University-based continuing education for pharmacists

University-based continuing education (CE) fulfills an important role to support the professional development of pharmacists, advance the practice of pharmacy, and contribute to societal needs for research and healthcare services. Opportunities for pharmacists to engage in new models of patient care are numerous worldwide, particularly as pharmacists' scope of practice has expanded. Approaches to CE have changed to address the changing needs of pharmacists and now include a variety of approaches to support development of knowledge and skills. There is emphasis on the learning process as well as the knowledge, with the introduction of the concept of continuing professional development (CPD).As institutions of research and education, universities are uniquely positioned to bridge the gap between academic and practice environments, providing opportunities for translation of knowledge to practice. The Faculty of Pharmacy and Pharmaceutical Sciences at the University of Alberta is a provider of CE in Alberta, Canada, where an expanded scope of pharmacy practice includes prescribing, administering injections, accessing electronic patient records, and ordering laboratory tests. In this paper, the Faculty offers views about future directions for CE, including the integration of CE with core faculty activities, expanding the audience for CE, areas of focus for learning, and partnerships. Finally, we hope to ignite dialogue with others in the profession about the role and function of university-based CE.     

Practice Functions Necessary for the Delivery of Pharmaceutical Care

Pharmaceutical care is a concept outlining the responsibilities of individual pharmacists to individual patients. Although widely accepted on a philosophical basis, there is a lack of comprehensive information about the functions and responsibilities pharmacists undertake when providing pharmaceutical care. Pharmacy educators and practitioners at the faculty of pharmacy, University of Toronto, developed and informally tested a process that details the practice functions required of pharmacists when providing pharmaceutical care as originally defined.     

Factors affecting pharmacists' selection of rural or urban practice sites in Nebraska.

A questionnaire was used to determine why pharmacists in Nebraska chose urban or rural practice sites and to help the University of Nebraska College of Pharmacy encourage students to consider rural practice. Questionnaires were mailed to 1427 Nebraska pharmacists to gather data about their practice, job satisfaction, location of rearing, location of spouse's rearing, and prepharmacy and clerkship training. Usable responses were sorted into those from urban pharmacists (residing in Omaha and Lincoln and their suburban areas) and those from rural pharmacists (all others). Of the 689 usable responses, 315 (45.7%) were from urban pharmacists and 374 (54.3%) were from rural pharmacists. Of the rural pharmacists, 93% [corrected] grew up in communities of fewer than 100,000 people and 60% grew up in communities of fewer than 5,000 people. Respondents cited income potential, desirability of practice site, influence of spouse and family, and quality of children's schools as factors that most influenced their choice of practice site. Based on the survey results, the University of Nebraska College of Pharmacy took actions to recruit students from rural communities and increase students' exposure to rural practice settings. Pharmacists who were reared or trained in rural areas were more likely to practice in rural Nebraska than pharmacists who had only urban experience.     

Pharmaceutical chemistry in a pharmacy practice

The authors examine the utility and application of pharmaceutical chemistry is taught at the Faculty of Pharmacy, Semmelweis University, in the everyday pharmacy practice. Selected examples of the professional chemical knowledge necessary in different activities of pharmacists (as in drug quality control, storage of medicines, preparation of drugs in pharmacy and their issue (expenditure) to the patient etc.) are reviewed. Their experimental work on determination of expiry of an "ex tempore" prepared medicine demonstrates that it is possible to meet the principles of Good Pharmacy Practice (GPP). The paper is based on certain chapters of diploma work of H. B., tutor T. N. K.     

The Utrecht Pharmacy Practice network for Education and Research: a network of community and hospital pharmacies in the Netherlands

Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the characteristics and benefits of the Utrecht Pharmacy Practice network for Education and Research, a practice based research network affiliated with the Department of Pharmaceutical Sciences of Utrecht University. Yearly, this network is used to realize approximately 600 student internships (in hospital and community pharmacies) and 20 research projects. To date, most research has been performed in community pharmacy and research questions frequently concerned prescribing behavior or adherence and subjects related to uptake of regulations in the pharmacy setting. Researchers gain access to different types of data from daily practice, pharmacists receive feedback on the functioning of their own pharmacy and students get in depth insight into pharmacy practice.     

Educating students for practice: educational outcomes and community experience

The education of pharmacists in the United States integrates classroom and experiential learning. Two organizations played a key role in determining the current education of pharmacy students. They are the Accreditation Council for Pharmacy Education and the American Association of Colleges of Pharmacy. The curriculum offered today provides opportunities for students to learn and achieve ability-based outcomes in both didactic and experiential courses. This review of pharmacy education focuses generally on the national leadership of pharmacy education both past and present and specifically on outcomes of practice that students are expected to achieve. Included in the discussion are recommendations for how preceptors in a community practice model can build on the college curriculum by recognizing and incorporating ability-based outcomes into their activities of the introductory and advanced practice courses.     

Pharmacist competency certification in aminoglycoside dosing

A pharmacist competency-certification program was developed to train and evaluate newly hired pharmacists, provide continuing education and skills development for staff pharmacists, and standardize clinical pharmacy practice at a 940-bed teaching hospital. A pretest, self-teaching module, and written final examination were developed; the total program can be completed in approximately one month. The self-teaching module contains 37 pages of factual material on the pharmacology, pharmacokinetics, antimicrobial spectra, cost, relative toxicities, and dosing and monitoring techniques for aminoglycoside antibiotics. The pretest and final examination consist of 20 multiple-choice questions based on actual patient cases. Following its initial implementation, 21 of 49 staff pharmacists elected to complete the program. There was an equal representation of pharmacist trainees, novice pharmacists, and experienced clinical pharmacists. All three groups demonstrated improvement over pretest scores. The trainees and novice pharmacists showed the greatest improvement. This program defines a standard of practice and provides a continuing-education tool. Because of its success, the program has been mandated in the orientation of all clinical pharmacists.     

Pharmacists' perceptions of their professional role: insights into hospital pharmacy culture

Background:

Numerous studies have demonstrated the positive impacts of pharmacists on patient outcomes. To capitalize on these positive impacts, hospital pharmacy organizations around the world are now calling on pharmacists to shift their focus from distribution of medications to patient outcomes. This new emphasis is consistent with the vision statement for the profession of pharmacy in Canada, as set out in the Blueprint for Pharmacy: “Optimal drug therapy outcomes for Canadians through patient-centred care”. Given the ambitious nature of this statement and these goals, it is essential to understand what pharmacists currently think of their practice.

Objective:

To conduct a qualitative and semiquantitative analysis of hospital pharmacists’ perceptions of their role in patient care.

Methods:

A researcher posing as a University of Alberta student who was studying how health professionals use language to describe what they do contacted the pharmacy departments of all hospitals in Alberta. The “top-of-mind” approach was used in asking hospital pharmacists 2 questions: (1) How many years have you been practising pharmacy? (2) In 3 or 4 words (or phrases), from your perspective could you please tell me, “What does a pharmacist do”? These techniques were used to minimize the impact of social desirability bias. Content analysis was used to categorize hospital pharmacists’ responses into 4 broad categories: patient-centred, drug-focused, drug distribution, and ambiguous.

Results:

A total of 103 phone calls were made to hospital pharmacies, and 85 pharmacists contacted in this way were willing to participate in the survey. Hospital pharmacists provided 333 individual responses to the question about their activities. Of these, 79 (23.7%) were patient-centred, 98 (29.4%) were drug-focused, and 82 (24.6%) were in the drug-distribution category. Ambiguous responses accounted for the remaining 74 (22.2%).

Conclusion:

Aspects of care categorized as other than patient-centred should not be construed as unimportant. However, the fact that they were reported in this survey more frequently than patient-centred aspects suggests that hospital pharmacists in Alberta may have not fully embraced the concept of patient-centred care as outlined in the Blueprint for Pharmacy.     

The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice

Reflective practice strategies can enable healthcare practitioners to draw on previous experiences to render more effective judgment in clinical situations. The central argument presented in this commentary is that education programs and structures for continuing professional development (CPD) and revalidation of professionals sharpen their focus regarding self-assessment to identify gaps in skills and attitudes rather than merely as a means of on-going monitoring. Pharmacy undergraduate and professional education need to promote reflective practice strategies that foster self-evaluation to promote pharmacists’ readiness for practice change and advance patient care within rapidly expanding roles and scope of practice.     

Recurrent education for pharmacists to support regional medicine

New-generation pharmacists who graduate from the 6-year pharmacy education program will come into being in Japan in 2 years' time. The new program regards technical skills and caring attitudes suitable for healthcare professionals as important, as well as expert knowledge. Pharmacists are expected to become more involved in pharmacotherapy and patient care to overcome rural physician shortage and achieve better outcomes in pharmacotherapy. Pharmacists themselves also want to contribute to improve pharmacotherapy and patient care. Pharmacists educated with the former 4-year education program, however, hardly had a chance to learn clinical pharmacy or pharmaceutical care when they were pharmacy students. They have so far studied clinical knowledge, skills, and attitudes by themselves mostly after graduation. Therefore most pharmacists have not received systematic education or training about clinical pharmacy. Pharmacy schools employ pharmacists and physicians as professors, and built practical rooms for pre-clinical training to study pharmacy practice in recent years. We should use those human resources and laboratory equipment in pharmacy schools to facilitate recurrent education for pharmacists. Internet-based real time remote lecture is also useful for pharmacists working far from pharmacy schools to attend a recurrent class. I propose an education system in which pharmacists who completed the recurrent education program teach students pharmacy practice in their worksites, and both pharmacists and students are developing their practical skills to a high degree together.     

Obligations of Investigators in Clinical Research a Pharmacist's Perspective

Abstract

The Department of Pharmacy Practice at the University of Illinois at Chicago, College of Pharmacy currently employs 40 fulltime clinical pharmacists who have minimal drug distribution responsibilities and provide pharmacy services to a specific patient care team and are involved with the education of pharmacy and medical students. In addition, these clinical pharmacists have collaborated in the clinical research activities of the medical and surgical staffs at the University of Illinois, Since many of these pharmacists have gain recognition as primary and co-investigators by various study sponsors, the Department of Pharmacy Practice has developed a program to inform each clinical pharmacist of his/her responsibilities as a clinical investigator. The following document summarizes the Department's policies and procedures.     

培养临床药师 促进合理用药

通过对国内外开展临床药学工作和临床药学教育理论与实践的研究与分析,结合天津医科大学药学院与天津市卫生局及所属医疗机构为建立临床药师制、开展临床药学服务、培养临床药师所进行的临床药学教育教学实践,探讨建立适合中国国情的在成人队伍中进行临床药师培养的模式与方法。     

Planning for health information exchange: Perspectives of community pharmacists in the Community Pharmacy Enhanced Services Network of Indiana

BackgroundCommunity pharmacists are one of the most accessible health professionals and provide many different services. However, lack of access to complete patient information is a barrier to making meaningful patient interventions.ObjectivesTo determine (1) current and desired health information access among community pharmacists in the Community Pharmacy Enhanced Services Network (CPESN) of Indiana and (2) design considerations for a health information exchange tool for use by community pharmacists.MethodsThis voluntary study was conducted over an 8-day survey period in which 40 pharmacies within the CPESN Indiana network were contacted during regular business hours and asked to take part in a 15-minute telephone survey. Questions asked were informed by the following Consolidated Framework for Implementation Research intervention characteristics domain constructs: relative advantage, evidence strength and quality, adaptability, trialability, complexity, costs, and design quality and packaging.ResultsOf the 40 contacted pharmacies, 32 (80%) completed the survey. Most pharmacies reported access to immunization registry data; no other routine access was reported by any pharmacy. In questions assessing the relative advantage of Health Information Exchange (HIE) access compared with their current information access, at least 84.4% said that they agreed or strongly agreed with all statements. When choosing the data element most desirable to have access to via HIE in a community pharmacy, the most frequently selected choices were updated medication orders (n = 18, 56.3%), progress notes (n = 5, 15.6%), and laboratory tests (n = 4, 12.5%). Suggestions to improve ease of implementation included integration within dispensing software and clinical decision-making support features, such as alerts for pertinent lab values.ConclusionIntegrating HIE data into community pharmacies would provide community pharmacists with access to important patient data, and pharmacists believed that this would improve their practice. Future research should explore whether implementation of this type of tool leads to better patient outcomes and improved pharmacist job satisfaction.     

The Role of Academic Pharmacy in Tobacco Cessation and Control

Despite decades of public health initiatives, tobacco use remains the leading known preventable cause of death in the United States. Clinicians have a proven, positive effect on patients’ ability to quit, and pharmacists are strategically positioned to assist patients with quitting. The American Association of Colleges of Pharmacy recognizes health promotion and disease prevention as a key educational outcome; as such, tobacco cessation education should be a required component of pharmacy curricula to ensure that all pharmacy graduates possess the requisite evidence-based knowledge and skills to intervene with patients who use tobacco. Faculty members teaching tobacco cessation-related content must be knowledgeable and proficient in providing comprehensive cessation counseling, and all preceptors and practicing pharmacists providing direct patient care should screen for tobacco use and provide at least minimal counseling as a routine component of care. Pharmacy organizations should establish policies and resolutions addressing the profession’s role in tobacco cessation and control, and the profession should work together to eliminate tobacco sales in all practice settings where pharmacy services are rendered.     

Alternative ways of facilitating nutritional support without a nutrition support team

In the absence of a formal nutritional support team, a group of physicians, pharmacists, dietitians, and nurses at the authors' institution organized to devise alternative ways to facilitate nutritional support. The efforts of this group led to the redesign of the Pharmacy Department's parenteral nutrition order form into a clinical tool for the prescribing physician, and the development of a system for daily patient monitoring by dietitians and pharmacists for patients receiving specialized nutritional products. The delivery of parenteral nutrition was also streamlined to coordinate with the daily patient monitoring. A future goal is to increase three-way communication and teamwork among the physicians, dietitians, and pharmacists. These methods may be practical alternatives to facilitating nutritional support without the benefit of a support team.     

Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.Design. Twenty-two second-year student pharmacists were randomly selected from volunteers, given program training, and scheduled for three 5-hour evening shifts in 2013-2014. Pre/post surveys and reflection statements were collected from 19 students. Data were analyzed with a mixed methods approach.Assessment. Survey results revealed an increase in student self-efficacy (p<0.05) and positive perceptions of SMART. Qualitative findings suggest the program provided opportunities for students to develop strategies for practice, promoted an appreciation for the various roles pharmacists play in health care, and fostered an appreciation for the complexity of real-world practice.Conclusion. Early clinical experiences can enhance student learning and development while fostering an appreciation for pharmacy practice.     

Unifying a profession and a health care system: Building the case for a “one pharmacy” global community

The rational use of medicines to achieve better patient outcomes is a global concern. This need has pressured the practice of pharmacy to move away from focusing only on dispensing of the drug product towards the patient's appropriate utilization of the medicine. PharmAlliance, a unique partnership among three leading schools of pharmacy at the University of North Carolina at Chapel Hill (United States), Monash University (Australia), and University College London (United Kingdom), convened a Global Summit of Pharmacy Practice Innovation in November 2017 to bring together the leaders of the professional associations of the three countries to dialogue about how to lead the identified changes. A framework of “One Pharmacy Community” resulted from the discussions and was conceptualized from the overarching theme of the Summit. Recognizing and articulating these similarities into a One Pharmacy Community framework enables the development of a consistent global nomenclature of pharmacy services. The four pillars that resulted from the conversation are education, research, practice, and collaboration. Each of these are essential and dependent on the other in order to enable pharmacy practice to meet the global requirements of patient-focused health care design and delivery. This article describes the framework and each of the pillars.     

Development and implementation of a smoking cessation clinic in community pharmacy practice

OBJECTIVE: To describe a pharmacist-operated program to help people stop smoking. SETTING: Community chain (mass-merchandise) pharmacy practice sites in Virginia. PARTICIPANTS: Faculty at the Virginia Commonwealth University School of Pharmacy (VCU) and 15 practicing pharmacists. PRACTICE DESCRIPTION: Smoking cessation clinics within the pharmacy departments of seven Target stores. PRACTICE INNOVATION: With input from the practicing pharmacists and using the most current strategies reported in the literature, faculty at VCU developed a training manual for smoking cessation counseling. This manual was used to facilitate a 4-hour training session and also served as a resource for pharmacists in the smoking cessation clinics. Pharmacists were taught about behavioral modifications, the Transtheoretical Model of Change as applied to smoking cessation, documentation, the Fagerstr?m Test for Nicotine Dependence, smoking cessation therapies, patient counseling techniques, physical assessment skills, and how to develop an individualized action plan for smoking cessation. As pharmacists established smoking cessation clinics, issues such as workflow, continuous quality improvement, and marketing were addressed by the faculty members and practitioners. RESULTS: Using the process and tools described in this article, pharmacists successfully established and operated smoking cessation clinics. CONCLUSION: The process and materials developed for this demonstration project can serve as templates for other pharmacy faculty members and community pharmacists who wish to offer smoking cessation clinics.