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Barrickman AL, Gálvez-Peralta M, Johnson H, Purnell K, Harvey M. Development of an integrated rheumatoid arthritis simulation that reinforces specialty pharmacy and managed care concepts. CURRENTS IN PHARMACY TEACHING & LEARNING 2023:S1877-1297(23)00077-1. [PMID: 37088656 DOI: 10.1016/j.cptl.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/10/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND PURPOSE As pharmacy services expand, it is critical for schools/colleges of pharmacy to prepare learners to provide patient care in a variety of settings and to subsequently assess skills that are necessary for clinical practice. The objectives of this study were to (1) develop and implement a simulation that required students to integrate knowledge from multiple courses and disciplines, (2) assess students' performance and perceptions of the activity, and (3) measure student confidence related to managed care, specialty pharmacy, and clinical and foundational concepts prior to and after the simulation. EDUCATIONAL ACTIVITY AND SETTING Faculty developed an integrated simulation that required students to provide information for prior authorization of a new medication, counsel a patient on rheumatoid arthritis and the medication, and address patient questions about insurance formularies, cost, and prior authorization processes. Students completed pre- and post-surveys to determine changes in knowledge and perceptions of the simulation. Exam questions that corresponded to simulation concepts were also analyzed. FINDINGS Analysis of pre-post surveys indicated that students' self-perceived knowledge and confidence significantly improved in all areas (P < .001 and P < .05, respectively). Student perceptions of the simulation were positive, with comments referencing the activity's realism. Correct answers on knowledge-based questions related to simulation concepts were selected by at least 90% of students on course examinations. SUMMARY This integrated simulation was effective at increasing self-perceived student knowledge and confidence on concepts from all disciplines, and it can easily be replicated and adapted at other pharmacy institutions.
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Affiliation(s)
- Ashleigh L Barrickman
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, PO Box 9520, Morgantown, WV 26506, United States.
| | - Marina Gálvez-Peralta
- Department of Pharmaceutical Sciences, West Virginia University School of Pharmacy, PO Box 9520, Morgantown, WV 26506, United States.
| | - Heather Johnson
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, PO Box 9520, Morgantown, WV 26506, United States.
| | - Katherine Purnell
- Highmark Health, 120 Fifth Avenue, Pittsburgh, PA 15222, United States
| | - Madelyn Harvey
- West Virginia University Medicine Allied Health Solutions, 3040 University Avenue, Morgantown, WV 26505, United States.
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Bowers R, Perkins S, Trotta K, Mills B, Ghassemi E. Comparison of Student Pharmacists' Knowledge Retention Utilizing Electronic Health Records Versus Simultaneously Completing Simulated Experiences. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:ajpe8857. [PMID: 34862177 PMCID: PMC10159378 DOI: 10.5688/ajpe8857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/30/2021] [Indexed: 05/06/2023]
Abstract
Objective. The purpose of this study was to determine whether the addition of standardized patients or the addition of interprofessional student teams with standardized patients to the use of a simulated electronic health record improved student knowledge retention and perceptions.Methods. This was a prospective cohort study assessing three cohorts of first-year student pharmacists in pharmacy skills laboratory activities that occurred in 2018, 2019, and 2021. The primary objective of the study was to compare knowledge retention of the case material between groups at one month. Each year, an element of simulated experience was added onto the previous year's case. In 2018, students completed the case using only the electronic health record web application. In 2019, the previous year's experience was combined with an objective structured clinical examination (OSCE) with standardized patients. In 2021, the 2019 experience was supplemented with student physician assistants. Case scores and student perceptions were also compared between groups.Results. Of the 260 potential participants, 238 students were included in the primary analysis. Results showed that with the addition of interprofessional team-based care and standardized patients, significant improvement was demonstrated in knowledge retention assessments at one month. Mean knowledge retention assessment scores for the 2018, 2019, and 2021 groups were 63.8%, 71.7%, and 76.1%, respectively. Significant improvement was also found in student perceptions.Conclusion. Adding standardized patients and interprofessional team-based care to a pharmacy skills laboratory that uses a simulated electronic health record significantly improved student knowledge retention and perceptions.
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Affiliation(s)
- Riley Bowers
- Campbell University, College of Pharmacy & Health Sciences, Buies Creek, North Carolina
| | - Scott Perkins
- Campbell University, College of Pharmacy & Health Sciences, Buies Creek, North Carolina
| | - Katie Trotta
- Campbell University, College of Pharmacy & Health Sciences, Buies Creek, North Carolina
| | - Beth Mills
- Campbell University, College of Pharmacy & Health Sciences, Buies Creek, North Carolina
| | - Emily Ghassemi
- Campbell University, College of Pharmacy & Health Sciences, Buies Creek, North Carolina
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Nguyen W, O'Reilly CL, Moles RJ, Robinson JD, Brand-Eubanks D, Kim AP, El-Den S. A systematic review of patient interactions with student pharmacists in educational settings. J Am Pharm Assoc (2003) 2021; 61:678-693.e3. [PMID: 34483057 DOI: 10.1016/j.japh.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients may contribute to various aspects of student pharmacists' education within clinical, experiential and educational settings. There is an emerging body of literature describing and evaluating the contribution of patients to health care education; however, little is known about patients' contribution to pharmacy education specifically within educational settings. OBJECTIVE To explore the evidence relating to the involvement of patients in the education of student pharmacists, in terms of the nature, extent, and outcomes of their contribution. METHODS A systematic literature search was undertaken within Embase, MEDLINE, Education Resources Information Center, International Pharmaceutical Abstracts, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to April 10, 2020. Inclusion criteria included primary research studies reporting on the active involvement of patients in pharmacy education, within an educational setting. Quality assessment appraisal for the included studies was conducted using the Mixed Methods Appraisal Tool. RESULTS Twelve studies were eligible for inclusion in this systematic review. Nine studies explored the use of patients as educators providing valuable insight about their lived experience. Six studies involved patients in question-and-answer sessions, providing students with opportunities to inquire about their lived experience in relation to medicines, health care, and medical conditions. Studies that reported on students' learning outcomes demonstrated improvements in communication skills, deeper understanding of patients' lived experience particularly relating to mental illness, and increased confidence in providing care for patients. Among patients, participation in the educational process led to greater satisfaction, empowerment, and knowledge from sharing personal experiences. There were no clinical outcomes measured among patients participating in the included studies. The 5 nonrandomized quantitative studies ranged from low to moderate levels of quality, the 4 mixed-methods studies were of low quality, and the 3 qualitative studies were of high quality. CONCLUSION The involvement of patients in the education of student pharmacists was found to benefit both patients and students. Student-specific outcomes included development of communication skills and new insights about patients' lived experience. Further research is needed to better understand the long-term impact of patient involvement in pharmacy education, in terms of students' learning outcomes and clinical outcomes among patients.
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Andrews LB, Cardinale M, Dixit D. Integrating high fidelity patient simulation into a skills-based doctor of pharmacy curriculum: A literature review with focus on the bedrock pilot course. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:1320-1328. [PMID: 32867930 DOI: 10.1016/j.cptl.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/02/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Simulation-based teaching is an effective instructional strategy gaining momentum in pharmacy education but remains variable across programs. This is the first known report depicting the development of a multifaceted, integrated simulation program during concurrent initiation of a new skills-based pharmacy curriculum. METHODS A significant infrastructure expansion created simulation areas whose availability corresponded with the initiation of a new skills-based curriculum. Integration of simulation occurred with existing personnel resources using area pilots. Pilots developed operational and educational design standards spanning the pre-simulation, simulation, and debriefing phases. The value of high-fidelity simulation pilots detailed here was assessed through both student survey and successful transference of tools to other courses. RESULTS The pilots developed core operational and educational design standards, super-user faculty groups, and created an operational director position, essential for simulation promulgation throughout the curriculum. In the high-fidelity patient simulation pilot, operational elements included mannequin and equipment procedures, best practices for faculty and confederate engagement, and formulary development. Educational design standards addressed objective development, session flow, team roles, and debriefing. A grading rubric template aligned goals and assessed outcomes. All elements were structured into a planning worksheet. Student survey reflected the perceived value of this pilot. CONCLUSIONS Operational support, integration coordination, and perceived value are all essential elements for successful curricular integration of simulation in a pharmacy curriculum. The pilots created the operational and educational structure establishing standards and defining required resources to sustain success. These pilots allowed for rapid curricular proliferation of simulation across the first and third professional years.
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Affiliation(s)
- Liza Barbarello Andrews
- The State University of New Jersey, Ernest Mario School of Pharmacy, Pharmacy Practice and Administration, 160 Frelinghuysen Road, Piscataway, New Jersey 08854, United States.
| | - Maria Cardinale
- The State University of New Jersey, Ernest Mario School of Pharmacy, Pharmacy Practice and Administration, 160 Frelinghuysen Road, Piscataway, New Jersey 08854, United States
| | - Deepali Dixit
- The State University of New Jersey, Ernest Mario School of Pharmacy, Pharmacy Practice and Administration, 160 Frelinghuysen Road, Piscataway, New Jersey 08854, United States
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The Role of a Simulation-Based Activity on Student Perceptions of Parenteral Nutrition Education. PHARMACY 2020; 8:pharmacy8030123. [PMID: 32708253 PMCID: PMC7559931 DOI: 10.3390/pharmacy8030123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction: Parenteral nutrition (PN) education in pharmacy schools and postgraduate programs may not sufficiently prepare future pharmacists for clinical practice. Limited data exist regarding innovative teaching strategies in the area of PN. The purpose of this study was to identify students’ perceptions of a simulated PN activity in a pharmacotherapeutics course. Methods: Second-year Doctor of Pharmacy (PharmD) students from two cohorts (N = 84 for both cohorts) completed a PN assignment using simulated PN materials, which resembled those seen in clinical practice. Before and after the activity, students completed identical surveys about their perceived competence and interest in PN, which were analyzed using Wilcoxon signed-rank tests. Results: Following the simulation, the percentage of students affirming their perceived competence (selecting strongly agree or agree in the survey) in their ability to describe the process of combining ingredients to make a PN admixture (45.2% vs. 83.3%, p < 0.001) and calculate PN-related problems (58.3% vs. 83.3%, p < 0.001) improved. The proportion of students expressing interest in PN increased after the simulation (78.6% vs. 86.9%, p < 0.001). Conclusion: A simulated practicum experience in PN was viewed positively by PharmD students at this university, and may be a valuable active learning experience to incorporate in a PharmD curriculum.
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Alnawayseh T, Naddaf A, Taybeh E. The impact of the clinical pharmacist on the use of inhalers among asthmatic patients in Alkarak region in the South of Jordan. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2020. [DOI: 10.1111/jphs.12339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Karle E, Patel TP, Zweig J, Krvavac A. Understanding the Knowledge Gap and Assessing Comfort Level among Healthcare Professionals Who Provide Inhaler Education. COPD 2020; 17:197-204. [PMID: 32237908 DOI: 10.1080/15412555.2020.1746251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Inhaled medications play a pivotal role in the management of COPD and asthma. Provider knowledge and ability to teach various devices is paramount as poor inhaler technique directly correlates with worse disease control. The goal of our survey was to assess the knowledge and comfort level with various inhaled devices among providers involved in patient inhaler education. We constructed a 20-question survey consisting of a five-question Likert scale-based comfort assessment and a 15-question multiple-choice inhaler knowledge test that was distributed both internally and nationwide. Groups surveyed included internal medicine residents, family medicine residents, pulmonary fellows, respiratory therapists, nursing staff, and pharmacists. A total of 557 providers responded to the survey. The overall correct response rate among all respondents was only 47%. There was no significant difference between correct response rates among prescribers (internal medicine residents, family medicine residents, and pulmonary fellows) and non-prescribers (respiratory therapists, nursing staff, and pharmacists), 47% and 47%, respectively (p = 0.6919). However, respiratory therapists had the overall highest correct response rate of 85%. Over 72% of respondents indicated that they educate patients on inhaler technique as part of their clinical duties. Furthermore, the correct response rates for various inhaler devices varied with 55% among metered dose inhalers, 52% among dry powder inhalers, and 34% among soft-mist inhalers. Our study reveals that there is a continued need for education on the subject of inhaler devices among providers given their overall poor knowledge, particularly in an era of fast-changing inhaler devices. We continue without knowing what we teach.
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Affiliation(s)
- Ethan Karle
- Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Tarang P Patel
- Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Jason Zweig
- Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Armin Krvavac
- Division of Pulmonary, Critical Care, and Environmental Medicine, Department of Medicine, University of Missouri, Columbia, Missouri, USA
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Ndukwe HC, Shaul D, Shin J, Pang CD, Swee CY, Hong BT, Dummer JF, Fitzgerald C, Wilby KJ, Marra CA. Assessment of inhaler technique among fourth-year pharmacy students: Implications for the use of entrustable professional activities. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:281-286. [PMID: 32273063 DOI: 10.1016/j.cptl.2019.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/27/2019] [Accepted: 12/04/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION It is unknown when and how often competency assessments should occur in pharmacy education. Using inhaler technique as an example competency, the study objectives were to measure the proportion of near-graduation students demonstrating correct technique approximately one year after initial training and to measure reliability between assessors. METHODS A sample of 45 near-graduation pharmacy students with prior education on correct inhaler technique participated in this direct observation study at the University of Otago. Five trained assessors simultaneously rated each participant's inhaler technique demonstration using a checklist. RESULTS Of 37 participants demonstrating a pressurized metered dose inhaler, 21.62% demonstrated correct technique. No participants among eight volunteers demonstrated proper use of a dry powder inhaler. On average, two steps were performed correctly for each inhaler type. Steps with the highest error rate were "hold the inhaler upright and shake well," "breath out gently, away from the inhaler," and "keep breathing in slowly and deeply". The intraclass correlation coefficient for any inhaler type was excellent (0.91), suggesting assessors had strong reliability. CONCLUSIONS Students did not retain ability to correctly demonstrate inhaler technique one year after initial instruction. This finding supports the notion that demonstrable tasks may need to be frequently assessed to ensure the task is mastered and becomes a routine part of a student's practice. It also suggests that assessment of milestones and/or entrustable professional activities may need to occur at different time points throughout a program, rather than allowing for "signing off" prematurely.
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Affiliation(s)
- Henry C Ndukwe
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Diana Shaul
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Juhyun Shin
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Chun Ding Pang
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Chia Yin Swee
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand
| | - Bee Teng Hong
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Jack F Dummer
- Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand.
| | | | - Kyle J Wilby
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
| | - Carlo A Marra
- School of Pharmacy, University of Otago, Dunedin 9054, New Zealand.
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Topal E, Arga M, Özmen AH, Kurşun MA, İlhan ÖA, Alıcı M. The pharmacists' ability to use pressurized metered-dose inhalers with a spacer device and factors affecting it. J Asthma 2020; 58:659-664. [PMID: 32066310 DOI: 10.1080/02770903.2020.1731823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of this study is to evaluate the pharmacists' ability to use pMDIs with a spacer device and the factors that affect this ability.Method: Face to face interviews were conducted with the pharmacists. A nine item questionnaire was completed and the checklist for how to use pMDIs with a spacer device was filled out.Results: A total of 307 pharmacists voluntarily participated in this study. Fifty-six (18.2%) of the pharmacists stated that they did not know how to use pMDIs with a spacer device. These pharmacists were excluded and remaining 251 pharmacists included in the study. Only 100 (39.8%) pharmacists demonstrated all of the inhaler spacer device usage steps correctly. The step in which pharmacists made the most mistakes was "take 5-6 deep and slow breaths, hold for 10 s and slow breaths." Those pharmacists who were more likely to correctly use pMDIs with a spacer device were younger (p = 0.023), had dispensed more asthma medications per day (p < 0.001), had dispensed more asthma medications per day for patients younger than six years of age (p = 0.016), and sold inhaler spacer devices at their pharmacy (p = 0.042).Conclusion: Approximately one third of the pharmacists in the current study were able to correctly demonstrate all of the steps for proper usage of pMDIs with a spacer device, which indicates that pharmacists should be included in the training program and be provided continuous training on the use of pMDIs with a spacer device.
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Affiliation(s)
- Erdem Topal
- Department of Pediatric Allergy and Immunology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Mustafa Arga
- Department of Pediatric Allergy and Immunology, İstanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Abdullah Hakan Özmen
- Department of Pediatrics, Bakırköy Sadi Konuk Education and Research Hospital, İstanbul, Turkey
| | - Muhammet Arif Kurşun
- Department of Pediatric Allergy and Immunology, İstanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Ömer Adil İlhan
- Department of Pediatric Allergy and Immunology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Mustafa Alıcı
- Department of Pediatric Allergy and Immunology, İnönü University Faculty of Medicine, Malatya, Turkey
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Basak T, Demirtas A, Iyigun E. The effect of simulation based education on patient teaching skills of nursing students: A randomized controlled study. J Prof Nurs 2019; 35:417-424. [DOI: 10.1016/j.profnurs.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/27/2019] [Accepted: 02/04/2019] [Indexed: 11/29/2022]
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Vogelberg C. Anticholinergics in asthma: are we utilizing asthma therapies effectively? Ther Clin Risk Manag 2019; 15:405-408. [PMID: 30936703 PMCID: PMC6422406 DOI: 10.2147/tcrm.s190363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Christian Vogelberg
- Department of Pediatric Pulmonology and Allergy, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany,
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Jenkins C. Barriers to achieving asthma control in adults: evidence for the role of tiotropium in current management strategies. Ther Clin Risk Manag 2019; 15:423-435. [PMID: 30936705 PMCID: PMC6422417 DOI: 10.2147/tcrm.s177603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Despite the availability of a range of treatment options and management guidelines, a high proportion of adults with asthma remain uncontrolled. The challenge of managing uncontrolled asthma includes providing efficacious treatment while limiting side effects, recognizing situations when a change in asthma therapy is required, and considering patient preferences and satisfaction. In line with the Global Initiative for Asthma report, asthma management is based on a backbone of inhaled corticosteroid (ICS) therapy and use of add-on therapies to achieve disease control. This review considers whether add-on options could be better utilized in clinical practice. A number of long-acting muscarinic antagonists are in development, but tiotropium is the most widely studied for use in asthma. Evidence demonstrating the efficacy of tiotropium as an add-on therapy to at least ICS in adults with symptomatic mild, moderate, and severe asthma is presented from randomized controlled trials and real-world evidence. In addition, the benefit of tiotropium therapy in a wide range of patient phenotypes and disease severities without the need for biomarker assessment is discussed. Additional strategies that complement this approach, such as recognizing and overcoming barriers to adherence, ensuring optimal device use, and education and support to enhance patient–physician communication, are discussed. Physician education can also help raise awareness that additional management options are available for patients with moderate-to-severe asthma who remain uncontrolled on ICS/long-acting β2-agonist treatment.
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Affiliation(s)
- Christine Jenkins
- Department of Thoracic Medicine, The George Institute for Global Health and Concord Clinical School, University of Sydney, Sydney, NSW, Australia,
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Toumas-Shehata M, Henricks M, Ovchinikova L, Smith L, Bosnic-Anticevich S. Teaching Pharmacy Undergraduate Students Inhaler Device Technique and Exploring Factors Affecting Maintenance of Technique. Can Respir J 2018; 2018:1597217. [PMID: 30057652 PMCID: PMC6051252 DOI: 10.1155/2018/1597217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/23/2018] [Indexed: 11/18/2022] Open
Abstract
Aim To determine the effect of inhaler device technique education on the maintenance of the inhaler device technique of undergraduate pharmacy students over time and to determine the factors, if any, related to inhaler device technique maintenance in the academic setting. Methods This study took the form of a prospective, unpaired samples repeated measures design. Participants had their inhaler technique assessed at baseline. Participants were then shown how to use an inhaler as a group. Participants then worked in pairs and took turns teaching and assessing each other on the correct inhaler technique using the 9-step checklist. Immediately following the delivery of the intervention, participants had their inhaler technique reassessed. All participants were then trained to mastery through individualised training. Twelve months following the collection of baseline data, all participants had their inhaler technique assessed and completed two questionnaires. Results Following the delivery of the intervention, there was a significant increase in the proportion of participants with the correct inhaler technique when compared to baseline (11% to 61%, resp.). There was a significant reduction in the proportion of participants demonstrating the correct technique 12 months following training (28%). The strongest determinant of inhaler technique maintenance is experience with showing patients how to use their inhalers. Conclusion Repeated training is essential to ensure that the technique is mastered and maintained, and consolidation of skills through exposure to train others may be most effective.
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Affiliation(s)
- Mariam Toumas-Shehata
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2037, Australia
| | - Mark Henricks
- Utrecht University, P.O. Box 80.115, 3508 TC Utrecht, Netherlands
| | - Ludmila Ovchinikova
- The University of Sydney, A15–Pharmacy and Bank Building, Sydney, NSW 2006, Australia
| | - Lorraine Smith
- The University of Sydney, A15–Pharmacy and Bank Building, Sydney, NSW 2006, Australia
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Elhajji FD, Basheti IA. Animal use in pharmacy undergraduate pharmacology laboratories: Students' perceptions and need assessments. Saudi Pharm J 2018; 26:1098-1105. [PMID: 30532630 PMCID: PMC6260479 DOI: 10.1016/j.jsps.2018.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/30/2018] [Indexed: 12/01/2022] Open
Abstract
Background During the undergraduate years, laboratory practical classes using experimental animals are important in pharmacy schools. Limitations for experimental use of animals exist, including the procurement of animals, the difficulty in performing animal experiments, ethical considerations, and more often students' preferences. Objective To evaluate pharmacy students’ perceptions, barriers, and confidence regarding animal use in the pharmacology laboratory course, and the effect of animal handling on their confidence. Methods This observational pre- and post-course parallel group design study was conducted during the Pharmacology laboratory involving 3rd-year pharmacology students from one school of pharmacy in Jordan. A questionnaire was designed and validated to collect students’ demographic characteristics, perceived barriers and perceptions regarding animal handling during the lab, and the level of confidence pre- and post-course, assessing differences between those who handled and those who did not handle animals. Results All Pharmacology lab students (n = 212) with a mean age of 21.11 (SD 1.32) and the majority being females (77.0%) were enrolled. Students who refused to handle animals (n = 105, 49.5%) stated phobia as the main barrier. Students who accepted to handle animals agreed more with the importance of seeing and practicing animal handling, with animal handling being essential to understand the effect of drugs on animals and in its importance to gain skills, than those who refused. More than half of students (55.9%) reported feeling confident/somewhat confident in animal handling and in giving animals injections (50.8%) at baseline. At the end of the course, students who accepted animal handling reported significantly higher confidence. Conclusion This study revealed important students’ barriers and perspectives to animal handling. Those who handled the animals reported better confidence in certain areas at the end of the course than those who refused. Engaging students when making decisions regarding educational practices paves the way for change to the current traditional paradigm in the education of future scholars.
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Affiliation(s)
- Feras D Elhajji
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Iman A Basheti
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Chamberlin SM, White CE, Wheeler JS, Eudaley ST, Franks AS, Rowe AS. Implementation and assessment of a pulmonary diseases elective course for third-year pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:571-578. [PMID: 29986816 DOI: 10.1016/j.cptl.2018.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 11/21/2017] [Accepted: 02/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Given the significant public health burden of pulmonary diseases and the vital role pharmacists play in management across the continuum of care (and within transitions in care), an elective course for pharmacy students focused on pulmonary diseases was developed. EDUCATIONAL ACTIVITY A month-long elective course for third-year pharmacy students consisting of 12 class sessions delivered in two-hour periods three times per week, was implemented. The course was delivered using the team-based learning (TBL) format in addition to hands-on skills and simulation sessions. Knowledge and skills assessments were administered before and after completion of the course. Student perceptions of self-confidence and ability regarding management of pulmonary diseases pre- and post-course and their perceptions of the course and TBL as a teaching strategy for this course were evaluated upon course completion. CRITICAL ANALYSIS Nine students completed the course. Mean scores on knowledge and skills assessment significantly improved after completion of the course (54.5% pre-course vs. 79.3% post-course; p < 0.05% and 60.3% pre-course vs. 93.2% post-course; p < 0.05, respectively). Student perceptions of their ability to care for patients with pulmonary diseases significantly increased, compared to pre-assessments, in all areas taught in the course (p< 0.05). Additionally, students' confidence in managing specific disease states significantly improved in all areas (p < 0.05) except for spirometry (p = 0.06). Students' knowledge, skills, and confidence regarding management of common pulmonary disease states improved following this month-long elective course delivered using a combination of TBL activities and hands-on skills sessions.
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Affiliation(s)
- Shaunta' M Chamberlin
- Department of Family Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, Box U-67, Knoxville, TN 37920, United States.
| | - Cyle E White
- Infectious Diseases Pharmacy Specialist, Department of Pharmacy, Erlanger Health System, 975 E 3rd Street, Chattanooga, TN 37403, United States.
| | - James S Wheeler
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 193 Polk Ave, Suite 2D, Nashville, TN 37210, United States.
| | - Sarah T Eudaley
- Department of Family Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, Box U-67, Knoxville, TN 37920, United States; Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920, United States.
| | - Andrea S Franks
- Department of Family Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, Box U-67, Knoxville, TN 37920, United States; Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920, United States.
| | - A Shaun Rowe
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920, United States.
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Plaza V, Giner J, Rodrigo GJ, Dolovich MB, Sanchis J. Errors in the Use of Inhalers by Health Care Professionals: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:987-995. [PMID: 29355645 DOI: 10.1016/j.jaip.2017.12.032] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/15/2017] [Accepted: 12/30/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Inefficient inhaler technique (IT) compromises the optimal delivery of medication. However, the IT knowledge of health care professionals (HCPs) has received scant attention. OBJECTIVE The objective of this study was to perform a systematic review of published reports assessing the IT proficiency of HCPs in using pressurized metered dose (pMDI) and dry powder (DPI) inhalers. METHODS Studies published between 1975 and 2014 that directly assessed the IT skills of HCPs were selected according to predefined selection criteria. RESULTS Data were extracted from 55 studies involving 6,304 HCPs who performed 9,996 tests to demonstrate their IT proficiency. Overall, the IT was considered correct in 15.5% of cases (95% confidence interval [CI], 12-19.3), decreasing over time from 20.5% (95% CI, 14.9-26.8) from the early period (defined as 1975-1995) to 10.8% (95% CI, 7.3-14.8) during the late period (1996-2014). The most common errors in the use of pMDIs were as follows: not breathing out completely before inhalation (75%; 95% CI, 56-90), lack of coordination (64%; 95% CI, 29-92), and postinhalation breath-hold (63%; 95% CI, 52-72). The most common errors using DPI were deficient preparation (89%; 95% CI, 82-95), not breathing out completely before inhalation (79%; 95% CI, 68-87), and no breath-hold (76%; 95% CI, 67-84). CONCLUSIONS HCPs demonstrated inadequate knowledge of the proper use of inhalers. The poor understanding of the correct use of these devices may prevent these professionals from being able to adequately assess and teach proper inhalation techniques to their patients.
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Affiliation(s)
- Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Jordi Giner
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gustavo J Rodrigo
- Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay
| | - Myrna B Dolovich
- Department of Medicine, Division of Respirology, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Joaquin Sanchis
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
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Bowers R, Tunney R, Kelly K, Mills B, Trotta K, Wheeless CN, Drew R. Impact of Standardized Simulated Patients on First-Year Pharmacy Students' Knowledge Retention of Insulin Injection Technique and Counseling Skills. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:113. [PMID: 28970614 PMCID: PMC5607723 DOI: 10.5688/ajpe816113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/17/2016] [Indexed: 05/22/2023]
Abstract
Objective. To compare pre- and post-intervention test scores assessing insulin injection technique and counseling skills among P1 students with (intervention) or without (control) simulated patients, and to compare counseling checklist and knowledge retention test scores between groups. Methods. This study utilized cluster randomization. In addition to traditional instruction, the intervention group counseled a simulated patient on the use of insulin using the teach-back method. Test score changes from baseline were analyzed via two-sample t-test. Results. The intervention group exhibited a significantly greater increase in knowledge test scores from baseline compared to the control group. Similar changes were seen in post-instruction counseling checklist scores and knowledge retention test scores from baseline. Conclusion. Simulated patient interactions, when added to traditional coursework within a P1 skills lab, improve student counseling aptitude and knowledge retention scores.
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Affiliation(s)
- Riley Bowers
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Harnett Health System, Lillington, North Carolina
| | - Robert Tunney
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Vidant Medical Center, Greenville, North Carolina
| | - Kim Kelly
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Harnett Health System, Lillington, North Carolina
| | - Beth Mills
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Benson Area Medical Center, Benson, North Carolina
| | - Katie Trotta
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
| | | | - Richard Drew
- Campbell University College of Pharmacy & Health Sciences, Buies Creek, North Carolina
- Duke University School of Medicine, Durham, North Carolina
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18
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Taglieri CA, Crosby SJ, Zimmerman K, Schneider T, Patel DK. Evaluation of the Use of a Virtual Patient on Student Competence and Confidence in Performing Simulated Clinic Visits. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2017; 81:87. [PMID: 28720915 PMCID: PMC5508086 DOI: 10.5688/ajpe81587] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/26/2016] [Indexed: 05/22/2023]
Abstract
Objective. To assess the effect of incorporating virtual patient activities in a pharmacy skills lab on student competence and confidence when conducting real-time comprehensive clinic visits with mock patients. Methods. Students were randomly assigned to a control or intervention group. The control group completed the clinic visit prior to completing virtual patient activities. The intervention group completed the virtual patient activities prior to the clinic visit. Student proficiency was evaluated in the mock lab. All students completed additional exercises with the virtual patient and were subsequently assessed. Student impressions were assessed via a pre- and post-experience survey. Results. Student performance conducting clinic visits was higher in the intervention group compared to the control group. Overall student performance continued to improve in the subsequent module. There was no change in student confidence from pre- to post-experience. Student rating of the ease of use and realistic simulation of the virtual patient increased; however, student rating of the helpfulness of the virtual patient decreased. Despite student rating of the helpfulness of the virtual patient program, student performance improved. Conclusion. Virtual patient activities enhanced student performance during mock clinic visits. Students felt the virtual patient realistically simulated a real patient. Virtual patients may provide additional learning opportunities for students.
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Affiliation(s)
- Catherine A Taglieri
- Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, Massachusetts
| | - Steven J Crosby
- Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, Massachusetts
| | - Kristin Zimmerman
- Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, Massachusetts
| | - Tulip Schneider
- Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, Massachusetts
| | - Dhiren K Patel
- Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, Massachusetts
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Kaplan B, Murihead L, Zhang W. Leveraging Partnerships: Nursing Student Veteran-Centered Simulation In Situ. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2017.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Borgmeyer A, Gyr PM, Ahmad E, Ercole PM, Balakas K. Pediatric nurse practitioners effective in teaching providers the Asthma Action Plan using simulation. J Pediatr Nurs 2017; 34:53-57. [PMID: 28087087 DOI: 10.1016/j.pedn.2017.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 11/17/2022]
Abstract
Despite traditional education regarding the Asthma Action Plan (AAP), providers in the inpatient setting of a pediatric hospital reported lack of knowledge regarding the AAP and lack of confidence in teaching the AAP to patients and families. The purpose of this study was to assess the effect of a pediatric nurse practitioner (PNP)-led class incorporating simulation on resident physician knowledge of the AAP and confidence in teaching families the AAP. The study setting was a 250 bed Midwest academic pediatric hospital. The 26 participants were second year residents completing a four-week pediatric pulmonary rotation. The class consisted of a brief didactic component regarding the AAP, simulation to teach a patient/parent actor the AAP based on PNP-developed scenarios, and debriefing of the experience. The average composite score on the pre- and post-simulation knowledge assessment showed improvement from 44.8% to 80.4% (p<0.001). All participants answered favorably on questions regarding perceived benefit of the class and 80.8% strongly agreed that they felt more confident teaching the AAP after the class. This study demonstrates that resident physician knowledge of the AAP and confidence in teaching the AAP improved after a PNP-led simulation class.
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Affiliation(s)
- Anne Borgmeyer
- St. Louis Children's Hospital, St. Louis, MO, United States.
| | - Patricia M Gyr
- St. Louis Children's Hospital, St. Louis, MO, United States
| | - Emily Ahmad
- St. Louis Children's Hospital, St. Louis, MO, United States
| | | | - Karen Balakas
- St. Louis Children's Hospital, St. Louis, MO, United States
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21
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Affiliation(s)
- Lama H Nazer
- Lama H Nazer, PharmD, BCPS, is with the Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
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22
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Basheti IA, Hamadi SA, Reddel HK. Inter-professional education unveiling significant association between asthma knowledge and inhaler technique. Pharm Pract (Granada) 2016; 14:713. [PMID: 27011779 PMCID: PMC4800018 DOI: 10.18549/pharmpract.2016.01.713] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 03/04/2016] [Indexed: 12/02/2022] Open
Abstract
Objectives: To explore whether an association exists between health care professionals’ (HCPs) asthma knowledge and inhaler technique demonstration skills. Methods: HCPs’ asthma knowledge and inhaler technique demonstration skills were assessed at baseline at an inter-professional educational workshop focusing on asthma medication use. Asthma knowledge was assessed via a published questionnaire. Correct inhaler technique for the three inhalers, the Accuhaler, Turbuhaler and pressurized Metered Dose Inhaler (pMDI) was assessed using published checklists. Results: Two hundred HCPs agreed to participate: 10 specialists (medical doctors specialized in respiratory diseases) (5%), 46 general practitioners (23%), 79 pharmacists (39%), 15 pharmacists’ assistants (8%), 40 nurses (20%) and 10 respiratory therapists (5%). Backwards stepwise multiple regression conducted to determine predictors of HCPs’ inhaler technique, showed that out of many independent variables (asthma knowledge score, profession, age, gender, place of work, years in practice and previous personal use of the study inhaler/s), asthma knowledge score was the only variable showing significant association with inhaler technique (R2=0.162, p<0.001). Conclusion: This study revealed significant associations between asthma knowledge and inhaler technique scores for all HCPs. Providing inter-professional workshops for all HCPs involved integrating education on asthma knowledge and practice of inhaler technique skills are looked-for.
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Affiliation(s)
- Iman A Basheti
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science University , Amman ( Jordan ).
| | - Salim A Hamadi
- Department of Pharmacology & Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, Petra University . Amman ( Jordan ).
| | - Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney . Sydney, NSW ( Australia ).
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