Out of the Shadow of the Pandemic: Enhancing Introductory Experiential Student Learning

By: Emily Tolliver, PharmD Candidate 2022, Mikayla Bell, PharmD Candidate 2023, Nicole Hahn, PharmD, Michael Nagy, PharmD, BCACP

Transitioning out of the shadows of the COVID19 pandemic, could lessons learned evolve the traditional Introductory Pharmacy Practice Experiences (IPPE) in a mutually beneficial manner? The cancelation of IPPE rotations in the early phases of the pandemic showed that traditional observation is non-essential and limits the maximum potential benefit for clinical practice sites and students. As IPPE students are actively progressing with their completed didactic education, preceptors need active learning approaches that are specific, can be tailored, and flexible to practice settings.  

Experiential education is a vital component of pharmacy education that all students receive. The Accreditation Council for Pharmacy Education (ACPE) requires students to obtain a minimum of 300 hours of IPPE to ensure students are prepared for their Advanced Pharmacy Practice Experience (APPE). However, the activities students participate in during these experiential hours vary greatly with uncertain degrees of impact on the student’s readiness for APPEs. It is common for students to describe their IPPE rotations as mainly observational, and while it is important to observe and understand the actions preceptors perform, hands-on active learning may enhance the lasting educational impact.¹

Option for IPPE Hands-on Learning: Population Health Management

Population health management is incorporated in the American Association of Colleges of Pharmacy (AACP) Entrustable Professional Activities and is a recommended component of both ACPE 2016 accreditation standards and Center for Advancement of Pharmacy Education (CAPE) educational outcomes. Therefore, training should be intentionally integrated into didactic and experiential areas of the curriculum. However, the ways to actively train student skills in this area are generally early in development.²

Why Population Health Management?

Population health management is a focus area per the American Society of Health System Pharmacists (ASHP) 2021 Foundation Pharmacy Forecast due to its significant impact as healthcare progresses from a fee-for-service model towards a more holistic model where successful health outcomes drive medical interventions. Through examination of evidence-based metrics, population health management seeks to reduce healthcare costs per capita while optimizing patient health and satisfaction.³ However, considering the multitude of patients with varying severity of illnesses, identifying and triaging patients who would reap the most benefit from intervention is no small task. 

Pharmacists in Population Health Management 

Academic pharmacy education highlights the importance of team-based medicine and thus infers the significant role pharmacists (and students) can play on the team. As medication experts, pharmacists have become increasingly involved in population health management by providing evidence-based therapy education and medication management for both patients and providers. By targeting specific patient populations and optimizing medication regimens, pharmacists can beneficially impact both clinical and financial outcomes.^4,5 In an ideal experiential educational training, student learners act as pharmacist extenders to increase clinical impact while gaining hands-on learning. 

How Population Health Management Expands IPPE Student Learning 

During an IPPE rotation, I worked alongside a PGY1 resident on a population health management project focused on inhaled corticosteroid (ICS) de-escalation in patients with COPD. At the same time of this IPPE rotation, I was completing my didactic learning on COPD and initially was not confident in my ability to contribute to the project. As I learned about the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report and therapeutic recommendations for COPD patients, I saw the potential impact of this project. Specifically, I observed how pharmacists actively apply evidence-based medicine to improve patient outcomes. The opportunity allowed me to take the knowledge from a lecture and apply it to a real patient population. Throughout the IPPE rotation, I followed up with patients to see how the changes I helped implement influenced patient outcomes. This experience cemented COPD management in my mind in addition to exemplifying how evidence-based recommendations translate to patient care. Being involved in this process also incited the opportunity to interact professionally with the project team and learn about the residency project structure. As a student considering residency with no prior formal project experience, the opportunity enhanced my research skills and will guide my future residency and career decisions. 

Educator’s Takeaway 

Participation in population health management as an IPPE student positively complements didactic instruction of evidence-based medicine. Population health management projects should be tailored to IPPE students’ education level and serve as a hands-on learning experience. The associated activities demonstrate how evidence-based recommendations are put into practice, and the implications those changes can have for patients. As emphasis on population health management increases in healthcare, it is essential students participate in similar models to prepare for their future careers. To enhance the utility of experiential education, pharmacy educators should incorporate population health management into their didactic curriculum and require students complete a project during longitudinal IPPEs. As educators, what other hands-on learning approaches could be used to increase the value of IPPE rotations?

References:

1. Gleason BL, Peeters MJ, Resman-Targoff BH, et al. An active-learning strategies primer for achieving ability-based educational outcomes. Am J Pharm Educ. 2011;75(9):186. doi:10.5688/ajpe759186
2. Pakyz AL, Cheang KI, Stultz JS, Moczygemba LR. Learning activities to build population health management skills for pharmacy students. Am J Pharm Educ. 2018;82(8):6390. doi:10.5688/ajpe6390
3. Swarthout M, Bishop MA. Population health management: review of concepts and definitions. Am J Health-Syst Pharm. 2017;74(18):1405-11. doi:10.2146/ajhp170025
4. Shermock KM. Population health management: Challenges and opportunities for pharmacy. Am J Health Syst Pharm. 2017;74(18):1398-1399. doi:10.2146/ajhp170530
5. Sanborn MD. Population health management and the pharmacist’s role. Am J Health Syst Pharm. 2017;74(18):1400-1401. doi:10.2146/ajhp170157

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Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning