A senior care clerkship for pharmacy students

This paper describes a 200-hour senior care clerkship for pharmacy students over a five-year period from 1998-2003.

This clerkship used community long-term resources of a 160+ bed skilled nursing facility, adult day care, and senior citizen centers involving medicine, pharmacy, and nursing preceptors.

The facility consultant pharmacist was the primary preceptor of students. He conducted pharmacy rounds and daily patient case reviews three times per week. He provided monthly drug regimen review (DRR) and quarterly drug utilization review (DUR) to the skilled nursing facility and, as needed, consultation and therapeutic recommendations to the adult day care center and the senior citizen center.

A 200-hour clerkship was developed with multidisciplinary preceptor experiences to orient internal and external PharmD students to long-term care adult consultation with the attending physicians and nurses in the three sites. Each student prepared for physician rounds by performing an intensive DRR process for selected nursing facility patients. This included a preliminary discussion with the charge nurse on the unit and the consultant pharmacist. As directed, each rotation group proposed and completed one DUR project and written report. The overall goal was to enable the student to serve as a consultant pharmacist and, upon graduation, become a certified geriatric pharmacist. Rotation-specific objectives, evaluation instruments, and DRR and DUR processes are described.

Documentation of contact time, completion of DRR and DUR activities, and interprofessional communication activities.

There were 96 students who completed a 200-hour clerkship over five, 40-hour weeks during a five-year period from 1998 to 2003. Students evaluated some 10,000 patient-months of skilled nursing facility drug therapy and completed 20 DUR projects. All former students who have provided verbal feedback on their clinical training in this rotation have indicated that the rounds and conference contact with the medical director and med passes with the nurse were the key components in that they contributed most to effective interprofessional communication beyond what the consultant pharmacist preceptor offered.

A senior care clerkship can be enhanced with medical director preceptorship in conjunction with the facility consultant pharmacist and nursing staff. This clerkship offered an experiential training that enabled pharmacy students to more effectively communicate with attending physicians and nurses, provide senior pharmacy care, and orient students to the opportunity for geriatric pharmacist certification.