Identification of essential knowledge for inpatient general medicine advanced pharmacy practice experiences

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Objective: With diversity in advanced pharmacy practice experience (APPE) preceptors, rotation options, and site characteristics, inpatient general medicine (IGM) APPEs provide varied experiences for students. There is a concern for continuity of essential knowledge standards across experiences. To identify essential knowledge for students to learn during an IGM APPE. Methods: Expert pharmacists in acute care and/or student precepting in an inpatient setting participated in a three-round modified Delphi process to build consensus. Through three rounds of survey consensus building, experts designated 143 pharmacotherapy topics as essential or non-essential for an IGM APPE. Topics that achieved 80% or more agreement met consensus as essential. Topics that achieved less than 80% agreement by the end of the surveys were considered non-essential. Results: Twenty-eight experts reached consensus on 70 (49%) topics as essential, 40 (28%) topics as non-essential, and 33 (23%) topics as indeterminate after round one. Three additional topics suggested by the experts were included with the 33 indeterminate topics for round two considerations. At the conclusion of round three, 73 total topics met consensus as essential for IGM APPE students. Essential topics aligned with the categories of renal, cardiovascular, gastrointestinal, and neurologic disorders as well as infectious diseases. Non-essential topic categories consisted of oncologic, dermatologic, and gynecological/obstetric disorders. Conclusion: Identified essential knowledge, as found in this study, may serve as a guide for preceptors and afford students the opportunity of consistent experiences across varying IGM APPEs. Validation with pharmacy curriculum and postgraduate competency recommendations support many of these consensus findings. More research is needed to identify the appropriate number of topics addressed during APPE rotations and how to assess that knowledge.

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