Can Virtual Introductory Experiential Education Fill the Need for Telehealth Education?

By: Emily Kim, PharmD candidate 2023, Stacy Taylor, PharmD, MHA, BCPS and Esther P. Black, PhD

Fortuitous Pandemic Discovery: Hidden Benefits of Virtual Introductory Experiential Education 

COVID-19 accelerated many changes in healthcare and provided an opportunity for exponential growth in telehealth. Ambulatory care pharmacists incorporated telehealth consultations into practice, and many institutional pharmacists began working remotely.^1,2 Within pharmacy education, telehealth-focused content is currently lacking, including HIPAA considerations, telehealth etiquette, and technological understandings. The American Journal of Pharmaceutical Education recently issued a call to action to incorporate telehealth education into the pharmacy curriculum to prepare students for the changing landscape of pharmacy practice.³ 

In 2020, the University of Kentucky College of Pharmacy (UKCOP) allowed a portion of the Introductory Pharmacy Practice Experience (IPPE) curriculum to be completed virtually to accommodate preceptors and students with challenging situations. A select number of students were assigned to ambulatory pharmacists who were now conducting telehealth appointments. The IPPE component, titled Longitudinal Experiential Education in Pharmacy (LEEP), exposes students to direct patient care across multiple fields of pharmacy. LEEP consists of 20 hours each semester of the 2nd and 3rd professional years, with students self-scheduling 4-6 hour sessions over the course of 7 weeks.  

We experienced success with virtual LEEP and believe this model maximizes the benefits of virtual experiential education. For example, virtual LEEP offers increased inclusivity and flexibility by eliminating transportation and geographical concerns which allows for site expansion. General virtual experiential education may incur concerns about suboptimal engagement.⁴ However, we believe high levels of engagement can be maintained with an intermittent, longitudinal experience such as LEEP, especially when incorporating telehealth education. Ultimately, virtual LEEP provides an authentic conduit for telehealth education, preparing new graduates for expanding career opportunities in telehealth. 

Vicarious Learning theory: Preceptor’s Guide for Conducting Virtual Telehealth Education

The framework we used for virtual LEEP is grounded in Vicarious Learning Theory which posits an individual can successfully learn by observation.⁵ The pedagogy behind Vicarious Learning differs from simple observation by requiring the learner to mentally engage to gain a full understanding of the rationale behind the clinician’s roles, responsibilities, and decision-making processes and then visualize themselves completing the same activities. This theory was applied to virtual telehealth IPPEs using the following step-by-step approach (Figure 1). Of note, preceptors were provided access to a preceptor toolkit prior to the rotation. This toolkit contained ideas for remote activities such as a pharmacy simulation program (Safe Pharmacy Simulation) and social media project (Tweetorial). Educational resources were provided to expand discussion materials such as a pharmacy podcast (Pharm So Hard) and discussion board (iForumRx).

Figure 1. Guide for Preceptors Conducting Virtual Telehealth Education 

Virtual Telehealth Education: Student Anecdote   

My LEEP was completed virtually with a pharmacist providing telehealth consultations at an ambulatory diabetes management clinic. Due to the remote nature of virtual LEEP, I was given remote access to electronic health records (EHR). This involved downloading multiple softwares onto my laptop and contacting the IT department. I was reminded to not use any patient identifiers in my notes and assignments, and any information sent via email were to be without patient identifiers.

Through this experience, I was able to learn skills unique to telehealth such as telehealth etiquette, interview techniques, and technological skills. I was able to see the software used for secure communication between providers as well as the documentation process for reimbursement. During interviews, I observed hurdles specific to telehealth such as inability to see patients’ body language, increased complexity when using an interpreter, and inability to provide printed educational materials. However, I was able to observe how my preceptor mitigated these issues and still provided patient centered care. Furthermore, this experience did not lack traditional, non-virtual experiential education lessons such as, learning to navigate  EHR and writing mock SOAP notes which allowed me to be well prepared for future experiential education. 

Continuing Virtual Experiential Education 

Virtual experiential education is an effective modality to prepare early learners for patient care and the growing field of telehealth. To deliver a quality virtual experience, there must be commitment by both the college/school of pharmacy and the preceptor towards effective communication and technological support. 

How has your program adapted experiential education to address the gap of telehealth education in pharmacy curriculum?

Acknowledgements

Special thanks to Dr. Jeff Cain for his input. 

References

1.  Segal EM, Alwan L, Pitney C, et al. Establishing clinical pharmacist telehealth services during the COVID-19 pandemic. American Journal of Health-System Pharmacy. 2020;77(17):1403-1408. doi:10.1093/ajhp/zxaa184
2. Kjerengtroen S, Wilde SM, Fontaine GV, Forbush KM, Gorder CMV, Wohlt P. COVID-19 preparedness: Clinical pharmacy services remote staffing in a quaternary, level I trauma and comprehensive stroke center. American Journal of Health-System Pharmacy. 2020;77(15):1250-1256. doi:10.1093/ajhp/zxaa132
3. Frenzel J, Porter A. The need to educate pharmacy students in telepharmacy and telehealth. Am J Pharm Educ. 2021;85(8):Article 8566.
4. Nuffer, W., Gilliam, E., Thompson, M. and Trujillo, J., 2021. Can an APPE be delivered as a virtual experience?. [online] Pulses. Available at: <https://cptlpulses.com/2020/10/29/appe-virtual/> [Accessed 14 May 2021].
5. Roberts D. Vicarious learning: A review of the literature. Nurse Educ Pract. 2010;10(1):13-16. doi:10.1016/j.nepr.2009.01.017 

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