Pharmacy Education Crosses the Rubicon

Falling NAPLEX pass rates are cause for concern

INTRODUCTION

First-time pass rates of the North American Pharmacist Licensure Examination (NAPLEX) have declined 7% from 2019 to 2022 with more than a third of schools experiencing a decline of ≥10%.

COMMENTARY

The cause of the decline is likely multifactorial and extends beyond the impact of the COVID-19 pandemic. Changes to the NAPLEX blueprint in 2021, curricular revisions in response to the implementation of Accreditation Council for Pharmacy Education Standards 2016, and changes to prerequisite course requirements in response to declining enrollment must also be evaluated as potential causes.

IMPLICATIONS

The academy must respond to this decline by scrutinizing admissions, curriculum, and assessment processes. We urge the National Association of Boards of Pharmacy to provide access to student-level data on NAPLEX performance and increase transparency in passing standard practices to inform this process.

Lecture Capture Is the New Standard of Practice in Pharmacy Education

The desire and need for remote access to education dramatically increased during the COVID-19 pandemic. As higher education struggles to find its "new normal," pharmacy programs have begun to review changes and approaches to decide which should be continued. This Commentary advocates that the use of lecture capture as an instructional delivery strategy, is no longer just a supplement to learning, but is now a standard of practice in health professions education. Lecture capture creates equity for students by providing additional opportunities to review material. Students may be balancing schoolwork with a job, caring for their children, or fulfilling other obligations. Lecture capture allows students to acquire information at lower levels of Bloom's taxonomy at a time that fits into their schedule, at a pace appropriate for them, and in a method that may better suit their learning needs. Students entering pharmacy school at this time have learned from audio/video media (eg, YouTube, Ted Talks, podcasts) and nontraditional educational competitors (eg, Khan Academy, Coursera, MasterClass). Students have become accustomed to learning via media technology and regularly do so in their everyday lives. Students desire lecture capture as it provides an opportunity to review unclear, complicated, or missed concepts as part of the studying process. Though its use is flexible, like any tool, lecture capture should not be used for all situations. Benefits and disadvantages of lecture capture for students, faculty, and institutions are described herein.

Remote Work in Pharmacy Academia and Implications for the New Normal

Objective. To determine the extent to which pharmacy faculty engaged in remote work during the first two years of the COVID-19 pandemic and, secondarily, to characterize pharmacy faculty and administrator perceptions of remote work.Methods. A 28-question online survey was sent to 6548 members of the American Association of Colleges of Pharmacy (AACP). Questions centered on the extent of remote work and perceptions of its impact on productivity, effectiveness, and work-life balance. Focus groups were held to provide additional insight, and data were analyzed statistically.Results. In total, 6322 AACP members met inclusion criteria, of whom 1293 responded to the survey (21% response rate). At least one faculty member responded from 139 schools (99% response rate), and at least one administrator responded from 126 schools (89% response rate). During the pandemic, 97% of faculty were permitted to work remotely, 94% of whom did so at least some of the time. Most faculty indicated no change or an improvement in productivity (85%) and effectiveness (80%). Similarly, most administrators indicated no change or an increase in their unit's productivity (81%) and effectiveness (85%). More than half of respondents indicated better work-life balance while working remotely.Conclusion. Nearly all respondents were permitted to work remotely at least some of the time during the pandemic. Considering that most faculty and administrators believe productivity and effectiveness were not compromised and that there appear to be benefits to work-life balance, schools of pharmacy in the United States should consider permitting faculty to work remotely some of the time as we navigate the pandemic and thereafter.

Using Team Innovation and Networking to Respond to Rapid Changes in the Academy

When COVID-19 shuttered schools across the nation, it propelled higher education institutions into uncharted territories. Institutions had to make rapid decisions in a short period of time with limited information or direction. In these uncertain and challenging times, pharmacy academics in the United States and around the world reached out to one another to discuss, share, and learn. What began with a few members of the Student Services Personnel Special Interest Group (SIG) grew to many members who banded together as a team through open discussions to innovative problem-solving. Working together through open discussions created a setting that promoted diverse ideas, multiple perspectives, and a depth of knowledge to address some of the most challenging issues faced by pharmacy education. When partnering together, institutions had a much greater resource of knowledge and support that could be leveraged to broadly benefit the Academy.

Educating pharmacy students through a pandemic: Reflecting on our COVID-19 experience

The impact of the COVID-19 pandemic on pharmacy education worldwide has been immense, affecting students, educators and regulatory agencies. Pharmacy programmes have had to rapidly adapt in their delivery of education, maintaining standards while also ensuring the safety of all stakeholders. In this commentary, we describe the challenges, compromises and solutions adopted by our institution throughout the pandemic, the lessons learnt, adaptive measures taken, and strategies to develop and future-proof our curricula.

Use of Learning Management System Data to Predict Student Success in a Pharmacy Capstone Course

Objective. Learning management system (LMS) data from online classes may provide opportunities to identify students at risk of failure. Previous LMS studies have not addressed the possibility of change in student engagement over time. The purpose of this study was to apply a novel statistical technique, group-based trajectory modeling (GBTM) to LMS data in an online course to identify predictors of successful course completion.Methods. Exploratory GBTM was used to assess the association of LMS activity (total activity time, dates of activity, and pages viewed) and attendance at virtual synchronous learning sessions with examination performance in a capstone disease-management course delivered in the final didactic quarter of a three-year Doctor of Pharmacy program. Groups were assigned based on trajectories of weekly page view counts using structural-equation modeling.Results. Group-based trajectory modeling identified three page view engagement groups (median total page views, n): group 1, high (1,818, n=24): group 2, moderate (1,029, n=74), and group 3, low (441 views, n=35). Group assignment alone was somewhat associated with final grade. Stratification based on consistent virtual synchronous learning session attendance improved predictive accuracy; for example, a top (A or A-) grade was earned by 49.0% and 24.0%, respectively, of group 2 students with and without consistent synchronous engagement.Conclusion. Application of GBTM to LMS data, including information about synchronous engagement, could provide data that allow educators to identify early warning signs that a student may fail a course and target interventions to those at-risk students. The technique should be further tested with alternative LMS data and obtained early in the didactic curriculum, before patterns of engagement are established.

Impact of the COVID-19 pandemic on faculty at research-intensive United States schools/colleges of pharmacy

INTRODUCTION

To describe the impact of the SARS-CoV-2 pandemic on teaching, research, practice, and work-life integration for pharmacy faculty at research-intensive institutions.

METHODS

An online survey related to transition to remote work, impact on faculty responsibilities, demographics, and other elements was sent to nine research-intensive United States public schools/colleges of pharmacy. Respondents were asked to describe challenges in moving to remote instruction as a result of the pandemic. The 75-item survey asked respondents to rate the degree to which factors were challenging and levels of concern with the abrupt transition. Responses were analyzed using descriptive statistics and comparison of means using paired samples t-tests between spring and fall semesters, for the types of students taught, and for faculty discipline.

RESULTS

Surveys were completed by 279 faculty (36% response rate), with 62% self-identifying as pharmacy practice faculty. The highest reported challenges were family/home responsibilities (41%), assisting children with schoolwork (28%), and availability of childcare (22%). Concerns most identified by respondents were increased workload, potential for academic dishonesty, and inability to effectively conduct hands-on activities. Practice faculty encountered barriers using telehealth and delivering virtual experiential education, while both practice and research faculty reported concerns with research progress.

CONCLUSIONS

The pandemic has led to substantial challenges and increased workload in many areas. As the pandemic persists, administration should consider reported barriers and concerns to inform expectations. Evaluation of novel instructional design, assessment methods, and best practices in the virtual learning environment is highly encouraged to ensure student competencies are met.

Impact of COVID-19 on graduating U.S. pharmacy students in the early epicenter of the pandemic in New York City

Objective

To describe the self-reported impact of the COVID-19 pandemic among final year student pharmacists enrolled in a Doctor of Pharmacy program in New York City during the first peak of the outbreak March through May 2020.

Methods

A required senior seminar course for graduating student pharmacists served as a conduit for faculty led monitoring of the wellbeing of the cohort through three data sources: 1) polling data regarding stress factors during a COVID-19 informational session (March 2020), 2) survey data from a 12-item COVID-19 Impact Survey developed and administered electronically in May 2020 and 3) qualitative data from reflection papers mentioning COVID-19. Descriptive statistics, bivariate analysis and thematic analysis were used to summarize data.

Results

In March, almost half of respondents (total = 185) reported high personal (47.6%) and school related stress (42.1%). Most students were participating in advanced pharmacy practice experiences (80%) and working in a pharmacy (80%). Survey data (n = 96) revealed the majority of participants perceived negative impact on their future career (69%) and reported concern for people close to them with suspected and confirmed COVID-19. One-third of participants reported knowing someone who died from COVID-19 and 8% were self-confirmed COVID-19 positive. Themes emerging from the reflection papers included: changed perspective, gained experience as a pharmacist during a pandemic, concern for loved ones, and positive outlook.

Conclusion

The COVID-19 pandemic had a significant impact on the wellbeing of a cohort of graduating student pharmacists in New York during the initial peaks of the spread in the United States. The results reinforce a need for student support during emergency situations, especially during the final year.

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In March 2020, COVID-19 blazed through New York City resulting in tremendous challenges for health professions training.

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Pharmacists remained the most accessible health profession but lacked the ability to ensure safety for student pharmacists.

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This study describes the personal experiences of student pharmacists during the peak of the pandemic.

WITHDRAWN: What just happened? Impact of on-campus activities suspension on learning during COVID-19 lockdown – Pharmacy students’ perspective

The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jsps.2020.12.008. The duplicate article has therefore been withdrawn.

The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Meeting pharmacy educational outcomes through effective use of the virtual simulation MyDispense

INTRODUCTION

One of the challenges of pharmacy schools worldwide is the need to link theoretical training with the mastery of practical skills. A virtual pharmacy simulation, MyDispense, developed by the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, enables students to practice the skills of a professional pharmacist, from novice to highly advanced, in a safe virtual environment that is web-based and highly accessible. The free online simulation allows students to undertake scenarios where patients can present with prescription or self-care requirements, and are also challenged with validation tasks requiring them to check the work of virtual colleagues for accuracy, legality, and medicine safety.

COMMENTARY

This commentary describes the use of a virtual simulation, MyDispense, in enhancing didactic instruction, complementing experiential education, and the challenges of the virtual simulation to pharmacy educators. MyDispense is now deployed to 186 schools of pharmacy across 34 countries to over 25,000 students worldwide who have completed over 963,000 exercises globally.

IMPLICATIONS

The severe acute respiratory syndrome 2 (aka COVID-19) pandemic presents challenges to pharmacy education requiring many educators to switch to remote online learning. Simulation programs, such as MyDispense, help to replicate aspects of pharmacy practice and can be used creatively to meet course needs. The use of MyDispense is an excellent example of pharmacy educators collaborating globally and learning from each other to improve student learning.

Changes to summative skills-based assessments within the Big Ten Academic Alliance Performance-Based Assessment Collaborative (BTAA-PBAC) due to COVID-19

Background

In Spring 2020 many academic institutions transitioned to remote learning in response to the developing COVID-19 pandemic. These changes affected skills-based training, as schools of pharmacy were forced to transition traditionally in-person assessments to a remote setting. The purpose of this article is to describe the experience of pharmacy skills lab coordinators when transitioning summative skills-based assessments (SSBA).

Methods

A web-based survey instrument administered through QualtricsXM was sent to all institutions in the Big Ten Academic Alliance-Performance Based Assessment Collaborative. Only one member from each institution completed the survey on behalf of the institution. The survey consisted of four sections: changes made to skills evaluated; changes made to the delivery of those evaluations; challenges to and strategies used by the skills lab program when switching to remote learning; and recommendations for incorporating remote learning within future SSBAs. Survey respondents were invited to participate in an optional unstructured interview regarding survey answers.

Results

Nine of ten invited institutions responded to the survey. Of the nine respondents, three participated in the post-survey interview. Overall, 79.5% (93/117) of skills planned to be assessed were assessed with or without modification, with 8.5% (10/117) of skills canceled and 10.3% (12/117) of skills assessments postponed. The most common challenges mentioned were the lack of preparation time, inability to assess certain skills virtually, and student barriers. The most common recommendations made were to prioritize lab components and incorporate flexibility in planning and scheduling.

Discussion

The results indicate that most skills were still assessed during the Spring 2020 semester. Though the transition to remote learning was challenging and unique for each institution, common strategies and recommendations identified here provide opportunities for academics to analyze and prioritize learning objectives and to rethink how to develop and deliver SSBAs as remote assessments.

What does experiential education look like in a global pandemic? Reflecting back and looking forward

PURPOSE

The purpose of this reflection or wisdom of experience article is to describe and reflect on the impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on experiential education (EE) leadership and teams. Additionally, this reflection will shift the focus from the spring 2020 environment of SARS-CoV-2 to what EE teams and college administration can learn from those experiences. Moving forward, EE teams and administrators can be better equipped to proactively plan for future emergencies.

DESCRIPTION

Using the "What? So What? Now What?" model of reflection, this manuscript will broadly describe the experiences of three EE administrators and their teams during the SARS-CoV-2 pandemic. Proposed lessons learned as well as future planning strategies will be presented.

ANALYSIS/INTERPRETATION

The world of education was unprepared for the SARS-CoV-2 pandemic, and most sectors were left scrambling to adjust to new models very quickly with no planning or preparation. In the realm of pharmacy education, SARS-CoV-2 caused complete disruption for pharmacy students on rotations, clinical sites, preceptors, and EE teams. In reflecting on spring 2020, much can be gained and applied to future planning efforts so that institutions can be better prepared for future crises.

CONCLUSIONS/IMPLICATIONS

While still in the pandemic, schools must plan for the coming year. EE teams can work together to prepare for emergencies, craft contingency plans, and build additional capacity into their teams and available rotation offerings.

Continuing to Challenge the Paradigm of What Is Possible in Pharmacy Education and Practice Post-COVID-19

The COVID-19 pandemic has caused boundless disruptions to every element of life. It has also brought with it lessons from the past that will likely extend into the future as humans continue to interface with the ever-increasing threats of zoonotic diseases. The pandemic has challenged the profession and the Academy to adjust, modify, and adapt. It has also stretched the bounds of what had previously been thought possible within the realms of medicine. As the Academy begins to reach and crest the apex of the epidemic it should be reminded of the many lessons associated with the pandemic and of the constant need to challenge the paradigm of what is possible.

Adapting pharmacy experiential education during COVID-19: Innovating remote preceptor resources, tools, and patient care delivery beyond virtual meetings

Purpose

To describe the innovative teaching practices, tools, and resources for remote learning developed by a school of pharmacy with a decentralized experiential program to empower and support preceptors in response to the coronavirus disease 2019 (COVID-19) pandemic.

Summary

As the pandemic has continued, there have been significant shifts in pharmacy workflow, staffing, and patient care delivery. Pharmacy students are slowly being reintegrated into these learning environments. Although preceptors are willing and eager to teach, many lack the resources, tools, and support to create remote learning experiences at their facilities. The University of the Pacific Thomas J. Long School of Pharmacy has a decentralized experiential education model in which faculty regional coordinators with clinical practices and diverse expertise are disseminated throughout California. This model allowed us to collaborate and understand preceptor needs from a local level. We created a preceptor COVID-19 guidance document, introduced innovative virtual playbooks to pivot up to 100% remote rotations, and promoted the layered learning model to integrate pharmacy residents into the remote teaching space. Communication and flexibility are key to ensure student and preceptor safety while maintaining high-quality advanced pharmacy practice experiences and preserving patient-student relationships in telehealth.

Conclusion

Overall, we successfully created innovative solutions and leveraged our decentralized experiential model to meet the teaching and learning demands during an unanticipated crisis. We continue to adapt and plan to assess the effectiveness of the tools by administering surveys of preceptors and pharmacy students.

What just happened? Impact of on-campus activities suspension on pharmacy education during COVID-19 lockdown - A students' perspective

Introduction

COVID-19 pandemic induced lockdown, suspending all on-campus educational activities in the Kingdom of Saudi Arabia (KSA), compelling to continue the education online. We explored pharmacy students' perspective on its impact on their learning.

Methods

A Twitter chat was organized on three consecutive days, after final examinations, inviting all pharmacy students in KSA to participate. Day 1 chat included 11 questions regarding learning and assessment, Day 2 chat included six questions about online examinations and six questions about technology use, Day 3 chat included six questions related to lessons learnt from the learning experiences during the lockdown. The questions were validated and piloted before the chat. The responses were copied, reviewed to remove any confidential information, and thematically analyzed by two teams of research students independently.

Results

During the three-day chat, 790 responses were received in total. Thematic analysis generated 944 codes which were categorized into 43 subthemes. These subthemes were further categorized into six main themes: 'facilitators for online education', 'barriers for online education', 'online versus onsite education', 'role of technology in online education', 'suggestions for improving online education' and 'long-term impact of online education during lockdown'. Participants highlighted several facilitators and barriers which affected their education during the lockdown, compared online education with onsite education, and provided suggestions for improving online education based on their learning experiences during the lockdown.

Conclusion

As COVID-19 pandemic and its repercussions are expected to last longer, pharmacy colleges and academic staff will find these findings useful to prepare for the coming years, ensuring pedagogical and accreditation standards.

Leading a Digital Transformation in Pharmacy Education with a Pandemic as the Accelerant

The global COVID-19 pandemic has not only posed a challenge to education but created an opportunity to spearhead a digital transformation and the novel delivery of a Pharm.D. curriculum. The process to transform the curriculum in a sustainable and iterative manner involved multiple steps including: (1) Communication, (2) Maintaining faculty engagement, (3) Allowing outside the box thinking, (4) Providing resources and tools and (5) Creating accountability and timelines. At our institution, we have been interested in digital transformation since completing our interview of global leaders. We began our journey using the current COVID-19 pandemic as an accelerant for change. Digital transformation in any industry is not a simple undertaking. However, with planning, aligned organizational interests, consistent and regular communication, provision of resources and tools, engaging faculty and creating accountability and timelines with deliverables the implementation can be successful. When the global pandemic wanes and educational institutions commence in-person classes, having undergone the stages of digital transformation, we will be able to embrace these changes and transform education, not having to reproduce pre-pandemic educational systems.