Training Student Pharmacists to Perform Point-of-Care Testing

Impact of Simulation Manikins to Train Pharmacy Students in Nasal, Throat, and Oral Fluid Swab Collection

Introduction: A point-of-care testing (POCT) certificate was implemented in a required pharmacy skills-based course. The purpose of this study was to evaluate the impact of manikins on student confidence in performing POCT swabs for infectious diseases. Innovation: Manikins were used to train second-year pharmacy students on nasal swabs, throat swabs, and oral fluid swabs. Student skills were assessed on manikins first, then on a peer. Proficiency was defined as a score of 90% or higher. Students completed a pre- and post-training survey regarding their confidence performing swabs. Student confidence was based on Likert style responses (i.e., 'Strongly Disagree' [score: 1], to 'Strongly Agree' [score: 5]) performing the swabs. Median change in confidence was calculated using quantile regression. Findings: All students (n=63) demonstrated proficiency in performing swabs. Median confidence for nasal, throat, and oral fluid swabs changed by 2.0 (95% CI: 1.5, 2.5), 2.0 (95% CI: 1.5, 2.5), and 2.0 (95%CI: 1.3, 2.7), respectively. The majority of students reported time spent practicing was adequate for the nasal (n=51, 81%), throat (n=51, 81%), and oral fluid swab (n=59, 94%). All participating students reported manikins to be moderately (n=17, 27%) or extremely (n=46, 73%) valuable, and all students rated their overall experience with manikins as positive (n=63, 100%). Student comments revealed manikins helped to visualize anatomy, practice skills without peer discomfort, and minimize risk during the COVID-19 pandemic. Conclusion: This study demonstrated that inclusion of practice on manikins increased student confidence in performing POCT for infectious diseases. In addition, the majority of students indicated that the use of manikins was valuable to their learning and reported feeling prepared to perform POCT in practice after using the manikins.

Implementing community pharmacy-based influenza point-of-care test-and-treat under collaborative practice agreement

Background

Early and accessible testing for influenza with point-of-care testing (POCT) can be a critical factor for deciding to begin antiviral treatment. More than 10,000 pharmacies across the USA offer Clinical Laboratory Improvement Amendments-waived POCT for infectious diseases, such as influenza A/B. Knowledge of barriers and facilitators to large-scale POCT implementation may be useful in scaling POCT for influenza test-and-treat services (Flu POCT). The objective of this study was to explore the experiences of pharmacists who were early adopters of Flu POCT and treatment under collaborative practice agreement in community pharmacy settings.

Methods

Qualitative research design with in-depth, semi-structured virtual video interviews of licensed US community pharmacists. Interview questions were derived from the Consolidated Framework for Implementation Research (CFIR). Interviewees were selected via a purposeful sampling of pharmacists who were enrolled in a nationwide clinical trial involving pharmacy-based influenza test-and-treat under a collaborative agreement. Interviews were recorded and transcribed. A deductive analytic approach was used via constructs from the CFIR.

Results

Six pharmacists were interviewed. Interviews ranged from 28 to 70 min, with an average length of 46 min. Four broad themes emerged from the data, and each had corresponding subthemes and supporting quotes: influence of the Flu POCT service characteristics on pharmacy implementation, influence of factors outside of the pharmacy setting in Flu POCT implementation, factors within the pharmacy setting influencing implementation, and process of implementing Flu POCT. A novel pharmacy-based Flu POCT implementation framework is presented.

Conclusions

Implementation of community pharmacy-based Flu POCT services is feasible; but, a thorough understanding of both barriers and facilitators to their implementation is needed to increase the spread and scale of these programs. Specifically, pharmacy stakeholders should focus efforts on increasing patient and provider awareness, pharmacist acceptance, leadership support, and support of health providers external to the pharmacy to improve implementation success.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00324-z.

Training student pharmacists to administer pediatric immunizations

BACKGROUND AND PURPOSE

To describe the implementation of a pediatric vaccination training for student pharmacists and to assess student confidence in providing pediatric vaccinations after taking part in a mixed media, traditional lecture, and active learning, formatted training course.

EDUCATIONAL ACTIVITY AND SETTING

Student pharmacists were trained with a two-hour pediatric immunization training module which consisted of materials to detail administration techniques. Students were assessed using a live skills assessment and a multiple-choice knowledge examination. To assess student confidence in these skills, the students were given a pre- and post-instruction survey which was analyzed using the Mann-Whitney U test.

FINDINGS

All 170 students enrolled successfully completed the knowledge assessment with an average score of 87% (SD 10%). The skills assessment items most commonly needing remediation were verifying that caregivers received the Vaccine Information Sheet (24%) and reviewing comfort measures and after care instructions with the caregiver (24%). The pre-course survey was completed by 169 out of 170 student pharmacists (99.4%) while the post-course survey was completed by 164 student pharmacists (96.4%) with each item showing a statistically significant increase in perceived confidence in vaccine administration.

SUMMARY

Pediatric vaccination training was integrated into a doctor of pharmacy curriculum with the goals of increasing student knowledge and confidence in giving pediatric immunizations. Upon course completion, there was a statistically significant increase in student-perceived knowledge and confidence when administering pediatric immunizations. By expanding access to pediatric immunizers, pharmacists can aid in increasing immunization rates improving public health in their communities.

Public Health Education Should Include Point-of-Care Testing: Lessons Learned from the Covid-19 Pandemic

GOAL

The goal is to present key principles of point-of-care testing (POCT) in educational curricula that meet critical needs for rapid decision-making in disasters, outbreaks of highly infectious diseases, emergency management, and complex crises.

OBSERVATIONS

The coronavirus disease 19 (COVID-19) pandemic unequivocally proved the value of POC strategies. Striking needs identified by COVID-19 challenges have yet to be entirely fulfilled. A comprehensive national survey showed absence of POCT training in public health colleges, schools, and programs. Fundamental improvements in national structuring of POC knowledge, skills, experience, training, dissemination, accreditation, and licensing are necessary, so that multidisciplinary public health teams can respond effectively and efficiently by geospatially optimizing the control and mitigation of highly infectious diseases and other critical challenges.

CONCLUSIONS

Four sets of POCT learning objectives were developed for public health and other educational institutions. Global implementation of POC diagnostics in the hands of trained personnel will help avoid untimely worldwide crises, huge economic losses, uncounted excess mortality, and sudden disruptive surges of dangerous infectious threats to personal security and cultural stability.

Pharmacy students' perspectives on involvement in workplace-based preventative health and wellness events

INTRODUCTION

Canadian pharmacy students have varied exposure within their academic curricula and limited opportunities for hands-on preventative health experiences prior to practicums. We aimed to explore pharmacy student perceptions of readiness to engage in patient education and assessment activities in health promotion events.

METHODS

Under licensed pharmacist supervision, volunteer pharmacy students delivered health promotion events to University of British Columbia staff and faculty between 2017 and 2020. Students attended a one-hour, group training session with a licensed pharmacist prior to participating in four hours of service delivery. Post-event, anonymous, electronic surveys were emailed to student participants to gauge perceived change(s) in knowledge and skill development as a result of participation. Data analysis was by descriptive statistics.

RESULTS

Surveys were sent to 151 pharmacy student volunteers from 2017 to 2020. A total of 69 responses were received (response rate = 45.7%), 60 of which were complete (completion rate = 39.7%). Overall, students reported a shift from feeling competent to confident in the various domains assessed as a result of participation. The majority of students strongly agreed or agreed that they were well-prepared for the event and felt supported by pharmacist supervisors.

CONCLUSIONS

Pharmacy students felt that participation in a brief preventative health and wellness intervention increased confidence in knowledge and patient care skills, regardless of year of study. Early exposure to health promotion activities may accelerate and enhance clinical abilities of pharmacy students while preparing them for expanding pharmacist roles.

Training student pharmacists to facilitate human immunodeficiency virus point-of-care testing

BACKGROUND AND PURPOSE

The advent of HIV point-of-care testing (POCT) has increased ease of access to HIV testing in the outpatient setting. As community pharmacy continues to expand, it is crucial that student pharmacists are exposed to POCT in the classroom so they are prepared for more intensive training as a pharmacist as they could be providing POCT in future practice. Our objective was to train student pharmacists to perform HIV POCT and educate patients on results and implications of testing. Educational activity and setting: Following a didactic HIV lecture, second-year student pharmacists learned to utilize the OraQuick ADVANCE Rapid HIV-½ Antibody Test in a one-hour workshop. Participants were then assessed using a 4-point Likert type scale during an individual, 10-min skills lab on their ability to provide POCT using sample kits and interpret simulated results. Data were analyzed using descriptive statistics.

FINDINGS

Forty-one students participated. Students showed competency when performing HIV POCT, as 92.7% of students were able to describe the test, and 97.6% of students were able to interpret the results correctly. Students scored a mean of 46.2 points overall (maximum of 50).

SUMMARY

Results suggest training student pharmacists to perform HIV POCT may better prepare them to administer the test and counsel patients on results in an outpatient setting. Future studies should examine the differences in the ability to perform POCT between pharmacists who received training as students and those who did not.

Strategies, Ideas, and Lessons Learned While Engaging in SoTL Without Formal Training

Most pharmacy faculty members are more confident in their foundation as research scientists or clinical pharmacists than with the scholarship of teaching and learning (SoTL). However, many wish to enter this rewarding field of scholarship in order to test pedagogical innovations, measure teaching effectiveness, and share success with the Academy. This commentary provides general advice for those who wish to explore SoTL but lack formal education and training in this area. Four opportunities are highlighted: educational research, small activities and projects, course redesign, and longitudinal assessment and evaluation.