Research and Education Needs for Complex Generics

Complex generics are generic versions of drug products that generally have complex active ingredients, complex formulations, complex routes of delivery, complex dosage forms, are complex drug-device combination products, or have other characteristics that can make it complex to demonstrate bioequivalence or to develop as generics. These complex products (i.e. complex generics) are an important element of the United States (U.S.) Food and Drug Administration's (FDA's) Generic Drug User Fee Amendments (GDUFA) II Commitment Letter. The Center for Research on Complex Generics (CRCG) was formed by a grant from the FDA to address challenges associated with the development of complex generics. To understand these challenges, the CRCG conducted a "Survey of Scientific Challenges in the Development of Complex Generics". The three main areas of questioning were directed toward which (types of) complex products, which methods of analysis to support a demonstration of bioequivalence, and which educational topics the CRCG should prioritize. The survey was open to the public on a website maintained by the CRCG. Regarding complex products, the top three selections were complex injectables, formulations, and nanomaterials; drug-device combination products; and inhalation and nasal products. Regarding methods of analysis, the top three selections were locally-acting physiologically-based pharmacokinetic modeling; oral absorption models and bioequivalence; and data analytics and machine learning. Regarding educational topics, the top three selections were complex injectables, formulations, and nanomaterials; drug-device combination products; and data analytics, including quantitative methods and modeling & simulation. These survey results will help prioritize the CRCG's initial research and educational initiatives.

Continuing to Challenge the Paradigm of What Is Possible in Pharmacy Education and Practice Post-COVID-19

The COVID-19 pandemic has caused boundless disruptions to every element of life. It has also brought with it lessons from the past that will likely extend into the future as humans continue to interface with the ever-increasing threats of zoonotic diseases. The pandemic has challenged the profession and the Academy to adjust, modify, and adapt. It has also stretched the bounds of what had previously been thought possible within the realms of medicine. As the Academy begins to reach and crest the apex of the epidemic it should be reminded of the many lessons associated with the pandemic and of the constant need to challenge the paradigm of what is possible.

Advancing Our Pharmacy Reformation - Accelerating Education and Practice Transformation: Report of the 2019-2020 Argus Commission

The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.

Facilitation of a multisite student topic discussion series using web-based conferencing technology

INTRODUCTION

While technology's use and impact in the classroom setting is well-documented in literature, use during experiential education is less defined. Our objectives were to assess the change in clinical knowledge and application skills following a multisite topic discussion (TD) series using web-based conferencing technology during ambulatory care advanced pharmacy practice experiences (APPEs) and to assess student perceptions of learning through use of this modality.

METHODS

A multisite TD series was created using web-based conferencing technology for students assigned to a clinical faculty member's ambulatory care APPE. Five topic discussions were conducted during each five-week rotation block covering disease states integral to ambulatory care practice. Pre- and post-assessments were administered to assess student learning and a survey was administered to assess student perceptions of learning.

RESULTS

A total of 151 students were invited to participate in the study with 114 (75.5%) included in the final analysis. Overall student performance improved significantly from 53.3 ± 12.7% on the pre-assessment to 65.8 ± 14.3% on the post-assessment, with student performance on the post-assessment improving significantly in all topic areas. Students perceived that the TD series enhanced their learning and ability to apply clinical information while creating an online learning community.

CONCLUSIONS

The addition of a multisite TD series using web-based conferencing technology successfully enhanced student knowledge. Student perceptions of this new web-based learning community were positive overall, despite some technological limitations. The results of this study support the use of web-based conferencing technology to enhance student learning during APPEs.

Exploring pharmacy residency program director preference of pharmacy student organization membership and leadership involvement on residency candidate interview selection

INTRODUCTION

Pharmacy student professional organization involvement and leadership are important qualifications of a pharmacy residency candidate. It is unknown if membership in specific student pharmacy organizations or types of leadership roles within these organizations are preferred by residency program directors (RPDs). The purpose of the study was to determine preference and importance of specific pharmacy student professional organization membership and leadership involvement when selecting residency candidates for an interview by RPDs.

METHODS

A descriptive study was conducted using an online survey. Pharmacy RPDs with involvement in reviewing applicants for interviews were included. RPDs ranked the importance and preference of specific student professional organization membership, breadth versus depth of involvement, and leadership position held on selecting candidates for an interview.

RESULTS

The survey was sent to 2084 RPDs. A total of 232 respondents met inclusion criteria and completed the survey. The majority (95.5%) of RPDs reported student membership as important, while 28.6% had preference for a specific organization. A total of 56.3% of RPDs reported student leadership as "very important" and 76.1% preferred depth over breadth of involvement. A total of 55.6% of RPDs preferred applicants with a high-level leadership position.

CONCLUSIONS

Pharmacy student professional organization membership is important to RPDs when selecting residency candidates for an interview. The majority of RPDs have no preference for a specific organization, while 28.6% report a preference that affects interview selection. RPDs report leadership as important and place higher importance on depth versus breadth of involvement, with greater preference for a high-level leadership position.

The role of online learning in pharmacy education: A nationwide survey of student pharmacists

INTRODUCTION

Student pharmacists have significant exposure to online learning methods in their pre-pharmacy educational experiences. With decreasing resources and faculty shortages in pharmacy education, online delivery of course content is an efficient way to deliver pharmacy curricula while optimizing classroom time for active learning strategies. The purpose of this study was to assess student preferences associated with the utility of online learning methods such as online platforms, social media, and handheld devices.

METHODS

An anonymous, voluntary 43-question online survey was delivered to students at colleges and schools of pharmacy in the United States (US). Frequency statistics were used to establish prevalence of student preferences.

RESULTS

Overall, 1873 students from 29 schools of pharmacy completed the survey. Of these students, 30% preferred a blended course structure (with online and classroom components) throughout the curriculum, as compared to 47% of students who preferred live lectures exclusively. Approximately 57% of students found smart phones very or extremely valuable for their academic success. Approximately 61% of students reported using their smart phones and 37% reported using their tablets "always" or "often" during the past year for academic activities; however, only 31% of students found paper textbooks very or extremely valuable for their academic success, with approximately 26% using them "always" or "often."

CONCLUSIONS

US pharmacy students prefer a blend of traditional classroom and online learning methods. When updating and revising pharmacy curricula, colleges and schools of pharmacy should consider the inclusion of technology and online learning methodologies.

We are all patient-centred now, aren't we? Lessons from new pharmacy graduates

INTRODUCTION

Patient-centredness is considered integral to the delivery of modern healthcare. This qualitative, longitudinal study explored the meaning and development of the practice of pharmacy graduates, leading to a focus on patient-centredness. The approach adopted in this study aligned with the principles of hermeneutic phenomenology.

METHODS

Twelve pharmacy graduates (seven females) from The University of Queensland were observed at work and interviewed about their experiences of pharmacy practice every six months for two years following graduation.

RESULTS

These 12 graduates initially understood and enacted pharmacy practice in a range of ways. A distinguishing characteristic related to how patients/customers featured in their practice. For some, ensuring the efficient supply or administration of correct and safe medicines with instructions was the focus, with patients viewed as source and recipient of information. For others, the focus was communicating effectively with patients/customers to provide individualised advice to avoid medication-related problems. A third group focused on achieving a broader goal, to provide individualised care to optimise health outcomes from medicines. Initial understanding of patient-centredness remained largely unchanged for most participants over the two years, despite the passage of time and experience gained.

CONCLUSIONS

This study calls into question an assumption of a common meaning for patient-centredness. The findings highlight the need to question and debate what patient-centredness means in contemporary pharmacy practice, rather than simply being an aspirational or theoretical concept. It is important that pharmacists and educators appreciate the centrality of understanding of practice for development, to optimally facilitate the development of patient-centred pharmacists.

Evaluation of an intervention to support the development of clinical problem solving skills during a hospital-based experiential learning program for South African pharmacy students

INTRODUCTION

Final year pharmacy students at the Nelson Mandela University described feeling unprepared for the complexities of clinical reasoning and problem solving during the hospital-based experiential learning program (ELP). The fifteen week ELP is part of the third Pharmacology and Therapeutics module taken in the final year of the four year Bachelor of Pharmacy (BPharm) degree program. An intervention, in the form of supplementary academic support sessions, was implemented during the ELP. The aim of the research was to evaluate the intervention from the perspectives of the students' experience as well as academic performance in the ELP.

METHODS

A mixed-methods approach using a quasi-experimental, intervention-based design was employed. Final year students in Year 1 (control cohort) completed the ELP as usual without additional academic support. In the consecutive academic year (Year 2), the intervention cohort completed the ELP that was enhanced with the intervention. Student feedback provided qualitative data, while quantitative data in the form of assessment marks were used as a measure of academic performance.

RESULTS

The students' experience of the intervention was overwhelming positive and provided evidence that the students felt better prepared for patient case analysis as a result of the intervention. A small but significant improvement in academic performance in the ELP was also seen.

CONCLUSIONS

The intervention, using a modified team based learning (TBL) approach developed from student-identified needs, was successfully implemented and provided a means of enhancing the development of problem solving and clinical reasoning skills during the ELP, through additional academic support sessions.

In the midst of curricular revision, remember the importance of over-the-counter and self-care education

INTRODUCTION

Over-the-counter (OTC) and self-care products are frequently utilized by adult patients as initial treatment for common health issues. This availability of OTC/self-care products, coupled with the accessibility of community-based pharmacists, uniquely positions pharmacists to serve as stewards of appropriate OTC/self-care treatment. As a result, community-based pharmacists must be competent in the practice of providing individualized, patient-specific, OTC recommendations and self-care education to assist patients in achieving optimal self-managed health outcomes.

COMMENTARY

Schools and colleges of pharmacy often undergo curricular revision/integration. As a result, it is often necessary to reallocate credit hours dedicated to OTC/self-care content. Curriculum committees should therefore be aware of several best-practice resources that may assist them with this task.

IMPLICATIONS

The impact on OTC/self-care content during curricular revision/integration directly effects the preparation of graduate ready student pharmacists and ultimately patient's self-managed health outcomes. Considerations include appointing an OTC/self-care champion to oversee the integration of OTC/self-care content as well as post-revision monitoring to ensure core topic areas are being adequately covered in the didactic curriculum and in accordance with best practices.

Developing a comprehensive APPE-readiness plan with a focus on skills, attitudes, and behaviors

BACKGROUND AND PURPOSE

Pharmacy schools must have a framework to ensure students have the necessary knowledge, skills, attitudes, and behaviors to be successful during advanced pharmacy practice experiences (APPEs).

EDUCATIONAL ACTIVITY AND SETTING

Ten summative assessments, called APPE-readiness assessments (ARAs), were developed based on eight competencies encompassing skills, behaviors, and attitudes that must be demonstrated prior to APPEs. All eight competencies were assessed in the course Case Studies in Pharmacotherapy IV, which is offered in the final semester of the didactic curriculum immediately prior to APPEs. A 15-question pre- and post-survey was conducted to assess student confidence in performing each APPE-readiness competency. Cohort data was evaluated by the curriculum and assessment committee to assess curriculum effectiveness and areas for improvement.

FINDINGS

Upon completion of the course, the average first-attempt pass rate across all ARAs was 92.4%. All students who failed on the first attempt passed on the second attempt, thereby demonstrating APPE-readiness. Out of 62 students, 45 and 44 completed the pre- and post-survey, respectively. Prior to the ARAs, the overall average of students who felt (strongly) confident about their ability to perform each competency was 82.2 ± 2.1%. This increased to 92.6 ± 1.6% after the ARAs.

SUMMARY

The development of an APPE-readiness assessment plan focusing on skills, attitudes, and behaviors provides insight into student and cohort performance and allows for continuous quality assurance of the pre-APPE curriculum.

Ambulatory care elective: Introduction to core practice concepts

BACKGROUND AND PURPOSE

Introduction to various pharmacy practice environments is effectively accomplished through concentrated elective courses. The ambulatory care elective utilized innovative active learning strategies to enhance chronic disease management, foster empathy, and introduce strategic planning in an ambulatory care center.

EDUCATIONAL ACTIVITY AND SETTING

A new two-credit hour ambulatory elective course was offered to third-year pharmacy students in a four-year doctor of pharmacy program. This 30-hour, 2-week long course, ran simultaneously between three campuses, and included six modules. The course employed lectures, active learning activities, shadowing, role playing, and a simulation.

FINDINGS

Course evaluations and student reflections indicate high satisfaction with the course and reveal value in the simulation.

SUMMARY

Active learning sessions in this third-year pharmacy elective allowed application of lecture materials to explore the focused practice of ambulatory care. Discussion topics were varied, allowing students to gauge the breadth of opportunities offered in ambulatory pharmacy, while also appreciating the scope of skills required for successful and sustainable practice. Students valued the chronic disease state simulation, which provided a unique approach to foster personal attributes.

Awareness about nanotechnology and its applications in drug industry among pharmacy students

INTRODUCTION

Given the multiple nanotechnology-based pharmaceutical products that are available on the drug market, nanotechnology education has to be offered within pharmacy undergraduate curricula.

METHODS

A cross-sectional study was carried out to assess the level of nanotechnology awareness among pharmacy students using two questionnaires. The study targeted 500 students and the deans of the faculties of pharmacy in Jordan.

RESULTS

Results show that most of the students had poor knowledge about nanotechnology and that academic courses are the leading source of information. <10% of students attended experiments related to nanotechnology. About 50% of students did not have any knowledge about the safety of nanotechnology. All the deans stated that there is no specific practical or theoretical course to teach nanotechnology, but the concepts are taught within other courses.

CONCLUSIONS

Pharmacy students' knowledge about nanotechnology is poor, and courses within pharmacy curricula need to be dedicated to teaching nanotechnology and its applications.

Application of Absorb-Do-Connect learning framework to foster experiential, practice, and career-ready learners

INTRODUCTION

As educators, we have the opportunity to produce experiential-ready, practice-ready, and career-ready practitioners. Student attitudes and values influence how learned knowledge and skills will be enacted, and therefore are key determinants of career-readiness. However, attitudes and values can be challenging to see and measure in learners. In this commentary, the authors propose purposeful selection and application of an educational framework to foster those less tangible, but powerful, factors.

PERSPECTIVE

To illustrate this perspective, authors describe key components of the Absorb-Do-Connect learning framework and provide rationale for the framework's alignment with self-efficacy theory. The authors propose that Absorb-Do-Connect can be applied within pharmacy education to design learning activities that establish relevance in learning and subsequently foster self-efficacy through growth in attitudes and values.

IMPLICATIONS

The Accreditation Council for Pharmacy Education Standards emphasize connecting current education to past experiences and future practice to establish relevance in learning. In this manner, authors suggest Absorb-Do-Connect can be used by schools and colleges of pharmacy to inform new innovations and revise existing coursework to meet the standards. Opportunity exists to formally assess the relationship between absorbing, engaging with and purposely connecting knowledge and skills, and the development of self-efficacy in student pharmacists.

Considerations for the incorporation of mindfulness into pharmacy education

INTRODUCTION

A range of approaches are needed to bolster the mental health and well-being of pharmacists and student pharmacists.

COMMENTARY

In recent years, medical and nursing educators have been training students to use mindfulness-oriented meditation (MOM) techniques such as Mindfulness-Based Stress Reduction (MBSR) for mental health, wellness, and greater attention and presence. MOM training should be considered for incorporation into pharmacy education. Mindfulness can be included in the pharmacy curriculum in a variety of ways. These include introducing students to the topic didactically, encouraging and facilitating students to take an MBSR course, workshop, or online self-study, and integrating mindfulness through mindful moments during critical educational activities like product verification and communication assessments.

IMPLICATIONS

Mindfulness may be a valuable skill for student pharmacists, thus we encourage schools to expose students to the concepts of mindfulness and MOM techniques like MBSR. Additionally, more robust and rigorous research is needed to better understand the effects of MOM in different settings and contexts.

The Impact of Pharmacy Student Participation in the White Coat Ceremony on Professionalization

Objective. To assess the impact of participation in a formal white coat ceremony on Doctor of Pharmacy (PharmD) students' professionalization by analyzing students' reflective writing. Methods. First-year PharmD students participated in the college's white coat ceremony following orientation. During the Foundations of Pharmacy course in the first semester, students were instructed to reflect on and write about the impact the white coat ceremony had on them as a graded assignment. A grading rubric was developed to standardize assessment of the reflections and to differentiate critical reflection (which cites future behavioral change) from other forms of reflection that are less impactful, such as non-critical reflection, general understanding, and non-reflection. Thematic analysis was conducted and prevalent themes were identified. Each reflection was then reviewed to identify up to three themes. Results. Of the 225 students in the incoming class of 2020, 218 submitted valid reflection assignments. Of these, 92% met critical reflection criteria. Four percent offered "negative connotation," while 75% described an eye-opening experience or realization. Of 483 thematic classifications, six student professionalization themes were identified, as follows: personal achievement (26%), professionalism (21%), welcome to pharmacy (18%), patient care (16.8%), life-long learning (12.8%), and code of ethics (5.2%). Conclusion. For the majority of PharmD students, the white coat ceremony held during first-year orientation had a positive impact on their professionalization. All pharmacy schools should conduct a white coat ceremony that includes recitation of the Pledge of Professionalism as an impactful first step toward student professionalization.

Global Health Learning Outcomes in Pharmacy Students Completing International Advanced Pharmacy Practice Experiences

Objective. To examine the global health learning outcomes of Doctor of Pharmacy (PharmD) students from three US schools who participated in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, prospective study was used to assess fourth-year PharmD students at three US pharmacy schools who participated in an international APPE during the 2017-2018 academic year and a matched cohort (control group) of PharmD students who did not participate in an international APPE. To evaluate students' self-perceived growth in the Consortium of Universities for Global Health (CUGH) competencies, all students completed a 13-item retrospective pre-post instrument using a five-point Likert scale. The students who had completed an international APPE were invited to participate in a focus group (N=22). Paired and independent t tests and multiple linear regression were used to analyze data. Qualitative open-ended questions and focus group data were mapped to knowledge, skills, and attitudes themes. Results. The students who completed an international APPE (N=81) showed significantly more growth in CUGH competencies than students who did not (mean improvement in total score of 10.3 [7.0] vs 2.4 [6.0]). International APPE participation was the only significant predictor of growth in CUGH competencies. The international APPE students reported improvements in cultural awareness and appreciation, communication skills, problem-solving skills, adaptability, self-awareness, personal and professional outlook, and global health perspective. Conclusion. Pharmacy students' participation in international APPEs led to significant improvement in all CUGH competencies. The CUGH competency framework appears to be a suitable instrument to assess pharmacy students' global health learning outcomes.

Global collaboration to deliver a live pharmacy teaching and learning curriculum

BACKGROUND AND PURPOSE

The Indiana Pharmacy Teaching Certificate Program (IPTeC) offered a live, two-day conference to pharmacy residents, fellows, and preceptors in Indiana, while simultaneously live-streaming to participants in Doha, Qatar. Participants engaged in longitudinal activities for a one-year period. The purpose is to evaluate this pilot extension of a teaching and learning curriculum (TLC) to experienced preceptors in a global partnership and determine whether global and local participants perceive similar quality of programming.

EDUCATIONAL ACTIVITY AND SETTING

Upon completion of the two-day conference, all pharmacists from two years of the program were encouraged to complete the standard course evaluations, consisting of nine items, in order to obtain continuing education (CE) credit. Evaluations of the program were analyzed by location cohort.

FINDINGS

A total of 206 eligible pharmacists attended the program, with 154 completing the course evaluations (response rate 75%). "Good" or "outstanding" median ratings were given to each learning objective by both location cohorts, with domestic participants more likely to give "outstanding" ratings (6/9 items versus 0/9 items).

SUMMARY

This pilot extension was successful in providing educational content satisfying learning objectives from the perspective of domestic participants and remote participants in Qatar. This type of global collaboration can meet the needs of trainees and experienced preceptors to advance pharmacy education and training.

An Exploration of Pharmacy Education Researchers' Perceptions and Experiences Conducting Qualitative Research

Objective. To investigate pharmacy education researchers' experiences in conducting qualitative research and their perceptions of qualitative research in pharmacy education Methods. A phenomenological approach was used to conduct one-time, in-depth interviews with 19 participants from 12 schools and colleges of pharmacy. Interview transcripts were coded and themes were identified using a modified form of the Sort and Sift, Think and Shift method of data analysis. Results. Faculty members were the largest subgroup in the sample, followed by graduate students, postdoctoral fellows/scholars, and residents. Pharmacy education researchers had varying levels of training in conducting qualitative research and some had none at all. Salient findings included that pharmacy educators' lack of training and exposure to qualitative research was a barrier to entry to conducting qualitative research; the lack of understanding and value of qualitative research in pharmacy education impacts the acceptability of qualitative research projects in Journals and academic meetings; and qualitative research offers several benefits in answering complex research questions. Conclusion. The application of rigorous qualitative research in pharmacy education holds great potential in addressing complex and evolving healthcare problems. This work provides empirical evidence of the ongoing anecdotal dialogue that has long existed in pharmacy education concerning why some researchers are hesitant to conduct qualitative research, the challenges encountered by those who employ qualitative approaches, and the benefits qualitative approaches provide.

Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

Background Pharmacists in many developed countries have been granted prescribing authorities under what is known as "non-medical prescribing" or "pharmacist prescribing". However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists' perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

A pragmatic approach to introducing mixed methods research training for pharmacy students in Namibia

BACKGROUND AND PURPOSE

Pharmacy and medical training were introduced for the first time in Namibia in 2011 and 2010 respectively. All students must complete a research project as part of their training, which is supported by various courses in the respective curricula including research methods. Following a revision of the medical curriculum, there was an opportunity to review the way research methods was taught for both degrees, piloting in pharmacy then expanding to other disciplines. An educational activity that was part of the research methods course for training pharmacy students in Namibia is described.

EDUCATIONAL ACTIVITY AND SETTING

The activity described related to a new approach in the running of the research methods course for pharmacy students and included, in a portfolio-based approach, a group project. Students were tasked to collect qualitative data from medical student colleagues that they then needed to codify and ultimately articulate into a survey questionnaire. The questionnaire was subsequently sent out to collect responses on medicines-related items that could be analyzed quantitatively in subsequent teaching sessions. Supportive lectures, tutorials and portfolio assignments were provided during the project. Data were collected the following year to create a more substantive dataset and a screencast video made to benefit future students in the course.

FINDINGS AND DISCUSSION

Through the course of this activity students developed a questionnaire survey tool based on qualitative responses to brief interviews with medical students and emergent themes based on qualitative analyses. A dataset was created that allowed demonstration of quantitative analyses and extraction of sub-scales from the questionnaire. Further educational resources were developed to ensure sustainability of this educational resource and retention in the taught curriculum.

SUMMARY

The current article discusses the development, implementation and evaluation of this research methods course component. The application of data collected as part of the activity and its relevance to the educational activity is examined as well as lessons learned for the future running of the project and further evaluation.

Development and inclusion of an entrustable professional activity (EPA) scale in a simulation-based medicine dispensing assessment

BACKGROUND AND PURPOSE

Effective, safe, and patient-centred dispensing is a core task of community pharmacists. Entrustable professional activities (EPAs) offer a way of defining and assessing these daily practice activities. Although EPAs have become popular within competency-based medical education programs, their use is new to pharmacy education and assessment.

EDUCATIONAL ACTIVITY AND SETTING

A simulation-based assessment framework containing a scale of entrustment was developed to evaluate the readiness of Year 4 undergraduate pharmacy students to safely manage the supply of prescribed medicine(s) in a community pharmacy. The assessment framework was piloted in a fourth year "Transition to Practice" course with 28 simulation-based assessments conducted.

FINDINGS

An entrustment framework was developed and implemented successfully with Year 4 undergraduate pharmacy students. The EPA for medicine dispensing integrates competency domains that include information gathering, providing patient-centred care, clinical reasoning, medicine dispensing, and professional communications. On a scale ranging from level 1 to level 5, the majority (73%) of entrustment ratings were level 2 or level 3; and of the students who achieved different ratings between clinical scenarios, 75% of students improved on their second simulation attempt. There was a strong correlation between the global EPA ratings with the total score achieved across the domains.

SUMMARY

Using simulation-based assessment, entrustment decision making can be incorporated in "entry to profession" undergraduate and postgraduate pharmacy courses to assess students' readiness to transition between learning and professional practice.

Decolonizing and Indigenizing pharmacy education in Canada

BACKGROUND

An emphasis on equity, diversity, and inclusion is growing within the field of education, including health professions education. In particular, no published literature exists regarding decolonizing and Indigenizing pharmacy education. Post-secondary pharmacy programs in Canada have a unique opportunity to learn from the decolonizing and Indigenizing practices observed in the educational programs of other health professions and post-secondary institutions and become international leaders in this area.

METHODS

Literature searches on PubMed, MEDLINE, ERIC (Ovid), iPortal, and PsycINFO were performed, revealing zero articles on decolonizing and/or Indigenizing pharmacy education. Search terms were expanded to include all health professions education programs with published literature on decolonizing and Indigenizing practices. All publications that included either or both terms (decolonizing and/or Indigenizing) and within any realm of health professions education (e.g., curriculum, assessment, evaluation, instructional design) were reviewed.

RESULTS

Literature on decolonizing and Indigenizing health professions education in health disciplines, such as nursing and speech pathology, were reviewed. In conjunction with literature on decolonization and Indigenization of education, with a focus on post-secondary institutions, a number of strategies are proposed to decolonize and Indigenize pharmacy education.

IMPLICATIONS

Findings from this review will better inform post-secondary pharmacy education programs to engage in decolonization and Indigenization practices. Engaging in decolonization and Indigenization of pharmacy education is expected to not only improve the educational experience of Indigenous students in pharmacy programs, but also improve the care received by Indigenous patients from all graduates of pharmacy.

Interprofessional objective structured clinical examination with physician assistant and pharmacy students - A qualitative and quantitative study

BACKGROUND

To assess the impact of an interprofessional objective structured clinical examination (iOSCE) on attitudes/perceptions regarding interprofessional practice (IPP) and to determine if patient (simulated) outcomes improved with interprofessional collaboration (pharmacy and physician assistant (PA) students).

INTERPROFESSIONAL EDUCATION ACTIVITY

A team of interprofessional faculty designed an iOSCE case and grading checklist containing key interventions. Students individually reviewed the case and were asked to document potential changes to the admission orders. Then they were given the opportunity to collaborate in an interprofessional team to discuss the case and orders. Finally, the team presented their recommendations to an interprofessional faculty panel. Individual and team scores were compared to determine the impact of interprofessional collaboration. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered pre- and post-iOSCE to assess changes in opinions about interprofessional learning.

DISCUSSION

Individual and team iOSCE scores for 187 students were evaluated (86 PA and 101 pharmacy). A 21% absolute increase in the number of key interventions was found when comparing average individual scores to average team scores (2.11/5 vs. 3.18/5, p < 0.001). While in aggregate the students had a positive attitude towards IPE pre-iOSCE, RIPLS responses were strengthened post-iOSCE.

IMPLICATIONS

Through iOSCEs, it appears students can learn from and with one another to improve patient care and gain perspective on the roles/skills of interprofessional colleagues.

The use of social media as a tool to educate United Kingdom undergraduate pharmacy students about public health

BACKGROUND AND PURPOSE

The role of community pharmacists in England now includes public health service delivery, which is deemed to be an essential pharmacy service. This study aimed to evaluate pharmacy students' perceptions of social media as a learning tool and to investigate if workplace skills could be imbedded into a course assignment.

EDUCATIONAL ACTIVITY AND SETTING

Final year Kingston University MPharm students (N = 120) were divided into 10 groups for a course assignment. They had to deliver an offline and online public health campaign on an assigned topic. Following the campaign, students delivered an oral presentation and created a poster to showcase their campaign content and strategy.

FINDINGS

Over half (51.3%) preferred the self-directed learning aspect of the assignment while 28.2% preferred the delivery of the campaign and use of social media. Students noted that they had developed team working, communication and creativity skills. Most (93.6%) agreed that social media was an effective tool when learning about public health. Students achieved higher scores for their social media pages than they did for their oral presentation.

SUMMARY

A blended learning approach proved to be an effective way to teach final year pharmacy students about public health topics. Social media was noted as an effective tool to learn about public health. A public health assignment is an effective way to support pharmacy students to learn how to use this medium appropriately to support healthy lifestyles.

Design and implementation of a molecular imaging elective for third-year pharmacy students

OBJECTIVE

To design, implement, and evaluate a molecular imaging elective course that would expose Doctor of Pharmacy (PharmD) students to fundamentals of various imaging modalities and their pre-clinical and clinical applications.

METHODS

The "Surveys of Multi-Modality Imaging" course is a two-credit hour elective course offered to third-year PharmD and doctoral students. Experiential learning methods including active learning application-based exercises were used to supplement didactic lectures in the form of field trips (with follow-up debriefings), small group team-based tasks, hands-on demonstrations, visual modelling, gamification with problem sets, concept maps regarding given modalities, and concluding with written summary reports and formal in-class group presentations. In addition to standard course evaluations, a pre- and post-course survey were conducted to assess the students' confidence regarding course content.

RESULTS

Since its implementation in 2013, 101 students have completed the course with 72% being PharmD students (n = 73) and the remainder being doctoral students in pharmaceutical science (n = 28). Pre- and post-assessments completed by the students the last two offerings (n = 40 of a possible 43) indicated a shift in students' self-reported confidence in discussing imaging modalities from a total of 2.4% confidence (pre-course) to 97.4% confidence (post-course). Also, post-course survey indicated that 77.5% (n = 31 of 40 participants) students strongly agreed that our immersive and experiential learning activities were beneficial to overall learning for this elective.

CONCLUSION

Students who participated in this innovative experiential learning-grounded course gained an appreciation for molecular imaging and its value and role in modern drug therapy.

Assessment of the effect of communication skills training on communication apprehension in first year pharmacy students - A two-year study

INTRODUCTION

The purpose of the study is to assess the impact of a communication skills course on communication apprehension (CA) in two cohorts of first-year (P1), first quarter pharmacy students over a consecutive two-year span.

METHODS

The personal report of CA (PCRA-24) was administered at the beginning and completion (pre-post) of a skills-centered communication course to two cohorts of P1, first quarter pharmacy students over a consecutive two-year period. The delivery of the communications course was redesigned during this timeframe based on post-course analysis data and student feedback to incorporate opportunities for students to engage in active learning activities throughout the course.

RESULTS

Results of the study revealed a statistically significant reduction of total CA in both cohorts. Cohort 1 had significant reduction of CA in all four measured domains: group discussion meetings, interpersonal communication, and public speaking. Cohort 2 had significant reduction in two of the domains (group and meeting).

CONCLUSIONS

Overall, this study indicated that the format of this P1, first quarter communications course had a positive effect on student CA. In addition to the data collected for this research project, post-course evaluations and student comments indicated an overall positive reaction to the design and delivery of the course material, active learning assignments, and assessments.

Establishing consensus for general practice pharmacist education: A Delphi study

INTRODUCTION

An evolving area of pharmacist professional practice is performing as team members in general practice teams. To date, there is a paucity of literature to guide schools and colleges of pharmacy regarding the educational needs of pharmacists training for this area of practice.

METHODS

This study employed a three-round e-Delphi method with the aim of establishing a consensus position on educational needs of pharmacists intending to work in the general practice setting. Educators from all Australian universities with a pharmacy school were invited to participate as part of the expert panel. Delphi panellists completed two e-survey rounds. A panel videoconference was then completed with results of the discussion confirmed in a final third e-survey. This study defined a proportion of experts rating agree or strongly agree at ≥75% to determine consensus and disagree or strongly disagree at ≥75% to determine non-consensus.

RESULTS

Ten of the 18 invited panellists agreed to participate in the study and completed both survey rounds; nine panellists completed the third-round survey. Twenty-six general practice pharmacist activities were identified as educational needs. Seventeen general practice pharmacist activities required no additional training. Five general practice pharmacist activities did not reach consensus.

CONCLUSIONS

This study is one of the first investigations of educational needs of pharmacists wishing to practice in the general practice setting. The panel differentiated between activities that could be performed by less experienced pharmacists operating at a general level and those that would require further training.

Impact of virtual simulation in self-care therapeutics course on introductory pharmacy practice experience self-care encounters

BACKGROUND AND PURPOSE

Pharmacy education programs use simulation to provide a realistic and safe environment for student learning. We studied whether incorporation of virtual simulation into a required first year self-care therapeutics course impacted frequency of interactions, self-reported student confidence, and preceptor-reported student performance during second-year community pharmacy introductory pharmacy practice experiences (IPPEs).

EDUCATIONAL ACTIVITY AND SETTING

Virtual simulation cases using MyDispense were incorporated into a self-care therapeutics course in winter 2017. Students and preceptors were surveyed at the end of the fall semester community pharmacy IPPE. Data from IPPE experiences was compared with students who took the self-care therapeutics course in winter 2016 (control).

FINDINGS

Students completed 30 virtual simulation cases and three cases as part of the final examination (n = 33). Students in the intervention group reported more patient care interactions during their IPPEs than students who did not complete virtual simulation cases, but there was no difference in self-reported confidence. Preceptors did not report any differences in the ability of students to complete over-the-counter medication interactions during IPPEs.

SUMMARY

Cases were well received by students although they took longer to complete than initially anticipated. Students in the intervention group reported significantly more patient care interactions during IPPEs than those in the control group; however, there were no differences in self-reported confidence. Incorporation of virtual simulation was a sustainable change as the cases were able to be re-used the following year with minimal edits.

Comparison of NAPLEX pass rates for non-modifiable determinants of pharmacy programs in the United States

INTRODUCTION

Students consider numerous variables before applying to a doctor of pharmacy program. Some key non-modifiable variables may include program length, institution type, graduating class size, and pharmacy school grading system. The purpose of this study was to determine if there exists a difference in North American Pharmacists Licensure Examination (NAPLEX) performance based upon these variables.

METHODS

This was a retrospective cohort study using observational data. NAPLEX pass rates from 2015 to 2017 were obtained from the National Association of Boards of Pharmacy (NABP) website. Data for pharmacy programs were extracted from the program, Pharmacy College Application Service, American Association of Colleges of Pharmacy, and NABP websites.

RESULTS

Based on each pharmacy program's performance on NAPLEX, variables with significantly higher pass rates were public institutions and those with graduating class sizes of 100 or more students.

CONCLUSIONS

The results of this study suggest that graduating class size of 100 or more students and public institutions were significant predictors of success on the NAPLEX. Lower pass rates in 2016 may be due to the examination changes implemented by NABP that year. It is possible that programs and students were not being adequately prepared for the changes made to the NAPLEX format. Although not statistically significant, there was a rise in pass rates between the years 2016 and 2017. Therefore, future studies such as this one should be performed to compare NAPLEX pass rates from 2017 forward.

Effectiveness of a pharmacy teaching certificate program offered to practicing pharmacists

INTRODUCTION

Regardless of the practice setting, pharmacists' roles often expand beyond patient-centered services and into health-related educational roles for patients, healthcare providers, and student pharmacists. Teaching roles of a clinical pharmacist can include providing invited presentations (such as continuing education lectures), teaching colleagues about new clinical initiatives, precepting students during advanced pharmacy practice experiences (APPEs) and introductory pharmacy practice experiences (IPPEs), and precepting residents on rotations. This program was designed to evaluate the effect of a university-affiliated pharmacy teaching certificate program on participant knowledge and perceived confidence in specific areas of academic pharmacy and preceptor development.

METHODS

A 10-month program consisting of four live modules with associated continuing education (CE) credit was offered to pharmacy residents and practicing pharmacists in the surrounding area. The program format utilized didactic and active learning strategies with "at home" assignments to reinforce material presented. Content knowledge was measured with written summative assessments provided at the start and end of each module. Perceived confidence was assessed through online surveys provided at the start and end of the program. All results were evaluated using paired t-tests.

RESULTS

Data were obtained from 14 participants in the first cohort and 18 participants in the second cohort. For each of the four modules, there was a significant difference in pre- and post-knowledge assessments. Confidence data was also significantly increased regarding topics in each module.

CONCLUSION

Knowledge assessments and perception surveys suggest that this university-affiliated teaching certificate program improved both knowledge and perceived confidence for program participants.

Student confidence with oncology pharmacy competencies

OBJECTIVE

The purpose of this study was to assess the change in student confidence to perform oncology pharmacy competencies before and after completing oncology didactic instruction using a flipped classroom approach.

METHODS

First year doctor of pharmacy students completed a survey prior to the Applied Science and Therapeutics (AST) oncology module (pre-survey) and the same survey following the completion of the oncology module (post-survey). The survey consisted of questions addressing prior oncology pharmacy experience related to employment (research or patient care) and education, level of interest in oncology pharmacy, and level of confidence to perform thirteen oncology pharmacy competencies.

RESULTS

One-hundred sixteen students completed the pre-survey and 35 completed the post-survey. Students completing both surveys reported greater confidence in all oncology pharmacy competencies (p < 0.0001) after instruction. The greatest increases in student confidence were related to chemotherapy dose calculations, patient education, and drug-drug interactions.

CONCLUSIONS

The delivery of oncology content using flipped classroom instruction in the AST course successfully increased student confidence in ability to perform oncology pharmacy competencies. Cancer screening, cancer risk factors, and the preparation and dispensing of chemotherapy were competencies identified as needing greater emphasis in classroom instruction. Future studies are needed to assess student's knowledge and application of oncology pharmacy competencies in both the experiential and classroom settings.

Pharmacy students' medication history taking competency: Simulation and feedback learning intervention

INTRODUCTION

Obtaining accurate patient medication histories and performing medication reconciliation are core pharmacy practice skills that optimize patient safety at transitions of care. Competency-based learning and assessment of medication reconciliation skills are essential methods in undergraduate pharmacy education. The aim of this study was to investigate the impact of an in-classroom simulation- and feedback-driven training activity on pharmacy students' medication reconciliation skills, self-perceived confidence, and overall student satisfaction.

METHODS

Over a three-day learning activity in 2016, pharmacy students from a private university in Jordan were assessed by roleplay on their ability to conduct a simulated patient medication interview, obtain the Best Possible Medication History, reconcile the history against a hospital medication chart, identify discrepancies, and document findings. Students received immediate feedback and observed peers undergo the assessment process. Pre- and post-simulation questionnaires and supplementary focus groups enabled collection of quantitative and qualitative data pertaining to student self-perceived confidence, perceptions, experiences, and usefulness of the course.

RESULTS

Assessment-based competency scores demonstrated significant improvement in student performance during the activity. Self-perceived confidence scores significantly improved after the medication reconciliation training intervention. Focus group content analysis yielded positive responses such as students valuing receiving feedback on performance and recommendations for future training.

CONCLUSIONS

Simulation with feedback was a useful tool to teach pharmacy students medication reconciliation in Jordan. Subsequent to the study, medication reconciliation and interactive teaching methods were added to curriculum to supplement traditional teaching modalities.

Evaluation of a peer- and self-grading process for clinical writing assignments

OBJECTIVES

As class sizes in pharmacy education increase, faculty must develop new assessment strategies for essay writing assignments. This study evaluated accuracy and student perceptions of an innovative grading process that utilizes both peer- and self-assessment.

METHODS

Four SOAP note sessions were evaluated. Each session included four activities: a writing workshop, assessment workshop, and reflection session. For each assessment workshop students scored their note and a blinded peer's note using a grading form, facilitated by a faculty-led discussion. In a subsequent reflection session, students reviewed their peer- and self-assigned grades and could petition for faculty review if desired. The average self-, peer-, and final-grades were compared for each of the four SOAP note sessions using ANOVA. After the fourth session, students completed an anonymous 10-question Likert-scale survey regarding their perceptions of the process and three open-response questions. Survey results were analyzed with descriptive statistics.

RESULTS

Approximately 140 students participated. No difference was found between the average self-, peer-, and final-grades for all four sessions (p > 0.05). The survey response rate was 65% (91/140). Survey questions were grouped into three themes. The majority of students either strongly agreed or agreed that sessions were well organized and effective (≥84%), assessment workshops enhanced learning (≥68%), and the scoring method was fair (≥72%). The lowest score (mean 2.53 on a 4-point scale) reflected satisfaction with peer-provided feedback. When asked what they liked most, respondents most commonly cited that faculty-led review and discussion enhanced clinical knowledge.

IMPLICATIONS

The combination of a peer- and self-assessment process was accurate, well-received, and can be used to decrease faculty workload.

Introducing pharmacy students to the structure and function of general practice through undergraduate placements

BACKGROUND AND PURPOSE

The aim of this study was to design and evaluate the introduction of a sustainable and feasible structure of placements in general practice for third-year pharmacy students at the University of Sunderland. The national agenda in the United Kingdom (UK) calls for an increased presence of pharmacists within general practice; therefore, development of placements in this is setting is aligned to the development of these new roles.

EDUCATIONAL ACTIVITY AND SETTING

The placements were located in general practice surgeries in the North East of England in the UK. Students engaged in activities which introduced them to the structure and function of general practice and familiarise them with the role of pharmacists and other practice staff. Two cohorts undertook the education activity during the development process. The first cohort was comprised of 213 students, with 193 students the following year.

FINDINGS

An action research approach was taken to evaluate and revise the design of the placement. The final design and delivery have been shown to have a positive impact on student learning experience, be feasible and sustainable. The placement was also successful at introducing students to potential future roles in general practice for pharmacists.

SUMMARY

This model of general practice placement provision was found to be a feasible and sustainable delivery model, which was well received by undergraduate students.

Using debates as the primary pedagogy to teach critical care in a PharmD curriculum elective course

BACKGROUND AND PURPOSE

Debate is a pedagogy that incorporates deeper learning and has been used in many areas of healthcare and higher education. Debates have primarily been described within a course, but not as the predominant pedagogy for a course, particularly in pharmacy education or critical care instruction.

EDUCATIONAL ACTIVITY AND SETTING

Debating the Evidence was a two-credit hour course taught by debate-style pedagogy on an extended campus to third year pharmacy students in a four-year curricular program. The class met weekly for two hours over 15 weeks, and students came prepared to debate preselected topics. Focus groups for students enrolled over two years were conducted to gauge students' perceptions of this course structure.

FINDINGS

The debate-dominant course structure seemed to increase accountability of learning, pre-class preparation, and in-class engagement. Students had difficulty debating with lower quality evidence, but were able to use physiologic reason and adverse effect profiles when robust literature was lacking. All students enrolled over two course offerings consented and participated in the focus groups. Themes identified across both semesters included: 1) efficiency with accessing and evaluating drug literature, 2) increased understanding of an individualized patient-centered approach, and 3) an appreciation for patient care in the acute setting.

SUMMARY

An entirely debate-style critical care elective course was perceived to be beneficial to students. Scalability and impact on student learning requires further assessment.

Implementation of objective structured clinical examinations (OSCEs) in a doctor of pharmacy program

BACKGROUND AND PURPOSE

Objective structured clinical examinations (OSCEs) are an assessment solution that can be adapted in multiple ways within the doctor of pharmacy (PharmD) curriculum to assess clinical and communication skills and to improve teaching and learning across the curriculum.

EDUCATIONAL ACTIVITY AND SETTING

The University of Florida College of Pharmacy formed an OSCE Assessment Committee, wrote blueprints for the OSCEs aligned with Entrustable Professional Activities (EPAs), and delivered OSCEs in the first and third professional years of the PharmD program.

FINDINGS

Overall, students performed well on both the first year OSCE and third year OSCE (96 to 97% pass rate on first attempt).

SUMMARY

OSCEs provide a number of benefits to students, faculty, and preceptors. Students are afforded the opportunity to demonstrate the knowledge and skills they have acquired during pharmacy school. Likewise, faculty are able to determine if the skills they are teaching are being retained by students. Faculty are also able to assess if students are ready for pharmacy practice rotations. OSCEs also identify areas within the curriculum which may need reinforcement or review. In order for OSCEs to provide benefit to students and to the college, thought should be given as to what skills OSCEs will assess, how they will be developed and administered, and how they will be graded and used to determine progression through the curriculum.

Institutional factors associated with global health education across US pharmacy schools

INTRODUCTION

The objective of this study is to explore the relationship between institutional factors and offerings of global health education opportunities in pharmacy schools.

METHODS

Data for this project came from a review of international advanced pharmacy practice experiences (APPEs) and global course offerings for US pharmacy schools conducted between February 1 and March 31, 2014. These data were merged with data on institutional factors which may influence a school's offering of APPEs or courses. Institutional factors included tuition, class size, academic medical center affiliation, year established, and others. Multivariable regression models were used to evaluate the relationship between individual institutional factors and APPEs and global courses.

RESULTS

In multivariable adjusted models, older and more established schools had a larger percent of the graduating class with an international APPE (9.5% vs. 2.6%, p < 0.01) and a larger number of international APPEs (3.8 vs. 1.4, p < 0.01) than schools founded after 1980. Schools with higher tuition (>$25,000/year) had, on average, a larger percent of their graduating class with an international APPE (7.9% vs. 3.1%, p < 0.05), a larger number of international APPEs (3.7 vs. 1.5, p < 0.01), and more interprofessional international APPEs (3.1 vs. 0.7, p < 0.001). There were more course offerings at older schools (1.1 vs. 0.4, p < 0.05) and those with higher tuition (1.3 vs. 0.4, p < 0.01).

CONCLUSIONS

More established schools and those with higher tuition appeared to have more robust global offerings. Schools can consider local opportunities to provide global experiential and didactic experiences, which may reduce the financial burden of global programs.

Consideration of Aggressive and Strategic Approaches to Address Declining Enrollment in US Pharmacy Schools

Members from Cohort 13 of the Academic Leadership Fellows Program (ALFP) 2016-2017 were challenged to present a debate on the topic: "In Turbulent Times, Pharmacy Education Leaders Must Take Aggressive Action to Prevent Further Declines in Enrollment" at the American Association of Colleges of Pharmacy INfluence 2017 meeting in Rio Grande, Puerto Rico. This paper is the result of thoughtful insights emerging from this debate. We present a discussion of the question of whether pharmacy education leaders must take aggressive action or strategic approaches to prevent further declines in enrollment. There are many thoughts regarding current declines in enrollment. Some educators contend that a more aggressive approach is needed while others argue that, while aggressive actions might lead to short-term gains, a more viable approach involves strategic actions targeting the underlying causes for decreasing enrollment. This paper explores themes of enrollment challenges, current and future workforce needs, and financial issues for both pharmacy programs and students. In summation, both aggressive actions and a strategic, sustainable approach are urgently needed to address declining enrollment.

We should pay more attention to student curiosity

INTRODUCTION

Educators sometimes become frustrated when students appear interested only in learning the "right answers for the exam" versus being truly engaged and taking initiative to develop their own questions that add to the learning process. Some have suggested that because information is so readily accessible in today's digital environment that the desire to undertake scholarly inquiry may gradually be lost.

COMMENTARY

Curiosity is a trait that drives people to ask exploratory questions and find creative ways to solve problems. It has been linked with a variety of desired academic and professional outcomes, but is a construct rarely addressed within educational literature. This commentary suggests that curiosity is a characteristic to which pharmacy educators should pay more attention. A series of questions are posed for pharmacy educators to consider with regard to screening for, promoting, and developing curiosity within our student population.

IMPLICATIONS

Pharmacy educators need to be intentional about designing programs and instructional practices in ways that promote and incentivize student curiosity. The questions posed to the Academy are intended to evoke discussion and further study of curiosity within pharmacy education.

Developing a Comprehensive First-year Capstone to Assess and Inform Student Learning and Curriculum Effectiveness

Objective. To describe the development and implementation of an innovative, comprehensive, multi-day module focused on assessing and providing feedback on student cognitive and interpersonal skill development and practice readiness after the first year (PY1) of a Doctor of Pharmacy (PharmD) curriculum. Methods. A multi-day capstone assessment was developed to evaluate first-year students' knowledge of course content, ability to find and apply information, and interpersonal skills, including teamwork and adaptability. The PY1 Capstone consisted of four parts. Knowledge was assessed using 130 multiple-choice items on first-year course content and 50 fill-in-the-blank items on Top 200 brand and generic drug names. The ability to find and apply information was assessed using a 45-question open-book test. Interpersonal skills were assessed using a specially designed multiple mini-interview (MMI). The final part of the assessment was a debriefing session that provided rapid-cycle feedback on capstone performance and a bridge between students' recently completed first-year coursework and an upcoming 2-month experiential immersion. Results. The average score on the closed-book and open-book assessments were 75% and 68%, respectively. Most students displayed satisfactory interpersonal skills based on the MMI. Students viewed the assessment positively based on post-assessment survey responses (>75%). Most students (98%) reported not studying for the assessment, indicating that the results should reflect students' retention of knowledge and skills. Conclusion. The capstone assesses students on knowledge and skills and provides students with feedback on areas to focus on during their early immersion. Continued work is needed to ensure the process is transparent and cost-effective.

Reliability of peer assessment of patient education simulations

BACKGROUND

At Belmont University College of Pharmacy, the final introductory pharmacy practice experience (IPPE) course in the IPPE series, IPPE V, is designed to assess readiness for advanced pharmacy practice experiences and includes three patient counseling simulations. These simulations have required greater resources. The objective of our study was to determine if student performance on patient counseling simulations can be accurately assessed by peers.

EDUCATIONAL ACTIVITY

Students were required to participate in patient counseling simulations throughout the semester. For each simulation, students were assigned one role: pharmacist, patient, or peer-evaluator. Each pharmacist counseled the patient on a specific product while the peer-evaluator assessed the accuracy and completeness of the counseling using a detailed checklist. The patient used a checklist to assess the pharmacist's communication skills. Faculty assessed the student evaluators and the patients by counting the number of discrepancies between the student evaluator's and the live faculty checklists. Students were surveyed at the end of the semester regarding their beliefs and perceptions of peer assessment for the communication simulations.

CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY

Of 65 students enrolled in the spring 2018 course, complete recordings and checklists were available for 54 simulations (83.1%). Interrater reliability was high with all correlation coefficients exceeding 0.86. Students agreed that they were comfortable assessing patient education content (82.14%) and communication skills (82.14%). Our results indicate that peer evaluation during patient education simulation is reliable and acceptable to students.

Redesigning a Pharmacology Course to Promote Active Learning

Objective. To incorporate active-learning sessions into a lecture-based pharmacology course, assess the impact on student learning and attitudes, and address commonly perceived barriers to implementing active learning. Methods. Prior to the redesign, the course met twice a week for 75 minutes. As part of the redesign, the two weekly lecture sessions were reduced to 50 minutes each. Additionally, students were assigned to one of three sections that met separately once a week for a 50-minute recitation session in which they applied course concepts to cases, problems, and situations. Data from the two years before the redesign and two years after it were assessed. Results. Students' average course grade increased 2.5% after the redesign. Average ratings of the course and instructor on student evaluations each increased significantly (around 0.3 points on a 5-point scale). Conclusion. Student knowledge and performance in a pharmacology course increased when a portion of the time previously devoted to lecture was replaced with an active-learning session. This experience can serve as a blueprint for how to convert a lecture-only course into a hybrid lecture and recitation model.

A Review of Strategies for Designing, Administering, and Using Student Ratings of Instruction

Objective. To review and recommend strategies for utilizing student ratings of instruction (course and instructor) including considerations regarding design, administration, and use and interpretation of results. Findings. Improving course delivery and pedagogy using student ratings of instruction requires programs to design evaluation instruments that are aligned with the following good, scholarly teaching criteria: offer 10-20 rating scale questions and at least one written response question, ensure that students understand what the questions are asking, use a standardized form for evaluating all faculty members, allow for additional tailored questions to be added to the form, and employ a four- or five-point rating scale with a "not applicable" option. When administering evaluations, programs should limit the number of faculty members evaluated to those teaching greater than or equal to five clock hours of lecture or schedule evaluations based on academic rank; use an online course evaluation tool; randomly select students to participate; offer the evaluation at the end of the term (and/or midpoint for team taught classes); offer the evaluation during scheduled class time; and allow for voluntary, anonymous student participation. Finally, programs should create an assessment plan that outlines the results' release timeline, a list of who will receive result summaries, and how the results will be used. Programs should also encourage faculty reflection, offer mentoring in results interpretation, coach faculty members to summarize and quantify comments and longitudinally track results using tables, and create an accountability action plan to address deficiencies. Summary. In order to better ensure that student ratings of instruction are used to improve teaching, colleges and schools should adopt intentional design, structured administration processes, and transparent reporting of results.

Explaining Pharmacy Students' Dispensing Intentions in Substance Abuse-Related Gray Areas Using the Theory of Planned Behavior

Objective. To examine the extent to which theory of planned behavior (TPB) constructs and demographic characteristics explain pharmacy students' dispensing intentions in ethically or legally gray areas involving potential substance misuse or abuse. Methods. Two cohorts of third-year Doctor of Pharmacy (PharmD) students (n=159) were provided with five written cases describing common "gray area" dispensing scenarios in community practice involving medications and devices with potential for misuse or abuse (eg, long-term buprenorphine maintenance prescription without evidence of tapering, early refill of a narcotic for an out-of-town patient, non-prescription sale of pseudoephedrine). Students completed a 12-item survey instrument for each case. Items assessed whether the student would dispense the medication or device in the given scenario, how many times in 10 similar scenarios the student would dispense the medication or device, attitudes regarding dispensing, and subjective norm and perceived behavioral control beliefs. Results. Wide variation in the percentages of students who would dispense the medications or devices was noted across the five scenarios (14% in the buprenorphine scenario to 61% in the pseudoephedrine scenario). Attitude scores significantly predicted dispensing decisions in all scenarios (p<.001), whereas subjective norm and perceived behavioral control beliefs were significant predictors of dispensing only in select case scenarios. Gender and community pharmacy work experience did not consistently predict dispensing intentions. Conclusion. Student attitudes consistently predicted intent to dispense across five gray practice scenarios. These findings can be used to inform development of educational interventions that influence students' attitudes and self-awareness in community practice decision-making scenarios involving potential substance misuse or abuse.

Students' Perceptions on a Business Plan Assignment for an Ambulatory Care Pharmacy Elective

Objective. To evaluate a business-centered assignment implemented in a pharmacy elective course at two different institutions and analyze student perceptions of the delivery platforms used and the value and utility of the assignment. Methods. The ambulatory care electives at Butler University and Samford University introduce students to the expanding role of the ambulatory care pharmacist, emphasizing business plan development for new ambulatory care pharmacy services. As part of the elective, students are asked to work in groups to complete a business plan for a new ambulatory care service of their choosing. A survey was conducted to assess student perceptions on the assignment. Results. Of the 58 students who completed the business plan assignment, 49 completed the survey and were included in the data analysis. Overall, 100% of Samford students and 97% of Butler students either strongly agreed or agreed that the business plan was an innovative assignment unlike others completed in the curriculum. Samford students strongly agreed (100%) that if asked by a future employer to develop a new pharmacy service, concepts learned from this assignment would be useful, compared to 59% of Butler students who felt this way. While both the web and written delivery platforms had identical learning outcomes, the written business plan was the approach that the majority of students were more comfortable using. Conclusion. The business plan assignment was used as a method to familiarize students with the process of developing new ambulatory care pharmacy services. Based on survey results, the students perceived this to be an innovative assignment that allowed them to feel confident in developing and communicating ambulatory care business plans. As the practice of ambulatory care pharmacy expands, assignments such as this can be included in the pharmacy curriculum to meet the need for teaching effective business strategies to future pharmacists.

The Need for Palliative Care in Pharmacy Education

There is a growing need for palliative care pharmacists in the United States. There is also a gap in the education of palliative care for pharmacy students. To address both, pharmacy schools must develop and disseminate palliative care-focused experiences, including traditional didactic lectures, problem-based learning, interactive skills, laboratory- and web-based experiences. This commentary presents the need for palliative care-focused experiences in the Doctor of Pharmacy (PharmD) degree program, and how schools can take smaller steps to tackle this issue.

Cross-cultural Comparison of Pharmacy Students' Attitudes, Knowledge, Practice, and Barriers Regarding Evidence-based Medicine

Objective. To explore cultural influences on US and Japanese pharmacy students' evidence-based medicine (EBM) attitudes, knowledge, and behavior. Methods. A cross-sectional study was conducted using a self-administered survey. Senior students in one pharmacy school in the United States and two pharmacy schools in Japan were invited to complete a 33-item survey instrument. Results. Students in both countries reported having positive attitudes and understanding of EBM concepts. In their self-evaluation, American students rated their current EBM practice, EBM skills, and access to EBM resources higher than Japanese students rated themselves in these areas. The most common barriers to EBM for American students were lack of time (84.5%), lack of statistical knowledge (63.9%), and lack of critical appraisal skills (53.1%). The most common barriers to EBM for Japanese students were lack of training (92.6%), lack of clinical knowledge (90.4%), and lack of opportunity (88.8%). Conclusion. Although barriers to implementing EBM and confidence levels in using EBM differed between US and Japanese pharmacy students, both cohorts recognized EBM as an important skillset for the pharmacy profession. Culturally specific approaches to teaching EBM to pharmacy students are needed to improve EBM use in practice.

Assessment of First-Year Student Pharmacists’ Intercultural Competency Skills Using a Validated Scale and International Scenarios

Objective. To assess first-professional year student pharmacists' level of intercultural competency using international scenarios and a validated scale. Methods. The Wesleyan Intercultural Competence Scale (WICS), a validated questionnaire, was administered to student pharmacists to self-assess their intercultural skills based on their responses to various situations that students encounter in international settings. Student pharmacists rated 16 items on a 5-point Likert scale ranging from "very inaccurate" to "very accurate." Their responses allowed their intercultural competency skills to be ranked among six developmental stages. Results. The 48 participants had traveled outside of the United States an average of 2.6 times, and 34 (71%) of them spoke another language besides English. Students' average comfort level with working with culturally diverse health care students was 4.5 out of 5, and their average comfort level with working with patients of different cultures and background was 4.6 out of 5. The students' average overall score on the WICS was 21.9 out of 36, which indicated the majority of the students were in the acceptance phase of cultural competency. Conclusion. The results of this study can inform pharmacy school faculty and administrators regarding the importance of developing targeted and/or comprehensive cultural competency training for student pharmacists, in both the didactic and experiential settings, especially during global health experiences.

Readiness to provide pharmaceutical care to transgender patients: Perspectives from pharmacists and transgender individuals

OBJECTIVES

The objectives of this study were (1) to assess pharmacist readiness to provide pharmaceutical care for transgender patients through measuring both pharmacists' knowledge and attitudes towards transgender patients, (2) to assess transgender patients' perception of pharmacist readiness to provide them pharmaceutical care through measuring both pharmacists' knowledge and attitudes toward them, and (3) to compare pharmacist readiness to provide pharmaceutical care for transgender patients and patient perception of this readiness.

DESIGN

The study used a descriptive, cross-sectional design. The pharmacist's readiness and the transgender patient's perception of their readiness, defined as a combination of knowledge and attitude, were evaluated. Two separate, validated questionnaires with dichotomous, multiple choice, and open-ended questions were used to measure both constructs among both populations.

SETTING

Community-based research.

PARTICIPANTS

Pharmacists practicing in Puerto Rico were provided the questionnaire by e-mail or in person. Transgender participants in Puerto Rico were recruited through health clinics and community partners and were surveyed in person. The analysis included responses from 96 pharmacists and 31 transgender participants.

RESULTS

The majority of the pharmacists' knowledge scores (90%) were found in the low (0-5) and moderate (6-10) ranges, with a mean score of 7.23 out of a total possible score of 16 (SD ±2.36). For the attitude construct, most of the scores (81%) were found in the high (18-26) range, with a mean score of 19.63 out of a total possible score of 26 (SD ±3.65). For both constructs, transgender patient perceptions echoed the results of the pharmacists, indicating several perceived knowledge deficits in combination with mostly positive attitudes.

CONCLUSION

The majority of pharmacists demonstrated positive attitudes toward caring for transgender patients, and transgender patients also perceived these positive attitudes from pharmacists. However, the measured and perceived knowledge deficits observed in this study suggest the need for educational interventions to improve pharmacist readiness to provide care for transgender patients.