Evaluating advanced pharmacy technician roles in the provision of point-of-care testing

OBJECTIVES

Assess the impact of pharmacy technician-supported point-of-care testing (POCT), including sample collection, on the number of cholesterol screenings performed in a community pharmacy setting. Secondary objectives include assessment of provider perceptions and patient satisfaction of POCT when executed by a technician.

PRACTICE DESCRIPTION

Thirty-two community pharmacies in 1 regional division of a large community pharmacy chain in Tennessee; 16 participated in a certified pharmacy technician (CPhT) training program, and 16 did not.

PRACTICE INNOVATION

CPhTs supported POCT service delivery limited to the nonprofessional, technical tasks (e.g., sample collection, quality assurance).

EVALUATION

The primary objective was evaluated by comparing the total number of screenings for control and intervention sites. Descriptive and inferential statistics were used. Both secondary measures were assessed via anonymous, Likert-type scale questionnaires.

RESULTS

Intervention pharmacies performed 358 screenings, whereas control pharmacies performed 255 screenings (16.8% difference). The patient perception survey found that 94% (149 of 159) of those who received screening with CPhT involvement agreed or strongly agreed that the service was valuable, and 70% (111 of 159) reported that they are likely to follow up with their primary care providers to discuss the results. Furthermore, most patients were in agreement that they were overall satisfied with the screening services provided by the CPhT (94%, 149 of 159), and the CPhT was professional while performing the screening (95%, 151 of 159). The provider perceptions survey on service implementation found that most pharmacy personnel agreed or strongly agreed that CPhTs performing POCT was feasible, appropriate, and acceptable.

CONCLUSION

This study provided preliminary data that technician-supported POCT may positively impact the number of screenings provided. In addition, provider perceptions were positive, and patients felt satisfied with the studied technician model.

Assessing dental students' competence: best practice recommendations in the performance assessment literature and investigation of current practices in predoctoral dental education

In this article, the Task Force on Student Outcomes Assessment of the American Dental Education Association's Commission on Change and Innovation in Dental Education describes the current status of student outcomes assessment in U.S. dental education. This review is divided into six sections. The first summarizes the literature on assessment of dental students' performance. Section two discusses catalysts, with a focus on problem-based learning, for development of new assessment methods, while the third section presents several resources and guides that can be used to inform selection of assessment techniques for various domains of competence. The fourth section describes the methodology and results of a 2008 survey of current assessment practices in U.S. dental schools. In the fifth section, findings from this survey are discussed within the context of competency-based education, the educational model for the predoctoral curriculum endorsed by the American Dental Education Association and prescribed by the Commission on Dental Accreditation. The article concludes with a summary of assessments recommended as optimal strategies to measure three components of professional competence based on the triangulation model. The survey of assessment practices in predoctoral education was completed by 931 course directors, representing 45 percent of course directors nationwide, from fifty-three of the fifty-six U.S. dental schools. Survey findings indicate that five traditional mainstays of student performance evaluation-multiple-choice testing, lab practicals, daily grades, clinical competency exams, and procedural requirements-still comprise the primary assessment tools in dental education. The survey revealed that a group of newer assessment techniques, although frequently identified as best practices in the literature and commonly used in other areas of health professions education, are rarely employed in predoctoral dental education.

Two Third-Year Medical Student–Level Laboratory Shock Exercises without Large Animals

BACKGROUND

Historically, medical schools have taught principles of hemodynamic shock using large animal models. Such exercises are infrequent today due to the increasing aversion of students and the wider community to the use of large animals in teaching. Herein, we describe two alternative exercises that communicated basic science and clinical principles of shock effectively.

METHODS

We developed two complementary, distinct single-afternoon laboratory exercises for third-year medical students. The first exercise (lab) demonstrated three principles: (1) in vitro cytokine-induced apoptosis (illustrating mechanisms and consequences of sepsis), (2) the hemodynamic manifestations of hypovolemia and septic shock in rats, and (3) the effects of fluid resuscitation or vasopressor administration in these same rat models. In the second exercise, students managed the diagnosis, initial resuscitation, surgical treatment, and ICU care of a "patient" with abdominal sepsis, using a manikin-based patient simulator and actual patient test data. Current basic science and clinical literature were incorporated.

RESULTS

Efficacy was evaluated by polling students in one of four rotations (n = 25). Educational value of the lab exercise was rated 3.70 (1, worst rating; 5, best rating), whereas its applicability to clinical care was rated 4.35. Educational value and clinical applicability of the patient simulator were rated 4.52 and 4.76, respectively.

CONCLUSIONS

These exercises combining laboratory demonstrations of the pathophysiologic mechanisms and manifestations of shock with simulation were judged effective and clinically relevant while fulfilling the National Institutes of Health (NIH) mandate to reduce use of experimental animals.

Interpersonal behavior of children at risk for schizophrenia

Investigations of the childhood antecedents of adult schizophrenia may clarify our understanding of the etiology of the disease, provide guidelines for meaningful classification of subtypes of schizophrenic illness, point to strategies for identifying those individuals in need for early intervention, and suggest appropriate techniques for early intervention. Among the more salient characteristics of schizophrenic illness are disturbances in interpersonal relations, especially withdrawal from normal social interaction.