Pharmacoeconomic education in US colleges and schools of pharmacy: an update

Objectives

To determine the extent of pharmacoeconomics education at US pharmacy colleges and schools in 2007.

Methods

An e-mail survey was developed and sent to pharmacoeconomics instructors at all US colleges of pharmacy.

Results

Of the 90 colleges and schools of pharmacy that completed the survey, 7 colleges and schools did not currently have someone teaching pharmacoeconomics (eg, new school or looking for instructor). For the 83 colleges and schools that had an instructor who taught pharmacoeconomics, 69 covered pharmacoeconomic-related topics in a required course only; 5, in an elective course only; and 9, in both a required and elective course. The number of hours of pharmacoeconomic-related topics presented in required courses ranged from 1 to 48 hours (mean = 21 ± 14; median = 19).

Conclusions

Pharmacoeconomics education courses are offered at the majority of US colleges and schools of pharmacy. There was a wide range of hours devoted to pharmacoeconomic-related topics and the topics covered in these colleges and schools varied. Although the majority of US colleges and schools of pharmacy offer pharmacoeconomics courses, official guidelines are needed for the specific aspects and topics that should be covered in the classroom.     

Active-Learning Processes Used in US Pharmacy Education

Objective

To document the type and extent of active-learning techniques used in US colleges and schools of pharmacy as well as factors associated with use of these techniques.

Methods

A survey instrument was developed to assess whether and to what extent active learning was used by faculty members of US colleges and schools of pharmacy. This survey instrument was distributed via the American Association of Colleges of Pharmacy (AACP) mailing list.

Results

Ninety-five percent (114) of all US colleges and schools of pharmacy were represented with at least 1 survey among the 1179 responses received. Eighty-seven percent of respondents used active-learning techniques in their classroom activities. The heavier the teaching workload the more active-learning strategies were used. Other factors correlated with higher use of active-learning strategies included younger faculty member age (inverse relationship), lower faculty member rank (inverse relationship), and departments that focused on practice, clinical and social, behavioral, and/or administrative sciences.

Conclusions

Active learning has been embraced by pharmacy educators and is used to some extent by the majority of US colleges and schools of pharmacy. Future research should focus on how active-learning methods can be used most effectively within pharmacy education, how it can gain even broader acceptance throughout the academy, and how the effect of active learning on programmatic outcomes can be better documented.     

Capacity of Hospitals to Partner with Academia to Meet Experiential Education Requirements for Pharmacy Students

Purpose

Current hospital and health-system participation in and the future capacity for experiential education for pharmacy students was investigated.

Methods

An online survey of ASHP members identified as U.S. pharmacy directors was conducted to assess their current and future involvement in partnering with colleges and schools to meet the experiential education requirements for doctor of pharmacy students and the current status of the student learning experiences. Questionnaire items examined the factors on which expanded involvement in experiential education would depend, the nature of support provided by colleges and schools, the types of experiences available for students, respondents'' perceptions of factors influencing the quality of experiential education, the value of experiential education to the sites, respondents'' challenges and concerns about experiential education, and respondents'' current capacity and projections for introductory and advanced experiences through 2012.

Results

Data from 549 respondents were analyzed. Most respondents indicated that they had conducted advanced experiences for their 2007 graduates and anticipated that they would continue to do so. Among the top challenges identified regarding advanced experiences were concerns about time to serve and be trained as preceptors and a lack of standardization and coordination among colleges and schools. Hospitals forecasting their future capacity to accommodate students indicated that their projections were highly dependent on the number of pharmacists at their hospitals. Many respondents noted that their capacity projections were tied to their ability to expand clinical services at their hospitals.

Conclusion

A survey of pharmacy directors suggested an ability of U.S. hospitals to conduct advanced experiential education opportunities for pharmacy students through 2012 and to expand introductory experiences.     

Pharmacy Informatics Syllabi in Doctor of Pharmacy Programs in the US

Objectives

To assess pharmacy informatics education, identify current competencies, and develop a foundational set of recommendations.

Methods

Accredited pharmacy programs were contacted. Data were collected using a mixed-mode procedure. Didactic and experiential syllabi were analyzed for compliance with informatics competencies in Accreditation Council for Pharmacy Education (ACPE) Standards 2007.

Results

Thirty-two of 89 schools responded; 25 provided syllabi (36% response rate, 28% submission rate). Twenty-seven didactic and 9 experiential syllabi were received. The syllabi contained a diverse mix of educational content, some of which represented pharmacy informatics content as defined by ACPE. Schools are teaching clinical system terminology, applications, and evaluation.

Conclusions

Many professional programs are not providing instruction in pharmacy informatics. There may be confusion within the academy/profession between pharmacy informatics and drug information practice. Much work is required for programs to become compliant with the ACPE 2007 pharmacy informatics competencies.     

National Survey of Volunteer Pharmacy Preceptors

Objectives

To survey pharmacy preceptors regarding experiential education and determine the implications of the findings on colleges and schools of pharmacy.

Methods

An online survey was sent to 4,396 experiential sites. The survey instrument consisted of 41 questions regarding the experiential education environment from the preceptor''s perspective (eg, experiential load, time-quality issues, compensation, etc).

Results

One thousand one hundred sixty-three preceptors responded (26.5%) to the survey. Concerning experiential load, 73% took 2 or more students in the past year and almost half of the sites had to turn placements away. Nearly all preceptors felt that the more time they spent with students, the higher quality the experience, and 20% felt they didn''t have enough time to provide a quality experience. Thirty-six percent of respondents chose monetary stipend as the form of compensation they valued most.

Conclusions

This study provides insights into the issues that concern volunteer preceptors and the findings could be used to enhance the quality of experiential education in pharmacy.     

Faculty Awards at US Colleges and Schools of Pharmacy

Objectives

To determine recognition given for outstanding teaching, service, and scholarship at US colleges and schools of pharmacy, the types of awards given, and the process used to select the recipients.

Methods

A self-administered questionnaire was made available online in 2006 to deans at 89 colleges and schools of pharmacy.

Results

Sixty-four usable responses (72%) were obtained. An award to acknowledge teaching excellence was most commonly reported (92%), followed by an award for adjunct/volunteer faculty/preceptors (79%). The majority of the institutions (31 out of 58) reported offering 1 teaching award annually. The 2 most common methods for selecting the recipient of the teaching award were by student vote and by college/school committee vote following nominations. Twenty-four of the 63 respondents indicated that their institution provided an award for research/scholarship and 18 offered an award for outstanding service.

Conclusions

Teaching excellence was recognized and rewarded at most US colleges and schools of pharmacy; however, research/scholarship and service were formally recognized less frequently.     

Attributes of Colleges and Schools of Pharmacy in the United States

Objectives

To compare the attributes of US colleges and schools of pharmacy and describe the extent of change to the pharmacy education enterprise associated with the addition of new schools.

Methods

Attributes analyzed included whether the college or school of pharmacy was old or new, public or private, secular or faith-based, and on or not on an academic health center (AHC) campus; had 3- or 4- year programs; and had PhD students enrolled. PharmD student enrollment-to-faculty ratios and junior-to-senior faculty ratios also were examined.

Results

Of the new colleges/schools, 76% were private and 79% were not located on a campus with an AHC; 6% had PhD enrollment compared with 80% of old colleges/schools. Faculty ratios were related to several college/school attributes, including the presence or absence of PhD students and whether the college/school was public or private.

Conclusions

Attributes of new colleges and schools of pharmacy have changed the overall profile of all colleges and schools of pharmacy. For example, smaller percentages of all colleges and schools of pharmacy are public and have PhD enrollees.     

Instrument to measure psychological contract violation in pharmacy students

Objectives

To adapt and evaluate an instrument that measures perceived psychological contract violations in pharmacy students by schools and colleges of pharmacy.

Design

A psychological contract violations measure was developed from existing literature and the 1997 ACPE Guidelines and pilot-tested with second-year pharmacy students at 2 schools of pharmacy. A revised measure then was administered to second-year pharmacy students at 6 schools of pharmacy. Using a 5-point Likert-type scale, participants were asked to indicate the level of obligations they received compared to what was promised by the school of pharmacy.

Results

Exploratory factor analysis on the psychological contract violations measure was conducted using principal components analysis resulting in 7 factors, which led to a revised measure with 26 items. Using a sample of 339 students, the proposed 7-factor measurement model was tested using confirmatory factor analysis. In general, the results supported the hypothesized model. The final 23-item scale demonstrated both reliability and validity. Some students perceived certain aspects of the psychological contract that exists with their school of pharmacy were being violated.

Conclusion

The psychological contract violations measure may serve as a valuable tool in helping to identify areas where their students believe that schools/colleges of pharmacy have not fulfilled promised obligations.     

Mobile Computing Initiatives Within Pharmacy Education

Objectives

To identify mobile computing initiatives within pharmacy education, including how devices are obtained, supported, and utilized within the curriculum.

Methods

An 18-item questionnaire was developed and delivered to academic affairs deans (or closest equivalent) of 98 colleges and schools of pharmacy.

Results

Fifty-four colleges and schools completed the questionnaire for a 55% completion rate. Thirteen of those schools have implemented mobile computing requirements for students. Twenty schools reported they were likely to formally consider implementing a mobile computing initiative within 5 years.

Conclusions

Numerous models of mobile computing initiatives exist in terms of device obtainment, technical support, infrastructure, and utilization within the curriculum. Responders identified flexibility in teaching and learning as the most positive aspect of the initiatives and computer-aided distraction as the most negative, Numerous factors should be taken into consideration when deciding if and how a mobile computing requirement should be implemented.     

The structured interview and interviewer training in the admissions process

Objectives

To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training.

Methods

A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation.

Results

Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews.

Conclusions

Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy.     

The Status of US Multi-campus Colleges and Schools of Pharmacy

Objective

To assess the current status of multi-campus colleges and schools of pharmacy within the United States.

Methods

Data on multi-campus programs, technology, communication, and opinions regarding benefits and challenges were collected from Web sites, e-mail, and phone interviews from all colleges and schools of pharmacy with students in class on more than 1 campus.

Results

Twenty schools and colleges of pharmacy (18 public and 2 private) had multi-campus programs; 16 ran parallel campuses and 4 ran sequential campuses. Most programs used synchronous delivery of classes. The most frequently reported reasons for establishing the multi-campus program were to have access to a hospital and/or medical campus and clinical resources located away from the main campus and to increase class size. Effectiveness of distance education technology was most often sited as a challenge.

Conclusion

About 20% of colleges and schools of pharmacy have multi-campus programs most often to facilitate access to clinical resources and to increase class size. These programs expand learning opportunities and face challenges related to technology, resources, and communication.     

Barriers to Expanding Advanced Pharmacy Practice Experience Site Availability in an Experiential Education Consortium

Objectives

To compare 2006-2007 and projected 2010-2011 advanced pharmacy practice experience (APPE) availability and needs for 4 colleges and schools of pharmacy in Georgia and Alabama and to examine barriers and offer potential solutions to increase APPE site and preceptor availability.

Methods

Data on APPE needs and availability were gathered prospectively and evaluated relative to current and projected enrollment and planned programmatic changes.

Results

Combined 2006-2007 non-community APPE needs and availabilities were 3,590 and 4,427, respectively, with a surplus availability of 837. Combined projected 2010-2011 non-community APPEs were estimated at 4,309. Assuming 2006-2007 non-community availability remained unchanged, the surplus availability declined to 118.

Conclusions

The need for quality experiential education represents a significant barrier and rate-limiting step to the matriculation of the increased numbers of pharmacists. Barriers to expanding APPE availability include: introductory pharmacy practice experience (IPPE) and APPE expansion, growth of new and existing pharmacy programs, financial instability of acute care facilities, and lack of preceptor development resources. Regional experiential education consortiums can provide a constructive approach to improve access to quality sites and preceptors through standardizing processes and leveraging resources.     

Research-related Coursework and Research Experiences in Doctor of Pharmacy Programs

Objectives

To evaluate the research-related coursework and research experiences in doctor of pharmacy programs and compare the findings to those of 2 previous studies.

Methods

A questionnaire was mailed to 88 colleges and schools of pharmacy in the United States and Puerto Rico. The survey instrument sought information on formal research-related coursework; required and elective research experiences; and perceptions of student-conducted research.

Results

Seventy-nine colleges and schools completed the questionnaire for a response rate of 88%. Most colleges (>90%) required students to study/complete courses in biostatistics and drug information/literature evaluation; approximately half required research methods coursework. Twenty-five percent required some form of project and requirements were not influenced by class size. Students could often work in teams to complete projects. Respondents generally thought participation in research had some value for motivated students.

Conclusions

This study demonstrates the variability in extent of research-related coursework and research experiences in PharmD programs across the country.     

Objective structured clinical examinations in doctor of pharmacy programs in the United States

Objectives

To describe current objective structured clinical examination (OSCE) practices in doctor of pharmacy (PharmD) programs in the United States.

Methods

Structured interviews were conducted with PharmD faculty members between September 2008 and May 2010 to collect information about awareness of and interest in OSCE, current OSCE practices, and barriers to OSCEs.

Results

Of 108 US colleges and schools of pharmacy identified, interviews were completed for a representative sample of 88 programs (81.5% participation rate). Thirty-two pharmacy programs reported using OSCEs; however, practices within these programs varied. Eleven of the programs consistently administered examinations of 3 or more stations, required all students to complete the same scenario(s), and had processes in place to ensure consistency of standardized patients'' role portrayal. Of the 55 programs not using OSCEs, approximately half were interested in using the technique. Common barriers to OSCE implementation or expansion were cost and faculty members'' workloads.

Conclusions

There is wide interest in using OSCEs within pharmacy education. However, few colleges and schools of pharmacy conduct OSCEs in an optimal manner, and most do not adhere to best practices in OSCE construction and administration.     

Professional technical standards in colleges and schools of pharmacy

Objective

To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE).

Methods

The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information.

Results

Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures.

Conclusion

More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study.     

Pharmacy Students' Ability to Identify Potential Drug-Drug Interactions

Objective

To evaluate the ability of third- and fourth-year pharmacy students to identify clinically significant drug-drug interactions (DDIs)

Methods

A questionnaire designed to measure DDI knowledge was disseminated to fourth-year pharmacy students in a school of pharmacy. A second questionnaire was distributed to third-year pharmacy students in 2 schools of pharmacy (schools A and B) and re-administered to students in 1 of the schools 1 year later.

Results

Class of 2005 fourth-year pharmacy students correctly categorized an average of 52% ± 13% DDI pairs on the first questionnaire. Third-year pharmacy students at schools A and B correctly categorized an average of 61% ± 18% and 66% ± 15% of DDI pairs, respectively. The average percentage of correct responses for fourth-year students from the class of 2007 was 65% (± 17%).

Conclusion

Pharmacy students'' ability to identify important DDIs is far from optimal, even after completing experiential requirements.     

Redesign and Evaluation of a Patient Assessment Course

Objectives

To redesign a patient assessment course using a structured instructional design process and evaluate student learning.

Design

Course coordinators collaborated with an instructional design and development expert to incorporate new pedagogical approaches (eg, Web-based self-tests), create new learning activities (eg, peer collaboration on worksheets, SOAP note writing), and develop grading rubrics.

Assessment

Formative and summative surveys were administered for student self-assessment and course evaluation. Seventy-six students (78%) completed the summative survey. The mean course grade was 91.8% ± 3.6%, with more than 75% of students reporting achievement of primary course learning objectives. All of the additional learning activities helped students meet the learning objectives with the exception of the written drug information response.

Conclusion

The use of a structured instructional design process to redesign a patient assessment course was successful in creating a curriculum that succeeded in teaching students the specified learning objectives. Other colleges and schools are encouraged to collaborate with an instructional design and development expert to improve the pharmacy curriculum.     

My First Patient Program to Introduce First-Year Pharmacy Students to Health Promotion and Disease Prevention

Objectives

To implement and assess the effectiveness of a program to teach pharmacy students the importance of taking personal responsibility for their health.

Design

The My First Patient Program was created and lectures were incorporated into an existing first-year course to introduce the concepts of health beliefs, behavior modification, stress management, substance abuse, and nutrition. Each student received a comprehensive health screening and health risk assessment which they used to develop a personal health portfolio and identify strategies to attain and/or maintain their personal health goals.

Assessment

Student learning was assessed through written assignments and student reflections, follow-up surveys, and course evaluations. Students'' attainment of health goals and their ability to identify their personal health status illustrated the positive impact of the program.

Conclusion

This program serves as a model for colleges and schools of pharmacy and for other health professions in the instruction of health promotion, disease prevention, and behavior modification.