Practice Settings, Job Responsibilities, and Job Satisfaction of Nontraditional PharmD and BS Pharmacy Graduates

Objectives

To assess differences in the practice of pharmacy and in job satisfaction between graduates of a nontraditional doctor of pharmacy (PharmD) program and a bachelor of science (BS) in pharmacy program.

Methods

Two separate survey instruments were mailed to 293 PharmD graduates and 293 BS graduates.

Results

Two hundred fourteen (73.0%) of the 293 nontraditional PharmD graduates and 189 (64.5%) of the 293 BS graduates completed the survey instruments. Nontraditional PharmD graduates expressed greater satisfaction, both in their current position and with pharmacy as a career, compared to BS graduates. Nontraditional PharmD graduates were more likely than BS graduates to practice in a hospital and have more clinical responsibilities.

Conclusions

Nontraditional PharmD graduates are more likely to have greater satisfaction with their job and with pharmacy as a career compared to BS-trained pharmacists.     

Assessment of factors influencing community pharmacy residents' pursuit of academic positions

Objectives

To determine the percentage of residents accepting faculty positions following completion of a community pharmacy residency program (CPRP) and identify influences to pursue/not pursue an academic career.

Methods

CPRP directors and preceptors across the United States were contacted and 53 community pharmacy residents were identified. The residents were invited to participate in surveys at the beginning and end of the 2005-2006 residency year.

Results

Forty-five residents (85%) completed the preliminary survey instrument and 40 (75%) completed the follow-up survey instrument. Of these, 36 completed both survey instruments. Initially, 28 (62%) respondents indicated a faculty position as one of their potential job preferences. After completing their residency program, 3 (8%) residents accepted faculty positions; and 3 (8%) others were awaiting offers at follow-up. Reasons for accepting a faculty position were positive teaching experiences and the influence of a mentor or preceptor. Reasons for not pursuing a faculty position included lack of interest, geographic location, disliked teaching experiences, lack of preparedness, and non-competitive salary.

Conclusion

Many community pharmacy residents consider faculty positions early in their residency but few pursue faculty positions. CPRPs and colleges of pharmacy should work together to enhance residents'' experiences to foster interest in academia.     

Satisfaction Survey for a Medication Management Program: Satisfaction Guaranteed?

Background:

Providing clinical pharmacy services to patients in their homes after discharge from hospital has been reported to reduce health care costs and improve outcomes. The Medication Management Program of the Fraser Health Authority involves pharmacists making home visits to provide clinical pharmacy services to elderly patients who have recently been discharged from hospital and others considered to be at high risk for adverse drug events. Although clinical and economic outcomes of this program have been evaluated, humanistic outcomes such as satisfaction have not been assessed. Moreover, very little evaluation of patient satisfaction with home pharmacy services has been reported in the literature.

Objective:

To evaluate patient satisfaction with the Medication Management Program.

Methods:

A telephone survey instrument, consisting of 7 Likert-scale items and 2 open-ended questions, was developed and administered to patients who received a home pharmacist visit between September 1 and November 23, 2011. In addition to the survey responses, demographic and clinical data for both respondents and nonrespondents were collected.

Results:

Of the 175 patients invited to participate in the survey, 103 (58.9%) agreed to participate. The majority of respondents agreed or strongly agreed with all of the survey items, indicating satisfaction with the program. For example, 97 (94%) agreed or strongly agreed that they would recommend the pharmacist home visit program continue to be available, and all 103 (100%) agreed or strongly agreed that they were satisfied with the pharmacist home visit. Respondents provided some suggestions for program improvement.

Conclusions:

The survey findings demonstrate that patients were satisfied with the home clinical pharmacy services offered through the Fraser Health Medication Management Program.     

Academic pharmacy administrators' perceptions of core requirements for entry into professional pharmacy programs

Objectives

To determine which basic and social science courses academic pharmacy administrators believe should be required for entry into the professional pharmacy program and what they believe should be the required length of preprofessional study.

Methods

An online survey was sent to deans of all colleges and schools of pharmacy in the United States. Survey respondents were asked to indicate their level of agreement as to whether the basic and social science courses listed in the survey instrument should be required for admission to the professional program. The survey instrument also included queries regarding the optimal length of preprofessional study, whether professional assessment testing should be part of admission requirements, and the respondents'' demographic information.

Results

The majority of respondents strongly agreed that the fundamental coursework in the basic sciences (general biology, general chemistry, organic chemistry) and English composition should be required for entrance into the professional program. Most respondents also agreed that public speaking, ethics, and advanced basic science and math courses (physiology, biochemistry, calculus, statistics) should be completed prior to entering the professional program. The preprofessional requirements that respondents suggested were not necessary included many of the social science courses. Respondents were evenly divided over the ideal length for preprofessional pharmacy education programs.

Conclusions

Although requirements for preprofessional admission have been changing, there is no consistent agreement on the content or length of the preprofessional program.     

Association Between Increased Number of US Pharmacy Graduates and Pharmacist Counts by State from 2000-2009

Objective

To determine whether growth in the number of pharmacy graduates and newly accredited schools from 2000 to 2009 were larger in states with fewer pharmacists per population age ≥ 65 years.

Methods

States were aggregated into quartiles based on rank-ordered ratios of in-state pharmacists per 100,000 population aged ≥ 65 years. Quartiles were then compared with respect to the number of new graduates.

Results

The mean cumulative number of graduates was highest in the first quartile of states (those with the greatest need for pharmacists) and lowest in the fourth quartile of states. States with the greatest need for pharmacists had the lowest positive growth in number of pharmacists per population ≥ 65 years. The majority of new schools in 2009 were located in states with relatively low numbers of pharmacists.

Conclusion

The growth in new pharmacy graduates created by expansion in schools as well as in graduates per school helped states meet demand between 2000 and 2009. However, tremendous variation remains in the number of graduates as well as the number of pharmacists across states. The quartile framework is useful for assessing the number of new pharmacy graduates based on pharmacists per population ratios. Based on current dynamics in the supply and demand of pharmacists, frequent monitoring is recommended.     

Economic Impact of Pharmacy Graduates on a Regional Economy

Objectives

To analyze the impact of recent pharmacy graduates on a local economy.

Methods

Input-output analysis was applied to data from Spokane County, Washington, in 2006 and the findings were reviewed and conclusions were drawn.

Results

The local college of pharmacy added nearly $1 million (in 2006) directly to the local economy. New pharmacists added nearly $400,000 in direct value. However, because the graduates alleviated a shortage of pharmacists in the area, thereby avoiding both the tangible and intangible (eg, human health) economic costs of a continued shortage, the true economic impact may have been even greater.

Conclusions

Doctor of pharmacy (PharmD) graduates entering the workforce add substantial value, both to the local retail pharmacy industry specifically and the local economy in general. Thus, the economic impact of the pharmacy practice program training these students is also substantial.     

Development needs of volunteer pharmacy practice preceptors

Objective

To determine the training needs and interests of volunteer pharmacy preceptors.

Methods

Volunteer preceptors (n=576) were surveyed on various aspects of precepting and their needs related to additional training.

Results

Two hundred thirty-six preceptors (40.9%) responded. Preceptors were less confident about enforcing attendance policies, identifying and managing unmotivated or failing students, identifying dishonesty or plagiarism, and handling conflict. While only 29.5% of respondents agreed that having an APPE student decreased their overall workload, approximately half (48.1%) indicated that student pharmacists helped them complete their daily tasks and 67.8% agreed that APPE students extended patient care. Respondents who had received training were significantly more confident than preceptors who had not received training in their abilities to clarify expectations, evaluate a student''s knowledge, and foster skills related to critical thinking and problem solving.

Conclusions

Training programs for pharmacy preceptors are effective; however, important areas in which additional training is needed or desired were identified among both new and experienced preceptors.     

Nepalese Pharmacy Students' Perceptions Regarding Mental Disorders and Pharmacy Education

Objective

To determine Nepalese pharmacy students'' perceptions of whether mental disorders impact performance in pharmacy school.

Method

All first- and third-year undergraduate pharmacy students (n=226) in Nepal were invited to complete a modified version of the Mental Illness Performance Scale.

Results

Among the 200 respondents (response rate 88.5%), 14% reported that they had a mental disorder. The majority (92%) of third-year students agreed or strongly agreed that depression would interfere with a student''s academic performance. Almost half of first-year students agreed or strongly agreed that alcohol or drug abuse would be grounds for both rejecting an applicant from pharmacy school (49%) and dismissal of a student from pharmacy school (46%).

Conclusions

Students perceived a high level of academic impairment associated with mental disorders, but the majority did not perceive that mental disorders were grounds for dismissal from or rejection of entry to pharmacy school. Students'' attitudes may discourage them from seeking help or providing mental health support to others.     

Assessment of Pharmacy Student Professionalism Across a Curriculum

Objectives

To evaluate changes in professionalism across the curriculum among pharmacy students in different classes.

Methods

A professionalism instrument was administered early in the first (P1) year, upon completing the introductory pharmacy practice experiences (IPPE) near the end of the second (P2) year, and upon completing the advanced pharmacy practice experiences (APPE) at the end of the fourth (P4) year.

Results

The professionalism scale and its subscales were compared for the 3 time points for the class of 2009. Significant differences were noted in professionalism scores between the P1 and P4 years and for altruism, accountability, and honor/integrity subscale scores for the class of 2009. No significant differences were noted when the scores for 4 P1 classes, and 3 P2 classes were compared.

Conclusion

An increase in professionalism scores and altruism, accountability, and honor/integrity scores was demonstrated, providing evidence that the curricular and co-curricular activities in the school of pharmacy helped develop professionalism in the class of 2009 students.     

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.     

Pharmacogenomics training using an instructional software system

Objectives

To implement an elective course in pharmacogenomics designed to teach pharmacy students about the fundamentals of pharmacogenomics and the anticipated changes it will bring to the profession.

Design

The 8 sessions of the course covered the basics of pharmacogenomics, genomic biotechnology, implementation of pharmacogenetics in pharmacy, information security and privacy, ethical issues related to the use of genomic data, pharmacoepidemiology, and use and promotion of GeneScription, a software program designed to mimic the professional pharmacy environment.

Assessment

Student grades were based on completion of a patient education pamphlet, a 2-page paper on pharmacogenomics, and precourse and postcourse survey instruments. In the postcourse survey, all students strongly agreed that genomic data could be used to determine the optimal dose of a drug and genomic data for metabolizing enzymes could be stored in a safe place. Students also were more willing to submit deoxyribonucleic acid (DNA) data for genetic profiling and better understood how DNA analysis is performed after completing the course.

Conclusions

An elective course in pharmacogenomics equipped pharmacy students with the basic knowledge necessary to make clinical decisions based on pharmacogenomic data and to teach other healthcare professionals and patients about pharmacogenomics. For personalized medicine to become a reality, all pharmacists and pharmacy students must learn this knowledge and these skills.     

Audit of renal drug dosing: comparison of 2 methods and evaluation of pharmacists' knowledge, attitudes, and behaviour

Background:

The renal dosing directive of the Winnipeg Regional Health Authority Pharmacy Program outlines an auditable pharmacy service whereby pharmacists are required to perform documentation (i.e., document their rationale) only if they do not adjust the dose of any medications listed in the directive.

Objective:

To compare the suitability of manual orders (hard copy) and reports from the pharmacy information system (computer-generated) for determining pharmacists’ compliance with the renal dosing directive; to measure compliance with the renal dosing directive; and to determine pharmacists’ opinions about audit programs.

Methods:

A retrospective audit was used to compare 400 manual orders with the corresponding orders in reports from the pharmacy information system, to determine compliance with the renal dosing directive. An e-mail survey was performed to gather pharmacists’ opinions about audit programs.

Results:

Of the 400 orders evaluated, 86 (22%) required consideration of a dose adjustment. Of these, 78 (91%) showed that dosing followed the guidelines for renal dysfunction in standard pharmacy references. Six (7%) of 86 manual orders and 8 (9%) of 86 pharmacy information system orders were not compliant with the renal dosing directive (i.e., no dosage adjustment and no documentation of rationale). Of 77 pharmacists approached, 34 (44%) completed the survey. Most respondents (31/34 [91%]) agreed that auditing is beneficial to patients, and the same number (31/34 [91%]) agreed that auditing provides important information to the pharmacy program. Only 17 (50%) were aware of medications listed in the renal dosing directive, and 14 (41%) felt that they had received sufficient education about pharmacy directives. Most respondents (29/34 [85%]) agreed that audits would reveal areas for improvement, and all (34/34 [100%]) would comply with any changes required to facilitate performance of an audit if such changes did not increase workload.

Conclusions:

Similar results were obtained with the 2 auditing methods used for this study (manual orders and reports from the pharmacy information system). However, pharmacists’ current use of electronic documentation limits the feasibility of pharmacy information system audits. Survey respondents claimed that they were not familiar with the renal dosing directive, but they did agree that auditing clinical services is beneficial.     

Incorporating an Immunization Certificate Program into the Pharmacy Curriculum

Objective

To describe the method of incorporating an immunization certificate training program, such as the American Pharmacists Association''s (APhA) Pharmacy-Based Immunization Delivery into a pharmacy curriculum.

Design

The program was delivered over 3 weeks in the spring semester of the third professional year (P3) as part of a required Pharmacy Care Lab sequence.

Assessment

Student response surveys and faculty input were used to evaluate the placement of the program in the curriculum.

Conclusion

Optional comments yielded more than 44% of students providing positive open-ended feedback regarding the course while almost 10% felt the course should not be mandated in the curriculum.     

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.     

Preceptors, interns, and newly registered pharmacists' perceptions of New Zealand pharmacy graduates' preparedness to practice

Objective

To determine the perceptions of pharmacy interns and newly registered pharmacists and preceptors regarding the preparedness of graduates to enter professional practice.

Methods

A questionnaire was developed from the New Zealand Competence Standards for the Pharmacy Profession (pharmacist level), with additional questions on communication skills included. The instrument contained 16 items and was mailed to preceptors (n=141), interns (n=72), and newly-registered pharmacists (n=101). Microsoft Excel (pivot tables) was used to analyse the quantitative responses. The final question asked respondents to provide free-text comments about the questionnaire, graduates and the program and responses were analyzed quantitatively and thematically.

Results

The response rates were 54.6% (n = 77) for preceptors, 100% (n = 72) for interns and 45.5% (n = 46), for newly registered pharmacists. The majority of responses (87.6%; n=2,562) were in agreement that the degree had prepared graduates for practice. Overall, preceptor perceptions of graduates'' preparedness for practice were less favorable than graduates'' self-perceptions of their preparedness. Four themes were identified from the free-text comments: the need for improved skills, more professional attitudes, better English communication, and additional training in extemporaneous compounding.

Conclusion

Feedback elicited from graduates and preceptors was helpful in identifying the strengths and weaknesses of a new bachelor of pharmacy (BPharm) program and proved useful in both the accreditation and curriculum revision processes.     

Independent Community Pharmacists' Perspectives on Compounding in Contemporary Pharmacy Education

Objectives

To identify compounding practices of independent community pharmacy practitioners in order to make recommendations for the development of curricular objectives for doctor of pharmacy (PharmD) programs.

Methods

Independent community practitioners were asked about compounding regarding their motivations, common activities, educational exposures, and recommendations for PharmD education.

Results

Most respondents (69%) accepted compounding as a component of pharmaceutical care and compounded dermatological preparations for local effects, oral solutions, and suspensions at least once a week. Ninety-five percent were exposed to compounding in required pharmacy school courses and most (98%) who identified compounding as a professional service offered in their pharmacy sought additional postgraduate compounding education. Regardless of the extent of compounding emphasis in the practices surveyed, 84% stated that PharmD curricula should include compounding.

Conclusions

Pharmacy schools should define compounding curricular objectives and develop compounding abilities in a required laboratory course to prepare graduates for pharmaceutical care practice.     

A summer research training program to foster PharmD students' interest in research

Objectives

To establish and assess the effectiveness of a 10-week summer research program on increasing doctor of pharmacy (PharmD) students'' interest in research, particularly as it related to future career choices.

Design

Survey instruments were sent to 25 participants who had completed the research program in the summer of 2004, 2005, or 2006 to assess their satisfaction with the program and its influence on their career choices after graduation.

Assessment

Respondents reported a high degree of satisfaction with the program, indicating that the program allowed them to determine their suitability for a career in research, and 55% reported their intention to pursue additional research training.

Conclusion

A brief introduction to the clinical research environment helped pharmacy students understand the clinical sciences and careers in research. The introduction increased the likelihood of students pursuing a research career path after obtaining their PharmD degree.     

Teaching Electrocardiogram Basics Using Dance and Movement

Objective

To implement and assess an innovative approach to teaching electrocardiogram (ECG) rhythms using dance and movement.

Design

Recognition of ECG rhythms was taught to a group of third-year pharmacy students using dance and movement via collaboration with a dance faculty member. A control group was taught using traditional pharmacy lecture and PowerPoint slides.

Assessment

A pretest and posttest were administered to both groups. There was a trend in test score improvement in the dance and movement group. After the sessions, a focus group was held to assess student perceptions using qualitative methods. Students thought the addition of dance helped them with speed of retention and recognition of ECG rhythms. Some students reported feeling out of their comfort zone.

Conclusion

Interprofessional collaboration between pharmacy and dance faculty members resulted in an innovative teaching methodology for ECG rhythms that increased test scores.     

An elective course on lifestyle modifications in pharmacotherapy

Objectives

Develop and implement a pharmacy course explaining basic lifestyle modification components and assess changes in student knowledge, skills, beliefs, and confidence after completing the course.

Design

A 2-credit hour elective course was offered to pharmacy students in which basic lifestyle modification components were applied to case-based patients with hypertension, dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome in the pharmacy practice setting through comprehensive wellness programs. Knowledge, skills, beliefs, and confidence assessments were embedded into the course.

Assessment

There were significant improvements in students'' skills and confidence, and in most knowledge areas, but not in their beliefs regarding health behaviors.

Conclusion

Implementing an elective course on lifestyle modifications is an effective means of teaching students about wellness and disease prevention.