Home Medication Reviews in a Patient Care Experience for Undergraduate Pharmacy Students

Objectives. To evaluate the effectiveness of conducting medication management reviews (MMRs) and home medication reviews (HMRs) on improving undergraduate pharmacy students'' pharmaceutical care skills and clinical knowledge.Design. Fifth-year bachelor of science in pharmacy students were enrolled in a structured course in which MMR cases based on real patient scenarios were completed, findings were discussed in groups, and comprehensive feedback was provided by course instructors. Each student was then asked to recruit a real patient through a community pharmacy and conduct an HMR.Assessment. Students’ pre- and post-course scores on the same MMR case improved significantly, with 84.6% of students passing the post-course assessment. Students also completed a new post-course MMR case and 74.8% received a passing score. Students'' answers on a post-course self-assessment showed a significant improvement in their scores regarding knowledge and skills in conducting MMRs and HMRs.Conclusion. Medication management reviews and home medication reviews are excellent tools for educating pharmacy students and providing them with needed actual clinical practice experience.     

Education,Training, and Academic Experience of Newly Hired,First-Time Pharmacy Faculty Members

Objective. To describe the education, training, and academic experiences of newly hired faculty members at US colleges and schools of pharmacy during the 2012-2013 academic year.Methods. A survey regarding education, training, and academic experiences was conducted of all first-time faculty members at US colleges and schools of pharmacy hired during the 2012-2013 academic year.Results. Pharmacy practice faculty members accounted for the majority (68.2%) of new hires. Ambulatory care was the most common pharmacy specialty position (29.8%). Most new faculty members had a doctor of pharmacy (PharmD) as their terminal degree (74.8%), and 88.3% of pharmacy practice faculty members completed a residency. Of new faculty members who responded to the survey, 102 (67.5%) had at least 3 prior academic teaching, precepting, or research experiences.Conclusion. New faculty members were hired most frequently for clinical faculty positions at the assistant professor level and most frequently in the specialty of ambulatory care. Prior academic experience included precepting pharmacy students, facilitating small discussions, and guest lecturing.     

Does self-reflection and peer-assessment improve Saudi pharmacy students’ academic performance and metacognitive skills?

Background: The patient-centered focus of clinical pharmacy practice which demands nuanced application of specialized knowledge and skills targeted to meeting patient-specific therapeutic needs warrant that the training strategy used for PharmD graduates must empower with the ability to use the higher level cognitive processes and critical thinking effectively in service delivery. However, the historical disposition to learning in the Middle East and among Saudi students appeared heavily focused on rote memorization and recall of memorized facts. Objectives: To assess the impact of active pedagogic strategies such as self-reflection and peer assessment on pharmacy students’ academic performance and metacognitive skills, and evaluate students’ feedback on the impact of these active pedagogic strategies on their overall learning experience. Method: An exploratory prospective cohort study was conducted among 4th year students at the College of Clinical Pharmacy, King Faisal University, Saudi Arabia to assess the impact of self-reflection and peer-assessment in a semester-wide assessment tasks in two compulsory first semester 4th year courses (Therapeutics-3 and Pharmacoeconomics). An end-of-course evaluation survey with a pre-tested 5-item open-ended questionnaire was also conducted to evaluate students’ feedback on the impact of active pedagogic strategies on their overall learning experience. Result: Male students (study group) constituted 40.7% of the cohort while 59.3% were females (control group) with mean ± SD age of 23.2 ± 5.6 and 22.1 ± 4.9 years respectively. The mean ± SD scores for quizzes, mid-term and final exams, and the overall percentage pass were significantly higher in the study group for both courses (P < 0.001). The majority of the students in the study group opined that the exposure to active pedagogic strategies enabled them to improve their use of critical thinking, facilitated deeper engagement with their learning and improved their clinical decision-making and discussion skills. Conclusion: The use of active pedagogic strategies such as self-reflection and peer-assessment appeared to significantly improve examination performance, facilitate deep and constructive engagement with learning and fostered students’ confidence in the use of critical thinking and clinical decision-making.     

Exploring the relationship between examination pass rates and eligibility pathways among pharmacist candidates for initial board certification

ObjectivesTo compare examination pass rates among different eligibility cohorts for initial board certification in 6 recognized pharmacy practice specialties.DesignRetrospective observational cohort study.Setting and participantsPracticing U.S. pharmacists who were approved candidates for initial board certification examinations in the following Board of Pharmacy Specialties (BPS)–recognized specialties: ambulatory care pharmacy, critical care pharmacy, oncology pharmacy, pediatric pharmacy, pharmacotherapy, and psychiatric pharmacy.Outcome measuresThe number and percentage of BPS-approved candidates that pass initial board certification examinations differentiated by specialty and eligibility pathway (i.e., completion of postgraduate residency training or demonstration of postlicensure specialized practice experience).ResultsInitial board certification examination outcome (i.e., pass or fail) was assessed for a total of 15,171 candidates from Fall 2015 to Fall 2018. Pass rates for that period based on eligibility pathway (e.g., completion of a PGY-2 specialty residency, completion of a PGY-1 residency plus 1–2 years of postlicensure specialized practice experience, or 3–4 years of postlicensure specialized practice experience) were, respectively as follows: ambulatory care pharmacy (n = 2081): 94%, 84%, and 55% (P < 0.0001); critical care pharmacy (n = 2111): 99%, 94%, and 79% (P < 0.0001); oncology pharmacy (n = 1195) 93%, 75%, and 50% (P < 0.0001); pediatric pharmacy (n = 1119): 87%, 73%, and 57%; (P < 0.0001); pharmacotherapy (n = 8368): 88%, 59% (P < 0.0001); and psychiatric pharmacy (n = 477): 93%, 72%, 49% (P < 0.0001).ConclusionFrom 2015 to 2018, the percentage of BPS-approved candidates that passed initial board certification examinations in ambulatory care pharmacy, critical care pharmacy, oncology pharmacy, pediatric pharmacy, pharmacotherapy, and psychiatric pharmacy was significantly higher for cohorts deemed to be board eligible based on completion of postgraduate residency training.     

Incorporating Hypertensive Patient Education on Salt Intake Into an Introductory Pharmacy Practice Experience

Objective. To evaluate the impact of the Salt Education Program for hypertensive adults on student pharmacists'' knowledge, behaviors, and attitudes regarding sodium consumption.Design. As part of the introductory pharmacy practice experience program in community pharmacies, student pharmacists assessed patients'' sodium intake knowledge and behaviors, taught them how to read nutrition labels, and obtained information about their hypertensive conditions. Students completed pre-and post-intervention questionnaires in April and August 2012, respectively.Assessment. One hundred thirty student pharmacists (70% female, 78% white) completed pre- and post-intervention questionnaires. Students demonstrated significant improvements in knowledge scores (p<0.001) and perceived benefit of a low-salt diet (p=0.004). Further, there were significant improvements in the self-reported frequency of looking at sodium content of foods when shopping (p<0.001) and purchasing low-salt foods (p=0.004).Conclusion. Changes in students'' knowledge, behaviors, and attitudes after participating in the Salt Education program suggested that the program was effective in improving student knowledge, behaviors, and attitudes.     

Educational card games to teach pharmacotherapeutics in an advanced pharmacy practice experience

Objective

To implement and assess the effectiveness of card games to teach pharmacotherapeutic topics to pharmacy students and to determine the relationship between students'' assessment scores and their learning styles.

Design

Two card games, Cardiology Go Fish and Infectious Diseases Gin Rummy, were created and taught to pharmacy students enrolled in an advanced pharmacy practice experience (APPE). Students were required to play each game for 1 hour, 3 times over a 6-week period.

Assessment

Forty-five students completed a 90-question assessment administered prior to and after the 6-week period in which the games were played. Students'' cardiology and infectious diseases assessment scores improved significantly as compared with scores on pharmacy practice questions, 19.2% vs. 5.1%, (p < 0.001) and 10.3% vs. 5.1% (p = 0.006), respectively. Students learned from participating in the games regardless of their learning preference as determined by the VARK (visual, aural, read/write, kinesthetic) questionnaire; however, the cardiology assessment scores of students with a preference for kinetic learning improved the most.

Conclusions

Incorporating innovative learning tools such as card games into the curriculum of APPEs can enhance the educational experience of pharmacy students.     

A case-based toxicology elective course to enhance student learning in pharmacotherapy

Objective. To assess the impact of a case-based toxicology elective course on student learning in related required courses and student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA) examination.Design. A case-based clinical toxicology elective course that contained topics from 2 required courses, Pharmacology III and Pharmacotherapy II, was offered in the spring 2009 to second- and third-year pharmacy students.Assessment. Scores on the Toxicology subsection of the PCOA of students enrolled in the elective were higher than those of students not enrolled (91.3% ± 4.1 vs. 67.2% ± 5.7). Enrollment in the elective was related to increased examination scores among Pharmacotherapy II students (89.5% ± 2.0 vs. 83.9% ± 1.8). Students indicated on course survey instruments that they were satisfied with the new elective offering.Conclusions. A toxicology elective provided a clinically relevant, active-learning experience for pharmacy students that addressed a curricular need within the college and increased examination scores.     

Effectiveness of a national approach to prescribing education for multiple disciplines

Aims

To evaluate the effectiveness of a national approach to prescribing education on health professional students’ prescribing and therapeutics knowledge, across multiple disciplines.

Methods

In a university examination setting, 83 medical, 40 pharmacy and 13 nurse practitioner students from three different universities completed a set of multiple choice questions (MCQs) before and after completing an online module from the National Prescribing Curriculum (NPC). To minimize overestimation of knowledge, students had to indicate the level of certainty for each answer on a three‐point scale. MCQs were scored using a validated certainty‐based marking scheme resulting in a composite score (maximum 30 and minimum −60). Students were asked to rate their perception of usefulness of the module.

Results

At the pre‐module phase, there were no significant differences in the composite MCQ scores between the medical (9.0 ± 10.3), pharmacy (10.2 ± 10.6) and nurse practitioner (8.0 ± 10.7) students. The scores improved significantly for all groups at the post‐module phase (P < 0.01 for all groups) by similar extents (post‐module results: medical, 14.5 ± 9.6; pharmacy, 14.4 ± 9.9; nurse practitioner, 12.1 ± 9.6). 39.4% of the MCQs answered incorrectly with high level of certainty at the pre‐module phase were still answered incorrectly with high level of certainty at the post‐module phase. Almost all students (with no significant difference between the groups) found the NPC modules, post‐module MCQs and feedback useful as a learning tool.

Conclusions

A national online approach to prescribing education can improve therapeutics knowledge of students from multiple disciplines of health care and contribute towards streamlining interdisciplinary learning in medication management.     

A Workshop on Smoking Cessation for Pharmacy Students

Objective. To develop, implement, and evaluate a targeted educational intervention focusing on smoking cessation with final-year undergraduate pharmacy students.Design. A smoking-cessation educational workshop entitled Smoking Cessation in Pharmacy (SCIP) was designed on the principles of adult learning and implemented with a full cohort of final-year undergraduate pharmacy students at the University of Sydney. A previously validated questionnaire testing the knowledge and attitudes of respondents was administered both before and after implementation of the designed workshop to evaluate changes resulting from the intervention. Informal feedback was obtained from students.Assessment. Pre-course mean total knowledge and attitude scores calculated were 65.8±9.1 and 86.4±12.1, respectively. The post-course mean total knowledge score was 74.9±8.1, and the attitude score was 88.8±9.1 Improvement in knowledge and attitudes was significant (p<0.05).Conclusion. Educational interventions for pharmacy students designed with careful attention to pedagogic principles can improve knowledge about evidence-based smoking-cessation strategies and enhance positive attitudes to pharmacist roles in smoking cessation.     

Evaluation of Student Factors Associated with Pre-NAPLEX Scores

Objective: To examine relationships among students’ Pre-NAPLEX scores and prepharmacy, pharmacy school, and demographic variables to better understand factors that may contribute to Pre-NAPLEX performance.Methods: A retrospective review of pharmacy students’ Pre-NAPLEX scores, demographics, prepharmacy factors, and pharmacy school factors was performed. Bivariate (eg, ANOVA) and correlational analyses and stepwise linear regression were conducted to examine the significance of various factors and their relationship to Pre-NAPLEX score.Results: 168 students were included, with the majority being female (60.7%) and White (72%). Mean Pre-NAPLEX score was 68.95 ± 14.5. Non-Hispanic White students had significantly higher Pre-NAPLEX scores compared to minority students (p<0.001). Pre-NAPLEX score was correlated (p<0.001) to race/ethnicity (r=-0.341), PCAT score (r=0.272), and pharmacy school GPA (r=0.346). The regression model (adjusted R²=0.216; p<0.001) included pharmacy school GPA, academic probation, academic remediation, and PCAT composite.Conclusion: This study highlighted that select demographic, prepharmacy, and pharmacy school factors were associated with Pre-NAPLEX outcomes. Such factors may assist colleges/schools of pharmacy in identifying students who may be at risk for poorer NAPLEX performance and may need greater preparation.     

Stakeholder Perspectives on Outcome Expectations of Pharmacy Graduates From a Caribbean School of Pharmacy

Objectives. To explore stakeholders’ views regarding the performance of pharmacy graduates upon entering the workforce and to identify curricular deficiencies and possible solutions.Methods. Practicing pharmacists, many of whom were members of government and pharmacy organizations, were asked to complete a 40-item questionnaire to determine their views regarding the educational outcomes of pharmacy graduates from a Caribbean pharmacy school. In addition, the stakeholders participated in focus group discussions to capture feedback not gathered on the questionnaire.Results. Ten stakeholders completed the questionnaire and 11 participated in the focus group discussions. Stakeholders rated graduates higher than average in 13 educational outcomes: application of knowledge and skills, patient care, communication skills, confidentiality, ethics, problem solving, and innovation. However, responses to open-ended questions and comments made during the focus group discussions identified deficiencies, which included a lack of clinical faculty members and qualified preceptors to teach pharmacy students, and the need to revise basic sciences courses. Conclusion. Feedback from key stakeholders suggests that the quality of pharmacy graduates is above average for the most part; however, additional work is needed to address the deficiencies identified.     

Engaging Pharmacy Students with Diverse Patient Populations to Improve Cultural Competence

Objective

To develop and implement learning activities within an advanced pharmacy practice experience (APPE) to improve students'' cultural competence.

Design

During their AAPE at Community Access Pharmacy, students participated in topic discussions with faculty members, used interpreters to interview Hispanic patients, visited a Mexican grocery store, evaluated nontraditional medicine practices in the Hispanic community, and served as part of a patient care team at a homeless shelter and an HIV/AIDS clinic. The students reflected on these activities in daily logs and completed a final evaluation of their experiences.

Assessment

Forty-three students completed the rotation from 2004-2007. Almost all learned something new about counseling patients with cultural/language differences (98%) and became more aware of financial barriers to health care and potential solutions to overcome them (93%). Students'' reflections were positive and showed progression toward cultural competence.

Conclusion

A culturally diverse patient population provided opportunities for APPE students to develop the skills necessary to become culturally competent pharmacists. Future work should focus on potential evaluation tools to assess curricular cultural competency outcomes in APPE''s.     

Using Grey Literature to Prepare Pharmacy Students for an Evolving Healthcare Delivery System

Objectives. To assess the impact of using “grey literature” (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students’ perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information.Design. A reading from the grey literature was identified and assigned to the students for each topic in the course.Assessment. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students’ knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (p<0.05).Conclusions. Assignment of grey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.     

High-fidelity patient simulation series to supplement introductory pharmacy practice experiences

Objective

To introduce a high-fidelity simulation series into a 5-year doctor of pharmacy (PharmD) curriculum to demonstrate a hybrid model for introductory pharmacy practice experience (IPPE) delivery.

Design

Fourth-year pharmacy students at a satellite campus participated in a 6-week high-fidelity patient simulation series in which small groups of students worked with members of a patient care team to care for patients in the following scenarios: asthma exacerbation, acute decompensated heart failure, and infective endocarditis with a subsequent anaphylactic reaction to the antibiotic. Fourth-year pharmacy students at the main campus who did not participate in the simulation served as a comparator group.

Assessment

Students'' scores on a knowledge-based post-simulation quiz were significantly higher than scores on the presimulation quiz (p < 0.05). Knowledge retention was significantly higher among the simulation participants than students in the comparator group (p = 0.004). The majority (76%) of students felt more confident “making clinical recommendations to a healthcare provider” after completing the simulation series (p = 0.01).

Conclusion

High-fidelity patient simulation is an effective active-learning strategy to augment IPPEs that allows students to apply clinical skills in a realistic but low-risk patient care setting.     

The Impact of an Early Clinical Experience on Pharmacy Student Learning About Ambulatory Care Practice

Objective. To determine whether student confidence in their knowledge of ambulatory care pharmacy and ability to contribute to patient care in this setting increased after participating in an ambulatory care introductory pharmacy practice experience (IPPE), and whether it changed student interest in pursuing a career in ambulatory care pharmacy.Methods. Second-year pharmacy students (n=86) completed a required ambulatory care experience which included four hours of didactic work and 13.5 hours of clinic experience with an ambulatory care pharmacist. Before and after the experience, students completed an eight-question survey in which they rated their confidence in their knowledge of ambulatory care practice and in providing patient care in this setting, as well as their interest in a career in ambulatory care. A five-point Likert scale was used to assess student confidence (1=not at all confident, 5=very confident) and interest in ambulatory care (1=not at all interested, 5=extremely interested). The Wilcoxon signed rank test was used to compare pre-post survey responses.Results. Eighty-five pharmacy students completed both the pre- and post-survey. Median scores on the post-intervention test increased from 3 to 4 in seven of the domains assessed. Student interest in a career in ambulatory care remained unchanged.Conclusion. An ambulatory care IPPE increased student confidence in their understanding of ambulatory care pharmacy practice and caring for patients in this setting.     

Student Pharmacists’ Perceptions of Male Faculty Teaching Female-Specific Sex and Gender Health Topics

Objective. The primary objective of this study was to assess perceptions of second year pharmacy students regarding predominantly male faculty instructing them regarding female physiology, pathophysiology, and gender health topics.Methods. A cross-sectional survey was administered to second year pharmacy students at a small, private, non-profit college of pharmacy at the conclusion of their women’s health integrated pharmacotherapeutics course. Students were asked to rate their level of agreement with various statements using a five-point Likert scale on which 1=strongly disagree and 5=strongly agree.Results. Forty-seven students completed the survey (26 female and 21 male). The students indicated high agreement with statement: “Prior to the lectures, I felt comfortable having male faculty teach the majority of women''s health topics” (median=5, IQR=4-5). Students also indicated neutrality towards the statement: “The gender of the instructor is of importance in the didactic instruction of women’s health topics” (median=3, IQR=1-3). No significant differences were observed regarding student gender.Conclusion. Pharmacy students were generally amenable to male faculty teaching female-specific sex and gender health topics. This pattern was observed in both male and female students.     

Online Virtual-Patient Cases Versus Traditional Problem-Based Learning in Advanced Pharmacy Practice Experiences

Objective. To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students.Design. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed.Evaluation. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001).Conclusion. The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.