Impact of an elective course on pharmacy students' attitudes, beliefs, and competency regarding Medicare Part D

Impact of Experiential Education on the Intersectionality of Pharmacy Student Personal and Professional Identity Formation

OBJECTIVE

The objective of this review was to summarize evidence relating to the impact of experiential education on the development of professional identity formation (PIF) and determine areas for future research and development to improve the integration of a professional identity within the student's unique personal identity within experiential education programs.

METHODS

A systematic scoping review was conducted using the systematic evidence-based approach following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published between 2012 and 2022 related to the development of PIF in relation to the experiential experience were researched using PubMed, MEDLINE, ScienceDirect, Eric, and JSTOR (search engines) to find relevant articles.

RESULTS

A total of 986 articles were identified from the literature search. After undergoing an exclusion criterion, the total number of articles was reduced to 23 to be included in this review. Following the full-text review of the 23 articles, the authors identified common themes or domains and key findings relating to PIF and pharmacy experiential education. Articles were then assigned to 1 or more of the following domains: Experiential Education and PIF, Experiential Education and Professional Socialization, and Factors that influence PIF.

CONCLUSION

This review found that professional identity is highly impacted by experiential education and that pharmacy students cannot rely on didactic teaching alone but need to be exposed to authentic practice settings early within their curriculum by means of experiential education.

Determinant Factors of Voluntary or Mandatory Vaccination against COVID-19: A Survey Study among Students at Albanian University

INTRODUCTION

The world faced serious health and socioeconomic issues with the advent of COVID-19. Along with handwashing, social distancing, and the wearing of masks, vaccination was considered by medical authorities as a key way to curb the spread of the virus. One of the measures that have been proposed to increase vaccinations is the mandatory policy. The purpose of this study was to compare the determinants of voluntary and mandatory vaccination among students at Albanian University.

METHODOLOGY

This cross-sectional study, conducted by means of an online survey, was conducted among students enrolled at the private Albanian University, Tirana, Albania during the last week of the winter semester, 7-14 February 2022.

RESULTS

In sum, 878 students participated in this study, among whom 612 (69.7%) were females and 266 (30%) were males. Of the participants, 506 (57%) were enrolled in medical science (MS) and 372 (42.3%) were in the non-medical science (Non-MS) group. A total of 773 (88%) were vaccinated against COVID-19, and 105 (11.8%) were not vaccinated. A total of 466 (53%) reported voluntary vaccination, and 412 (46.9%) reported mandatory vaccination. Among the students who were vaccinated voluntarily, 266 (57%) were from the MS group and 200 (42.9%) were from the Non-MS group. A total of 237 (57.5%) of students in the mandatory vaccination group were from the MS group, and 175 (42.4%) were from the Non-MS group.

CONCLUSIONS

Vaccine safety and efficacy were hindering factors in vaccination. Additionally, based on the results of this study, the students felt encouraged by the academic staff to vaccinate. This clearly demonstrates that the staff does not lack the skills to enhance students' knowledge about the risk of infectious diseases and the importance of vaccination. Therefore, to influence students' attitudes as much as possible toward vaccination, comprehensive educational programs, including modifications of existing curricula, should be considered.

Impact of service-learning placement on pharmacy student knowledge, attitudes, and confidence in helping patients navigate Medicare Part D

INTRODUCTION

Pharmacists are in a prime position to empower patients to navigate Medicare Part D. This study aimed to determine if service-learning has a place in pharmacy student Medicare education. The primary objective of the study was to assess knowledge, attitudes, and confidence of first-year pharmacy students at Medicare focused service-learning sites compared to students at alternative sites.

METHODS

First-year pharmacy students at the University of Pittsburgh School of Pharmacy were assessed on their knowledge, attitudes, and confidence of Medicare Part D after a semester of service-learning either at a State Health Insurance Assistance Program (SHIP) or at an alternative site not focused on Medicare (control). All students attended a four-part lecture series on Medicare before starting service-learning. Students were surveyed at baseline and after their service-learning experience.

RESULTS

A total of 110 (94.8%) students successfully completed both the pre- and post-survey. Knowledge improved significantly in the SHIP group (P = .01) and did not increase significantly in the control group (P = .06). Attitudes toward Medicare Part D, assessed on a Likert scale, became less favorable in the control group (-0.40, P < .001). Student confidence in the ability to counsel patients on Medicare part D improved in the SHIP group (0.42, P < .001) and decreased in the control group (-0.80, P < .001).

CONCLUSIONS

Combining a didactic lecture series on Medicare Part D with service-learning involving Medicare counseling may solidify student knowledge of Medicare as well as students' confidence in helping patients navigate Medicare Part D.

Insurance Adjudication Simulation Across Multiple Institutions and Levels of Learners

Objective. A virtual educational innovation was designed and implemented to have student pharmacists simulate insurance processing. This article describes the impact of this third-party payer simulation on student knowledge and confidence and reports student perceptions of the activity.Methods. First-, second-, and third-year pharmacy students (P1, P2, and P3 students, respectively) at four institutions completed the self-paced simulation. Knowledge was assessed by comparing results of multiple-choice questions on the pre- and post-assessments and evaluated by the Wilcoxon signed rank test. Confidence was assessed by students' change in self-reported confidence scale measurements and compared using the chi-square test.Results. The simulation had a significant impact on student knowledge. The largest improvement was in P1 students, with a pre- to post-assessment average score difference (scale 0-100) of 16.6 compared to 7.2 for P2 and 10.2 for P3 students. Significant improvement was seen on most of the knowledge questions, with variations for certain questions between groups. All groups had significantly improved self-rated confidence in their abilities. Most students agreed that they would recommend this activity to other students (91.7%) and that it encouraged them to think about the material in a new way (85%).Conclusions. Through an innovative simulation on prescription insurance processing, positive results were seen across all three levels of learners. Knowledge assessments significantly improved, and student confidence increased across all groups and all confidence items. Participants would recommend this activity to other students and felt it was an effective way to learn about insurance adjudication.

A Pilot Program to Teach Pharmacy Students Practical Skills to Navigate Drug Insurance Benefits

Pharmacists must be able to navigate prescription drug coverages to help providers and patients reduce out-of-pocket costs. Traditionally, curricula on drug insurance benefits rely on lectures and lack a practicum that offers students hands-on experience with determining formulary and cost-sharing information. An activity for pharmacy students to update a free public website that summarizes formularies and copayment requirements across major insurers was piloted. Pharmacy students were trained to locate online formularies and identify a drug’s coverage tier, step therapy, prior authorization, and cost-sharing during a 6-week experiential rotation. Students checked formularies from six insurance plans for 250-plus drugs across 15 health conditions. Graduates were surveyed (74% response rate) about the activities’ impact on their learning and ability to navigate drug benefits. Respondents rated the training as helpful in learning whether a drug was covered (100%), or required step therapy or prior authorization (100%). The majority of graduates reported being able to look up formulary coverage (90%), step therapy or prior authorization (90%), and copayment requirements (65%). Our innovative skills-based pilot activity was effective in teaching pharmacy students to navigate insurance formularies, which is essential for helping patients access medications.

Educational Approach to Increase Student Pharmacist Confidence with Medicare

Objective:

To describe a didactic, case-based approach to teach student pharmacists about Medicare enabling them to consider the spectrum of coverage options, as well as both medical and drug needs, when assessing insurance plans.

Innovation:

Education on Medicare often focuses on Part D. However, the growing popularity of Medicare Advantage plans requires students to have a more comprehensive understanding of Medicare. To address this gap, a didactic, case-based approach was developed where students received four 90-minute lectures on Medicare and then applied the information through a patient case. Data was collected on student-reported confidence with Medicare, and attitudes towards the importance of understanding insurance in improving patient care. Surveys were conducted at baseline, after the didactic lectures (interim survey), and upon project completion (final survey).

Key Findings:

Confidence with Medicare increased between the baseline and interim survey (all p ≤ 0.001). Additional gains were seen after completing the project in helping patients navigate financial assistance programs (p ≤ 0.001) and selecting specific plans (p ≤ 0.05). After the interim survey, students more strongly agreed with statements related to knowledge of insurance as an opportunity to help advocate for patients (p ≤ 0.001), and the need to consider Medicare coverage when making medication recommendations (p ≤ 0.05)

Conclusion:

The combination of didactic lectures and a case-based exercise positively impacted self-reported student confidence in their knowledge, as well as attitude towards Medicare. Increasing student confidence in Medicare and willingness to engage beneficiaries in conversations about insurance coverage may be a strategy to improve patient care and health outcomes.

Qualitative exploration of factors influencing the plan selection process by Medicare beneficiaries

BACKGROUND: Because Medicare plan coverage and costs change annually and older adults, the major beneficiaries of Medicare, are faced with multiple health conditions and changing medical needs, Medicare beneficiaries should evaluate their options during open enrollment every year. However, because of the complexity of plan selection, it may be challenging for Medicare beneficiaries to make an appropriate decision from among competing options. OBJECTIVES: To (a) identify factors that beneficiaries consider having influenced their plan selection decision and (b) describe the decision-making process according to the consumer decision-making model (CDM). The 2 research questions guiding this study included (a) factors Medicare beneficiaries considered having influenced their Medicare plan selection decision and (b) characteristics of decision-making processes employed by Medicare beneficiaries. METHODS: This is a phenomenological qualitative study. Semistructured in-person or telephone interviews with Alabama residents who have Medicare as the sole insurance provider were conducted between June and August 2019. Participant recruitment continued until reaching the saturation point. Each interview session consisted of structured questions identifying characteristics of participants and open-ended questions used to elicit participant Medicare plan decisionmaking process and factors affecting their decision. Data were analyzed using content analysis with a process of qualitative inductive coding. RESULTS: Twenty participants were interviewed. Twenty codes were identified and categorized into 5 themes regarding the factors influencing plan selection decisions by beneficiaries. When making a plan selection, participants were influenced by plan attributes (including cost, coverage, access to doctors, region, quality rating, and transportation); information resources and personal assistance; knowledge about Medicare; status and changes in personal situation; and experience with Medicare. Additionally, we identified 7 codes relating to beneficiary characteristics during decision-making processes, including being proactive, setting priorities, limiting choices, evaluating plans against personal needs, acquiescing to recommendations, sticking to the status quo, and weighing trade-offs. We consulted the CDM and created a conceptual model demonstrating a 5-step Medicare plan selection decision-making process and the factors influencing that process. DISCLOSURES: This study was supported by the Auburn University Undergraduate Research Program. The authors declare no conflicts of interest. CONCLUSIONS: This study created a step-by-step decision flowchart of Medicare plan selection to illustrate the complexity of the plan selection that Medicare beneficiaries must use. We uncovered the plan selection decision-making process among Medicare beneficiaries and factors affecting that process. Drawing from the CDM and the study findings, we developed a conceptual model. Findings will help researchers and community agencies target Medicare beneficiaries with different needs for assistance and design decision-making interventions/tools to help beneficiaries make rational decisions when selecting Medicare plans. These findings suggest that health care professionals should be involved in assistance programs to maximize efficiency of Medicare plan selection and to improve monitoring and consulting mechanisms to ensure the reliability of assistance information and services.

Experiential education in the pharmacy undergraduate curricula in Brazil

Objective:

Considering the curriculum reform process taking place in pharmacy undergraduate programs in Brazil and the importance of practical experience to students throughout their learning process in university, this study aims to provide an overview of pharmacy undergraduate programs in Brazil and their respective internships.

Methods:

An observational, descriptive, cross-sectional study. A documentary analysis of pharmacy undergraduate programs in the face-to-face modality was carried out, with data obtained from the Political Pedagogical Projects of the programs, the curricula, and course descriptions containing information on internships, all provided by the Brazilian Ministry of Education. The data collected concerned higher education institutions (HEIs), pharmacy programs and internships.

Results:

Pharmacy undergraduate programs in Brazil have a median duration of 10 semesters, requiring from students a median of 6 internships, from the 6^th semester on, totalizing 826 hours. The programs lack uniformity among their internships, mainly regarding total hours and the semester in which internships start. The pharmacy internships cover, in greater number, the areas of outpatient and community pharmacy, clinical analysis, and pharmaceutical technology, respectively, being clinical analysis the area with more hours. Public and private HEIs have different internship proceedings in their curricula, hence no homogeneity among them in the different regions of Brazil.

Conclusions:

This study demonstrates the diversity of pharmacy programs in Brazil in the context of internships, reflecting on the training and the activity of pharmacists in recent decades. Further studies are needed to deepen the understanding of this theme.

Implementation of a pharmacist-delivered Medicare counseling service in a rural community health center

OBJECTIVE

To describe a pharmacist-delivered Medicare counseling service in a rural community health center for providing patients and community members with information and resources to facilitate informed Medicare plan selection(s).

SETTING

Federally-qualified health center.

PRACTICE INNOVATION

Health center patients and community members met with a pharmacist for individual Medicare counseling. The appointments provided an opportunity to educate clients on Original Medicare and private plan options for supplemental medical and drug coverage, compare specific plans, and assess eligibility for financial assistance programs.

EVALUATION

Data were collected from client contact forms completed for individuals counseled between July 1, 2015 and June 30, 2018. Data were then summarized with descriptive statistics and analyzed with Fisher exact tests.

RESULTS

A total of 47 appointments were completed with 31 unique clients. They were mostly women (n = 18, 58.1%) and aged 65 years or more (n = 17; 54.8%) but evenly divided between patients established with the health center (n = 15; 48.4%) and community members (n = 16; 51.6%). During appointments, the most common topic was an explanation of medical or drug benefits (n = 40; 85.1%) followed by comparison of specific plans (n = 25; 53.2%) and then screening individuals for Original Medicare or private plan eligibility (n = 27; 57.4%). There were no statistically significant differences when comparing topics discussed for current versus new Medicare beneficiaries. During follow-up visits, patients were less likely to be screened for Original Medicare or private plan eligibility (74.2% vs. 25%; P = 0.002), financial assistance programs (77.4% vs. 37.5%; P = 0.011), or have specific plans compared (71.0% vs. 37.5%; P = 0.034).

CONCLUSION

A pharmacist-provided Medicare counseling service in a rural community health center was used by both patients and community members. This may be an effective strategy to improve beneficiary understanding of Medicare benefits and enable the selection of better insurance plans in underserved populations. Further research is needed to assess individual-level outcomes and scalability to other settings.

Design, implementation, and outcomes of an elective course on preliminary structural biology for undergraduate students majoring in biotechnology

Biotechnological pharmaceuticals is a key course offered to third-year undergraduates majoring in biotechnology in our university. However, students often experience difficulties in understanding the principles of related technologies. In this study, we developed and implemented an elective course on preliminary structural biology for biotechnology undergraduates, aiming at reinforcing the principles of these technologies by experimental practice. The course was composed of three phases and lasted for 15 weeks, 18 students were randomly divided into six teams and were encouraged to design, prepare, carry out, and conclude a project on their own. The main contents of their project were cloning, expression, purification, and crystal screening of HpaA, a lipoprotein from the gastric pathogen Helicobacter pylori. Examination scores of biotechnology pharmaceuticals were used to assess learning outcomes. The results showed that students who participated in this course gained higher scores in the final examination, and they performed better on the questions specifically related to the elective course. These results demonstrated that the course enhanced students' understanding of the technologies involved in this course by practical applications. Thus, this elective course was effective in helping biotechnology undergraduates to learn the theory and application of biological technologies, and the experience gained in this course may be useful for other technology-based courses.

Teaching and Learning Pharmacy Services: A Teaching Method for Developing Competencies for Patient-Centered Care Through Experiential Learning in a Real Workplace

INTRODUCTION

Considering the transformation process that has been occurring in pharmacy education and the urgent need to address social health needs, proposals of teaching methods for the development of competences and skills in patient-centered care have become an issue worth discussing. The study describes and discusses the method that has been used for developing of these competencies through experiential learning in a university pharmacy in Brazil.

EDUCATIONAL ACTIVITY

The Teaching and Learning of Pharmacy Services (TLPS) method encompasses 2 components: theoretical-reflexive one (developing protocols covering the patient care process) and practical-reflexive one (using the protocols with real patients). TLPS connects the 2 components in a way to enable students to acquire and apply theoretical knowledge for a comprehensive assessment of the patients' needs and understand how clinical reasoning and decision-making take place. The assessment process is performed, by the supervisor, which evaluates the behaviors necessary for good professional performance.

DISCUSSION

The active learning methodologies have been effectively used in the classroom as a way to stimulate critical thinking, problem-solving, and clinical reasoning. However, experiential learning is considered a central point in the learning process and essential for knowledge building. Thus, the method herein described is shown as an innovative tool to promote self-learning, consolidation and interrelation of the acquired knowledge, easier identification of patients' needs, normalization of behaviors, and improvement in the quality of care.

Implementation of a Medicare Plan Selection Assistance Program Through a Community Partnership

Objective. To describe the implementation and outcomes of a sustainable Medicare Plan Selection Assistance Program conducted through a partnership between Auburn University Harrison School of Pharmacy (AU) and the Alabama State Health Insurance and Assistance Program (SHIP) since 2013. Methods. The program's goal is to assist Medicare beneficiaries in Medicare Part D plan selection. Reported outcomes included Medicare beneficiaries' plan cost savings and satisfaction, and pharmacy students' self-reported changes in knowledge and attitudes. Results. Each year, more than 80 pharmacy students assist more than 120 beneficiaries; at least 10 events are held covering 6-10 Alabama counties. On average, Medicare beneficiaries had a projected savings of $278.71 (2013), $1,081.66 (2014), $842.84 (2015), and $1,382.90 (2016) after enrolling in a new plan, and most students reported perceived increased ability to help beneficiaries select the most appropriate Medicare Part D plan. Conclusion. The program produced positive outcomes for both beneficiaries and students. Other pharmacy schools may consider partnering with their State Health Insurance and Assistance Program to deliver a similar program to benefit their students and Medicare beneficiaries.

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

OUR SITUATION

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

METHODOLOGICAL LITERATURE REVIEW

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

OUR RECOMMENDATIONS AND THEIR APPLICATIONS

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

POTENTIAL IMPACT

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

Confidence in skills applied to patient care among PharmD students in telehealth medication management programs versus other settings

INTRODUCTION

Exposure to medication therapy management (MTM) courses has demonstrated to increase student pharmacist's confidence in the application of patient care skills. The purpose of this study was to evaluate the effects of student pharmacists' work experience in a telehealth MTM program, versus hospital or community settings, on their confidence in skills applied in patient care.

METHODS

This was a cross-sectional multicenter survey. Confidence in patient care among student pharmacists was assessed between those who worked in a telehealth MTM program versus other settings. The data was evaluated using Chi-Square, Fisher exact, unpaired-t, Kruskal-Wallis, and Mann-Whitney U tests.

RESULTS

282 surveys were completed. First-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a comprehensive medication review (CMR) (p < .001), interviewing patients (p < .001), identifying medication errors (p < .001), and making therapeutic recommendations to patients (p = .04) and prescribers (p = .04). Second and third-year student pharmacists who worked in telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p ≤ .005). Fourth-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p = .003), interviewing patients (p = .02), and identifying medication errors (p = .04).

CONCLUSION

Student pharmacists' participation in a telehealth MTM program may markedly increase their confidence in skills applied in patient care. MTM work experience should be offered to student pharmacists during their PharmD programs to enhance their confidence in the provision of patient care.

Competencies for the provision of comprehensive medication management services in an experiential learning project

OBJECTIVE

To understand students' and tutors' perceptions of the development of clinical competencies for the delivery of comprehensive medication management services in an experiential learning project linked to a Brazilian school of pharmacy.

METHODS

An autoethnographic qualitative study was carried out based on participant observation, focus groups and individual interviews with students and tutors involved in an experiential learning project.

RESULTS

The study revealed the development of competencies related to the philosophy of practice, the pharmacotherapy workup of drug therapy and interprofessional relationships.

CONCLUSIONS

The experiential learning project contributed to the professional development of pharmacy students in pharmaceutical care practice, pointing to its potential benefits for incorporation into professional pharmacy curricula.

Assessing student knowledge, confidence, accuracy, and proficiency in providing Medicare Part D assistance

PURPOSE

To assess the impact of coordinated didactic, simulation-based, and experiential learning on pharmacy students' knowledge and confidence with Medicare Part D and their accuracy and proficiency with the Medicare Plan Finder Tool.

EDUCATIONAL ACTIVITY

Forty-two pharmacy students participated in a two-semester Medicare Part D elective course in which didactic, simulation-based and experiential learning methods were employed. Students' knowledge, confidence, accuracy, and proficiency were assessed at three course time points: first day of class, last day of in-class education, and after completion of outreach.

FINDINGS

Student confidence with Part D and efficiency using the Plan Finder Tool significantly improved at each successive time point (p<0.01). Student knowledge was significantly improved both on the last day of class and after outreach completion as compared to the first day of class (p<0.01).

SUMMARY

Basic Part D knowledge improved with the didactic and simulation-based portion of the course. The experiential component improved student confidence and efficiency in helping Medicare beneficiaries.