1
|
Roper KL, South AM, Palmer S, Johnson J, Sims L, Hustedde C, Mangino AA. Evaluation of a Novel Equity-Focused Curriculum for Early-Stage Medical Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241230755. [PMID: 38361770 PMCID: PMC10868471 DOI: 10.1177/23821205241230755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/10/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVES Medical school curricula have increasingly incorporated topics and content related to health equity and affiliated social determinants of health. However, there is limited literature to guide how programs might measure the success of these initiatives. Previous studies assessed medical student attitudes and perceived knowledge, preparedness, and skills. Based on self-reported measures of these attributes, we compared within-group and between-group differences at the onset of a novel equity-focused curriculum implementation. METHODS A multi-component approach to "thread" lectures, panel discussions, and other content dedicated to health equity concepts was assessed using adapted versions of two validated survey instruments of the measured constructs. Baseline data were collected prior to coursework and at follow-up early in students' second year assessed change attributable to the equity-focused curriculum thread, with additional comparison to a cohort of second-year students who had no exposure to the curriculum. Data were collected at the beginning of academic years 2021-2022 and 2022-2023. RESULTS The multivariate analysis of variance indicated significant change over time (p < 0.001) with the analyses of variance identifying students' perceived current skills and topic knowledge increasing over time. No significant differences were found between two separate groups of M2 students. CONCLUSIONS Students' perceived skills at working with diverse patient populations and knowledge of topics focused on health equity increased across the study, despite a much smaller response rate for the same student cohort at follow-up. Students' perception that they are prepared to care for patients of diverse backgrounds was unaffected. Attitudinal assessment revealed a ceiling effect at baseline, which should be explored further with longitudinal assessment. For the ongoing effort to evaluate the success of equity-focused curricula and programs, this study contributes evidence of change on some but not all outcomes, and can help guide other programs in determining which outcomes best reflect areas of programmatic need and impact.
Collapse
Affiliation(s)
- Karen L. Roper
- Department of Family and Community Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Anna-Maria South
- Department of Internal Medicine, Division of Hospital Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Skyler Palmer
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Julia Johnson
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Lillian Sims
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Carol Hustedde
- Department of Family and Community Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Anthony A. Mangino
- Department of Biostatistics, University of Kentucky College of Public Health, Lexington, KY, USA
| |
Collapse
|
2
|
Empowering Student Pharmacists through Social Determinants of Health Activities to Address Patient Outcomes. PHARMACY 2022; 10:pharmacy10060176. [PMID: 36548332 PMCID: PMC9786584 DOI: 10.3390/pharmacy10060176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The pharmacy education and its educators have to expose the student pharmacists to a plethora of activities regarding health disparities. It is essential for student pharmacists to be introduced to the key elements that comprise the Social Determinants of Health (SDOH) during their didactic curriculum. However, while there have been efforts made in the United States to incorporate the SDOH in the pharmacy curricula, there is limited research on student pharmacists' perspectives of how content in the didactic curriculum prepared them to provide patient care. A quantitative approach was used for this study. For the Class of 2023, activities were added to a skills-based course series and a professional development course series to introduce, apply, and illustrate how SDOH can impact pharmacist-provided care and patient health experiences. As part of the College's assessment plan, a survey is sent to the third-year student pharmacists in January prior to beginning Advanced Pharmacy Practice Experiences (APPEs). The online survey consists of 24 Likert Scale questions with five choices ranging from Strongly Agree to Strongly Disagree and not applicable. Four of the 24 questions pertained to health disparities and SDOH and were evaluated in this study. The responses were analyzed using SPSS for Windows, version 25.0 (IBM Corporation, Armonk, NY, USA). Descriptive statistics were calculated for all variables. Chi-square tests were used for all nominal data and Mann-Whitney test was used for all nonparametric numeric data. A total of 530 student pharmacists completed the survey. The mean age was 26 years and majority of the respondents identified as female (64%). More students strongly agreed that they had the ability to identify and address SDOH to improve access to or the delivery of healthcare in the class of 2023 (51.4%) compared to the class of 2022 (37.8%) and class of 2021 (35.8%). In addition, the mean survey score for the question between the class of 2023 improved significantly compared to the class of 2022 (p = 0.015) and 2021 (p = 0.004). Overall, this study suggests that longitudinal activities involving SDOH can improve student pharmacists' assessment of their abilities to interact with and care for a diverse patient population. The results suggest that the curriculum activities implemented to address a plethora of patients improve student assessment of their abilities to identify and incorporate SDOH in providing patient-centered care.
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Medina MS, Maerten-Rivera J, Zhao Y, Henson B. A Systematic Review of Assessment Tools Measuring Cultural Competence Outcomes Relevant to Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8672. [PMID: 35027358 PMCID: PMC10159442 DOI: 10.5688/ajpe8672] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 01/02/2022] [Indexed: 05/06/2023]
Abstract
Objective. To identify and describe validated assessment tools that measure cultural competence and are relevant to pharmacy education.Methods. A systematic approach was used to identify quantitative cultural competence assessment tools relevant to pharmacy education. A systematic search of the literature was conducted using the OVID and EBSCO databases and a manual search of journals deemed likely to include tools relevant to pharmacy education. To be eligible for the review, the tools had to be developed using a study sample from the United States, have at least one peer-reviewed validated publication, be applicable to the pharmacy profession, and be published since 2010.Results. The systematic literature and manual search identified 27 tools. Twelve assessment tools met the criteria to be included in the summary and their relevancy to pharmacy education is discussed.Conclusion. A review of literature demonstrates that assessment tools vary widely and there is no one tool that can effectively assess all aspects of cultural competence in pharmacy students or the Doctor of Pharmacy curriculum. As cultural competence is a priority within the accreditation standards for pharmacy education, PharmD programs are encouraged to develop additional tools that measure observed performance.
Collapse
Affiliation(s)
- Melissa S Medina
- The University of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jaime Maerten-Rivera
- University of Buffalo, School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York
| | - Yichen Zhao
- University of Buffalo, School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York
| | | |
Collapse
|
5
|
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.
Collapse
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:
| |
Collapse
|
6
|
Echeverri M, Unni E, Harpe SE, Kavookjian J, Alkhateeb F, Ekong G, Law A. Identifying areas of improvement for cultural competence in pharmacy curricula: A multi-school study using the self-assessment of perceived level of cultural competence (SAPLCC) questionnaire. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1278-1287. [PMID: 34521520 PMCID: PMC8477352 DOI: 10.1016/j.cptl.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 03/25/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The implementation of culturally competent healthcare services has been considered a key strategy for the provision of patient-centered care; however, a need remains to address the requirements of teaching cultural competence, including identifying gaps, designing and evaluating curricula, and assessing students' progress toward program objectives. The objective of this study was to explore the applicability of the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire in the identification of improvement areas in cultural competence content in pharmacy curricula. METHODS This study used previously-collected SAPLCC data from student pharmacists at eight United States pharmacy schools. Total and factor-specific SAPLCC scores were calculated based on the 14 factors published previously and grouped into six domains (knowledge, skills, attitudes, encounters, abilities, and awareness). Differences in overall scores by domain and factors across various student characteristics were examined using analysis of variance. RESULTS The overall mean total SAPLCC score was classified as moderate. Third-year students had significantly higher SAPLCC mean scores than first-year students, and African American students scored significantly higher than their counterparts. At the factor-level, students scored higher in the Attitudes and Awareness domains and scored lower in the Knowledge, Skills, and Encounters domains. CONCLUSIONS The application of the SAPLCC in schools participating in this preliminary study allowed for the identification of content areas that may benefit from revision. The SAPLCC may be a useful tool for mapping cultural competence curricular content by each specific domain and identifying areas of potential improvement regarding cultural competence training within pharmacy curricula.
Collapse
Affiliation(s)
- Margarita Echeverri
- Division of Clinical and Administrative Sciences, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, United States.
| | - Elizabeth Unni
- Department of Social, Behavioral, and Administrative Sciences, Touro College of Pharmacy, 230 West 125(th) Street, New York, NY 10027, United States.
| | - Spencer E Harpe
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, 555 31st Street, Downers Grove, IL 60515, United States.
| | - Jan Kavookjian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, 4306c Walker Building, Auburn, AL 36849, United States.
| | - Fadi Alkhateeb
- Academic Affairs, Qatar University, Bazeladiyat ad Dawhah, Qatar.
| | - Gladys Ekong
- Department of Pharmaceutical and Administrative Sciences, Western New England College of Pharmacy and Health Sciences, 1215 Wilbraham Road, Springfield, MA 01119, United States.
| | - Anandi Law
- Associate Dean, Assessment, Western University of Health Sciences, 309 E. Second St, Pomona, CA 91766, United States.
| |
Collapse
|
7
|
Zeenny RM, Akel M, Hajj A, Sacre H, Hallit S, Salameh P. Descriptive assessment of graduates' perceptions of pharmacy-related competencies based on the Lebanese pharmacy core competencies framework. Pharm Pract (Granada) 2021; 19:2320. [PMID: 34221200 PMCID: PMC8234617 DOI: 10.18549/pharmpract.2021.2.2320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/13/2021] [Indexed: 11/14/2022] Open
Abstract
Background Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. In 2017, the Official Pharmacists' Association in Lebanon [OPL - Order of Pharmacists of Lebanon] took the initiative to develop a pharmacy core competency framework. Objective The primary objective of this survey was to evaluate graduates' perceptions of pharmacy-related competencies "taught" across Lebanese pharmacy schools/faculties, based on the suggested Lebanese Pharmacy Competencies Framework. This study also explored the association between graduates' demographics, university attributes, and self-assessed competency performance. Methods A cross-sectional study involving pharmacists who graduated from Lebanese universities was performed through a 40-minute online questionnaire distributed over social media platforms and groups of pharmacists. Results Pharmacists perceived their competence as moderate upon graduation, the lowest scores being in fundamental knowledge and medicine supply; the highest reported scores were in personal skills and safe/rational use of medicines. Moreover, females, younger graduates, PharmD holders, and pharmacists working in hospitals/clinical settings and academia had the highest perception of their competencies. Pharmacists in the public sector and medical laboratory directors had the lowest perception of competence. Conclusions When comparing the taught curriculum to the suggested Lebanese Pharmacy Competency Framework, all domains need to be improved to optimize the perception, education, and practice of pharmacists. It is essential to emphasize fundamental knowledge, medicines supply, and public health competencies in undergraduate curricula and improve continuing professional education.
Collapse
Affiliation(s)
- Rony M Zeenny
- PharmD. Department of Clinical Pharmacy, American University Beirut Medical Center. Beirut (Lebanon).
| | - Marwan Akel
- PharmD, PhD. School of Pharmacy, Lebanese International University. Beirut (Lebanon).
| | - Aline Hajj
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Saint-Joseph University. Beirut (Lebanon).
| | - Hala Sacre
- PharmD. National Institute of Public Health, Clinical Epidemiology & Toxicology (INSPECT-LB). Beirut (Lebanon).
| | - Souheil Hallit
- PharmD, PhD. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK). Jounieh (Lebanon).
| | - Pascale Salameh
- PharmD, PhD. Medical School, University of Nicosia. Nicosia (Cyprus).
| |
Collapse
|