Currents in Pharmacy Teaching and Learning 16 (2024) 58–63

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Currents in Pharmacy Teaching and Learning

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currents-in-pharmacy-teaching-and-learning

Experiences in Teaching and Learning

Virtual site visits - an emerging option for experiential

quality assurance
Janel P. Soucie a, Janelle L. Krueger b, Lisa Vandervoort a, Antoinette K. Brown b,
Carinda Feild c, *
a
University of Florida College of Pharmacy, Orlando Campus, 6550 Sanger Rd, Orlando, FL 32827, United States
b
Experiential Education, University of Wyoming School of Pharmacy, Dept. 3375, 1000 E. University Ave., Laramie, WY 82071, United States
c
University of Florida College of Pharmacy, 9200 113St N, Seminole, FL 33772, United States

A R T I C L E I N F O A B S T R A C T

Keywords: Background and purpose: Site visits are a valuable tool for experiential quality assurance. There is
Experiential education sparse literature regarding the use of a virtual modality for completion of site visits. This
Experiential learning manuscript describes the experience of using of onsite and virtual site visits, including benefits
Quality assurance
and limitations of each approach, by two pharmacy experiential programs.
Preceptors
Virtual communication
Educational activity and setting: Each experiential program utilizes both virtual and onsite visits to
assess site quality, provide preceptor development, and connect with sites and preceptors. In­
formation gathered and documentation processes are similar for both institutions for both visit
modalities. The two pharmacy institutions differ in size, geographical location, number of
experiential sites, and experiential department structure.
Findings: Based on site evaluator feedback from the two institutions, both visit modalities ach­
ieved the goals of evaluating sites for quality, fostering relationships with preceptors, and
affording opportunities to provide preceptor development. Positive features of virtual site visits
were increased flexibility with scheduling, expanded participation and engagement, increased
efficiency, and decreased cost. Drawbacks noted with virtual site visits were challenges touring
the site, decreased ability to observe group dynamics and culture, and participant multi-tasking.
Summary: A virtual approach to completing experiential site visits achieved programmatic goals.
Utilizing a combination of virtual and onsite visits may facilitate a customized approach to
navigating the advantages and disadvantages of each modality.

Background and purpose

The Accreditation Council for Pharmacy Education establishes accreditation standards for doctor of pharmacy degree programs.
Guidance for delivery of required experiential programs is included within Standard 10 (curriculum design, delivery, and oversight)
and indicates that an experiential quality assurance process must be in place.1 The standards also outline expectations for how
experiential programs interface with experiential training sites and preceptors. Standard 20 advises that schools or colleges must use
quality criteria to recruit, orient, and evaluate preceptors, and Standard 22 indicates that practice sites should be regularly evaluated.1

* Corresponding author.
E-mail addresses: jsoucie@cop.ufl.edu (J.P. Soucie), jkruege1@uwyo.edu (J.L. Krueger), Lvandervoort@cop.ufl.edu (L. Vandervoort),
Abrown13@uwyo.edu (A.K. Brown), Cfeild@cop.ufl.edu (C. Feild).

https://doi.org/10.1016/j.cptl.2023.12.006

Available online 5 January 2024

1877-1297/© 2023 Elsevier Inc. All rights reserved.
J.P. Soucie et al. Currents in Pharmacy Teaching and Learning 16 (2024) 58–63

The accompanying accreditation guidance document further delineates expected preceptor and site attributes.2 Additional informa­
tion about United States accreditation standards, is provided in the eAppendix. The accreditation standards, however, do not outline
how experiential quality assurance processes occur or how sites and preceptors are to be evaluated. While there is no specific directive
delineating site visits as a quality assurance tool, site visits have been used for this purpose.3,4 In addition, pharmacy programs find site
visits a useful way to connect with preceptors, review program specifics, and provide development opportunities.5,6
Not only do experiential programs find site visits useful as part of their quality assurance processes, but preceptors also find value in
site visits. Burgett et al6 surveyed their school’s preceptors to determine if site visits met preceptors’ needs. The vast majority
(approximately 88%) of respondents indicated that site visits met their needs for orientation, reviewing experience requirements and
preceptor expectations, and obtaining guidance regarding assigned advanced pharmacy practice experience students. Unsurprisingly,
preceptors also agreed that site visits improved communication with the pharmacy program.
While site visits are valuable to the ongoing quality assurance process for pharmacy student experiences and foster relationships
between the program and site, experiential teams face several challenges in completing traditional onsite site visits. Experiential sites
may be a considerable distance from the college campus, requiring the experiential office team to commit significant time and re­
sources to travel to and from the location. As budgets have tightened for many programs, particularly with declining admissions,
travel-related costs are often one of the first areas to be restricted. Time limitations and scheduling logistics are also a factor as
experiential teams must plan site visits around their teaching and other program responsibilities and match that to the availability of
preceptors. Programs may also be impacted by seasonal weather conditions, which can make travel hazardous and advanced
scheduling of visits challenging. Finally, some sites may limit visitors (e.g., as noted during the COVID-19 pandemic) or not have a
physical location to visit (e.g., virtual experiences).
Pharmacy educators have commonly conducted experiential site visits onsite; however, one study published by Clarke et al 7 in
2018 evaluated the use of virtual site visits and how they were perceived by preceptors even before the COVID-19 pandemic. The
authors conducted both onsite and virtual site visits and surveyed preceptors as to the value of the visit and preferred method for future
visits. Both groups of preceptors found site visits valuable, and there was no statistical difference in preceptor perceptions based on the
method. Preceptors who received virtual visits wanted this type of visit in the future, and those receiving onsite visits were split
between having no preference or preferring another onsite visit. Findings suggested that preceptors were open to virtual site visits and
that this modality could be a useful alternative to address logistical and resource challenges faced by experiential programs.
As a result of the COVID-19 pandemic, the acceptability and functionality of video conferencing increased in all aspects of society.
Specifically, within pharmacy education, experiential educators often relied on this technology when onsite quality assurance visits
were halted due to university or state travel restrictions and experiential site visitor limitations. With the expanded familiarity and
adoption of this modality, experiential programs have another option when connecting with sites and preceptors. However, new
questions have arisen regarding the extent to which programs will continue using virtual visits, whether this modality meets pro­
grammatic goals for assessing experiential site quality, and how the virtual format compares to an onsite visit. This paper will describe
the experiences of two pharmacy experiential programs utilizing virtual site visits highlighting visit logistics, the feasibility of the
virtual format to meet programmatic goals and future plans. The two programs described are quite different in terms of school size,
geographic location, and configuration of the experiential team (Table 1), thereby facilitating a generalizable discussion regarding the
optimal use of virtual site visits within pharmacy education.

Educational activity and setting

The University of Florida College of Pharmacy (UFCOP) and the University of Wyoming School of Pharmacy (UWSOP) programs
are described in Table 1. Comparing the two programs, differences between the UFCOP and UWSOP programs include the number of
campuses and average class size, the number of active experiential sites, the experiential employee to student ratio, and the

Table 1
Institution and experiential program descriptions.
University of Florida University of Wyoming
College of Pharmacy School of Pharmacy

Number of campuses 3 1
Average class size 250 50
Office of experiential programs 1.8 FTE faculty administrative 2 FTE faculty member
3.5 FTE staff 1 FTE staff
2.4 FTE regional coordinator 0.25 FTE faculty during summer for site visits
Introductory pharmacy practice Community: 4 weeks in summer after first year Community: 4 weeks
experience Hospital: 4 weeks in summer after second year Hospital: 4 weeks
Both occur summer after first year
Advanced pharmacy practice Required to complete seven, 6-week experiences during Required to complete nine, 4-week experiences during
experience fourth year fourth year
Site locations Florida Wyoming
United States United States
International
Number of experiential sites 540 225

FTE = full time equivalent.

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organization of experiential office personnel. Similarities between the two programs include a widespread geographical area
encompassing experiential sites, the use of both virtual and onsite site visit modalities, and criteria determining which site visit
modality is utilized.
At the UFCOP, site visits are completed throughout the year with the goal of a visit to each site a minimum of every two years by a
regional coordinator. Regional coordinators are appointed faculty pharmacists who recruit, support, and ensure quality of sites. Site
visits conducted by regional coordinators are an integral part of the experiential quality assurance process. The regional coordinator
prioritizes site visits based on the date of last visit, frequency of site utilization, or specific need to visit (problem identified, new site,
etc.). Prior to March 2020, almost all site visits within the state of Florida were conducted onsite. From March 2020 to 2021, many site
visits were conducted using a video conferencing platform (e.g., Zoom, Microsoft Teams) due to pandemic-related site visitor re­
strictions and university travel restrictions. Currently, site visits are conducted either onsite or virtually, emphasizing onsite visits.
When deciding to visit onsite or virtually, the experiential program considers the following factors: new vs. established site, distance to
the site, time since last onsite visit, the reason for visit (routine visit vs. the need to address specific concern), and preceptor/site
preference. Discussions during site visits encompass a variety of topics, with standard topics for discussion listed in Table 2. In addition
to these topics, preceptor development frequently occurs and can be focused preceptor support/coaching or more broad development
such as the delivery of a continuing education program. Site visits conducted virtually cover the same content as those completed
onsite. Stakeholder types (i.e. student coordinators and preceptors) are the same for virtual and onsite visits. Student feedback is
collected while onsite if a student is present during the visit. For visits conducted virtually, student feedback is typically collected via
email. All site visits are documented using a standardized form and housed in the experiential management system, CORE ELMS.
At the UWSOP, site visits are completed by faculty pharmacists primarily in the summer due to unpredictable weather impacts on
winter travel. The experiential team prioritizes sites to visit based on formal and informal student feedback (e.g., site or preceptor
challenges), date of the last visit, frequency of site utilization, newer sites or preceptors, and other identified factors (e.g., untimely
completion of student evaluations, student challenges). The two primary faculty completing site visits divide the work and develop a
plan for completing the visits. Prior to March 2020, all site visits were completed onsite. From March 2020 to August 2021, all visits
were completed in a virtual format due to site and university requirements related to the COVID-19 pandemic. Virtual visits were
conducted via video conferencing platform technology (e.g., Zoom, Microsoft Teams) and could be completed at any time of the year
since travel was not involved. Starting in fall 2021, the program began conducting site visits using both onsite and virtual modalities.
Choice of visit type is based on a combination of factors, including new vs. established site, time of year, distance to the site, ability to
coordinate a visit with other sites in the geographic area, the number of visits that site has received, the impact of an onsite visit on
resolving site and/or preceptor concerns, and preceptor preference. A variety of topics are addressed during a site visit, and discussion
may also be tailored to the specific needs or requests of the site or preceptor. In general, discussions typically include the topics listed in
Table 2. The site visit agenda, whether onsite or virtual, is identical, and the same site stakeholders are invited no matter which
modality is chosen. Student feedback is typically not collected during a site visit since visits may occur when a student is not scheduled.
However, if present, student feedback may be obtained. Site visit documentation is completed using a standardized form housed using
the form management system Microsoft Forms.
The authors described, evaluated, and compared the virtual site visit process experience for both institutions to gain understanding
of experiential faculty perceptions of the virtual site visit process and the process impact. The authors conducted holistic discussions
with the 11 individuals responsible for completing site visits for each program. During these conversations, participants were asked to
describe and reflect on their experience with the virtual site visit process. Those making site visits were asked to delineate the benefits
and limitations of both onsite and virtual modalities, factors considered when determining which site visit modality to use, and
whether site visit objectives were met when using virtual visits. Responses were reviewed to capture the experiences of both programs
and to identify common themes. Based on this review, advantages and disadvantages of the virtual site visit modality were identified,
and comparisons between visit modalities were made. This project was deemed exempt by the University of Florida and the University
of Wyoming Institutional Review Boards.

Table 2
Site visit discussion topics per institution.
University of Florida College of Pharmacy University of Wyoming School of Pharmacy

Preceptor feedback on student performance and preparedness Preceptor feedback on student performance and preparedness
Opportunity for student participation in the Pharmacists’ Patient Care Preceptor feedback on evaluation process
Process
Opportunity for student(s) to achieve desired outcomes Importance of regular communication both verbally and in writing beyond
mid-term and final evaluations
Opportunity for student interaction with the interprofessional team Opportunity for student interprofessional interactions
Opportunity for layered learning Modalities used to facilitate student learning
Adequacy of time for precepting Preferred methods for preceptor development
Site resources and facilities Site resources and facilities
Student feedback on site / rotation(s) Positive aspects and/or areas for development of the preceptor, experience,
and/or site obtained through student evaluations.

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Findings

The two programs found that both modalities achieved the programmatic goals of evaluating sites for quality, fostering re­
lationships with preceptors, and affording opportunities to provide preceptor development. While each modality effectively met
program needs, there were some advantages and disadvantages noted with the virtual site visit approach. When given the opportunity
to select the visit type, site preference for visit type varied.
Positive elements of a visit conducted virtually included connecting more easily with geographically distant sites. Additionally, a
visit conducted virtually allowed for more flexibility with scheduling of the visit. Since physical travel to the site was unnecessary,
experiential personnel could more easily schedule site visits around other activities, more visits could be scheduled during the same
time frame, and weather-related factors had no impact. In addition, scheduling a virtual site visit afforded more flexibility for the
experiential site. Virtual site visits, in some cases, allowed for increased participation of preceptors, other site personnel, and additional
experiential personnel. There were times when it was more feasible to join a virtual meeting from one’s workstation or home office
rather than requiring travel to a site or relocation to a meeting room. A virtual visit allowed a single visit to encompass multiple sites
within the same health-system since all sites could join one virtual meeting simultaneously, increasing the visit’s reach and efficiency.
An additional benefit of virtual site visits was the ability to share documents more easily through the screen-sharing capabilities of
many virtual meeting platforms. Furthermore, the two institutions noted that virtual site visits with preceptors in the community
sector often resulted in an interaction where the preceptor was more focused and less distracted since these visits were often scheduled
when the pharmacist did not have primary dispensing responsibilities.
Positive financial elements of the virtual site visit modality included reduced travel time and associated expenses for the experi­
ential team, as travel was eliminated and resulted in reduced costs and increased efficiency. Thus, budgetary savings were realized by
using virtual site visits for a portion of quality assurance visits. In addition, last-minute changes, such as unexpected cancellations,
were more easily accommodated with a virtual format and did not result in lost travel time or expenses.
Drawbacks of virtual site visits in comparison to onsite visits include the inability to physically tour a facility during a virtual site
visit, although in some cases, a video tour was an option. A virtual site visit did not provide the opportunity to view and experience
aspects of the site outside of the meeting participants, such as the nearby neighborhood, parking, and hospital departments outside the
pharmacy. At times it was more difficult to assess team dynamics and workflow through a virtual site visit when the team was not
observed in their physical environment. The convenient virtual format, allowing participants to join from their workstations, was
occasionally associated with less participant engagement due to multitasking during the meeting. In some cases, engagement was
diminished due to the non-use of the video functionality, either by participant choice or technological difficulties. Lastly, other
technical issues, such as connectivity problems, occasionally presented challenges.
Student feedback was obtained during both virtual and onsite visits. At UFCOP, no common differences were noted between
student feedback obtained from the two types of site visits. If feedback was not obtained during the onsite visit or the visit was
conducted virtually, student feedback could be solicited via email. Some students were more forthcoming when feedback was provided
via email, while others were more comfortable giving feedback onsite. As previously noted, team dynamics such as preceptor-student
interactions may be more easily observed in an onsite format. At UWSOP, it was noted that when student feedback was obtained during
onsite visits, students were more forthcoming when they could provide this feedback to the experiential team member in private.
Otherwise, student feedback was typically more robust on written evaluations than during onsite visits.

Discussion

The experiences of the UFCOP and UWSOP suggest that virtual site visits are effective for achieving the goal of connecting with
preceptors and conducting experiential quality assurance. Virtual site visits present an attractive opportunity for experiential programs
to achieve the goals of a site visit using an alternative approach to the traditional onsite visit. The virtual modality may be particularly
beneficial for programs that offer an online or distance learning pathway or incorporate many geographically distant experiential sites.
To date, only one article in pharmacy literature has evaluated the use of virtual site visits.7 This 2018 study by Clarke et al7 was
conducted to determine if preceptors valued virtual or onsite visits differently and if a preference for subsequent visits could be
determined. Preceptors were open to participating in virtual site visits, and those receiving a virtual site visit generally preferred that
modality. While this study focused on preceptor perspectives, it was not designed to explore the impact that virtual site visits may have
on the experiential education team. However, the authors indicated that virtual site visits could positively impact pharmacy experi­
ential programs by decreasing the costs and time necessary to monitor experiential site quality. The experiences of the UFCOP and
UWSOP experiential programs are consistent with this supposition, with feedback from both programs noting that the use of the virtual
site-visit modality was associated with decreased use of both time and financial resources for the experiential department. Workload
and financial issues are ongoing concerns amongst experiential programs.8 Therefore, the virtual modality offers an opportunity to
reduce workload and cost while still meeting quality assurance needs.
In the Clarke et al7 study, the authors conducted virtual and onsite visits using the same data collection form and having the same
personnel conduct visits. Likewise, the experiential programs at UFCOP and UWSOP have conducted virtual site visits similarly to the
institutions’ traditional onsite visits by using the same documentation form, discussing similar topics, involving the same personnel,
and devoting the same amount of time to the actual visit. Much like the findings from Clarke et al.,7 during virtual site visits, the
experiential teams could read nonverbal cues and engage in real-time communication, similar to conversations and information shared
during onsite visits. In this way, virtual site visits were superior to phone calls, which do not provide the opportunity to observe body
language, and email communication, which can be misinterpreted due to the inability to detect tone and verbal and non-verbal cues

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Table 3
Factors suggested to inform decision whether to conduct an onsite or virtual site visit.
Consider an onsite site visit Consider a virtual site visit

Initial visit to the experiential site
Site/preceptor or student concerns
Technology challenges (lack of compatible virtual meeting platform, no
webcams available, etc.)
Significant time interval since last onsite visit
Preferred by experiential site / experiential office staff
Site/preceptor with prior onsite visit(s)
Stable site with no student / preceptor concerns
Site geographically distant from experiential staff visiting site
Urgent need to visit when travel is not feasible
Preferred by experiential site / experiential office staff

present in real-time communication.

While virtual site visits have several advantages, there are situations where this modality may be less desirable than an onsite visit.
The decision whether to conduct a visit onsite or virtually will likely be impacted by multiple factors. Based on their experiences, the
authors suggest the considerations noted in Table 3 when deciding which visit modality to choose, noting that the final decision
regarding modality chosen will be holistic and multifaceted. For example, a virtual visit may be the modality chosen for a routine visit
at a geographically distant, established site with no urgent issues. In contrast, an onsite visit may generally be preferred for an initial
site visit at a newly established site. Travel restrictions, time limitations, and financial impacts are some additional factors that may
influence the decision. The UFCOP and UWSOP experiential programs plan to continue using virtual site visits with these consider­
ations in mind.
When the virtual modality is chosen for a site visit, based on their experiences, the authors suggest the following approaches to
optimize the experience. All meeting attendees should participate with the webcam on to allow for the observation of facial expres­
sions, body language, and other nonverbal cues that are otherwise not visible and to facilitate a more personal connection. More than
one option for a virtual meeting platform should be offered to ensure the site can choose the platform most compatible with their needs
(i.e. related to site technology restrictions or preference for ease of use). Attendees should be encouraged to practice with the platform
in advance or allow extra time during the meeting to troubleshoot any technical difficulties that may arise.
The observations discussed in this manuscript reflect the experiences of two institutions, which may limit generalizability to other
programs. However, it is noted that the two institutions are geographically and demographically different, which may broaden
applicability. An additional area of study would include collecting data regarding the experiences of a broader range of institutions
with the use of virtual site visits. A study is currently underway to gather survey data from across the academy and further characterize
the experiences of programs in this space.

Summary

Based on the experiences of the two institutions, a virtual modality provided a complementary mechanism to onsite visits for
completing experiential site visits and achieving programmatic goals. Because there were advantages and disadvantages to the virtual
modality, programs may find that utilizing both visit types facilitates the optimization of meeting quality goals and managing fiscal
and operational constraints.

Disclosure(s)

None.

Credit author statement

Virtual Site Visits—An Emerging Option for Experiential Quality Assurance.

Author statement

Janel P. Soucie: Project administration, conceptualization, methodology, literature search, writing - original draft, writing - re­
view and editing
Janelle Krueger: Conceptualization, methodology, literature search, writing-original draft, writing-review and editing
Lisa Vandervoort: Writing – review and editing
Antoinette Brown: Writing – review and editing
Carinda Feild: Writing – original draft, writing - review and editing

Declaration of Competing Interest

None.

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Appendix A. Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.cptl.2023.12.006.

References

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2016”). Accreditation Council for Pharmacy Education; 2 February 2015. Accessed 17 December 2023 https://www.acpe-accredit.org/pdf/
GuidanceforStandards2016FINAL.pdf.
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schools of pharmacy. Am J Pharm Educ. 2005;69(1):10–18. https://doi.org/10.5688/aj690102.
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Further-reading

9. Accreditation Council for Pharmacy Education. https://www.acpe-accredit.org/pharmd-program-accreditation/.

10. Association for Experiential Education. https://www.aee.org/what-is-experiential-education.

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