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.

Skills laboratory faculty job satisfaction: Effects of high-contact teaching and the COVID-19 pandemic.

INTRODUCTION: The objective of this study is to describe the workload responsibilities and job satisfaction of skills laboratory faculty, both before and during the COVID-19 pandemic. METHODS: School of pharmacy (SOP) skills laboratory faculty were surveyed in fall 2021 to gather information on workload responsibilities and job satisfaction, before and during the COVID-19 pandemic. Quantitative data were reported using descriptive statistics and, when appropriate, student t-tests were used to compare responses from before and during COVID-19. Qualitative data were coded for themes by two investigators with a third investigator used to reach consensus. RESULTS: A total of 45 skills laboratory faculty from 44 of 142 SOP responded to the survey. Faculty reported an average percent effort of 43.9% laboratory teaching, 13.9% non-laboratory teaching, 12.8% service, 6.5% administration, 12.5% patient care, and 10.4% scholarship. Overall job satisfaction decreased from before COVID-19 to during COVID-19, and faculty members' satisfaction specifically with their laboratory role decreased from 7.5 to 6.6 (P = .003). Several themes were identified when respondents described what they loved most about teaching in the laboratory as well as the challenges associated, the majority of which were personnel, resources, and time. CONCLUSIONS: Skills laboratory faculty reported a high number of laboratory courses coordinated each year along with many hours dedicated each week to prepare and conduct skills laboratory activities. While the pandemic is over, the unique aspects of coordinating student-centered courses likely requires more support for skills laboratory faculty members to avoid burnout and improve job satisfaction.

A lot in a little: Assessment of skills laboratory course structures and faculty workloads.

INTRODUCTION: Pharmacy skills development is essential to pharmacy programs to ensure "practice-ready" graduates. The objective was to describe the landscape of skills laboratory (lab) courses and faculty workload across United States schools and colleges of pharmacy (S/COP). METHODS: The American Association of Colleges of Pharmacy Laboratory Instructors Special Interest Group disseminated an anonymous questionnaire to collect faculty demographics, skills lab format, faculty workload, and job satisfaction. Descriptive statistics were generated, and paired t-tests were used to assess changes before and during COVID-19. RESULTS: Faculty from 44 of 142 S/COP responded. Participants (n = 45) were more frequently assistant professors (49%), non-tenure track (80%), and female (98%). A mean of 103 students per class, with a mean of two lab courses in both the first and second years and 1.6 in the third year were reported. Courses had a mean 1.6 lab coordinators each. Many institutions leverage non-lab faculty, pharmacy volunteers, post-graduate trainees, and senior professional students to assist. Faculty reported a mean 28.2 hours per week related to lab activities. The mean assigned percent effort was 44% for teaching in the skills lab, demonstrating consistency with effort calculations. Job satisfaction (scale 1-10) decreased from 7.6 before COVID-19 to 6.4 during COVID-19 (P < .01), with satisfaction specifically with their lab role decreasing from 7.5 to 6.6 (P = .003). CONCLUSIONS: Skills lab faculty reported significant time coordinating labs and identified the need for additional support. S/COP should ensure appropriate personnel resources are available to provide quality clinical skills training.

Design, Implementation, and Outcomes of an Interprofessional Mobile Web Application for Preceptors for Challenging Issues.

OBJECTIVE: The purpose of this study was to develop and assess an easily accessible interprofessional mobile web application to assist preceptors with challenging teaching and learning situations. METHODS: Phase 1 was a modified Delphi process of 48 advanced practice nursing, dentistry, medicine, and pharmacy preceptors to determine the content of the application. Phase 2 consisted of 12 preceptors from the 4 disciplines piloting a prototype to refine the tool using design-thinking principles. Feedback was analyzed using inductive coding and thematic analysis. Phase 3 evaluated the impact of the final tool on 80 preceptors' satisfaction, knowledge, self-efficacy, and perception of behavior change. RESULTS: Consensus on 10 topics was reached in the following 3 themes: feedback and communication, clinical and professional development of learners, and precepting efficiency. Preceptors rated the tool as efficient and applicable. Features perceived as useful included concise and applicable content that was easy to navigate with practical video examples. Features to improve included academic jargon, length of content, and lack of connectivity with other preceptors. Knowledge and self-efficacy improved after the use of the refined tool. Change in perceptions of behavior after 1 month was mixed, with a significant change in accessing resources to address challenging situations and regularly reflecting on challenging situations and no significant change in awareness, frequency, or success in managing challenging situations. CONCLUSION: An interprofessional mobile web application for challenging teaching and learning situations developed through a modified Delphi process was deemed efficient and relevant and demonstrated positive knowledge and self-efficacy change.

Assessing the mental health, physical health, and well-being of doctor of pharmacy students.

INTRODUCTION: Student well-being is a growing area of interest, though existing literature assessing multiple areas of well-being is lacking. This study aimed to evaluate the well-being of pharmacy students corresponding to three well-being domains (physical health, mental health, personal well-being and burnout) and identify characteristics associated with these domains. METHODS: An online survey adapted from various instruments was disseminated to pharmacy students from 11 pharmacy programs. Survey responses were compared using basic descriptive statistics, and Pearson's chi-Square was used for association analyses. RESULTS: Eight hundred thirty-six students from responded to the survey (24.3% response rate). For physical health, 59.3% of students reported sleeping <7  hours per night and 60.4% reported exercising 1 to 5  hours per week. For mental health, 24.8% of students screened positive for depression and 42% screened positive for anxiety. Lastly, 65.9% of students were at risk for decreased well-being and 63.7% for burnout. Based on association analyses, gender and pharmacy year were associated with screening positive for anxiety and burnout, gender was associated with decreased well-being, and relationship status was associated with screening positive for depression. CONCLUSIONS: This study revealed pharmacy students are at risk for lack of sleep and exercise, depression or anxiety, decreased well-being, and burnout. Also, several characteristics were found to be associated with these negative well-being outcomes. Although response rate and participant demographics could impact the generalizability of these findings, findings further increase awareness about student well-being and inform pharmacy programs supporting well-being by better understanding student risks.

Well-being Content Inclusion in Pharmacy Education Across the United States and Canada.

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment.Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content.Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. Well-being content was most prevalent within the cocurricular realm and incorporated into didactic and elective more than experiential curricula. The most content came from intellectual, emotional, and physical pillars, and the least content came from financial, spiritual, and environmental pillars. Less than 50% of schools and colleges of pharmacy include well-being within their strategic plans or core values. Funding is primarily at the level of the university (59%) or the school or college of pharmacy (59%). Almost half of respondents reported inclusion of some assessment, with a need for more training, expertise, and standardization.Conclusion. Survey results revealed a wide range of implementation and assessment of well-being programs across the United States and Canada. These results provide a reference point for the state of well-being programs that can serve as a call to action and research across the Academy.

Designing an online cultural communication module for pharmacy students across three countries.

BACKGROUND AND PURPOSE: Health care professionals are required to interact with increasingly diverse cultural groups and complexity of culture. The purpose of this study was to design and disseminate an online cultural communication module for use by pharmacy students across three countries. EDUCATIONAL ACTIVITY AND SETTING: Three pharmacy schools from Australia, the United States, and the United Kingdom developed 18 role-play videos demonstrating interactions between pharmacists and patients from diverse cultural groups. Videos were incorporated into an online module and implemented within each school's existing skills laboratory and/or communication curricula in 2019. Students completed a survey and a reflection at the module's end. Open-ended responses were analyzed qualitatively using an inductive approach. FINDINGS: Ninety-five percent of students (n = 500) across the three schools attempted the module. A total of 89% agreed the videos were useful in helping them understand the language and terms relating to cultural awareness in pharmacy, and 90% agreed the module helped them learn approaches to communicate with culturally diverse people in pharmacy. However, some students found the module lengthy and experienced technical issues with the platform. The majority of students identified awareness of cultural differences, respect for patient, and a person-centered approach as important when communicating with patients. SUMMARY: There is a growing need for appropriate training models to enhance cross-cultural skills and cultural awareness in health care professional training such as pharmacy. Collaborating internationally to develop a teaching innovation focused on widening understanding of culture and added to the depth of learning.

The catalyst for change in teaching and assessing virtual laboratory skills.

INTRODUCTION: Historically, pharmacy skills laboratory courses have primarily been delivered utilizing in-person instruction; however, changes in methods of healthcare delivery serve as a catalyst to consider best practices for virtual learning in the skills laboratory setting. PERSPECTIVE: Shifting to a virtual delivery method is valuable for future curriculum and course development. Three specific delivery methods including flipped classroom, virtual formative simulations, and telehealth objective structured clinical examinations, provide examples of the opportunities and challenges instructors may encounter when shifting delivery methods. Furthermore, the examples illuminate the need to deliberately incorporate virtual technology into pharmacy skills laboratory courses to ensure students are practice-ready for the changing methods of delivery in the healthcare environment. IMPLICATIONS: Skills laboratory instructors and students must reimagine how patient care skills can be taught and assessed. It is imperative to reassess priorities and adapt skills-based courses to incorporate the virtual learning environment to prepare student pharmacists for future practice.

Remote OSCE Experience: What First Year Pharmacy Students Liked, Learned, and Suggested for Future Implementations.

During the wake of the COVID-19 pandemic, many schools quickly transitioned their teaching and assessment strategies to online formats. In Spring 2020, a 3-station remote Objective Structured Clinical Examination (OSCE) was implemented for first-year pharmacy students. The day following the remote OSCEs students answered three open-text prompts about the remote OSCE experience: (1) "I liked...", (2) "I learned…", and (3) "I suggest…". Responses were open-coded and frequency counts were calculated to determine the most prevalent codes. Concept maps were created to visualize and explore connections between the codes. Out of 157 students, 156 students completed the reflection assignment, a 99.36% response rate. The three major themes in the Liked data were: Logistics (n = 65, 41.7%), Differences In-person Versus Remote (n = 59, 37.8%), and Skill Development (n = 43, 27.6%). The three major themes in the Learned data were: Technology (n = 66, 42.3%), Communication (n = 58, 37.2%), and Skill Development (n = 56, 35.9%). The three major themes in the Suggest data were: Logistics (n = 89, 57.1%), Technology (n = 31, 19.9%), and Continuation of Remote OSCE (n = 31, 19.9%). Overall, the remote OSCE experience was well-received, and students described it as applicable to their future pharmacy practice. Future work should explore the design, implementation, and outcomes of remote OSCEs.

Testing of a Program to Automatically Analyze Students' Concept Maps.

Concept maps are graphical representations of how various concepts relate to one another. Assessment of concept maps developed by students in the pharmacy curriculum helps to evaluate student understanding of course material. However, providing feedback on concept maps can be time-consuming and often requires the grader to be a content expert. The purpose of this study was to develop and validate a software program to provide students with feedback on their concept map performance. Student maps for four different disease states were compared against expert concept maps. The analysis of the program compared favorably to a manual assessment of student maps for the maps' complexity and content but did not correlate for their organization. The value of using a software program to quickly and efficiently analyze concept maps is discussed.

Establishing a successful teaching assistant program in pharmacy skills laboratory courses.

INTRODUCTION: Laboratory-based courses often require more manpower than faculty can provide to facilitate active learning activities in the classroom as well as skills-based assessments. PERSPECTIVE: Pharmacy and graduate student and resident teaching assistants (TAs) can be incorporated into laboratory-based courses to help meet this need. Before using student and resident TAs in laboratory-based courses, a number of items need to be considered. This paper will discuss how to recruit, train, and evaluate student and resident TAs. It will also detail the benefits to the faculty, the students in the classroom, and the TAs themselves. Finally, lessons learned from five schools of pharmacy who use student and/or resident TAs will be shared. IMPLICATIONS: Schools of pharmacy should implement a formalized process for utilizing student and resident TAs in laboratory-based courses especially where faculty manpower limitations exist.

Suggested pharmacy practice laboratory activities to align with pre-APPE domains in the Doctor of Pharmacy curriculum.

OUR SITUATION: The Accreditation Council for Pharmacy Education outlines ability statements that pharmacy students should be able to demonstrate prior to beginning their Advanced Pharmacy Practice Experiences (APPEs). Practice laboratory courses offer extensive opportunities for students to participate in activities and assessments that enable them to meet the objectives outlined in the Pre-APPE Core Domains in Standards 2016. This review identifies selected published literature, activities, and assessment methods that can be adapted and implemented in practice laboratory courses to help achieve the abilities outlined within the Pre-APPE Core Domains. METHODOLOGICAL LITERATURE REVIEW: The Medline database and journals related to pharmacy education were searched to identify activities and assessments for each domain. Search terms for each core domain were extracted from the domain titles, ability statements, and performance competencies and coupled with "laboratory" or "lab." "Pharmacy" was also added as a search term when searching the Medline database. Preference was given to example activities published in the last 15 years. Abstracts and activities based on author experience were also included. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Specific examples of how activities and assessments can be included in practice laboratories to develop or refresh skills identified in the pre-APPE core domains were described. POTENTIAL IMPACT: The practice laboratory setting is an ideal place for students to learn and practice the skills necessary to demonstrate readiness for APPEs. This paper serves as a resource for instructors, curriculum committees, or pharmacy programs looking for ideas to expand specific training or develop particular skill areas.

Improving Dental Students' Long-Term Retention of Pharmacy Knowledge with "Medication Minutes".

A major challenge in foundational science courses in dental curricula is the application of information from the classroom to a clinical setting. To bridge this gap, the aim of this study was to increase students' learning in a foundational pharmacology course through increasing clinical relevance and using formative assessment. Second-year dental students in an introductory pharmacology course were presented material in a traditional basic science lecture format and in brief examples of pharmacy-generated clinical content (Medication Minutes). Short-term retention was assessed with a series of five post-class session, non-graded quizzes, each containing four questions: two knowledge-based (one from basic science material and one Medication Minute) and two application-based (one from basic science material and one Medication Minute). Ten knowledge-based (basic science material) questions and ten application-based (Medication Minutes) questions were included on exams throughout the semester. The primary outcome was to measure long-term retention using performance on these questions on an assessment the following semester. Additionally, the impact of student engagement on examination performance was evaluated based on the number of quizzes each student completed. Students who completed three or more quizzes (n=43, 53%) were designated as "highly engaged," while students who completed less than three quizzes (n=36, 44%) were defined as "less engaged." Two students (3%) were excluded for not completing the long-term assessment or not consenting to the study. On short-term retention measures, the students performed better on the Medication Minute (M=0.76) than basic science (M=0.58) (p<0.001) material; however, on the in-semester examinations, there was no difference in performance. On long-term retention measures, the students performed better on Medication Minute material (M=0.64) than basic science material (M=0.33) (p<0.001); this was true for both highly engaged and less-engaged students. These results suggest that teaching pharmacology in a clinical context yielded better long-term retention than teaching with a non-clinical focus.

An evaluation of pharmacogenomic information provided by five common drug information resources.

INTRODUCTION: This study evaluated whether pharmacogenomic information contained in the Food and Drug Administration (FDA)-approved package inserts of sixty-five drugs was present in five drug information resources. METHODS: The study searched for biomarkers from the FDA package inserts in 5 drug information sources: American Hospital Formulary Service Drug Information (AHFS), Facts & Comparisons 4.0 (Facts), ePocrates Online Free (ePocrates Free), Lexicomp Online (Lexicomp), and Micromedex 2.0. Each resource had the opportunity to present biomarker information for 65 drugs, a total of 325 opportunities. A binary system was used to indicate presence or absence of the biomarker information. A sub-analysis was performed on the 13 most frequently prescribed drugs in the United States. RESULTS: Package insert biomarker information was available, on average, for 81.5% of the 65 FDA-listed drugs in 2011. Percent availability for the individual resources was: Lexicomp, 95.3%; Micromedex 2.0, 92.3%; Facts, 76.9%; AHFS, 75.3%; and ePocrates Free, 67.7%. The sub-analysis of the 13 top drugs showed Lexicomp and Micromedex 2.0 had the most mentions, 92.3%; ePocrates Free had the least, 53.8%. CONCLUSION: The strongest resource for pharmacogenomic information was Lexicomp. The gap between Lexicomp and ePocrates Free is concerning. Clinicians would miss pharmacogenomic information 6.6 times more often in ePocrates Free than in Lexicomp. IMPLICATIONS: Health sciences librarians should be aware of the variation in biomarker availability when recommending drug resources for licensing and use. Librarians can also use this study to encourage publishers to include pharmacogenomics information from the package insert as a minimum standard.

Long-term Results of an Analytical Assessment of Student Compounded Preparations.

OBJECTIVE: To investigate the long-term (ie, 6-year) impact of a required remake vs an optional remake on student performance in a compounding laboratory course in which students' compounded preparations were analyzed. METHODS: The analysis data for several preparations made by students were compared for differences in the analyzed content of the active pharmaceutical ingredient (API) and the number of students who successfully compounded the preparation on the first attempt. RESULTS: There was a consistent statistical difference in the API amount or concentration in 4 of the preparations (diphenhydramine, ketoprofen, metoprolol, and progesterone) in each optional remake year compared to the required remake year. As the analysis requirement was continued, the outcome for each preparation approached and/or attained the expected API result. Two preparations required more than 1 year to demonstrate a statistical difference. CONCLUSION: The analytical assessment resulted in a consistent, long-term improvement in student performance during the 5-year period after the optional remake policy was instituted. Our assumption is that investment in such an assessment would result in a similar benefits at other colleges and schools of pharmacy.