 = extremely difficult) for finding additional APPE sites over the next three years.
Community preceptor sites often take pharmacy students from more than one school of pharmacy. One of the difficulties in arranging rotations for pharmacy students stems from the different starting dates and differing lengths of rotations across schools (Traynor, 2004). Our pharmacy school elected to standardize all of its APPE rotations to five weeks starting in May 2008 to correspond with rotation lengths of other pharmacy schools in the region. Due to our school’s close proximity to at least six other pharmacy schools, there is significant competition for APPE sites. Our rotation start and end dates will now be coordinated with other pharmacy schools in the region. Only one such collaboration among U.S. pharmacy schools has been reported in the literature (Duke et al., 2008).
The primary objective of this study was to assess preceptors’ support for a standardized rotation schedule for students from the local schools that compete for APPE sites. A secondary objective was to ascertain how preceptors’ believe a regional standardized rotation schedule might affect the number of students their sites would be able to accept.
The study investigators developed a brief survey instrument to assess pharmacists’ perceptions of a coordinated APPE rotation system. Survey questions sought to gather information about preceptors’ sites: the type of pharmacy practice site; number of students from all schools of pharmacy rotating at the site at any one time; the estimated number of APPE students currently precepted per year from all schools of pharmacy.
Participants were asked “Do you support the idea of standardizing starting dates for rotations among regional pharmacy schools?” Allowable responses were that they “support”, “do not support” or have “no opinion” on this idea. Preceptors were also asked, “How do you believe standardizing rotation starting dates among regional pharmacy schools will affect the total number of students you will take for rotations from all pharmacy schools combined?” Response options were that they anticipated taking “more students”, “same number of students”, and “fewer students.”
The questionnaire was sent via e-mail to all active Shenandoah University APPE preceptors for whom e-mail addresses were available. Preceptors who did not have e-mail access were contacted via telephone and U.S. mail. Follow-up e-mails or telephone calls were made to non-respondents after three weeks. All responses were held confidential. Responses were entered into a spreadsheet for analysis. The Shenandoah University Institutional Review Board approved the study.
Two hundred thirty-two preceptors were eligible and contacted for study participation. Questionnaire responses were received from 133 preceptors (57%). The type of sites reported by the 130 respondents were: community retail setting 37% (n=48), hospital 36% (n=47), ambulatory care 13% (n=17) and “other” sites 14% (n=18). Rotations considered as “other” sites included those focused on providing drug information, nuclear pharmacy, home infusion, managed care and hospital pharmacy management (e.g., managing formulary policies). Respondents indicated that the mean number of students their sites allow at any one time was 2.1 ± 2.0, and the mean number of students sites are willing to accept each year was 12.1 ± 17.0. Ninety percent of respondents indicate that their sites accept students from at least two different schools of pharmacy.
The primary objective of this study was to assess preceptors’ support for a rotation schedule standardized among regional pharmacy schools. Of the 133 respondents, 75% supported the proposal (n=100), 23% had no opinion (n=30) and 2% (n=3) did not support the proposal. Most respondents (n=105, 79%) anticipated that standardizing the schedule would not affect the number of students their sites could accept, 24 (18%) thought their sites could accept more students, and 4 (3%) thought their sites could accept fewer students (Figure 1).
Figure 1: Preceptors’ anticipated impact of a proposed standardized schedule on the number of students their sites can accept
This study finds that APPE preceptors who teach our students overwhelmingly support the initiative to standardize APPE rotation schedules between the local schools that compete for APPE rotation sites. From a pharmacy school perspective, a potential benefit of a standardized APPE schedule is to be able to increase the number of students that preceptors could accommodate over the course of a year. In light of the difficulty of finding enough APPE sites for students, regionally standardizing rotation schedules might be one way of increasing rotation slots without the need to recruit additional preceptors. However, fewer than one-in-five of this study’s participating preceptors anticipated that their sites could accommodate more students when schools’ rotation schedules were coordinated. Most anticipated they would not be able to take more students. It appears the overall effect would potentially be a small increase in APPE sites in a minority of sites as a result of standardizing rotation schedules.
A consortium consisting of state and private schools that synchronized APPE dates in an effort to reduce the burden to preceptors of overlapping rotation “start date/end date” and increase site availability has been described in the literature (Duke et al., 2008). Pharmacy schools have also been successful at collaborating with specific APPE sites, specifically community pharmacy practice sites, in determining the availability of APPE rotations among pharmacy schools competing in the Greater Chicago area (Johnson et al, 2009). There is scant other literature describing such initiatives in other professional health programs, yet there are potential positive benefits in standardizing rotation schedules regardless of the field of study. For example, preceptors willing to accept APPE students could potentially benefit by having fewer site orientation sessions and greater ease of scheduling students since they are not balancing different school schedules.
There are limitations to this study. One limitation to the study is that the primary outcome responses were measured on a 3-point scale and preceptors’ perceptions of the proposed scheduling change might not have been fully expressed through the limited, three option choice. Another limitation is that the questionnaire was administered and treated in a confidential but not anonymous manner which could have created response and social desirability bias by influencing who returned questionnaires and how they responded. This study was only conducted among a single university’s preceptor pool within one country, limiting its generalizability.
The majority of APPE preceptors at our School of Pharmacy who responded to our survey support standardization of rotation schedules among multiple pharmacy schools that compete for the same APPE sites. Implementation of a standardized rotation schedule will most likely have a neutral effect on APPE availability or perhaps a slight increase in availability of rotation slots in a minority of sites. APPE preceptors generally favor a coordinated rotation schedule among local pharmacy schools but this coordination might not increase the number of students they accept.
Duke, L., Unterwagner, W., & Byrd, D. (2008). Establishment of a multi-state experiential pharmacy program consortium. American Journal of Pharmaceutical Education, 72(3), Article 62. Retrieved March 6, 2009, from: http://www.ajpe.org/view.asp?art=aj720362&pdf=yes
Johnson, C., Crawford, S., Lin, S., Salmon, J., & Mobley, M. ( 2009 ). Neighborhood geographical factors and the presence of advanced pharmacy practice sites in Greater Chicago. American Journal of Pharmaceutical Education, 73(1), Article 8.Retrieved March 6, 2009, from: http://www.ajpe.org/view.asp?art=aj730108&pdf=yes
Plaza, C., & Draugalis, J. (2000). Implications of advanced pharmacy practice experience placements. American Journal of Pharmaceutical Education, 64, 404-409.
Plaza, C., & Draugalis, J. (2005). Implications of advanced pharmacy practice experience placements: a 5-year update. American Journal of Phamaceutical Education, 69, 296-303.
Traynor, K. (2004). Experiential education requirements squeeze schools, rotation sites. American Journal of Health-System Pharmacy, 61, 1537-1538.