Experiential Learning Manual

Experiential learning is a valuable and integral component of the pharmacy curriculum. It is designed as a student-preceptor learning experience to strengthen the confidence, independence and competence of the student.

The term “experiential learning” has several meanings, which are helpful to keep in mind as you read this Manual. Traditionally, the term “experiential learning” has been used to contrast time spent in pharmacy practice settings to time in didactic classrooms. More recently, experiential learning refers to a variety of curricular and co-curricular activities that students are expected to complete through the course of the Doctor of Pharmacy curriculum. Some of these activities may occur at practice sites; others may occur in various settings on-campus. Regardless of the location, the emphasis is on the development of skills integral to actual pharmacy practice.

This Experiential Learning Program Manual provides information that can help you to understand and manage the experiential education component of the curriculum and gain an overall sense of experiential learning. The document can be used as a reference and be consulted whenever you have questions about experiential learning. If you cannot find the answers to your questions, please contact the Director or Associate Director of Experiential Learning or one of the Experiential Learning Coordinators.

Index:

Purpose

For the past 50 years, pharmacy education has been guided by the notion that students must first “learn pharmacy,” and then “practice pharmacy.” In more recent times, this “first learn—then do” approach has been giving way to the notion of “learning by doing.”

At the University of Pittsburgh School of Pharmacy, like most schools of pharmacy in the United States, students are expected to begin thinking and acting like a pharmacist from the very first day of their professional studies. With this approach, there is a constant interplay between theoretical knowledge and practical knowledge. Experiential learning gives the student an opportunity to transfer information from didactic classes into practice settings. At the same time, students have an opportunity to generate insights and questions about pharmacy practice that they can take back to the classroom for discussion.

Experiential learning also provides students with a “hands-on” opportunity to learn how to be a pharmacist in a real, as opposed to simulated, practice setting. This is where students develop communication skills with patients and other medical professionals; where they learn how to provide pharmaceutical care in diverse settings; and where career choices are often confirmed or molded. Finally, it is an opportunity for the preceptor to give back to the profession by helping to prepare the practitioners of tomorrow.

Organization

At the University of Pittsburgh School of Pharmacy, experiential learning consists of a progressive set of practice-based experiences that prepares a student to practice as a generalist who is competent to provide primary, patient-centered, pharmaceutical care.

The specific focus of experiential learning changes each year based on a combination of factors including: (1) emphasis of the learning goal; (2) the setting or context of practices; (3) the amount and continuity of contact with patients; (4) the acuity level of the patients’ conditions; and (5) expected level of proficiency in performing pharmaceutical care. The following chart summarizes the shift in emphasis in experiential learning over the four years of professional study.

Year Emphasis

P-1

BEGINNING CORE PRACTICE SKILLS DEVELOPMENT

  • Enhance social awareness and understanding of health-related issues and unmet medical needs within the community
  • Encourage public health through wellness and disease prevention programs
  • Develop communication skills with patients from diverse populations
P-2

COMMUNITY PHARMACY PRACTICE

  • Development of prescription processing, dispensing and counseling skills
  • Emphasis on practicing pharmaceutical care in the community pharmacy setting
P-3

INSTITUTIONAL/HEALTH SYSTEM PHARMACY PRACTICE

  • Providing responsible drug delivery
  • Emphasis on practicing pharmaceutical care in the institutional (hospital) /health system setting
P-3

ADVANCED PHARMACY PRACTICE EXPERIENCES

  • Intensive practice of the pharmaceutical care process at the generalist level with increasingly complex pharmacotherapeutic problems

Eight full-time rotations (each are five weeks in length)

  • (1) Inpatient Acute Care Rotation
  • (1) Ambulatory Care Rotation
  • (1) Inpatient Acute Care Rotation or (1) Ambulatory Care Rotation
  • (1) Community Pharmacy Rotation
  • (1) Hospital (Institutional)/Health System Pharmacy Rotation
  • (3) Elective Rotations (e.g., consulting, FDA, academic, research, managed care, international)

As the chart indicates, students will spend time in various practice settings during each year of study. While in the setting, students may be expected to complete certain assignments, which are provided by the School of Pharmacy or their preceptor. In addition, students are expected to participate in debriefing sessions on campus. During these sessions students will exchange information about their experiences with other students in order to broaden and deepen their understanding of pharmacy practice. Students will also be asked to complete reflective writing exercises and conduct reviews on topics/issues related to their field experiences.

Student Dress and Conduct at Experiential Learning Sites

The following guidelines regarding student dress and conduct apply:

  1. Students are expected to dress in a PROFESSIONAL manner at all times. Proper dress includes a white laboratory coat and a name tag. Learners must adhere to the dress code policies of the educational, professional, and research settings and environments to which they are assigned.
  2. The student is/ to conduct him/herself in a manner, which is professional, courteous, and reflects positively on the individual, the preceptor and the School of Pharmacy. Student behavior at practice sites must be consistent with the School of Pharmacy Guidelines for Professional Code of Conduct for Students (see link below) as well as all applicable practice site policies and procedures and all local, state, and federal laws. Failure to adhere to these guidelines may result in failure of the rotation or course.
  3. The student will maintain all confidences with respect to patient health information (as required by HIPAA), pricing fee systems, business practices, etc., which may be revealed at the site.
  4. The student is NOT to receive any financial remuneration from the preceptor for work performed during experiential activities. If there is any concern with professionalism, conduct, or discrimination, please contact the Office of Experiential Learning for guidance. Discussion will occur with the student and preceptor regarding the issue, and corrective actions will be implemented to avoid future occurrences. Related School of Pharmacy and University policies are linked below.

Links to the Code of Conduct, Professional Dress Guidelines, and Social Media Guidelines are found in the PharmD Student Handbook as below:

Portfolio

Students are required to maintain an academic portfolio during all four years of the PharmD program. The portfolio helps students to reflect on their professional development, to seek additional experience where needed, and provides them with a creative means for documenting progress. Projects, assignments, and activities completed in the course of experiential learning should be included in the portfolio as evidence of mastery of the curricular outcomes. In the P3 and P4 years, students will maintain both Presentation and Assessment Portfolios. Portfolio submission requirements and portfolio review expectations will be presented to each class in a training session prior to the start of the academic year.

Requirements

Please note that select courses require that students complete experiential rotations at facilities external to the University, and such facilities will or may require as a condition of student participation any or all of the following site requirements

  • All students must obtain a Pennsylvania Pharmacy Intern license by December of P1 year
  • Documentation of immunity to certain infectious diseases by documented history or vaccination including titers for certain agents (ex.: measles, rubella, hepatitis B)
  • A negative two-step tuberculin skin test or chest x-ray if indicated
  • A physical examination
  • Criminal background check(s) and/or child abuse history clearance with disclosure to site of any convictions consistent with their criteria
  • A urine drug screen with disclosure to site of any positive findings for drugs that are taken without medical supervision
  • Provide evidence of and maintain personal medical insurance coverage at all times while at off-campus training sites
  • Provide CPR, HIPAA and/or other clinical training certifications as required by site
  • All students admitted to the University of Pittsburgh School of Pharmacy are required to purchase and create an on-line certified background profile (CastleBranch, Inc.). All information listed above will be housed in this database. The students and the Office of Experiential Learning have access to this database. Instructions for setting up an account and uploading files will be provided at an in-person session during orientation to the Experiential Learning Program.

Should a student be denied access to, or be removed from, a field placement site for any reason, including, but not limited to, a positive drug screen or a positive criminal background check, the student will be obligated to disclose the reason for the denial/removal to the School of Pharmacy, and may be required by the School of Pharmacy to undergo a criminal background check and/or substance abuse evaluation as a condition of resuming the experiential learning portion of the professional program. Should a student fail a background check, clearance and/or drug screen, the School of Pharmacy cannot guarantee that it will be able to place the student at another entity for the requisite field education, thereby affecting the ability to graduate on schedule from the pharmacy program. Additionally, in order to become licensed as a pharmacist, many states will request information from the applicant or the applicant’s school or college of pharmacy as to whether the applicant has been convicted of a misdemeanor, a felony, or a felonious or illegal act associated with alcohol and/or substance abuse. Thus, should the School of Pharmacy become aware of failed background checks, clearances, or drug screens it may be required to provide such information to the applicable pharmacy licensing board and such information may affect future ability to be licensed as a pharmacist.

All costs associated with licensure, medical insurance, background checks and drug screenings are the responsibility of the student. Depending on the requirements of the affiliation agreement between the site and the University, other requested documentation may be coordinated by or required at the training site or facilitated by the University using campus-based programs or by an external agency. In all cases, the student is ultimately responsible for assuring the requirements have been satisfied.

For more information about required clearances and background checks, visit the PharmD Student Manual: Criminal background and Substance Abuse Policy.

Student Responsibilities

It is the student’s responsibility to:

  1. Maintain current Professional Liability Insurance. The cost of this insurance is included in your tuition. Please check your statement to confirm this.  If, for some reason, it does not appear on your statement, contact the Assistant Director, Experiential Learning Programs (Ms. Anna Schmotzer). An insurance certificate can be provided by the School if required.
  2. Complete all site-specific prerequisites, such as background checks, drug screenings, inservices, etc., in time to avoid delay or cancellation of rotation. Delays or cancellations because of inadequate preparation for a rotation may results in the inability to complete the course or rotation requirements in time to progress with your class.
  3. Seek help from the preceptor or another pharmacist when unsure of expectations, practice responsibilities, treatment protocols, or drug information. Do not publicly question or dispute guidance by the preceptor. Discuss any disagreements in private.
  4. Make sure that professional decisions and tasks are adequately monitored. NO STUDENT IS TO DISPENSE A FINAL PRODUCT OR MAKE RECOMMENDATIONS WITHOUT FIRST CONSULTING THE PHARMACIST PRECEPTOR FOR REVIEW AND APPROVAL.
  5. Be aware of and comply with all laws, rules and regulations, which govern pharmacy practice.
  6. Comply with the School and University policy on immunization (See General Appendices, Immunization requirements).
  7. Participate actively and communicate effectively in all areas of practice. Passive observation is not an effective or acceptable approach to experiential learning
  8. Students are responsible for completing all criminal background checks and clearances at their own expense. The School has contracted with CastleBranch, Inc. to house all of this information. (see instructions in General Appendices Criminal Background).
  9. Fully complete all required hours of training at experiential sites and provide accurate and complete documentation of time as directed. Obtain verification by the preceptor or other pharmacist of hours spent at the site on the Hours Documentation form as required by certain IPPE activities.
  10. Be punctual and reliable in your attendance. The Absence Request Policy must be followed by all students. The student must notify the preceptor if (s)he will be late, and both the preceptor and the experiential learning director if (s)he will be absent. Absences for reasons other than illness or emergencies may be granted at the discretion of the Director of Experiential Learning and the preceptor. An Absence Request Form must be submitted to the Director of Experiential Learning in advance for approval, unless the absence is due to an emergency. Missed hours must be made up at the convenience of the preceptor.  The Absence Request Form can also be on the home page of E*Value at  https://www.e-value.net/home-main.cfm.Credits toward licensure requirements and academic completion are both based upon completion of the required number of hours at experiential sites
  11. Recognize that unexcused absence may be grounds for an incomplete or failing grade.
  12. Maintain your own health insurance coverage. Students may be exposed to patients with communicable diseases. Although the risk is minimal, students should exercise caution and follow the advice of their preceptor. Conversely, students who have an infectious disease that may be transmitted to a patient, such as an upper respiratory infection or gastroenteritis, should notify their preceptor so that appropriate steps can be taken to minimize exposure to the patient.
  13. Transportation to and from an experiential learning site, as well as, any parking costs are the student’s responsibility.
  14. Housing during fourth-year rotations that are geographically distant from the University is the student’s responsibility.
  15. Students must have certification in basic CPR. The School will arrange for CPR certification classes during the P1 and P3 years; however students may also obtain certification on their own. The course is approved by the American Heart Association and is arranged by the Center for Emergency Medicine on the University of Pittsburgh campus.  Students who are already certified must provide proof of certification to the Assistant Director, Experiential Learning Program.  Proof of certification must must be uploaded on your CastleBranch certified background profile.
  16. Students must attend all on-campus debriefing sessions.
  17. Students will be responsible for completing evaluations of themselves, their preceptors, and the rotation sites as directed by course coordinators. Failure to complete the necessary evaluations on time may result in a grade of Unsatisfactory for the course or rotation.
  18. ANY STUDENT WHO DOES NOT COMPLY WITH THE GENERAL REQUIREMENTS AND RESPONSIBILITIES OF EXPERIENTIAL LEARNING WILL NOT SATISFACTORILY COMPLETE THE COURSE.

Preceptor Responsibilities

  1. Assume primary responsibility for the student(s) assigned to the site
  2. Preceptors may designate selected teaching responsibility to pharmacy or medical residents, working cooperatively with a designated faculty member, or other qualified pharmacy practitioners that are deemed appropriate.
  3. Provide orientation and definition of activities.
  4. Ensure students are aware of assigned responsibilities.
  5. Ensure students understand the requirements to successfully meet the rotation goals and objectives.
  6. Provide a description of student responsibilities, goals and objectives, the rotation schedule and any suggested readings.
  7. Provide an atmosphere and create opportunities for students to accomplish the stated goals and objectives of the learning experience.
  8. Prepare and conduct discussion sessions of selected patient care topics to expand the student’s knowledge base and experiences.
  9. Provide students with frequent and specific feedback on performance, including written evaluations with identification of strengths, weaknesses and progress toward the stated goals and objectives.
  10. Provide guidance and direction for improvement.
  11. Be a role model of professionalism and a strong patient advocate.
  12. Complete required student evaluations and verification of student hours by the completion or end of each rotation experience.

Selection Criteria for Preceptors and Sites

All preceptors participating in the Experiential Learning Program do so as volunteers and are recognized by the School as Associate Clinical Preceptors for Pharmacy and Therapeutics.  Preceptors receive no financial compensation, but may enjoy other privileges such as access to the university’s Health Sciences Library System and free continuing education.

Criteria for Preceptor Selection Include the Following:

  1. The preceptor should be a pharmacist in good standing with their home State Board of Pharmacy as required by the practice environment. Preceptors involved with the service learning aspect of the EL Program and with select APPE Elective rotations are exempt from this requirement but must be competent in their field of expertise.
  2. Preceptors must practice ethically, provide services of high quality and show compassion for patients. (Pharmacist preceptors must abide by the Code of Ethics set forth by the American Pharmaceutical Association.)
  3. Preceptors must have sufficient time to organize the student’s experience and be able to document and assess student performance.
  4. Preceptors should engage in professional growth and life-long learning through participation in professional organizations and continuing education programs.
  5. Pharmacist preceptors must provide learning experiences that stress the responsible provision of pharmaceutical care and the optimization of patient drug therapy outcomes.
  6. Preceptors must participate in preceptor training and development activities conducted by the School.
  7. Preceptors should provide a valid e-mail address as the Office of Experiential Learning utilizes e-mail as a primary mean of communication to preceptors.
  8. In selecting pharmacist preceptors, preference is given to pharmacists who:
    • ​​​​​Have developed an innovative practice site
    • Hold an advanced degree or specialty certification
    • Have availability to engage in one or more of the following activities:
      • Frequent and direct patient contact
      • Have opportunities to counsel patients, ideally in a private area
      • Formulate, evaluate and monitor patient drug therapies
      • Interprofessional practice environment
      • Access to medical records
      • Identify and resolve public health problems and health disparities
      • Access to internet for literature and health-related information searches
      • Interpret, prepare, compound and dispense medications
      • Have opportunities for interaction with other health-related agencies
      • Have opportunities for pharmacotherapy/pharmaceutical care research

Prospective preceptors are asked to complete a Preceptor Data Form and a Site Description Form to provide the School with information on education, licensure, professional affiliations, and site characteristics.  In addition, all preceptors are asked to submit a copy of their CV or resume.  The School reviews these materials to determine whether a site and/or preceptor will be able to provide a positive learning experience for our students.  The School may follow-up with a personal visit to the site or a phone call to further assess suitability and to explain how our program works.

Preceptors and sites are evaluated by students after each learning experience, and may also be evaluated by a faculty member via a site visit.  It is each course coordinator’s responsibility to help review student evaluations of preceptors and sites and to identify any issues.  All findings are brought to the attention of the Director of Experiential Learning who incorporates the information into our quality assessment and improvement plan.  If any action is required, it may include telephone calls, site visits, preceptor training, or dismissal from the program.  The results of student evaluations are communicated to preceptors annually.

Criteria for Site Selection Include the Following:

  1. Each practice site shall meet all standards set by relevant regulatory agencies.
  2. Preceptors and sites must be free of any violations of local, state and/or federal laws.
  3. All sites must be clean and should reflect a professional image.
  4. Sufficient reference materials must be available at sites for the provision of information to health professionals and patients.
  5. Students should have access to all relevant patient medical information, including medications, medication use history, and information regarding patient history, physical examination, disease states, and laboratory tests.
  6. All sites must maintain adequate staffing to allow students a meaningful educational experience.
  7. Students must be permitted to perform pharmacist functions under the supervision of the preceptor at pharmacy sites.

Documentation, Evaluation, and Grading

Documentation: Students are required to accumulate a total of 1500 hours of pharmacy practice experience in order to apply for pharmacy licensure in the state of Pennsylvania. The experiential learning component of the School’s curriculum can be used to fulfill 1000 of these hours. Therefore, it is extremely important that students complete all of the hours devoted to experiential learning. An Hours Documentation Form specific for the academic year should be used for this purpose, where required (P1, P2).

Preceptor Evaluation: Preceptors will use the appropriate evaluation form to assess the student’s performance at the practice site and will recommend a grade of Honors, Satisfactory or Unsatisfactory. Preceptors should discuss their assessment and grade recommendation with the student. Both the student and the preceptor must sign the evaluation form for those rotations not utilizing an electronic evaluation.

Grading: Experiential learning is graded on an Honors/Satisfactory/Unsatisfactory basis. The student’s grade will be awarded based on a combination of data provided through preceptor evaluation, self-evaluation, and faculty evaluation. A mastery approach to performance assessment is used for the evaluation. A mastery approach to learning and evaluation is based on the assumption that competence develops over time and with practice. The Experiential Learning Coordinators will determine final grades. In some instances, the grade the preceptor recommends for a student may differ from that given by the Experiential Learning Coordinators.

Self-Evaluation: At the end of each semester, students are responsible for completing a critical self-assessment of their learning. Students will use the appropriate evaluation form for documenting this assessment.

Student Evaluation of Preceptor and Rotation Site: Students are expected to evaluate the preceptor and learning site using the Student Evaluation of Preceptor(s) and Site Form. In order to receive a grade for the course associated with the learning experience, the student must submit the required evaluations via paper or through the E*Value database when prompted to do so by E*Value.

For APPE rotations, preceptors should submit a mid-point and final evaluation of their students via the E*Value database.

Resources for Experiential Learning

Practice Sites
A myriad of practice sites are used for experiential learning, including community and hospital pharmacies; pharmaceutical care centers within ambulatory clinics, managed care and long-term care settings; as well as alternative sites. Qualified preceptors and their practice sites are an extremely important and valued resource. The student’s attitude and conduct at a site reflects not only on themselves as individuals, but also on the School. Students must treat these resources with respect.

During the first three years of study, many, but not all, practice sites are within a reasonable distance from the University of Pittsburgh. However, particularly in the P4 year, sites located inside as well as outside of Allegheny County are used to provide students with productive environments for mastering pharmacy practice skills. Students may be required to do rotations at sites greater than one hour driving distance from the University of Pittsburgh. All introductory pharmacy practice experiences (IPPEs) and required (non-elective) advanced pharmacy practice experiences (APPEs) must be done in the United States, or its territories and possessions. Elective APPEs may be done outside the United States if approved by the School of Pharmacy.

Preceptors

The relationship that the student establishes with the practicing pharmacist or other health professional who agrees to precept their work, is a critical factor in the quality of the experiential learning experience. 

Reference Materials

Throughout a student’s program of studies, a variety of reference sources will be used. Some of these will be located in the practice sites where students are gaining experience; others will be found in the University libraries; still others may be from textbooks or databases used for other classes.

E*Value/Forms/Assignments

A. The Experiential Learning Program utilizes E*Value and the Pitt e-mail system to support the Experiential Learning Program. Students should plan to monitor their Pitt e-mail accounts on a regular basis so as not to miss important announcements.

B. All announcements will be sent to the e-mail address that you were assigned when you first became a student at the University of Pittsburgh. Forwarding your Pitt e-mail to another e-mail address frequently fails due to security characteristics of the Pitt e-mail system, and may result in the student missing important information. Receiving email from the School while on rotation is the student’s responsibility.

C. Electronic submission of the Pharmacy Interaction Tracking Tool, the “PITT Form,” is required to document patient care interactions during all experiential learning activities. The link for the electronic PITT form is http://students.pharmacy.pitt.edu/pittform-links/. The form is password protected, and students will be notified of the password during orientation to experiential learning activities. Please contact the Experiential Learning Office if you have any trouble completing the forms.

D. Evaluations completed by students for APPE rotations (Student Midpoint and Final Self-Evaluations and Student Evaluations of Preceptor and Site) must be submitted online through E*Value. The Student Midpoint Self-Evaluation must be completed at the mid-point of each rotation and all other evaluations are due no later than one week after the rotation ends. Evaluations must be submitted on time, through E*Value, in order to successfully complete the rotation and avoid an “Incomplete” grade.

E. Preceptor Evaluation of Student: For rotations in the P3 and P4 years, your preceptor will be completing your evaluations in E*Value. It is the student’s responsibility to ensure that the Preceptor Evaluations of the Studentare completed and submitted. Failure to receive the completed evaluations will result in a grade of “Incomplete” for the rotation. An unresolved “Incomplete” grade will necessitate retaking the rotation.

Absence Request Policy and Form

  1. Any absences by students of one day or less per rotation should be handled by the student and the preceptor.  In these instances, it is the preceptor’s decision and responsibility to specify and outline a plan for the make-up of the missed day.
     
  2. Advanced Pharmacy Practice Experiences (P4 Year)
  • Any absences in excess of one day per rotation will require the student to complete the “Absence Request” form (attached).  If possible (advance knowledge of an absence), this form should be submitted to both the preceptor and Ms. Anna Schmotzer in the Experiential Learning Office at least six weeks prior to the scheduled absence.  In the event the absence is not scheduled (e.g., illness, emergency), the student must notify the preceptor as soon as the absence is going to occur, and the form should be submitted to both the preceptor and Ms. Anna Schmotzer in the Experiential Learning Office within three days of the student’s return.  The Experiential Learning Office will determine if the student can successfully make-up the missed rotation time after reviewing the plan for make-up of the missed days.
     
  • Days missed due to interviews and attending professional meetings (e.g., ASHP Midyear, AMCP Nexus, APhA, PPA) are considered absences and the guidelines outlined in items #1 and #2 above should be followed.  Students must discuss interview schedules and professional meetings with their preceptor six weeks before rotation start date. It is the preceptor’s decision if the student time off can be granted and made up. If the missed hours cannot be made up by the end of the rotation, the preceptor should contact the Experiential Learning Office for guidance. 
     
  • If the student is attending a professional meeting during a scheduled APPE rotation, by the Monday following the end of that specific rotation, the student must submit the following documentation to their Pitt Pharmacy Dashboard, in addition to their other required assignments:
    • One-page reflection describing activities in which the student participated at the meeting, how the meeting contributed to the student’s learning, and which curricular outcomes that the meeting helped the student to achieve. The student should also post the project presented at the meeting, if applicable (e.g., the poster, the presentation)
  1. Introductory Pharmacy Practice Experiences (P3 Year)
  • During on-site activities, a student must notify the preceptor and Ms. Schmotzer (annas@pitt.edu) if he/she will be late or absent and also complete an Absence Request Form (see Home Page of E*Value for form) to be submitted to Ms. Schmotzer via email. Hours, activities and assignments will be made up at the convenience of the preceptor. Students may be requested to provide physician documentation as evidence of illness. Given the compressed and “full-time” nature of each IPPE week, a student who missed two or more days in an IPPE week will be required to repeat the experience in a later IPPE time block at an available site as available and may require delay in APPE schedules.
  1. Absence requests for family vacations, personal travel, or other non-rotation/non-school reasons are not excused absences. Repeated absences from a rotation will result in an unsatisfactory grade for that rotation.

 

Appendices

Rotation Syllabi

 

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