Services and staffing practices in academic health sciences libraries serving college of osteopathic medicine programs: a mixed methods study.

OBJECTIVE: This study describes and assesses services, staffing practices, and trends in academic health sciences libraries that serve accredited college of osteopathic medicine (COM) programs in the United States. METHODS: The study was conducted in three phases. In phase one, the investigators collected data on library services and staffing through the publicly facing websites of the COM libraries. In phase two, thirty-five COM library directors were invited to complete a survey regarding their services, staffing, supported programs, and students served. In phase three, seven COM library directors participated in phone interviews regarding services that increased their visibility, their motivation to offer expanded services, adequacy of staffing, and competencies required for new librarian roles. The investigators incorporated the Medical Library Association (MLA) competencies as a framework to structure the results. RESULTS: Phase one identified 35 COM libraries serving between 162 and 8,281 students. In phase two, 30 out of a possible 35 survey respondents indicated that the top services offered or considered by COM libraries were in the MLA competency areas of "Instruction & Instructional Design" and "Evidence-Based Practice & Research." In addition, we discovered that COM libraries had a median of 10 full-time equivalent (FTE) staff per 1,000 students. Phase three data revealed that library directors attributed their libraries' success to the skills and talents of their staff, the wide range of resources and services they offered, and the desirability of their physical spaces. Library directors identified skills in the same MLA competency areas as phase two, as well as in the MLA competency areas of "Information Management" and "Leadership & Management," as being desirable for new staff. CONCLUSION: The study results provide information for medical school administrators and library directors to help identify trends across US osteopathic medical schools in order to justify the need for additional services and staffing. These results can assist medical and library leadership in COM schools in planning for their future academic health sciences libraries. Finally, the findings could assist programs in library and information sciences in redesigning their curriculums based on the MLA competencies for students who seek future careers in academic health sciences libraries.

Incorporating ACPE Standards in a Holistic Approach to School Operations and Accreditation.

Auburn University Harrison School of Pharmacy (AUHSOP) implemented a comprehensive, holistic process of continuous quality improvement (CQI) for its program using the Accreditation Council for Pharmacy Education's (ACPE) Accreditation Standards as the foundation. The process served as a way to increase the impact of the accreditation standards through continuous monitoring and programmatic improvements. Internally generated standards were also included in the CQI process. Design of the program included defining the program, establishing quality criteria, developing a table of measures that provided evaluation metrics, and assessing the program annually. Each year, faculty members, staff, students and other constituents assess the program for strengths, areas for improvement and insights. A CQI report is created and is made available to constituents, including ACPE through the Assessment and Management System (AAMS). Areas for improvement and new goals are then incorporated into the school's strategic plan and committee assignments for the year. Some of the suggestions included making the program appraisal more meaningful and on a continuous, ongoing basis compared to doing an appraisal for accreditation purposes at 8-year intervals. The process has increased constituent awareness of all aspects of the program and prompted numerous improvements since its adoption. A culture of assessment resulted from the process.

An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes.

Student use of health literacy tools to improve patient understanding and medication adherence.

OBJECTIVE: Evaluate curricular changes related to health literacy and determine impact on independent-living senior residents as part of an introductory pharmacy practice experience for third-year student pharmacists. DESIGN: Students were randomly assigned a resident whom they visited multiple times to conduct assessments and provide various services using three methods: Ask Me 3™ Four Habits Model, and Teach-back. SETTING: The study was conducted at independent-living apartments within a 24-mile radius from the St. Louis College of Pharmacy, St. Louis, Missouri. PATIENTS, PARTICIPANTS: Participants (n = 147 to 173, across all three years) were volunteer, elderly residents, living at a facility that collaborated with the research. INTERVENTIONS: Within one academic year, students collected medical and medication histories, conducted household safety checks, performed screening assessments, assessed adherence, and provided general recommendations to a resident. MAIN OUTCOME MEASURE(S): Outcomes included resident satisfaction, student satisfaction, and correlations between student use of health literacy tools and resident satisfaction. RESULTS: Exit surveys indicated resident overall satisfaction with the program, increased understanding of health-related information, increased confidence in asking health care professionals questions about their health, and greater commitment to medication adherence as a result of the experience. Students were highly satisfied with the program. Analyses reveal some correlations between a previously determined performance level of student communication and resident satisfaction. CONCLUSIONS: Students' use of health literacy communication tools during encounters with independent-living senior residents can result in greater patient understanding and empowerment, which may in turn help improve medication adherence.

Assessment of students' critical-thinking and problem-solving abilities across a 6-year doctor of pharmacy program.

OBJECTIVE: To determine the feasibility of using a validated set of assessment rubrics to assess students' critical-thinking and problem-solving abilities across a doctor of pharmacy (PharmD) curriculum. METHODS: Trained faculty assessors used validated rubrics to assess student work samples for critical-thinking and problem-solving abilities. Assessment scores were collected and analyzed to determine student achievement of these 2 ability outcomes across the curriculum. Feasibility of the process was evaluated in terms of time and resources used. RESULTS: One hundred sixty-one samples were assessed for critical thinking, and 159 samples were assessed for problem-solving. Rubric scoring allowed assessors to evaluate four 5- to 7-page work samples per hour. The analysis indicated that overall critical-thinking scores improved over the curriculum. Although low yield for problem-solving samples precluded meaningful data analysis, it was informative for identifying potentially needed curricular improvements. CONCLUSIONS: Use of assessment rubrics for program ability outcomes was deemed authentic and feasible. Problem-solving was identified as a curricular area that may need improving. This assessment method has great potential to inform continuous quality improvement of a PharmD program.

Health literacy: use of the Four Habits Model to improve student pharmacists' communication.

OBJECTIVE: To assess whether student pharmacists' communication skills improved using the Four Habits Model (FHM) at the St. Louis College of Pharmacy. METHODS: During the Fall of 2009 and 2010, student pharmacists in the third professional year learned and practiced the FHM. They were given feedback by faculty on three of the four Habits, used the FHM for self and peer assessment, and were formally evaluated on all four Habits during a standardized patient encounter. RESULTS: Student pharmacist performance significantly improved from baseline during both Fall 2009 and Fall 2010 in the majority of the Habits assessed. CONCLUSION: Use of the FHM in pharmacy education can improve a student pharmacists' ability to display the four Habits of communicating and developing relationships with patients. Tailoring of the FHM to pharmacy encounters will further enhance the utility of this communication framework. PRACTICE IMPLICATIONS: Use of the FHM enhances the measurement and assessment of the relational aspects of student pharmacist-patient communication skills. Consistent use of the FHM over time is likely necessary to fully develop and retain communication skills. The overall goal is to improve patient's health literacy and appropriate medication use by improving communication and the pharmacist-patient relationship.

A review of remediation programs in pharmacy and other health professions.

The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines 2007 states that colleges and schools of pharmacy must have a remediation policy. Few comparative studies on remediation have been published by colleges and schools of pharmacy, making it challenging to implement effective and validated approaches. Effective remediation policies should include early detection of problems in academic performance, strategies to help students develop better approaches for academic success, and facilitation of self-directed learning. While the cost of remediation can be significant, revenues generated either cover or exceed the cost of delivering the remediation service. Additional research on remediation in pharmacy education across the United States and abroad is needed to make sound decisions in developing effective policies. This paper provides a review of current practices and recommendations for remediation in pharmacy and health care education.