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Experiential Education

(86) Prevalence, Impact, and Response to Students Experiencing Distressing APPE-related Events

    Primary Author(s)

  • Katherine Newman, PharmD

    Director of Experiential Education and Clinical Associate Professor
    Southern Illinois University Edwardsville
    Edwardsville, Illinois, United States

    • Co-Author(s)

  • Valerie Ruehter, PharmD, BCPP

    Assistant Dean of Experiential Learning
    University of Missouri Kansas City
    Kansas City, Missouri, United States

Objective : Healthcare students and professionals are often faced with distressing experiences as part of their everyday work. Though well documented in nursing and medical literature, the prevalence of work-related trauma in pharmacy is unknown. This study aimed to determine the frequency, impact, and response to distressing events during Advanced Pharmacy Practice Experiences (APPEs).

Methods: Utilizing published medical literature as a guide, a survey was created and administered through Qualtrics to identify frequency and types of distressing APPE-related events experienced by students at two schools of pharmacy. Each semester, students were asked to complete the survey indicating how many distressing events they experienced and the type(s) of distressing events (patient-care related, student-provider conflict, patient mistreatment by a provider, or other). Students answered questions about the perceived impact of the experience, how it was addressed by preceptors, and provided open-ended text feedback.

Results: During the 2021-22 APPE year, 148 responses were recorded (28.3% response rate). At least one distressing event was reported by 64.4% of students. Events were most frequently reported during hospital (39.4%) or acute care (21.8%) rotations, however events were reported on all rotation types. Patient-care related events were most common (40.4%) followed by student-provider conflict (34.9%). Many students (44.8%) reported lasting impacts, most commonly intrusive, recurrent memories. Only 35.3% of students reported a discussion with someone at the practice site after the distressing event occurred.

Conclusions: Rates of student-reported distressing events are noteworthy and similar to those in other healthcare professions. Students may need support processing these experiences, yet debriefing was rare. Pharmacy programs may address this important issue through programmatic changes, student preparation, and preceptor education.