title: The layered learning practice model: Lessons learned from implementation.
abstract: OBJECTIVE
  Pharmacists' views about the implementation, benefits, and attributes of a layered learning practice model (LLPM) were examined.
  
  
  METHODS
  Eligible and willing attending pharmacists at the same institution that had implemented an LLPM completed an individual, 90-minute, face-to-face interview using a structured interview guide developed by the interdisciplinary study team. Interviews were digitally recorded and transcribed verbatim without personal identifiers. Three researchers independently reviewed preliminary findings to reach consensus on emerging themes. In cases where thematic coding diverged, the researchers discussed their analyses until consensus was reached.
  
  
  RESULTS
  Of 25 eligible attending pharmacists, 24 (96%) agreed to participate. The sample was drawn from both acute and ambulatory care practice settings and all clinical specialty areas. Attending pharmacists described several experiences implementing the LLPM and perceived benefits of the model. Attending pharmacists identified seven key attributes for hospital and health-system pharmacy departments that are needed to design and implement effective LLPMs: shared leadership, a systematic approach, good communication, flexibility for attending pharmacists, adequate resources, commitment, and evaluation. Participants also highlighted several potential challenges and obstacles for organizations to consider before implementing an LLPM.
  
  
  CONCLUSIONS
  According to attending pharmacists involved in an LLPM, successful implementation of an LLPM required shared leadership, a systematic approach, communication, flexibility, resources, commitment, and a process for evaluation.
authors.affiliation: Division of Practice Advancement and Clinical Education, University of North Carolina (UNC) Eshelman School of Pharmacy, Department of Pharmacy, UNC Medical Center, Chapel Hill, NC. nickipinelli@unc.edu.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Pinelli
authors.affiliation: Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Department of Pharmacy, UNC Medical Center, Chapel Hill, NC.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Eckel
authors.affiliation: UNC Center for Health Promotion and Disease Prevention, Department of Health Behavior, Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Maihan B
authors.initials: MB
authors.lastname: Vu
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.affiliation: Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill, NC.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Roth
mesh_terms: D001291:Attitude of Health Personnel; D004512:Education, Pharmacy / Q000379:methods* / Q000458:organization & administration; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D010595:Pharmacists / Q000458:organization & administration; D024382:Professional Role
keywords: clinical education; experiential education; layered learning practice model; pharmacy; pharmacy practice