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Open Access Research article

A demonstration study comparing “role-emergent” versus “role-established” pharmacy clinical placement experiences in long-term care facilities

Rosemin Kassam1*, Mona Kwong2 and John B Collins3

Author Affiliations

1 Faculty of Medicine, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

2 Howe Street Pharmacy, 1070 Howe Street, Vancouver, BC V6Z 1P5, Canada

3 Department of Educational Studies, University of British Columbia, 2044 Lower Mall, Vancouver, BC V6T 1Z2, Canada

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BMC Medical Education 2013, 13:104  doi:10.1186/1472-6920-13-104

Published: 5 August 2013

Abstract

Background

Increasing challenges to recruit hospital sites with full-time on-site pharmacy preceptors for institutional-based Advanced Pharmacy Practice Experiences (APPE) has made it necessary to consider alternate experiential models. Sites with on-site discipline specific preceptors to supervise students have typically been referred to in the literature as “role-established” sites. In British Columbia, long-term care (LTC) facilities offered a unique opportunity to address placement capacity issues. However, since the majority of these facilities are serviced by off-site community pharmacists, this study was undertaken to explore the viability of supervising pharmacy students remotely – a model referred to in the literature as “role-emergent” placements. This paper’s objectives are to discuss pharmacy preceptors’ and LTC non-pharmacist staff experiences with this model.

Methods

The study consisted of three phases: (1) the development phase which included delivery of a training program to create a pool of potential LTC preceptors, (2) an evaluation phase to test the viability of the LTC role-emergent model with seven pharmacists (two role-established and five role-emergent) together with their LTC staff, and (3) expansion of LTC role-emergent sites to build capacity. Both qualitative and quantitative methods were used to obtain feedback from pharmacists and staff and t-tests and Mann–Whitney U tests were used to examine equivalency of survey outcomes from staff representing both models.

Results

The 76 pharmacists who completed the training program survey rated the modules as “largely” meeting their learning needs. All five role-emergent pharmacists and 29 LTC participating staff reported positive experiences with the pharmacy preceptor-student-staff collaboration. Preceptors reported that having students work side-by-side with facility staff promoted inter-professional collaboration. The staff viewed students’ presence as a mutually beneficial experience, suggesting that the students’ presence had enabled them to deliver better care to the residents. As a direct result of the study findings, the annual role-emergent placement capacity was increased to over 45 by the end of the study.

Conclusions

This study demonstrated that role-emergent LTC facilities were not only viable for quality institutional APPEs but also provided more available sites, greater student placement capacity, and more trained pharmacy preceptors than could be achieved in role-established facilities.

Keywords:
Residential care; Long-term care; Pharmacy; Clerkship; Clinical education; Clinical practice; Non-traditional clinical placements; Role-emergent; Role-emerging; Institutional; Experiential