Leveraging an Implementation Fidelity Framework to Assess Quality in Experiential Education

Abstract

Objective. Experiential education comprises a significant component of many health professions degree programs. Since the experiential curriculum typically occurs at external sites, schools and colleges of pharmacy are often challenged with determining how and what students learn during this time. Fidelity metrics can provide insight into the extent to which experiential programs are implemented as designed. Our School implemented a new curriculum that included a series of three, two-month introductory pharmacy practice experiences (IPPE). The objective of this study was to articulate a logic model for the first IPPE within the series, identify key variables to program implementation, define fidelity indices and benchmarks, and compute a single fidelity score for each site.

Methods. Data were collected from the course syllabus, learning outcomes, assignments, and evaluations from students and preceptors for 50 sites that hosted 147 students for an IPPE. A logic model was defined to articulate inputs, activities, outputs, and outcomes of the IPPE. Data were reviewed for key variables and measures to include in the fidelity framework; a fidelity score was generated for each site.

Results. Twenty-four variables were identified across three components that were deemed critical for experience implementation (eg, patient care activities, preceptor compliance, and overall site training and evaluation). The mean fidelity score for all sites was 59.1% (16.4% SD).

Conclusion. A logic model and fidelity framework provided an objective method to assess the extent to which practice sites delivered the IPPE course. This work could be used as a basis for individualizing quality assurance efforts.