肿瘤药学科普创作的实践解析

目的：通过具体案例解析,探讨肿瘤药学科普作品创作,提高肿瘤药学科普创作能力。方法：以文章类、表演类、视频类科普作品为例,从作品设计宗旨出发对肿瘤药学科普作品的创意、内容选择、设计、制作过程及注意事项等进行深入剖析,总结肿瘤药学科普创作的特点和难点、作品内容选择的注意事项及创作常用工具和手段。结果：肿瘤药学科普创作中应注意的五大要素是：科学性、思想性、通俗性、艺术性和技巧性。由于肿瘤患者对疾病认识和感受的特殊性,肿瘤药学科普创作最大的难点是在整体氛围上既不能显得沉重,也不能过于轻松。克服该难点可以通过文章总结的"四个避免"和"四个多用"来实现。结论：在肿瘤药学科普创作中充分考虑"五大要素",注意"四个避免"和"四个多用",充分利用现代化工具和手段,有助于创作出内容充实、形式生动、人文色彩浓厚的肿瘤药学科普作品,体现肿瘤专科药师的服务价值和温度。     

An advanced pharmacy practice experience in sports pharmacy

Objective

To establish and evaluate an advanced pharmacy practice experience (APPE) in sports pharmacy.

Design

Students actively participated in a variety of activities for this new 6-week elective APPE, including drug-testing collections, delivering presentations, and providing drug information. Students also learned about assays, compounding, and dispensing medications specifically for athletes, and visited various athletic medical facilities. Student were given written and practical certification examinations for drug-testing collections, and their specimen measurements were compared to those obtained by the testing laboratory for validation; satisfaction surveys were obtained from testing sites; and presentation evaluations were obtained from audience participants.

Assessment

Students were able to accurately measure pH and specific gravity of urine samples and all students passed the certification examination. Students rated the APPE very high. Also, students received high satisfaction ratings on surveys administered to the officials of the schools where they tested and members of the groups to whom they gave presentations.

Conclusion

Students gained experience and insight into the various roles of pharmacists in sports pharmacy and developed confidence in their ability to conduct drug-testing collections.     

Integration of an introductory pharmacy practice experience with an advanced pharmacy practice experience in adult internal medicine

Objective. To describe the development, implementation, and assessment of an internal medicine introductory pharmacy practice experience (IPPE) that was integrated with an existing advanced pharmacy practice experience (APPE) in internal medicine.Design. A structured IPPE was designed for first-, second-, and third-year pharmacy (P1, P2, and P3) students. Activities for the IPPE were based on the established APPE and the individual learner''s educational level.Assessment. Students reported a greater understanding of clinical pharmacists’ roles, increased confidence in their clinical skills, and better preparation for APPEs. Peers viewed the approach as innovative and transferable to other practice settings. Participating faculty members provided a greater number of contact hours compared to traditional one-time site visits.Conclusions. Integrating an IPPE with an existing APPE is an effective and efficient way to provide patient care experiences for students in the P1-P3 years in accordance with accreditation standards.     

A capstone advanced pharmacy practice experience in research

Objective

To implement a required capstone experience in research for pharmacy students, assess course outcomes, and solicit mentors'' and students'' opinions regarding the structure and efficacy of the course.

Design

Fourth-year pharmacy students chose a research project, selected a mentor, and completed a 5-week capstone advanced pharmacy practice experience (APPE), during which they wrote a research paper and presented their research at a poster session.

Assessment

Eighty students completed the capstone experience in 2008-2009 and 56 faculty and non-faculty pharmacists served as mentors. Based on their responses on a course evaluation, the students'' experience with their mentor and course instructor were positive. Thirty-one mentors completed a survey on which they indicated their overall support of the capstone project, but wanted their role to be better defined and felt the students needed to have additional training in statistics, survey question design, and the IRB process before completing the APPE.

Conclusion

The capstone APPE was perceived by students and mentors as a positive learning experience that allowed the student to take information from the curriculum and apply it to a real-world situation. Additional research is needed to determine whether pharmacy students will use the research skills acquired in their future careers.     

循证药学与循证药学临床实践研究

循证药学是遵循最佳科学依据的药学实践过程,而循证药学临床实践的基础是最佳的研究证据、药学临床实践经验和患者的意愿,同时不能脱离具体的临床环境和条件,循证药学临床实践步骤包括提出临床用药问题,检索临床用药问题的最佳研究证据,评价证据的真实性并找出最佳证据,应用当前最佳证据指导临床用药实践和后效评价临床用药实践结果。同时并对药学临床实践进行了示例,还介绍了循证药学的机遇与挑战。     

Clinical pharmacy consultations provided by American and Kenyan pharmacy students during an acute care advanced pharmacy practice experience

Objective

To compare the clinical consultations provided by American and Kenyan pharmacy students in an acute care setting in a developing country.

Methods

The documented pharmacy consultation recommendations made by American and Kenyan pharmacy students during patient care rounds on an advanced pharmacy practice experience at a referral hospital in Kenya were reviewed and classified according to type of intervention and therapeutic area.

Results

The Kenyan students documented more interventions than American students (16.7 vs. 12.0 interventions/day) and provided significantly more consultations regarding human immunodeficiency virus (HIV) and antibiotics. The top area of consultations provided by American students was cardiovascular diseases.

Conclusions

American and Kenyan pharmacy students successfully providing clinical pharmacy consultations in a resource-constrained, acute-care practice setting suggests an important role for pharmacy students in the reconciliation of prescriber orders with medication administration records and in providing drug information.     

药师在老年科临床药学实践的系统评价

目的:探索与评价药师基于老年科病房的临床药学实践的特征、内容及效果。方法:计算机检索PubMed、EMbase、Cochrane图书馆临床对照试验资料库、CHINAL、Clinical Trials、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库,检索时间均从建库至2014年10月31日。由2位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价并交叉核对后,进行系统评价,必要时采用STATA 12.0进行Meta分析。结果:共纳入15篇文献,其中2篇为随机对照研究,7篇为队列研究,6篇为病例系列研究,共涉及2 796名患者。研究结果表明,药师在老年科进行临床实践实施地点、团队合作、实践时间、使用工具、实践目的均较为多样化,实践内容以医嘱审核(9/15)、药物重整(5/15)为主。在药师实践的效果方面,药师提出了药物重整、药物相关问题等多方面建议,药师建议被接受比例的范围为45.0%~90.0%;进行单臂的Meta分析后,整体而言,药师建议被接受的比例为63.7%[95%CI, (0.523, 0.751)]。尽管药师的药学实践对死亡率、再入院率等终点指标效果并不明确,但能够提高患者的用药合理性,降低患者的用药复杂程度,提高患者的依从性,降低患者的额外就诊率[OR 0.44, 95%CI(0.22, 0.88),P=0.021]。结论:药师在老年科的临床药学实践形式和内容多样化,临床实践可对临床产生积极的作用,仍需设计良好的研究进一步明确药师对于终点结局的效果。     

A collaborative and reflective academic advanced pharmacy practice experience

Objectives. To implement a co-precepted advanced pharmacy practice experience (APPE) focused on traditional pharmacy faculty and administrative responsibilities and reflection opportunities.Design. A multi-faceted, reflection-infused academic APPE was designed that exposed students to activities related to teaching, curriculum revision, scholarly writing, committee service, faculty role-modeling, mentorship and development, and school-level administrative decision-making.Assessment. Two students completed the APPE in the first 2 semesters it was offered (1 in spring 2010 and 1 in fall 2010). Formative and summative evaluations confirmed that the students achieved the APPE goals and viewed the experience as valuable, informative, and enjoyable as expressed both in reflective journal submissions and survey comments.Conclusion. Co-precepting by pharmacy faculty members primarily engaged in traditional faculty- and administration-related responsibilities can provide students with a robust learning experience that surpasses that which could be achieved by a single mentor.     

Swedish students' and preceptors' perceptions of what students learn in a six-month advanced pharmacy practice experience

Objective. To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden.Methods. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories.Results. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development.Conclusions. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire.     

美国药事管理专业研究生教育及其借鉴意义

介绍美国药事管理专业硕士研究生教育的基本情况．提及目前美国药事管理的研究方向、课程设置、入学和毕业条件等，并根据我国药事管理专业目前面临的情况，提出一些针对性的建议，期望引起国内药事管理研究生教育人员的重视，促进该专业在我国的发展。     

Women's health promotion within a community advanced pharmacy practice experience

Objective

To establish low-cost easily conducted health promotion interventions for advanced pharmacy practice experience (APPE) students in community pharmacy settings that would increase women''s awareness about health issues using Food and Drug Administration (FDA) educational materials.

Methods

Students distributed fact sheets on medication use, heart disease, and diabetes to women over 45 years of age at 6 community pharmacy APPE sites. Interventions completed were either personal medication records (PMR) to identify medication-related problems (MRP) or heart health screenings followed by completion of an anonymous patient satisfaction survey instrument.

Results

Over 1500 fact sheets were distributed. Fifty-eight women (age 61 ± 15 years) completed PMRs, which identified 57 MRPs in 42 patients. Twenty-four women indicated the screening was “useful/very useful” for increasing medication understanding. Sixty-three women completed heart health screenings. Thirty-one of the 40 who completed the survey instrument indicated the screening was “useful/very useful” for learning heart disease risk.

Conclusions

Community pharmacy APPE students interventions identified MRPs and patients at risk for heart disease. These health promotion interventions enhanced women''s awareness of these topics while guiding students to achieve the desired curricular outcomes.     

A quality improvement course review of advanced pharmacy practice experiences

Objectives. To determine strengths of and quality improvements needed in advanced pharmacy practice experiences (APPE) through a systematic course review process.Design. Following the “developing a curriculum” (DACUM) format, course materials and assessments were reviewed by the curricular subcommittee responsible for experiential education and by key stakeholders. Course sequence overview and data were presented and discussed. A course review worksheet was completed, outlining strengths and areas for improvement.Assessment. Student feedback was positive. Strengths and areas for improvement were identified. The committee found reviewing the sequence of 8 APPE courses to be challenging.Conclusions. Course reviews are a necessary process in curricular quality improvement but can be difficult to accomplish. We found overall feedback about APPEs was positive and student performance was high. Areas identified as needing improvement will be the focus of continuous quality improvement of the APPE sequence.     

Impact of advanced pharmacy practice experience placement changes in colleges and schools of pharmacy

Objective. To document the annual number of advanced pharmacy practice experience (APPE) placement changes for students across 5 colleges and schools of pharmacy, identify and compare initiating reasons, and estimate the associated administrative workload.Methods. Data collection occurred from finalization of the 2008-2009 APPE assignments throughout the last date of the APPE schedule. Internet-based customized tracking forms were used to categorize the initiating reason for the placement change and the administrative time required per change (0 to 120 minutes).Results. APPE placement changes per institution varied from 14% to 53% of total assignments. Reasons for changes were: administrator initiated (20%), student initiated (23%), and site/preceptor initiated (57%) Total administrative time required per change varied across institutions from 3,130 to 22,750 minutes, while the average time per reassignment was 42.5 minutes.Conclusion. APPE placements are subject to high instability. Significant differences exist between public and private colleges and schools of pharmacy as to the number and type of APPE reassignments made and associated workload estimates.     

Impact of a debate on pharmacy students' views of online pharmacy practice

Objectives To evaluate the impact of a debate on pharmacy students' perceptions, using online pharmacy practice as the debate topic. Methods This is a quasi‐experimental interrupted time‐series study. A 60 min debate was organized as a lunchtime meeting. A four‐category Likert scale questionnaire (fully agree, partially agree, partially disagree, fully disagree) measured the debate participants' level of agreement with 25 statements (main issues associated with online pharmacy) in the pre‐phase (before the debate), post‐phase 1 (after the debate) and post‐phase 2 (6 months after the debate). One hundred and seventy‐seven students were recruited (response rate of 100% in the pre‐phase and post‐phase 1, 31% in post‐phase 2). Four questions measured the perceptions of the students on this pedagogical technique. Key findings The overall proportion of respondents in favour of online pharmacy practice showed little variation among the three phases. However, on average (mean ± SD) 43 ± 8% of the respondents changed their opinion, 21 ± 7% reversed their opinion, 22 ± 4% nuanced their opinion and 1 ± 1% radically changed their opinion. Respectively 98% (post‐phase 1) and 96% (post‐phase 2) of the respondents were of the opinion that debate was a very useful teaching formula in their pharmacist training and 79 and 66% thought debate significantly changed their opinion of the issue. Conclusions Few data have been collected on the use of debates as part of healthcare professional training. The impact of a debate on how pharmacy students feel about online pharmacy practice is described.     

Community pharmacy and the extended community pharmacist practice roles: The UAE experiences

Background: The pharmaceutical care and ‘extended’ roles are still not practiced optimally by community pharmacists. Several studies have discussed the practice of community pharmacy in the UAE and have shown that most community pharmacists only counsel patients. However, UAE, has taken initiatives to allow and prepare community pharmacists to practice ‘extended’ roles. Aim of the review: The aim was to review the current roles of community pharmacists in Abu Dhabi Emirate, United Arab Emirates (UAE). Objective: The objective was to encourage community pharmacists toward extending their practice roles. Methods: In 2010, Health Authority Abu Dhabi (HAAD) surveyed community pharmacists, using an online questionnaire, on their preferences toward extending their counseling roles and their opinion of the greatest challenge facing the extension of their counseling roles. Results: Following this survey, several programs have been developed to prepare community pharmacists to undertake these extended counseling roles. In addition to that, HAAD redefined the scope of pharmacist roles to include some extended/enhanced roles. Abu Dhabi Health Services (SEHA) mission is to ensure reliable excellence in healthcare. It has put clear plans to achieve this; these include increasing focus on public health matters, developing and monitoring evidence-based clinical policies, training health professionals to comply with international standards to deliver world-class quality care, among others. Prior to making further plans to extend community pharmacists’ roles, and to ensure the success of these plans, it is imperative to establish the views of community pharmacists in Abu Dhabi on practicing extended roles and to gain understanding and information on what pharmacists see as preferred change strategies or facilitators to change. Conclusions: In an attempt to adapt to the changes occurring and to the growing needs of patients and to maximize the utilization of community pharmacists’ unique structured strategies are needed to be introduced to the community pharmacy profession.     

Journal clubs during advanced pharmacy practice experiences to teach literature-evaluation skills

Objective. To determine pharmacy students’ attitudes and academic performance related to journal club during 2 advanced pharmacy practice experiences (APPEs).Design. Fourth-year pharmacy students were required to complete 3 journal club assignments during drug information and internal medicine APPEs.Assessment. A majority (91.3%) of the 105 students who responded to a 21-item survey instrument indicated that journal club assignments during the drug-information APPE were valuable to their understanding of research design and statistics. Students who completed the drug-information APPE before the internal medicine APPE scored higher on their understanding of the strengths and weaknesses and the clinical relevance of studies and had a higher learning slope (p = 0.01) than did students who completed the internal medicine APPE first.Conclusion. Incorporating journal clubs into APPEs is an effective means of teaching literature-evaluation skills to pharmacy students.