Pharmacy Students’ Perceptions of Cultural Competence Encounters During Practice Experiences

Objective. To determine pharmacy students’ perceptions regarding cultural competence training, cross-cultural experiences during advanced pharmacy practice experiences (APPEs), and perceived comfort levels with various cultural encounters.Methods. Fourth-year pharmacy (P4) students were asked to complete a questionnaire at the end of their fourth APPE.Results. Fifty-two of 124 respondents (31.9%) reported having 1 or more cultural competence events during their APPEs, the most common of which was caring for a patient with limited English proficiency.Conclusion. Students reported high levels of comfort with specific types of cultural encounters (disabilities, sexuality, financial barriers, mental health), but reported to be less comfortable in other situations.     

Potential Cost Avoidance of Pharmacy Students’ Patient Care Activities During Advanced Pharmacy Practice Experiences

Objectives. To evaluate the potential cost avoidance of student interventions documented by fourth-year (P4) student pharmacists during advanced pharmacy practice experiences (APPEs) in outpatient and inpatient settings.Methods. The school-wide Web-based intervention database was retrospectively analyzed to review characteristics of interventions documented during the 2011-2012 APPE cycle. Potential cost avoidance for interventions was derived from a comprehensive literature review and adjusted to 2011 dollars based on the consumer price index for medical care.Results. Eighty-seven students (71% of the graduating class) documented 5,775 interventions over 36 weeks, with an estimated potential total cost avoidance of $908,800. The intervention categories associated with the greatest cost avoidance were prevention of adverse drug events, provider education, and patient education.Conclusions. Fourth-year student pharmacists and their preceptors had a positive impact, contributing to potential cost avoidance in both the inpatient and outpatient pharmacy settings.     

Variables Affecting Pharmacy Students’ Patient Care Interventions during Advanced Pharmacy Practice Experiences

Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE).Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey.Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency. Timing of the APPE, previous specialty elective course completion, and previous hospital experience did not result in any significant difference in self-initiated recommendations.Conclusion. Preceptors should not base practice experience expectations for self-initiated interventions on previous student experience or future intentions. Additionally, factors leading to lower rates of self-initiated interventions on infectious diseases or pediatrics APPEs should be explored.     

Pharmacy Students’ Knowledge of Black Box Warnings

Objective

To evaluate the progression of pharmacy students’ knowledge of black box warnings across 3 years of didactic training, and to determine how they stay current with new warnings.

Methods

A cross-sectional survey instrument was administered to pharmacy students in their first (P1), second (P2), and third (P3) professional years. The survey assessed student awareness of medications possessing a black box warning and familiarity with the warning content for 20 medications (15 with and 5 without warnings).

Results

Mean number of correct responses identifying the presence or absence of a black box warning among the 20 medications were 5.8 ± 3.3, 9.6 ± 4.0, and 14.8 ± 2.8 for the P1, P2, and P3 students, respectively. Knowledge of black box warning content was variable. Students were least aware of the warning content for stavudine and enoxaparin. Students were most familiar with the warning content for paroxetine and estrogen.

Conclusion

Students’ awareness and understanding of black box warnings was proportional to their educational progression, but their knowledge level was inconsistent across drug groups.     

Implementing Standards 2007 to Improve Students�� Preparation for Advanced Pharmacy Practice Experiences

Objective

To examine the impact of implementation of the Accreditation Council for Pharmacy Education''s (ACPE''s) Standards 2007 on pharmacy students’ preparation for their first advanced pharmacy practice experience (APPE).

Design

The doctor of pharmacy (PharmD) curriculum was altered to include introductory pharmacy practice experiences (IPPE), second-year therapeutics, classroom integration of practice experiences, more biomedical sciences, an electronic portfolio system, life-long learning exercises, and additional content based on Appendix B of Standards 2007. Curricular outcomes and the assessment plan also were revised based on Standards 2007.

Assessment

To evaluate the impact of these changes to the curriculum, faculty members rated 9 behaviors of students observed during the third week of their first APPE and compared their scores with those of students who were evaluated in 2004 before the curriculum had been revised. Students completing the revised curriculum performed all 9 behaviors more often and had a better average score than students evaluated in 2004.

Conclusion

Curricular revisions implemented to address ACPE Standards 2007 were associated with positive clinical behaviors in students beginning their experiential education.     

Pharmacy students’ satisfaction with Introductory Pharmacy Practice Experiences (IPPE) at community pharmacy: The case of Saudi Arabia

ObjectiveTo assess pharmacy students’ satisfaction with introductory pharmacy practice experiences (IPPE) at community pharmacy and the impact of the training on their future career.MethodsA self-administered questionnaire was made available to 74 male pharmacy students who completed 4 weeks community pharmacy IPPE. The questionnaire consists of 24 questions that were organized into 5 domains with a scale of six options were used to answer each question.ResultsA total of 43 students completed the survey (58%). Most of them evaluated their training experience as either as good (41.86%) or excellent (41.86%). One third of students (34.88%) were very satisfied about the clarity of the community pharmacy IPPE goals and objectives given prior to the training period. About half of students (51.6%) received a good direction and feedback from their preceptors. Regarding the contact with the patient or guardian, (39.53%) of the students chose neutral while (25.58%) of the students were very satisfied. The learning environment was satisfactory for (32.56%) of students. Regarding skills domain, students strongly agreed that their skills were improved; Communication skills as reported by (48.84%) of students, documentation skills as reported by (34.88%) of students, and clinical skills as reported by (34.88%) of students.ConclusionSurveyed male students were in general satisfied with their training experience at community pharmacy. Providing an orientation to the community pharmacy preceptors and granted electronic access of necessary information to the students might increase their satisfaction.     

Resident Physicians’ Acceptance of Pharmacy Students’ Pharmacotherapy Recommendations During an Ambulatory Care Advanced Pharmacy Practice Experience

Objective

To compare the acceptance rates of written versus verbal pharmacotherapy recommendations made by pharmacy students on an ambulatory care advanced pharmacy practice experience (APPE).

Methods

Fourth-year pharmacy students made written and verbal pharmacotherapy recommendations to resident physicians in an internal medicine clinic at an urban, teaching hospital over a 10-month period. The types of recommendations and outcomes of the interventions were recorded using a data collection form to determine differences in acceptance rates for written versus verbal recommendations. The recommendation types and corresponding acceptance rates were also compared.

Results

Of 542 pharmacotherapy recommendations made by 14 APPE students during the 10-month study period, 65.1% were written and 34.9% were verbal. Of the 189 verbal recommendations, 97.9% were accepted, compared with 83.6% of written recommendations (p < 0.0001). The most frequent types of recommendations and overall rates of acceptance were dosage change (87.0%), laboratory monitoring (85.8%), and medication initiation based on evidence-based medicine guidelines (79.3%).

Conclusion

Verbal pharmacotherapy recommendations made by pharmacy students were accepted by resident physicians at a significantly higher rate than written recommendations in an outpatient internal medicine clinic.     

Patient Simulation to Demonstrate Students�� Competency in Core Domain Abilities Prior to Beginning Advanced Pharmacy Practice Experiences

Objective. To implement a simulation-based introductory pharmacy practice experience (IPPE) and determine its effectiveness in assessing pharmacy students’ core domain abilities prior to beginning advanced pharmacy practice experience (APPE). Design. A 60-hour IPPE that used simulation-based techniques to provide clinical experiences was implemented. Twenty-eight students were enrolled in this simulation IPPE, while 60 were enrolled in hospital and specialty IPPEs within the region.Assessment. The IPPE assessed 10 out of 11 of the pre-APPE core domain abilities, and on the practical examination, 67% of students passed compared to 52% of students in the control group. Students performed better on all 6 knowledge quizzes after completing the simulation IPPE. Based on scores on the Perception of Preparedness to Perform (PREP) survey, students felt more prepared regarding “technical” aspects after completing the simulation experience (p<0.001). Ninety-six percent of the respondents agreed with the statement “I am more aware of medication errors after this IPPE.”Conclusion. Simulation is an effective method for assessing the pre-APPE abilities of pharmacy students, preparing them for real clinical encounters, and for making them more aware of medication errors and other patient safety issues.     

Pharmacy Students’ Interpretation of Academic Integrity

Objective. To explore pharmacy students’ recognition and interpretation of situations constituting breaches of academic integrity.Methods. A survey instrument comprising 10 hypothetical student(s) scenarios was completed by 852 students in the bachelor of pharmacy program at an Australian university. The scenarios were relevant to current modes of assessment and presented degrees of ambiguity around academic integrity.Results. Identification of the hypothetical student(s) at fault, particularly in the deliberately ambiguous scenarios, was not related to the respondents’ year of study or sex. Students with fewer years of postsecondary education were more definitive in their interpretation of contentious cases. Respondents from all 4 years of study reported witnessing many of these behaviors among their peers.Conclusion. This study provided novel insight into the ambiguity surrounding academic integrity and students’ perceptions relating to the deliberate or inadvertent involvement of other parties.     

Pharmacy Students’ Ability to Think About Thinking

Objective. To investigate students’ metacognitive skills to distinguish what they know from what they do not know, to assess students’ prediction of performance on a summative examination, and to compare student-identified incorrect questions with actual examination performance in order to improve exam quality.Methods. Students completed a test-taking questionnaire identifying items perceived to be incorrect and rating their test-taking ability.Results. Higher performing students evidenced better metacognitive skills by more accurately identifying incorrect items on the exam. Most students (86%) underpredicted their performance on the summative examination (actual=73.6 ± 7.1 versus predicted=63.7 ± 10.5, p<0.05). Student responses helped refine items and resulted in examination changes.Conclusion. Metacognition is important to the development of life-long learning in pharmacy students. Students able to monitor what they know and what they do not know can improve their performance.     

An Interprofessional Diabetes Experience to Improve Pharmacy and Nursing Students’ Competency in Collaborative Practice

Objective. To improve pharmacy and nursing students’ competency in collaborative practice by having them participate in an interprofessional diabetes experience involving social networking.Design. An existing elective course on diabetes management was modified to include interprofessional content based on Interprofessional Education Collaborative (IPEC) competency domains. Web-based collaborative tools (social networking and video chat) were used to allow nursing and pharmacy students located on 2 different campuses to apply diabetes management content as an interprofessional team.Assessment. Mixed-method analyses demonstrated an increase in students’ knowledge of the roles and responsibilities of the other profession and developed an understanding of interprofessional communication strategies and their central role in effective teamwork.Conclusion. Interprofessional content and activities can be effectively integrated into an existing course and offered successfully to students from other professional programs and on remote campuses.     

Capacity Ratios to Assess the Solvency of a College’s Advanced Pharmacy Practice Experience Program

Objective. To use the capacity ratio to determine solvency in 10 advanced pharmacy practice experiences (APPEs) offered by a college of pharmacy.Methods. Availability in each APPE was determined based on preceptor responses, and student need was tabulated from 3 preference forms. Capacity ratios were calculated by dividing preceptor availability by the sum of student requests plus 20% of student requests; ratios ≥ 1 indicated solvency. For the 3 required APPEs, minimum capacity ratios were calculated by dividing availability by the sum of student number plus 20% of the student number. When possible, the capacity ratio for the APPE was calculated by geographic zone.Results. The 3 required APPEs had statewide minimum capacity ratios that were consistent with solvency: advanced community (2.8), advanced institutional (1.6), and ambulatory care (2.5). Only 3 of 7 elective APPEs demonstrated solvency. The elective APPEs for which requests exceeded availability were association management (0.8), emergency medicine (0.8), cardiology (0.6), and human immunodeficiency virus (HIV) ambulatory care clinic (0.4). Analysis by zone revealed additional insolvent practice experiences in some locations.Conclusions. The capacity ratio allowed for assessment of 10 APPEs and identification of practice experience areas that need expansion. While the capacity ratio is a proposed standardized assessment, it does have some limitations, such as an inability to account for practice experience quality, scheduling conflicts, and geographic zone issues.     

Assessment of Korean Pharmacy Students’ Empathy Using the Jefferson Scale of Empathy

Objective. To validate the Korean-translated Jefferson Scale of Empathy-Health Professions Student version (JSE-HPS) and to investigate the empathy levels of pharmacy students in South Korea.Methods. The JSE-HPS and the Interpersonal Reactivity Index (IRI) were administered to 452 pharmacy students in their second and third years at 5 Korean universities. Confirmatory factor analysis (CFA), correlations, and one-way ANOVAs were conducted for data analyses.Results. The final sample size comprised 447 responses. The 3-factor model of the JSE-HPS was confirmed by CFA and the convergent validity was also supported by its correlations with the IRI subscales. The overall mean score was 80.3. Pharmacy students enrolled in women’s or private universities reported significantly higher levels of overall empathy than their counterparts in co-ed or national universities.Conclusion. Our findings empirically support the psychometric soundness of the Korean JSE-HPS for pharmacy students.     

Pharmacy Students’ Attitudes Toward Debt

Objective. To examine pharmacy students’ attitudes toward debt.Methods. Two hundred thirteen pharmacy students at the University of Minnesota were surveyed using items designed to assess attitudes toward debt. Factor analysis was performed to identify common themes. Subgroup analysis was performed to examine whether students’ debt-tolerant attitudes varied according to their demographic characteristics, past loan experience, monthly income, and workload.Results. Principal component extraction with varimax rotation identified 3 factor themes accounting for 49.0% of the total variance: tolerant attitudes toward debt (23.5%); contemplation and knowledge about loans (14.3%); and fear of debt (11.2%). Tolerant attitudes toward debt were higher if students were white or if they had had past loan experience.Conclusion. These 3 themes in students’ attitudes toward debt were consistent with those identified in previous research. Pharmacy schools should consider providing a structured financial education to improve student management of debt.     

Mental Health Curricula at Schools of Pharmacy in the United Kingdom and Recent Graduates’ Readiness to Practice

Objective. To assess mental health education in the undergraduate pharmacy curricula in the United Kingdom and gauge how well prepared graduates are to manage mental health patients.Method. The authors conducted semi-structured telephone interviews with pharmacy educators and administered an electronic self-administered survey instrument to pharmacy graduates.Results. The mental health conditions of depression, schizophrenia, bipolar disorder, and Parkinson disease were taught, in detail, by all schools, but more specialized areas of mental health (eg, personality disorder, autism) were generally not taught. Just 5 of 19 schools attempted to teach the broader social aspects of mental health. A third of the schools provided experiential learning opportunities. Graduates and recently registered pharmacists stated that undergraduate education had prepared them adequately with regard to knowledge on conditions and treatment options, but that they were not as well prepared to talk with mental health patients and deal with practical drug management-related issues.Conclusion. The mental health portion of the undergraduate pharmacy curricula in colleges and schools of pharmacy in the United Kingdom is largely theoretical, and pharmacy students have little exposure to mental health patients. Graduates identified an inability to effectively communicate with these patients and manage common drug management-related issues.