Multifaceted Strategy That Improves Students' Achievement of Entrustable Professional Activities Across Advanced Pharmacy Practice Experiences

Objective: To outline an approach to help students achieve Entrustable Professional Activities (EPAs) entrustment during a sequence of Advanced Pharmacy Practice Experiences (APPEs) by implementing longitudinal monitoring and individualized intervention and remediation strategies. Methods: Using the recommended EPAs within the core APPEs (acute care, ambulatory care, community, institutional), students were expected to achieve entrustment on all EPAs by graduation. A longitudinal monitoring approach, using an "EPA report card," was implemented to continuously identify students at risk of not meeting the EPA requirement of "Level 3" entrustment (perform with reactive supervision). Individualized interventions, including proactive outreach and in-sequence remediation, were incorporated into the APPE core and elective sequence to help ensure all students were entrusted by the end of APPEs without requiring further end-of-year remediation to graduate. Results: For the graduating classes of 2023 and 2024, 12% (8 of 69) and 16% (12 of 75) students, respectively, were identified as at risk of not meeting EPA entrustment. Proactive outreach, in-sequence remediation, or a combination of both strategies, were used to enhance learning and EPA performance. As a result, all students achieved "Level 3" entrustment on the deficient EPA(s) by the end of the APPE sequence. No student required further end-of-year remediation to graduate. Conclusion: Utilizing a multifaceted strategy provided timely, real-world practice opportunities to improve the students' achievement of EPAs across the APPE curriculum and decreased the need for end-of-year remediation and potential graduation delays.