A Quality IPPE Institutional Experience

by Teresa Elsobky, Pharm.D., PGY2 Psychiatric Pharmacy Resident, University of Maryland School of Pharmacy

Introductory Pharmacy Practice Experiences (IPPE) are a requirement designed to be a pharmacy student’s first structured experience with direct patient care in a health care setting.¹  They provide transitional experiential activities and active learning opportunities for students to apply lessons learned in the classroom in the “real world.”² As a pharmacy student, I had to complete two IPPEs: a 40-hour IPPE community experience and an 80-hour IPPE institutional experience. My IPPE institutional rotation experience, in particular, stands out in my mind. During this rotation, I did not have a chance to participate in the medication use process in its entirety – from when a prescriber writes a medication order to when the medication is administered to the patient.  While I mastered the task of stocking a Pyxis^® machine, I did not understand why these specific medications were made available or how to prevent medication errors from occurring. During that introductory experience, I never entered a medication order into the hospital’s health information system.  It wasn’t until my advanced pharmacy practice experience (APPE) during a institutional rotation that I learned about the medication use process.

Image from: http://www.pharmacy.arizona.edu/programs/rotations

An IPPE institutional rotation can be conducted in many ways, but the goals and objectives should be clear and similar across all Doctor of Pharmacy curricula. According to the Accreditation Council for Pharmacy Education (ACPE), an IPPE rotation should “continue in a progressive manner leading to entry into the advanced pharmacy practice experiences.”3  IPPE rotations should be appropriately designed in order to prepare students for the direct patient care activities that occur during advanced rotations. In 2009, a task force of the American Association of Colleges of Pharmacy (AACP) developed a nationally defined set of IPPE competencies that these competencies should be mastered prior to APPEs.⁴ These competencies included the following broad categories: processing and documenting prescriptions/drug orders; understanding professional norms and behaving in a professional manner; understanding dosage forms/devices and how their use should be communicated to patients; and assisting patients with self care.⁴  These competencies were established to help schools and preceptors create valuable IPPE rotations with clear goals, objectives, and activities.

After looking at several different institutions’ IPPE rotation syllabi, here are some general goals and objectives that I believe should be achieved during an IPPE: participating in pharmacy operations in a role similar to the pharmacist’s,⁵ observing an interprofessional team,⁵ explaining the roles and responsibilities of every pharmacy staff member,⁶ and identifying personal learning needs by participating in a continuing professional development process.⁶

How will a pharmacy student accomplish these objectives?  What activities can the preceptor arrange to aid in the successful completion of these goals?  Preceptors can not spend every moment with their students during the rotation, but they should facilitate the necessary tasks to make it a fulfilling experience.¹ Certain activities that will help achieve the rotation goals include:⁶ being involved in the preparation and dispensing of oral, topical, and intravenous medications; observing the medication use process (understanding how orders are written and delivered to the pharmacy, shadowing a pharmacist as he/she inputs and verifies medication orders, and seeing how the patient receives the medication after the order has been processed); attending Pharmacy & Therapeutics Committee meetings; helping to maintain patients’ medication profiles; assisting the pharmacist report an Adverse Drug Reaction (ADR); formulating an alternative drug selection when a drug-drug interaction exists; communicating verbally and in writing with various healthcare disciplines and patients; formulating a timely response to drug information questions from hospital staff members; and utilizing resources (efficiently!) to look up answers to drug information questions.

Creating a quality IPPE institutional rotation is important and vital to pharmacy students’ professional growth, as this is the first structured experience with patient care.   Schools/Colleges of Pharmacy and preceptors should focus on setting realistic goals and designing fulfilling experiences during these rotations that will enable students to accomplish these goals. The recommendations set forth by the AACP Task Force for IPPE rotations should be used as a resource⁴ and every student should be expected to master these competencies before advancing to APPE rotations.

References

1. Owle C, Lawrence S. IntroductoryPharmacy Practice Experiences: What Students Should Expect [Internet]. Southern Pines (NC): Coastal Research Group; 2011 Dec 14.
2. Chisholm M, DiPiro J, Fagan S. An Innovative Introductory Pharmacy Practice Experience Model. Am J Pharm Educ. 2003; 67:171-8.
3. American Council on Pharmacy Education Standards 2007. Accessed March 9, 2014
4. Task Force on IPPE Competencies, American Association of Colleges of Pharmacy (ACCP). Report to: Board of Directors 2009 May.
5. Ackman M, Mysak T. Structuring an Early Clinical Experience for Pharmacy Students: Lessons Learned from the Hospital Perspective. Can J Hosp Pharm 2009;62:320-5.
6. Eshelman School of Pharmacy (University of North Carolina). Rotation workbook to: IPPE pharmacy students (University of North Carolina Eshelman School of Pharmacy). 2013.