Development and implementation of a remotely precepted, interprofessional advanced pharmacy practice experience in rural Guatemala

Background and purpose: It is well-established that interprofessional experiences in the international setting provide students with additional skills in cultural humility and adapting to specific patient circumstances. Though these experiences are integral to the development of students, they are difficult to establish due to a lack of in-country preceptorship. This manuscript describes the development and implementation of an interprofessional advanced pharmacy practice experience (APPE) and outlines the interventions students have made to advance patient care, build trust, and improve the education of patients and providers in rural Guatemala. Educational activity and setting: The APPE in rural Guatemala was developed to include pharmacy distribution activities, education (patient, technician, provider, community), and clinical pharmacy services in an interprofessional environment. Pharmacy faculty served remotely as the primary preceptors using FaceTime, WhatsApp, and email. Findings: A total of 12 APPE pharmacy students have completed the six-week Guatemala rotation since implementation. Students reported that they spent the majority of their time (60% to 70%) seeing patients and training the technician. The remaining time was split between assisting United States and Guatemalan providers during clinic visits and conducting home visits with community nurses. Students made 1191 patient care recommendations, of which 969 were accepted (81.4%). Students completed 17 patient education and quality improvement projects. This APPE in Guatemala meets the needs of underserved populations, establishes effectiveness of distance precepting by pharmacy faculty, and provides international, interprofessional opportunities for fourth year pharmacy students.