APPE Information

The Doctor of Pharmacy (PharmD) degree program graduation requirements related to advanced pharmacy practice experience (APPE) courses are outlined below.

• 4 blocks of required APPEs, and
• 4 blocks of APPE electives totaling 28 units, of which at least 2 are full time direct patient care (DPC) rotations

All required APPE rotations are 6 weeks and count for 7 units.

• CP 192 - Hospital Pharmacy Systems and Practice Experience
• CP 193 - Community Pharmacy Systems and Practice Experience
• CP 194 - Acute Care Experience
• CP 195 - Ambulatory Care Experience

Students must achieve the following goals for all required APPE rotations:

• Become an effective professional in the assigned practice setting
• Take initiative and be responsible for learning and actively participate in a variety of activities related to patient care and/or operations of the practice site
• Apply knowledge and skills gained from previous courses to promote safe, effective, and rational therapeutics
• Enhance their skills in communication, problem solving, and critical analysis

All elective APPE rotations are 6 weeks and count for 7 units. Elective APPEs use one of two course numbers based upon whether or not the rotation involves direct patient care.

• CP 190 - Elective Advanced Pharmacy Practice Experience (non DPC elective)
• CP 191 - Direct-Patient-Care (DPC) Elective Advanced Pharmacy Practice Experience (DPC elective).

The examples below are not an inclusive list and availability may change from year to year.

CP 190: Examples of non-Direct Patient Care (non-DPC) electives:

• Administration
• Automation/Informational Technology
• Clinical Informatics
• Compounding (closed-door pharmacy)
• Consulting
• Drug Information
• Drug Utilization/Medication Use Evaluation
• Industry
• Managed Care
• Nuclear Pharmacy
• Pharmacy Benefits Management
• Teratogen Registry
• Veterinary Medicine

CP 191: Examples of Direct Patient Care (DPC) APPE electives:

• Burn unit
• Cardiology
• Clinical Pharmacokinetics
• Compounding
• Community Pharmacy
• Critical Care
• Emergency Medicine
• Geriatrics
• Hematology/oncology
• HIV
• Home Care
• Hospice care
• Infectious Diseases
• Nephrology
• Neurology
• Neurosurgery
• Nutrition
• OB/GYN
• Oncology
• Pediatrics (including PICU/NICU settings)
• Poison Control
• Psychiatry
• Pulmonology
• Surgery
• Transitional Care
• Transplant Trauma

Students must achieve the following goals for all elective APPE rotations:

• Become an effective member within the practice setting
• Take initiative and be responsible for learning and actively participate in a variety of activities within the practice setting
• Apply knowledge and skills gained from previous courses to the practice setting
• Enhance their skills in communication, problem solving, and critical analysis

Advanced Pharmacy Practice Experiences (APPEs) are experiential courses designed to provide pharmacy students with the opportunity to become a member of the pharmacy healthcare team. Depending on the course, APPEs take place in a variety of settings in order to expose students to both traditional and nontraditional career opportunities within the profession.

Real-life, hands-on clinical experiences are key to UCSF doctor of pharmacy degree education. This is NOT a shadowing opportunity.

The purpose of an APPE is for students to integrate themselves into the practice setting. Once oriented by their primary preceptor (or in some cases, pharmacy site coordinator) to the facility and pharmacist scope of practice within the setting, students will build on prior knowledge, skills, and experiences to contribute as a future pharmacist to the daily workflow. Student efforts are expected to add value to the experiential partner site. Student pharmacists will develop relationships with site preceptors and team members over the course of their experience(s) within a site. Students will take on roles that optimize and/or improve patient care. Through these roles, they will also learn about the communities that they serve.

What role will the student play?

The main goal for the APPE student is to contribute authentically to work flow and patient care while achieving the learning goals and objectives outlined for APPEs in this document.

What is expected of students?

Students should be integrated into the daily work flow for service and direct patient care within the practice setting. They should approach their role with a high level of professionalism, commitment, and patient advocacy. Students should become competent in performing their assigned duties and interacting directly with patients and team members without direct supervision from the preceptor(s).

Since each APPE is different, students will rely on you and your team to explicitly state your specific expectations and objectives for the experience. If you give the student an activity beyond his/her scope of training to date, please be prepared to provide that student with the necessary additional support and additional training.

What is expected of preceptors?

Preceptors' main role is to act as a resource, coach, and mentor for the student throughout the experience. Preceptors are expected to:

• Set clear expectations within the first 2 days of the APPE for the student
• Orient the student to the workplace and team members
• Treat the student like a member of your team and workplace
• Integrate the student into your daily work flow
• Meet with the student often to check-in on goals, expectations, and progress
• Provide opportunities for the student to reflect upon and debrief with you over experiences
• Provide the student with enough guidance, support, and on-going real time performance based feedback to be successful in his/her role
• Evaluate the student’s performance per the course requirements

How do preceptors evaluate student performance?

A mid-point formative evaluation and a final summative evaluation will be completed for each student. The student will initiate the midpoint self-assessment evaluation, using the tool provided in E*Value. Students should reflect on the experience and their performance. The midpoint evaluation should be discussed with the preceptor at the practice site at the midpoint of the experience. If a student is not meeting expectations or is not progressing at any point prior to the midpoint formative evaluation, the preceptor should notify their local Experiential Program Director.

The preceptor will complete a final summative evaluation via E*Value, utilizing the same tool that was used and discussed during the midpoint evaluation. Preceptors can log into E*Value directly to complete the final summative evaluation or can utilize the link that will be emailed at the end of the experience.

How do students evaluate preceptor performance?

Students will complete both preceptor and site evaluation forms at the completion of each APPE. Once all evaluation forms have been received and grades have been submitted by the Experiential Program Director, preceptors will be able to view their precepting evaluations in E*Value. Site evaluation forms are available either directly from your Experiential Program Director or, for those who serve as site coordinators, within E*Value.

Avenues for student feedback

Chart

Printable version: PharmD Student Feedback Channels (PDF, 1 page, 68 KB)

Text

How do I provide effective feedback? For…

• Student life: Student Quality of Life Surveys (launching in 2018)

• Policy/Leadership:

  • Student town hall meetings

  • Student representation to the School’s Admissions, Assessment & Evaluation (AEC), Educational Policy (EPC), and Academic Standards committees

  • Student/School administration leadership meetings

• Teaching/content:

  • Didactic:

    • Student evaluations of teaching (for lecturers and facilitators)

    • Student evaluations of courses (for course administrators/classroom-based learning environment)

  • Experiential:

    • Student evaluations of experiential practice sites (I/APPEs only)

    • P4 APPE Program Survey

• Co-curriculum: Student feedback for co-curriculum (via CLE or Qualtrics form)

• Post-graduation:

  • UCSF (AACP) Graduating Student Survey

  • UCSF Graduate Placement Survey

  • UCSF (AACP) Alumni Survey

Effective feedback is:

• Timely.

• Thoughtful.

• Actionable.

Tips to improve your feedback:

• Focus feedback on the needs of the recipient, not the provider.

• Focus feedback on the behavior, not the person.

• Be as specific as possible with both reinforcing (“positive”) and corrective (“critical”) feedback.

Created by OEIS. Revised 9.19.17.

There are several locations throughout California at which our student pharmacists participate in Advanced Practice Pharmacy Experiences (APPEs).

San Francisco Bay Area

Program Director: Tram Cat, PharmD

Number of Students: 55-60

Major APPE Sites:

• UCSF Medical Center
• Zuckerberg San Francisco General
• Stanford Health
• Lucile Packard
• Walgreens

Our largest APPE program offers approximately 70 unique rotations at 30 different healthcare sites, including USCF Medical Center (at Parnassus, Mission Bay, and Mt. Zion), Sutter Health, Kaiser Permanente, Laguna Honda Hospital and Rehabilitation Center, United States Coast Guard, Zuckerberg San Francisco General Hospital, and Epocrates. With the School’s close working relationship with the UCSF Health Pharmacy Enterprise, rotations are available in pediatrics, renal transplant, pain management, cardiology, critical care, medication safety, and oncology. Elective rotations are available in: clinical toxicology, infectious diseases, telepharmacy, drug information, nuclear pharmacy, and pharmacy administration.

The San Francisco Bay Area program provides student pharmacists with interprofessional training, working with UCSF students in medicine, nursing, physical therapy, and dentistry on a variety of rotations and projects.

North Bay

Program Director: Kirsten Balano, PharmD

Number of Students: 14-16

Major APPE Sites:

• Sutter Santa Rosa Regional Medical Center
• Petaluma Health Center

Greater Sacramento

Program Director: Tiffany Pon, PharmD

Number of Students: 22-25

Major APPE Sites:

• UC Davis Medical Center
• Mercy Medical Group

The Greater Sacramento Program, established in 1985, is based at the University of California, Davis Medical Center (UCDMC) in Sacramento. As with the other off-campus programs, students complete all requirements for graduation locally. Over 150 practitioner-faculty-members located throughout the Sacramento metropolitan area serve as preceptors, role models, and mentors for student pharmacists assigned to the program. Faculty are employed in both teaching and community sites, providing student pharmacists with an opportunity to evaluate career opportunities in a variety of traditional and non-traditional practice settings.

The primary sites for required and many elective APPEs are UCDMC; the County of Sacramento; Kaiser Permanente (Folsom, Morse Avenue, Point West, Rancho Cordova, and Roseville); and the Veterans Affairs (Mather Field). Other elective APPEs are available at Chartwell; MedClinic; California Poison Control System, Sacramento; and the University of California, Davis Veterinary Medical Teaching Hospital. Graduating student pharmacists consistently rate the Greater Sacramento program highly for its rich learning environment, exposure to diverse patient populations, professional and nurturing faculty, rotation assignment flexibility, and the networking opportunities it provides.

Fresno

Program Director: Samantha Valle-Oseguera, PharmD

Number of Students: 16-18

Major APPE Sites:

• Community Medical Centers
• Kaweah Delta Health Care District
• Valley Children’s Hospital (including Walgreens)

The Fresno pharmacy education program formally began in 2001, although the School has offered elective rotations in the area since the early 1990s. In addition to the School of Pharmacy, the School of Medicine has had both undergraduate and graduate programs (residencies, including primary care and several specialties, and fellowships) based in Fresno for over 35 years. The Fresno program has grown to include six different health care systems and a variety of independent sites offering APPEs in diverse practice settings throughout the central San Joaquin Valley (Fresno/Clovis, Madera, Kingsburg and Visalia).

There is a full-time UCSF faculty member and a part-time administrative assistant currently assigned to the program. In addition, student pharmacists benefit from their interactions with almost 100 preceptors, many of whom are UCSF alums and/or hold volunteer faculty appointments in the School of Pharmacy. Most preceptors also precept students from other schools of pharmacy within and outside of California. Student pharmacists have opportunities to interact with students from the other pharmacy schools as well as with UCSF medical students and residents.

Southern California

Program Director: Yvette Hellier, PharmD

Number of Students: 15-17

Major APPE Sites:

• Cedars-Sinai Medical Center
• UC Irvine Medical Center
• Long Beach Memorial Medical Center
• Ralphs

The Southern California program began in 1980 with University of California, Irvine Medical Center and Long Beach Memorial Medical Center as the primary clerkship sites. Over the years, it has developed into a large program with about 40 different institutions, offering Advanced Pharmacy Practice Experiences (APPEs) in a wide variety of practice settings (about 120) throughout the Los Angeles and Orange County area.

One full-time UCSF faculty member leads the program with about 200 excellent preceptors who practice in these settings and who have volunteer faculty appointments with the School of Pharmacy. Many of these preceptors also teach students from University of Southern California (USC), University of the Pacific (UOP), Western University, and Loma Linda University. UCSF students frequently interact with the students from the other schools.

There are several institutions in the Inland Empire (Colton, Fontana, Ontario, Riverside) that may accommodate one student for the entire year (six to eight clerkships).

APPEs begin during late spring of second-year studies and continue through third-year studies in medical centers and hospitals, outpatient facilities, and community clinics at one of five APPE programs located throughout California.

About APPE sites

• Each program uses Kaiser Permanente as a major APPE site, usually across several locations. Veterans Affairs Facilities are another major APPE site (except for North Bay).
• Students often choose the program that allows them to live close to family and supportive communities.
• Each program offers diverse electives, faculty and preceptor mentorship. Accessing student health services may be challenging for all of the off-campus programs.
• Since the locations of APPEs vary, a car may be a necessary resource during this portion of the program.

APPE regions

Each region has a dedicated Program Director.

1. San Francisco Bay Area (San Francisco and areas immediately south and east)
2. North Bay (areas north and east of San Francisco Bay)
3. Greater Sacramento (northern portion of the California Central Valley)
4. Fresno (southern portion of the California Central Valley)
5. Southern California (Los Angeles and Orange Counties)