Background and Purpose: Increasing complexity in healthcare has led to the growth of pharmacists' clinical responsibilities, requiring a high level of adaptability and critical thinking. Therefore, pharmacy graduates need strong critical thinking and problem-solving skills to navigate complex patient care. Because of this, pharmacy school curriculum promotes critical thinking development through as case-based learning in the classroom setting, culminating with experiential learning that further emphasizes analysis and application. Previous studies have explored multi-preceptor approaches to advanced pharmacy practice experiences (APPE) to enhance student learning; however, these studies were not focused on critical thinking and had no direct evaluation of preceptor satisfaction. The purpose of this pilot study was to evaluate the impact of a standardized, multi-preceptor approach to acute care medicine APPEs on student critical thinking skills and preceptor satisfaction. Methods: This was an IRB-exempt, single center pilot study conducted from September 1st, 2025 to April 30th, 2026. During September 2025, a team of Acute Care Medicine APPE preceptors developed and implemented a standardized, multi-preceptor approach consisting of eight scheduled case-based active learning sessions focused on core internal medicine topics. The sessions were designed to enhance students’ critical thinking and clinical problem-solving skills. As part of their rotation, students were given a pre- and post-rotation competency assessment consisting of sixteen multiple-choice, case-based questions aligned with content from the eight sessions (maximum score: 16). The pre- and post-rotation assessments varied slightly but tested the same core concepts. Improvement in student critical thinking was measured by the change in pre- and post-rotation assessment scores. Preceptor satisfaction was assessed using an anonymous online survey at the end of the study period, consisting of ten Likert scale and three free response questions. All student assessment data were collected as part of routine educational activities within the rotation and analyzed in aggregate. Scores of all 4th year pharmacy students completing an Acute Care Medicine rotation in either Internal Medicine or Family Medicine at Wellstar MCG Health during the study period were included. Preceptors were included in the study if they served as the primary preceptor for at least one pharmacy student within the same timeframe. Change in assessment scores was analyzed using a paired t-test. All other results were analyzed using descriptive statistics. Results: Assessment data from 12 APPE students and survey responses from 6 preceptors were included in the analysis. Prior to acute care medicine rotation, the students included in the analysis had a median of 3 direct patient care APPE rotations [IQR: 2-3] and a median of 1 acute care APPE rotation [IQR: 1-2]. Average assessment scores increased significantly from pre- to post-rotation (8.08 vs 10.17, p = 0.0036). Across the 10 Likert-scale items, the majority of responses indicated agreement or strong agreement. Preceptors most strongly endorsed statements regarding team precepting effectiveness (16.7% agree, 83.3% strongly agree), student experience consistency (16.7% agree, 83.3% strongly agree), and critical thinking development (50% agree, 50% strongly agree). In free response questions, preceptors highlighted prespecified case-based discussions and collaborative scheduling as key strengths of the model. Conclusions: In this pilot study, 4th year pharmacy students demonstrated improved case-based assessment scores following an acute care medicine with a standardized, multi-preceptor model. This suggests that a multi-preceptor, case-based approach may support development of student critical thinking skills. Preceptors reported high satisfaction with the standardized model, with all preceptors in agreement that the acute care medicine team worked together effectively to precept students.
