Evaluation of a Newly Established Layered Learning Model in an Ambulatory Care Practice Setting

Given the need to accommodate overlapping longitudinal Introductory Pharmacy Practice Experience (IPPE) students and Advanced Pharmacy Practice Experience (APPE) students at regular intervals while meeting clinical demands, the opportunity to establish a layered learning model (LLM) became evident at University of Missouri - Kansas City School of Pharmacy. The purpose of this project was to establish an LLM at an ambulatory care site, observe the teaching-learning interactions between IPPE and APPE students, and evaluate student perceptions of the experience.

The LLM was implemented over the course of three traditional semesters during Spring 2016 through Spring 2017. Clinical services were offered 2.5 days per week. Overlapping student instructional time was established in conjunction with the provision of clinical pharmacy services and the structure of each rotation type. Third-year (P3) IPPE and fourth-year (P4) APPE students, who participated in the LLM at this site, completed a course evaluation pertaining to their experiences. The evaluation focused on APPE and practice readiness, as well as strengths and limitations of the LLM.

All 16 students completed the evaluation (100% response rate). All IPPE students indicated the LLM prepared them for APPEs in either an excellent (n=3, 37.5%) or above average (n=5, 62.5%) manner. Of the APPE students, most indicated the LLM prepared IPPE students for APPEs in an excellent (n=3, 37.5%) or above average (n=4, 50%) manner. Similarly, the majority of APPE students indicated the LLM prepared APPE students for practice in an excellent (n=3, 37.5%) or above average (n=5, 62.5%) manner. In addition, the following common themes developed, which highlight the benefits of the experience: reinforcement of knowledge through instruction, enhanced understanding of APPE expectations, exposure to multiple teaching styles, and creation of a comfortable learning environment. Students suggested the LLM include increased time for interaction with other learners.

An LLM involving P3 IPPE and P4 APPE pharmacy students, in an ambulatory care practice setting, was associated with positive student perceptions. Student feedback was best utilized to generate the hypothesis that this LLM may increase both APPE and practice readiness. However, further study is needed to confirm direct cause and effect.