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Martin SE, Hughes TD, Roller J, Ferreri SP. Assessing pharmacists' knowledge, attitudes, and practices of opioid management within different patient populations. J Am Pharm Assoc (2003) 2024; 64:414-421.e1. [PMID: 38049067 DOI: 10.1016/j.japh.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Racial disparities in drug overdose exist, with black, indigenous, and Hispanic individuals experiencing higher rates of opioid overdose deaths. Opioid use disorder prevention services, such as opioid deprescribing and naloxone dispensing, have been identified as ways to prevent opioid overdose. Pharmacists can help use these strategies, but racial disparities in use exist. OBJECTIVE This study aimed to evaluate North Carolina (NC) pharmacist knowledge, attitudes, and practices (KAP) of opioid management practices, including opioid deprescribing and naloxone dispensing, across different racial and ethnic groups. METHODS This was a prospective, cross-sectional study conducted through a Web-based KAP survey distributed via e-mail to all NC pharmacists using a modified Dillman's method. Descriptive statistics were used to analyze demographics and pharmacist KAP data. Attitudes data were further analyzed using one-way analysis of variance tests and Tukey's post hoc analyses. RESULTS After applying exclusion criteria, 527 participants were eligible for analysis; 254 of these individuals completed the entire survey. The survey response rate was 15.3% and respondents were mostly female (59.1%) and white (86.6%). Approximately half of pharmacists knew the correct opioid morphine milliequivalent cutoffs considered to be high risk (47.7%) and not to be exceeded (51.9%). When asked about chronic opioid statistics within the United States, respondents overestimated that 23.70% of patients on chronic opioid therapy receive naloxone (SD = 18.93%). Pharmacists believed that black patients were more likely to adhere to an opioid taper than any other race or ethnicity and Hispanic patients were more likely to adhere to naloxone treatment than any other race or ethnicity. Finally, 91% of pharmacists knew what an opioid taper was, but 77% of pharmacists had never designed one. CONCLUSIONS Gaps in knowledge may contribute to further disparities in opioid management. Pharmacists' attitudes may contribute to biases in opioid management practices and practices related to opioid deprescribing may limit the pharmacists' current role. More education is needed so pharmacists can play an increased role in opioid management across all patient populations.
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Kiles TM, Nonyel NP, Higgins M, Campbell HE. White coats, Black lives-racial trauma in Black pharmacists. J Am Pharm Assoc (2003) 2024; 64:450-456. [PMID: 38143040 DOI: 10.1016/j.japh.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Race-based traumatic stress, or racial trauma, can negatively impact the health and wellbeing of Black health professionals. However, the effects of racial trauma among Black pharmacists have not been thoroughly explored. OBJECTIVE The purpose of this study is to explore Black pharmacist experiences of race-based traumatic stress and its effects in the workplace. METHODS This qualitative study utilized focus groups among a convenience sample of Black pharmacist attendees of a national convention for an organization dedicated to serving underserved communities and minoritized pharmacy professionals. The data were analyzed with inductive coding and thematic analysis as proposed by Braun and Clark. RESULTS Three focus groups were conducted with a total of 22 participants. The majority of participants were female (77%), and the average age of the participants was 48.3 years old. Three themes related to racial trauma were identified. The participants described racial trauma as an ever-present phenomenon, tension with coworkers and institutions, and internal and external structures of support. The Black pharmacists in this study provided context and recommendations for employers to support their wellbeing. CONCLUSIONS An awareness of the hidden wounds that Black pharmacists carry with them to work every day is an important factor in creating diverse and inclusive workplaces. The results of this study give Black pharmacists a voice and a chance to share with colleagues their distinct realities. Employers and institutions should assess individual needs and implement strategies to support Black pharmacists in creating more inclusive work and professional environments.
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Alvarez NA, Cornelison B, Obeng-Kusi M, Slack M. Understanding faculty perceptions and experiences related to climate, diversity, equity, and inclusion at a college of pharmacy: A pilot study. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:24-33. [PMID: 38158325 DOI: 10.1016/j.cptl.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/28/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION A climate survey was piloted to obtain an understanding of the perceptions and personal experiences of faculty for intentional planning of future meaningful, effective, and sustainable diversity, equity, and inclusion (DEI) efforts at a college of pharmacy. METHODS A 48-item, four section, online survey was developed and administered to 69 faculty between October and November 2021. Likert-like five-point scales and free-text items were included to determine an overall assessment of climate, as well as perceptions and/or personal experiences for each domain of DEI, and demographics. RESULTS Thirty-nine (57%) faculty completed the survey. For climate, every attribute had at least one respondent that observed someone make an insensitive or disparaging remark "rarely," "occasionally," and "frequently." The response pattern was similar for personal experience with insensitive remarks. For participation in diversity activities, "awareness without participation" was selected by 56% of respondents. For perceptions of diversity, "fairly" or "very" was selected by 38% to 54% of respondents. For equity, "attainable for some" to "not attainable" was identified for 15% to 26% of respondents. CONCLUSIONS These pilot climate survey results inform climate improvement as it relates to DEI and informs survey instrument refinement.
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Affiliation(s)
- Nancy A Alvarez
- Pharmacy Practice and Science, University of Arizona R. Ken Coit College of Pharmacy - Phoenix, 650 East Van Buren Street, Phoenix, AZ 85004, United States.
| | - Bernadette Cornelison
- Pharmacy Practice and Science Department, University of Arizona R. Ken Coit College of Pharmacy - Tucson, PO Box 210202, Tucson, AZ 85721, United States.
| | - Mavis Obeng-Kusi
- Pharmacy Practice and Science Department, University of Arizona R. Ken Coit College of Pharmacy - Tucson, PO Box 210202, Tucson, AZ 85721, United States.
| | - Marion Slack
- Pharmacy Practice and Science Department, University of Arizona R. Ken Coit College of Pharmacy - Tucson, PO Box 210202, Tucson, AZ 85721, United States.
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Lipscomb J, Gálvez-Peralta M, Cropp CD, Delgado E, Crutchley R, Calinski D, Iwuchukwu O. A Genetics-Focused Lens on Social Constructs in Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100077. [PMID: 37714655 DOI: 10.1016/j.ajpe.2023.100077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/27/2023] [Accepted: 02/18/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Incorporating diversity, equity, inclusion, and anti-racism principles into clinical and didactic education is essential because each influence cognitive and affective attitudes in pharmacy practice. Educators must learn from the past to enlighten the future. For example, race is a social construct, not a biological construct. However, it persistently acts as a surrogate for determining medical diagnoses and treatment. FINDINGS Precision medicine and pharmacogenomics can serve as a basis for deconstructing social constructs surrounding race and other social determinants of health. SUMMARY In this review, the authors highlight why using race in health education will lead to less-than-optimal clinical decisions and discuss best practices for incorporating diversity, equity, inclusion, and anti-racism into health education from a pharmacogenomic-based perspective.
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Affiliation(s)
- Justina Lipscomb
- The University of Texas at Austin, College of Pharmacy, Austin, TX, USA.
| | - Marina Gálvez-Peralta
- West Virginia University Health Sciences Center, School of Pharmacy, Morgantown, WV, USA
| | - Cheryl D Cropp
- Samford University McWhorter, School of Pharmacy, Homewood, AL, USA
| | - Elina Delgado
- William Carey University, School of Pharmacy, Biloxi, MS, USA
| | - Rustin Crutchley
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Diane Calinski
- Manchester University, College of Pharmacy, North Manchester, IN, USA
| | - Otito Iwuchukwu
- Fairleigh Dickinson University, School of Pharmacy & Health Sciences, Florham Park, NJ, USA
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Medlin CG, Wilby KJ. The Impact of Moving Beyond Intersection to Integration of LGBTQIA+ Identities on Professional Identity Affirmation. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100024. [PMID: 37380264 DOI: 10.1016/j.ajpe.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 06/30/2023]
Abstract
There have been active calls within pharmacy education literature for the profession to work toward dismantling systemic oppression by elevating the voices of commonly underrepresented and marginalized communities, including the lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual(LGBTQIA+) community. There has also been a simultaneously growing interest in understanding how the intersection of one's personal identity with one's professional identity may help to foster greater affirmation within the profession. However, what has not been explored is how intersecting personal and professional identities may enhance the strength of one's LGBTQIA+ identity and therefore result in creating cultures of affirmation in addition to meaningful participation in professional advocacy. We link our lived experiences to a theoretical perspective through the minority stress model to demonstrate how distal and proximal stresses may affect pharmacy professionals' ability to fully integrate their professional and personal identities. Additionally, we call on the academy to strategically address gaps in LGBTQIA+ knowledge, equity, and professional development through research, shifts in culture, and education.
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Affiliation(s)
| | - Kyle John Wilby
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Canada
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Ho A, Minshew L, McLaughlin JE. Pedagogical Tools and Strategies for Developing Cultural Intelligence in Pharmacy Students and Educators. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100031. [PMID: 37288682 DOI: 10.1016/j.ajpe.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To review evidence-based pedagogical tools and strategies used to support the development of cultural intelligence in pharmacy education. FINDINGS An exhaustive list of search terms was included to capture the variety of terms for "cultural intelligence" (eg, cultural competence). The search was not limited to any publication year range. Search engines included PubMed, Embase, CINAHL, Scopus, ProQuest Dissertations and Theses, ERIC, and PsycInfo. A total of 639 articles were identified after removing duplicates. Eighty-two articles were included for full review after screening. Year of publication ranged from 2004 - 2021. Two articles (2.4%) described tools for educator development, whereas the rest (n = 80, 97.6%) focused on student development. Examples of tools reported included lectures and workshops. Twenty-seven articles (32.9%) described pedagogical tools for fostering cultural intelligence concurrently with interprofessional development; the remaining articles (n = 55, 67.0%) focused only on pharmacy. Thirty-two articles (39.0%) used quantitative analysis methods, and 13 articles (15.9%) used qualitative analysis methods. Sixty-four articles (78.0%) included outcomes of perceptions, 6 (7.3%) included outcomes of participation, and 33 (40.2%) included outcomes of performance. Although not every study addressed all 4 cultural intelligence framework domains (awareness, knowledge, practice, and desire), each domain was apparent within the included articles. SUMMARY Various pedagogical tools have been used to develop cultural intelligence in pharmacy students with some tools used more than others. Findings suggest that integrating various pedagogical methods throughout the curriculum aligns more closely with the dynamic nature of learning and continuous self-refinement required to develop cultural intelligence.
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Affiliation(s)
- Aimee Ho
- UNC Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Lana Minshew
- Robert and Patricia Kern Institute for the Transformation of Medical Education and the Department of Clinical Sciences in the School of Pharmacy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jacqueline E McLaughlin
- Division of Practice Advancement and Clinical Education, Director of the Center for Innovative Pharmacy Education and Research, UNC Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA.
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DiPiro JT, Allen DD, Lin A, Scott SA, Sorensen TD, Maine LL. Impact of Social Forces and Environmental Factors on Healthcare and Pharmacy Education: The Report of the 2021-2022 AACP Argus Commission. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:ajpe9452. [PMID: 36781186 PMCID: PMC10159613 DOI: 10.5688/ajpe9452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
| | - David D Allen
- University of Health Sciences and Pharmacy, St. Louis, Missouri
| | - Anne Lin
- Notre Dame of Maryland University, Baltimore, Maryland
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Todd D Sorensen
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Marie Kiles T, Chisholm-Burns M. Five Essential Steps for Faculty to Mitigate Racial Bias and Microaggressions in the Classroom. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:ajpe8796. [PMID: 34815214 PMCID: PMC10159380 DOI: 10.5688/ajpe8796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/15/2021] [Indexed: 05/06/2023]
Abstract
Educators must recognize the pharmacy curriculum itself is an instrument that can propagate or discourage systemic racism. The role of pharmacy education in disseminating racial bias through didactics deserves further consideration. While microaggressions have begun to be acknowledged in the pharmacy learning environment, specific guidance on mitigating racial microaggressions in the classroom has not been provided. This paper aims to suggest actionable strategies pharmacy educators may use to mitigate or prevent these negative classroom experiences. As such, it combines five experiences of racial biases and microaggressions in the classroom with suggested action items in a practical guide for pharmacy faculty members. It is our hope that this commentary will challenge faculty to self-assess their teaching, with the aim of preventing racial biases from propagating and creating better learning environments for future pharmacists.
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Affiliation(s)
- Tyler Marie Kiles
- University of Tennessee Health Science Center (UTHSC), College of Pharmacy, Memphis, Tennessee
| | - Marie Chisholm-Burns
- University of Tennessee Health Science Center (UTHSC), College of Pharmacy, Memphis, Tennessee
- University of Tennessee Health Science Center (UTHSC), College of Pharmacy, Nashville, Tennessee
- University of Tennessee Health Science Center (UTHSC), College of Pharmacy, Knoxville, Tennessee
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Terry K, Nickman NA, Mullin S, Ghule P, Tyler LS. Implementation of implicit bias awareness and action training in a pharmacy residency program. Am J Health Syst Pharm 2022; 79:1929-1937. [PMID: 35880865 DOI: 10.1093/ajhp/zxac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE To implement an implicit bias awareness and action seminar program for the University of Utah Health pharmacy residency program and measure knowledge, awareness, and comfort around race-related topics. SUMMARY An implicit bias awareness training program was implemented with a pre- and post-training survey to measure knowledge, comfort, and confidence around understanding and addressing biases. Fifty-one residents and preceptors participated in the implicit bias training, and 47 (92.2%) consented to take the survey. Twenty pharmacy residents and 27 preceptors attended at least 1 of the 4 training modules and completed the pre- and/or post-training survey. Eighteen of 20 residents (90.0%) and 19 of 27 (70.4%) preceptors completed the pretraining survey (37 total), while 11 of 20 residents (55.0%) and 10 of 27 (37.0%) preceptors completed the post-training survey (21 total). On the post-training survey, more correct answers were obtained for knowledge-based questions and a higher number of responses of strongly agree or agree was observed when assessing participants' comfort and confidence in addressing personal biases, bringing marginalized people into a conversation, addressing biased situations, and intervening when bias is observed. CONCLUSION After training, higher scores were attained on the survey for overall comfort and confidence in addressing personal biases and identifying and acting on witnessed biases.
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Affiliation(s)
| | - Nancy A Nickman
- University of Utah College of Pharmacy, Salt Lake City, UT, and University of Utah Health, Salt Lake City, UT, USA
| | | | - Priyanka Ghule
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | - Linda S Tyler
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
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Jubran N, Bratta P. Integrating Institutional and Individual Self‐Reflexivity Practices into Clinical Pharmacy Practice: A Critical Review of Race in a Widely Utilized Medical Guideline. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nadia Jubran
- Academic Detailing, Clinical Pharmacist Practitioner, VISN 5: Capitol Health Care Network, Washington DC Veterans Affairs Medical Center, 50 Irving St NW Washington D.C
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11
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Gray J, Hillman LA, Vivian E, St. Peter WL. Pharmacist's Role in Reducing
Medication‐Related
Racial Disparities in African American Patients with Chronic Kidney Disease. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Julie Gray
- University of Minnesota College of Pharmacy Minneapolis Minnesota
| | - Lisa A. Hillman
- University of Minnesota College of Pharmacy Minneapolis Minnesota
| | - Eva Vivian
- University of Wisconsin‐Madison School of Pharmacy Madison Wisconsin
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12
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Little MM, Johnson L, Hager K. A discussion of White fragility to facilitate cultural competence development in a foundations of pharmaceutical care class. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:572-581. [PMID: 35715097 DOI: 10.1016/j.cptl.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 02/21/2022] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The objective of this study was to explore pharmacy students' emotional reaction to the concept of White fragility and garner ideas about improving pharmacy curriculum to initiate constructive patient engagement across racial divides. METHODS An online questionnaire was distributed to 160 first-year pharmacy students after reading the article "White Fragility" for a Foundations of Pharmaceutical Care Course. Class prep questions included (1) How can the college and you improve the capacity and stamina of Whites, so they are prepared to teach and initiate constructive patient engagement across racial divides? and (2) Recognizing that emotions play a critical role in learning, how does the information in the "White Fragility" article make you feel? Responses were analyzed using a constant comparative method by all three authors; discrepancies were resolved by consensus. RESULTS Of the 160 students across two campuses, 157 submitted responses. Four major categories of college culture, curriculum, educational topics, and educational suggestions or enhancements emerged "to improve the capacity and stamina of Whites." With regard to the observed feelings after reading "White Fragility," seven categories of feelings (frequency) emerged, including awareness (49%), discomfort (38.2%), empathy (19.7%), defensiveness (16.6%), frustration (15.9%), empowerment (11.5%), and curiosity (8.3%). CONCLUSIONS This student cohort is at the beginning of their intercultural journey in pharmacy. Many indicated that more emphasis on and discussion about issues like White fragility and racism would benefit their ability to care for people from a wide variety of cultures to optimize patient outcomes.
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Affiliation(s)
- Meg M Little
- Assistant Professor, Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota College of Pharmacy, 1110 Kirby Drive, LSci 232, Duluth, MN 55812, United States.
| | - L'Aurelle Johnson
- Assistant Professor and Director of Diversity, Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Delivery Code 1332, 7-115C WDH, 308 Harvard St SE, Minneapolis, MN 55455, United States.
| | - Keri Hager
- Associate Professor and Co-Associate Dean for Clinical Affairs, Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota College of Pharmacy, United States.
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Wilby KJ, Cox D, Whelan AM, Arya V, Framp H, Mansour S. Representation of Diversity Within Written Patient Cases: Exploring the Presence of a ‘Hidden Curriculum’. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Kyle John Wilby
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
| | - Dianne Cox
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
| | - Anne Marie Whelan
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
| | - Vibhuti Arya
- College of Pharmacy and Health Sciences, St. John's University Queens NY
| | - Heidi Framp
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
| | - Susan Mansour
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
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Mathew A. In a world of mentors, aspire to be a sponsor. J Am Pharm Assoc (2003) 2022; 62:915-916. [DOI: 10.1016/j.japh.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
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Armbruster AL, Henson BN, Alsharif NZ. A Call to Action for a Programmatic Approach to Addressing Health Disparities and Cultural Competency in Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8412. [PMID: 35365486 PMCID: PMC10159443 DOI: 10.5688/ajpe8412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/14/2021] [Indexed: 05/06/2023]
Abstract
Pharmacy has recognized the importance of education in health disparities and cultural competency (HDCC) for two decades. More recently, there has been emphasis on incorporating equity, diversity, and inclusion (EDI) in pharmacy programs. While many institutions identify a need to incorporate a programmatic approach to HDCC education to meet the growing needs of a diverse population, pharmacy curricula continue to lack a holistic, programmatic approach. More than ever, Doctor of Pharmacy (PharmD) students should graduate with the knowledge, values, and skills to provide culturally appropriate care for a diverse patient population. This commentary advocates for a holistic, programmatic approach to integrating HDCC education and serves as a call to action for curricular development. It is hoped that this commentary will also set the foundation for additional scholarly work and recommendations regarding a programmatic approach.
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Affiliation(s)
- Anastasia L Armbruster
- St. Louis College of Pharmacy at University of Health Sciences and Pharmacy in St. Louis, St. Louis, Missouri
| | - Brianna N Henson
- University of Kentucky, College of Pharmacy, Lexington, Kentucky
| | - Naser Z Alsharif
- Creighton University, School of Pharmacy and Health Professions, Omaha, Nebraska
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Ko CL, Abdul-Mutakabbir JC, Astle KN, Bandali A, Brown JE, Childs-Kean LM, Hirsch EB, Mordino J, Saunders IM, Brown BR. Brighter Horizons: The Necessity of Concentrated Sponsorship Targeted Toward Minoritized Pharmacy Students. J Am Pharm Assoc (2003) 2022; 62:701-705. [DOI: 10.1016/j.japh.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
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17
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Kiles TM, Peroulas D, Borja-Hart N. Defining the role of pharmacists in addressing the social determinants of health. Res Social Adm Pharm 2022; 18:3699-3703. [DOI: 10.1016/j.sapharm.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/09/2021] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
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18
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Kucherepa U, O’Connell MB. Self-Assessment of Cultural Competence and Social Determinants of Health within a First-Year Required Pharmacy Course. PHARMACY (BASEL, SWITZERLAND) 2021; 10:pharmacy10010006. [PMID: 35076573 PMCID: PMC8788424 DOI: 10.3390/pharmacy10010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 12/03/2022]
Abstract
As social determinants of health (SDOH) and health disparities are integrated with cultural competence in healthcare education, tools assessing multiple topics are needed. The Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) survey is validated in student pharmacists and includes SDOH. The research objective was to determine if the SAPLCC survey can quantify cultural competence and SDOH course learning. First-year student pharmacists (N = 87) completed the SAPLCC survey anonymously before and after a social and administrative sciences course. The survey had 75 items with 1–4 Likert scales (4 high, total 300 points). All items were summed for the total score. Each item was assigned to a domain and factor. Factors were assigned to domains. The baseline total score was 190 ± 29 points, increasing by 63 ± 33 points post-course. All domains (i.e., knowledge, skills, attitudes, encounters, abilities, awareness), 13 of 14 factors, and total scores statistically increased. The SAPLCC tool captured student pharmacists’ self-reported changes in cultural competence and SDOH.
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Affiliation(s)
- Ulyana Kucherepa
- Clinical Pharmacy Department, SSM Health St. Mary’s Hospital—St. Louis, 6420 Clayton Rd., Richmond Heights, MO 63117, USA;
| | - Mary Beth O’Connell
- Pharmacy Practice Department, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA
- Correspondence:
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Addressing cultural competence and bias in treating migrant workers in pharmacies: Pharmacy students learning and changing norms. Res Social Adm Pharm 2021; 18:3362-3368. [PMID: 34857481 DOI: 10.1016/j.sapharm.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Little research addressed training pharmacy students on bias towards vulnerable patients such as migrant domestic workers (MDWs). This study evaluates a module addressing bias and cultural competence when working with MDWs in community pharmacies. METHODS Two cohorts of Lebanese Bachelor of pharmacy students completed this module as part of a core Public Health class. Guided by a social psychology framework, the module involved watching a lecture, discussing an article, watching a video addressing bias in healthcare, and taking an Implicit Association Test. Second, students interviewed one MDW and one pharmacist before filling a reflection worksheet. Students' reflections were analyzed qualitatively using content analysis. Further, to evaluate the module's impact quantitatively, an aggregate perception of helpfulness scale was created and validated. Items addressed students' own experience with the module as well as its impact on pharmacists interviewed by students. RESULTS Of 170 students completing the module and providing qualitative data, 131 were asked to fill a survey addressing perceptions of assignment helpfulness. Of those 131 students, 126 filled the survey. On a scale ranging from zero to four, the composite mean score for helpfulness was 3.4, SD = 0.5. Students reported a positive impact of the interview in improving awareness of bias for pharmacists they interviewed (mean = 3.5, SD = 0.6). Qualitative analysis produced insight into students' experience with the module including challenges in communication with MDWs; MDWs' experience with bias and its repercussions; predictability, or lack thereof, of assignment results; plans to address bias after taking the module; evaluation of interviewed pharmacist's service; and perceived pharmacists' impressions of the assignment. CONCLUSIONS A two-part module shows promise in educating pharmacy students about bias and cultural competence. Engaging target audience including pharmacists can make such experiences meaningful for students while providing a learning opportunity for those health professionals.
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McGee EU, Allen SN, Butler LM, McGraw-Senat CM, McCants TA. Holding pharmacy educators accountable in the wake of the anti-racism movement: A call to action. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1261-1264. [PMID: 34521517 DOI: 10.1016/j.cptl.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/21/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The recent murders of Black Americans has forced our society to reevaluate how the various systems in our nation view race and to attempt to dismantle and rebuild the structures that reinforce and perpetuate racial group inequity. PERSPECTIVE Cultural awareness education has been broadly integrated into pharmacy curricula across the country to comply with accreditation standards. Health disparities are currently addressed in the context of race and ethnicity but lack the connection to racism. Cultural awareness education should focus more on racism and its impact on healthcare. IMPLICATIONS In order to properly address racism in cultural awareness education, there has to be a deliberate curricular integration of anti-racism education addressing historical factors that have set the foundation of structural racism in this country. The current manifestations and impact on healthcare can be connected to this history. As a primary influencer of one of the most accessible healthcare professionals, pharmacy educators are at the forefront to educate and equip the next generation to strive for health equity in the context of racism.
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Affiliation(s)
- Edoabasi U McGee
- Philadelphia College of Osteopathic Medicine-Georgia Campus, School of Pharmacy, 625 Old Peachtree road NW, Suwanee, GA, United States.
| | - Shari N Allen
- Philadelphia College of Osteopathic Medicine-Georgia Campus, School of Pharmacy, 625 Old Peachtree road NW, Suwanee, GA, United States.
| | - Lakesha M Butler
- Southern Illinois University Edwardsville, School of Pharmacy, 200 University Park Drive, Suite 220, Edwardsville, IL 62025, United States.
| | - Candis M McGraw-Senat
- Philadelphia College of Osteopathic Medicine-Georgia Campus, School of Pharmacy, 625 Old Peachtree road NW, Suwanee, GA, United States.
| | - Tamara A McCants
- Howard University, College of Pharmacy, 2400 Sixth Street NW, Washington, DC 20059, United States.
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Butler LM, Arya V, Nonyel NP, Moore TS. The Rx-HEART Framework to Address Health Equity and Racism Within Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8590. [PMID: 34301560 PMCID: PMC8655143 DOI: 10.5688/ajpe8590] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/14/2021] [Indexed: 05/13/2023]
Abstract
Objective. To identify gaps in health equity and anti-racism education across the pharmacy curriculum, define the key health equity and anti-racism concepts that are suggested to be included across the pharmacy curriculum, and recommend a framework with steps to integrate health equity and anti-racism education across the pharmacy curriculum.Findings. Other professions, such as social work, nursing, and medicine, have taken steps to address social injustice by integrating anti-racism into their curriculum. The National Association of Social Workers (NASW) advocates for "social justice and social change with and on behalf of clients" and included racism and health equity in its mission to eradicate "discrimination, oppression, poverty, and other forms of social injustice." The American Association of Colleges of Nursing (AACN) curricular standards for baccalaureate nursing education provided four key changes for immediate implementation to overcome structural, individual, and ideological racism (SIIR). In October 2020, the Association of American Medical Colleges (AAMC) released a four-pillar framework to address racism.Summary. The Academy must also actively engage in efforts to eradicate social injustices by incorporating into its curriculum topics that would result in the graduation of culturally and linguistically sensitive and structurally competent pharmacists. The five-phase framework, Pharmacy Health Equity Anti-Racism Training (Rx-HEART) provides guidance on how to accomplish the objectives described in this paper and the theme issue on social injustice.
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Affiliation(s)
- Lakesha M Butler
- Southern Illinois University Edwardsville, School of Pharmacy, Edwardsville, Illinois
| | - Vibhuti Arya
- St. John's University, College and University of Health Sciences, Queens, New York
| | - Nkem P Nonyel
- University of Maryland Eastern Shore, School of Pharmacy and Health Professions, Princess Anne, Maryland
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Gaither CA. Pharmacists can be DEAI change agents. J Am Pharm Assoc (2003) 2021. [DOI: 10.1016/j.japh.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
COVID-19 is disproportionately impacting Black communities in the United States due to racial structures that increase exposure (e.g., densely populated areas, substandard housing, overrepresentation in essential work) and promote underlying diseases that exacerbate COVID-19. This manuscript uses Oath of a Pharmacist as a framework to propose a set of best practices for pharmacists to mitigate inequities such as achieve competence in the ideology of structural racism; identify systems of power that jeopardize Black health; value Black voices; name the socio-structural determinants of health; define race as a socio-political construction; name historical and contemporary racism; apply resources equitably based on need; collect robust data to solve complex problems; diminish bias and view patients holistically in the contexts of inequities; and advocate for Black lives. While race is biological fiction, Black individuals are at an increased risk for COVID-19 cases, hospitalizations, and deaths than their white counterparts due to navigating generations of racist practices that often converge with other inequities—such as sexism, classism. To describe these racial health disparities, structured, racial disadvantage is commonly ignored while personal choices and clinical care are highlighted as the culprits. Achieving health equity requires comprehension, acceptance, and assessment of structural racism, and pharmacists are highly trusted, uniquely positioned healthcare professionals who, through their knowledge, skills, and resources, can help attenuate the effects of structural racism to support Black lives.
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Affiliation(s)
- Nicole D Avant
- University of Cincinnati Experience-Based Learning and Career Education
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Erickson K, Lefler M, Robinson JD. A call to action: Now is the time to address systemic racism. J Am Pharm Assoc (2003) 2021; 61:e212. [PMID: 33781695 DOI: 10.1016/j.japh.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Kennedy Erickson
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
| | - Misty Lefler
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
| | - Jennifer D Robinson
- Associate Dean for Professional Education, Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA.
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Flemings E, Desselle S. Pharmacists' response to systemic racism: Creating a moral community. J Am Pharm Assoc (2003) 2021; 61:e69. [PMID: 33608223 DOI: 10.1016/j.japh.2021.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Affiliation(s)
| | - Shane Desselle
- Department of Social, Behavioral & Administrative Sciences Touro University, Vallejo, CA
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Arya V, Steeb DR. Changing the narrative. J Am Pharm Assoc (2003) 2021. [DOI: 10.1016/j.japh.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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