Implementing Research Into Practice as a Clinical Based New Practitioner Pharmacist

Scholarly activities are essential for enhancing the pharmacy profession, as well as for personal career development. New practitioner pharmacists in academic or community medical center settings may hesitate to incorporate research into their practice if they feel that they do not have the appropriate resources and guidance. While residency provides structured support for research endeavors, new pharmacists may still find research activities daunting to initiate on their own. Many factors should be considered, including strategies for incorporating research into current roles, collaboration efforts, professional opportunities, and timeline considerations, to help pharmacists effectively implement research early in their careers. This article provides new practitioners with a roadmap to navigate challenges and achieve success when integrating scholarly activities into their practice.

Nationwide Survey to Characterize and Compare the Research Experiences of American Society of Health-System Pharmacists-Accredited Postgraduate Year One Pharmacy Residency Programs

Background: Many Postgraduate Year One (PGY1) Pharmacy residencies provide research training however, details of this training are not well described. Publication rates have been utilized to assess residency research learning experiences. Higher publication rates have been reported by programs that have implemented a structured research learning experience. Objective: The primary objective was to identify differences in the research learning experiences for American Society of Health-System Pharmacists (ASHP) accredited PGY1 Pharmacy residencies with reported resident publication rates of ≥20% vs <20%. Methods: This survey was distributed to PGY1 Pharmacy residency program directors (RPDs). Seven sections were analyzed to identify research learning experience differences between programs with reported publication rates of ≥20% vs <20%: (1) program characteristics/research outcomes; (2) involved individuals; (3) requirements; (4) learning experience structure; (5) educational methods; (6) formal education; (7) barriers/RPD perceptions. Variables with P < 0.05 on logistic regression were considered statistically significant. Results: The survey response rate was 31.3% (308/984). Significant positive predictors for reported publication rates of ≥20% were: involved individuals: research director/coordinator, individuals trained in statistics, non-pharmacy medical staff; requirements: Collaborative Institutional Training Initiative training, research seminars/training courses, research manuscript; learning experience structure: research committee; educational methods: didactic residency-led lectures/courses, formal workshops, self-taught online modules; and formal education: manuscript preparation. Conclusion: This study suggests there are differences in the research learning experiences at PGY1 Pharmacy residencies with reported resident publications rates of ≥20% vs <20%. We encourage PGY1 Pharmacy residency programs to consider implementing elements associated with reported resident publication rates of ≥20%.

Characterizing redundancy in pharmacy residency research projects

PURPOSE

Each year, roughly 5,000 residents conduct research on clinical and practice-based topics to meet the requirements of the ASHP residency standards related to research and project management. Several investigators have evaluated residency research project publication rates, but redundancy among projects has not been evaluated. The primary objective of this study was to determine the rate of redundancy among pharmacy residency research projects.

METHODS

This was a retrospective cohort analysis of abstracts accepted to various regional pharmacy residency conferences from 2017 through 2020. Each abstract was placed in a pharmacy domain by therapeutic area. The categorized data for each year were then further evaluated to identify clinical categories for the year. Topics were labeled as redundant if at least 10 projects fell into the same focus area within a clinical category. Descriptive statistics were used to quantify the incidence of redundancy each year.

RESULTS

A total of 4,027 abstracts were included. The most common pharmacy domains were infectious disease, internal medicine, and benefit of pharmacy services. Overall, 8.2% projects (332 of 4,027) were categorized as redundant. The most common focus areas were rapid diagnostics, opioid reduction protocols, and vancomycin area-under-the-curve vs trough monitoring.

CONCLUSION

Pharmacy residency research projects encompassed topics across a wide range of pharmacotherapy areas. Approximately 1 in 12 projects was redundant. This is likely because the project addressed a "hot topic" in practice and may represent an opportunity for institutions to collaborate to optimize project efficiency and impact.

Relationship between publication of a postgraduate year 1 residency research project and subsequent career type at a large academic medical center

PURPOSE

The study objectives were to (1) quantify the overall incidence of residency publications of postgraduate year 1 (PGY1) residency alumni; (2) evaluate annual fluctuations in publications over time; and (3) compare the career types of residency alumni who published their PGY1 residency research projects to those for alumni who did not.

METHODS

A retrospective cohort study was performed among individuals who completed a PGY1 acute/ambulatory care residency between 2010 and 2021. A list of residency alumni was obtained along with the corresponding titles of their research projects. Each resident's name was entered into PubMed and Google Scholar to find the corresponding publication. LinkedIn and other publicly available resources were used to determine the career types of residents immediately after residency as well as their current career types.

RESULTS

In total, 178 residency alumni completed an acute/ambulatory care PGY1 residency, of whom 16.7% (30/178) published their residency research project. Publication was associated with career type among those who pursued a postgraduate year 2 residency but was not associated with career type immediately after the PGY1 residency or current career type. The presence of an academic preceptor was associated with a higher probability of publishing compared to residents who did not have an academic preceptor (31.5% vs 10.5%; P < 0.01).

CONCLUSION

The frequency of publications was within the range reported elsewhere, with fluctuations over time. Presence of an academic preceptor improved the probability of publication.

Research barriers in Saudi pharmacy residency training programs

Background

The aim of this study is to identify potential barriers to conducting and publishing pharmacy residency research.

Methods

A cross-sectional study surveyed pharmacy residents in Saudi Arabia from August to September 2020. The online survey assesses residents' characteristics, residency research experience, barriers to completion, and challenges in publishing. A Likert scale assessed factors and barriers to conducting and publishing research during residency. Descriptive statistics were performed for binary variables, with Likert scale responses visualized using Gannt charts.

Results

A total of 69 residents completed the survey, of whom 63.5 percent were female, and the median age was 28 years. More than half of the residents were in R2 (56.5 %), followed by R1 (24.6 %) and R3 (4.4 %). Half of residents had prior research experience, while 84.1 % had prior research training in workshops or courses. Cohort study design was the most common type of residency research project conducted. According to residents, the main barriers to conducting research were a lack of allocated time for research during rotations (81.7 %) and a lack of a realistic timeline determined by the SCFHS to finish the research project (66.2 %). Regarding barriers to publishing research, the majority of residents reported lack of time to work on the publication process (78.6 %), lack of previous publication experience (60 %), and lack of guidance from mentors (55.7 %) as the most important barriers.

Conclusion

Pharmacy residents face barriers to conducting research during their residency program, including limited allocated time during rotations, a lack of realistic timelines, and data collection limitations. Additionally, they face challenges in publishing their research due to a lack of experience, mentorship, and guidance. Future research should consider seeking the perspective of residency program directors and preceptors on research barriers and evaluating the publication rate of residents' projects.

Publication rates of pharmacy residents involved in a team-based research program

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

The University of Oklahoma College of Pharmacy (OUCOP) implemented an individualized residency research committee and skill development program to facilitate completion and publication of research projects. The purpose of this study was to evaluate the outcomes the program had on project publication rates and subsequent publications after graduation for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) residents.

METHODS

This study included OUCOP PGY1 and PGY2 residents from classes graduating from 2011 through 2019. Literature searches for all resident projects and subsequent publications were performed. Data collection included residency type (PGY1 vs PGY2), initial position after residency, and project type. The primary objective was to identify the publication rate of research projects. Secondary objectives included a comparison of the number of publications after residency graduation between residents who did and did not publish their residency project and analysis of factors associated with subsequent publications. Zero-inflated Poisson regression was utilized to analyze subsequent publication status controlling for other factors. Statistical analyses were performed using SAS/STAT with an a priori P value of <0.05.

RESULTS

Eighty-two projects were completed by 73 residents. Forty-three of 82 projects were published (52.4%) by 39 of 73 residents (52.1%). After residency graduation, 54 residents (74.0%) had a subsequent publication. Factors associated with subsequent publications were initial position in an academic role and completion of additional training after residency.

CONCLUSION

After implementation of the program, the majority of residents published their projects and had subsequent publications. Future efforts should be taken to identify opportunities to foster independence in research and scholarship for residents.

Publication of Pharmacy Residency Research: A 12-Year Cohort From an Academic Medical Center

BACKGROUND

Pharmacy residency programs provide research training experiences to residents, and publication is considered an indicator of high-quality research experiences.

OBJECTIVE

This study described attributes of pharmacy residents, residency programs, and residency major research projects and their associations with the outcome of publication in a peer-reviewed journal.

METHODS

Pharmacy residents who graduated from one academic medical center between 2001 and 2012 were invited to participate via an electronic survey distributed in February 2014. The survey collected attributes of the resident, residency program, and research project. The outcome of publication was self-reported by residents in 2014 and updated in July 2019 using a validated search strategy.

RESULTS

This study included 53 resident graduates representing 66 major pharmacy residency projects. Eighteen (27%) projects were published, occurring at an average of 13.8 months after residency graduation. The outcome of publication was more likely for residents with human subjects research experience prior to PGY1 training, residency programs that cultivated resident expertise in Institutional Review Board submission and statistical analysis, and projects with Institutional Review Board approval, a larger number of co-investigators, non-pharmacy co-investigators, and a larger sample size.

CONCLUSION

This cohort of residents, programs, and projects at an academic medical center identified many modifiable attributes that were associated with successful publication of resident research projects. Unfortunately, residency projects rarely used study design features that attenuate bias. Residents and preceptors were perceived as having limited expertise with statistical analysis and database management, which underscores the need to develop research infrastructure to enhance research training for pharmacy students, residents, and preceptors.

A Research Partnership to Enhance Postgraduate Pharmacy Residency Training Outcomes

Pharmacy residents must complete research as part of their program; however, challenges exist in providing experiences that result in successful research dissemination outcomes. A university-based research team, integrated into an ambulatory care pharmacy residency program aimed to improve presentation and publication rates of pharmacy resident research projects. Data on the number of postgraduate year-2 (PGY2) residents and their productivity were collected and summarized to assess progress. A total of 13 residents completed their residency over seven years. Each resident produced one regional presentation, and one national presentation beginning in year four. To date, three peer-reviewed papers have been published, with another one in-press. Responses from residents found lack of guidance, lack of data availability for projects and feedback fatigue were barriers to a positive research experience. To address these problems, a university-based research team was integrated to provide research mentor guided support, ensure study feasibility, and provide structured feedback. This program evaluation highlighted the integration of a PGY2 ambulatory care pharmacy residency with a designated, interprofessional university-based research team. Future work is warranted to reduce research-related barriers and formally evaluate resident post-program knowledge, skills, and subsequent dissemination rates.

PGY1 resident research projects: Publication rates, project completion policies, perceived values, and barriers

PURPOSE

To assess the publication rates of PGY1 pharmacy residents and to determine the beliefs of pharmacy residency program directors (RPDs) regarding PGY1 residency research projects, the residency-specific policies on publishing, and the perceived barriers to publishing for PGY1 residents.

METHODS

The 2013 American Society of Health-System Pharmacists Midyear Clinical Meeting resident poster presentation roster was used to compile the list of PGY1 residents who submitted an abstract. The Web of Science database was searched using the PGY1 residents' name and research title to determine if a publication resulted from the abstract by December 2016. Publication rates were calculated using several demographic subcategories. The PGY1 RPDs identified from the ASHP website (n = 1220) were surveyed to determine how they value the research project, policies regarding publishing at their institution, and potential barriers to publication.

RESULTS

Out of 1419 abstracts from PGY1 residents, 26 (1.8%) resulted in a publication by 2016. Of the 369 RPDs who responded, the majority complimented their programs as favorable environments for completing research, 55% stating that their institutions offered formal research training, 65% stating that they have preceptors specifically assigned for research, and 83% stating that they provide dedicated time to residents to complete their research. The common barriers to publication were difficulty in completing the project in one year and lack of continuity after residency completion.

CONCLUSION

Despite pharmacy residency programs requiring residents to complete a research project, most residents end the residency without a publication. Further research is needed to identify the residents' barriers to publications and resources needed to publish the research projects.

Critical Care PGY-2 Graduate Perceptions and Practices Regarding Residency Project Publication

Objective. To characterize the practices and perceptions of recent post-graduate year 2 (PGY2) critical care pharmacy (CCP) residents surrounding the completion and publication of their primary research project. Methods. Potential factors and perceptions influencing primary research project publication success were identified and incorporated in a validated electronic survey distributed to 2011 and 2012 PGY2 CCP residency program graduates. Results. Among the 94/124 (76%) respondents, 26% had published their research project (67% were first authors; 50% were successful on first submission), while 36% still planned to pursue publication, and 38% had no plans for their manuscript. Factors more commonly reported by publishing (vs. non-publishing) PGY2 graduates included: publication of their PGY1 research project, any publication during the PGY2 year, and national presentation of the PGY2 research project. Perceptions associated with research project publication success were a higher degree of self-motivation to publish, post-PGY2 mentor support, project's publication deemed important to post-PGY2 employer, adequate training for manuscript submission, and adequate time during residency for manuscript completion. Two factors, ≥1 publication during PGY2 [odds ratio (OR)=3.7; 95% confidence interval (CI) 1.3, 10.2] and research project presentation at a national conference (OR=4.5; 95% CI 1.2, 16.9); and two perceptions, self-motivation to publish (OR=8.1; 95% CI 1.7, 37.7) and post-PGY2 mentor support (OR=3.3; 95% CI 1.1, 9.8) were independently associated with publication success. Conclusion. Only one-quarter of PGY2 CCP residents published their primary research project. PGY2 programs should consider those factors associated with research project publication success when formulating strategies to increase resident publication rates.

Association between postgraduate year 2 residency program characteristics and primary project publication

PURPOSE

The association among residency program and research mentor characteristics, program director perceptions, and the publication of the primary research project for postgraduate year 2 (PGY2) graduates was assessed.

METHODS

Using a validated electronic survey, residency program directors (RPDs) of critical care PGY2 graduates were asked about primary research project publication success, program and research project mentor characteristics, and RPDs' perceptions surrounding project completion.

RESULTS

All 55 RPDs surveyed responded; 44 (79%) reported being a research project mentor. PGY2 research project publications in 2011 and 2012 totaled 26 (37%) and 27 (35%), respectively. A significant relationship existed between research project publication and the number of residents in the program (p < 0.01); the perception among the RPDs that research project publication is important to their employer (p < 0.01); and the research mentor's funding source (p = 0.04), employer (p < 0.01), number of prior publications (p = 0.01), and research training (p < 0.01). Variables independently associated with the publication of 2 or more research projects versus no publications included the number of graduates in the PGY2 program (odds ratio [OR], 5.6; p < 0.01), the RPD's perception that the employer valued research project publication (OR, 10.2; p < 0.01), and the number of prior publications by the least-experienced research mentor (OR, 23.5; p = 0.01). The publication of 1 research project versus no research projects was also independently associated with the RPD's perception that the employer valued research project publication (OR, 5.1; p = 0.04).

CONCLUSION

A survey of RPDs of critical care PGY2 residents found that the number of PGY2 residents, the number of publications by the least experienced research mentor, and the perception that publishing the residents' research projects is important to the employer were independently associated with publication rates of residency research projects.

Developing and improving residency research training

PURPOSE

Peer-reviewed literature on pharmacy residency research training is reviewed with an emphasis on innovative strategies for research training enhancement.

SUMMARY

There is a persistent gap between institutional expectations regarding the entry-level research skills of advanced-practice pharmacists and the research training experiences provided to pharmacy residents. This gap is especially problematic because pharmacy residency programs have become a primary source for recruitment of advanced-practice pharmacists. A literature review was conducted to characterize the current state of pharmacy residency research training and identify strategies to better prepare pharmacists for involvement in practice-based research. The 30 articles selected for review addressed four broad topic areas: residency stakeholder perceptions of research training, approaches to effective pharmacy residency research training, scholarly output resulting from resident research, and proposals and professional organization directives for advancement of pharmacy residency research training. Overall, the reviewed literature suggested four broad themes: (1) The extent and quality of research training provided to residents vary according to the limits imposed by the available expertise and resources of individual residency programs, (2) a formalized training approach is essential for research skills development, (3) proper training can improve scholarly output from resident research projects, and (4) guidelines alone are insufficient to ensure adequate development of research skills.

CONCLUSION

A review of the literature identified three strategies that can enhance residency research training: formalizing the process, engaging expertise and collaboration, and formatting the training for use across all pharmacy residency programs.

Ten year experience with student pharmacist research within a health system and education center

INTRODUCTION

Skills gained from research experience allow student pharmacists to evolve as practitioners, innovators and perpetual learners in an increasingly complex healthcare environment. Data published regarding pharmacy resident research are focused on external dissemination rates and research programs. Little is published regarding student research.

METHODS

This descriptive study was a five-year before and after comparison between the existing co-curricular model and a new longitudinal, 12-month research advanced pharmacy practice experience (L-APPE) model for student pharmacist research. The objective was to describe the development and transition to the L-APPE and compare the models in external dissemination rates and preceptor-classified impact on patient care. Preceptors were surveyed to characterize the impact on the health care institution.

RESULTS

Over a ten-year period, 65 fourth year students engaged in research. From 2006-2011, 28 students (43.4% of student cohort) completed co-curricular research projects. From 2011-2016, 37 students (40.2% of student cohort) completed the L-APPE. The number of national poster presentations increased 6-fold with the L-APPE, from 6 (21.4%) to 36 (97.3%) (p < 0.01). Combined posters and peer reviewed publications had a 350% higher occurrence (RR 4.5, 95% CI 1.9-10.9; p < 0.01). Preceptors classified L-APPE projects 1.5 times more often as leading to a change or affirmation of a practice model or prescribing pattern (83.3% vs 57.1%; p = 0.03).

DISCUSSION AND CONCLUSIONS

The L-APPE research model increased external dissemination rates and resulted in more meaningful practice model or prescribing pattern benefits. Additional study of pharmacy student research is warranted.

Implementation of a pharmacy research committee to enhance the pharmacy resident research experience

BACKGROUND AND PURPOSE

Most postgraduate year 1 (PGY1) pharmacy residents complete at least one research project as part of their graduation requirements. The research skills learned prepare residents to address research questions and generate evidence-based recommendations for patient care. However, there are multiple steps involved in a research project, and streamlining this process can be difficult.

EDUCATIONAL ACTIVITY AND SETTING

Northwestern Memorial Hospital (NMH), a large academic center located in Chicago, IL, developed a research committee (RC) to facilitate research within the department of pharmacy for residents and to maintain residency research support materials. These materials included a charter to help guide the organizational structure and operations of the RC, research timelines, and a seminar series.

FINDINGS

The RC works to ensure that the residents overcome any challenges that they may incur during their research projects by setting clear expectations and milestones. Feedback is provided by the residents and incorporated into the research process and support materials.

DISCUSSION

The RC allows for individualized attention and personalization of the research experience for each resident. The program endeavors each year to provide the message that publication should be the final goal of a research project and not presentation at a conference.

SUMMARY

Pharmacy residents receive support from the RC from throughout the year, not only when issues surround their project arise. Institutions may implement or modify existing programs based upon the resources provided.

Impact of co-investigators on pharmacy resident research publication

Objective:

To explore influences of co-investigators on the successful publication of a pharmacy residency project.

Methods:

We analyzed published and non-published research presented at a regional pharmacy conference. Abstracts were matched 1:1 based on state and abstract year. We assessed university affiliation, number, degree, and H-Index of co-investigators on the abstract. Descriptive and inferential analyses were used to identify variables associated with resident publication.

Results:

University-affiliated programs (p=0.015), highest H-Index of a non-physician co-investigator (p=0.002), and positive H-Index (≥1) of a non-physician co-investigator (p=0.017) were significant predictors of resident publication on univariate analyses. There were no differences in the number of co-investigators (p=0.051), projects with physician co-investigators (p=1.000), or projects with Doctor of Philosophy (PhD) or Master of Science (MS) co-investigators (p=0.536) between published and non-published projects. Multivariate analysis found that the highest H-index of non-physician co-investigator remained significant as a predictor to resident publication (odds ratio (OR) 1.09, 95% Confidence Interval (CI) 1.01-1.17).

Conclusions:

The quality of co-investigators, as measured by an increasing H-Index, is associated with the successful publication of residency projects. More emphasis may need to be placed on resident research co-investigator selection and training to prepare pharmacy residents for research and scholarly activity.

Evaluation of the Effect of A Structured Program to Guide Residents' Experience in Research (ASPIRE) on Pharmacy Residents' Knowledge, Confidence, and Attitude toward Research

STUDY OBJECTIVE

To evaluate the effect of A Structured Program to guide Resident Experience in Research (ASPIRE) on pharmacy residents' knowledge, confidence, and attitude toward research.

DESIGN

Nonrandomized controlled study using data from a validated questionnaire administered through an online survey.

PARTICIPANTS

Of 60 pharmacy residents (residency year 2013-2014) who completed the baseline assessment, the 41 residents who also completed the follow-up assessment were included in the final analysis; of those, 26 Colorado pharmacy postgraduate year 1 (PGY1) and year 2 (PGY2) residents were enrolled in ASPIRE between July 2013 and June 2014 (intervention group) and 16 PGY1 and PGY2 pharmacy residents outside of Colorado did not participate in ASPIRE (control group).

MEASUREMENTS AND MAIN RESULTS

Both the intervention and control groups completed a pre- and post-assessment at the beginning (July 2013 [baseline]) and end (May/June 2014 [follow-up]), respectively, of their residency year that measured knowledge (with a tool measuring biostatistics and research methodology knowledge), confidence, and attitude toward research. Research knowledge scores improved similarly from baseline to follow-up in the intervention and control groups: 11.8% and 11.3%, respectively (adjusted p=0.8). Research confidence improved significantly more in the intervention group, with a 48% increase in confidence score from before to after residency completion, compared with a 15% increase in the control group (adjusted p=0.002). Residents in both the intervention and control groups expressed positive attitudes toward pharmacist-conducted research, with 100% and 87% of intervention and control residents, respectively (adjusted p=0.970), agreeing that pharmacist-conducted research is essential to driving pharmacy practice and expanding the roles of pharmacists.

CONCLUSION

ASPIRE was not associated with greater research methodology knowledge but did significantly increase confidence in performing research.

Impact of resident research publication on early-career publication success

PURPOSE

The impact of resident research publication on early-career publication success is evaluated.

METHODS

This study included a retrospective cohort of pharmacy residents' abstracts presented at the Great Lakes Pharmacy Resident Conference (GLPRC). Published residency research projects at GLPRC (n = 76) were matched 1:1 to unpublished projects. Residents were followed forward for five years to identify early-career publications (postresidency publication positive) versus no publications (postresidency publication negative). The following characteristics of postresidency publication-positive and publication-negative residents were compared: publication of residency project, university-affiliated residencies, median number and interquartile range of coinvestigators, presence of a physician coinvestigator, highest nonphysician H-index of coinvestigators, and nonphysician H-index of ≥1 for any coinvestigator (indicating that a coinvestigator has previously published and been cited).

RESULTS

A total of 152 abstracts were reviewed (76 published and 76 unpublished projects). Using a predefined systematic search strategy, 55 former residents had a postresidency publication within five years after presenting their project at the GLPRC. Of the former residents who published their residency project, 38 (50%) were postresidency publication positive, while 17 former residents (22.4%) who did not publish resident research projects were postresidency publication positive. Univariate and multivariate analyses revealed that publication of the pharmacy resident research project and a university-affiliated residency program was positively associated with postresidency publication success.

CONCLUSION

Pharmacy residents who published their residency research project after its presentation at the GLPRC were twice as likely to have publication success within five years compared with residents who did not publish their residency research project. A university-affiliated residency was associated with postresidency publication success within five years after project presentation.

The Importance of Research during Pharmacy Residency Training

Practice-related projects and pharmacy practice research are requirements to complete postgraduate pharmacy residency programs. Many residents will complete residencies without fully developing the skills needed to perform research required for new clinical and academic positions. Many studies have quantified successes and identified characteristics that may be associated with successful resident publication. There are many benefits to gaining research and publication skills during residency training for the resident, preceptor/mentors, and the residency program. Published works have also suggested approaches than can be taken to improve research within a residency program. The aims of this article are to discuss the publication rates of resident research projects, suggest ways to improve residency research, review benefits of residency research, and briefly review research training alternatives.