Fourth-Year Advanced Practice Rotations Benefit Pharmacy Students and Preceptors

By Benjamin Waldrum

In recent years, the college introduced an interprofessional continuing education program that allows students to teach the teachers by making presentations to their preceptors and other health care professionals, who receive continuing education credits. The student-led, interprofessional program is called APPE Grand Rounds and is offered to pharmacists, technicians, physicians, nurses and physician assistants.

“It’s a great way for us to give back to the preceptors, because they do so much for us,” said Seth Heldenbrand, Pharm.D., associate dean of experiential education.

APPE stands for advanced pharmacy practice experiences, or rotations, that are exclusive to fourth-year pharmacy students as part of their experiential education. Most rotations are in Arkansas, with a select few are outside the United States.

In total, each student completes 10 APPEs for their final year of pharmacy school — one rotation each month, with at least 160 hours of work, for 10 months. These include one required rotation each for acute care, ambulatory care, community pharmacy and health-system administration. The other options include four for direct patient care and two electives.

A preceptor usually supervises one or two students, ensuring a close working relationship. Using the preceptor as a role model, students are required to spend the majority of their time in clinical practice, dispensing or technical activities related to direct patient care.

Since 2017, Heldenbrand has worked with the UAMS Office of Continuing Education to offer APPE Grand Rounds to preceptors and other professionals who work alongside the students. At the discretion of the preceptor, students make one-hour presentations at the end of each rotation, and practitioners receive continuing education credit.

Preceptors are required to maintain a certain level of continuing education credits, so the experience benefits both parties. The process is also streamlined thanks to the cooperation between the College of Pharmacy and the Office of Continuing Education.

However, preceptors use the program on a case-by-case basis depending on their availability.

“We have some excellent preceptors that incorporate a CE program as part of their rotation,” Heldenbrand said. “We’re advertising that and making sure preceptors are interested in doing it. It’s a great way to get a free, accredited hour of CE for each student that you have. It really happens on an on-demand basis, depending on the preceptor and the student.”

Kris Dunlap, Pharm.D., is the pharmacy clinical coordinator for the emergency department at Arkansas Children’s. A 2006 College of Pharmacy graduate, she has served as a preceptor for the college since 2014. Last year she was named a Distinguished Preceptor by the American Association of Colleges of Pharmacy.

Dunlap said being a preceptor and making use of the program has been rewarding.

“Precepting students has helped me learn and grow as a pharmacy professional,” Dunlap said. “One way the students have helped me is by providing CE for the pharmacy staff as part of their rotation. I find that taking students as an APPE preceptor is a very rewarding experience. My role in the Emergency Department allows me to keep up with many of my former students, regardless of where they end up practicing.”

Fourth-year pharmacy student Dylan Yowell said that presenting continuing education to pharmacists is a good opportunity for research and to refresh old lessons.

“Preparing a CE gives me a chance to dig deep into research articles and guidelines so that I can remember the underlying physiology of pharmacotherapy, including outcomes, side effects and recent updates to recommended treatment,” Yowell said. “I believe CE is helpful to existing practitioners, but preparing it requires a deep understanding of the topic. It can help a weak area of knowledge become a strength.”

The program has expanded in recent years to include other medical professionals and has significantly increased the number of credits received since its inception. At its peak in 2019, there were more than 1,400 total continuing education credits awarded, Heldenbrand said. Even after a dip during the COVID-19 pandemic, the program awards almost 1,000 credits each year.

“These are 100% student-led, which is rare,” Heldenbrand said. “We went from an environment where students could give zero hours of CE to now, where they can give 800 to 1,400 accredited hours to pharmacists specifically, per year.”