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Froedtert Hospital Medical College of Wisconsin

Expanding Pharmacist Practice Through the Utilization of Longitudinal Advanced Pharmacy Practice Experience Students

Sara Revolinski, Pharm.D, BCPS, Anne Zechlinski, Pharm.D., BCPS, Todd Karpinski, Pharm,D, M.S., Philip Brummond Pharm.D., M.S., Thomas S. Achey, Pharm.D., Brooke Fraser, Pharm.D.

Froedtert & the Medical College of Wisconsin – Froedtert Hospital, Milwaukee, Wisconsin

Health systems are increasingly asked to provide expanded services without parallel increases in resources, and pharmacy departments are no exception. Utilizing advanced pharmacy practice (APPE) students as clinical pharmacist extenders is one method that can be employed. We sought to maximize APPE student utility by creating a longitudinal experience that would mutually benefit both the health system and the student.

Our longitudinal APPE program was implemented in 2013 and is highly selective, requiring prospective students to submit an application and participate in an interview. Students are then selected via a match process. The program requires students to complete four to six rotations within our health system, preferably consecutively. This allows them to gain familiarity with the system thereby increasing integration with the practice model and minimizing orientation time. Additionally, these students complete a longitudinal project with results presented at a local or national conference, collaborate with a pharmacy resident on his or her residency research project, and participate in a drug use and disease state management initiative to expose them to non-traditional practice settings. These activities are designed to increase patient care services and to provide a wide breadth of experience for the student.

This program has demonstrated success not only in advancing clinical pharmacist practice, but also in preparing students for future pharmacy careers. By delegating more clinical work to students, our clinical pharmacists have been able to integrate into the positive blood culture process. Upon culture positivity, the microbiology lab notifies pharmacists, allowing them to evaluate the patient and make recommendations. Pharmacist involvement reduced time to administration of optimal antimicrobial therapy by over 20 hours and resulted in a 1.5-day decrease in length of stay. Based on survey results from the 2014-2015 year, 8 students presented their project results at a state meeting and 2 at a national meeting. Longitudinal APPE skill was assessed via survey by both the students in the program and their preceptors. Clinical pharmacists gauged longitudinal student skill to be better than that of traditional APPE students in the following categories: interacting with health care providers and patients, evaluating medication therapy, and determining patient follow-up and monitoring. Longitudinal students also felt their skill level in these areas improved after completing longitudinal rotations. For the 2014-2015 academic year, 11 of our 13 (84.6%) longitudinal students were matched with a residency program. This match rate exceeds the national rate of 64.5%.

Implementing a longitudinal APPE program successfully advanced pharmacy practice within our health system and successfully developed graduates who are well prepared for a pharmacy residency or career.

  1. Zellmer WA, ed. Pharmacy forecast 2015-2019: Strategic planning advice for pharmacy departments in hospitals and health systems. December 2014. Bethesda: Amercan Society of Health-System Pharmacy Research and Education Foundation.. 2015 Oct 24).
  2. National Matching Services. ASHP Resident Matching Program. Available. 2015 Jul 30).


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