First-year residency candidates' experience in various areas of pharmacy practice

Objective

To determine the extent of experience or exposure pharmacy residency candidates had in various areas of hospital pharmacy practice and to identify any candidate-specific variables that correlated with a larger extent of experience.

Methods

Over a 3-year period, a self-assessment survey instrument was administered to 116 postgraduate first-year (PGY1) pharmacy practice residency candidates to evaluate their extent of experience within various areas of hospital pharmacy practice such as patient care activities, drug information, and drug distribution/control.

Results

The residency candidates reported the greatest amount of experience in patient counseling, working with pharmacy databases, taking medication histories, pharmacokinetics, and outpatient dispensing procedures. They had less experience with medical emergencies, parenteral nutrition, and intravenous admixture techniques. Overall, there was no correlation between class rank, advanced pharmacy practice experiences, geographic region, or year of interview and the extent of candidates'' experience in any specific area of pharmacy.

Conclusion

PGY1 residency candidates in this sample reported minimal experience in areas necessary for hospital pharmacy practice and this suggests possible deficiencies in the PharmD curriculum. PGY1 residency programs in acute care settings should recognize these educational deficits and assure that residents have exposure to and develop proficiency in critical areas such as medical emergencies, parenteral nutrition, and intravenous admixture techniques.     

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.     

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.     

Practice Management Training in the PGY1 Residency Year: Best Practices From Two Nationwide Surveys

Purpose:

The development of future pharmacy leaders is vital to the advancement of our profession. Postgraduate year 1 (PGY1) residency training requires residents to exercise leadership and practice management skills. Two national surveys were conducted to describe the current state of practice management experiences and elucidate best practice recommendations.

Methods:

The surveys, online multiple choice and free response, queried American Society of Health-System Pharmacists (ASHP)–accredited residency program practice management preceptors (survey 1) and PGY1 residents (survey 2) and were distributed via the ASHP residency program directors’ listserv. Responses were reviewed and analyzed by members of the University HealthSystem Consortium Pharmacy Council Strategic Initiatives and Programming Committee.

Results:

Survey 1, completed by 240 institutions, identified that a combination of concentrated and longitudinal practice management experiences were used most frequently (47%), followed by concentrated alone (33%). Universally noted activities included meeting attendance (98%), projects (94%), and committee involvement (92%). Sixty-seven percent of the programs changed the experience in the previous 3 years, with 43% planning changes in the coming year. Survey 2 was completed by 58 PGY1 residents from 42 programs. Most (80%) residents stated they had enough time with their preceptors, and 55% rated their enjoyment of the rotation as 4 or 5 on a 1 to 5 scale (5 = most enjoyed)

Conclusion:

Our findings suggest that there is not a best practice for the structure or content of the PGY1 practice management experience. These results highlight key recommendations, including the need for practice management-specific preceptor development, incorporation of longitudinal experiences, and more practice management and leadership activities.Key Words: administration, leadership, residency, training     

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.     

Pharmacy Students' Ability to Identify Potential Drug-Drug Interactions

Objective

To evaluate the ability of third- and fourth-year pharmacy students to identify clinically significant drug-drug interactions (DDIs)

Methods

A questionnaire designed to measure DDI knowledge was disseminated to fourth-year pharmacy students in a school of pharmacy. A second questionnaire was distributed to third-year pharmacy students in 2 schools of pharmacy (schools A and B) and re-administered to students in 1 of the schools 1 year later.

Results

Class of 2005 fourth-year pharmacy students correctly categorized an average of 52% ± 13% DDI pairs on the first questionnaire. Third-year pharmacy students at schools A and B correctly categorized an average of 61% ± 18% and 66% ± 15% of DDI pairs, respectively. The average percentage of correct responses for fourth-year students from the class of 2007 was 65% (± 17%).

Conclusion

Pharmacy students'' ability to identify important DDIs is far from optimal, even after completing experiential requirements.     

The structured interview and interviewer training in the admissions process

Objectives

To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training.

Methods

A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation.

Results

Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews.

Conclusions

Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy.     

Attributes of Colleges and Schools of Pharmacy in the United States

Objectives

To compare the attributes of US colleges and schools of pharmacy and describe the extent of change to the pharmacy education enterprise associated with the addition of new schools.

Methods

Attributes analyzed included whether the college or school of pharmacy was old or new, public or private, secular or faith-based, and on or not on an academic health center (AHC) campus; had 3- or 4- year programs; and had PhD students enrolled. PharmD student enrollment-to-faculty ratios and junior-to-senior faculty ratios also were examined.

Results

Of the new colleges/schools, 76% were private and 79% were not located on a campus with an AHC; 6% had PhD enrollment compared with 80% of old colleges/schools. Faculty ratios were related to several college/school attributes, including the presence or absence of PhD students and whether the college/school was public or private.

Conclusions

Attributes of new colleges and schools of pharmacy have changed the overall profile of all colleges and schools of pharmacy. For example, smaller percentages of all colleges and schools of pharmacy are public and have PhD enrollees.     

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.     

Professional technical standards in colleges and schools of pharmacy

Objective

To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE).

Methods

The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information.

Results

Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures.

Conclusion

More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study.     

Faculty Awards at US Colleges and Schools of Pharmacy

Objectives

To determine recognition given for outstanding teaching, service, and scholarship at US colleges and schools of pharmacy, the types of awards given, and the process used to select the recipients.

Methods

A self-administered questionnaire was made available online in 2006 to deans at 89 colleges and schools of pharmacy.

Results

Sixty-four usable responses (72%) were obtained. An award to acknowledge teaching excellence was most commonly reported (92%), followed by an award for adjunct/volunteer faculty/preceptors (79%). The majority of the institutions (31 out of 58) reported offering 1 teaching award annually. The 2 most common methods for selecting the recipient of the teaching award were by student vote and by college/school committee vote following nominations. Twenty-four of the 63 respondents indicated that their institution provided an award for research/scholarship and 18 offered an award for outstanding service.

Conclusions

Teaching excellence was recognized and rewarded at most US colleges and schools of pharmacy; however, research/scholarship and service were formally recognized less frequently.     

The Status of US Multi-campus Colleges and Schools of Pharmacy

Objective

To assess the current status of multi-campus colleges and schools of pharmacy within the United States.

Methods

Data on multi-campus programs, technology, communication, and opinions regarding benefits and challenges were collected from Web sites, e-mail, and phone interviews from all colleges and schools of pharmacy with students in class on more than 1 campus.

Results

Twenty schools and colleges of pharmacy (18 public and 2 private) had multi-campus programs; 16 ran parallel campuses and 4 ran sequential campuses. Most programs used synchronous delivery of classes. The most frequently reported reasons for establishing the multi-campus program were to have access to a hospital and/or medical campus and clinical resources located away from the main campus and to increase class size. Effectiveness of distance education technology was most often sited as a challenge.

Conclusion

About 20% of colleges and schools of pharmacy have multi-campus programs most often to facilitate access to clinical resources and to increase class size. These programs expand learning opportunities and face challenges related to technology, resources, and communication.     

A Progress Assessment to Evaluate Pharmacy Students' Knowledge Prior to Beginning Advanced Pharmacy Practice Experiences

Objective

To develop an assessment that would (1) help doctor of pharmacy (PharmD) students review therapeutic decision making and build confidence in their skills, (2) provide pharmacy practice residents with the opportunity to lead small group discussions, and (3) provide the assessment committee with program-level assessment data.

Design

A case-based interactive assessment was developed and delivered to PharmD students immediately prior to advanced pharmacy practice experiences (APPEs). The assessment used an audience response system to allow immediate feedback followed by small group discussions led by pharmacy-practice residents. Students self-assessed their knowledge and confidence levels and developed personalized learning objectives for APPEs.

Assessment

Eighty-nine percent of students found the assessment useful, and pharmacy practice residents reported that it was helpful in developing precepting skills. The college assessment committee was able to use the data to supplement the ongoing College curricular mapping process.

Conclusions

An interactive assessment process can help students build confidence for experiential training, provide a learning opportunity for pharmacy residents, and produce program-level data for college assessment purposes. Planned modifications of the assessment include expanding the content areas covered and adding ability-based assessments such as communication skills.     

Evaluation of curricula content based on Thai pharmacy competency standards

Objective

To evaluate the curricula content of Thai pharmacy schools based on the Thai pharmacy competency standards.

Methods

Course syllabi were collected from 11 pharmacy schools. A questionnaire was developed based on the Thai pharmacy competency standards. Course coordinators completed the questionnaire assessing the curricula content.

Results

The curricula for both the bachelor of science in pharmacy degree (BS Pharm) and doctor of pharmacy (PharmD) degree programs included the minimum content required by the 8 competency domains. The dominant content area in BS Pharm degree programs was product-oriented material. The content ratio of patient to product to social and administrative pharmacy in the BS Pharm degree programs was 2:3:1, respectively. However, the content ratio suggested by the Thai Pharmacy Council was 3:2:1, respectively. For the PharmD programs, the largest content area was patient-oriented material, which was in agreement with the framework suggested by the Thai Pharmacy Council.

Conclusions

The curricula of all Thai pharmacy schools met the competency standards; however, some patient-oriented material should be expanded and some product-oriented content deleted in order to meet the recommended content ratio.     

Mobile Computing Initiatives Within Pharmacy Education

Objectives

To identify mobile computing initiatives within pharmacy education, including how devices are obtained, supported, and utilized within the curriculum.

Methods

An 18-item questionnaire was developed and delivered to academic affairs deans (or closest equivalent) of 98 colleges and schools of pharmacy.

Results

Fifty-four colleges and schools completed the questionnaire for a 55% completion rate. Thirteen of those schools have implemented mobile computing requirements for students. Twenty schools reported they were likely to formally consider implementing a mobile computing initiative within 5 years.

Conclusions

Numerous models of mobile computing initiatives exist in terms of device obtainment, technical support, infrastructure, and utilization within the curriculum. Responders identified flexibility in teaching and learning as the most positive aspect of the initiatives and computer-aided distraction as the most negative, Numerous factors should be taken into consideration when deciding if and how a mobile computing requirement should be implemented.     

Pharmacy students' perceptions of a required senior research project

Objectives

To determine pharmacy students'' perceptions of a required research project in a doctor of pharmacy curriculum.

Methods

A survey instrument was administered to senior pharmacy students to determine their perceptions of the project advisor and overall project experience and their postgraduation employment plans.

Results

Two-hundred twenty-nine (81.5%) students completed a survey instrument. The majority agreed or strongly agreed that the project provided a valuable learning experience (88.2%), provided a competitive advantage for postgraduate job opportunities (73.2%), and should be a continued graduation requirement (74.2%). Respondents with plans for a residency or fellowship were more likely than those entering a community or hospital/institutional pharmacy to agree that completion of the project made them more qualified or marketable and should be continued as a graduation requirement (p < 0.05).

Conclusions

A required research project was perceived by pharmacy students to be a beneficial experience. Students pursuing residency or fellowship were more likely to feel the project was beneficial than students entering the workforce.     

Pharmacoeconomic education in US colleges and schools of pharmacy: an update

Objectives

To determine the extent of pharmacoeconomics education at US pharmacy colleges and schools in 2007.

Methods

An e-mail survey was developed and sent to pharmacoeconomics instructors at all US colleges of pharmacy.

Results

Of the 90 colleges and schools of pharmacy that completed the survey, 7 colleges and schools did not currently have someone teaching pharmacoeconomics (eg, new school or looking for instructor). For the 83 colleges and schools that had an instructor who taught pharmacoeconomics, 69 covered pharmacoeconomic-related topics in a required course only; 5, in an elective course only; and 9, in both a required and elective course. The number of hours of pharmacoeconomic-related topics presented in required courses ranged from 1 to 48 hours (mean = 21 ± 14; median = 19).

Conclusions

Pharmacoeconomics education courses are offered at the majority of US colleges and schools of pharmacy. There was a wide range of hours devoted to pharmacoeconomic-related topics and the topics covered in these colleges and schools varied. Although the majority of US colleges and schools of pharmacy offer pharmacoeconomics courses, official guidelines are needed for the specific aspects and topics that should be covered in the classroom.     

Active-Learning Processes Used in US Pharmacy Education

Objective

To document the type and extent of active-learning techniques used in US colleges and schools of pharmacy as well as factors associated with use of these techniques.

Methods

A survey instrument was developed to assess whether and to what extent active learning was used by faculty members of US colleges and schools of pharmacy. This survey instrument was distributed via the American Association of Colleges of Pharmacy (AACP) mailing list.

Results

Ninety-five percent (114) of all US colleges and schools of pharmacy were represented with at least 1 survey among the 1179 responses received. Eighty-seven percent of respondents used active-learning techniques in their classroom activities. The heavier the teaching workload the more active-learning strategies were used. Other factors correlated with higher use of active-learning strategies included younger faculty member age (inverse relationship), lower faculty member rank (inverse relationship), and departments that focused on practice, clinical and social, behavioral, and/or administrative sciences.

Conclusions

Active learning has been embraced by pharmacy educators and is used to some extent by the majority of US colleges and schools of pharmacy. Future research should focus on how active-learning methods can be used most effectively within pharmacy education, how it can gain even broader acceptance throughout the academy, and how the effect of active learning on programmatic outcomes can be better documented.     

Third-year pharmacy students' work experience and attitudes and perceptions of the pharmacy profession

Objectives

To describe PharmD students'' work experiences and activities; examine their attitudes towards their work; examine perceptions of preceptor pharmacists they worked with; and determine important issues associated with career preference.

Methods

A written survey was administered to third-year doctor of pharmacy (PharmD) students at 8 colleges and schools of pharmacy in the Midwest.

Results

Five hundred thirty-three students (response rate = 70.4%) completed the survey instrument. Nearly 100% of PharmD students reported working in a pharmacy by the time their advanced pharmacy practice experiences (APPEs) began. Seventy-eight percent reported working in a community pharmacy, and 67% had worked in a chain community pharmacy. For all practice settings, students reported spending 69% of their time on activities such as compounding, dispensing, and distribution of drug products.

Conclusions

Most students are working in community pharmacy (mainly chain) positions where their primary function is traditional drug product dispensing and distribution. Having a controllable work schedule was the variable most strongly associated with career choice for all students.