A Mixed Methods Study of Resources Available for the Professional Development of Mid-Career Faculty

OBJECTIVE

To determine what resources are available and useful for the professional development of mid-career faculty (MCF) in pharmacy education to foster career advancement.

METHODS

A 37-question survey was sent to 7236 members of the American Association of Colleges of Pharmacy, an estimated 4640 of whom represented the target population of associate professors, full professors, and administrators. Semi-structured focus groups involving these 3 groups of faculty were held to provide additional insight.

RESULTS

Of 4640 targeted pharmacy faculty, 825 completed the survey (18% response rate). At least one response was received from 98% of colleges and schools of pharmacy. Over 75% of MCF indicated a goal to advance to full professor, of whom only 55% were very or extremely confident they would be promoted. Clarity in expectations for advancement was identified as the most important factor for advancement; however, only 57% of MCF respondents agreed that their department/division has clearly delineated expectations for promotion. Protected time for research/scholarship was perceived by MCF as another important factor for advancement but was not provided as a resource to 61% of faculty. Thematic analysis of 7 focus groups including 31 faculty revealed 10 themes reinforcing the survey results.

CONCLUSION

This study identified misalignment between the needs of MCF and the resources available to facilitate development/advancement.

A Call to Action for the Professional Development of Mid-Career Faculty

Despite taking on heavier teaching and service loads, an expanding research program, and serving as mentors to junior faculty, mid-career faculty often feel unsupported. Providing a solid foundation through resource allocation and sharing between and within institutions can facilitate establishment or improvement of faculty development initiatives, workload equity, transparent policies, routine performance evaluation, a process for faculty recognition, and a system of mentoring to create an environment where this essential group of faculty can continue to grow. The following discussion, which includes suggested methods to achieve these goals with a focus on mid-career faculty, serves as a call to action for pharmacy school administrators to assess the state of mid-career faculty at their institution, and if indicated, implement systems that promote success among this group.

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.

Enhancing Pharmacy Faculty Well-Being and Productivity While Reducing Burnout

Objective To explore methods that pharmacy programs can use to redefine their work environment to reduce stress, improve well-being, and increase faculty productivity.Findings To demonstrate a culture of support, organizations should consider a five-fold approach to enhancing and maintaining faculty well-being, including optimizing faculty and staff support, establishing a faculty development and mentoring program, permitting flexibility in work schedules, improving productivity of meetings, and managing communication tools. Individuals can also take measures to improve their well-being, including controlling email, giving attention to faculty citizenship, implementing stress reduction and coping techniques, and maintaining boundaries between work and home.Summary This article discusses approaches that have been shown to reduce burnout and provides strategies organizations and individuals can implement to improve productivity and faculty well-being. While certain areas, such as faculty wellness and productivity, have been well-studied in the pharmacy and health professions literature, significant gaps were identified in other areas, including alternate work arrangements. In some cases, data from the business sector can be extrapolated to pharmacy education; however, inferences from effective corporate strategies may not be transferable to the culture and expectations of academia. While there is significant overlap between institutional and individual strategies, a culture of communication, collaboration, support, and citizenship is foundational. There is no single strategy that will work for everyone, and flexibility is important to develop an individualized approach.

Health information technology utilization and impact on COVID-19 vaccination

The use of health information technology (HIT) during the coronavirus disease 2019 (COVID-19) pandemic has rapidly increased. During the pandemic, HIT has been used to provide telehealth services, education on the severe acute respiratory syndrome coronavirus 2 disease, updates on epidemiology and treatments, and most recently, access to scheduling systems for the COVID-19 vaccines. Disparities and health equity, with higher rates of illness, hospitalization, and death, during the pandemic has been documented in Hispanic or Latinx, black, and Native American or Alaska Native persons. Social determinants of health affect these persons disproportionately, including having lower socioeconomic status, lack of reliable transportation, lack of good quality broadband, being employed as an "essential worker," lack of quality housing, and access to and distrust of the government and health care setting. Patients who have limited or low health literacy will also be at risk for inequitable access to the COVID-19 vaccine owing to the complexities associated with the current vaccine distribution models and the heavy reliance on HIT.

Assessment of a Scholars Program Designed to Enhance Pharmacy Students' Competitiveness for Postgraduate Residency Training

Objective. To assess pharmacy residency match/placement rates and student perceptions of a program designed to enhance Doctor of Pharmacy (PharmD) student competitiveness for postgraduate residency positions. Methods. The Scholars Program was developed to provide advanced training to select PharmD students who had an interest in postgraduate residency training and was completed during the third and fourth professional years. The program consisted of mentoring; elective coursework encompassing clinical practice, teaching, and leadership; modified experiential education; journal club meetings; teaching assistant duties; conducting research and/or scholarship; and delivering professional presentations. Residency match/placement rates of students who had completed the program were compared to national data and to students in the school who were not enrolled in the program. Perceptions of the program were assessed using an online survey. Results. Sixty-four students enrolled in and completed the Scholars Program from 2013 to 2019. Of these, 58 (91%) pursued postgraduate residency training. Students enrolled in the program had a higher combined phase 1/phase 2 match rate (91.4% vs 67.4%) than students in other PharmD programs across the United States. Similarly, students enrolled in the Scholars Program had a higher combined phase 1/phase 2 match rate (91.4% vs 62.9%) and overall residency placement rate (96.6% vs 67.0%) compared to students in the school who were not enrolled in the program. More than 85% of students enrolled in the Scholars Program who pursued residency training agreed that the program prepared them for and helped them attain a postgraduate residency. Conclusion. Pharmacy students enrolled in the Scholars Program experienced high residency match/placement rates and viewed the program as valuable preparation for postgraduate training.

Facilitating Advancement of Clinical-Track Pharmacy Faculty Members

Clinical faculty members in most pharmacy practice departments are expected to engage in practice, teaching, research and scholarship, and service. Although new clinical faculty members are typically well equipped to engage in the clinical practice aspect of their position, they generally lack experience in the other academic pillars and, depending on the institution, may not have dedicated time to engage in each area of effort, particularly research and scholarship. Consequently, achieving balance and realizing success in the tripartite mission of academia can be challenging. A multimodal approach can be used to facilitate advancement among clinical faculty members through faculty development and mentoring, attention to workload, clear expectations, and provision of feedback on performance and progression toward goals. This approach, which has been well received, has been associated with higher rates of promotion among clinical faculty members at one institution. Schools and colleges of pharmacy that value research and scholarship and are struggling to facilitate advancement among clinical faculty members may consider adopting some or all aspects of this program.

Immunization Education in US Pharmacy Colleges and Schools

Objective. To determine the extent to which immunization is covered at US colleges and schools of pharmacy and to characterize what immunization- and vaccine-related content is taught. Methods. An invitation to complete a 23-question online survey instrument was sent to 128 accredited US pharmacy colleges and schools. Frequency and descriptive statistics were used to characterize the data, and the Fisher exact test was used to compare opportunities for students to engage in introductory and advanced pharmacy practice experiences (IPPEs and APPEs) at schools located in states that did or did not allow pharmacy students and interns to vaccinate. Results. Eighty accredited US pharmacy schools responded to the survey (62.5% response rate). The APhA Pharmacy-Based Immunization Delivery Program was offered by 73 (91.3%) schools, while a different immunization certificate program was offered by 5 (6.3%) schools. Sixty-nine (86.3%) and 36 (45%) of the schools had integrated immunization topics into their required core curriculum (mean 8.4 contact hours) and elective curriculum, respectively. Of the 27 immunization-related topics identified, 23 (85.2%) were covered by at least 80% of schools. More than 80% of schools offered IPPEs and more than 90% offered APPEs that provided opportunities for students to engage in immunization-related activities. Schools located in states that permitted pharmacy students and interns to vaccinate more commonly offered immunization-related opportunities through IPPEs (86.5% vs. 0%) and APPEs (97.3% vs. 20%) than those schools in states that did not. Conclusion. Immunization curricula at US colleges and schools of pharmacy appear to align with ACPE standards, as well as the recommendations of the American Association of Colleges of Pharmacy and the American College of Clinical Pharmacy. Furthermore, nearly all of the schools are using the APhA Program to do so.

Global Health Education in Doctor of Pharmacy Programs in the United States

Objective. To determine the extent and manner in which global health education is taught at US PharmD programs. Methods. A pre-tested 40-question electronic survey instrument was developed and sent to each of the 127 accredited or candidate-status US doctor of pharmacy (PharmD) programs. Results. Twenty-eight public and 27 private PharmD programs responded to the survey (43.3%). Twenty-five (45.5%) programs had integrated global health topics into their required didactic curriculum, and 30 of 52 programs (57.7%) offered at least one standalone global health elective course. Of the 52 programs that provided details regarding experiential education, 41 (78.8%) offered introductory and/or advanced pharmacy practice experiences (IPPEs and/or APPEs) in global health, and 34 (65.4%) programs offered medical mission trips. Conclusion. Doctor of pharmacy programs participating in global health education most commonly educate students on global health through experiential learning, while inclusion of required and elective coursework in global health was less common. To adequately prepare students for an increasingly global society, US PharmD programs should consider expanding global health education.

Introduction and Assessment of a Blended-Learning Model to Teach Patient Assessment in a Doctor of Pharmacy Program

Objective. To integrate a blended-learning model into a two-course patient assessment sequence in a doctor of pharmacy (PharmD) program and to assess the academic performance and perceptions of enrolled students. Design. A blended-learning model consisting of a flipped classroom format was integrated into a patient assessment (PA) course sequence. Course grades of students in the blended-learning (intervention) and traditional-classroom (control) groups were compared. A survey was administered to assess student perceptions. Assessment. The mean numeric grades of students in the intervention group were higher than those of students in the traditional group (PA1 course: 92.2±3.1 vs 90.0±4.3; and PA2 course: 90.3±4.9 vs 85.8±4.2). Eighty-six percent of the students in the intervention group agreed that the instructional methodologies used in this course facilitated understanding of the material. Conclusion. The blended-learning model was associated with improved academic performance and was well-received by students.

Engaging Postgraduate Year-2 Pharmacy Residents in Formal Co-evaluation of Platform Presentations at a Regional Residency Conference

Objective. To implement and assess the perceived impact of a program designed to engage postgraduate year-2 (PGY2) pharmacy residents in formal co-evaluation of platform presentations at a regional residency conference. Design. A PGY2 formal co-evaluator program was designed and conducted over two years. Postgraduate year-2 residents were paired with a preceptor for modeling, coaching, and facilitating. To assess the perceived usefulness of this program, a 2-question presurvey and an 11-question postsurvey were distributed to participating residents. Assessment. Eighty-two residents completed the program and pre/postsurveys (response rate=94.3%). The percentage of residents who rated themselves as skilled in critically evaluating a platform presentation increased from 56.1% to 100%, while the percentage of residents who rated themselves as skilled in providing constructive feedback increased from 67.1% to 98.8%. Conclusion. This novel program, which was designed to engage PGY2 pharmacy residents in formal platform presentation co-evaluation, was well received and improved resident self-reported skills.

Antibiotic Management of Methicillin-Resistant Staphylococcus aureus–Associated Acute Pulmonary Exacerbations in Cystic Fibrosis

Objective: To review the treatment of methicillin-resistant Staphylococcus aureus (MRSA)–associated acute pulmonary exacerbations (APEs) in cystic fibrosis (CF). Data Sources: A search of PubMed, MEDLINE, Cochrane Library and Clinicaltrials.gov databases through November 2014 was conducted using the search terms Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, pulmonary exacerbations, and cystic fibrosis. Study Selection and Data Extraction: All English-language research articles, case reports, and case series were evaluated. A total of 185 articles were identified related to MRSA and CF; 30 articles that studied treatments of MRSA APE in CF were included. Data Synthesis: The persistent presence of MRSA in the respiratory tract of patients with CF has been associated with higher morbidity and an increased risk of death. Limited clinical data exist supporting the efficacy of any specific antimicrobial currently available for the treatment of APE secondary to MRSA. Conclusions: Data extrapolated from other populations suggest that vancomycin and linezolid are appropriate first-line treatment options for the treatment of APE secondary to MRSA. Second-line options include doxycycline or minocycline and trimethoprim/sulfamethoxazole, each of which may be useful in patients coinfected with other respiratory pathogens, for which they may provide overlapping coverage. Ceftaroline and ceftobiprole are newer antibiotics that appear to have a potential role in the treatment of APE in CF, but the latter is not currently available to the US market. Although potentially useful, clindamycin is limited by high rates of resistance, telavancin is limited by its toxicity profile, and tigecycline is limited by a lack of demonstrated efficacy for infections that are similar to that seen in the CF population. Studies investigating the clinical utility of the above-cited antibiotics for APE in CF secondary to MRSA are desperately needed to broaden the treatment armamentarium for this medical condition.

Education in pediatrics in US colleges and schools of pharmacy

OBJECTIVE

To determine the extent to which pediatrics is taught at US doctor of pharmacy (PharmD) programs and to characterize what is being taught and how.

METHODS

A 40-question online survey instrument was sent to accredited and candidate-status US PharmD programs.

RESULTS

Of 86 participating programs (67.2% response rate), 81 (94.2%) indicated that pediatric topics were included in their required classroom curricula (mean, 21.9 contact hours). A pediatric elective course was offered by 61.0% of programs (mean, 25.9 contact hours). Advanced pharmacy practice experiences (APPEs) in pediatrics were offered by 97.4% of programs, with an average of 27 students per program completing this practice experience annually.

CONCLUSIONS

Almost all responding programs incorporated pediatrics in their required curricula. Pediatric elective courses provided an adequate mean number of contact hours, but 39.0% of programs did not offer an elective course. One-fifth of students completed a pediatric APPE prior to graduation. Continued expansion of pediatric-focused classroom and experiential curricula across US PharmD programs is recommended.

Impact of electronic device use in class on pharmacy students' academic performance

OBJECTIVES

To evaluate and assess the impact of pharmacy students' electronic device (e-device) use during a lecture-based pharmacotherapeutics sequence.

METHODS

A validated survey instrument to assess e-device use was e-mailed to 238 second- (P2) and third-year (P3) pharmacy students. Grades were reviewed retrospectively and correlated with e-device use to determine its impact on academic performance.

RESULTS

Of 140 responding students (59% response rate), 106 reported using e-devices during class for course-related (91.5%) and non-course-related (81.1%) activities. When P2 and P3 students were combined, e-device use was not associated with academic performance (p = 0.70). Academic performance was not impacted among P3 students (p = 0.86), but P2 students performed better academically if they refrained from using e-devices during class (mean grade = 88.5% vs. 83.3%; p=0.019).

CONCLUSIONS

The impact of e-device use on overall academic performance was negligible. Use of e-devices by students enrolled in their first pharmacotherapeutics course may negatively impact academics.

Program to prepare pharmacy students for their postgraduate training search

OBJECTIVE

To design and assess an educational program for preparing pharmacy students for success during the American Society of Health-System Pharmacists Midyear Clinical Meeting (ASHP-MCM) and postgraduate training search.

DESIGN

An informational handout packet was prepared and a 1-hour educational forum was conducted prior to the 2007 and 2008 ASHP-MCMs. Following the ASHP-MCM, participating students were invited to complete an anonymous online survey instrument.

ASSESSMENT

Among the 66 participating students, 73% agreed they were adequately prepared for the ASHP-MCM, with 89%, 80%, and 79% agreeing the educational forum equipped them for their activities preceding, during, and following the ASHP-MCM, and 90%, 83%, and 69% agreeing the informational handout packet equipped them for their activities preceding, during, and following the ASHP-MCM. Among 14 students seeking a residency during the 2008 ASHP-MCM, 86% were successfully placed with a program.

CONCLUSION

An educational program was useful in preparing students for success during the ASHP-MCM and postgraduate training search.

Safety of ceftriaxone sodium at extremes of age

BACKGROUND

Isolated reports of neonatal and infant deaths associated with ceftriaxone-calcium precipitation in the lungs and kidneys have prompted a recommendation from the US FDA in June 2007 advising that in patients of all ages, calcium-containing solutions should not be administered simultaneously or within 48 h of the last ceftriaxone dose.

OBJECTIVE

To provide a comprehensive review of the literature surrounding the safety of ceftriaxone in the neonatal (< or = 28 days) and geriatric populations (> or = 65 years).

METHODS

Multi-database literature search for original research articles, review articles and case reports pertaining to safety of ceftriaxone in the neonatal and geriatric populations.

RESULTS/CONCLUSIONS

Ceftriaxone should be avoided or significantly minimized in neonates (especially those treated concomitantly with intravenous calcium solutions and those with hyperbilirubinemia), and potentially restricted in the geriatric population treated concomitantly with intravenous calcium.