Academic accommodation strategies for pharmacy students with learning disabilities: What else can be done?

Strategies to increase accessibility for students with disabilities in health professional education programs: A scoping review: BEME Review No. 94

PURPOSE

Despite legislative changes, students with disabilities experience lower retention and higher attrition in health professional programs (HPP), compared to nondisabled peers. The purpose of this study was to identify strategies in the literature that may improve HPP accessibility for disabled students.

METHODS

The Joanna Briggs Institute methodology was applied to this scoping review. Five databases, four Google domains, and five websites of organizations that promote student accessibility were searched. Reviewers applied inclusion and exclusion criteria for title and abstract screening; conducted full-text reviews; and extracted and analyzed data using counts, frequencies, coding, and categorizing to identify strategies.

RESULTS

Strategies to improve HPP accessibility were reported most often in literature from the USA, and by nursing and medical professions. The most salient strategy was 'types of accommodations' provided by HPP, followed by 'education, critical reflection and culture change for educators and staff.'

CONCLUSIONS

While types of accommodations are reported often, they may not be widely applicable nor generalizable given the number of students with disabilities are increasing and the need to consider each student's unique accommodations. A multi-pronged approach of education, critical reflection, and culture change for educators and staff may support shifting HPP more broadly towards embracing inclusivity.

Preceptor perspectives on disability-related accommodations in pharmacy experiential education

INTRODUCTION

Accreditation Council for Pharmacy Education Standards require reasonable accommodation for students with disabilities in an educational setting. There is limited information regarding preceptor experiences and perspectives associated with accommodations in the pharmacy experiential learning environment. This study examined preceptor experiences and viewpoints and explored opportunities for schools/colleges of pharmacy (S/COP) to provide support and education for preceptors when meeting access needs.

METHODS

A collaborative team from seven S/COP experiential programs developed, pilot tested, and electronically distributed a questionnaire. The questionnaire collected information on preceptor demographics, experiences with disability-related accommodations, concerns and confidence in implementation, support from the academic institution, and additional needs. An open-ended question was analyzed using thematic analysis, and quantitative responses were described using descriptive statistics.

RESULTS

A total of 294 respondents consented to participate, met inclusion criteria, and submitted a questionnaire response (∼5 % response rate). Many respondents had not experienced requests for accommodation. The most common challenges related to implementation of accommodations were lack of clarity regarding the accommodation request (22 %) and uncertainty regarding how to apply the accommodation within the preceptor's practice (23 %). Most respondents (76 %) felt they would benefit from professional development in this area. Thematic analysis of free-text responses indicated a desire for resources, education, and for advanced notice when accommodation is needed.

CONCLUSION

While many preceptors may not have received requests for accommodation, opportunities exist for S/COP related to preceptor education, provision of resources, and transparent and proactive communication between the academic institution and the preceptor to support students with disabilities.

CONTRIBUTION TO THE LITERATURE

Requests for accommodations in the experiential education setting are an increasingly important topic for those involved in pharmacy experiential education, including directors, preceptors, and sites. The current body of literature published to date provides guidance, resources, strategies, and reviews of legal implications to consider when developing accommodations for experiential education. Additional literature provides insights from schools and colleges of pharmacy. However, there is limited information available regarding preceptor experiences and perspectives associated with accommodations in the pharmacy experiential learning environment. This manuscript outlines a study examining preceptor experiences and viewpoints. The results provide insight into preceptor perspectives as well as potential future opportunities for schools and colleges of pharmacy to support students with disabilities and implementation of accommodations.

Counting on Change: Conquering Challenges in Teaching Pharmaceutical Calculations

All pharmacists are expected to accurately perform pharmaceutical calculations to ensure patient safety. In recent years, there have been trends in declining performance on the North American Pharmacist Licensure Examination related to calculations. Understanding the cause of this decline and determining methods to correct underlying issues could benefit pharmacy administration, faculty, students, and patients. The aims of this commentary are to present the factors impacting the students' pharmaceutical calculations abilities, discuss the consequences of declining math skills, and provide a call to action for scholarship of teaching and learning pertaining to calculations, as well as increased administrative support to rectify this challenge.

Assessing methodological quality in dental education research using MERSQI: Analysis of publications from two journals

PURPOSE

The Medical Education Research Study Quality Instrument (MERSQI) has been used frequently to assess the methodological quality of medical education but not for dental education. The present study aimed to assess the methodological quality using MERSQI scores of articles published in the Journal of Dental Education (JDE) and the European Journal of Dental Education (EJDE).

METHODS

A cross-sectional assessment of the quality of manuscripts published in 2012, 2017, and 2022 JDE and EJDE was conducted. MERSQI data, numbers of authors, first and corresponding author degrees, geographic origins, and funding information were also extracted for each included study. Descriptive and analytical statistics were conducted, and significance level was set at α < 0.05.

RESULTS

Four hundred ninety-five articles met the inclusion criteria. The most common study design was a single-group cross-sectional or single-group posttest and conducted in one institution for all studied years. In all journals and years, studies were assessed mainly by participants. The study outcome was mostly satisfaction, attitudes, perceptions, opinions, and general facts. The total mean MERSQI score for each journal and year varied. Year and geographic origin significantly affected the total MERSQI score. Papers originating from Asia had the highest score, followed by South America, Europe, North America, Oceania, and Africa.

CONCLUSION

MERSQI score is applicable to the assessment of the methodological quality of dental educational research. The MERSQI score for most of the domains was similar for both journals. The MERSQI score was affected by publication years and geographic origins.

Trauma-Informed Pedagogy: Instructional Strategies to Support Student Success

Over the past several years, the ongoing coronavirus disease 2019 pandemic has contributed to challenging working and life conditions. As a result, the midwifery and health care workforce has faced significant shortages due to burnout. Increased societal awareness of historical trauma and systemic racism embedded within US culture has also led to increased anxiety and signs of trauma among midwifery and health profession students. Now more than ever, innovative teaching strategies are needed to support students, reduce the risks of burnout, and increase diversity in the workforce. One strategy is to adopt a trauma-informed pedagogy within midwifery education. Trauma-informed pedagogy is founded on core assumptions of trauma-informed care and thus supports student success by recognizing that the student cannot be separated from their own life experiences. Faculty and preceptors can develop empathetic, flexible supports that communicate care and concern regarding students' personal and social situations, and emotions. Empathetic behavior from teachers also increases student learning motivation, making it easier for students to actively engage in learning thereby reducing their distress. The purpose of this State of the Science review, therefore, was to describe the literature surrounding trauma-informed pedagogy and to offer concrete educational strategies that faculty members and educational programs can employ to increase the success of a diverse student body. This can be accomplished through flexibility in curriculum design and outcome measurement to ensure attainment of end of program learning outcomes. Institutional and administrative support are essential to develop a faculty who realize the benefit and value of trauma-informed pedagogy underpinning student success.

Base rates of non-credible performance in a post-secondary student sample seeking accessibility accommodations

Objective: Performance Validity Tests (PVTs) have been used to identify non-credible performance in clinical, medicolegal, forensic, and, more recently, academic settings. The inclusion of PVTs when administering psychoeducational assessments is essential given that specific accommodation such as flexible deadlines and increased writing time can provide an external incentive for students without disabilities to feign symptoms. Method: The present study used archival data to establish base rates of non-credible performance in a sample of post-secondary students (n = 1045) who underwent a comprehensive psychoeducational evaluation for the purposes of obtaining academic accommodations. In accordance with current guidelines, non-credible performance was determined by failure on two or more freestanding or embedded PVTs. Results: 9.4% of participants failed at least two of the PVTs they were administered, of which 8.5% failed two PVTs, and approximately 1% failed three PVTs. Base rates of failure for specific PVTs ranged from 25% (b Test) to 11.2% (TOVA). Conclusions: The present study found a lower base rate of non-credible performance than previously observed in comparable populations. This likely reflects the utilization of conservative criteria in detecting non-credible performance to avoid false positives. By contrast, inconsistent base rates previously found in the literature may reflect inconsistent methodologies. These results further emphasize the importance of administering multiple PVTs during psychoeducational assessments. The implications of these findings can further inform clinicians administering assessments in academic settings and aid in the appropriate utilization of PVTs in psychoeducational evaluation to determine accessibility accommodations.

Envisioning the Future of Student Success: Report of the 2022-2023 AACP Student Affairs Standing Committee

Over the past several years, traditional metrics have indicated declining student success within colleges and schools of pharmacy. Though students may be less well-prepared for professional school than in years past, once candidates are admitted to our institutions, we have a responsibility to effectively support their progression through the program. The 2022-2023 Student Affairs Committee was convened to evaluate and advance the construct of student success within Doctor of Pharmacy programs. The Student Affairs Committee was charged with identifying environmental factors affecting the ability of pharmacy students to be successful; determining how colleges and schools of pharmacy are currently meeting needs related to student progress; conducting a literature review to determine what academic support measures minimize attrition; and developing innovative suggestions and recommendations that better support student success. To accomplish this work, we conducted an extensive literature review and synthesis of evidence, engaged in professional networking across the Academy, and administered a wide-ranging student success survey to all colleges and schools of pharmacy. In this report, we explore the complex and interacting systems that affect learning behavior and academic success and offer a novel, comprehensive description of how the Academy is currently responding to challenges of academic and student success. Additionally, we envision the future of student success, offering 7 recommendations to the American Association of Colleges of Pharmacy and 5 suggestions to members of the Academy to advance this vision.

Cognitive Strategies: Moderating the Relationship between Executive Functions and Daily Functioning

Whereas prior studies have addressed relationships between cognitive strategies and learning and achievement, very few dealt with their connection to daily functioning. This study examines the moderation effect of the frequency of compensatory cognitive strategy use within that relationship among university students. A sample of 336 students (18-36 years; 180 women, 156 men) answered the Dysexecutive Questionnaire (DEX; executive function components), Time Organization and Participation Scale (TOPS; daily functioning), and Compensatory Cognitive Strategies Scale (CCSS; strategy use). The results showed significant correlations between the DEX and TOPS for three CCSS levels (-1.0, -1.0 to 1.0, and 1.0 SD from average); the higher the frequency of cognitive strategy use, the stronger the association between the DEX and TOPS. The findings suggest that more frequently use of cognitive strategies can strengthen efficient daily functioning.

Accessibility of drug databases and resources with assistive technology

INTRODUCTION

Pharmacy programs are responsible for providing appropriate academic accommodations to student learners in the classroom including individuals with disabilities according to Accreditation Council for Pharmacy Education Accreditation Standards.

COMMENTARY

In the literature, faculty have published methods on teaching strategies and assistive technologies to increase accessibility in a laboratory setting and implementation of resources for learners with visual or hearing impairment. An area that has not been highlighted in the literature is the accessibility of drug databases and resources often utilized in pharmacy practice and is an integral part of pharmacy curricula. This commentary provides information about the accessibility of the content and features within drug databases and resources using assistive technology for individuals with visual impairment.

IMPLICATIONS

Pharmacy programs must conduct testing of software and drug resources commonly used to ensure appropriate accommodations are provided for learners with disabilities. In addition, external stakeholders who develop drug information resources may need to consider accessibility of content for student learners with visual impairment and other forms of disability.

Addressing the Challenges of Providing Accommodations for Pharmacy Students With Disabilities Across Learning Environments

In accordance with the Americans with Disabilities Act of 1990 and the Accreditation Council for Pharmacy Education Standards 2016, schools and colleges are required to provide reasonable disability-related accommodations for eligible students enrolled in a Doctor of Pharmacy (PharmD) program. Strategies for providing reasonable and effective accommodations in didactic classrooms have been well defined. In contrast, PharmD programs often grapple with supporting learners requiring disability-related accommodations during skills-based laboratory and experiential learning performance assessments. A process that supports individualized accommodation planning, spans the breadth of the curriculum, aligns with course-level goals and learning objectives, and supports achievement of the 2013 Center for the Advancement of Pharmacy Education Educational Outcomes at the PharmD program level is essential to a student's successful academic progression. This commentary discusses challenges that arise when developing accommodation plans in patient-care skills laboratories and offers methods for bridging skills-based accommodation needs to experiential settings, while managing accommodations in an ever-evolving practice landscape.

Experiential education accommodations for students with disabilities in United States pharmacy schools: An exploratory study

INTRODUCTION

We sought to identify challenges and possible outcomes for pharmacy schools providing accommodations on experiential rotations for students with disabilities.

METHODS

A survey was developed and sent to the experiential education departments of pharmacy schools across the nation and anonymous responses were collected. Quantitative survey results were assessed using descriptive statistics, and qualitative results were assessed using thematic analysis.

RESULTS

A total of 43 individuals who self-identified as current members of the experiential education department of their school responded to the survey. Student, preceptor, and institutional challenges and barriers were identified, and various approaches to providing accommodations for students with disabilities during experiential rotations were described.

CONCLUSIONS

Providing accommodations for students on experiential rotations remains a challenge for pharmacy programs. However, guidance for pharmacy schools on proper support of students with disabilities on experiential rotations remains limited.

Facilitating the retention and success of students with disabilities in health sciences: Experiences and recommendations by nursing faculty members

This paper explores the experiences of 19 Spanish faculty members teaching nursing students with disabilities and their recommendations to other colleagues about how to facilitate their retention and success. Students themselves nominated those faculty members they felt had contributed to their learning at university. We carried out a qualitative study with individual interviews and observations. We conducted an analysis of all the information using a system of categories and codes with different themes: experience teaching students with disabilities, personal and professional impact on the faculty and recommendations to other colleagues. The findings indicate that the participants had positive experiences teaching nursing students with disabilities, although they also commented on negative aspects. The impact of students with disabilities was greater at the professional level, as they had helped them become better professionals. Moreover, these participants gave recommendations to help other colleagues contribute to the inclusion of all their students. The study concludes that it is necessary to engage in inclusive pedagogy that contemplates students' needs and develops practices that allow for their learning and participation. Just like their peers, students with disabilities can successfully complete their degrees providing the necessary support is offered, and this includes sensitized, well-informed and properly-trained faculty.

The Visibility of Disabilities within Pharmacy Program Recruitment Material

BACKGROUND

Targeted recruitment of students with disabilities is a novel area in pharmacy education and may help to attract qualified students in light of decreasing applicant numbers. The aim of this study was to explore the visibility of disabilities within online recruitment material for pharmacy programs and to determine the location of targeted information available to prospective students with disabilities.

METHODS

The top 50 ranked programs offering a professional pharmacy degree under the Pharmacy and Pharmacology QS subject rankings were identified and included if recruitment material was published in English. Online recruitment material was reviewed for presence of persons with disabilities in photos, presence or description of persons with disabilities in videos, information specific to disabilities on the program website (e.g. technical standards), and information specific to disabilities on the university website (if not located on the program website).

RESULTS

A total of 41 international program websites met the inclusion criteria. No programs included pictures or videos featuring persons with disabilities. A total of 18 (44%) of programs had disability information on the program website and an additional 18 (44%) of programs included information on the university website. There were 5 (12%) of programs that did not include any information about disabilities on the program or university website.

CONCLUSION

Recruitment material for pharmacy degree programs should be current, inclusive, and reflective of student populations eligible to be admitted. This study found a distinct underrepresentation of students with disabilities and information pertaining to disabilities within recruitment material for a sample of international pharmacy programs.