Accreditation – Should All Pharmacy Programs Be Alike?

by Caitlin Frese, Pharm.D., PGY1 Pharmacy Practice Resident, Johns Hopkins Bayview Medical Center

The Accreditation Council for Pharmacy Education (ACPE) is the national agency responsible for accrediting professional pharmacy degree programs since 1932.¹  According to ACPE’s 2013 annual report, there were 109 fully accredited programs, 16 schools in candidate status, and 4 with pre-candidate status.²  Accreditation in healthcare is commonplace – schools/colleges, continuing education providers, and residency training programs are all accredited. Why is accreditation important?  And should all programs be the same?

Accreditation is intended to ensure that high standards are met – not only in terms of the instructional design of the learning program but also its execution. For colleges/schools that offer the Doctor of Pharmacy degree, standards relate to the curriculum, experiential education program, strategic plan, faculty qualifications, and organizational support.  Although accreditation is intended to ensure that every school/college meets and maintains high standards, there is wide variability in skills and competencies obtained by students.  For example, schools of pharmacy located on a academic health sciences campus provide the opportunity for interdisciplinary interactions earlier in their curricula.  Programs located in states with progressive pharmacy practice acts may offer students a greater breadth of practice experiences relative to other programs that are limited by legal constraints.  Differences in curricular design, assessment strategies, experiential education opportunities, and interprofessional interaction often sets one accredited school apart from another.

National pharmaceutical organizations have advocated for revisions in the ACPE accreditation standards to ensure that future graduates are ready for practice and can meet employer expectations.  At a 2012 conference, stakeholders provided recommendations including:

• Greater emphasis on developing skills for literature evaluation and data interpretation.
• Identifying and cultivating behavioral attributes needed by pharmacists in practice including interprofessional collaboration, clinical reasoning, and motivation.
• Ensuring assessment data is utilized for program improvement.
• Using standard assessment questions at the conclusion of advanced practice experiences such as “Would you hire this student?” and “Are the student’s skills at a level ready to enter practice?”³

Many of the recommendations focus on ensuring the pharmacy program adequately trains student pharmacists to enter the workforce as healthcare providers capable of providing direct-patient care.

Reviewing future employer expectations highlights gaps in the current ACPE standards.  Some expectations relate to managerial and business aspects of pharmacy (e.g. delegating tasks, measure/report performance, pharmaceutical supply chains); others place emphasis on health care delivery systems.⁴  Some employers expressed expectations that students should be competent in everyday activities such as documenting in electronic records, respecting patient confidentiality, managing drug waste, and administering common dosage forms.⁴   

After reflecting on my education and listening to the experiences of other recent graduates from different schools of pharmacy, many (but not all) of these expectations are already included in the curriculum.  However, the depth to which they are taught (if they are taught at all) varies greatly.  This likely explains the variability in competencies seen among graduating students today.

ACPE has released a draft version of the 2016 accreditation standards for comment.  These draft standards incorporate many of the recommendations from the stakeholders conference.⁵ These new standards would force schools/colleges of pharmacy to critically review their current curriculum and find opportunities for enhancement. Terminology within the proposed standards better delineates which items are necessary (i.e. “must” statements listed in the standard document) versus items recommended to enhance the quality of the program (i.e. “should” and “could” statements listed in the guidance document).⁵ Twenty-six standards are organized into three major themes: Educational Outcomes, Structure and Process to Promote Achievement of Education Outcomes, and Assessment.⁵ This change in organization of the standards document mirrors the change pharmacy. As health care delivery changes, the pharmacist’s role has shifted from the traditional dispensing/drug distribution functions to a focus on patient care functions, health outcomes, and cost-effective use of drugs.  This shift is evident within the proposed draft of Educational Outcomes as there is greater emphasis on patient care functions and practicing in interprofessional healthcare teams.⁵

One key change between the current and proposed standards is the separation of standards and guidance statements.^5,6 This separation is where pharmacy schools/colleges can customize their program and truly shine.  ACPE acknowledges that pharmacy programs differ and the guidance document is intended to elevate a program from meeting the bare minimum to producing outstanding graduates with unique skills that are highly sought by employers.

For faculty (or those seeking faculty positions), knowledge of the proposed standards and guidance documents should inform course development. The new standards allow for flexibility in terms of innovative course design and delivery methods.⁶  This could include adopting the “flipped classroom” method when redesigning a course or creating a new interdisciplinary elective.  The guidance document includes examples of co-curricular experiences that can be built into courses including student participation in activities such as Legislative Day, brown bag and medication review events, and serving as an institutional ambassador.⁶  It is unlikely that a school/college of pharmacy will be able to successfully implement and master all recommendations included in the guidance document.  Being selective about what can be optimally incorporated into the pharmacy program will maximize student learning and help set the school/college apart.

Ultimately the guidance document encourages schools to strive for excellence.  Accreditation ensures that students gain foundational knowledge and attain a reasonably similar level of competency to perform core professional functions regardless of what school/college they attend.  However, not all schools / colleges are alike.  Utilizing the guidance recommendations and capitalizing on local or state resources will help good programs become great programs.

References

1. Accreditation Council for Pharmacy Education. Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree (Guidelines Version 2.0, Adopted: January 23, 2011, Effective: February 14, 2011). Accessed March 14, 2014.
2. Vlasses PH, Wadelin JW, Boyer JG, et al. Annual Report of the Accreditation Council for Pharmacy Education. Am J Pharm Educ 2013; 77(4):Article 83.
3. Zellmer WA, Beardsley RS, Vlasses PH. Recommendations for the Next Generation of Accreditation Standards for Doctor of Pharmacy Education. Am J Pharm Educ 2013; 77(3):Article 45.
4. Vlasses PH, Patel N, Rouse MJ, et al. Employer Expectations of New Pharmacy Graduates: Implications for the Pharmacy Degree Accreditation Standards. Am J Pharm Educ 2013; 77(3):Article 47.
5. Accreditation Council for Pharmacy Education. Accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree (Draft Standards 2016, Released: February 3, 2014).  Accessed March 14, 2014
6. Accreditation Council for Pharmacy Education. Guidance for the accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree (Draft guidance for standards 2016, Released: February 3, 2014).  Accessed March 14, 2014.