Student and preceptor perspectives on expanding ambulatory introductory pharmacy practice experience hours

Current accreditation standards require PharmD programs to ensure experiential learning exposure to contemporary pharmacy practice. Though ambulatory care is a required advanced pharmacy practice experience (APPE), it is not required in introductory pharmacy practice experiences (IPPEs), leaving little information on the impact and optimal structure of ambulatory IPPEs. Increasing hour requirements may benefit student outcomes.

This quasi-experimental survey evaluated the impact of increasing ambulatory IPPE from 20 to 30 h for third-year pharmacy students at one Texas institution. Student self-perceptions of confidence, skills, and APPE-readiness were assessed via pre-post surveys. Preceptors who supervised both cohorts completed a survey comparing observed student performance.

287 students participated (175 in the 20-h cohort, 112 in the 30-h cohort). The 30-h cohort reported larger gains in confidence across most competencies, with 75 % strongly agreeing they felt APPE-ready compared to 47 % in the 20-h cohort (p = 0.0047). Preceptor evaluations did not reflect differences in observed competency between cohorts. Only 45 % of preceptors perceived benefit from additional hours, citing logistical challenges related to the extended scheduling window.

Extending ambulatory IPPEs appears to enhance students' perceived self-efficacy and readiness. The lack of corresponding changes in preceptor-rated performance may reflect limited observation opportunities, short exposure, or insensitivity of current assessment tools to detect incremental skill gains.

Extending ambulatory IPPEs from 20 to 30 h improved perceived confidence and APPE-readiness but not preceptor-rated competency. Further research is needed to determine the IPPE duration that yields measurable performance improvements.