A Deeper Reflection on the Integration of the Pharmacists' Patient Care Process.

OBJECTIVE: Given the importance of developing student understanding and application of the Pharmacists' Patient Care Process (PPCP), programs may be able to use successful approaches from other institutions to enhance their curricular and experiential learning and assessment of student outcomes. The study objective was to explore successful methods of integrating the PPCP and outline areas of challenge. METHODS: This study used a qualitative study design with semistructured interviews to gain insight from participants' lived experiences. Pharmacy faculty members participating in a national survey or who were authors of articles about PPCP initiatives were recruited to provide greater detail about building successful and innovative curricula. Thematic analysis identified commonalities and differences among the interviewed participants. RESULTS: A total of 10 interviews were conducted. The following 4 overarching themes arose from the data: discussions around intentional integration of the PPCP across multiple core courses may foster innovations in teaching strategies; intentional integration alone does not equate to PPCP integration across the curriculum; intentional integration may enhance program assessment; and PPCP data from experiential coursework may not be widely used in curricular continuous quality improvement. CONCLUSION: Pharmacy programs will ideally involve the entire faculty, including experiential and basic and social/administrative science members, in weaving the PPCP throughout the curriculum. Rigorous assessment can better inform interventions related to student competency in various steps of the PPCP. Pharmacy programs should also clarify how data obtained from preceptors observing student performance in each of the PPCP steps are used to assess student mastery of this critical skill.

Frequency of essential elements in required advanced pharmacy practice experiences (FEER - APPE).

INTRODUCTION: This study evaluated student reported achievement of essential elements (EE) across three required advanced pharmacy practice experiences (APPEs) to identify differences in the frequency of each EE during different delivery modalities. METHODS: APPE students from three different programs were assigned a self-assessment EE inventory after required acute care, ambulatory care, and community pharmacy APPEs between May 2018 and December 2020. Using a four-point frequency scale, students reported exposure to and completion of each EE. Pooled data were analyzed to compare differences in frequencies of EE during standard and disrupted delivery. All standard delivery APPEs were in-person, but during the study period APPEs shifted to a disrupted delivery using hybrid and remote formats. Frequency changes were reported as combined data and compared between programs. RESULTS: A total of 2191 of 2259 (97%) evaluations were completed. Acute care APPEs had a statistically significant change in frequency of evidence-based medicine elements. Ambulatory care APPEs had a statistically significant decrease in the frequency of reported pharmacist patient care elements. Community pharmacy had a statistically significant decrease in frequency in each category of EE except practice management. Statistically significant differences between programs were observed for select EEs. CONCLUSIONS: The frequency of EE completion during disrupted APPEs revealed minimal change. Acute care was the least impacted whereas community APPEs experienced the greatest change. This may be attributable to shifts in direct patient interactions during the disruption. Ambulatory care was impacted to a lesser degree, potentially due to utilization of telehealth communications.

Inclusion of the Pharmacist Patient Care Process in Doctor of Pharmacy Curricula.

Objective. With the inclusion of the Pharmacists' Patient Care Process (PPCP) in the most recent Accreditation Council for Pharmacy Education standards, institutions must determine how best to vertically and horizontally integrate and assess the PPCP in the curriculum. The objective of this study was to identify the breadth and depth of PPCP implementation as well as faculty involvement in teaching the PPCP at ACPE-accredited institutions.Methods. A survey to address the study objectives was developed, piloted, and distributed electronically to all US pharmacy institutions in candidate or accredited status. Electronic reminders were implemented to improve response rates. The data were analyzed descriptively.Results. Approximately 70% of institutions responded to the survey. Integration of the PPCP was most often championed by an individual faculty member and/or a committee. Practice faculty taught PPCP at nearly all institutions, while only a third of survey respondents reported that foundational and social administrative faculty taught the PPCP. Development related to PPCP curricular integration mainly focused on preceptors. Most institutions integrated the PPCP through the didactic and experiential curriculum in an approach that allowed for reinforcement or mastery of concepts. There were limited integration efforts into interprofessional education. Institutions had a plan for assessing the effectiveness of the integration, but were varied in their approach.Conclusion. Institutions have embraced integrating the PPCP into their curricula, didactically and experientially. Progress still needs to be made regarding inclusion of all faculty in teaching the PPCP as well as integrating the PPCP into other key curricular areas, such as interprofessional learning. Faculty development efforts may be beneficial to address these aspects.

Advancing Pharmacy Education and Workforce Development Amid the COVID-19 Pandemic: Report of the 2020-2021 AACP Academic Affairs Committee.

EXECUTIVE SUMMARY The 2020-2021 Academic Affairs Committee was charged to (1) Read all six reports from the 2019-20 AACP standing committees to identify elements of these reports that are relevant to your committee's work this year; (2) Determine what changes made in colleges and schools of pharmacy during the COVID-19 pandemic should be continued to advance pharmacy education; (3) Develop a realistic model for colleges and schools of pharmacy to share resources to meet the curricular needs of member schools; (4) Create strategies by which colleges and schools of pharmacy can meet current and future workforce development needs particularly in light of the changes in healthcare delivery as a result of the COVID-19 pandemic; (5) Identify salient activities for the Center To Accelerate Pharmacy Practice Transformation and Academic Innovation (CTAP) for consideration by the AACP Strategic Planning Committee and AACP staff. This report provides an overview of changes made in schools and colleges of pharmacy implemented in response to the COVID-19 pandemic that may be continued to advance pharmacy education; a realistic model for colleges and schools of pharmacy to share resources to meet the curricular needs of member schools; and strategies by which schools and colleges of pharmacy can meet current and future workforce development needs, particularly in light of the changes in healthcare delivery as a result of the COVID-19 pandemic. The committee is proposing one policy statement for consideration by the 2021 AACP House of Delegates, four suggestions for consideration by schools and colleges of pharmacy (including two endorsements for suggestions from the 2020-21 Argus Commission), and one recommendation for consideration by AACP for CTAP to implement and oversee.

Moving out of disciplinary silos - Integration of the Pharmacists' Patient Care Process.

INTRODUCTION: In order to better delineate the specific roles of the pharmacist in generating positive health outcomes, pharmacy programs have incorporated the Pharmacists' Patient Care Process (PPCP). However, there has been limited integration in disciplines outside of pharmacy practice. PERSPECTIVE: This article makes the case that schools need to commit to fully integrating the PPCP that is inclusive of all disciplines. By fostering such integration, all faculty can recognize their role in creating practice-ready, team-ready pharmacists that are consistent, collaborative, and drive positive patient health outcomes. There also is likely innovative integrative efforts being done related to the PPCP in non-practice disciplines, and this article provides some ideas for future scholarly efforts. IMPLICATIONS: If the academy embraces the PPCP fully, we can unite and demonstrate how pharmacists contribute value to the healthcare team.

Implementation of a research capstone course with expanded flexibility.

BACKGROUND AND PURPOSE: A research-focused capstone course was designed to improve flexibility in the way pharmacy students meet the university's capstone requirement. The requirement aims to integrate knowledge, skills, and attitudes from didactic coursework and to apply them in a scholarly way to improve critical and evidence-based thinking, communication skills, and professionalism. This report describes the capstone course and faculty and student perceptions after the first year of implementation. EDUCATIONAL ACTIVITY AND SETTING: The course allows students to work with a faculty advisor on a four-semester hour research project of mutual interest that can be completed in any one of three semesters. After the first student cohort completed their projects, faculty and student perceptions were captured via electronic survey. FINDINGS: A total of 38 students (36%) and 22 advisors (71%) responded to the survey. Approximately 90% of students and faculty agreed that student groups had achieved course objectives upon completion. Although faculty members felt that participating in the capstone course increased their workload and in some cases reduced their productivity, faculty members felt that the course had a beneficial impact for students. SUMMARY: The new capstone course was well received. The flexibility of the course was both a strength and a limitation as most students wanted more structure in the expectations and grading of the project in the form of a rubric or other standardized assessments.

Integration of the Pharmacists' Patient Care Process (PPCP) into a Comprehensive Disease Management Course Series.

Objective. To implement and assess the curricular integration of the Pharmacists' Patient Care Process (PPCP) in a course series for second- and third-year pharmacy students. Methods. The five-step PPCP was integrated within a four-semester pharmacotherapy course starting with the introductory course lectures. Beginning in the spring of 2015, the five steps of the PPCP were delivered to 129 P2 students, along with rollout of curricular integration within corresponding classroom and seminar activities and assessments. Integration focused on the development of course-specific lecture and seminar materials, a faculty guidance strategy and templates, and evaluation approaches for course assessments. Student comprehension and utilization of the PPCP were assessed via 61 unique assessments (12 examinations and 49 quizzes). Faculty incorporation and perception of the PPCP were evaluated via survey. Results. Overall, students demonstrated the most understanding on the lowest levels of the PPCP: 83.6% and 82.2% for the Collect and Implement components, respectively, compared to the higher-level components of Planning (78.0%) and Follow-up (76.0%). Faculty understanding, integration, and utilization of the PPCP in course materials were assessed approximately 6 months after implementation. Twenty-two faculty (96% of course instructors) participated in the survey. Eighteen (82%) have modified instructional materials to incorporate PPCP and among these, 89% agreed/strongly agreed that they possessed a clear understanding of the PPCP. Conclusion. Implementing a successful curricular change such as the integration of the PPCP across multiple courses requires a multi-faceted approach. The development of faculty templates and provision of support through various methods are necessary to ensure consistent and comprehensive integration across the curriculum. Additionally, evaluation of student performance and achievement of intended outcomes should be used to guide curricular assessments and continuous quality improvements throughout the process.

Adapting Leadership Styles to Reflect Generational Differences in the Academy.

The topic of adapting one's leadership style is controversial and can generate great debate. When one considers adapting one's leadership style, the question of authenticity often bubbles to the surface. This is even more compelling in the context of generational differences in our society and workforce. How can faculty members be effective if they refuse to adapt their leadership style to students' learning styles and generational characteristics? Leadership development is an ongoing focus for the American Association of Colleges of Pharmacy (AACP) to prepare faculty for roles as future leaders in higher education while a major redistribution of generations is occurring within the workforce. These generations are molded by many factors, including the economy, significant events, technology, and education. As experienced leaders, we affirm that one's leadership styles must be honed over time and adapted to reflect generational differences in academic pharmacy among colleagues, students, alumni, and stakeholders, including patients. Current and future leaders need further education and development so that their awareness of generational characteristics prepares them to adapt their leadership styles to more effectively engage and lead people of any generation.

A reflective teaching challenge to motivate educational innovation.

OBJECTIVE: To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. DESIGN: A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. ASSESSMENT: A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. CONCLUSION: The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

Educational outcomes necessary to enter pharmacy residency training.

It is the position of the American College of Clinical Pharmacy (ACCP) that formal postgraduate residency training, or equivalent experience, is required to enter direct patient care practice. Therefore, it is important to align professional degree educational outcomes with the knowledge, skills, and attitudes needed to enter residency training. This position statement addresses the outcomes necessary in the professional degree program curriculum to ensure the ability of pharmacy graduates to transition effectively into postgraduate year one residency training. Five key outcome areas are identified: communication, direct patient care, professionalism, research, and practice management. The position statement examines how performance in each of the five outcome areas should be addressed by professional degree programs. The ACCP believes that for the student to achieve the clinical proficiency necessary to enter residency training, the professional degree program should emphasize, assess, and provide adequate opportunities for students to practice: communication with patients, caregivers, and members of the health care team in direct patient care environments; provision of direct patient care in a wide variety of practice settings, especially those involving patient-centered, team-based care; professionalism under the supervision and guidance of faculty and preceptors who model and teach the traits of a health care professional; application of principles of research that engender an appreciation for the role of research and scholarship in one's professional development; and application of practice management, including documentation of direct patient care activities that affect drug-related outcomes.

The spectrum of statin therapy in cancer patients: is there a need for further investigation?

Although our understanding of the relationship between cancer and statin use continues to improve, it remains a complex association requiring further research focusing on both biologic and clinical end points in a wide range of patient populations. To date, most of the published results are from observational studies detailing the risk of incident cancers or from randomized controlled trials with cardiovascular primary end points and cancer only as a secondary end point. Although there is certainly great value in the information obtained from observational studies, they cannot prove a causal link between statins and cancer, and it would then seem appropriate to design and implement clinical trials. Such studies should consider three main end products of the mevalonate pathway (cholesterol, geranyl pyrophosphate, and farnesyl pyrophosphate) from a mechanistic perspective, as well as the potential for cancer cell mediation with statin use, in addition to pertinent clinical end points including cancer incidence and mortality.

Providers' perceptions of student pharmacists on inpatient general medicine practice experiences.

OBJECTIVE: To assess health care providers' perceptions of student pharmacists involved as members of a general medicine team. METHODS: A brief, anonymous, online survey instrument was distributed to 134 health care providers at 4 major medical centers in Massachusetts who interacted with Northeastern University student pharmacists during inpatient general medicine advanced pharmacy practice experiences beginning in March 2011. The survey instrument assessed health care provider perception of student pharmacists' involvement, preparedness, clinical skills, and therapeutic recommendations. RESULTS: Of the 79 providers who responded, 96.2% reported that student pharmacists were prepared for medical rounds and 87.3% reported that student pharmacists were active participants in patient care. Also, 94.9% and 98.7% of providers indicated that student pharmacist recommendations were appropriate and accurate, respectively. The majority (61.8%) of providers believed that student pharmacist involvement on internal medicine teams was beneficial. CONCLUSIONS: Provider perceptions regarding student pharmacist participation on general medicine practice experiences were mostly positive.

Follow-up assessment of a faculty peer observation and evaluation program.

OBJECTIVE: To assess a previously described peer observation and evaluation program 2 years after implementation. METHODS: An pre-implementation survey assessed faculty needs and attitudes related to peer evaluation. Two years after implementation, the survey was repeated and additional questions asked regarding adherence to peer observation and evaluation policies and procedures, feedback received, and impact on teaching. RESULTS: Faculty attitudes towards peer evaluation stayed the same or improved post-implementation. Adherence to the initial 3 steps of the process was high (100%, 100%, and 94%, respectively); however, step 4, which required a final discussion after student assessments were finished, was completed by only 47% of the respondents. All faculty members reported receiving a balance of positive and constructive feedback; 78% agreed that peer observation and evaluation gave them concrete suggestions for improving their teaching; and 89% felt that the benefits of peer observation and evaluation outweighed the effort of participating. CONCLUSIONS: Faculty members adhered to the policies and procedures of peer observation and evaluation and found peer feedback was beneficial.

The role of curriculum committees in pharmacy education.

OBJECTIVE: To conduct a follow-up survey of curriculum committee chairs in US colleges and schools of pharmacy to describe current committee structures and functions and determine whether changes have occurred over time. METHODS: A descriptive cross-sectional study design using a 30-item survey instrument regarding the structure, function, and charges of curriculum committees was sent to 100 curriculum committee chairs. Several new variables were added to the questionnaire to explore the use of systematic reviews, oversight of experiential education, and the impact of accreditation standards on work focus. RESULTS: Eighty-five chairs responded. Curriculum committees are on average 1 person larger, less likely to have a student vote, more likely to have formal charges, and more likely to be involved in implementing an outcomes-based curriculum compared with 1994. Committees have shifted their work focus from review of curricular content to curricular revision. CONCLUSIONS: Curriculum committees continue to evolve as they respond to changes in pharmacy education and accreditation standards.