Suggested pharmacy practice laboratory activities to align with pre-APPE domains in the Doctor of Pharmacy curriculum

OUR SITUATION

The Accreditation Council for Pharmacy Education outlines ability statements that pharmacy students should be able to demonstrate prior to beginning their Advanced Pharmacy Practice Experiences (APPEs). Practice laboratory courses offer extensive opportunities for students to participate in activities and assessments that enable them to meet the objectives outlined in the Pre-APPE Core Domains in Standards 2016. This review identifies selected published literature, activities, and assessment methods that can be adapted and implemented in practice laboratory courses to help achieve the abilities outlined within the Pre-APPE Core Domains.

METHODOLOGICAL LITERATURE REVIEW

The Medline database and journals related to pharmacy education were searched to identify activities and assessments for each domain. Search terms for each core domain were extracted from the domain titles, ability statements, and performance competencies and coupled with "laboratory" or "lab." "Pharmacy" was also added as a search term when searching the Medline database. Preference was given to example activities published in the last 15 years. Abstracts and activities based on author experience were also included.

OUR RECOMMENDATIONS AND THEIR APPLICATIONS

Specific examples of how activities and assessments can be included in practice laboratories to develop or refresh skills identified in the pre-APPE core domains were described.

POTENTIAL IMPACT

The practice laboratory setting is an ideal place for students to learn and practice the skills necessary to demonstrate readiness for APPEs. This paper serves as a resource for instructors, curriculum committees, or pharmacy programs looking for ideas to expand specific training or develop particular skill areas.

A pilot program featuring formative peer review of faculty teaching at a college of pharmacy

BACKGROUND AND PURPOSE

Although student ratings are the most common method for evaluating faculty performance in the classroom in schools of pharmacy, this should not be the sole approach to provide feedback to faculty regarding teaching.

EDUCATIONAL ACTIVITY AND SETTING

This initiative targeted individuals at the ranks of Clinical Assistant or Assistant Professor who taught during the 2016-2017 academic year. As part of the process, the peer reviewer(s) attended a class taught by the faculty member under review. During the observation, the peer reviewer(s) completed rubrics and noted strengths and areas for improvement. Participating faculty members were asked to complete a post-evaluation survey to evaluate the pilot program and offer suggestions for enhancement FINDINGS: Based on a 64.3% response rate (9/14) from reviewers and 92.9% (13/14) from faculty members under review, 100% (9/9) of reviewers and 92.3% (12/13) of faculty members under review would recommend the peer review program to their colleagues. However, 77.8% (7/9) of the reviewers and only 46.2% (6/13) of faculty members under review supported the use of the peer review method as part of the annual faculty evaluation and development process.

DISCUSSION/SUMMARY

Ultimately, this process of peer review will be implemented across the college, benefiting faculty evaluation and development, as part of the promotion and tenure process. With our positive feedback and suggestions for improvement, the authors hope this will serve as a guide for institutions to develop peer review programs that will positively supplement student ratings and provide an additional, meaningful form of evaluation for self- improvement and promotion/tenure.

Allocation of faculty and curricular time to the teaching of transitions of care concepts by colleges of pharmacy

INTRODUCTION

To determine the allocation of faculty and curricular time to the teaching of transitions of care (ToC) concepts by colleges of pharmacy (COPs) to equip students with the necessary skills for the provision of these services.

METHODS

A novel 15-question anonymous electronic survey was sent to 136 pharmacy practice chairpersons.

RESULTS

Response rate was 26.5% (n = 36). Of these, 47% employed ToC faculty while 44% are not actively recruiting for that position in the foreseeable future. Median total curriculum hours dedicated to teaching ToC was four (interquartile range two to 10 hours). Medication reconciliation skills were taught didactically and via interactive lab sessions by 53% of respondents. Only 11% offered an interdisciplinary ToC program. A significant association between not having ToC faculty and lack of implementation of ToC concepts within a pharmacy curriculum (p = 0.02, Fisher's Exact) and practice site (p = 0.045, Pearson's) was observed. Barriers to adopting ToC within the curriculum (e.g., uncertainty of placement within curriculum, resistance by faculty and administrators) and at a practice site (e.g., inadequate infrastructure to accommodate ToC delivery, ToC faculty unavailability and resistance by other health care providers) were reported.

DISCUSSION AND CONCLUSIONS

This study demonstrated that COPs devote curricular time to ToC activities and involve dedicated faculty in the provision of these services. Several barriers to employing ToC faculty and planning additional time in the curriculum for teaching these skills were identified. Future research should determine the best methods for training students to ensure competence in performing ToC tasks.

Incorporation of Professionalism Expectations and Evaluative Processes Within a College of Pharmacy

Objective. To determine professionalism factors of interest to the University of South Florida (USF) College of Pharmacy (COP) and develop a programmatic plan to monitor the professionalization of students, faculty, preceptors and staff. Methods. In 2013, the USF COP began investigating how best to incorporate processes to capture professionalism across all aspects of the program. A Professionalism Task Force was convened to identify key professionalism factors valued by faculty and preceptors to be incorporated in pharmacy practice experiences, didactic courses, faculty, and preceptor performance evaluations. A factor analysis was performed to identify items for inclusion in professional practice experience evaluations, course syllabi, faculty, preceptor and staff evaluations. Results. The analysis identified 11 factors for practice experiences, three for syllabi, and five for performance evaluations. The information from the factor analysis spurred additional discussion that led to the development of a programmatic plan for professionalization. Conclusion. A brief description of the programmatic professionalization plan is provided, including possible assessment processes. The goal of this endeavor was to ensure appropriate support and development of professionalization across the COP community.

Practical Tips for Integrating Clinical Relevance into Foundational Science Courses

The integration of foundational science and clinical science education is a hallmark of educational reform within the health professions, and an increasing number of pharmacy schools are implementing integrated curricula in professional pharmacy programs. Although the foundational sciences serve as an essential framework for understanding clinical knowledge, instructors may face challenges when integrating clinical science into foundational science courses. Here we present practical learner-centered teaching tips to address these challenges.

Examining the relationship between prerequisite grades and types of academic performance in pharmacy school

PURPOSE

To investigate relationships between different prerequisite course grades and grade point average (GPA) of different types of academic performance in a Canadian entry-to-practice pharmacy program while controlling for important demographic variables.

METHODS

Data from eight years of recently admitted students (2007-2014) were used to conduct a series of multiple linear regression analyses to assess relationships between prerequisite course GPA and eight different pharmacy school academic performance variables including: GPA in each of the first three years of the program, overall Y1-Y3 GPA, and GPA in pharmaceutical science, clinical science, clinical practice, and behavioral, social, and administrative (BSA) science courses. Demographic predictor variables including gender, mature status, and whether students attended ranked versus non-ranked universities were included as control variables.

RESULTS

Analysis reveals that Biology and Biochemistry prerequisite GPA consistently predicts all eight academic performance variables while prerequisite English GPA was found to predict only clinical practice and BSA GPA. Being female and attending ranked universities were revealed as positively associated with most types of performance. Being classified as a mature student generally predicted lower academic performance.

CONCLUSIONS

The consistent relationship between biology-based prerequisites and academic performance warrants consideration for increasing their weight in admissions GPA calculations. The fact that the set of prerequisites and demographic variables are weaker predictors of clinical practice and BSA performance than pharmaceutical science performance provides empirical support for recent moves to include non-traditional admission criteria.

Identifying Shared Values for School-Affiliated Student Organizations

Objective. To identify shared values for student organizations. Methods. A three-round Delphi approach was utilized to identify and prioritize shared values among student organization leadership. In round 1, student leaders selected 15 values from a list of 36 organizational values and were given an opportunity to include up to five suggestions not incorporated within the original list. Student leaders narrowed the 15 values to 12 in round 2. The top 12 priorities were ranked in round 3 and participants were invited to write a brief statement regarding their perspectives of the results. Results. Twelve shared values were identified and ranked: professional development, improving leadership of your members, advancing the role of pharmacy, planning quality events, networking, improving the academic experience for peers, community service, learning from pharmacy shadowing/speakers, social outlet, recruitment/gaining student membership, attracting students to events, and gaining national/local attention or awards. Conclusion. This study contributes to the small but growing body of literature concerning student organizations in pharmacy education and provides a foundation by which this work could be advanced. Given the importance of student organizations in promoting student development, identifying strategies for supporting and facilitating the effectiveness of these groups is critical for optimizing student outcomes and institutional effectiveness.

Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model

INTRODUCTION

With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model.

METHODS

A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty.

RESULTS

The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty.

DISCUSSION AND CONCLUSIONS

Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy.

Assessing self-assessment practices: A survey of U.S. colleges and schools of pharmacy

OBJECTIVE

This study quantifies and describes student self-assessment approaches in colleges of pharmacy across the United States.

METHODS

Faculty members identified as assessment directors from college websites at U.S. colleges of pharmacy were electronically surveyed. Prior to distribution, feedback and question validation was sought from select assessment directors. Surveys were distributed and recorded, via Qualtrics^® survey software and analyzed in Microsoft Excel^®.

RESULTS

Responses were received from 49 colleges of pharmacy (n = 49/134, 37% response rate). The most commonly used strategies were reflective essays (n = 44/49, 90%), portfolios (n = 40/49, 82%), student self-evaluations (n = 35/49, 71%) and questionnaires/surveys/checklists (n = 29/49, 59%). Out of 49 submitted surveys, 35 programs noted students received feedback on self-assessment. Feedback came most commonly from faculty (n = 31/35, 88%). Thirty-four programs responded regarding self-assessment integration including fifteen colleges (n = 15/34, 44%) that integrated self-assessment both into the curriculum and co-curricular activities, while 14 (n = 14/34, 41%) integrated self-assessment exclusively into the curriculum, and five (n = 5/34, 15%) used self-assessment exclusively in co-curricular activities.

DISCUSSION AND CONCLUSIONS

Student self-assessment is a critical first step of the Continuing Professional Development (CPD) process. Colleges and schools of pharmacy use a wide variety of methods to develop this skill in preparing future practitioners.

Transitioning from pharmacy practice into administration

Transitioning from a pharmacy practice faculty member into an administrator will offer new challenges you have never faced in your career. Whether you are currently considering a transition in your career or have recently made such a transition, many questions will come up along the way. Through this commentary, I offer some advice from my own personal trials and errors as I continue on my administrative journey, and I hope this will help you in yours.

[The social sciences at the Faculty of Pharmacy: and innovative course of community health at the University of Montreal]

Social sciences are important for training in pharmacy faculties. The course set up at the Faculty of Pharmacy of the University of Montreal in 2011 is a very innovative way to meet this challenge. The purpose of this report is to share this experience by providing a synthetic description. Many students were able to develop new skills and strengthen their skills, including leadership and critical thinking. The Faculty of Pharmacy was also able to achieve greater visibility in the Montreal community, that is to say from the associations, but also with what is out there called the "local health network" linking various health care professionals and institutions. Beyond the quantifiable results, this course is an evolving learning process in which the group interactions, individual and collective values and the task sharing allow students to build a working knowledge of social factors, which d.etermine health problems.

Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning

Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

Methods Used by Colleges and Schools of Pharmacy to Prepare Student Pharmacists for Careers in Academia

Objective. To identify the methods used by US colleges and schools of pharmacy to prepare student pharmacists for academic careers. Method. An 18-item survey instrument was developed and distributed to US colleges and schools of pharmacy. Representatives were asked about faculty responsibilities, experiences in academia currently offered to student pharmacists, and representatives' perception of their student pharmacists' preparedness for careers in academia, including barriers in current programming. Results. Representatives from 96 colleges/schools responded. The vast majority (96%) provided academia-focused advanced pharmacy practice experiences (APPEs), 40% provided didactic coursework in academia, 28% offered a longitudinal research track, and 42% offered academia-focused independent studies. Teaching methods and creating learning objectives were the most common pedagogical content, while assessment activities were diverse. Time was the most prevalent barrier to providing training for academic careers; however, degree of student pharmacist interest, faculty inexperience, and lack of leadership support were also commonly reported. Conclusions: Colleges and schools of pharmacy vary in the extent to which they prepare student pharmacists for careers in academia. Advanced pharmacy practice experiences were the most common method of training offered. Standardization of training for academia may better promote this career path to student pharmacists.

Identification and Development of Items Comprising Organizational Citizenship Behaviors Among Pharmacy Faculty

Objective. Identify behaviors that can compose a measure of organizational citizenship by pharmacy faculty. Methods. A four-round, modified Delphi procedure using open-ended questions (Round 1) was conducted with 13 panelists from pharmacy academia. The items generated were evaluated and refined for inclusion in subsequent rounds. A consensus was reached after completing four rounds. Results. The panel produced a set of 26 items indicative of extra-role behaviors by faculty colleagues considered to compose a measure of citizenship, which is an expressed manifestation of collegiality. Conclusions. The items generated require testing for validation and reliability in a large sample to create a measure of organizational citizenship. Even prior to doing so, the list of items can serve as a resource for mentorship of junior and senior faculty alike.

A Modified Delphi Process to Define Competencies for Assessment Leads Supporting a Doctor of Pharmacy Program

Objective. To define the competencies for individuals designated as assessment leads in colleges and schools of pharmacy. Methods. Twenty-three assessment experts in pharmacy participated in a modified Delphi process to describe competencies for an assessment lead, defined as the individual responsible for curricular assessment and assessment-related to doctor of pharmacy program accreditation. Round 1 asked open-ended questions about knowledge, skills, and attitudes. Round 2 grouped responses for comment and rating for consensus, which was prospectively set at 80%. Results. Twelve competencies were defined and grouped into 3 areas: Context for Assessment, Managing the Process of Assessment, and Leadership of Assessment Activities. In order to verify the panel's work, assessment competencies from other disciplines were reviewed and compared. Conclusions. The competencies describe roles for assessment professionals as experts, managers, and leaders of assessment processes. They can be used by assessment professionals in self-assessing areas for professional development and by administrators in selecting, developing, and supporting designated leads.

Virtual Patient Case Sharing Across Two Schools of Pharmacy

Objective. To expand the use of virtual patients at 2 schools of pharmacy through virtual patient case sharing. Design. Faculty members at two schools of pharmacy collaborated to expand the use of virtual patients. Two simulation programs, vpSim and DecisionSim (Decision Simulation, LLC, Chadsford, PA), were used to create interactive patient cases for a required course and an elective course at the different schools. Each school developed cases for their own use and then shared the cases with the other school. Assessment. The development, sharing, and subsequent modification of cases were examined using a standardized data collection form completed by both schools. Survey instruments were used to gather data regarding faculty perception and student satisfaction. Pre- and post-tests were administered to assess student learning. Five cases were developed and shared between the institutions. The time spent constructing new cases (22 hours/case) was significantly longer than the time spent modifying the shared cases (1.2 hours/case). Faculty members and students were largely satisfied with case sharing and the use of virtual patient cases, respectively. Virtual patients significantly enhanced student learning of material (mean score: 3.2 vs 3.6 on a 5-point scale). Conclusions. The sharing of virtual patient cases may allow institutions to overcome barriers to implementation of virtual patient programs, namely faculty resources, while improving student learning and satisfaction.

The Multiple Mini-Interview as an Admission Tool for a PharmD Program Satellite Campus

Objective. To assess the multiple mini-interview (MMI) as an admission tool for a satellite campus. Methods. In 2013, the MMI was implemented as part of a new admissions model at the UNC Eshelman School of Pharmacy. From fall 2013 to spring 2015, 73 candidates were interviewed by 15 raters on the satellite campus in Asheville, North Carolina. A many-facet Rasch measurement (MFRM) with three facets was used to determine the variance in candidate ratings attributable to rater severity, candidate ability, and station difficulty. Candidates were surveyed to explore their perceptions of the MMI. Results. Rasch measures accounted for 48.3% of total variance in candidate scores. Rater severity accounted for 9.1% of the variance, and candidate ability accounted for 36.2% of the variance. Eighty percent of survey respondents (strongly) agreed that interviewers got to know them based on questions they answered.Conclusion. This study suggests that the MMI is a useful and valid tool for candidate selection at a satellite campus.

Fellowships in community pharmacy research: Experiences of five schools and colleges of pharmacy

OBJECTIVE

To describe common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships.

SETTING

Five schools and colleges of pharmacy in the United States.

PRACTICE DESCRIPTION

Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training.

PRACTICE INNOVATION

Community pharmacy fellowships, each structured as 2 years long and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill, and The Ohio State University.

EVALUATION

Program directors from each of the 5 community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs.

RESULTS

Common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n = 4) have been successful in securing pharmacy faculty positions.

CONCLUSION

Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice.

Using Bourdieu's Theoretical Framework to Examine How the Pharmacy Educator Views Pharmacy Knowledge

OBJECTIVE

To explore how different pharmacy educators view pharmacy knowledge within the United Kingdom MPharm program and to relate these findings to Pierre Bourdieu's theoretical framework.

METHODS

Twelve qualitative interviews were conducted with 4 faculty members from 3 different types of schools of pharmacy in the United Kingdom: a newer school, an established teaching-based school, and an established research-intensive school. Selection was based on a representation of both science-based and practice-based disciplines, gender balance, and teaching experience.

RESULTS

The interview transcripts indicated how these members of the academic community describe knowledge. There was a polarization between science-based and practice-based educators in terms of Bourdieu's description of field, species of capital, and habitus.

CONCLUSION

A Bourdieusian perspective on the differences among faculty member responses supports our understanding of curriculum integration and offers some practical implications for the future development of pharmacy programs.

Development and Implementation of an Advising Program's Meet-and-Greet Session

OBJECTIVE

To describe the implementation and perceptions of an advising program's meet-and-greet session on student/faculty interactions.

DESIGN

Student advisees and faculty advisors attended a meet-and-greet program designed to facilitate introductions. Two online surveys evaluating program perceptions were electronically distributed to participants.

ASSESSMENT

Twenty-eight advisors and 226 students attended; 17 faculty members and 42% (n=95) of students completed the survey. Advisors and advisees found the program valuable (100%, 85%) and recommended holding it again (100%, 93%), respectively. Most advisors agreed that the event improved success in meeting advisees while reducing time needed to schedule and meet with advisees. Students felt more comfortable contacting advisors after participating, with 83% agreeing it was more convenient than scheduling separate meeting times.

CONCLUSION

An advising meet-and-greet program facilitated initial advisee/advisor meetings while reducing self-reported faculty time/resources. This activity could be implemented by other institutions seeking to promote student advising relationships.