Smith Jennifer N, Phan Yvonne, Johnson Mikala, Emmerson Kaitlin, West Bre-Oscha, Adams Jessica, McGiness Thaddeus, Otsuka Shelley
Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
Curr Pharm Teach Learn. 2018 Jul;10(7):940-945. doi: 10.1016/j.cptl.2018.04.009. Epub 2018 Apr 27.
Several schools of pharmacy across the United States have taken steps to incorporate international medical mission trips into the doctor of pharmacy (PharmD) curriculum. This study aims to describe the impact of advanced pharmacy practice experience (APPE)-level student pharmacists on an interprofessional team during an international medical mission trip to Jamaica.
The Jamaica Medical Mission (JMM) trip is an annual event involving healthcare professionals from several disciplines across multiple universities and healthcare systems. At this institution, the JMM trip is included as part of a rural health elective APPE rotation. Students electing to participate in this rotation are provided with the opportunity to serve as active participants on an interprofessional healthcare team in underserved and under-resourced communities throughout Jamaica. The JMM trip that took place during June 2016 included healthcare professionals and students in the fields of medicine, dentistry, optometry, nursing, and pharmacy. A total of five pharmacist preceptors and 10 pharmacy students attended the JMM trip in June 2016. Approximately three to five clinic sites per day were conducted simultaneously on each of the seven clinic days at various locations throughout Jamaica. The interprofessional healthcare teams provided free medical care, including physical exams and access to prescription and non-prescription medications.
The interprofessional healthcare team saw a total of 1014 patients and dispensed 1879 prescriptions during the seven clinic days. A total of 811 clinical recommendations were made by student pharmacists and/or pharmacy preceptors. Of these recommendations, 561 (69%) were made by student pharmacists without pharmacy preceptor prompting, 103 (13%) were made by the student pharmacist with preceptor prompting, and 147 (18%) were made by pharmacy preceptors. Over 70% of recommendations made by student pharmacists without pharmacy preceptor prompting were accepted by prescribers.
This study sought to describe the impact of APPE-level student pharmacists on an interprofessional team during an international medical mission trip. Our findings demonstrate that APPE-level student pharmacists were capable of making a substantial number of clinical recommendations without preceptor prompting. The number of recommendations made by students without preceptor prompting were consistently greater than the number of recommendations made with preceptor prompting throughout the trip. Future studies should address student competence in achieving learning objectives associated with international, interprofessional APPE rotations.
美国多所药学院已采取措施，将国际医疗任务之旅纳入药学博士（PharmD）课程。本研究旨在描述高级药学实践经验（APPE）阶段的学生药剂师在前往牙买加的国际医疗任务之旅中，对跨专业团队产生的影响。
牙买加医疗任务（JMM）之旅是一项年度活动，涉及多所大学和医疗系统中多个学科的医疗保健专业人员。在该机构，JMM之旅是农村健康选修APPE轮转的一部分。选择参加此次轮转的学生有机会在牙买加各地服务欠缺和资源不足的社区中，作为跨专业医疗团队的积极参与者。2016年6月进行的JMM之旅包括医学、牙科、验光、护理和药学领域的医疗保健专业人员和学生。2016年6月共有5名药剂师带教老师和10名药学专业学生参加了JMM之旅。在牙买加各地的七个诊所日中，每天大约同时开展三到五个诊所点的工作。跨专业医疗团队提供免费医疗服务，包括身体检查以及提供处方药和非处方药。
在七个诊所日期间，跨专业医疗团队共接待了1014名患者，分发了1879份处方。学生药剂师和/或药剂师带教老师总共提出了811条临床建议。在这些建议中，561条（69%）是学生药剂师在没有药剂师带教老师提示的情况下提出的，103条（13%）是在带教老师提示下由学生药剂师提出的，147条（18%）是由药剂师带教老师提出的。在没有药剂师带教老师提示的情况下，学生药剂师提出的建议中超过70%被开处方者接受。
本研究旨在描述APPE阶段的学生药剂师在国际医疗任务之旅中对跨专业团队产生的影响。我们的研究结果表明，APPE阶段的学生药剂师在没有带教老师提示的情况下能够提出大量临床建议。在整个旅程中，没有带教老师提示时学生提出的建议数量始终多于有带教老师提示时提出的建议数量。未来的研究应关注学生在实现与国际跨专业APPE轮转相关学习目标方面的能力。
