An Elective Course on Postgraduate Residency Training

Objective. To develop, implement, and assess the impact of an elective course for pharmacy students on postgraduate pharmacy residency training.Design. An elective course on residency training was developed using short lectures, group discussions, and active-learning strategies, such as small-group exercises, mock match, and mock interview.Assessment. Students were asked to self-assess their understanding and abilities related to residency training at the beginning and end of the semester based on course objectives. The median post-semester responses increased for all objectives compared to baseline (p<0.05).Conclusion. A residency elective using a variety of teaching methods increased student knowledge and confidence in their skills regarding residency training.     

Development of a Pharmacy Residency Research Certificate Program

Background: Similar to teaching certificate programs, which have been incorporated in many pharmacy residencies to improve teaching skills, resident research certificate programs could provide residents with more exposure to biostatistics and research design. However, few research certificate programs have been described. Objective: To assess the impact of a research certificate program on residents’ attitude toward, confidence in, and knowledge of research. Methods: A resident research certificate program was created for the 2018-2019 residency class at our institution, which included 33 pharmacy residents (15 postgraduate year-1 [PGY1] and 18 PGY2 residents). The program consisted of 7 sessions aimed at providing residents with research training. To earn a certificate, participants were required to attend 6 or more sessions and achieve a score greater than or equal to 70% on a postassessment. An optional questionnaire assessing attitude, confidence, and knowledge was also administered at baseline and following the certificate program. Results: Of the 33 residents participating in the research certificate program, 21 (9 PGY1 and 12 PGY2) residents completed both the baseline and follow-up questionnaire and were included in the analysis. All items assessing attitude and 3 of 6 items assessing confidence improved significantly following the certificate program when compared to baseline (P < .05 for all). Median knowledge scores were no different on the baseline versus follow-up questionnaire (P = .54). Conclusions: After completing a research certificate program, resident knowledge scores did not differ from baseline, but attitudes toward research and confidence appeared to improve. Research certificate programs could be an avenue for providing pharmacy residents with increased exposure to and comfort with biostatistics and research design.     

The influence of an elective introductory clinical research course on pharmacy student interest in pursuing research-based careers

Objective

To assess the impact of an elective clinical research course on second- and third-year pharmacy students'' knowledge of clinical research methods, training programs, career options, and interest in pursuing postgraduate training.

Design

A 2-credit hour elective course in clinical research was designed that included lectures, discussions, workshops, and in-class presentations related to study design and implementation, protocol synthesis, research evaluation, ethical and legal considerations, data analysis, and professional opportunities involving clinical research. Learner knowledge of these topics was assessed using several methods, including 3 assignments related to research protocol, ethical documentation, and presentation.

Assessment

A survey instrument designed to evaluate the effect the course had on pharmacy students'' knowledge of clinical research methods and interest in pursuing postgraduate training in clinical research was administered. Students who completed the elective had a greater level of familiarity with research-related topics, training options, and career opportunities (p < 0.05) and a greater interest in pursuing a career in clinical research (p < 0.05) than did students in a matched control group.

Conclusion

Taking a 2-credit hour elective course in clinical research increased pharmacy students'' interest in pursuing a career in clinical research.     

An elective course in information mastery

Objective

To design and implement an elective course in information mastery and assess its impact on students'' ability to identify information needs and formulate clinically relevant, evidence-based answers.

Design

A semester-long (15-week) elective course was offered to third-year (P3) doctor of pharmacy (PharmD) students that outlined the necessary knowledge and skills for using information mastery in evidence-based practice.

Assessment

Results of a pre- and postcourse survey instrument demonstrated an increase in students'' knowledge of information mastery and confidence in and familiarity with the practice of evidence-based medicine in pharmacy. Students who had completed the elective were able to provide higher quality search strategies and evidence-based answers to a clinical question than other P3 students, and P4 students who did not participate in the elective.

Conclusion

An elective course in information mastery improved students'' knowledge and understanding of information mastery as it pertains to practicing evidence-based medicine.     

A Solid Organ Transplant Elective Course for Pharmacy Students

Objective. To develop and implement a solid organ transplant elective course for second- and third-year pharmacy students, and assess its impact on students’ knowledge in the management of medications, adverse effects, and complications in organ transplantation patients.Design. Topics related to the care of solid organ transplant patients were covered in depth. Students were required to complete a group presentation focusing on common infectious disease topics encountered in solid organ transplant patients.Assessment. Students’ solid organ transplantation knowledge was assessed using examinations quizzes, a group presentation, and class participation. With an average class grade of 87%, students demonstrated knowledge of the course material. Most students felt that their knowledge increased significantly with regard to the course objectives.Conclusion. Students who completed the elective course significantly improved their confidence and knowledge regarding solid organ transplantation, felt more prepared than their peers who did not complete the course, and became open to exploring careers or residencies in this area.     

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.     

Promoting residencies to pharmacy students

A program for promoting pharmacy residency training to pharmacy students at the University of the Pacific (UOP) is described. A residency club was started in 1982 to increase UOP students' interest in residency training and to provide them with relevant information. Some students needed to be convinced that residencies were primarily educational rather than staffing experiences. Students were made aware of pharmacists' practice in specialty areas, for which residency training is needed, and were taught how to prepare themselves for selection for residencies. The club was formed to encourage mutual support among the students, which would be less likely to occur if residencies were promoted only through work with individual students. Club meetings provide information about available residencies, the application process, and the value of residency training to a career in pharmacy. Students are taught how to prepare curricula vitae, how to interview, and how to select programs to which to apply. Applications for residencies increased. Although the rate of acceptance was low at first, it was expected to increase as more UOP students demonstrated their interest in and qualification for residency training. The promotion of residencies as part of a balanced career planning and placement program for pharmacy students is encouraged.     

An Academician Preparation Program for Pharmacy Residents

Objective. To assess the evolution and effectiveness of the Academician Preparation Program to provide knowledge and skills in teaching and evaluating to pharmacy residents, as well as generate interest in academic careers.Design. Participants attended seminars and participated in additional teaching, precepting, facilitating, and evaluating activities. Residents maintained a teaching portfolio and met with a faculty mentor quarterly to review their progress toward completion of the requirements for the Academician Preparation Program certificate.Assessment. Since the program was first offered in 2005, it has expanded to 7 sites throughout the state. As of June 2012, 155 residents had completed the program and 20 (13%) had accepted full-time academic positions. Many others were serving as adjunct faculty members or preceptors. The majority of those enrolled in pharmacy residencies completed the program.Conclusion. An optional, organized academic preparation program was of interest to residents, fostered academic careers, and helped meet residency accreditation guidelines.     

National Survey Regarding the Importance of Leadership in PGY1 Pharmacy Practice Residency Training

Background:

Leadership is considered a professional obligation for all pharmacists. It is important to integrate leadership training in residency programs to meet the leadership needs and requirements of the profession.

Objective:

To evaluate the importance of leadership development during postgraduate year 1 (PGY1) pharmacy practice residency training as perceived by new practitioners.

Methods:

A 15-question online survey was distributed to residency-trained new practitioners to assess (1) amount of time dedicated to leadership training during residency training, (2) different leadership tools utilized, (3) residents’ participation in various committees or councils, (4) perceived benefit of increased leadership training, (5) importance of having a mentor, (6) understanding of the residency organization’s strategic objectives, (7) discussion of Pharmacy Practice Model Initiative (PPMI) during residency training, and (8) adequacy of leadership training in preparation to become a pharmacy practice leader.

Results:

Although the majority of resident respondents had less than 20% of their residency devoted to leadership, nearly all survey participants acknowledged that leadership is an important component of PGY1 residency training. Residents agreed that their residency experience would have benefited from increased leadership opportunities. Most residents were knowledgeable about their organization’s strategic objectives but did not have a full understanding of pharmacy initiatives such as the PPMI.

Conclusion:

Feedback from residents indicates that an optimal dedication to leadership training would range between 20% and 30% of the residency year. Increased focus on PPMI, mentorship, and expanded use of leadership tools can serve as a way to help meet the future leadership needs of the pharmacy profession and help to better prepare residents to become pharmacy practice leaders.     

Student and Faculty Observations and Perceptions of Professionalism in Online Domain Scenarios

Objectives. To relate common online scenarios to tenets of professionalism, assess frequency of observed scenarios in 4 online domains, and compare second-year (P2) pharmacy students, fourth-year (P4) pharmacy students’, and faculty members’ perceptions of professionalism.Methods. A 63-item survey instrument consisting of scenarios of behavior in online domains was developed. Using a Likert scale, participants reported whether they had observed each scenario and whether each scenario was professional.Results. Of the 296 participants who completed the survey instrument, 53% were P2 students, 49% were P4 students, and 68% were faculty members. Most of the observed scenario responses were for social networking sites. There were statistical differences among the 3 cohorts’ perception over whether a scenario demonstrated professional behavior in 6 of the 10 most frequently observed scenarios, and 4 out of 6 of these scenarios were in the social networking domain.Conclusion. Second-year pharmacy students and faculty members were more in alignment with their perception of professionalism then P4 students, suggesting that P4 students may be more complacent in their perception of professionalism.     

The Effect of Transitioning from Residency to Pharmacy Practice on Learning Style

Objective: To describe the evolution of learning styles of pharmacy residents as they transition from residency to practice.Methods: Cross-sectional survey and interview-based study. A complete provincial cohort of former pharmacy residents (N=28), who had their learning styles characterized with the Pharmacists’ Inventory of Learning Styles (PILS) at the beginning of their residency and, 1 year post-residency, were invited to repeat the PILS. Interviews were administered to consenting participants to gain additional insight.Results: Twenty-seven of the former residents (96%) completed the PILS survey and 16 (59%) completed the post-PILS interview. Thirteen (48%) changed their dominant learning style and 20 (74%) changed their secondary learning style. Six (22%) participants did not change either learning style. The overall proportion of dominant assimilators (59%) and convergers (26%) remained similar to baseline (52% and 26%, respectively), meaning participants had adopted and abandoned different learning style in similar numbers. Change in learning style was associated with being a preceptor (p<0.05), as 58% of the 12 former residents who became preceptors stated in the interview they had adjusted their teaching practices based on knowledge of their learning styles gained during their residency.Conclusion: Changing learning style is common for former residents after 1 year in postresidency practice. There is no overall direction to the change; former residents transition into and out of various learning styles with similar frequency and retain preferences for passive/abstract learning approaches over active/concrete ones. The early-career lability in learning style the study demonstrated may reveal an opportunity to guide pharmacists toward more active learning preferences through residency curricula, preceptorship, and mentorship.     

A needs assessment study of hospital pharmacy residency preceptors

Background:

Canadian pharmacy residency programs rely on preceptors to support the growing demand of graduates wishing to pursue hospital residencies. Understanding the educational needs of these preceptors is important to ensure that they are well prepared to deliver successful programs.

Objective:

To determine what new and experienced residency preceptors self-identify as learning needs in order to become more effective preceptors for pharmacy residents.

Methods:

A needs assessment of preceptors from the 31 accredited Canadian general hospital pharmacy residency programs was conducted. The study had 4 key components: interviews and focus group discussions with key informants, a pilot study, an online survey, and member checking (seeking clarification and further explanation from study participants). The residency coordinators and a convenience sample of 5 preceptors from each program were invited to participate in the survey component.

Results:

Of a possible 186 participants, 132 (71%) responded to the survey. Of these, 128 (97%) were confident that they met the 2010 standards of the Canadian Hospital Pharmacy Residency Board (CHPRB). Preceptors ranked communication skills, giving effective feedback, and clinical knowledge as the most important elements of being an effective preceptor. Managing workload, performing evaluations, and dealing with difficult residents were commonly reported challenges. Preceptors expressed a preference for interactive workshops and mentorship programs with experienced colleagues when first becoming preceptors, followed by 1-day training sessions or online learning modules every other year for ongoing educational support. The most beneficial support topics selected were providing constructive feedback, practical assessment strategies, small-group teaching strategies, effective communication skills, and setting goals and objectives.

Conclusions:

This study identified several learning needs of hospital residency preceptors and showed that preceptors would appreciate educational support. Utilization of these results by residency program administrators, the CHPRB, and faculties of pharmacy could be beneficial for residency programs across Canada.     

An Anticoagulation Therapy Elective for Third-Year Pharmacy Students

Objective

To develop an anticoagulation elective course for third-year pharmacy students to enhance their knowledge and skills for providing anticoagulation services.

Design

Content developed for the course focused on standards of care, evaluation of primary literature, clinical application, billing and regulatory issues, written and verbal communication, and patient education. Teaching methods included lectures, discussions, demonstrations, and self-directed learning.

Assessment

Assessment methods included multiple-choice examinations, evaluation of patient cases, student presentations, and a practical examination. Students demonstrated competencies in multiple areas and rated the course favorably. Students who completed the elective reported being more prepared for anticoagulation activities than those who did not. Confidence levels regarding participation in anticoagulation services postgraduation were similar.

Conclusion

The elective provided valuable experience in anticoagulation therapy and increased students'' perception of their preparedness related to dealing with anticoagulation issues while on advanced pharmacy practice experiences (APPEs). More exposure to management topics and the logistics of initiating anticoagulation services should be incorporated.     

Addressing Burnout in Pharmacy Residency Programs

Addressing health care provider burnout has become a top priority for many health care systems. Unfortunately, a paucity of literature is available on preventing and managing burnout in pharmacy residents despite an increase in articles on the prevalence of pharmacy burnout. This limits the ability of pharmacy managers to understand and address burnout in this high-risk population. Until further investigation into the most beneficial, evidence-based strategies for managing burnout in this population is conducted, this commentary offers strategies to address and mitigate burnout in pharmacy residency training programs based on the available interdisciplinary literature.The authors have first-hand experience with burnout and aim to begin a paradigm shift to emphasize well-being and reshape the culture of postgraduate training. Dr. Potter has dedicated time to developing programming and founded an interprofessional well-being organization called Mindfulness in Newly Developing Students of Healthcare (MINDS) for health care students and providing recommendations for pharmacy residency programs. As a program director, Dr. Cadiz focuses on the development of realistic and effective strategies to eliminate burnout and foster well-being in her pharmacy residency training program.     

A diabetes self-management education class taught by pharmacy students

Objective. To assess the impact of pharmacy students teaching a diabetes self-management education (DSME) class on their competence and confidence in providing diabetes education.Design. Pharmacy students enrolled in a service-learning elective first observed pharmacy faculty members teaching a DSME class and then 4 weeks later organized and taught a DSME class to a different group of patients at a student-run free medical clinic.Assessment. Student performance as assessed by faculty members using a rubric was above average, with a mean score of 3.3 on a 4.0 scale. Overall, student confidence after teaching the group DSME class was significantly higher than before teaching the class.Conclusion. Organizing and teaching a DSME class improved third-year pharmacy students’ confidence and diabetes knowledge and skills, as well as provided a valuable service to patients at a free medical clinic.     

An Oncology Pharmacy Practice Elective Course for Third-Year Pharmacy Students

Objective. To develop and implement a 1-credit-hour oncology pharmacy practice elective course for third-year pharmacy students and assess its impact on examination scores in a required pharmacotherapeutics course.Design. Major topics were identified to focus on therapeutic management and supportive care of the oncology patient. Psychosocial topics were incorporated to help pharmacy students better relate to oncology patients.Assessment. Learning was assessed by means of 2 computer-based examinations, weekly reflection posts, and a completed oncology service-learning project and reflection paper. Students enrolled in the course achieved higher pharmacotherapeutics oncology section examination scores than students who had not taken the course. Also, this course increased students’ interest in oncology pharmacy.Conclusion. The oncology pharmacy elective course has received overwhelmingly positive feedback from students and student enrollment continues to grow. We will continue to offer this course to future practitioners.     

Role of Pharmacy Residency Training in Career Planning: A Student’s Perspective

Pharmacy students typically become more focused on career planning and assessment in the final year of their PharmD training. Weighing career options in the advanced pharmacy practice experience year can be both exciting and stressful. The goal of this article is to provide a primer on how pharmacy students can assess how a residency can fit into career planning. This article will describe the various career paths available to graduating students, highlight ways in which a residency can complement career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. Most career paths require some additional training, and a residency provides appropriate experience very quickly compared to on-the-job training. Alternative plans to residency training must also be considered, as there are not enough residency positions for candidates. Directors of pharmacy must consider several factors when giving career advice on pharmacy residency training to pharmacy students; they should provide the students with an honest assessment of their work skills and their abilities to successfully complete a residency. This assessment will help the students to set a plan for improvement and give them a better chance at being matched to a pharmacy residency.Students typically become more focused on career planning and assessment in the final year of their PharmD training. That year is reserved for advanced pharmacy practice experiences (APPEs), in which students rotate for a minimum of 1,500 hours at 9 often unique practice sites under the guidance of a preceptor and additional staff. Throughout this year, the students are exposed to many different aspects of pharmacy including community, ambulatory care, hospital/health system, inpatient/acute care, and elective rotations. The exposure to the different pharmacy practice settings often causes the students to reevaluate or reconsider their chosen career path. In addition, family members, preceptors, friends, and colleagues often inquire about the students’ job plans, further education, or training. This time of exploring career options can be exciting, as well as stressful, for students on the verge of graduation. Often the decisions students make during the final year of the PharmD program are binding for many years following graduation, possibly even limiting their future career goals. Some students may make decisions based on the necessity to pay off a heavy school loan debt or the desire to work in a particular geographic area due to family concerns.Students often request career advice from pharmacy directors, who are acting as either their APPE preceptor or in connection with their employment. The pharmacy profession and job market have changed drastically in the last 10 to 15 years, making a student’s viewpoint on career planning and assessment very different from that of a pharmacy director who has been in the profession for many years. Acting as a mentor, the pharmacy director can help the students explore the following questions: How much school debt do I have? What personal concerns will influence my career plan? What aspects of pharmacy do I enjoy? Where do I see myself in 20 years? How is the profession of pharmacy changing? Should I pursue a residency?To the last question, and as part of the career planning and assessment process, students need to decide whether to pursue a residency or an entry-level pharmacist position upon graduation. Postgraduate residencies are becoming an increasingly popular option as the competition in the job market increases; the additional years of training may provide better preparation for a specific position.Despite the increase in students pursuing residency training, most PharmD students have chosen to work in community practice upon graduation. These practice areas do not require the completion of postgraduate training. According to the 2014 Pharmacy Student Graduating Survey conducted by the American Association of Colleges of Pharmacy (AACP), 5,827 of 9,527 (61%) responding students indicated that they planned to work in a chain community pharmacy upon graduation.¹ For those students entering hospital pharmacy, 3,147 of 9,527 (33%) responding students planned to pursue a staff position. There were 2,461 (25%) responding students who had plans to pursue a pharmacy residency program upon graduation.¹Residency training provides knowledge and experience at a faster pace and in a more systematic manner than can be obtained in an entry-level pharmacist position. Residency training also provides the opportunity for interprofessional collaboration, instills personal and professional confidence, provides avenues in which to advocate for the profession of pharmacy, and broadens clinical decision-making abilities. With the profession of pharmacy becoming an increasingly clinically focused profession, residency training enables a pharmacist to practice at the “top of their license” and provide exceptional patient care. It can also enable a pharmacist to become a sought after candidate by employers.The goal of this article is to provide a primer on how pharmacy students can evaluate the role of a pharmacy residency in their career planning. The article will describe the various career paths available to graduating students, highlight ways in which a residency can compliment career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. The information in this article will help students in deciding whether or not to pursue postgraduate education. In addition, this article may provide a helpful student perspective for pharmacy directors as they serve as mentors for students and young pharmacists.     

A Week-Long Diabetes Simulation for Pharmacy Students

Objective

To assess students'' attitudes and confidence about type 2 diabetes mellitus and diabetes self-management education before and after participation in Living With Diabetes Week simulation.

Design

Third-year pharmacy students took part in diabetes lectures, interactive laboratory sessions, and a week-long simulation of life as a patient with diabetes in the Clinical Assessment course. Pre-/postintervention survey instruments and experimental and control group comparisons were completed assessing attitudes and confidence relating to knowledge about diabetes.

Assessment

The understanding that diabetes has a psychosocial impact, patient autonomy is necessary, and the seriousness of the disease increased. Students'' confidence in their diabetes self-management education skills also increased.

Conclusion

The Living With Diabetes Week simulation changed pharmacy students'' attitudes toward patients with diabetes and increased confidence in diabetes education skills.     

Characteristics That Define a Successful Pharmacy Resident as Perceived by Residency Programs

Purpose:

To identify the subjective and objective characteristics that pharmacy residency programs use to define a successful resident and to determine what percentage of their 2009-2010 residency class they felt were successful.

Methods:

An electronic survey was sent via e-mail to all residency program directors (RPDs) of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residency programs in the United States. A 3-part survey instrument was developed following validation of questions for clarity and reliability using a pilot survey. Respondents were asked to rank the importance of 20 subjective characteristics for a resident to possess in order to be considered successful and the importance of different objective measurements of accomplishment in the definition of a “successful” resident using a Likert scale where 1 = not at all important, 2 = some importance, 3 = very important, and 4 = critical.

Results:

Of the 1,081 surveys sent to RPDs, 473 respondents answered at least one question, yielding a response rate of 43.8%. The most critically important subjective characteristics in defining a successful resident as ranked among PGY1 residency programs are dependability, professionalism, self-motivation/initiative, and work ethic. PGY2 programs ranked clinical knowledge and skills, critical thinking, and dependability as the most important. The most critically important objective characteristic in defining a successful resident as ranked among both PGY1 and PGY2 programs is obtaining a clinical position. The majority of PGY1 and PGY2 respondents felt that 76% to 100% of their 2009-2010 residency class was successful based on the characteristics they rated most important.

Conclusion:

Identification of the characteristics that pharmacy residency programs use to define success will allow them to identify predictors of success and optimal methods of selecting residents who possess these characteristics.