Establishing an investigational drugs and research residency at an academic medical center

PURPOSE

The development, structure, and implementation of an innovative residency program designed to help meet a growing need for pharmacists with specialized expertise in investigational drug use and clinical research are described.

SUMMARY

Clinical research has become an increasingly complex field, but prior to 2017 there were no U.S. specialty residency training programs focused on pharmacists' role in drug development and the care of patients enrolled in clinical trials. In 2016 Johns Hopkins Hospital (JHH) launched an initiative to develop residency training standards specific to the areas of investigational drug use and clinical research. The residency development process consisted of creation of a residency development committee; a needs assessment, including formation of a diverse panel of internal and external experts to guide identification of key competency areas and development of residency goals and objectives; design of the program's structure, including a framework for required and elective rotations; submission of an application for pre-candidate status to the ASHP Commission on Credentialing; and recruitment efforts.

CONCLUSION

The JHH investigational drugs and research residency, a combined PGY1 and PGY2 program with 5 competency areas, 14 goals, and 49 objectives, was granted pre-candidate status by ASHP in November 2016. The first resident began the program in June 2017.

Evaluating the online platform of a blended-learning pharmacist continuing education degree program

BACKGROUND

Distance-based continuing education opportunities are increasingly embraced by health professionals worldwide.

METHODS

To evaluate the online component of a blended-learning degree program for pharmacists, we conducted a structured self-assessment and peer review using an instrument systematically devised according to Moore's principles of transactional distance. The web-based platform for 14 courses was reviewed by both local and external faculty, followed by shared reflection of individual and aggregate results.

RESULTS

Findings indicated a number of course elements for modification to enhance the structure, dialog, and autonomy of the student learning experience.

CONCLUSION

Our process was an important exercise in quality assurance and is worthwhile for other health disciplines developing and delivering distance-based content to pursue.

Making a Curricular Commitment to Continuing Professional Development in Doctor of Pharmacy Programs

As outlined in the Accreditation Council for Pharmacy Education (ACPE) Standards 2016, colleges and schools of pharmacy must provide an environment and culture that promotes self-directed lifelong learning. Continuing professional development (CPD) serves as a model that can foster and support self-directed, lifelong learning. The benefits of adopting a CPD model include assistance with attaining Center for the Advancement of Pharmaceutical Education (CAPE) 2013 Outcomes, such as self-awareness. This model can also support the individualization of experiential learning and student action on feedback from curricular-level assessments. The major skills involved in CPD, such as reflection and documentation, are frequently addressed in pharmacy curricula. However, these skills may be developed in isolation or exercised for purposes other than learning. The aim of this statement is to aid schools in creating "CPD ready" practitioners by defining the skill sets involved in CPD and making recommendations for advancing CPD in curricula.

Using an intervention mapping framework to develop an online mental health continuing education program for pharmacy staff

INTRODUCTION

Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community; however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping.

METHODS

The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers.

RESULTS

An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers.

DISCUSSION

Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce.

A five-state continuing professional development pilot program for practicing pharmacists

OBJECTIVE

To determine whether a structured educational intervention would support pharmacists' utilization of a continuing professional development (CPD) model compared to pharmacist control subjects.

METHODS

A prospective, randomized, observational case-control study of CPD was conducted in which pharmacists participated in several educational interventions, and study and control groups completed prestudy and poststudy survey instruments.

RESULTS

Survey data from 57 pharmacists (n = 28 study, n = 29 control) were analyzed and significant outcomes from the CPD stages of reflect, plan, act, evaluate, and record were found between matched study subjects and study and control group comparisons.

CONCLUSIONS

With appropriate training and support, pharmacists can utilize a CPD approach to their lifelong learning and professional development.

A model for continuing pharmacy education

OBJECTIVE

To develop and implement a continuing pharmacy education (CPE) program at Kaiser Permanente Colorado (KPCO) DESIGN: To address the continuing education needs of its diverse pharmacy staff, an internal continuing pharmacy education (CPE) program was developed. The pharmacy department became an accredited provider by the Accreditation Council for Pharmacy Education (ACPE). Live, interactive, and evidence-based CPE programs, presented by highly qualified internal staff members, utilized videoconferencing and a Web-based learning management system. Cross-accreditation of medical and pharmacy educational programs was offered to KPCO staff members.

ASSESSMENT

Annual needs assessments were conducted to ensure the provision of relevant educational topics and to assess learning needs. To demonstrate outcomes of the CPE programs, 2 methods were utilized: objective effectiveness assessment and knowledge acquisition assessment. This program met the objectives for CPE activities a large majority of the time (usually over 90%), demonstrated statistically significant (p < 0.05) improvement in knowledge from before to after the CPE activity in 11 of 13 questions asked, and minimized the cost to acquire CPE credit for both the pharmacy department and its staff members.

CONCLUSION

The KPCO continuing pharmacy education program has developed a high quality and cost-favorable system that has resulted in significant improvements in attendee knowledge.

Enhancing patient care via a pharmacist-managed rural anticoagulation clinic

Integrating specialized pharmacist services and follow-up with the laboratory, home care nursing, retail pharmacy and physicians can ensure optimal outcomes for patients receiving anticoagulation, or "blood thinner," therapy. Improved patient education and discharge care planning can bridge disconnects, enable patients to better manage their care and ensure better patient outcomes and more effective use of health system resources. Specially trained pharmacists can provide safe and effective management of a high-alert medication to help prevent potentially life-threatening clots or bleeding. With advanced prescribing authorization, the pharmacist can seamlessly provide this service both locally in a community and via Telehealth to surrounding areas, potentially for any Albertan. Warfarin therapy may be lifelong or short-term (three to six months), but all patients require regular monitoring with blood tests. Many variables, both lifestyle and medication related, can impact therapy, and through extensive education and access via telephone to an "expert" for questions and follow-up of blood tests, patients are empowered to better regulate their anticoagulants. Anticoagulation pharmacists, as part of an AMS (anticoagulation management service), can provide a continuum of care for patients while in hospital, when discharged home, as an outpatient in the community or as a resident of a long-term care facility or seniors' home.

The effectiveness of commitment to change statements on improving practice behaviors following continuing pharmacy education

OBJECTIVES

To determine the effectiveness of commitment to change (CTC) statements on behavior or practice change after a continuing pharmacy education (CPE) program, and to assess the percentage of CTC statements that are linked to program objectives.

METHODS

Following a CPE program, 33 participants were asked to complete a CTC statement and describe changes that they planned on making in their behavior as preceptors. Six months later participants were asked to return the CTC statement and note the status of the change.

RESULTS

Twenty-eight participants completed the CTC. Twenty-one (75%) participants returned the CTC statement 6 months later with a status report. Seventy percent of the 56 changes described by the 21 participants had been fully implemented. The majority of the changes (88%) matched program objectives.

CONCLUSION

Writing a CTC statement following completion of a CPE program may positively affect behavior change.

Evaluation of the national pharmacy preceptor education program

OBJECTIVE

The process evaluation findings and key issues from a trial of the effectiveness and national applicability of a national online educational curriculum for pharmacist preceptors are presented.

DESIGN

A multi-method triangulated research design was used to elicit qualitative and quantitative data preceptors. The data collection method involved an anonymous questionnaire with both quantitative components and open-ended qualitative responses.

SETTING

An online education program for preceptors of Australian pharmacy students in rural areas.

PARTICIPANTS

Rural pharmacists in the three states were invited to trial the package and participate in the associated research/evaluation project.

MAIN OUTCOME MEASURES

The Australian Pharmacy Preceptor Education (APPE) program is an important and valuable educational tool for the professional development of pharmacists. It contained pertinent information and appropriate activities, and the delivery strategy was well accepted. The evaluation findings support a national implementation.

RESULTS

Program strengths include the ease of access, self-directed learning and the interactive nature emphasising the benefit of sharing ideas and feedback. Potential program limitations include technical delays and unclear instructions for undertaking the program.

CONCLUSION

The online APPE program is a flexible delivery strategy which has the potential to dramatically improve the skills and knowledge of pharmacists acting as preceptors and, thereby, impact on the learning provided in rural hospitals and community pharmacies for undergraduate students and new graduates alike.

International trends in lifelong learning for pharmacists

Lifelong learning for community pharmacists is shifting from continuing education (CE) towards continuing professional development (CPD) in some countries. The objectives of this report were to compare lifelong learning frameworks for community pharmacists in different countries, and determine to what extent the concept of CPD has been implemented. A literature search was conducted as well as an Internet search on the web sites of professional pharmacy associations and authorities in 8 countries. The results of this review show that the concept of CPD has been implemented primarily in countries that have a long tradition in lifelong learning, such as Great Britain. However, most countries have opted for the CE approach, eg, France, or for a combination of CE and CPD, eg, New Zealand. This approach combines the controllability by regulatory organizations that CE requires with the advantage of sustained behavior change seen in successful CPD programs.

Non-prescription medicines: a process for standards development and testing in community pharmacy

OBJECTIVE

The objective of the study was to develop and test standards of practice for handling non-prescription medicines.

METHOD

In consultation with pharmacy registering authorities, key professional and consumer groups and selected community pharmacists, standards of practice were developed in the areas of Resource Management; Professional Practice; Pharmacy Design and Environment; and Rights and Needs of Customers. These standards defined and described minimum professional activities required in the provision of non-prescription medicines at a consistent and measurable level of practice. Seven standards were described and further defined by 20 criteria, including practice indicators. The Standards were tested in 40 community pharmacies in two States and after further adaptation, endorsed by all Australian pharmacy registering authorities and major Australian pharmacy and consumer organisations. The consultation process effectively engaged practicing pharmacists in developing standards to enable community pharmacists meet their legislative and professional responsibilities.

MAIN OUTCOME MEASURES

Community pharmacies were audited against a set of standards of practice for handling non-prescription medicines developed in this project. Pharmacies were audited on the Standards at baseline, mid-intervention and post-intervention. Behavior of community pharmacists and their staff in relation to these standards was measured by conducting pseudo-patron visits to participating pharmacies.

RESULTS

The testing process demonstrated a significant improvement in the quality of service delivered by staff in community pharmacies in the management of requests involving non-prescription medicines. The use of pseudo-patron visits, as a training tool with immediate feedback, was an acceptable and effective method of achieving changes in practice. Feedback from staff in the pharmacies regarding the pseudo-patron visits was very positive.

CONCLUSION

Results demonstrated the methodology employed was effective in increasing overall compliance with the Standards from a rate of 47.4% to 70.0% (P < 0.01). This project led to a recommendation for the development and execution of a national implementation strategy.

Patient outcomes following an intervention involving community pharmacists in the management of depression

OBJECTIVE

Documentation and evaluation of patient outcomes in a pilot study into the role of rural community pharmacists in the management of depression.

DESIGN

Parallel groups design with a control and intervention group.

SETTING

Thirty-two community pharmacies in rural and remote New South Wales, Australia.

PARTICIPANTS

One hundred and six patient participants, mean age of 46 years, predominantly female, not currently employed, recruited by participating pharmacists.

INTERVENTIONS

Intervention pharmacists were given video-conference training on the nature and management of depression by a psychiatrist, psychologist and general practitioner and asked to dispense medication with extra advice and support. Control pharmacists were asked to provide usual care.

MAIN OUTCOME MEASURES

Adherence by self-report, K10, Drug Attitude Index.

RESULTS

The results indicated that adherence to medications was high in both groups (95% versus 96%) and that both groups had improved significantly in wellbeing (a reduction K10 score of 4 (control) versus 4.7 (intervention)). No significant change was found in attitude to drug treatment once baseline scores were controlled for.

CONCLUSIONS

Because both groups improved in wellbeing it is not possible to claim that the training provided to the intervention pharmacists was responsible for the success. However, the improvements gained in such a short time (two months) suggest that the involvement of pharmacists has had a beneficial rather than negative effect. Further research into the most appropriate ways in which to integrate the skills of pharmacists into a model of mental health care delivery in rural communities is recommended.

The implementation of a harm minimisation model for the identification and treatment of over-the-counter drug misuse and abuse in community pharmacies in Northern Ireland

OBJECTIVE

This study tested an intervention model which sought to minimise over-the-counter (OTC) drug misuse and abuse in community pharmacies.

METHOD

Pharmacists in six community pharmacies in the Greater Belfast area volunteered to participate in the study. The intervention model consisted of client identification and recruitment, treatment and referrals, and finally follow-up data collection and outcome measurements. All pharmacists participated in semi-structured interviews to explore their views and experiences of the study.

RESULTS

Pharmacists identified 196 cases of suspected abuse/misuse. Pharmacists approached 70 of the identified clients during the six-month study; some clients agreed to stop using the product of abuse/misuse, used an alternative, or had been switched to a maintenance prescription under general practitioner (GP) supervision. No client proceeded to completion of the follow-up phase (e.g. health-related quality of life). Analysis of the interviews revealed that pharmacists had encountered some difficulties in approaching potential clients, but had used skills gained in the study in other aspects of their practice.

CONCLUSIONS

Some difficulties were encountered in implementing the harm minimisation model, but these may be alleviated by further training and greater collaborative working.

PRACTICE IMPLICATIONS

Notwithstanding the challenges faced in the study, this approach to harm minimisation should be considered for wider implementation in community pharmacy.

Implementation of a professional program in Finnish community pharmacies in 2000-2002

The aim was to assess implementation of a national 4-year project to promote professional strategy in Finnish community pharmacies during the 2.5 years of program's action in 2000-2002. A survey of random sample of 734 community pharmacists in Finland was conducted in 2002 (response rate 51%, n = 376). The questionnaire included an implementation scale and two open-ended questions on patient counselling. Many of the actions were not optimally implemented 2.5 years after starting the project. Some individual actions may have been taken, but the systematic long-term development process has not yet been started in many pharmacies. Future challenges in implementation will be a better commitment of the pharmacy owners to the goals of the national professional strategy and a better access to Internet-based drug information sources while counselling patients.

An evaluation of managing and educating patients on the risk of glucocorticoid-induced osteoporosis

OBJECTIVE

To assess the impact of risk management activities on patient risk of glucocorticoid-induced osteoporosis.

METHODS

Ninety-six adult patients taking chronic glucocorticoid therapy in 15 community pharmacies. Patients in the control group received usual and customary care. Patients in the treatment pharmacies received education and an educational pamphlet about the risks of glucocorticoid-induced osteoporosis. In addition, the treatment group pharmacists monitored the patients' drug therapy, to identify and address drug-related problems. Data including the glucocorticoid taken by the patient, medications, and osteoporosis risk factors were collected at baseline and after 9 months of monitoring, via Web-based survey completed in the pharmacy. Using an intent to treat approach, the pre-post frequency changes were compared with contrasts for presence of bisphosphonate therapy, presence of estrogen therapy, presence of calcium supplement, discussion of glucocorticoid-induced osteoporosis risk, discussion of bone density test, presence of bone mineral density test, reported inactivity, and reported low calcium diet.

RESULTS

The contrast was significant in favor of the treatment pharmacies for the frequency of patients taking a calcium supplement (Control [-6.9%] vs. Treatment [17.1%], P < 0.05). No other contrast was significant.

CONCLUSIONS

Community pharmacists are capable of increasing calcium supplementation among patients at risk for glucocorticoid-induced osteoporosis. Pharmacists who educate at-risk patients can impact the self-care of these patients.

[Training of pharmacy personnel in the management of a centralized unit: the Oncolor network experience]

The network of cancer care units in Lorraine area (Oncolor) developed management training for people working in chemotherapy units, and cytotoxic drug preparation. The programme was framed both for staff of executives (pharmacists), and technicians. Firstly, comparison between practices and theoretical recommendations lead to the elaboration of standardized operating procedures. Secondly, we elaborated a specific handbook for this education programme. A series of four-days independent sessions were organized for pharmacists and technicians. Each session combined theoretical and technical teaching for preparing antineoplastic drugs. Participants passing a successful final examination received a certificate from the Oncolor's network attesting their capacity to manage a chemotherapy unit. Four sessions were performed, with 35 participants. Only 31 passed at final examination. This preliminary experience will be enlarged to all members of the network and regularly brought up to date.

Program planning for a community pharmacy residency support service using the nominal group technique

OBJECTIVE

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs).

SETTING

Advisory committee of nationally recognized experts in CPRPs in a small-group planning session.

PRACTICE DESCRIPTION

CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies.

PRACTICE INNOVATION

The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs.

INTERVENTIONS

Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs.

MAIN OUTCOME MEASURE

Group consensus on the priority needs of CPRPs was determined through rank order voting.

RESULTS

The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors.

CONCLUSION

The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

Inhaler education for hospital-based pharmacists: how much is required?

OBJECTIVE

To compare the effectiveness of a more intensive educational intervention with a less intensive intervention on the ability of hospital pharmacists to be prepared to educate patients regarding inhaled device technique.

DESIGN

Randomized controlled trial. Inhaler technique and knowledge were assessed pre-education, immediately after and three months after education by a research assistant blinded to the educational allocation.

SETTING

Tertiary hospital pharmacy department.

POPULATION STUDIED

Hospital-based pharmacists.

INTERVENTION

A 1 h 'hands-on' session with feedback (more intense education, MIE) or written materials describing inhaler use (less intense education, LIE).

MAIN RESULTS

The change in overall score from pre-education to early posteducation for MIE was greater than for LIE (mean [95% CI]) (2.64 [1.27 to 4.01] versus 1.26 [0.05 to 2.47], P<0.001). Assessment scores improved for all device demonstrations and general knowledge. The change in score from the pre-education to the late posteducation period was only slightly higher in the MIE group than the LIE group, a difference that was not statistically significant (1.78 [0.82 to 2.74] versus 1. 22 [0.06 to 2.39], P=0.09). Scores in both groups were lower in the late posteducation period compared with the early posteducation period. Greater increases in total score in the immediate posteducation period were associated with a low baseline score and the MIE intervention.

CONCLUSION

Individual coaching in inhaler technique produces greater improvement in inhaler knowledge among hospital pharmacists than provision of written materials. However, the advantage of the more intensive intervention was short-lived, with little advantage evident in three months.

Clinical training program for distributive pharmacists

A training program to enable staff pharmacists in a state correctional system to shift their practice from distributive to clinical is described. Under a contract with the Texas Department of Criminal Justice (TDCJ), the University of Houston College of Pharmacy provides pharmaceutical services to 145,000 patients in 100 correctional facilities. An automated centralized distribution site was built in 1993 and four regional pharmacies were subsequently closed, resulting in the reallocation of eight distributive pharmacists positions to clinical services. Four of the eight pharmacists who would be displaced began a retraining program in preparation for decentralized clinical positions. The 18-month program, developed by university staff on contract to TDCJ and college faculty members, included 34 home-study modules, case studies, case presentations, seminars, and supervised practice experience. Three of the pharmacists completed the program, passed competency tests, and were certified for clinical practice privileges, including drug therapy assessment and written consultations. The three pharmacists now operate ambulatory care clinics at prison units. A clinical skills training program developed by a college of pharmacy correctional services division in cooperation with faculty members enabled staff pharmacists to convert their roles from distributive to clinical.

AIDS prevention training for pharmacy workers in Mexico City

Mexican pharmacies play an important adjunct health care role in sexually transmitted disease prevention and treatment. In light of the rapid spread of the AIDS pandemic, research was initiated in 1989 to investigate the feasibility of pharmacies assisting in AIDS and STD prevention and control through community education and condom promotion. This study was implemented in three stages: a needs assessment, development of a training course and complementary materials, and an evaluation of the course and materials. The instruments used in the needs assessment were a KAP questionnaire and 'mystery shopper' visits to pharmacies. The evaluation design utilized pre- and post-tests, condom sales tracking and 'mystery shopper' visits. The needs assessment found that pharmacy employees have some basic knowledge about AIDS and STDs, but lack important information and do not communicate effectively with clients in spite of client interest in these topics. Pharmacy workers expressed great in learning more about AIDS and STDs. The evaluation of the intensive 8-hour course and supporting materials showed that, when given together, the course and materials increased short term knowledge about AIDS and condom use. However, the interventions were less successful in achieving longer term information retention, transfer of knowledge to clients or in influencing condom sales. Adjustments in the training course content and in participant recruitment strategies are recommended.

Nutritional support: pharmacists' influence on the prescribing process

A commitment was made at a 1,025-bed county teaching facility to increase staff pharmacists' involvement in nutritional support and physician prescribing. The plan was to utilize the Nutritional Support Clinical Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient care for patients receiving parenteral nutrition. The implementation included specialized training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition patients, pharmacists' attendance at nutritional support rounds, documentation of all pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation (DUE) process. The results of the increased influence of pharmacists on the prescribing process included more appropriate parenteral nutrition therapy, earlier transitioning from parenteral to enteral nutrition, recognition of staff pharmacists as resources by the physicians, and increased job satisfaction for pharmacists.

Hiring pharmacists and technical personnel: Part 3: Orientation and training

Training new employees is an important and necessary component of the creation of a team to provide pharmacy services. A structured, focused review of application materials, a tailored training program planned in advance, and the use of multiple trainers can lead to an effective training program and a satisfied, productive new employee. The planned training program leads to a consistent approach to physician, nurse, and patient customers and sets expectations for skills, interaction, behavior, and quality that are the basis of a long-term relationship. Employees may continue this training process over the entire course of their career. A well-designed training program will also provide portable skills and meet the goals and needs of the employee as well.

Regional pharmacokinetics educational program

An educational program for hospital pharmacists in and near Vermont is described and its impact on departmental clinical practice evaluated. Pharmacists were instructed by practitioners from a single institution in basic pharmacokinetics, practice guidelines for aminoglycoside therapy, and use of a computer program for aminoglycoside dosage determination. Participants completed a multiple-choice precourse test, a similar postcourse test, and a third test six months after class completion. Test scores were compared with those from a control group of pharmacists. Pharmacy directors from study group hospitals completed questionnaires measuring aminoglycoside clinical services before and six months after the program. Compared with the control group, participants scored higher on the postcourse tests. Results from the questionnaire indicate that the program affected clinical practice in almost all participating pharmacy departments. A consistent pharmacokinetic strategy for reviewing aminoglycoside dosages and evaluating serum aminoglycoside concentrations is now practiced in most Vermont hospitals. An educational program originating in one hospital can expand pharmacists' knowledge and influence departmental clinical practice throughout a region.

Shared resources: joint hospital sponsorship of continuing education

Two competitive hospitals have successfully shared resources to present an annual interdisciplinary pharmacology symposium for the past 10 years. Hospitals can contain costs and create synergy by collaboration and shared resources.

Using self-evaluation to maintain competence

This limited study examined differences in pharmacists' competencies through self-assessment. By using self-assessment with specified objectives, pharmacists can target areas for CE programs. Pharmacists can then improve and maintain their competencies in these specific areas. A future study could focus on discovering the reasons some pharmacists do not feel comfortable in giving advice/information to other healthcare professionals.

Expansion of clinical pharmacy services through staff development

A program that trains and uses staff pharmacists for clinical services is described. A position was created that is filled by staff pharmacists on six-week rotations. All full-time pharmacists may participate; they work under the direction and supervision of clinical pharmacists. Basic responsibilities in the rotation include responding to drug information requests, assisting with drug-use evaluation and adverse drug experience programs, assisting with research, writing and editing for newsletters, participating in staff development programs, and reviewing and clarifying drug orders for the skilled-nursing facility. About 60% of eligible pharmacists have participated in this program. The pharmacists have gained new practice skills, greater opportunity for career enhancement, and improved attitudes toward work and colleagues, and the department has been able to provide more clinical services. The focus of the rotation is now being changed from performing clinical tasks to assuming more responsibility for patient outcomes related to drug therapy. A rotating clinical position has enabled staff pharmacists to gain additional nondispensing skills and contribute to the development and maintenance of clinical services.

Drug information centers as bases for continuing education programs in Kuwait

Over the past few years, there has been a modernization of pharmaceutical services in Kuwait. In 1983 a drug information center was opened. A one-year postgraduate, long-distance program leading to a diploma in clinical pharmacy was started in October 1987 in cooperation with Queen's University of Belfast, Ireland. Pharmacist and physician tutors were assigned to supervise students in the major hospitals in Kuwait. A questionnaire was developed and distributed to 50 practicing pharmacists to assess the feasibility of using the Drug Information Center at Adan Hospital (DICAH) as a base for continuing education programs. Although certain difficulties were identified, it was concluded that the DICAH has the potential to be used as a base for future continuing education for pharmacists in Kuwait, especially as there is no school of pharmacy in the country.

Pharmaceutical continuing-education program based on a core curriculum

The use of a core curriculum concept in the establishment of a comprehensive continuing-education program is described. A departmental staff development committee was selected to develop a core curriculum of topics for professional continuing education. Six core curriculum areas of interest and importance were identified: cardiology; infectious disease; total parenteral nutrition, acid-base balance, and fluid and electrolytes; pharmacy management; critical-care medicine; and pharmacokinetics. Coordinators were selected from the staff to identify topics and speakers in each core curriculum area. The drug information center was assigned responsibility for logistical aspects of the program such as scheduling, evaluations, objectives, information support, and providing continuing-education credit. A survey of staff perceptions revealed a very positive view of the program. The staff rated the program highly as meeting their needs for continuing-education credit, as an employee benefit, and in covering topics related to their practice. The core curriculum concept has been shown to be a successful and effective approach to the establishment of a comprehensive continuing-education program.

Assessing the pharmacy practitioner's need for AIDS education

Meeting the needs of pharmacists for information on AIDS remains a challenge for health planners. Years from graduation, clinical practice, and degree of patient contact are variables to be surveyed before designing a program. Availability of professional companion literature can encourage pharmacists to educate their patients regarding safe sex, side effects of medications, treatment of symptoms, and HIV infection. Pharmacists should regularly attend programs regarding HIV infection to stay current with the rapid advances in treatment.

A descriptive analysis of pharmacy continuing education offerings in 1985

This study reports the results of a national survey of ACPE-approved provider continuing education offerings during 1985. The study was designed to identify frequently-presented topics, characterize types of programs offered, describe the providers offering programs and detail continuing education activities on a regional basis. Data were requested through the mail and the ACPE "program description form" was used as the source of the study data. Two hundred and one (84.1%) ACPE-approved providers from eight regions of the country and Puerto Rico participated and data from 2,461 programs were analyzed. Differences and similarities among programs offered and characteristics of providers were reported. Additional information was generated on when programs were offered, methods of presentation, average tuition charged and average credit hours offered. Significant differences were noted. Comparisons with previous national studies were made where possible. Among the findings was: an impact by mandatory continuing education requirements on the number of programs available; an increase in average program tuition charges; a decrease in the average number of credit hours per program; and an increase in competition among providers. Programs provided a rich variety of offerings, required a moderate tuition charge, were offered in every month, and used many different formats and delivery methods.

Regional coordinators of continuing pharmacy education. Seven years later

In 1976 a regional network of coordinators of continuing education was established in British Columbia to increase the accessibility of programs to all pharmacists. The purpose of this paper is to report the contributions of the network to continuing education since its inauguration. As of 1983, 94 pharmacists have been trained to assist with the design and management of continuing education programs and they have had a significant impact on regional programming. When yearly summary statistics from the four years prior to the network are compared to the seven subsequent years an approximate five-fold increase in the average number of programs is found. There is also a greater than two fold increase in the average number of contact hours and an approximate six-fold increase in the average number of registrations. The network of coordinators has increased not only the quantity but also the relevancy of programs by focusing on regional needs. In addition, the network has had spill-over benefits to the University of British Columbia and the licensing body in some of their other province-wide activities such as teleconferencing competency assessment, and poison prevention programs.