Evolution and Validation of Practice Standards, Training, and Professional Development

Critical Care Societies Collaborative (CCSC) – http://ccsconline.org/workforce

Collaborative effort of several stakeholder organizations in critical care to define the workforce

shortage in critical care and advocate for federal action to address the problem

ii.

Most of this work has focused on intensivist and ICU nurse shortages, but there is also

recognition of shortages of other professionals, including critical care pharmacists.

Current and objective quantification of critical care pharmacist shortage or demand is unavailable.

Minimum requirements for all levels of ICU service (levels I–III)

Graduate of Accreditation Council for Pharmacy Education (ACPE)-accredited school or college

of pharmacy

Licensure and registration by a state board of pharmacy

PGY1 pharmacy practice residency based in a hospital

PGY2 critical care residency or fellowship

First critical care pharmacy residency described: 1981 (The Ohio State University)

ii.

ASHP critical care pharmacy residency standards published in 1990

iii.

189 ASHP-accredited critical care residencies in 2024; increased from 8 in 2001 and 39 in 2005

iv.

Most PGY2 critical care residents are somewhat or very satisfied (91% and 76%, respectively)

with their program and mentorship according to a 2012 survey.

Critical care pharmacy research training: Long history of fellowship training; however,

the ACCP Directory of Residencies, Fellowships, and Graduate Programs lists fellowship

programs with a primary or secondary focus on critical care

Nontraditional alternative paths: There is no widely accepted or clearly defined alternative pathway

to specialty experience and competence in critical care pharmacy. Some potential pathways and

components of a self-directed training program are outlined in the text that follows. The extent and

variety of experiences needed may be determined by the practice setting, level of care to be provided,

baseline knowledge, availability and willingness of qualified mentors, and other personal and professional

skills of the individual. Although many potential paths are defined later, those that provide continued,

practical experience during a prolonged period in a supervised or mentored environment are considered

of greatest value in developing competency in the ICU setting.

Mentored or supervised clinical practice experience without residency

Clinical practice experience must be hands-on and team based under supervision.

ii.

Mentors may be PGY2- or fellowship-trained critical care pharmacists, clinical pharmacists

with equivalent experience, critical care faculty from affiliated schools of pharmacy, intensivist

physicians, and/or other critical care professionals.

iii.

Several mentors may best meet the variety of needs of the mentee pharmacist.

iv.

Reinforced by frequent reading and analysis of the critical care primary and secondary literature,

journal club participation, and frequent critical discussions of the clinical implications of the

primary literature

Normally, expect at least 3–4 years of mentored/supervised experience to gain competency for

independent clinical practice (optimal services) in level I and II ICUs. Shorter periods may be

adequate to provide lower levels of service to level II and III ICUs.

PGY1 with supervised/mentored ICU clinical practice experience

Mentored clinical experiences similar to those described earlier

ii.

PGY1 with critical care experiences during residency may be adequate to provide fundamental

and desirable services to level II and III ICUs.

iii.

Normally, expect 2–3 years of mentored/supervised experience to gain competency for

independent clinical practice (optimal services) in level I and II ICUs.