Accreditation Council for Pharmacy Education Issues Guidance

Pharmacy schools will not be required to report substantive changes to the curriculum that are temporary and only in response to campus restrictions on instruction and experiential education as long as the changes do not violate the standards of the Accreditation Council for Pharmacy Education (ACPE), the organization said in a message to pharmacy deans March 17.

Janet Engle, Pharm.D., executive director of the ACPE, issued guidance and suggestions from the ACPE regarding issues facing the schools due to the COVID-19 pandemic.

Richard Kasmer, Pharm.D., J.D., dean of the College of Pharmacy, said that the ACPE will allow maximum flexibility in the delivery of experiential curriculum while continuing to require that pharmacy students complete a minimum of 1,440 hours during their fourth year.

The letter from the ACPE follows.

March 17, 2020

Dear Deans,

ACPE and AACP appreciate any opportunity where we can engage with our colleges and schools of pharmacy. We had an opportunity to participate in a conference call with a group of AACP members to discuss the issues facing schools due to the COVID‐19 pandemic.  This discussion was very useful and helped both organizations better understand the serious issues facing colleges and schools of pharmacy.  One of the outcomes of the call was that ACPE would provide additional guidance. [Note: Later today AACP will be announcing additional conference calls via Go to Meeting for Wednesday, Thursday and Friday at noon ET for ACPE to build upon the information below and respond to schools’ questions.]

Last week we sent a communication from ACPE delineating the requirements for didactic and experiential education.  We received questions from a few schools the week before and had received positive feedback about that response and decided to send it out to all.  Some schools have indicated that it was helpful in encouraging university upper administration not to include pharmacy or the health sciences in the guidance that no classes or experiential education could be offered, as our clinical clerkships are critical for graduation.  However, from our subsequent discussion with various deans, faculty and AACP, we realized that, in some cases, schools needed more guidance and support.

Below, to provide ideas that support flexibility during this unique public health crisis, we have identified some examples of innovation that might be helpful for experiential programs.  These are not prescriptive, only suggestions. We encourage you to do what is most appropriate for your programmatic needs.  You also do not need to contact ACPE for guidance on your innovations as long as they are within the standards.   However, we are happy to help if you have questions.

Specialty inpatient rotations such as cardiology, nephrology, or transplant can count towards the core inpatient general medicine requirement.  If a student completed one of these rotations earlier in the year as an elective, compare the objectives and competencies of the specialty rotation against the internal medicine outcomes.  Many may overlap and where there are deficiencies, faculty can use their professional judgement and decide how best to address them.  In reverse, if your inpatient medicine faculty can’t accept students or already have students, consider using the specialty faculty to provide a required core rotation but ask them to use the syllabus and objectives for the inpatient general medicine experience.

Review the elective experiences a student has taken and compare the objectives of that rotation with the objectives of the missing core rotation (see example above).  If there is enough overlap, the rotation may count for a core rotation with some additional supplementation to cover the deficiencies or missing objectives.

Student opportunities using telehealth may count for ambulatory care or IPPE hours if they meet the competencies developed for your ambulatory care/IPPE rotations.

Student participation in poison center activities and/or call centers for COVID‐19 are also possibilities for an ambulatory care APPE rotation or an IPPE rotation.

Keep in mind that ACPE standards require 160 hours (4 weeks) for each core rotation.  If your rotations are 5 or 6 weeks, the additional time can be used for virtual education or any other activities per the faculty member or preceptor’s professional judgement.  In addition, not all 160 hours have to be completed on‐site.  Journal clubs, case presentations, etc. which are commonly done in core rotations can all be done virtually.  This is not to say that all activities on a core rotation can be done off‐site but those that are amenable to another form of learning could be considered.

If your practice sites allow it and can provide qualified preceptors, consider using evening and weekend hours for student rotations as student pharmacists can be very helpful in providing care and other services to non‐Covid‐19 patients during this time of extreme stress on our health care system.

If you currently do not have any simulation hours in your IPPE instruction or it is less than the maximum of 60 hours, consider adding simulation to decrease the number of live hours that need to be provided. Given the current scenario with COVID‐19, the types of instruction that could be offered via simulation is much broader than the definition used in the past, which was to do things in simulation that were “difficult to do in the real world.”  The list of things that fit that definition is much broader today than even a week ago.

Review your experiential placements.  If you have students completing electives in sites that could be used and are needed for core experiences, consider moving the elective student to another site to increase your capacity for core rotations.

If you require more than 1440 hours of APPE in your curriculum, consider a temporary adjustment to now only require 1440 hours, while still respecting the required core experiences of 160 hours.  However, make sure that you comply with your university requirements for total number of credits and the state licensure requirements.

ACPE has always encouraged creativity and innovation. You do not have to achieve the desired outcomes of your curriculum in the same way you always have – if you can come up with alternatives that meet the standard and your curricular objectives, that is fine.

With regard to skills labs, they do not need to be completely cancelled during this time of online instruction.   Any concepts that may prepare the student for a skill can be offered virtually.  Let your faculty use their professional judgement to deliver the lab and meet the objectives.  The actual performance of the “skill” can be delayed to a later date when students are back on campus.

Many schools have reported concerns about the ability to administer the PCOA exam since students are not on campus.  We have been in contact with NABP and they plan to offer an alternative.  A communication from NABP will be forthcoming.

During this time of uncertainty and change due to COVID‐19, ACPE will not require schools to report substantive changes to the curriculum that are TEMPORARY and only in response to campus restrictions on instruction and experiential education as long as the changes do not violate the Standards.  All other changes (changes in leadership, permanent changes to the curriculum, etc.) should be reported as usual.

While ACPE understands that schools are under a great deal of pressure with the loss of normal resources, our job is to assure quality in pharmacy education and we do that through the standards that all have agreed are necessary to produce a practice‐ready pharmacist. ACPE staff do not have the authority to change the standards.  Should the situation become even more dire, we will continue to work with our Board and NABP to determine an approach that is appropriate.  We have been in contact with AACP, NABP and ASHP and will involve others as necessary to provide support to the schools.

This is our guidance as of today – it could change at any time given the fluidity of the situation.  If you have any questions, please feel free to reach out to any member of the ACPE staff.

Janet P. Engle, Pharm.D., Ph.D. (Hon), FAPhA, FCCP, FNAP
Executive Director, Accreditation Council for Pharmacy Education (ACPE)

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