EXPERIENCE

Students as catalysts to increase

community pharmacy–led direct patient
care services
Jennifer L. Rodis, Timothy R. Ulbrich, Brandon T. Jennings, Betsy M. Elswick, and Rebekah Jackowski
McKinley

Jennifer L. Rodis, PharmD, BCPS, FA-

Abstract PhA, Associate Professor of Clinical Phar-
macy and Assistant Dean for Outreach and
Engagement, College of Pharmacy, Ohio
State University, Columbus, OH
Objective: To describe the impact on community pharmacy service devel-
opment of a faculty–student–pharmacist collaborative program offered by Timothy R. Ulbrich, PharmD, Associate
five U.S. colleges. Professor of Pharmacy Practice and Asso-
ciate Dean for Workforce Development and
Practice Advancement, College of Phar-
Setting: Colleges of pharmacy and community pharmacies in Arizona, Il- macy, Northeast Ohio Medical University,
Rootstown, OH
linois, Ohio, Utah, and West Virginia.
Brandon T. Jennings, PharmD, BCACP,
Practice description: Partner for Promotion (PFP) is an elective, longitu- Associate Professor of Pharmacotherapy,
College of Pharmacy, University of Utah,
dinal advanced pharmacy practice experience (APPE) focused on enhance- Salt Lake City, UT
ment of community pharmacy management skills, specifically the develop-
Betsy M. Elswick, PharmD, Clinical Asso-
ment and implementation of direct patient care services. This faculty–stu- ciate Professor, School of Pharmacy, West
dent–pharmacist collaborative model has been implemented in five U.S. Virginia University, Morgantown, WV
colleges of pharmacy beyond the originating institution. Rebekah Jackowski McKinley, PharmD,
Assistant Professor, College of Pharmacy–
Evaluation: Data on pharmacy demographics and the impact of PFP on ser- Glendale, Midwestern University, Glendale,
AZ
vice creation and longevity at these partnering schools were reported via
annual online surveys completed by faculty directors at each partnering col- Correspondence: Jennifer L. Rodis,
PharmD, BCPS, FAPhA, Ohio State
lege of pharmacy. University College of Pharmacy, Parks Hall
Rm. 129B, 500 W. 12th Ave., Columbus,
Results: Over a 3-year period, 19 pharmacy teams across five states worked OH 43210; rodis.2@osu.edu
to create a total of 15 direct patient care services, 12 of which were still being Disclosure: Jennifer L. Rodis is the creator
offered to patients at the time of data collection (80% longevity). The PFP of the licensed Partner for Promotion
program described in this article. The
program guided 38 students through the process of developing and imple- authors declare no other relevant conflicts
menting a sustainable service at a community pharmacy. All participating of interest or financial relationships.
faculty from partnering colleges of pharmacy (100%) indicated that PFP
Funding: Community Pharmacy Foundation
model materials were “very useful” (4-point Likert scale; 1, not useful, to grant.
4, very useful), and all five colleges plan to continue offering the program
Previous presentation: Poster (research
moving forward. in progress) at the American Pharmacists
Association Annual Meeting &  Exposition,
Conclusion: The PFP model of training and service development can have March 25–28, 2011, Seattle, WA.
a positive impact on the pharmacy profession, serve as an avenue for train- Acknowledgments:  The authors thank 
ing students in the development of clinical services, and be a catalyst for Yolanda Hardy, PharmD; Donald Brower,
BSPharm; Charisse Johnson, MS,
establishing the growth of community pharmacy as a patient-centered, ser- PharmD; and Gretchen Garofoli, PharmD,
vice-oriented partner in the health care system. for their contributions to this project and
data reporting.
J Am Pharm Assoc. 2015;55:642–648. Received November 25, 2014. Accepted for
doi: 10.1331/JAPhA.2015.14261 publication June 18, 2015. Published online
in advance of print October 9, 2015.

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 IMPACT OF FACULTY–STUDENT–PHARMACIST COLLABORATIVE
A s the U.S. health care landscape continues to
evolve, both practicing pharmacists and student
pharmacists have great opportunities to be involved
with shaping reform in this area. Legislative changes
have expanded the role of the pharmacist in all prac-
tice settings.1,2 This is especially true in community
pharmacies, where medication therapy management
(MTM) has altered the way pharmacies do business
and pharmacists approach their jobs and has allowed
pharmacists to push the boundaries of their practices
to include more patient-centered pharmacy services.3–5
However, while many pharmacists are already
involved in offering these types of services, a large
population of pharmacists and pharmacies has yet to
engage in such activities. Pharmacist surveys have re-
vealed that common barriers to involvement in patient-
centered pharmacy services include the time required
and the need to understand management or business
elements of service initiation and provision.3,4,6 These
findings may be influenced by the fact that pharmacy
school education has primarily focused on training
pharmacists to provide effective patient care.
Key Points
Background:
❚❚ Opportunities exist for pharmacists to engage
in medication therapy management (MTM),
but many pharmacists lack the time and
business and management skills needed to
integrate such services into community phar-
macies.
❚❚ Student pharmacists need service develop-
ment experience as an adjunct to clinical train-
ing, and they can serve as pharmacist extend-
ers to assist with service expansion and care.
❚❚ A need exists for new models to facilitate the
expansion of MTM services in the community
pharmacy setting.
Findings:
❚❚ The Partner for Promotion (PFP) program pro-
vides a development model for direct patient
care services via collaboration between com-
munity pharmacy preceptors and college of
pharmacy faculty and students.
❚❚ PFP was adopted by five U.S. colleges of phar-
macy and used to facilitate service develop-
ment between 2009 and 2013, with 80% of ser-
vices developed through the model continu-
ing beyond the first program year.
❚❚ Participating college of pharmacy faculty were
satisfied with the PFP program and continue
to foster community practice advancement
through offering PFP to students and commu-
nity pharmacy preceptors.
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EXPERIENCE
While student pharmacists may learn some man-
agement concepts in didactic environments, they are
not often given the opportunity to apply these concepts
to an actual pharmacy setting. Further, student phar-
macists are most often placed into experiential educa-
tion practice sites with well-functioning clinical phar-
macy services, precluding them from obtaining the
necessary business and service development knowl-
edge for application to future practice opportunities.
In the provision of patient care, student pharma-
cists can serve as pharmacist extenders to help mini-
mize the amount of time required for pharmacists to
provide clinical services. Several published examples
have shown how student pharmacists can assist in pro-
viding such advanced patient care services as face-to-
face or telephonic MTM.7,8 However, while such an ap-
proach is quite successful in developing the next gen-
eration of patient care providers, it often lacks the in-
struction needed to help college of pharmacy graduates
create a sustainable business model for future clinical
practice. Similarly, student business planning competi-
tions sponsored through national and state pharmacy
organizations can provide students with valuable
learning opportunities, but such experiences may also
lack real-world applicability.
While there is evidence describing the contribution
of student pharmacists to the provision of patient care
services and a need exists for hands-on student train-
ing in sustainable business planning related to service
development, evidence is lacking in the pharmacy
literature describing how students might engage in
and have an impact on service creation and/or expan-
sion.
Objective
The purpose of this project was to describe the impact
on community pharmacy service development of a
faculty–student–pharmacist collaborative program
offered by five U.S. colleges. While previous papers
have described the impact of the Partner for Promotion
(PFP) program offered at Ohio State University College
of Pharmacy, the purpose of this paper is to describe
direct patient care service development through PFP at
colleges of pharmacy beyond the originating institu-
tion and in pharmacies across the United States.
Methods
Practice description
Partner for Promotion (PFP) is an elective, longitudi-
nal advanced pharmacy practice experience (APPE)
that connects college of pharmacy faculty and students
with community preceptors for a year-long commu-
nity pharmacy management program, with a specific
focus on direct patient care service development and
implementation.
At Ohio State University College of Pharmacy,
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 EXPERIENCE IMPACT OF FACULTY–STUDENT–PHARMACIST COLLABORATIVE

where PFP has been offered since 2005, there has been
evidence of program impact on student business and
management skill development.9,10 Between 2009 and
2013, the PFP model was expanded to five other U.S. col-
leges of pharmacy, with the aim of evaluating broadly
the impact on community pharmacy service develop-
ment of a program bringing together community phar-
macists, pharmacy school faculty, and students to fos-
ter student-led service development.
Study setting and population
Adoption of the PFP model at five U.S. colleges of phar-
macy occurred through a recruitment process aimed
at identifying a lead community pharmacy faculty
member within each academic institution. A list of po-
tential faculty and college partners was compiled by
networking through the Community Pharmacy Resi-
dency Program forums associated with the American
Pharmacists Association and via discussions with na-
tional leaders in academic community pharmacy and
national pharmacy organizations.
Faculty and colleges were invited to participate
with the goal of including colleges of pharmacy with
varying demographics in terms of geography, funding
source, size, and years in existence. Once a college in-
dicated interest, the identified lead community faculty
member within each institution was responsible for
championing integration of PFP into the curriculum.
Institutional administrative approval was then at-
tained, legal contracts were signed, and faculty part-
ners received training on the PFP model. This expan-
sion project was funded by a Community Pharmacy
Foundation grant and deemed exempt by the Ohio
State University Institutional Review Board.
Study procedures
To encourage sustainability of the PFP program at these
participating institutions, the model was shared with-
out directives on use. Faculty were trained via an in-
person meeting during which they were provided hard
copy and electronic versions of the program model and
guided through case studies to consider various sce-
narios and lessons learned. The intent was for all par-
ticipating faculty to work as a network to enhance edu-
cation and practice development related to advanced
patient care services in community pharmacies, with
the PFP program functioning as the framework and
the students as catalysts. This was facilitated by each
institution individually offering its own version of the
program based on the PFP model, with ownership at
the local college of pharmacy.
Following training, faculty champions established

Table 1. Characteristics of pharmacies adopting Partner for Promotion program model of direct patient care service development in collaboration with
college of pharmacy faculty and students
No. prescriptions Clinical services No. years pharmacist
College of pharmacy Pharmacy type per weeka offered prior to PFPb in practicec
Independent 1,200 No 34
Independent 2,000 No 4
Clinic n/ad No 5
Chain 2,800 No 12
Chicago State University Chain 3,500 No 10
Midwestern University–Glendale Regional chain 1,200 Yes 13
Independent 960 Yes 28
Regional chain 350 Yes 36
Regional chain 525 No 20
Northeast Ohio Medical University Regional chain 525 No 39
Independent 2,000 No 14
Independent 1,000 No 17
Independent 1,000 No 18
Independent 1,500 No 3
Yes
Chain 2,000 (employees only) 26
Health-System
University of Utahe Retail 700 No 14
West Virginia University Independent 1,500 Yes 32
a
Prescription amounts are approximate.
b
Patient care services provided beyond Omnibus Budget Reconciliation Act of 1990 (OBRA ‘90) counseling.
c
Pharmacist preceptor working in collaboration with participating pharmacies and college faculty/students.
d
Site was a clinic/nondispensing pharmacy.
e
Initiated community pharmacy residency after Partner for Promotion built infrastructure over a 2-year period.

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 IMPACT OF FACULTY–STUDENT–PHARMACIST COLLABORATIVE EXPERIENCE

their own timelines for rollout of PFP at their institu- Results

tions, with all but one school allowing for a year of
planning in advance of rollout (the exception rolled out
the program during the first year). Participating faculty
recruited pharmacy sites and students based on exist-
ing relationships, evidence of successful student train-
ing, potential for growth of sites, and the availability of
college-specific screening and interview processes for
students. Students and preceptors at each participat-
ing school followed the PFP model timeline for service
development and were required to complete the same
training modules and develop associated business
planning materials (see Supplemental Table 1 at japha.
org). Assessment of and feedback on materials were
guided by rubrics included with the PFP model, in-
creasing consistency in the mentoring provided at the
different schools of pharmacy.
Evaluations
Program impact was evaluated through annual survey
reports submitted by a faculty member at each of the
five partnering colleges via Qualtrics (www.qualtrics.
com). Metrics used for program evaluation included
pharmacy site and preceptor demographics, number
of participating community pharmacy sites, number
of students participating, number and type of patient-
centered services developed, service longevity, and fac-
ulty satisfaction.
Quarterly online meetings were conducted to en-
sure that lead community faculty were supported
throughout the project, with individual consults and
communication encouraged. In addition, the lead fac-
ulty group convened once a year at the American Phar-
macists Association Annual Meeting & Exposition in
the spring of 2011, 2012, and 2013.
Between 2010 and 2013, five colleges of pharmacy be-
yond the originating institution offered their own
version of the PFP program. The partnering institu-
tions included Chicago State University; Midwestern
University–Glendale in Glendale, AZ; Northeast Ohio
Medical University in Rootstown, OH; University of
Utah in Salt Lake City; and West Virginia University in
Morgantown, WV.
Each college offered the program to between one
and three pharmacy sites partnered with two students
per site annually. Demographics of participating phar-
macy sites are included in Table 1. The PFP program
was completed by 19 different faculty–student–phar-
macist teams at pharmacies affiliated with the partner-
ing institutions between 2010 and 2013. A total of 38
students were engaged in these collaborative teams,
which also included participation from pharmacy
practice residents. A community pharmacy service
was developed at each site annually, with a total of 15
services implemented. Of those 15 services created
through PFP, 12 were still being offered at the time of
data collection—an 80% rate of longevity.
Various direct patient care services were created by
students and community partners engaged in the PFP
program with these institutions, including MTM, im-
munizations, wellness screenings, and prevention ser-
vices, as well as disease-focused and education servic-
es (Table 2). Those services implemented successfully
were provided within the workflow of the pharmacy
following graduation of student participants. Depend-
ing on the type of service created and the workflow pat-
tern and staffing model of the individual pharmacy, the
services were provided by existing pharmacists, added
positions, and/or a team of experiential students, resi-

Table 2. Number of community pharmacies engaged in the Partner for Promotion program model, direct patient care services developed, and
services continued following project completion
No. pharmacies engaged Number of services
College of pharmacy in program (2009–2013) No./type of services developeda continuingb post-project
2 immunization (2012, 2013) 2c
Chicago State University 6 1 blood pressure (2013)
Midwestern University–Glendale 1 None 0
2 MTM (2012, 2013)
Northeast Ohio Medical 1 veterinary compounding (2012)
University 4 1 diabetes education (2013) 4
2 immunization (2010, 2011)
2 education (2012)
1 compounding (2012)
University 1 preventative health screening
of Utah 6 (2013) 4d
1 medical nutrition (2012)
West Virginia University 2 1 tobacco cessation (2013) 2
a
Includes only those pharmacies that successfully implemented a service during their program year.
b
Continuing is defined as actively recruiting and providing care to patients at the time of data collection.
c
Continuation of blood pressure service unknown due to college faculty’s loss of communication with pharmacy site.
d
The two services not continuing were the 2011 immunization service and one of the 2012 education programs.

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 EXPERIENCE IMPACT OF FACULTY–STUDENT–PHARMACIST COLLABORATIVE
dents, and/or technicians. The teams that developed
services that were not implemented faced challenges
related to financial feasibility, workflow, and/or staff-
ing limitations.
All five colleges planned to continue offering the
PFP program as part of their curriculum and/or restart
the program with current or new faculty or depart-
mental oversight, as applicable. Those three colleges
experiencing faculty shifts in 2012 allocated resources
to the program so that it would be continued moving
forward. Participating faculty from partnering schools
of pharmacy were universally satisfied with the PFP
model, with 100% indicating via survey that the PFP
materials were “very useful” (4-point Likert scale; 1,
not useful, to 4, very useful).
Discussion
This project demonstrated successful community
pharmacy service development via the PFP model at
five U.S. colleges of pharmacy beyond the originating
institution. A total of 19 faculty–student–pharmacist
teams were engaged in the project, with 12 of the 15 ser-
vices created through the program still being offered
to patients at the time of data collection. The program
ultimately guided 38 students through the process of
developing and implementing a sustainable service
in a community pharmacy. All participating faculty
from partnering colleges of pharmacy were satisfied
with the program model materials, and all five colleges
planned to continue offering the PFP program moving
forward.
Markers of program success
Faculty and investigators identified key elements for
success of this project, including integrity of program
materials, easy online access to the materials, regular
communication among the faculty network, and own-
ership of the materials to be used at each institution at
the discretion of the faculty partner.
Success of PFP was also dependent on the high
quality of pharmacy sites and preceptors established
by the participating colleges of pharmacy and their
engaged students. According to the American Society
of Health-System Pharmacists, attributes of successful
pharmacy preceptors include excellent communica-
tion skills; interpersonal traits such as warmth, inter-
est, and compassion; and excellence in teaching and
leadership.11A personality trait inventory was not com-
pleted for PFP preceptors participating in this program,
but the faculty at each college selected experienced and
motivated preceptors dedicated to improving the qual-
ity and quantity of community pharmacy services. Spe-
cific characteristics of participating students may also
help determine the success and sustainability of clini-
cal services at experiential sites. However, while each
college used individual screening processes to identify
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students to participate in the program, the exact traits
of successful students have not been evaluated.
According to participating pharmacy faculty, the
characteristics of pharmacy sites that were most suc-
cessful in service implementation and longevity dur-
ing the project included corporate or management buy-
in and supporting infrastructure, clinical support via
dedicated coordinators, and corporate vision of com-
munity pharmacy growth in the provision of direct
patient care services. Other factors contributing to posi-
tive outcomes included a fully staffed pharmacy site, a
willingness of technicians and pharmacists to embrace
collaboration, and an organized and efficient workflow.
Operating a pharmacy that ran well prior to new ser-
vice integration was also identified as a factor of suc-
cessful implementation and longevity. In addition, fac-
ulty felt that achieving an effective service was affected
by the drive, passion, and accountability of pharmacy
preceptors who ingrained the new service into a phar-
macy’s existing workflow and culture and who were
committed to continuing it beyond the PFP year.
Service provision and the future of patient care
With major shifts occurring in the U.S. health care sys-
tem, community pharmacy must be an engaged part-
ner in health care delivery beyond the dispensing of
medication.2,12–16 Pay-for-performance initiatives such
as those associated with accountable care organizations
(ACOs), patient-centered medical homes (PCMHs), and
Medicare’s star ratings program are changing the focus
of health care from visit-based to outcomes-based com-
pensation.2,17,18
Through this demonstration project, PFP provid-
ed a tool for expanding health and wellness services
in community pharmacy settings in a variety of geo-
graphic areas throughout the United States. The servic-
es created through these faculty–student–pharmacist
teams have the potential to impact key quality markers
that are becoming the foundation for health care pay-
ment structures. Community pharmacy services de-
signed to provide MTM, and immunization’s, as well as
chronic disease management and education may have
a positive impact on such issues as medication adher-
ence, older adults’ high-risk use of medication, and vac-
cine rates, thus securing the indispensable role of the
pharmacist in improving health outcomes.18
As practice sites work to advance their patient-cen-
tered offerings, subsequent students on APPE rotation
can benefit from contributing to the provision of these
value-added community pharmacy services. While
fostering skill development of future pharmacists, this
also builds up the personnel infrastructure for com-
munity pharmacy to provide such services to patients.
Evidence shows that students involved in clinical
service provision exhibit increased competence and
confidence in their patient care skills. A study by Had-
Journal of the American Pharmacists Association
 IMPACT OF FACULTY–STUDENT–PHARMACIST COLLABORATIVE
dad et al. evaluated the change in students’ confidence
level regarding health promotion, MTM, and inter-
professional care following participation in a 5-week
APPE focused on community engagement, with a com-
parison of pre- and post-APPE surveys showing a sta-
tistically significant improvement.19 A separate study
by Dahl and Hall indicated that University of Florida
students who completed a fourth-year experiential
rotation at an MTM call center reported significantly
higher self-efficacy in performing MTM services than
nonparticipating fourth-year students and were poten-
tially more likely to pursue opportunities to provide
such services in the future.20
The college of pharmacy network engaged in this
project has the potential to collaborate on practice and
educational research related to formally identifying
the strengths or personality traits of preceptors at expe-
riential community pharmacy sites engaged in patient
care implementation programs, preferred attributes of
successful students, and indicators of program success
based on the characteristics of pharmacy staff and sites.
Future research should focus on evaluating patient
outcomes and such pharmacy-based outcomes as fi-
nancial sustainability and workflow. PFP continues to
seek opportunities for program expansion and adop-
tion at additional U.S. colleges of pharmacy as well as
through collaborations with other health care and pub-
lic health entities.
Limitations
One potential limitation to the generalizability of this
project is the process of faculty selection. The primary
investigator for this project selected individuals with
extensive experience in community practice and edu-
cation. In expanding the program to other colleges of
pharmacy, participating faculty partners may have
other backgrounds that affect the success of program
transfer and local use in different ways. Another limi-
tation is that PFP is a licensed product with a transfer
fee that was waived during this grant-funded demon-
stration project. This fee could potentially limit further
expansion of the model, but local practice and educa-
tional development grants may be available to support
program cost.
Conclusion
This report provides an update 3 years after adoption
of the PFP faculty–student–pharmacist collaborative
program model. Time will tell if the model is sustain-
able long term at the five participating U.S. colleges of
pharmacy, as well as the impact on students, commu-
nity partners, and faculty.  We  hope  that this type of
model of training and service development can have
a  positive impact on  the pharmacy profession, serve
as an avenue to train student pharmacists in the skills
needed to develop community-based patient care ser-
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EXPERIENCE
vices, and be a catalyst for the growth of community
pharmacy as a patient-centered, service-oriented part-
ner in the health care system.
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Harbor At Sunset • Cold Spring Harbor, NY • 2011 • Anthony F. DeMonte, PharmD

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