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Cady EA, Dillon AJ, Bourland K, Rybakov I, Cluck DB, Veve MP. You'll have to call the attending: Impact of a longitudinal, "real-time" case-based infectious diseases elective on entrustable professional activities to enhance APPE readiness. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102092. [PMID: 38670830 DOI: 10.1016/j.cptl.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/02/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND PURPOSE Transitioning from the didactic to experiential setting is challenging for student pharmacists, perhaps due to lack of experiences providing "real-time" clinician interaction. We describe findings from a semester-long infectious diseases (ID) didactic elective that utilized a national cohort of preceptors and faculty across the United States to mimic clinician interaction and "real-time" ID management of various disease states. The mechanics of this elective provide a framework for others to implement to enhance advanced pharmacy practice experience (APPE) readiness. EDUCATION ACTIVITY AND SETTING Students enrolled in an ID elective course at a school of pharmacy participated in "real-time" acute care scenarios. They assisted in multidisciplinary management of a patient's infection, mimicking "rounds" on an APPE, via interaction with external pharmacist volunteers (playing the roles of other healthcare personnel). Additionally, students formally presented and discussed their cases within the class, further promoting learning while optimizing presentation skills. Pharmacist volunteers were surveyed to assess student performances as measured by four entrustable professional activities (EPAs). FINDINGS A total of 48 volunteer opportunities occurred during two course offerings. Results from 43 surveys were analyzed (90% response rate). Of those responses, 22/24 (92%) played the role of attending physician, and 19/24 (79%) played the role of technician. Volunteers agreed that students met the four EPAs evaluated (agreement was 85-100%). SUMMARY This semester-long elective provided "real-time" experience and feedback for pre-APPE students to enhance APPE readiness and reinforce EPAs. Students are likely to benefit from mimicked intra-professional interaction and augmented critical thinking skills that could be adapted to various disease states within pharmacy curricula.
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Affiliation(s)
- Elizabeth A Cady
- Southern Illinois University at Edwardsville School of Pharmacy, 200 University Park Dr., Edwardsville, IL 62025, United States of America.
| | - Austin J Dillon
- HSHS St. John's Hospital, 800 East Carpenter St, Springfield, IL 62769, United States of America.
| | - Kendra Bourland
- HSHS St. John's Hospital, 800 East Carpenter St, Springfield, IL 62769, United States of America.
| | - Ilya Rybakov
- Hancock Regional Hospital, 801 N. State Street, Greenfield, IN 46140, United States of America
| | - David B Cluck
- UVA Health, 1215 Lee Street, Charlottesville, VA 22903, United States of America
| | - Michael P Veve
- Wayne State University, College of Pharmacy, 259 Mack Ave, Detroit, MI 48201, United States of America.
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Howe V, Whitworth A, Noonan A, Medel I, Perez S, Christenberry EJ. A scoping review of advanced pharmacy practice experience readiness assessment measures across schools of pharmacy. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102088. [PMID: 38604892 DOI: 10.1016/j.cptl.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The development and implementation of Advanced Pharmacy Practice Experience (APPE) readiness assessments has been an area of increased interest to the academy since the publication of the Accreditation Council for Pharmacy Education (ACPE) standards in 2016. This scoping literature review aims to provide an updated summary of current APPE readiness assessment practices among ACPE-accredited institutions in the United States (US). METHODS A literature search was conducted between 2022 and 2024 using the terms "APPE student readiness," "APPE readiness assessment," "APPE preparedness," "APPE student preparedness," "pharmacy" AND "readiness assessment", "pharmacy" AND "practice readiness," and "pharmacy" AND "student practice readiness" in Pubmed and Embase. The websites for the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning were also searched using these terms. Abstracts for all results were reviewed. Abstract only and poster presentations were excluded, as well as articles centered on non-US and/or non-ACPE-accredited institutions. Data was collected regarding the outcomes assessed, type of assessment activity, and how the assessment was implemented. Results were reviewed by a second author to ensure consistency in reporting. RESULTS A total of 289 unique abstracts were reviewed by author pairs for inclusion based on relevance to the review objectives. A total of 13 articles were included in the final analysis. Each institution measured different knowledge areas, abilities, and entrustable professional activities (EPAs). Most programs had a summative component, with APPE readiness being primarily assessed in the final didactic year of the pharmacy curriculum. Most programs report at least one source of validity. IMPLICATIONS Given the lack of specific APPE readiness assessment requirements in the ACPE Standards 2016, the different assessment methods among programs were not surprising. However, the commonalities identified can be leveraged with the release of the Curricular Outcomes and Entrustable Professional Activities (COEPA) 2022 to promote a standardized definition of APPE readiness. Future research should focus on formative assessment methods embedded throughout the didactic curriculum to identify "at-risk" students prior to a "high-stakes" summative assessment at the end of the didactic curriculum that impedes student progression to the APPE year.
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Affiliation(s)
- Vicki Howe
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
| | - Ashley Whitworth
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
| | - April Noonan
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
| | - Ines Medel
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
| | - Sebastian Perez
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
| | - Emily J Christenberry
- The University of Texas at El Paso School of Pharmacy, 500 W. University Ave, El Paso, TX 79968, United States of America.
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Garling KA, Wong B. An initial reliability analysis of a patient counseling rubric to objectively measure student pharmacist performance. Heliyon 2023; 9:e15768. [PMID: 37206018 PMCID: PMC10189406 DOI: 10.1016/j.heliyon.2023.e15768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
Current literature outlines the documented need for improved communication during patient medication counseling. Although many tools exist, there needs to be a national standardized tool that complies with federal and state law, to objectively measure student pharmacist performance during patient counseling in the community pharmacy setting. The primary objective of this study is to perform an initial analysis of the internal consistency reliability of a patient medication counseling rubric designed with an Indian Health Services theoretical framework. Secondary objectives include measuring changes in student performance over the time of the study. The 18-item rubric was developed to objectively measure student pharmacist performance during patient medication counseling sessions in a 21-h Introductory Pharmacy Practice Experience (IPPE) course. The community-pharmacy-based IPPE patient counseling course evaluates students' communication skills and patient-centered counseling techniques in live and simulated patient counseling sessions. Three pharmacist evaluators assessed a total of 247 student counseling sessions. The rubric's internal consistency reliability was analyzed, and student performance improvement was observed within the course. Students' performance was evaluated as "meets expectations" in most live and simulated sessions. However, an independent groups t-test showed that the mean performance score for the live counseling sessions (2.59, SD = 0.29) was higher (p < 0.001) than that for the simulated counseling sessions (2.35, SD = 0.35). Students' performance in the course improved over three weeks [Week 1: mean (SD) = 2.29 (0.32), Week 2: mean (SD) = 2.44 (0.33), Week 3: mean (SD) = 2.62 (0.29); p < 0.001]. A Tukey-Kramer comparison post hoc test found a significant increase in the mean performance scores between weeks (p < 0.05). The overall internal consistency reliability of the counseling rubric was determined acceptable, with a Cronbach's alpha of 0.75. Further study is required, including the assessment of inter-rater reliability, factor analysis, variable analysis, and use in other states with patient confirmation testing necessary to validate the rubric for use with student pharmacists in the community pharmacy setting.
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Affiliation(s)
- Kristin Ashley Garling
- The University of Texas at Austin – College of Pharmacy, Texas, USA
- Corresponding author.
| | - Benjamin Wong
- The University of Texas at Austin – College of Pharmacy, Texas, USA
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Baumgartner L, Israel H, Wong T, Sasaki-Hill D, Ip EJ, Barnett MJ. Performance on advanced pharmacy practice experiences after implementation of mock acute care patient simulations. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1572-1577. [PMID: 34895665 DOI: 10.1016/j.cptl.2021.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/09/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION We sought to compare student performance on acute care advanced pharmacy practice experiences (APPEs) pre- and post-incorporation of mock acute care patient simulations into the curriculum. METHODS A series of mock acute care APPE simulations (MACAS) were developed and incorporated into Touro University California College of Pharmacy curriculum for first- and second-year pharmacy students. Results for student performance on Acute Care I and Acute Care II APPEs were collected for students who received none, one year, or two years of the MACAS. Student admission characteristics and didactic academic performance (grade point average [GPA]) were also gathered. Student characteristics and APPE performance were compared across cohorts of students who received none, one year, and two years of MACAS. Multivariate models were created to measure the impact of the MACAS while controlling for student characteristics. RESULTS The final cohort included 394 students. In unadjusted analyses, students with one or two years of MACAS received significantly higher preceptor acute care APPE evaluations for communication, professionalism, and patient scores vs. students who received no MACAS. In multivariate models controlling for age, gender, and undergraduate GPA, one year of MACAS increased student acute care APPE communication, professionalism, and patient care scores, relative to no MACAS. Similar increases in acute care APPE scores were seen for students who received two years of MACAS. CONCLUSIONS MACAs significantly improved acute care APPE scores relative to students with no MACAS. This improvement in acute care APPEs occurred after students received a single year of MACAS.
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Affiliation(s)
- Laura Baumgartner
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America; Division of Primary Care and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305 United States of America.
| | - Heidi Israel
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America.
| | - Terri Wong
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America.
| | - Debbie Sasaki-Hill
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America.
| | - Eric J Ip
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America; Division of Primary Care and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305 United States of America.
| | - Mitchell J Barnett
- Touro University California College of Pharmacy, 1310 Club Dr., Mare Island, Vallejo, CA 94502, United States of America.
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Blakely ML, Biehle L. Evaluation of team communication in an interprofessional inpatient transition of care simulation. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 3:100059. [PMID: 35480618 PMCID: PMC9030718 DOI: 10.1016/j.rcsop.2021.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/17/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background Interprofessional education (IPE) provides unique opportunities for students to better understand their roles, roles of other healthcare professionals, and prepare for teamwork for patient benefit. Interprofessional team education is recognized as a key element in the 2016 ACPE standards. Objective Assess student self-perceived competence in four IPEC domains after an inpatient simulation activity. Methods Pre/post-test design used the Interprofessional Education Collaborative Competency Survey. The activity included medical, nursing, social work, and pharmacy students working in healthcare teams to develop collaborative treatment plans for simulated patients with altered mental status. Results Ninety-seven health profession students completed the activity, while 49 second-year (P2) student pharmacists participated in the study. All completed a pre-test and 47/49 (96%) completed a post-test. At pre-test, students ranked themselves highest in abilities to respect patient privacy (100% strongly agree) and acting with honesty and integrity in relationships (100% strongly agree). They reported lower ability in describing team development process. At post-test, significant increases were seen in managing ethical dilemmas (p < .002) and respect (p = .49), though decreases were seen in using appropriate or respectful language (p < .02). Conclusion Significant differences in student perceptions of ethics and communication were observed after participation in a transition of care inpatient IPE simulation.
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Draime JA, Wicker E, Laswell E, Chen AMH. Implementation and assessment patient cases using the SBAR method to teach patient quality of life issues. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1040-1045. [PMID: 34294245 DOI: 10.1016/j.cptl.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/15/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Quality of life (QoL) preferences are an important consideration with respect to the Pharmacists' Patient Care Process (PPCP) and should be assessed prior to implementing a patient-centered plan. The objectives of this intervention were to determine if the design of a QoL activity impacts student performance, and to discern student perceptions of an innovative, case-based activity. EDUCATIONAL ACTIVITY AND SETTING Two cohorts of students in their second professional year were asked to present an article that included a QoL consideration. The two student cohorts were asked to complete the activity using a case report and modified SBAR (Situation, Background, Assessment, Recommendation) format. Presentations were graded using a rubric, and scores were assessed retrospectively. An unpaired t-test was used to examine differences. The final cohort of students was also asked to complete a survey to gather their perspectives. Results were described using descriptive statistics; thematic analyses were also performed. FINDINGS Students who completed the SBAR activity (N = 71) performed significantly better than those who completed the article (N = 98) presentation (95.62 ± 5.47 vs. 86.30 ± 16.54, P < .001). Those who completed the survey (N = 22) felt they made moderate to excellent progress explaining QoL (86%) and that the activity was helpful (68%). Overall, students reported an improved understanding of the patient's perspective. SUMMARY The PPCP requires that students must consider the patient's QoL in order to develop an optimal patient-centered plan. Activities such as this may improve student understanding of QoL implications.
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Affiliation(s)
- Juanita A Draime
- Pharmacy Practice, Cedarville University School of Pharmacy, 251 N. Main Street, Cedarville, OH 45314, United States.
| | - Emily Wicker
- Class of 2021, Cedarville University School of Pharmacy, 251 N. Main Street, Cedarville, OH 45314, United States.
| | - Emily Laswell
- Pharmacy Practice, Cedarville University School of Pharmacy, 251 N. Main Street, Cedarville, OH 45314, United States.
| | - Aleda M H Chen
- Pharmacy Practice, Cedarville University School of Pharmacy, 251 N. Main Street, Cedarville, OH 45314, United States.
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Gruenberg K, Hsia S, O'Brien B, O'Sullivan P. Exploring Multiple Perspectives on Pharmacy Students' Readiness for Advanced Pharmacy Practice Experiences. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8358. [PMID: 34283732 PMCID: PMC8174613 DOI: 10.5688/ajpe8358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/29/2021] [Indexed: 05/14/2023]
Abstract
Objective. This study aimed to enrich the Academy's understanding of pharmacy students' readiness for advanced pharmacy practice experiences (APPEs) by exploring the perspectives of three primary stakeholders: APPE students, APPE preceptors, and APPE faculty site directors.Methods. A descriptive qualitative study of APPE readiness was conducted using workplace learning as a guiding conceptual framework. Data were collected between March and September 2019 through semi-structured focus groups and interviews with students (five groups), preceptors (four groups), and faculty site directors (one group, two individual interviews). The data were analyzed using directed content analysis.Results. Participants described APPE readiness as a multifaceted construct comprised of four themes: learner characteristics, participation in workplace activities, relationship-building, and workplace practices to orient and support students. While all participants addressed each category, faculty site directors and preceptors tended to focus on learner characteristics, while students emphasized their participation in the workplace and relationship building.Conclusion. Knowledge is widely recognized as a requirement for APPE readiness. This study identified learner characteristics, workplace participation, and relational skills as additional requirements. Some of these criteria are challenging to assess prior to APPEs, which makes orienting students both prior to and at the start of APPEs particularly important to support readiness. Thus, a comprehensive review of APPE readiness might also include assessing the readiness of workplaces, administrators, and preceptors for APPE students.
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Affiliation(s)
- Katherine Gruenberg
- University of California San Francisco, School of Pharmacy, San Francisco, California
| | - Stephanie Hsia
- University of California San Francisco, School of Pharmacy, San Francisco, California
| | - Bridget O'Brien
- University of California San Francisco, School of Medicine, San Francisco, California
| | - Patricia O'Sullivan
- University of California San Francisco, School of Medicine, San Francisco, California
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