Use of patient assessment skills in advanced pharmacy practice experiences

Pharmacy programs are required to teach patient assessment (PA) skills. However, pharmacist workforce survey data indicates that limited opportunities exist for students to practice PA skills in real-world settings. The study objectives were to (1) assess how often PA skills are utilized by fourth-year pharmacy (P4) students on advanced pharmacy practice experiences (APPEs), (2) determine perceived competence in performing PA skills, and (3) examine relationships between grade-point average or post-graduation plans and the number of skills performed and between skill use frequency and self-reported competency.

P4 students completed a questionnaire assessing 13 PA skills. Respondents performing a skill indicated frequency of use and rated their competence using a 5-point scale. Descriptive and bivariate statistics were reported.

The response rate was 81%. Measuring blood pressure (BP) (76%) and evaluating metered-dose inhaler (MDI) technique (74%) were most commonly performed. Peak-flow meter evaluation (6%) and lymph node examination (2%) were least commonly performed. Measuring BP and evaluating MDI technique had the highest competency ratings (4.6 + 0.7 for both). Lung (3.4 + 0.7) and heart (2.8 + 1) auscultation had the lowest competency ratings. Positive correlations were found between the frequency of skill use and self-reported competence for assessing MDI technique, peripheral pulses, and peripheral edema. No other findings were significant.

P4 students reported high perceived competency for PA skills performed frequently during APPEs. Preceptor education, requiring skill use, and encouraging students to proactively identify situations to use skills could increase opportunities for use of PA skills.